Pigtail catheter drainage for secondary spontaneous pneumothorax

Chen, C.-H.; Chen, W.; Hsu, Wu Huei

doi:10.1093/qjmed/hcl067

Cited by 8 publications

(1 citation statement)

References 5 publications

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“…Moreover, US-guided pigtail catheter for secondary spontaneous pneumothorax (SSP) is also effective and has low complication rate. A higher treatment failure rate was noted in infectious related SSP patients [21,22]. In mechanically ventilated patients, US-guided pigtail catheter drainage is also effective in treating iatrogenic pneumothorax [23].…”

Section: Ultrasound-guided Small-bore Chest Tube Insertionmentioning

confidence: 99%

Ultrasound Diagnosis of Chest Diseaseses

Liao¹,

Tu²,

Shih³

et al. 2013

Advancements and Breakthroughs in Ultrasound Imaging

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Section: Ultrasound-guided Small-bore Chest Tube Insertionmentioning

confidence: 99%

Ultrasound Diagnosis of Chest Diseaseses

Liao¹,

Tu²,

Shih³

et al. 2013

Advancements and Breakthroughs in Ultrasound Imaging

View full text Add to dashboard Cite

21st ESICM Annual Congress

2008

Intensive Care Med

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INTRODUCTION. Host infection by pathogens triggers an innate immune response leading to a systemic inflammatory response, often followed by an immune dysfunction which can favour the emergence of secondary infections. Dendritic cells (DCs) have a unique ability to link innate and adaptive immunity and may be centrally involved in the regulation of sepsis-induced immune suppression. We previously reported that polymicrobial sepsis durably affects the functions of DCs and confers long-term susceptibility to P. aeruginosa pneumonia. In this study, we assessed the contribution of DCs to lung defence towards secondary P. aeruginosa pneumonia. METHODS.We used a murine model of sublethal polymicrobial sepsis through cecal ligature and puncture (CLP). In this model, a short course of antibiotics and volume resuscitation allows long-term survival of 70% of mice. Eight days after CLP, we induced a secondary pneumonia through intratracheal instillation of P. aeruginosa (serotype PAO1) in post-septic mice. Bone marrow-derived DCs (BMDCs) were generated through 7-day culture of medullar progenitors in medium supplemented with GM-CSF. Concomitant to bacterial inoculation, we intratracheally administrated exogenous BMDCs into post-septic mice. Bacterial lung clearance was evaluated through quantitative culture of bronchoalveolar lavage (BAL) fluid. The lung response was assessed 4 and 24 hours after instillation through quantification of protein level, inflammatory cells, myeloperoxydase (MPO) activity and cytokine levels in the BAL fluid. RESULTS. After intratracheal instillation of 5x106 CFUs of P. aeruginosa, all sham-operated mice survived while post-septic mice displayed high susceptibility with a 80-percent mortality rate. As compared to sham-operated mice, post-septic mice displayed marked lung damage with early recruitment of neutrophils, cytokine imbalance with decreased IL-12p70 production and increased IL-10 release, but no defective bacterial lung clearance. Co-administration of 10 6 exogenous BMDCs into post-septic mice challenged with P. aeruginosa dramatically improved the survival rate to 70%. Intratracheal instillation of BMDCs did not improve bacterial clearance, but delayed neutrophil recruitment and subsequently reduced the MPO activity in BAL fluid. In addition, BMDCs strongly attenuated the early peak of TNF-alpha and restored a positive Il-12p70/IL-10 balance.CONCLUSION. Adoptive transfer of BMDCs reverses sepsis-induced immune suppression in a relevant model of secondary P. aeruginosa pneumonia. Unexpectedly, the mechanism of action of BMDCs did not involve enhanced antibacterial activity, but occurred by dampening the pulmonary inflammatory response. INTRODUCTION. Sepsis is characterized by the presence of a systemic inflammatory response syndrome (SIRS), which in turn leads to multiple organ failure and death. The lung is one of the primary organs prone to septic-induced injury which results, in part, due to an increase in pulmonary apoptosis. Phosphoinositide-3 kinase gamma (PI3 Kg), an isoform of th...

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