scholarly journals Heimlich Valve as an Ambulation Management of Persistent Pneumothorax or Fluidopneumothorax

2021 ◽  
Vol 7 (2) ◽  
pp. 86
Author(s):  
Faradila Nur Aini ◽  
Irmi Syafa'ah
Keyword(s):  
Pleural Cavity ◽  
Tension Pneumothorax ◽  
Loss Of Consciousness ◽  
Thoracic Cavity ◽  
Shortness Of Breath ◽  
Massive Pleural Effusion ◽  
Blue Discoloration ◽  
Efficient Alternative ◽  
Water Seal ◽  
Return Valve

Pneumothorax or fluidopneumothorax is a critical condition when there is some air or/and fluid in the plural cavity. The symptoms may include shortness of breath, chest pain, blue discoloration of the skin or lips, increased heart rate, and loss of consciousness. Pleural cavity drainage is management therapy with the concept of Water Seal Drainage (WSD), which requires a long hospital stay. Heimlich valve is a non-return valve that allows fluid and air to exit the thoracic cavity (on inspiration) and prevents fluid and air from re-entering (during expiration). Heimlich valve is a viable, inexpensive, convenient, safe, effective, and efficient alternative in the management of ambulation of patients requiring prolonged pleural cavity drainage. The use of Heimlich valve is an alternative option for patients with persistent pneumothorax or fluidopneumothorax. It can shorten the time of treatment in the hospital, lowering treatment costs, and minimize the presence of nosocomial infections. Relative contraindications include fluidopneumothorax with massive pleural effusion or empyema. The risks and complications are dislodgement or improper reattachment, leaking valve, adhesion, and blockage, thus becoming tension pneumothorax or pleural cavity infection. Currently the latest innovation also improves the patient’s convenience, like Thoracic Vent, Pneumostat, or Mini Mobile Dry Seal Drain.

scholarly journals Perbedaan Kecepatan Pengembangan Paru Sebelum dan Sesudah Latihan Pernapasan Diafragma dalam Upaya Mempercepat Pelepasan Water Seal Drainage (WSD)

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Rosalina Rosalina ◽  
Sukarno Sukarno ◽  
Yunita Galih Yudanari
Keyword(s):  
Pleural Cavity ◽  
Test Group ◽  
Sampling Technique ◽  
Drainage Water ◽  
P Value ◽  
Shortness Of Breath ◽  
Diaphragmatic Breathing ◽  
Breathing Exercises ◽  
Lung Expansion ◽  
Water Seal

An  Pleural effusion is an excessive accumulation of fluid, blood or water in the pleural cavity which will cause the increase of shortness of breath because of the decreasing space for lung expansion. One of the efforts  to reduce the complaints of shortness of breath is by insertion of water seal drainage. Water Seal Drainage (WSD) is a medical action performed to remove air or fluid from the pleural cavity. The patient's ability to breathe effectively is an indicator to release WSD. This study generally aims to determine the effectiveness of diaphragmatic breathing exercises on the speed of lung expansion in patients with  water seal drainage insertion. The research design  was pre experiment with  pre test - post test group design. The population in this study were patients with insertion of  WSD who were admitted to  Dr. Muwardi Surakarta Hospital. The sampling technique was purposive sampling. The number of samples were 16 respondents. To measure lung expansion, the indicator used  Peak Expiratory Flow Rate  as measured by  peak flow meter. Data analysis used dependent  t-test. The results show that there are differences in the speed of lung expansion  in patients with WSD insertion before and after diaphragmatic breathing exercises with  p-value of  0.0001. Suggestion  for nurses to be able to train diaphragmatic breathing exercise in patients with WSD insertion  increase  lung expansion so that WSD can be released and the risk of infection can be reduced. 

Teenage Tachypnea

2020 ◽  
pp. 41-48
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Chief Complaint ◽  
Anxiety State ◽  
Loss Of Consciousness ◽  
Shortness Of Breath ◽  
Psychiatric Facility ◽  
Chest Infection ◽  
Frequent Episodes ◽  
Chest X Ray ◽  
Carpopedal Spasm

This case involves a young woman sent from a psychiatric hospital to the emergency department for assessment. Her chief complaint is intermittent shortness of breath. According to the psychiatrist’s note, she has experienced frequent episodes of uncontrollable hyperventilation, associated with carpopedal spasm and loss of consciousness in the past. There is concern she may have a chest infection. A chest X-ray appears to exclude a chest infection as an explanation of her symptoms, and arrangements are made to transfer her back to the psychiatric facility with a diagnosis of exacerbation of anxiety state. Unexpectedly, there is a sudden deterioration in the patient’s condition, which proves fatal.

