Ultrasound-guided Pleural Effusion Drainage With a Small Catheter Using the Single-step Trocar or Modified Seldinger Technique

Abusedera, Mohammad A.; Alkady, Ola

doi:10.1097/lbr.0000000000000276

Cited by 11 publications

(6 citation statements)

References 26 publications

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“…Traditional opinions think that a large-diameter drainage tube (>24 F) is beneficial to pleural effusion drainage, while a small-diameter drainage tube (10-14 F) can also receive a similar effect (30,46,47), and can be easily accepted by these patients. Ultrasound-guided drainage tube placement technology is very practical for patients with serious diseases, empyema, encapsulated effusion and pleural thickening (8). To date, there have been no related highquality clinical studies on the most applicable drainage tube for chest drainage.…”

Section: Thoracocentesis and Chest Drainage Tube Placementmentioning

confidence: 99%

“…(III) How do we select antibiotics at the primary treatment stage? (IV) If antibiotic treatment becomes invalid, what would be our basis for selecting other treatment methods such as chest drainage (8), intrapleural cavity injection (9), medical thoracoscopy (10) and surgical operation (11), and how do we evaluate the prognosis of these patients (12)?…”

Section: Introductionmentioning

confidence: 99%

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Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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Pleural cavity infection continuously seriously threatens human health with continuous medical progress. From the perspective of pathophysiology, it can be divided into three stages: exudative stage, fibrin exudation and pus formation stage, and organization stage. Due to the pathogenic bacteria difference of pleural cavity infection and pulmonary infection, it is very important for disease treatment to analyze the bacteria and biochemical characteristics of the infectious pleural effusion. Most prognoses of patients have been relatively good, while for some patients, the complicated parapneumonic effusion or empyema could be evolved. Antibiotic treatment and sufficient drainage are the foundation for this treatment. No evidence can support the routine use of a fibrin agent. However, it has been reported that the plasminogen activator and deoxyribonuclease can be recommended to be applied in the pleural cavity. In case of failure on conservative medical treatment, operative treatment can be applied such as thoracoscopy and pleural decortication.According to the clinical characteristics of these patients, it is a key to research prognosis, as well as early evaluation and stratification, in the future.

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Section: Thoracocentesis and Chest Drainage Tube Placementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Infectious pleural effusion status and treatment progress

Yang

Zhang

2017

J. Thorac. Dis.

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“…In Denmark, the trocar technique is the predominant method [12]. A recent study suggests that the trocar method is both easier and faster compared to the Seldinger technique [11]. Training in a simulated setting could ensure that novice doctors obtain the skills to perform safe and quick insertions of pigtail catheters.…”

Section: Introductionmentioning

confidence: 99%

“…The invasive procedure is associated with more complications if the doctor is inexperienced or inadequately trained [6, 7]. To perform a successful procedure, the doctor requires knowledge of chest wall anatomy [8], aseptic techniques, pleural ultrasound [9-11], and basic surgical skills, as well as experience with the pigtail catheter system and an understanding of the therapeutic and diagnostic qualities of the procedure. TPCT can be performed in two different ways: using the Seldinger technique or the trocar method (in some studies referred to as the direct method).…”

Section: Introductionmentioning

confidence: 99%

Ensuring Basic Competence in Thoracentesis

et al. 2019

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Background: Trocar pigtail catheter thoracentesis (TPCT) is a common procedure often performed by junior physicians. Simulation-based training may effectively train physicians in the procedure prior to performing it on patients. An assessment tool with solid validity evidence is necessary to ensure sufficient procedural competence. Objectives: Our study objectives were (1) to collect evidence of validity for a newly developed pigtail catheter assessment tool (Thoracentesis Assessment Tool [ThorAT]) developed for the evaluation of TPCT performance and (2) to establish a pass/fail score for summative assessment. Methods: We assessed the validity evidence for the ThorAT using the recommended framework for validity by Messick. Thirty-four participants completed two consecutive procedures and their performance was assessed by two blinded, independent raters using the ThorAT. We compared performance scores to test whether the assessment tool was able to discern between the two groups, and a pass/fail score was established. Results: The assessment tool was able to discriminate between the two groups in terms of competence level. Experienced physicians received significantly higher test scores than novices in both the first and second procedure. A pass/fail score of 25.2 points was established, resulting in 4 (17%) passing novices and 1 (9%) failing experienced participant in the first procedure. In the second procedure 9 (39%) novices passed and 2 (18%) experienced participants failed. Conclusions: This study provides a tool for summative assessment of competence in TPCT. Strong validity evidence was gathered from five sources of evidence. A simulation-based training program using the ThorAT could ensure competence before performing thoracentesis on patients.

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“…Ultrasound guided catheter insertion and drainage is considered safe and effective procedure in pleural effusion, however the success rate is low when the effusion is loculated and septate. 11,12 Video assisted thoracic surgery (VATS) in loculated effusions is undoubtedly a better option, however it is both inaccessible and expensive option for vast majority of the population in resource limited facilities/communities. Open surgical modalities are more invasive and may be inaccessible or unaffordable by patients in developing countries.…”

mentioning

confidence: 99%