124: Incessant Refractory Polymorphic Ventricular Tachycardia After Cabg

Iguina, Michele; Shaikh, Umair; Danckers, Mauricio; Smithson, Sean

doi:10.1097/01.ccm.0000550881.02645.93

Cited by 8 publications

(15 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stage I (Exudative) and Stage II (Fibrinopurulent) can be managed conservatively with antibiotics and drainage [13]. Stage III (Organizing) is characterized by formation of granulation tissue and entrapment of the lung by a thick cortex, warranting invasive approach [2]. Management of CTE is challenging because of extensive pleural thickening, contracted chest cavity, and poor nutritional status [13].…”

Section: Discussionmentioning

confidence: 99%

“…Empyema thoracis is a pyogenic infection of an otherwise sterile pleural cavity characterized by accumulation of pus [1]. It is classified into three stages according to the American Thoracic Society: exudative, fibrinopurulent, and organizing [2]. It remains a common clinical problem in both developed and developing countries, however the etiology differs.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Role of Anti-Tuberculous Treatment in the Outcome of Decortication for Chronic Tuberculous Empyema

Sikander

Ahmad

Mazcuri

et al. 2021

Cureus

View full text Add to dashboard Cite

Introduction: Chronic tuberculous empyema (CTE) is a common complication of tuberculosis that requires some form of surgical intervention along with anti-tuberculosis therapy (ATT). The aim of this study was to determine the optimum duration of pre-operative ATT in CTE prior to the decortication and its outcomes. Material and Methods: This comparative prospective study was conducted from August 2019 to August 2020 in the Department of Thoracic Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan. A total of 70 patients were included in the study. They were grouped into two arms: patients operated at or within six weeks of ATT commencement (Group A) and patients operated after six weeks of ATT (Group B). Both groups had 35 participants each. Patients were evaluated based on a self-administered questionnaire. A p-value of less than 0.05 was considered significant. Result: In this study, there were 55 (78.6%) males and 15 (21.4%) females with a mean age of 33.5 ± 11.2 years. Diagnosis of CTE was most commonly made through sputum acid-fast bacilli (AFB) smear (n=35, 50%) which most commonly involved right upper (n=20, 28.6%) and lower lung lobes (n=20, 28.6%). Complications such as air leaks, need for ventilator support, need for intensive care unit (ICU) stay, residual collection, and pneumothorax all were significantly higher in Group A (31 patients out of 35) compared to Group B (18 patients out of 35). In Group B, 21 (60%) participants had full post-operative expansion of lungs, compared to eight (22.8%) in Group A (p=0.002). In total five participants had failure to expand lungs; all of them belonged to Group A (p=0.02). Conclusion: The optimum timing of surgery and preoperative ATT is crucial for achieving better outcomes and requires good collaboration between the treating pulmonologist and thoracic surgeon. Our study highlights the importance of pre-operative ATT for at least more than six weeks before undertaking decortication for better outcomes and minimizing morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Role of Anti-Tuberculous Treatment in the Outcome of Decortication for Chronic Tuberculous Empyema

Sikander

Ahmad

Mazcuri

et al. 2021

Cureus

View full text Add to dashboard Cite

show abstract

“…Empyema thoracic (ET) is defined as the presence of pus in the pleural cavity [1,2]. It can arise as a complication of pneumonia or as a result of penetrating thoracic injury, a postoperative complication of lung surgery, perforation of the esophagus either iatrogenic or due to thoracic trauma, thoracic duct injury, or as a complication of thoracentesis and tube thoracotomy [3]. It can also arise as a consequence of pulmonary tuberculosis when a broncho-pleural fistula develops and direct contamination of pleural space occurs with mycobacterium tuberculosis [4].…”

Section: Introductionmentioning

confidence: 99%

“…The goal of this procedure is to release the underlying lung and help re-expand it. Once the fibrous peel is removed from the lung and the chest wall, lung compliance improves, and the lung re-expands, greatly improving the patient's symptoms and exercise tolerance [3].…”