scholarly journals Unusual Malposition of a Chest Tube, Intrathoracic but Extrapleural

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Alqasem Fuad H. Al Mosa ◽  
Mohammed Ishaq ◽  
Mohamed Hussein Mohamed Ahmed
Keyword(s):  
Chest Tube ◽  
Complete Resolution ◽  
Pleural Cavity ◽  
Tube Thoracostomy ◽  
Thoracic Cavity ◽  
Common Complication ◽  
Thoracostomy Tube ◽  
Chest Computed Tomography ◽  
Initial Improvement ◽  
The Right

Chest tube malpositioning is reported to be the most common complication associated with tube thoracostomy. Intraparenchymal and intrafissural malpositions are the most commonly reported tube sites. We present a case about a 21-year-old patient with cystic fibrosis who was admitted due to bronchiectasis exacerbation and developed a right-sided pneumothorax for which a chest tube was inserted. Partial initial improvement in the pneumothorax was noted on the chest radiograph, after which the chest tube stopped functioning and the pneumothorax remained for 19 days. Chest computed tomography was done and revealed a malpositioned chest tube in the right side located inside the thoracic cavity but outside the pleural cavity (intrathoracic, extrapleural). The removed chest tube was patent with no obstructing materials in its lumen. A new thoracostomy tube was inserted and complete resolution of the pneumothorax followed.

scholarly journals Thoracic stomach syndrome after whole-stomach esophagectomy for esophageal cancer mimicking tension pneumothorax: a case report

2019 ◽  
Vol 13 (1) ◽  
Author(s):  
Daisuke Hasegawa ◽  
Hidefumi Komura ◽  
Ken Katsuta ◽  
Takahiro Kawaji ◽  
Osamu Nishida
Keyword(s):  
Esophageal Cancer ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Nasogastric Tube ◽  
Tension Pneumothorax ◽  
Differential Diagnoses ◽  
Tube Placement ◽  
Asian Woman ◽  
Thoracic Cavity ◽  
Thoracic Stomach

Abstract Background Sudden onset of respiratory failure is one of the most fearful manifestations in intensive care units. Among the differential diagnoses of respiratory failure, tension pneumothorax is a life-threatening disease that requires immediate invasive intervention to drain the air from the thoracic cavity. However, other etiologies with manifestations similar to those of tension pneumothorax should also be considered after whole-stomach esophagectomy for esophageal cancer. We report a rare case of a patient with thoracic stomach syndrome mimicking tension pneumothorax after esophagectomy with whole-stomach reconstruction. Case presentation A 49-year-old Asian woman was admitted to our intensive care unit after esophagectomy for esophageal cancer with whole-stomach reconstruction while under sedation and intubated. Despite initial stable vital signs, the patient rapidly developed tachypnea, low blood pressure, and low oxygen saturation. Chest radiography revealed a mediastinal shift and led to a presumptive diagnosis of tension pneumothorax. Hence, an aspiration catheter was inserted into the right pleural space. However, her clinical symptoms did not improve. Chest computed tomography was performed, which revealed a significantly distended reconstructed stomach that was compressing the nearby lung parenchyma. Her respiration improved immediately after nasogastric tube placement. After the procedure, we successfully extubated the patient. Conclusions Similar to tension pneumothorax, thoracic stomach syndrome requires immediate drainage of air from the thoracic cavity. However, unlike tension pneumothorax, this condition requires nasogastric tube insertion, which is the only way to safely remove the accumulated air and avoid possible complications that could occur due to percutaneous drainage. For patient safety, it might be clinically important to place nasogastric tubes after esophagectomy with whole-stomach reconstruction, even if radiographic guidance is required. In addition, clinicians should consider thoracic stomach syndrome as one of the differential diagnoses of respiratory failure after whole-stomach esophagectomy.

