Beneficial effects of chest tube drainage of pleural effusion in acute respiratory failure refractory to positive end-expiratory pressure ventilation

Surgery ◽  
1998 ◽  
Vol 123 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Mia Talmor ◽  
Lynn Hydo ◽  
Jeffrey G. Gershenwald ◽  
Philip S. Barie
Keyword(s):  
Respiratory Failure ◽  
Pleural Effusion ◽  
Acute Respiratory Failure ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Positive End Expiratory Pressure ◽  
Tube Drainage ◽  
Beneficial Effects

scholarly journals Chest Tube Drainage Under Radiological Guidance for Pleural Effusion and Pneumothorax in a Tertiary Care University Teaching Hospital: Review of 51 Cases

2005 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Luce Cantin ◽  
Carl Chartrand-Lefebvre ◽  
Luigi Lepanto ◽  
David Gianfelice ◽  
Antoine Rabbat ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Teaching Hospital ◽  
Chest Tube ◽  
Tertiary Care ◽  
Chest Tube Drainage ◽  
University Teaching ◽  
Tube Placement ◽  
Pigtail Catheter ◽  
First Line ◽  
Tube Drainage

BACKGROUND: Chest tube drainage under radiological guidance has been used with increasing frequency as a treatment option for pleural effusions and pneumothoraxes.OBJECTIVE: To evaluate the safety and usefulness of pleural drainage under radiological guidance for pleural effusion and pneumothorax in a tertiary care university teaching hospital.METHODS: A retrospective study of cases of chest tube placement under radiological guidance over a 12-month period in a university hospital.RESULTS: Fifty-one percutaneous pigtail catheter drainage cases were reviewed (30 patients). Forty-six (90%) chest tubes were inserted as a first-line treatment. The overall success rate of radiological drainage was 88%. Specific success rates were 92%, 85% and 91% for loculated pleural effusion, pneumothorax and empyema, respectively. The complications were few and minor.CONCLUSIONS: Pigtail catheter insertion under radiological guidance is a useful procedure for the treatment of sterile pleural effusion, empyema and pneumothorax. This technique can be used as a first-line procedure in the majority of cases.

Intrapleural Alteplase in a Patient with Complicated Pleural Effusion

2003 ◽  
Vol 37 (3) ◽  
pp. 376-379 ◽  
Author(s):  
Charlotte A Walker ◽  
Mary Beth Shirk ◽  
Marva M Tschampel ◽  
James A Visconti
Keyword(s):  
Pleural Effusion ◽  
Chest Tube ◽  
Pleural Cavity ◽  
Surgical Intervention ◽  
Chest Tube Drainage ◽  
Tube Drainage ◽  
X Ray ◽  
Case Summary ◽  
Chest X Ray ◽  
Intrapleural Administration

OBJECTIVE: To report the intrapleural use of alteplase in a patient diagnosed with complicated pleural effusion (CPE). CASE SUMMARY: A 62-year-old white woman admitted with respiratory distress and hypotension developed a right-sided multi-loculated pleural effusion. Thoracentesis and chest tube drainage were not successful in resolving the effusion. In an attempt to increase the drainage of the pleural effusion, alteplase 16 mg was administered into the pleural cavity via the chest tube on 6 consecutive days. As a result, the volume drained from the patient's chest tube increased, there was improvement on the chest X-ray, and she did not require surgical intervention. DISCUSSION: While streptokinase and urokinase have been shown to be useful adjuncts to chest tube drainage in the treatment of complicated pleural effusion and empyema, there have been no reports on the use of intrapleural alteplase. This report demonstrates that intrapleural administration of alteplase is a useful adjunct to tube drainage in resolving CPE. CONCLUSIONS: This patient's CPE resolved when intrapleural alteplase was used as an adjunct to chest tube drainage and antibiotics. Controlled trials need to be conducted to investigate fully the efficacy, dosing, and safety of intrapleural alteplase in the treatment of patients with CPE and empyema.

Severe dengue with massive pleural effusion requiring urgent intercostal chest tube drainage: a case report

2012 ◽  
Vol 30 (2) ◽  
pp. 389.e1-389.e2 ◽  
Author(s):  
Afzal Azim ◽  
Jyoti N. Sahoo ◽  
Arvind K. Baronia ◽  
Mohan Gurjar ◽  
Ratendra K. Singh ◽  
...  
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Severe Dengue ◽  
Tube Drainage ◽  
Massive Pleural Effusion

scholarly journals PERSISTENT PLEURAL EFFUSION FOLLOWING CARDIAC SURGERY SUCCESSFULLY TREATED WITH CHEST TUBE DRAINAGE: A CASE REPORT

CHEST Journal ◽  
2020 ◽  
Vol 157 (6) ◽  
pp. A196
Author(s):  
F. Olmati ◽  
A. Iacovelli ◽  
C.D. Evangelista ◽  
D. Moschetta ◽  
P. Palange
Keyword(s):  
Cardiac Surgery ◽  
Case Report ◽  
Pleural Effusion ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Tube Drainage

scholarly journals Pleural Effusion in Children: How often do we suspect Tubercular origin?

