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Pneumothorax

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1. Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn. (PubMed)

Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn. Pneumothorax occurs more frequently in the neonatal period than at any other time of life and is associated with increased mortality and morbidity. It can be treated with either aspiration with a syringe (using a needle or an angiocatheter) or a chest tube inserted in the anterior pleural space and then connected to a Heimlich valve or an underwater seal with continuous suction.To compare the efficacy and safety (...) of needle aspiration (either with immediate removal of the needle or with the needle left in situ) to intercostal tube drainage in the management of neonatal pneumothorax (PTX).We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL 2018, Issue 5), MEDLINE via PubMed (1966 to 4 June 2018), Embase (1980 to 4 June 2018), and CINAHL (1982 to 4 June 2018). We also searched clinical trials databases, conference proceedings

2019 Cochrane

6. Pneumothorax

Pneumothorax Pneumothorax - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Pneumothorax Last reviewed: February 2019 Last updated: April 2018 Summary Accumulation of air in the pleural space. Primary spontaneous pneumothoraces occur in young people without known respiratory illnesses. Patients with pre-existing pulmonary diseases may develop secondary spontaneous pneumothoraces. A tension pneumothorax is a medical (...) emergency that requires immediate intervention to decompress the involved hemithorax. Patients with pneumothoraces typically complain of dyspnoea and chest pain. In tension pneumothorax, patients are distressed with rapid laboured respirations, cyanosis, profuse diaphoresis, and tachycardia. First-line treatment of pneumothoraces includes observation with supplemental oxygen therapy, percutaneous aspiration of the air in the pleural space, chest-tube thoracostomy, and in some cases video-assisted

2018 BMJ Best Practice

7. Treatment of Open Pneumothorax Prior to Chest Tube Insertion: Clinical Evidence and Guidelines

Treatment of Open Pneumothorax Prior to Chest Tube Insertion: Clinical Evidence and Guidelines Treatment of Open Pneumothorax Prior to Chest Tube Insertion: Clinical Evidence and Guidelines | CADTH.ca Find the information you need Treatment of Open Pneumothorax Prior to Chest Tube Insertion: Clinical Evidence and Guidelines Treatment of Open Pneumothorax Prior to Chest Tube Insertion: Clinical Evidence and Guidelines Last updated: December 11, 2018 Project Number: RA0994-000 Product Line (...) : Research Type: Devices and Systems Report Type: Reference List Result type: Report Question What is the clinical evidence for interventions to treat open pneumothorax prior to chest tube insertion (tube thoracostomy)? What are the evidence-based guidelines for the treatment of open pneumothorax prior to chest tube insertion (tube thoracostomy)? Key Message One evidence-based guideline was identified regarding the treatment of open pneumothorax prior to chest tube insertion. No clinical evidence

2018 Canadian Agency for Drugs and Technologies in Health - Rapid Review

8. Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults. (PubMed)

Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults. For management of pneumothorax that occurs without underlying lung disease, also referred to as primary spontaneous pneumothorax, simple aspiration is technically easier to perform than intercostal tube drainage. In this systematic review, we seek to compare the clinical efficacy and safety of simple aspiration versus intercostal tube drainage for management of primary spontaneous pneumothorax (...) 2017). We checked the reference lists of included trials and contacted trial authors. We imposed no language restrictions.We included randomized controlled trials (RCTs) of adults 18 years of age and older with primary spontaneous pneumothorax that compared simple aspiration versus intercostal tube drainage.Two review authors independently selected studies for inclusion, assessed trial quality, and extracted data. We combined studies using the random-effects model.Of 2332 publications obtained

2017 Cochrane

9. Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn. (PubMed)

Needle aspiration versus intercostal tube drainage for pneumothorax in the newborn. Pneumothorax occurs more frequently in the neonatal period than at any other time of life and is associated with increased mortality and morbidity. It may be treated with either needle aspiration or insertion of a chest tube. The former consists of aspiration of air with a syringe through a needle or an angiocatheter, usually through the second or third intercostal space in the midclavicular line. The chest tube (...) is usually placed in the anterior pleural space passing through the sixth intercostal space into the pleural opening, turned anteriorly and directed to the location of the pneumothorax, and then connected to a Heimlich valve or an underwater seal with continuous suction.To compare the efficacy and safety of needle aspiration and intercostal tube drainage in the management of neonatal pneumothorax.We used the standard search strategy of the Cochrane Neonatal Review group to search the Cochrane Central

2016 Cochrane

10. Small bore pig tail catheter seldinger versus open chest drain large bore tube insertion for Secondary spontaneous pneumothorax?

