scholarly journals Estimation of the volume of postoperative intrathoracic bleeding after pulmonary resection: Is the volume of chest tube output predictive of that of intrathoracic hematoma?

2011 ◽  
Vol 25 (7) ◽  
pp. 696-701
Author(s):  
Hisao Asamura ◽  
Riken Kawachi ◽  
Mayumi Oyama ◽  
Hiroyuki Sakurai ◽  
Shun-ichi Watanabe
Keyword(s):  
Chest Tube ◽  
Pulmonary Resection ◽  
Tube Output ◽  
Chest Tube Output

scholarly journals Repair of a traumatic subarachnoid-pleural fistula with the percutaneous injection of fibrin glue in a 2-year-old

2016 ◽  
Vol 17 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Jason K. Chu ◽  
Brandon A. Miller ◽  
Michael P. Bazylewicz ◽  
John F. Holbrook ◽  
Joshua J. Chern
Keyword(s):  
Fibrin Glue ◽  
Chest Tube ◽  
Epidural Injection ◽  
Dural Defect ◽  
Percutaneous Injection ◽  
Ct Guided ◽  
First Line Therapy ◽  
Tube Output ◽  
Chest Tube Output ◽  
Dural Defects

Subarachnoid-pleural fistulas (SPFs) are rare clinical entities that occur after severe thoracic trauma or iatrogenic injury during anterolateral approaches to the spine. Treatment of these fistulas often entails open repair of the dural defect. The authors present the case of an SPF in a 2-year-old female after a penetrating injury to the chest. The diagnosis of an SPF was suspected given the high chest tube output and was confirmed with a positive β2-transferrin test of the chest tube fluid, as well as visualization of dural defects on MRI. The dural defects were successfully repaired with CT-guided percutaneous epidural injection of fibrin glue alone. This case represents the youngest pediatric patient with a traumatic SPF to be treated percutaneously. This technique can be safely used in pediatric patients, offers several advantages over open surgical repair, and could be considered as an alternative first-line therapy for the obliteration of SPFs.

scholarly journals Factors Related to Pleural Effusions After Fontan Procedure in the Era of Fenestration

Circulation ◽  
2001 ◽  
Vol 104 (suppl_1) ◽  
Author(s):  
Raymond T. Fedderly ◽  
Beth N. Whitstone ◽  
Stephanie J. Frisbee ◽  
James S. Tweddell ◽  
S. Bert Litwin
Keyword(s):  
Hospital Stay ◽  
Chest Tube ◽  
Single Ventricle ◽  
Fontan Procedure ◽  
Fontan Operation ◽  
Univariate Analysis ◽  
Ordinary Least Squares ◽  
Pleural Effusions ◽  
Tube Output ◽  
Chest Tube Output

Background Significant pleural effusions after the Fontan operation prolong hospital stay, may increase the risk of infection, and may necessitate a pleurodesis procedure. Methods and Results From February 1991 to April 2000, 98 consecutive patients under the age of 18 years underwent the fenestrated Fontan procedure at Children’s Hospital of Wisconsin. Ninety-four patients who survived at least 30 days after surgery were retrospectively evaluated for the following factors: age, ventricular morphology (right single ventricle, left single ventricle [RV/LV]), fenestration open (FO) or closed (FC) at end of operation, intracardiac Fontan (IF) or extracardiac Fontan (EF), days with chest tube output per day >5, 10, and/or 20 mL · kg −1 · d −1 (CTO5, CTO10, and CTO20, respectively), need for pleurodesis, length of hospital stay (LOS), operation during winter respiratory viral season of November through March (ReVS+, ReVS−), and pre-Fontan mean pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR). In univariate analysis, the ReVS+ patients had prolonged LOS, greater chest tube output, and more pleurodesis ( P <0.05), and PAP was related to CTO5 and CTO10 but not to CTO20 or LOS. No significant differences were found in LOS, CTO5, CTO10, CTO20, and need for pleurodesis between patients in RV/LV, FO/FC, IF/EF, or PVR groups. Patients <4 years of age had more instances of CTO20 ( P <0.05). When we used ordinary least squares regression analysis with age, FO or FC, RV or LV, PAP, and ReVS+ or ReVS− to predict each of CTO5, CTO10, CTO20, and LOS, only ReVS+ or ReVS− and age were statistically significant in all models. Conclusions Use of the Fontan procedure during the respiratory viral season appeared to be related to significant, prolonged pleural effusions and longer hospitalizations.