1970 ◽  
Vol 30 (3) ◽  
pp. 132-134
Author(s):  
PN Shrestha ◽  
A Rayamajhi
Keyword(s):  
Pleural Effusion ◽  
Chest Tube ◽  
Clinical History ◽  
Chest Tube Drainage ◽  
Pleural Effusions ◽  
Tube Drainage ◽  
Nephritic Syndrome ◽  
Study Results ◽  
Detailed Clinical History ◽  
Chest X Ray

Introduction: Pleural effusion is a common problem in children; mostly due to common causes like pyogenic or tubercular infections. Different studies have showed that about 30%-60% of pleural effusion have resulted into formation of empyema. Method: This was an observational study done in children aged 3 months to 14 years with a diagnosis of pleural effusion admitted at Kanti Children’s Hospital, Maharajgunj from August 2009 to March 2010. The aim of the study was done to find out different modalities of treatment for the same and their outcome. A detailed clinical history and physical examination, was done in all children. Chest x-ray, laboratory reports and treatment were recorded and all patients followed up until death or discharge. Any change of management was also noted. Pleural effusion caused by nephritic syndrome or congestive cardiac failure were excluded from the study. Results: During the study period of eight months, 64 patients were admitted with the diagnosis of pleural effusion. Boys to girls ratio was 2:1. Right-sided pleural effusions were more common than left sided pleural effusions (53% vs. 37%). Most of patients improved with parental antibiotics along with chest tube drainage (62%). One in three patients (31%) received anti-tubercular drugs. Three patients (4.6%) were referred to surgeon for decortications and one patient (1.6%) died. Conclusion: Though chest tube drainage with parental antibiotics was the mainstay of treatment of pleural effusion, however one-third of patients also received anti-tubercular drugs. Key words: Pleural effusion; pyogenic; decortication; adenosine deaminase (ADA). DOI: 10.3126/jnps.v30i3.3914J Nep Paedtr Soc 2010;30(3):132-134Introduction: Pleural effusion is a common problem in children; mostly due to common causes like pyogenic or tubercular infections. Different studies have showed that about 30%-60% of pleural effusion have resulted into formation of empyema. Method: This was an observational study done in children aged 3 months to 14 years with a diagnosis of pleural effusion admitted at Kanti Children’s Hospital, Maharajgunj from August 2009 to March 2010. The aim of the study was done to find out different modalities of treatment for the same and their outcome. A detailed clinical history and physical examination, was done in all children. Chest x-ray, laboratory reports and treatment were recorded and all patients followed up until death or discharge. Any change of management was also noted. Pleural effusion caused by nephritic syndrome or congestive cardiac failure were excluded from the study. Results: During the study period of eight months, 64 patients were admitted with the diagnosis of pleural effusion. Boys to girls ratio was 2:1. Right-sided pleural effusions were more common than left sided pleural effusions (53% vs. 37%). Most of patients improved with parental antibiotics along with chest tube drainage (62%). One in three patients (31%) received anti-tubercular drugs. Three patients (4.6%) were referred to surgeon for decortications and one patient (1.6%) died. Conclusion: Though chest tube drainage with parental antibiotics was the mainstay of treatment of pleural effusion, however one-third of patients also received anti- tubercular drugs. Key words: Pleural effusion, pyogenic, decortication, adenosine deaminase (ADA). DOI: 10.3126/jnps.v30i3.3914J Nep Paedtr Soc 2010;30(3):132-134

Clinico-bacteriological Profile and Outcome of Empyema Thoracis in Children at a Tertiary Care Hospital of Central Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Atanu Pan ◽  
Debarshi Jana
Keyword(s):  
Ct Scan ◽  
Broad Spectrum ◽  
Chest Tube ◽  
Chest Tube Drainage ◽  
Diagnostic Tools ◽  
High Morbidity ◽  
Care Hospital ◽  
Empyema Thoracis ◽  
First Line ◽  
Tube Drainage

Background: Empyema thoracis (ET) is a serious infection of the pleural space. Despite the availability of broad spectrum antibacterial, improved vaccination coverage and better diagnostic tools, Empyema Thoracis remains associated with high morbidity worldwide. Delay   in   early   diagnosis,   failure   to institute   appropriate   antimicrobial   therapy,   multidrug resistant   organisms,   malnutrition,   comorbidities,   poor health  seeking  behaviour  and  high treatment  cost  burden contribute  to  increased  morbidity  in  children. The available  treatment  options  include  intravenous broad-spectrum antibiotics  either  alone  or  in  combination  with surgical  procedure  (thoracocentesis,  chest  tube  drainage, fibrinolytic  therapy,  decortications  with  video  assistedthoracoscopic surgery (VATS) and open drainage. Methods: Fifty Children between 1 month to 16 years admitted in the Pediatrics Ward, PICU of College of Medical Sciences, Bharatpur,Nepal. Data analysis was done by SPSS 24.0. Results: Present study found that according to blood culture, 3(6.0%) patients had enterococcus, 40(80.0%) patients had no growth, 2(4.0%) patients had pseudomonas, 4(8.0%) patients had staphylococcus and 1(2.0%) patients had streptococcus. We found that 20(40.0%) patients had done CT scan thorax, 30(60.0%) patients had not done CT scan thorax and 32(64.0%) patients had Amoxiclav first line antibiotic and 18(36.0%) patients had Ceftriaxone first line antibiotic. Conclusions: Suitable antibiotics and prompt chest tube drainage is an effective method of treatment of childhood empyema, especially in resource-poor settings. Majority of the patients progress on this conservative management and have good recovery on follow up.  

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