Treatment of Pneumothoraces Utilizing Small Caliber Chest Tubes

Conces, Dewey J.; Tarver, Robert D.; Gray, William C.; Pearcy, Elizabeth A.

doi:10.1378/chest.94.1.55

Cited by 132 publications

(72 citation statements)

References 9 publications

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“…In our series, successful treatment of pneumothorax was accomplished in nine (90%) of 10 cases, with no further therapy required. The overall average duration of tube drainage was 1 .2 days, comparable to the 2.0-3.7 days reported with other small-caliber catheters [2][3][4]. The device is well tolerated by patients, and its compact, portable nature allows unrestricted patient ambulation and movement, similar to the more widely used Cook pneumothorax set (Cook, Bloomington, IN).…”

Section: Methodsmentioning

confidence: 58%

“…The manufacturer notes that the device is useful for treatment of spontaneous, posttraumatic, and iatrogenic pneumothoraces, although we assessed only the latter dlaim.The device is not designed for drainage of pleural fluid. Indeed, dogging of small-caliber catheters with fluid or debris has been reported as a cause of treatment failure [3,5]. This conceivably was the cause of the single treatment failure in our series, although other possibilities include kinking or The one patient in our series requiring a second thoracic vent emphasizes the need to advance the catheter/trocar combination slightly beyond the point at which deflections of the signal diaphragm are noted to ensure catheter placement within the pleural space.…”

Section: Methodsmentioning

confidence: 72%

“…Treatment of postbiopsy pneumothorax, when necessary, has traditionally been with large-bore (22-to 32-French) chest tubes. Several reports, however, indicate that postbiopsy pneumothoraces can be treated easily and effectively by using percutaneously inserted small catheters (7-to 9-French), often attached to a Heimlich one-way drainage valve [2][3][4][5][6][7]. We describe our initial experience with a new one-piece, commercially available pneumothorax treatment device, the Tru-Close Thoracic Vent (UreSil Corporation, Skokie, IL).…”

mentioning

confidence: 99%

See 2 more Smart Citations

A one-piece unit for treatment of pneumothorax complicating needle biopsy: evaluation in 10 patients.

Molina¹,

Solomon²,

Glazer³

et al. 1990

American Journal of Roentgenology

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Section: Methodsmentioning

confidence: 58%

Section: Methodsmentioning

confidence: 72%

mentioning

confidence: 99%

See 1 more Smart Citation

A one-piece unit for treatment of pneumothorax complicating needle biopsy: evaluation in 10 patients.

Molina¹,

Solomon²,

Glazer³

et al. 1990

American Journal of Roentgenology

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“…5). Success rate of drainage of iatrogenic pneumothorax is 75±97%, the vast majority resolving within 24±72 h [18,19,25,86,107,108]. Catheters can be connected to a one-way Heimlich valve.…”

Section: Pleural Collectionsmentioning

confidence: 99%

Imaging guided thoracic interventions

Ghaye¹,

Dondelinger²

2001

Eur Respir J

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Interventional Radiology is a technique based medical specialty, using all available imaging modalities (¯uoroscopy, ultrasound, computed tomography, magnetic resonance, angiography) for guidance of interventional techniques for diagnostic or therapeutic purposes.Actual, percutaneous transthoracic needle biopsy includes core needle biopsy besides ®ne needle aspiration. Any pleural, pulmonary or mediastinal¯uid or gas collection is amenable to percutaneous pulmonary catheter drainage.Treatment of haemoptysis of the bronchial artery or pulmonary artery origin, transcatheter embolization of pulmonary arteriovenous malformations and pseudoaneurysms, angioplasty and stenting of the superior vena caval system and percutaneous foreign body retrieval are well established routine procedures, precluding unnecessary surgery. These techniques are safe and effective in experienced hands.Computed tomography is helpful in pre-and postoperative imaging of patients being considered for endobronchial stenting. Many procedures can be performed on an outpatient basis, thus increasing the cost-effectiveness of radiologically guided interventions in the thorax.