scholarly journals Risk of Renal Dysfunction after Less Invasive Multivessel Coronary Artery Bypass Grafting

2012 ◽  
Vol 7 (3) ◽  
pp. 180-186 ◽  
Author(s):  
Soroosh Kiani ◽  
Alex K. Brown ◽  
Dinesh J. Kurian ◽  
Stanislav Henkin ◽  
Mary M. Flynn ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Chest Tube ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Off Pump ◽  
Transfusion Requirements ◽  
Tube Output ◽  
Chest Tube Output

Objective Several centers have established that off-pump, multivessel coronary artery bypass grafting performed via a small thoracotomy (MVST) is feasible. However, this procedure can be challenging when posterolateral coronary targets need to be grafted. We hypothesized that use of cardiopulmonary bypass via peripheral access (MVST-PA) would improve outcomes compared with a completely off-pump approach (OP-MVST). Methods This was a prospective observational study of patients undergoing OP-MVST (n = 46) versus MVST-PA (n = 45) using bilateral internal mammary artery grafts onto the left anterior descending coronary artery and circumflex/right coronary artery distribution. Hemostasis was quantified by measuring platelet function (aggregometry), chest tube output, thrombolysis in myocardial infarction bleeding score (%hematocrit change at 24 hours), and transfusion requirements. The rate of mortality and major morbidity at 30 days was defined according to The Society of Thoracic Surgeons criteria. Estimated glomerular filtration rate (normalized to baseline levels) was determined daily until discharge. Results The OP-MVST versus MVST-PA groups had similar risk factors at baseline and risks of composite morbidity/mortality at 30 days. However, renal failure was significantly increased after OP-MVST (10.87 vs 0%, P = 0.05), and MVST-PA affected hemostasis as evidenced by inhibition of platelet function (latency to response on aggregometry, 29.9 vs 17.9 seconds; P = 0.04) and higher transfusion requirement (2.31 vs 0.85 units of red blood cells/patient, P = 0.04; 55.6% vs 34.8% transfused; P = 0.059). However, 24-hour chest tube output was similar (645 vs 750 mL; P = 0.53). Conclusions In comparison with a completely off-pump strategy, use of cardiopulmonary bypass to assist MVST reduced the risk of renal dysfunction with only modest tradeoffs in other morbidities, for example, altered coagulation and higher transfusion requirements. These data justify further study of the effect of MVST-PA on renal complications.

Treatment of hepatic hydrothorax and reduction of chest tube output with octreotide

2001 ◽  
Vol 13 (8) ◽  
pp. 977-980 ◽  
Author(s):  
Rahel Pfammatter ◽  
Christiana Quattropani ◽  
Jürg Reichen ◽  
Burkhard Göke ◽  
Andreas C. C. Wagner
Keyword(s):  
Chest Tube ◽  
Hepatic Hydrothorax ◽  
Tube Output ◽  
Chest Tube Output

scholarly journals Thoracotomy for blunt chest trauma: is chest tube output a useful criterion?

2015 ◽  
Vol 3 (2) ◽  
pp. 81-85
Author(s):  
Yasuaki Mizushima ◽  
Shota Nakao ◽  
Hiroaki Watanabe ◽  
Tetsuya Matsuoka
Keyword(s):  
Chest Tube ◽  
Blunt Chest Trauma ◽  
Chest Trauma ◽  
Tube Output ◽  
Chest Tube Output

scholarly journals Early Identification of Primary Hypothyroidism in Neonates Exposed to Intralymphatic Iodinated Contrast: A Case Series

2018 ◽  
Vol 103 (10) ◽  
pp. 3585-3588 ◽  
Author(s):  
Christine E Cherella ◽  
David T Breault ◽  
Vidhu Thaker ◽  
Bat-Sheva Levine ◽  
Jessica R Smith
Keyword(s):  
Chest Tube ◽  
Reference Range ◽  
High Volume ◽  
Primary Hypothyroidism ◽  
Premature Neonates ◽  
Spot Urine ◽  
Iodinated Contrast ◽  
Tube Output ◽  
Chest Tube Output ◽  
Urine Iodine