Small bore pig tail catheter seldinger versus open chest drain large bore tube insertion for Secondary spontaneous pneumothorax? Q&A - Small bore pig tail catheter seldinger versus open chest drain large bore tube insertion for Secondary spontaneous pneumothorax? - Trip Database NEW! or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document (...) spontaneous pneumothorax? 1 Please log in to post a reply Your response: Reply Notes about answers If you see something you feel is wrong, don’t criticise (that misses the point of Triple) courteously and supportively give a counter answer. Answers given should be in good faith, but they should not be considered definitive, be critical. We do not endorse or verify content posted by users. Thanks for your response, Thanks for your question, Responded 13 Oct 2019 · , Information specialist, UK This recent

2019 Trip Community Q&A

11. New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax (PubMed)

New bullae formation in the staple line increases the risk of recurrent pneumothorax following video-assisted thoracoscopic surgery bullectomy for primary spontaneous pneumothorax The study aimed to investigate the association between the recurrence of pneumothorax following video-assisted thoracoscopic surgery (VATS) for primary spontaneous pneumothorax (PSP) and the formation of new bullae.This retrospective review examined patients who underwent VATS for PSP between April 2009 and December (...) 2014. Of the 415 operated lungs, high-resolution computed tomography (HRCT) scans of 85 were analyzed.Of the 85 HRCT scans examined, 21 (24.7%) were diagnosed with recurrent pneumothorax and 60 new bullae were found. In total, 39 new bullae were located in the staple line, 38 were at other sites far from the staplers, and 17 were concurrent in the stapling and non-stapling areas. The group with new bullae in staple line exhibited significantly higher recurrence rate following VATS than the groups

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2018 Journal of thoracic disease

12. Delivery Room Continuous Positive Airway Pressure and Pneumothorax

Delivery Room Continuous Positive Airway Pressure and Pneumothorax In 2011, the Neonatal Resuscitation Program (NRP) added consideration of continuous positive airway pressure (CPAP) for spontaneously breathing infants with labored breathing or hypoxia in the delivery room (DR). The objective of this study was to determine if DR-CPAP is associated with symptomatic pneumothorax in infants 35 to 42 weeks' gestational age.We included (1) a retrospective birth cohort study of neonates born between (...) 2001 and 2015 and (2) a nested cohort of those born between 2005 and 2015 who had a resuscitation call leading to admission to the NICU and did not receive positive-pressure ventilation.In the birth cohort (n = 200 381), pneumothorax increased after implementation of the 2011 NRP from 0.4% to 0.6% (P < .05). In the nested cohort (n = 6913), DR-CPAP increased linearly over time (r = 0.71; P = .01). Administration of DR-CPAP was associated with pneumothorax (odds ratio [OR]: 5.5; 95% confidence

2019 EvidenceUpdates

13. Thoracoscopic decortication for the management of trapped lung caused by 14‐year pneumothorax: A case report (PubMed)

Thoracoscopic decortication for the management of trapped lung caused by 14‐year pneumothorax: A case report Trapped lung is defined by the lung's inability to expand and fill the thoracic cavity because of a restricting "peel" caused by benign or malignant pleural disease. However, trapped lung secondary to pneumothorax is rarely reported. We present a case of trapped lung caused by a pneumothorax that occurred some 14 years before the patient presented to our hospital with a complaint (...) of incapacitating dyspnea. Computed tomography (CT) scans revealed trapping of the right lung with abnormal thickening of the visceral pleura. In view of the patient's history of pneumothorax, we concluded that his dyspnea was attributable mainly to the trapping of his lung by the earlier pneumothorax. We therefore scheduled thoracoscopic decortication, which was successfully completed. The patient's recovery after the operation was uneventful, and seven weeks after surgery the right lung had re-expanded well.©

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2018 Thoracic cancer

14. Chest ultrasonography to assess the kinetics and efficacy of talc pleurodesis in a model of pneumothorax: an experimental animal study (PubMed)

Chest ultrasonography to assess the kinetics and efficacy of talc pleurodesis in a model of pneumothorax: an experimental animal study Talc pleurodesis is used to avoid recurrences in malignant pleural effusions or pneumothorax. The lack of lung sliding detected by chest ultrasonography (CUS) after talc application is indicative of the effectiveness of pleurodesis. The objective of our study was to explore, in an animal model, the capacity of CUS to predict the quality of a symphysis induced (...) by talc poudrage (TP) and talc slurry (TS). We induced an artificial pneumothorax in six healthy pigs prior to talc application. TP was performed on one hemithorax, followed by TS on the other side 1 week later. 108 points on the chest were marked and evaluated by ultrasonography during the study. TP showed higher sonographic scores compared to TS starting from 72 h after talc administration. At autopsy, a higher grade of symphysis was observed for TP, and a high correlation rate was registered

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2018 ERJ open research

15. A Systematic Review and Meta-Analysis Comparing Pigtail Catheter and Chest Tube as the Initial Treatment for Pneumothorax