Massive growth of a meningioma into the brachial plexus and thoracic cavity after intraspinal and supraclavicular resection

2002 ◽  
Vol 96 (1) ◽  
pp. 107-111 ◽  
Author(s):  
Edward R. Smith ◽  
Mark Ott ◽  
John Wain ◽  
David N. Louis ◽  
E. Antonio Chiocca
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Peripheral Nerves ◽  
Pleural Cavity ◽  
Thoracic Cavity ◽  
Review Of The Literature ◽  
Spinal Meningioma ◽  
Content Type ◽  
Massive Growth ◽  
Thoracic Spinal

✓ Extracranial meningiomas comprise approximately 2% of all meningiomas. Involvement of peripheral nerves by meningioma, either by a primary tumor or through secondary extension of an intraaxial lesion, is a much rarer entity; there have been only two reported primary brachial plexus meningiomas and one description of secondary involvement of the brachial plexus by extension of an intraaxial lesion. Although thoracic cavity meningiomas have been described in the literature, their pathogenesis is poorly understood. The authors present the case report of a 36-year-old man who was initially treated for a thoracic spinal meningioma that infiltrated the brachial plexus. After resection, progressive and massive growth with infiltration of the brachial plexus and pleural cavity occurred over a 5-year period despite radio- and chemotherapy. The case report is followed by a review of the literature of this rare entity.

Bilateral Tension Pneumothorax Related to Acupuncture

2013 ◽  
Vol 31 (2) ◽  
pp. 242-244 ◽  
Author(s):  
Rumi Tagami ◽  
Takashi Moriya ◽  
Kosaku Kinoshita ◽  
Katsuhisa Tanjoh
Keyword(s):  
Risk Factors ◽  
Spontaneous Pneumothorax ◽  
Rare Case ◽  
Vital Signs ◽  
Tension Pneumothorax ◽  
Complete Information ◽  
Definitive Diagnosis ◽  
Shortness Of Breath ◽  
Chest Tubes ◽  
Bilateral Pneumothorax

We report on a patient with a rare case of bilateral tension pneumothorax that occurred after acupuncture. A 69-year-old large-bodied man, who otherwise had no risk factors for spontaneous pneumothorax, presented with chest pressure, cold sweats and shortness of breath. Immediately after bilateral pneumothorax had been identified on a chest radiograph in the emergency room, his blood pressure and percutaneous oxygen saturation suddenly decreased to 78 mm Hg and 86%, respectively. We confirmed deterioration in his cardiopulmonary status and diagnosed bilateral tension pneumothorax. We punctured his chest bilaterally and inserted chest tubes for drainage. His vital signs promptly recovered. After the bilateral puncture and drainage, we learnt that he had been treated with acupuncture on his upper back. We finally diagnosed a bilateral tension pneumothorax based on the symptoms that appeared 8 h after the acupuncture. Because the patient had no risk factors for spontaneous pneumothorax, no alternative diagnosis was proposed. We recommend that patients receiving acupuncture around the chest wall must be adequately informed of the possibility of complications and expected symptoms, as a definitive diagnosis can be difficult without complete information.

scholarly journals Intraoperative tension pneumothorax during posterior vertebral column resection in a child with congenital scoliosis

2019 ◽  
Vol 10 ◽  
pp. 155 ◽  
Author(s):  
Abolfazl Rahimizadeh ◽  
Valiollah Hassani ◽  
Nima Mohsenikabir ◽  
Ava Rahimizadeh ◽  
Mona Karimi ◽  
...  
Keyword(s):  
Vertebral Column ◽  
Pleural Cavity ◽  
Tension Pneumothorax ◽  
Congenital Scoliosis ◽  
Hemodynamic Instability ◽  
Urethral Catheter ◽  
Scoliosis Surgery ◽  
Surgical Team ◽  
Vertebral Column Resection ◽  
Posterior Vertebral Column Resection

Background:Intraoperative tension pneumothorax (TPT) is extremely rare in spinal surgery overall and particularly in extensive deformity procedures. Here, we report a TPT occurring in conjunction with posterior vertebral column resection (pVCR) for the treatment of congenital scoliosis.Case Description:A 12-year-old female undergoing congenital thoracic scoliosis surgery (e.g., pVCR) developed abrupt intraoperative increases in airway pressure and compromised hemodynamics that led to a TPT. This was directly attributed to an inadvertent pleural tear. Temporary drainage of the accumulated air was accomplished with a urethral catheter inserted directly into the pleural cavity. This was later supplemented with a standard chest tube. The child quickly improved and was routinely discharged a few days later.Conclusion:In patients undergoing pVCR, if the surgical team is faced with unexplained hemodynamic instability and increased airway resistance, a TPT should be strongly suspected and appropriately managed.