Abstract Context In neonates, iatrogenic hypothyroidism can result from topical or IV iodine exposure. Data on intralymphatic iodine exposure, risk factors for disease severity, and timing of hypothyroidism are limited. Case Descriptions We report 4 cases of premature neonates with previously normal thyroid function tests (TFTs) who developed hypothyroidism after intralymphatic iodinated contrast. Patients 1 and 2, premature infants with complex medical histories, had chylous effusions and high-volume chest tube output requiring imaging with lymphangiograms on day of life (DOL) 97 and DOL 43, respectively. They developed severe, primary hypothyroidism with TSH of 335.7 mIU/mL (reference range, 1.7 to 9.1) on DOL 111 and TSH of 470.2 mIU/mL (reference range, 1.7 to 9.1) on DOL 68. Patient 3 had prenatally diagnosed fetal hydrops manifesting with chylous effusions and high-volume chest tube output. The infant underwent lymphangiography on DOL 90 and was noted to have an elevated TSH of 13.35 mIU/mL (reference range, 1.7 to 9.1) 4 days later with spot urine iodine of 1742 µg/L (normal, &lt;200). Patient 4 had a lymphatic malformation and underwent sclerotherapy with doxycycline with intralymphatic iodine exposure on DOL 4 and was found to have a TSH of 16.7 µU/mL (reference range, 1.7 to 9.1) 3 days later with spot urine iodine of 228,712 µg/L (normal, &lt;200). The TFT results for all patients improved after levothyroxine administration. Conclusion Intralymphatic iodine should be considered a major risk factor in the development of iatrogenic primary hypothyroidism, especially in premature neonates soon after exposure. Close monitoring of TFTs is imperative to avoid potential long-term adverse outcomes in this population.

scholarly journals Transfusion requirements in cardiac Surgery III (TRICS III), Ticagrelor Substudy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Alraddadi ◽  
E Belley-Cote ◽  
N Shehata ◽  
D Mazer ◽  
R.P Whitlock
Keyword(s):  
Cardiac Surgery ◽  
Blood Loss ◽  
Chest Tube ◽  
Blood Product ◽  
Postoperative Bleeding ◽  
P Value ◽  
Product Use ◽  
Transfusion Requirements ◽  
Tube Output ◽  
Chest Tube Output

Abstract Background Ticagrelor, in addition to aspirin, has been demonstrated to reduce morbidity and mortality in patients with acute coronary syndrome compared to clopidogrel with aspirin. The treatment effect appeared to be maintained in the subgroup of patients who underwent urgent surgical revascularization. However, the risk of postoperative bleeding in these patients has not been well described. Research question We aimed to establish the effect of ticagrelor exposure within 7 days before surgery on blood loss as measured by postoperative chest tube output and blood product use. Method In a nested cohort study of patients enrolled in the Transfusion Requirements in Cardiac Surgery III (TRICS III) trial, we compared chest tube output and blood product use in patients based on their preoperative exposure to ticagrelor ≤3 days versus &gt;3 days before surgery. Results Of the 5243 patients in TRICS III, 87 patients were exposed to ticagrelor within 7 days with a mean age of 78 years (SD 6) and 74% were male. Patients exposed to ticagrelor 3 days or less before surgery bled a median of 730 ml (IQR 295, 2195) postoperatively in the first 24 hours postoperatively, compared to 518 ml (IQR 350, 1000) for those for whom ticagrelor was held for more than 3 days. We log-transformed the data and found that recent ticagrelor exposure (≤3 days) was associated with significantly more blood loss compared to no exposure for more than 3 days (P-value: 0.01). 69.6% of patients in the recent exposure group received at least one red blood cell transfusion versus 54.7% in patients exposed to ticagrelor more than 3 days pre-operatively (p-value: 0.214). Platelet and fresh frozen plasma transfusion were 52.2% vs 15.6% (p-value 0.001), and 39.1% vs 9.4% (p-value 0.003), respectively, for ticagrelor exposure ≤3 days compared to &gt;3 days. Cryoprecipitate use was 17.4% in the ≤3 days group and 3.1% in the &gt;3 days group (p-value 0.04). Only 1 patient in each group received prothrombin complex concentrate (PCC) transfusion. And 1 patient with exposure ≤3 days received Factor VII. Conclusion Exposure to ticagrelor within 3 days of surgery is associated with an increased risk of postoperative bleeding as assessed by greater chest tube output at 24 hours and more patients requiring blood product transfusion. A ticagrelor-reversing agent may improve the outcomes of patients who have been recently exposed to ticagrelor and require urgent cardiac surgery. Funding Acknowledgement Type of funding source: None

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