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Georg Siebenburger - One of the best experts on this subject based on the ideXlab platform.
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one year follow up case report of secondary Tension Pneumothorax in a covid 19 pneumonia patient
Infection, 2021Co-Authors: Felix Endres, Judith E Spiro, Ben Ockert, Wolfgang Bocker, Toki Anna Bolt, Amanda Tufman, Tobias Helfen, Fabian Gilbert, Boris Michael Holzapfel, Georg SiebenburgerAbstract:Purpose The Coronavirus Disease 2019 (COVID-19) may result not only in acute symptoms such as severe pneumonia, but also in persisting symptoms after months. Here we present a 1 year follow-up of a patient with a secondary Tension Pneumothorax due to COVID-19 pneumonia. Case presentation In May 2020, a 47-year-old male was admitted to the emergency department with fever, dry cough, and sore throat as well as acute chest pain and shortness of breath. Sputum testing (polymerase chain reaction, PCR) and computed tomography (CT) confirmed infection with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Eleven days after discharge, the patient returned to the emergency department with pronounced dyspnoea after coughing. CT showed a right-sided Tension Pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. For a period of 3 months following resolution of the Pneumothorax the patient complained of fatigue with mild joint pain and dyspnoea. After 1 year, the patient did not suffer from any persisting symptoms. The pulmonary function and blood parameters were normal, with the exception of slightly increased levels of D-Dimer. The CT scan revealed only discrete ground glass opacities (GGO) and subpleural linear opacities. Conclusion Tension Pneumothorax is a rare, severe complication of a SARS-CoV-2 infection but may resolve after treatment without negative long-term sequelae. Level of evidence V.
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secondary Tension Pneumothorax in a covid 19 pneumonia patient a case report
Infection, 2020Co-Authors: Judith E Spiro, Snezana Sisovic, Ben Ockert, Wolfgang Bocker, Georg SiebenburgerAbstract:Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed Pneumothorax in rare cases, but Tension Pneumothorax has only been reported once. A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided Tension Pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the Pneumothorax and the patient was discharged after 9 days of treatment. Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute Tension Pneumothorax. V
Johnathon M Aho - One of the best experts on this subject based on the ideXlab platform.
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Tension Pneumothorax decompression with colorimetric capnography pilot case series
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2021Co-Authors: Juna Musa, Matthew C Hernandez, Martin D Zielinski, Arjunmohan Mohan, Michael D Traynor, Cillian Mahony, Michael Ferrara, Joseph Immerman, Johnathon M AhoAbstract:Tension Pneumothorax is a life-threatening condition that can develop when either the visceral pleura is disrupted, or with injury to the tracheobronchial tree. Rapid, accurate diagnosis and appropriate management are required to prevent significant atelectasis, hypoxia, circulatory arrest, and ultimate patient demise. Needle decompression is the current standard of care for the management of Tension Pneumothorax. Healthcare providers struggle to assess the success of decompression due to a lack of any immediate objective feedback. The gaseous composition of Tension Pneumothorax is similar to that of end respiratory gas. This includes an increased partial pressure of carbon dioxide in comparison to atmospheric air, which makes colorimetric capnography an ideal confirmatory test. This colorimetric capnography device may help the healthcare providers to make an objective and accurate assessment of the success of the needle decompression, in particular in prehospital environments.
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decompression of Tension Pneumothorax in a trauma patient first use of a novel decompression colorimetric capnography device in human patient
The Japanese Journal of Thoracic and Cardiovascular Surgery, 2021Co-Authors: John Zietlow, Matthew C Hernandez, Andrew Bestland, Juna Musa, Michael J Ferrara, Kathleen S Berns, Jeff R Anderson, Martin D Zielinski, Johnathon M AhoAbstract:Tension Pneumothorax is a common cause of mortality in trauma. Tension Pneumothorax is the confinement of respired gases within the pleural cavity at increasing pressure resulting in hemodynamic collapse. Decompression is crucial in management. Emergency needle thoracostomy is a life-saving maneuver that allows atmospheric pressure equilibration and partial restoration of cardiac filling. Needle decompressions are usually performed under noisy, tense, and stressful circumstances, and objective assessment of success is difficult in the field. A device which is simple that objectively informs operators of successful decompression would be clinically useful. In previous work, we have demonstrated end-expiratory gas and gaseous composition of Tension Pneumothorax are similar due to increased carbon dioxide partial pressure relative to atmospheric gas composition. Therefore, a simple solution to objective needle decompression may be colorimetric capnography.We report a case of 58-year-old male treated by EMS following a motorcycle accident with left-sided chest pain, hypoxia, hypoTension, and clinical findings of Tension Pneumothorax. Needle decompression with colorimetric capnography using the device indicated decompression of his Tension Pneumothorax, with appropriate temporizing success.
