Clinical Evaluation of A Percutaneous Pneumothorax Catheter

Peters, Jay I.; Kubitschek, Kenneth R.

doi:10.1378/chest.86.5.714

Cited by 36 publications

(15 citation statements)

References 8 publications

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“…The higher complication rate was mainly the result of more frequent malfunction, especially obstruction, of the smaller‐bore PC. Similar problems − such as pleural fluid occlusion, 11 occluded three‐way stopcocks and dislodged catheters 15,16 − have been well documented previously with small‐bore catheters. In addition, air leaks exceeding the capacity of the catheter have been previously noted, 11,15 although this was not a frequent problem in the present study.…”

Section: Discussionsupporting

confidence: 60%

Comparison of large‐ and small‐bore intercostal catheters in the management of spontaneous pneumothorax

Vedam

Barnes

2003

Internal Medicine Journal

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Background: The prevalence of obstructive sleep apnoea (OSA) of individuals with Class III obesity (BMI ≥ 40) is usually over 70%. 1,2 ACT Health Obesity Management Service (OMS) commenced in 2014, but there were no referrals for polysomnography (PSG) for over 12 months. The investigation for sleep disordered breathing was initiated after a sleep physician joined the OMS in June 2015. The aims of this study are to describe the characteristics of a Class III obesity cohort who had sleep studies requested by ACT Health OMS physicians, to improve the positive predictive value and to assess referral rates of sleep studies after 12 months. Method: Retrospective chart review and descriptive analysis of the patients who attended ACT Health OMS and had diagnostic PSG in the 12 months between September 2015 and August 2016. Results: Four hundred and one patients were seen by physicians in OMS during this period and 46 patients (11.5%) had diagnostic PSG performed as they were considered to be at high risk of OSA by OMS physicians. 87% of patients referred for PSG by OMS physicians had OSA. There was also a high prevalence of multiple co-morbidities particularly anxiety/ depression, hypertension and arthritis similar to previous study. Five (10.9%) patients were previously diagnosed with OSA but not treated. 60.9% of these patients had Patient Health Questionnaire (PHQ-9) scored consistent with moderate or severe depression. The rate of smoking and alcohol consumption of OMS PSG patients was significantly lower than average Australian population of same age group. 39% of patients had subjective daytime sleepiness as measured by the Epworth Sleepiness Scale and this was not related to severity of OSA. OMS physicians did not record sleep-related symptoms in a large proportion of patients. Presence of sleep-related symptoms such as snoring, witnessed apnoea, frequency of wake and unrefreshed sleep were correlated with OSA diagnosis. Sleep latency of more than 1 h and daytime naps were not statistically related to OSA. Conclusions: This study showed that OMS physicians often did not record sleep-related symptoms and refer only a small proportion of the patient cohort for PSG. The prevalence of OSA is high in patients with Class III obesity and routine screening for sleep-related symptoms and referral for PSG where appropriate is recommended. Routine application of OSA symptom questionnaire such as OSA-50 or STOP-Bang may also be of value in this clinical setting. References 1. O'Keeffe T, Patterson EJ. Evidence supporting routine polysomnography before bariatric surgery. Obes Surg2004 Jan; 14: 23-26. 2. Lopez PP et al. Prevalence of sleep apnea in morbidly obese patients who presented for weight loss surgery evaluation: more evidence for routine screening for obstructive sleep apnea before weight loss surgery. Background: Pleural diseases are one of the most common clinical problems encountered worldwide. Large-bore (LB) intercostal tube (ICT; e.g. >20 F) drainage has been the standard of care in the management of pleural dis...

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Section: Discussionsupporting

confidence: 60%

Comparison of large‐ and small‐bore intercostal catheters in the management of spontaneous pneumothorax

Vedam

Barnes

2003

Internal Medicine Journal

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“…Chest drain obstruction occurred in 9% of patients. This has previously been described as a complication of small‐bore catheters, 14,15 but the risk can be reduced by regular flushing.…”

Section: Discussionmentioning

confidence: 99%

A study of the complications of small bore ‘Seldinger’ intercostal chest drains

2008

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“…Early studies 1,2,4 used a standard intravenous cannula for MCA. Recent studies 11,19 have employed a CVP type catheter. The major advantage of this type of catheter is that it can be left in situ until final review of the patient prior to discharge.…”

Section: Discussionmentioning

confidence: 99%

Microcatheter aspiration of spontaneous pneumothoraces in an emergency department

Cruse

Jelinek

1993

Emergency Medicine

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Objective: To assess the efficacy of microcatheter aspiration (MCA) of spontaneous pneumothoraces in the Emergency Department of Fremantle Hospital. Methods: From 1986–1993, patients less than 45 years old with a first spontaneous pneumothorax on chest X‐ray of greater than 20% were treated with MCA. Those with underlying lung disease or tension were excluded. MCA was performed with a 16G central venous pressure catheter. Patients were reassessed radiologically at six and 24 hours. The procedure was considered successful if there was less than 15% residual pneumothorax after aspiration and at 24 hours. Results: Of thirty patients studied, 22 (73%) had successful aspiration and were discharged the following day. Conclusions: Literature review and results of this study suggest that MCA is appropriate initial treatment for first or subsequent spontaneous or iatrogenic pneumothoraces of 20% lung volume or more, in the absence of coexisting lung disease or tension. Most patients can be successfully treated in the Emergency Department and will not require admission. This should result in less morbidity and time in hospital.

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Clinical Evaluation of A Percutaneous Pneumothorax Catheter

Cited by 36 publications

References 8 publications

Comparison of large‐ and small‐bore intercostal catheters in the management of spontaneous pneumothorax

Comparison of large‐ and small‐bore intercostal catheters in the management of spontaneous pneumothorax

A study of the complications of small bore ‘Seldinger’ intercostal chest drains

Microcatheter aspiration of spontaneous pneumothoraces in an emergency department

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