scholarly journals Manual on wound care after open-window thoracostomy

2020 ◽  
Author(s):  
Alcione de Jesus Gonçalves Santana ◽  
Leila Blanes ◽  
Christiane Steponavicius Sobral ◽  
Lydia Masako Ferreira
Keyword(s):  
Health Professionals ◽  
Content Validity ◽  
Healthcare Professionals ◽  
Pleural Cavity ◽  
Wound Care ◽  
Layout Design ◽  
Thoracic Cavity ◽  
Validity Index ◽  
Open Window ◽  
Open Window Thoracostomy

Objective: To produce and validate a manual on wound care after open-window thoracostomy for healthcare professionals. Methods: This is an experience report. Initially, articles in Portuguese, Spanish and English were selected from 2010 to 2018 in the Cochrane, SciELO, LILACS, PubMed and Google Academic databases and search sites for the development of the material. The following descriptors were used: “thoracotomy”, “thoracostomies”, “thoracic cavity”, “pleura”, “pleural cavity”, “injuries and lesions”. After consultation, the text was prepared, followed by illustrations and layout design. The completed manuscript was sent to experts for validation. The content validity index (CVI) was used to validate the manual. Results: The manual developed has thirty-six pages and seven chapters with the following themes: introduction, wound care after open-window thoracostomy, wound cleansing/debridement, dressings, care record, final considerations, and bibliography. Conclusion: It was possible to develop and validate a manual on wound care after open-window thoracostomy for the consultation of health professionals.

Sudden Death of a Patient With Pulmonary Langerhans Cell Histiocytosis

2005 ◽  
Vol 129 (6) ◽  
pp. 798-799 ◽  
Author(s):  
Hassan Nakhla ◽  
Mary I. Jumbelic
Keyword(s):  
Sudden Death ◽  
Chest Radiograph ◽  
Langerhans Cell Histiocytosis ◽  
Sudden Onset ◽  
Langerhans Cell ◽  
Loss Of Consciousness ◽  
Shortness Of Breath ◽  
Bilateral Pneumothorax ◽  
White Girl ◽  
Pulmonary Langerhans Cell Histiocytosis

Abstract We report a case of sudden death due to bilateral pneumothorax in a previously healthy 16-year-old adolescent white girl. She presented with sudden onset of shortness of breath followed by loss of consciousness. Postmortem chest radiograph showed bilateral pneumothoraces. Autopsy confirmed the bilateral pneumothorax and additionally showed emphysematous changes and bullae throughout the lung tissue. Microscopic sections of the lungs showed Langerhans cell histiocytosis. To the best of our knowledge, this is the first reported case of fatal presentation of pulmonary Langerhans cell histiocytosis.

Analyzing thoracic cavity gas during pneumothorax treatment to monitor the pneumothorax conditions in real time for updating the treatment strategy: A pilot study

TECHNOLOGY ◽  
2015 ◽  
Vol 03 (04) ◽  
pp. 189-193
Author(s):  
Hui Ma ◽  
Wei Jia ◽  
Yuechuan Li
Keyword(s):  
Real Time ◽  
Treatment Strategy ◽  
Tension Pneumothorax ◽  
Thoracic Cavity ◽  
Analysis Group ◽  
Partial Pressures ◽  
Group A ◽  
Group B ◽  
Cure Rates ◽  
Group D

ObjectivesTo monitor the pneumothorax conditions in real time by analyzing thoracic cavity gas during pneumothorax treatment, and provide instructions for updating the treatment strategy.MethodsThe partial pressures of O2and CO2in the thoracic cavity from 49 pneumothorax patients was analyzed before the management and after chest tube clogging during the management. The pneumothorax type was differentially diagnosed according to the partial pressure results, and the treatment strategy was updated accordingly.ResultsThe 49 pneumothorax patients were divided into four groups, as follows: Group A, 30 patients with a closed pneumothorax were confirmed to have a closed pneumothorax in the second analysis; Group B, 10 patients with an open pneumothorax were confirmed to have an open pneumothorax in the second analysis; Group C, three patients with a tension pneumothorax confirmed to have a tension pneumothorax in the second analysis; and Group D, six patients with a closed pneumothorax were re-diagnosed to have an open pneumothorax in the second analysis. The cure rates of the four groups after treatment were as follows: Group A (97%, 29/30), Group B (100%, 16/16), Group C (100%, 3/3) and Group D (100%, 6/6).ConclusionsAnalyzing thoracic cavity gas during pneumothorax treatment is suggested as an efficient way to monitor the pneumothorax conditions in real time and to provide instructions for updating the treatment strategy.

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