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needle decompression of Tension Pneumothorax with colorimetric capnography
Chest, 2017Co-Authors: Nimesh D Naik, Matthew C Hernandez, Jeff R Anderson, Martin D Zielinski, Erika K Ross, Johnathon M AhoAbstract:Background The success of needle decompression for Tension Pneumothorax is variable, and there are no objective measures assessing effective decompression. Colorimetric capnography, which detects carbon dioxide present within the pleural space, may serve as a simple test to assess effective needle decompression. Methods Three swine underwent traumatically induced Tension Pneumothorax (standard of care, n = 15; standard of care with needle capnography, n = 15). Needle thoracostomy was performed with an 8-cm angiocatheter. Similarly, decompression was performed with the addition of colorimetric capnography. Subjective operator assessment of decompression was recorded and compared with true decompression, using thoracoscopic visualization for both techniques. Areas under receiver operating curves were calculated and pairwise comparison was performed to assess statistical significance ( P Results The detection of decompression by needle colorimetric capnography was found to be 100% accurate (15 of 15 attempts), when compared with thoracoscopic assessment (true decompression). Furthermore, it accurately detected the lack of Tension Pneumothorax, that is, the absence of any pathologic/space-occupying lesion, in 100% of cases (10 of 10 attempts). Standard of care needle decompression was detected by operators in 9 of 15 attempts (60%) and was detected in 3 of 10 attempts when Tension Pneumothorax was not present (30%). True decompression, under direct visualization with thoracoscopy, occurred 15 of 15 times (100%) with capnography, and 12 of 15 times (80%) without capnography. Areas under receiver operating curves were 0.65 for standard of care and 1.0 for needle capnography ( P = .002). Conclusions Needle decompression with colorimetric capnography provides a rapid, effective, and highly accurate method for eliminating operator bias for Tension Pneumothorax decompression. This may be useful for the treatment of this life-threatening condition.
Matthew J. Martin - One of the best experts on this subject based on the ideXlab platform.
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evaluation of a novel thoracic entry device versus needle decompression in a Tension Pneumothorax swine model
American Journal of Surgery, 2018Co-Authors: John Kuckelman, Matthew J. Martin, Mike Derickson, Cody J Phillips, Morgan R Barron, Shannon T Marko, Matthew J EckertAbstract:Abstract Introduction Tension Pneumothorax (tPTX) remains a major cause of preventable death in trauma. Needle decompression (ND) has up to a 60% failure rate. Methods Post-mortem swine used. Interventions were randomized to 14G-needle decompression (ND, n = 25), bladed trocar with 36Fr cannula (BTW, n = 16), bladed trocar alone (BTWO, n = 16) and surgical thoracostomy (ST = 11). Simulated tPTX was created to a pressure(p) of 20 mmHg. Results Success (p Conclusion Bladed trocars can safely and effectively tPTX with a significantly higher success rates than needle decompression.
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physiology and cardiovascular effect of severe Tension Pneumothorax in a porcine model
Journal of Surgical Research, 2013Co-Authors: Daniel W Nelson, Christopher R Porta, Steven Satterly, Kelly Blair, Eric K Johnson, Kenji Inaba, Matthew J. MartinAbstract:Abstract Background Pneumothoraces are relatively common among trauma patients and can rapidly progress to Tension physiology and death if not identified and treated. We sought to develop a reliable and reproducible large animal model of Tension Pneumothorax and to examine the cardiovascular effects during progression from simple Pneumothorax to Tension Pneumothorax. Materials and methods Ten swine were intubated, sedated, and placed on mechanical ventilation. After a midline celiotomy, a 10-mm balloon-tipped laparoscopic trocar was placed through the diaphragm, and a 28F chest tube was placed in the standard position and clamped. Thoracic insufflation was performed in 5-mm increments, and continuous cardiovascular measurements were obtained. Results Mean insufflation pressures of 10 mm Hg were associated with a 67% decrease in cardiac output (6.6 L/min versus 2.2 l/min; P = 0.04). An additional increase in the insufflation pressure (mean 15 mm Hg) was associated with an 82% decrease in cardiac output from baseline (6.8 versus 1.2 L/min; P P P = 0.06), with the central venous pressure and pulmonary artery diastolic pressure approaching equalization immediately before the development of major hemodynamic decline. Pulseless electrical activity arrest was induced at an average of 20 mm Hg. Tension physiology was immediately reversible with adequate decompression, allowing for multiple repeated trials. Conclusions A reliable and highly reproducible model was created for severe Tension Pneumothorax in a large animal. Major cardiovascular instability proceeding to pulseless electrical activity arrest with stepwise insufflation was noted. This model could be highly useful for studying new diagnostic and treatment modalities for Tension Pneumothorax.
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Modified Veress needle decompression of Tension Pneumothorax: a randomized crossover animal study.
