Spontaneously breathing patients get tension pneumothoraces

Leigh-Smith, Simon; Harris, Tim; Roberts, Derek J.

doi:10.1136/thoraxjnl-2011-201307

Cited by 3 publications

(4 citation statements)

References 6 publications

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“…To reduce the risk of this bias, two investigators (DR, CB) will independently determine whether the clinical condition of the study patient(s) presented in each case report aligned with a previously published tension pneumothorax working definition [7,47]. According to this definition, a tension pneumothorax is defined not only by the type of its presenting clinical manifestations, but also according to its response to treatment as one ‘that results in significant respiratory or hemodynamic compromise that reverses [or at least significantly improves] on thoracic decompression alone’ [7,47]. …”

Section: Methodsmentioning

confidence: 99%

“…In the presence of greater than a low degree of between-study heterogeneity, we will conduct subgroup analyses and univariate meta-regression ( P value <0.10 considered significant given the low power of these tests) in order to explore the influence of sources of clinical and methodological study variation on the meta-analysis results. A priori study covariates of interest will include: 1) observational study design (that is, cohort versus case–control or cross-sectional), 2) use of antihypertensive medications or the presence of pulmonary disease among ≥50% of patients who were breathing unassisted, 3) percentage of patients receiving positive pressure ventilation (≥50% versus <50%), and 4) whether the presence of disease was determined using credible criteria that were at least partially independent of the clinical manifestations under study [7,46,47]. …”

Section: Methodsmentioning

confidence: 99%

“…First, we will assess whether our observed associations are sensitive to incorporation bias or the classification of tension pneumothorax. After conducting analyses using the data extracted from all reported cases, this will be done by recalculating all outcomes using only those cases where two investigators independently agreed that the clinical condition of the study patient(s) aligned with the tension pneumothorax working definition described above [7,47]. Outcomes will also be recalculated using only those case reports and series where study authors gave absolute numbers rather than narrative or subjective descriptions when reporting the presence or absence of hypotension.…”

Section: Methodsmentioning

confidence: 99%

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Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

et al. 2014

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BackgroundAlthough health care providers utilize classically described signs and symptoms to diagnose tension pneumothorax, available literature sources differ in their descriptions of its clinical manifestations. Moreover, while the clinical manifestations of tension pneumothorax have been suggested to differ among subjects of varying respiratory status, it remains unknown if these differences are supported by clinical evidence. Thus, the primary objective of this study is to systematically describe and contrast the clinical manifestations of tension pneumothorax among patients receiving positive pressure ventilation versus those who are breathing unassisted.Methods/DesignWe will search electronic bibliographic databases (MEDLINE, PubMed, EMBASE, and the Cochrane Database of Systematic Reviews) and clinical trial registries from their first available date as well as personal files, identified review articles, and included article bibliographies. Two investigators will independently screen identified article titles and abstracts and select observational (cohort, case–control, and cross-sectional) studies and case reports and series that report original data on clinical manifestations of tension pneumothorax. These investigators will also independently assess risk of bias and extract data. Identified data on the clinical manifestations of tension pneumothorax will be stratified according to whether adult or pediatric study patients were receiving positive pressure ventilation or were breathing unassisted, as well as whether the two investigators independently agreed that the clinical condition of the study patient(s) aligned with a previously published tension pneumothorax working definition. These data will then be summarized using a formal narrative synthesis alongside a meta-analysis of observational studies and then case reports and series where possible. Pooled or combined estimates of the occurrence rate of clinical manifestations will be calculated using random effects models (for observational studies) and generalized estimating equations adjusted for reported potential confounding factors (for case reports and series).DiscussionThis study will compile the world literature on tension pneumothorax and provide the first systematic description of the clinical manifestations of the disorder according to presenting patient respiratory status. It will also demonstrate a series of methods that may be used to address difficulties likely to be encountered during the conduct of a meta-analysis of data contained in published case reports and series. PROSPERO registration number: CRD42013005826.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

et al. 2014

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“…I could not resist your challenge in your Editorial, ‘Pre-drainage tension’, triggered by letters from Drs Simpson and Leigh Smith1 2 to make a ridiculous acronym 3…”

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confidence: 99%

Acronyms, pneumothoraces and the impact of international health on the NHS

Furness

2012

Thorax

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time, we have an up-to-date picture of how CAP is currently managed in the UK, where this differs from guideline recommendations and where attention should be paid to lead to improvements in practice. We believe that the BTS guidelines are a reasonable translation of the available scientific evidence with regard to this topic, but we also acknowledge that they are not perfect and may not be appropriate for all settings. Inevitably, they are weakest where there is least evidence and choice of antibiotics is one such area. We would like to see the guidelines improve, but this can only occur with better evidence. This requires future funding for clinical research in this important, but research-neglected area.

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Clinical suspicion regarding needle decompression for patients with chest trauma

Beaven

Harrison

Porter

et al. 2019

Journal of Paramedic Practice

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Background: Needle decompression of the chest is indicated for patients in a critical condition with rapid deterioration who have a life-threatening tension pneumothorax. Aim: To reassure UK prehospital care providers that needle decompression of the chest is not commonly required in chest trauma patients, and most can be safely managed without it. Methods: Case studies as part of a major trauma network continuous review process have revealed instances of needle decompression in the absence of tension pneumothorax. Images are presented where needle decompression was attempted in the absence of tension pneumothorax. Context: Expert opinion from our network's multidisciplinary trauma team discuss the occurrence of tension pneumothorax in self-ventilating patients, and the idea that tension pneumothorax is rare in the UK civilian trauma population is acknowledged. Other causes of chest hypoventilation are discussed.

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Spontaneously breathing patients get tension pneumothoraces

Cited by 3 publications

References 6 publications

Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

Clinical manifestations of tension pneumothorax: protocol for a systematic review and meta-analysis

Acronyms, pneumothoraces and the impact of international health on the NHS

Clinical suspicion regarding needle decompression for patients with chest trauma

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