Determination of the appropriate catheter length and place for needle thoracostomy by using computed tomography scans of pneumothorax patients

Akoglu, Haldun | Akoglu, Ebru Unal | Evman, Serdar | Akoglu, Tayfun | Denizbasi Altinok, Arzu | Guneysel, Ozlem | Onur, Ozge Ecmel

Article | 2013 | INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED44 ( 9 ) , pp.1177 - 1182

Introduction: The primary goal of this study was to compare the chest wall thicknesses (CWT) at the 2nd intercostal space (ICS) at the mid-clavicular line (MCL) and 5th ICS at the mid-axillary line (MAL) in a population of patients with a CT confirmed pneumothorax (PTX). This result will help physicians to determine the optimum needle thoracostomy (NT) puncture site in patients with a PTX. Materials and methods: All trauma patients who presented consecutively to A&E over a 12-month period were included. Among all the trauma patients with a chest CT (4204 patients), 160 were included in the final analysis. CWTs were measured at both . . .sides and were compared in all subgroup of patients. Results: The average CWT for men on the 2nd ICS-MCL was 38 mm and for women was 52 mm; on the other hand, on the 5th ICS-MAL was 33 mm for men and 38 mm for women. On the 2nd ICS-MCL 17% of men and 48% of women; on the 5th ICS-MAL 13% of men and 33% of women would be inaccessible with a routine 5-cm catheter. Patients with trauma, subcutaneous emphysema and multiple rib fractures would have thicker CWT on the 2nd ICS-MCL. Patients with trauma, lung contusion, sternum fracture, subcutaneous emphysema and multiple rib fractures would have thicker CWT on the 5th ICS-MAL. Conclusions: This study confirms that a 5.0-cm catheter would be unlikely to access the pleural space in at least 1/3 of female and 1/10 of male Turkish trauma patients, regardless of the puncture site. If NT is needed, the 5th ICS-MAL is a better option for a puncture site with thinner CWT. (C) 2012 Elsevier Ltd. All rights reserved Daha fazlası Daha az

A prospective study: Is handheld micropower impulse radar technology (Pneumoscan) a promising method to detect pneumothorax? [İleriye yönelik bir çalışma: Taşınabilir micropower impulse radar teknolojisi (pneumoscan) pnömotoraks tanısında umut veren bir metot mudur?]

Hocagil H. | Hocagil A.C. | Karacabey S. | Akkaya T. | Şimşek G. | Sanrı E.

Article | 2015 | Ulusal Travma ve Acil Cerrahi Dergisi21 ( 5 ) , pp.344 - 351

BACKGROUND: This study aimed to discuss the effectiveness of Pneumoscan working with micropower impulse radar (MIR) technology in diagnosing pneumothorax (PTX) in the emergency department. METHODS: Patients with suspicion of PTX and indication for thorax tomography (CT) were included into the study. Findings of the Thorax CT were compared with the results of Pneumoscan. Chi-square and Fisher’s exact tests were used in categorical variables. RESULTS: One hundred and fifteen patients were included into the study group; twelve patients presented with PTX diagnosed by CT, 10 of which were detected by Pneumoscan. Thirty-six true negative . . . results, sixty-seven false positive results, and two false negative results were obtained, which resulted in an overall sensitivity of 83.3%, specificity of 35.0% for Pneumoscan. There was no statistically significant difference between the effectiveness of Pneumoscan and CT on the detection of PTX (p=0.33). There was no difference between the size of PTX diagnosed by CT and PTX diagnosed by Pneumoscan (p=0.47). There was no statistically significant difference between Pneumoscan and CT on detecting the localisation of the PTX (p=1.00). For the 10 cases diagnosed by Pneumoscan, mean chest wall thickness was determined as 50.3 mm while mean chest wall thickness for two false negatives diagnosed by Pneumoscan was 56.5 mm. However, no statistically significant difference was found between the chest wall thickness and the effectiveness of Pneumoscan on the detection of the PTX (p=0.77). Among sixty-seven false positives diagnosed by Pneumoscan, 46.3% had additional medical signs such as bronchiectasis, pulmonary consolidation, pulmonary edema or pulmonary tumor when they had a reading with CT. The relationship between having additional medical signs at the reading with CT and the effectiveness of Pneumoscan on the detection of the PTX was investigated and no significant difference was found (p=0.472). CONCLUSION: Using Pneumoscan to detect PTX is controversial since the device has a high false positive ratio. Wherein, false positive diagnosis can cause unjustifiable chest tube insertion. In addition, the device failed to show the size of the PTX, and therefore, it did not aid in determining the treatment and prognosis on contrary to traditional diagnostic methods. The findings could not demonstrate that the device was efficient in emergency care. Further studies and increasing experience may change this outcome in upcoming years. © 2015 TJTES Daha fazlası Daha az

The results of computed tomography guided tru-cut transthoracic biopsy: Complications and related risk factors

Beşir F.H. | Altın R. | Kart L. | Akkoyunlu M. | Özdemir H. | Örnek T. | Gündoğdu S.

Article | 2011 | Wiener Klinische Wochenschrift123 ( 03.Apr ) , pp.79 - 82

Summary: INTRODUCTION: Transthoracic biopsy (TTB) is a well-defined and effective method used for pathologic sampling in the diagnosis of the pulmonary lesions. It is less invasive in comparison to surgical procedures. In addition, diagnostic rate of tru-cut biopsy is higher than that of fine needle aspiration biopsy (FNAB) especially for benign lesions. In this study, we presented tru-cut transthoracic biopsy (TTB) procedure results and the frequency of TTB complications with related risk factors. MATERIAL AND METHODS: A total of 102 patients were evaluated by CT scan guided tru-cut TTB in the diagnosis of lung lesions between Janu . . .ary 2003 and December 2007. The complications due to tru-cut TTB were recorded. The factors such as the lesion depth, the lesion size, and the emphysematous changes that accompany the lesion were evaluated through ? 2 test. RESULTS: Among the samples, 51% malignancy and 49% benign pathology were observed. Pneumothorax developed in 15.7% of the 102 procedures. It was found that the lesions distance from the pleura, the size of the lesion, and emphysematous changes around the lesion significantly increased the risk of pneumothorax. DISCUSSION: The tru-cut biopsy complications are similar to those of FNAB. In the centers where cytologic examination is insufficient in the diagnosis of lung lesions, tru-cut biopsy should be routinely performed as it is a reliable biopsy technique compared to FNAB. © 2011 Springer-Verlag Daha fazlası Daha az

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