The journal of trauma and acute care surgery, 2013Co-Authors: Dafney Lubin, Andrew Tang, Randall S. Friese, Matthew J. Martin, Daniel J. Green, Trevor Jones, Russell R. Means, Rashna Ginwalla, Terence O'keeffe, Bellal JosephAbstract:BACKGROUNDThe current prehospital standard of care using a large bore intravenous catheter for Tension Pneumothorax (tPTX) decompression is associated with a high failure rate. We developed a modified Veress needle (mVN) for this condition. The purpose of this study was to evaluate the effectiveness
Judith E Spiro - One of the best experts on this subject based on the ideXlab platform.
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one year follow up case report of secondary Tension Pneumothorax in a covid 19 pneumonia patient
Infection, 2021Co-Authors: Felix Endres, Judith E Spiro, Ben Ockert, Wolfgang Bocker, Toki Anna Bolt, Amanda Tufman, Tobias Helfen, Fabian Gilbert, Boris Michael Holzapfel, Georg SiebenburgerAbstract:Purpose The Coronavirus Disease 2019 (COVID-19) may result not only in acute symptoms such as severe pneumonia, but also in persisting symptoms after months. Here we present a 1 year follow-up of a patient with a secondary Tension Pneumothorax due to COVID-19 pneumonia. Case presentation In May 2020, a 47-year-old male was admitted to the emergency department with fever, dry cough, and sore throat as well as acute chest pain and shortness of breath. Sputum testing (polymerase chain reaction, PCR) and computed tomography (CT) confirmed infection with the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). Eleven days after discharge, the patient returned to the emergency department with pronounced dyspnoea after coughing. CT showed a right-sided Tension Pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. For a period of 3 months following resolution of the Pneumothorax the patient complained of fatigue with mild joint pain and dyspnoea. After 1 year, the patient did not suffer from any persisting symptoms. The pulmonary function and blood parameters were normal, with the exception of slightly increased levels of D-Dimer. The CT scan revealed only discrete ground glass opacities (GGO) and subpleural linear opacities. Conclusion Tension Pneumothorax is a rare, severe complication of a SARS-CoV-2 infection but may resolve after treatment without negative long-term sequelae. Level of evidence V.
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secondary Tension Pneumothorax in a covid 19 pneumonia patient a case report
Infection, 2020Co-Authors: Judith E Spiro, Snezana Sisovic, Ben Ockert, Wolfgang Bocker, Georg SiebenburgerAbstract:Especially in elderly and multimorbid patients, Coronavirus Disease 2019 (COVID-19) may result in severe pneumonia and secondary complications. Recent studies showed Pneumothorax in rare cases, but Tension Pneumothorax has only been reported once. A 47-year-old male was admitted to the emergency department with fever, dry cough and sore throat for the last 14 days as well as acute stenocardia and shortage of breath. Sputum testing (polymerase chain reaction, PCR) confirmed SARS-CoV-2 infection. Initial computed tomography (CT) showed bipulmonary groundglass opacities and consolidations with peripheral distribution. Hospitalization with supportive therapy (azithromycin) as well as non-invasive oxygenation led to a stabilization of the patient. After 5 days, sputum testing was negative and IgA/IgG antibody titres were positive for SARS-CoV-2. The patient was discharged after 7 days. On the 11th day, the patient realized pronounced dyspnoea after coughing and presented to the emergency department again. CT showed a right-sided Tension Pneumothorax, which was relieved by a chest drain (Buelau) via mini open thoracotomy. Negative pressure therapy resulted in regression of the Pneumothorax and the patient was discharged after 9 days of treatment. Treating physicians should be aware that COVID-19 patients might develop severe secondary pulmonary complications such as acute Tension Pneumothorax. V
Yong Soo Yuk - One of the best experts on this subject based on the ideXlab platform.
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life threatening simultaneous bilateral spontaneous Tension Pneumothorax a case report
The Korean Journal of Thoracic and Cardiovascular Surgery, 2011Co-Authors: Taegeun Rim, Joo Suck Bae, Yong Soo YukAbstract:Spontaneous Pneumothorax is a common clinical problem in emergency care. However, the overall incidences of primary spontaneous Pneumothorax has been reported from as low as 1.4% to 7.6%. The clinical findings of simultaneous bilateral spontaneous Pneumothorax can be variable. Clinical presentation is variable, ranging from mild dyspnea to Tension Pneumothorax. Bilateral Tension Pneumothorax can defined as cases where no tracheal deviation is detected in chest X-ray, and symptoms may be equal bilaterally. Herein, we present a case with simultaneous bilateral Tension Pneumothorax, severely deteriorated (i.e. with loss of consciousness, cyanosis, and hemodynamically unstable), that was successfully treated with immediate large-size needle decompression.