A Systematic Review and Meta-Analysis Comparing Pigtail Catheter and Chest Tube as the Initial Treatment for Pneumothorax The optimal initial treatment approach for pneumothorax remains controversial. This systemic review and meta-analysis investigated the effectiveness of small-bore pigtail catheter (PC) drainage compared with that of large-bore chest tube (LBCT) drainage as the initial treatment approach for all subtypes of pneumothorax.PubMed and Embase were systematically searched (...) for observational studies and randomized controlled trials published up to October 9, 2017, that compared PC and LBCT as the initial treatment for pneumothorax. The investigative outcomes included success rates, recurrence rates, complication rates, drainage duration, and hospital stay.Of the 11 included studies (875 patients), the success rate was similar in the PC (79.84%) and LBCT (82.87%) groups, with a risk ratio of 0.99 (95% CI, 0.93 to 1.05; I2 = 0%). Specifically, PC drainage was associated

2018 EvidenceUpdates

16. Conservative versus interventional management for primary spontaneous pneumothorax in adults. (PubMed)

Conservative versus interventional management for primary spontaneous pneumothorax in adults. Primary spontaneous pneumothorax is widely managed according to size with interventional techniques based on practice guidelines. Interventional management is not without complications and observational data suggest conservative management works. The current guidelines are based on expert consensus rather than evidence, and a systematic review may help in identifying evidence for this practice.The (...) objective of the review is to compare conservative and interventional treatments of adult primary spontaneous pneumothorax for outcomes of clinical efficacy, tolerability and safety.We searched the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, Issue 6, 2014); MEDLINE via Ovid SP (1920 to 26th June 2014); EMBASE via Ovid SP (1947 to 26th June 2014); CINAHL via EBSCO host (1980 to 26th June 2014); and ISI Web of Science (1945 to 26th June 2014). We searched ongoing

2014 Cochrane

17. Effect of Needle Aspiration of Pneumothorax on Subsequent Chest Drain Insertion in Newborns: A Randomized Clinical Trial

Effect of Needle Aspiration of Pneumothorax on Subsequent Chest Drain Insertion in Newborns: A Randomized Clinical Trial Treatment options for a symptomatic pneumothorax in newborns include needle aspiration (NA) and chest drain (CD) insertion. There is little consensus as to the preferred treatment, reflecting a lack of evidence from clinical trials.To investigate whether treating pneumothoraces diagnosed on chest radiography (CR) in newborns receiving respiratory support with NA results (...) in fewer infants having CDs inserted within 6 hours of diagnosis.This randomized clinical trial was conducted from October 7, 2013, to December 21, 2016. The setting was 5 tertiary European neonatal intensive care units. Infants receiving respiratory support (endotracheal ventilation, continuous positive airway pressure, or supplemental oxygen >40%) who had a pneumothorax on CR that clinicians deemed needed treatment were eligible for inclusion.Infants were randomly assigned (1:1) to drainage using NA

2018 EvidenceUpdates

18. Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016. (PubMed)

Trends in the Incidence and Recurrence of Inpatient-Treated Spontaneous Pneumothorax, 1968-2016. Spontaneous pneumothorax is a common disease known to have an unusual epidemiological profile, but there are limited contemporary population-based data.To estimate the incidence of hospital admissions for spontaneous pneumothorax, its recurrence and trends over time using large, longstanding hospitalization data sets in England.A population-based epidemiological study was conducted using an English (...) national data set and an English regional data set, each spanning 1968 to 2016, and including 170 929 hospital admission records of patients 15 years and older. Final date of the study period was December 31, 2016.Calendar year (for incidence) and readmission to hospital for spontaneous pneumothorax (for recurrence).Primary outcomes were rates of hospital admissions for spontaneous pneumothorax and recurrence, defined as a subsequent hospital readmission with spontaneous pneumothorax. Record-linkage

2018 JAMA

19. Lung Ultrasound for the Detection of Pneumothorax Might Be Misleading in Patients Following Lung Transplantation (PubMed)

Lung Ultrasound for the Detection of Pneumothorax Might Be Misleading in Patients Following Lung Transplantation 28875180 2018 11 13 2509-596X 3 3 2017 Jun Ultrasound international open Ultrasound Int Open Lung Ultrasound for the Detection of Pneumothorax Might Be Misleading in Patients Following Lung Transplantation. E128-E129 10.1055/s-0043-108992 Schroeder Ines I Department of Anesthesiology, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany. Weig Thomas T Department (...) of Anesthesiology, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany. Frey Lorenz L Department of Anesthesiology, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany. Scheiermann Patrick P Department of Anesthesiology, University Hospital Ludwig-Maximilians-University Munich, Munich, Germany. eng Journal Article 2017 09 01 Germany Ultrasound Int Open 101674542 2199-7152 lung transplantation pneumothorax ultrasound 2017 02 07 2017 02 07 2017 04 02 2017 9 7 6 0 2017 9

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2017 Ultrasound international open

20. Consideration of underlying causes of pneumothoraces in patients presenting with their first pneumothorax (PubMed)

Consideration of underlying causes of pneumothoraces in patients presenting with their first pneumothorax We report a case of cardiac arrest secondary to pneumothorax. The patient failed to improve, and further investigation showed an underlying condition predisposing the patient to the development of pneumothoraces - lymphangioleiomyomatosis. This highlights the importance of follow-up and investigation in patients presenting with their first pneumothorax.

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2017 Journal of the Intensive Care Society

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