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“…These series report high success rates of 87%-95%. [36][37][38] The present series represents a transition in the device used to alleviate TPTX in the IDF, and while it is a preliminary report that was not designed to assess outcomes, initial experience suggest the feasibility of this method.…”

Section: Discussionmentioning

confidence: 99%

Needle thoracostomy for tension pneumothorax: the Israeli Defense Forces experience

et al. 2015

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Background: Point of injury needle thoracostomy (NT) for tension pneumothorax is potentially lifesaving. Recent data raised concerns regarding the efficacy of conventional NT devices. Owing to these considerations, the Israeli Defense Forces Medical Corps (IDF-MC) recently introduced a longer, wider, more durable catheter for the performance of rapid chest decompression. The present series represents the IDF-MC experience with chest decompression by NT. Methods:We reviewed the IDF trauma registry from January 1997 to October 2012 to identify all cases in which NT was attempted.Results: During the study period a total of 111 patients underwent chest decompression by NT. Most casualties (54%) were wounded as a result of gunshot wounds (GSW); motor vehicle accidents (MVAs) were the second leading cause (16%). Most (79%) NTs were performed at the point of injury, while the rest were performed during evacuation by ambulance or helicopter (13% and 4%, respectively). Decreased breath sounds on the affected side were one of the most frequent clinical indications for NT, recorded in 28% of cases. Decreased breath sounds were more common in surviving than in nonsurviving patients. (37% v. 19%, p < 0.001). A chest tube was installed on the field in 35 patients (32%), all after NT. Conclusion:Standard NT has a high failure rate on the battlefield. Alternative measures for chest decompression, such as the Vygon catheter, appear to be a feasible alternative to conventional NT.Contexte : La thoracotomie à l'aiguille (TA) pour le pneumothorax sous tension sur les lieux mêmes du traumatisme peut sauver des vies. Des données récentes ont mis en doute l'efficacité des dispositifs de TA classiques. C'est pourquoi le corps médical de l'armée israélienne (CMAI) a récemment proposé un cathéter plus long, plus large et plus résistant pour décomprimer rapidement le pneumothorax. Le présent article résume l'expérience du CMAI en matière de décompression des pneumothorax au moyen de la TA.Méthodes : Nous avons passé en revue le registre des traumatismes de l'armée israé-lienne entre janvier 1997 et octobre 2012 pour relever tous les cas où une TA a été tentée.Résultats : Durant la période de l'étude 111 patients en tout ont subi une décom-pression à l'aide d'une TA. La plupart des cas (54 %) résultaient de blessures par balles; les accidents de la route venaient au second rang (16 %). La plupart (79 %) des TA ont été effectuées sur les lieux, tandis que les autres ont été effectuées durant l'évacuation par ambulance ou par hélicoptère (13 % et 4 %, respectivement). L'atténuation des bruits respiratoires du côté affecté était l'une des indications cliniques les plus fréquentes de la TA, enregistrée dans 28 % des cas. L'atténuation des bruits respiratoires était plus fréquente chez les patients qui ont survécu (37 % c. 19 %, p < 0,001). Un drain thoracique a été installé sur le terrain chez 35 patients (32 %), à chaque fois après une TA.Conclusion : La TA standard s'accompagne d'un taux d'échec élevé sur le champ de bataille. Une autre mesu...

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Treatment of Pneumothoraces Utilizing Small Caliber Chest Tubes

Cited by 132 publications

References 9 publications

A one-piece unit for treatment of pneumothorax complicating needle biopsy: evaluation in 10 patients.

A one-piece unit for treatment of pneumothorax complicating needle biopsy: evaluation in 10 patients.

Imaging guided thoracic interventions

Needle thoracostomy for tension pneumothorax: the Israeli Defense Forces experience

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