Section: Introductionmentioning

confidence: 99%

“…Over a period of days and weeks, the collection in the pleural space increases with the patient developing signs and symptoms of ET, namely fever, difficulty breathing and fatigue . If it is 1 1 1 1 1 2 not managed in a timely manner, ET progresses through the early stages of exudative and fibrinopurulent stages where loculations and adhesions develop, to the third stage, the organizing chronic empyema stage (after three weeks) [3]. Once the lung is entrapped, visceral pleural fibrosis prevents lung expansion.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Early Functional Results of Surgery for Organizing Phase of Empyema Thoracis in a High Output Centre for Thoracic Surgery

Ali

Ahmad

Shaikh

et al. 2020

Cureus

View full text Add to dashboard Cite

Spectrum of Microorganisms, Antibiotic Resistance Pattern, and Treatment Outcomes Among Patients With Empyema Thoracis: A Descriptive Cross-Sectional Study From the Bahawal Victoria Hospital Bahawalpur, Punjab, Pakistan

et al. 2021

View full text Add to dashboard Cite

Background: This study involves the analysis of spectrum of microorganisms, antibiotic resistance pattern, and treatment outcomes among empyema thoracis patients. This study also analyzes the factors associated with unsuccessful treatment outcome and duration of hospital stay among the patients.Methods: This was a descriptive, cross-sectional study carried out in the Pulmonology Ward of the Bahawal Victoria hospital, Bahawalpur, Pakistan. All patients with empyema thoracis registered at the study site during the period of 1 year were included in the study. Multivariate regression analysis was used to analyze the factors associated with duration of hospital stay and unsuccessful treatment outcome among the patients.Results: A total 110 patients were included in the study. Most of the patients (n = 73, 66.4%) were treated with piperacillin/tazobactam alone and in combination with either one or more than one antibiotics as an empiric therapy. Culture was positive in 58 (52.7%) patients and the most commonly identified organisms included, gram-negative Pseudomonas aeruginosa (n = 20; 18.8%) and Klebsiella sp. (n = 11, 10%) followed by same proportion of E. coli. The most commonly identified bacterial isolates showed high level of resistance against antibiotics used as an empiric therapy, while these showed low level of resistance against amoxicillin, clarithromycin, ertapenem, colistin, tigecycline, fosfomycin, rifampicin, and vancomycin. In this study, 82 (74.5%) patients successfully completed the treatment, while 12 (11%) showed no clinical improvement, 5 (4.5%) lost to follow up and 11 (10%) died. In multivariate binary logistic regression analysis, none of the patient attributes were significantly associated with unsuccessful treatment outcome, while in multivariate linear regression analysis, the factors which were significantly associated with duration of hospital stay included; duration of symptoms <2 weeks prior to admission (p = 0.008, beta = −0.247) and resistance to five antibiotic classes (p = 0.02, beta = 0.280).Conclusion: Close to 25% of the patients did not complete the treatment successfully. Most of the common bacterial isolates showed high level of resistance against the broad-spectrum antibiotics used as an empiric therapy. This is alarming. However, better sensitivity of common bacterial isolates against standardized first line treatment for empyema thoracis is promising.

show abstract

124: Incessant Refractory Polymorphic Ventricular Tachycardia After Cabg

Cited by 8 publications

References 0 publications

Role of Anti-Tuberculous Treatment in the Outcome of Decortication for Chronic Tuberculous Empyema

Role of Anti-Tuberculous Treatment in the Outcome of Decortication for Chronic Tuberculous Empyema

Early Functional Results of Surgery for Organizing Phase of Empyema Thoracis in a High Output Centre for Thoracic Surgery

Spectrum of Microorganisms, Antibiotic Resistance Pattern, and Treatment Outcomes Among Patients With Empyema Thoracis: A Descriptive Cross-Sectional Study From the Bahawal Victoria Hospital Bahawalpur, Punjab, Pakistan

Contact Info

Product

Resources

About