The Experts below are selected from a list of 777 Experts worldwide ranked by ideXlab platform
Said Hachimi-idrissi - One of the best experts on this subject based on the ideXlab platform.
-
824 Physiotherapy Techniques for Pleural Effusions in a Pediatric Intensive Care Unit (PICU): Which Technique is the Most Efficient?
Archives of Disease in Childhood, 2012Co-Authors: S Cooreman, V Van Gorp, N Najafi, Luc Huyghens, Said Hachimi-idrissiAbstract:Aims To compare different chest physiotherapy techniques in pediatric patient with infectious pleural effusion and Thorax drain admitted in PICU. Methods We conducted a monocentric, randomized, assessor-blind trial. The patients were randomized in three groups: those who have received intrapulmonary percussive ventilation (IPV), those who have received autogene Drainage (AD) and were compared to the control group (CG) which no physiotherapy was administered. Only physiotherapists were aware of the allocation group of the patients. Results 24 patients were included (IPV: 7, AD:8, CG: 9). All patients had a infectious pleural effusion and Thorax Drainage. The occurrence of lung-necrosis, empyema, drained pleural fluid per body area, need of fibroscopy and Video assisted thoracoscopy (VATS), total length of stay in PICU and in hospital, days of oxygenothepy needed and the evolution of CRP were compared in the three groups. No differences on the occurrence of empyema, the need of VATS, length of hospital stay in hospital and in PICU stay, the number of oxygenothepy days and the CRP evolution. But there were less occurrence of lung-necrosis, more drained pleural fluid and less need of fibroscopy in the IPV group. Conclusions These preliminary results show that the different chest physiotherapy has not been effective in reducing hospital stay, length of oxygenotherapy in patients with pleural effusion and Thorax drain when compared to the CG. In the IPV group less complications has occurred.
W. Korlacki - One of the best experts on this subject based on the ideXlab platform.
-
The role of thoracoscopy in the treatment of pleural empyema in children
Surgical Endoscopy And Other Interventional Techniques, 2006Co-Authors: J. Dzielicki, W. KorlackiAbstract:Background The treatment of empyema with pleural Drainage is a widely accepted surgical procedure. Currently, thoracoscopy often is used to treat this disease in some thoracic surgery centers. This report aims to present the authors’ experience with the treatment of pleural empyema and the benefits of thoracoscopy. Methods From 1997 to 2005, 49 children with a diagnosis of pleural empyema were treated by means of thoracoscopy in the authors’ department. The study group consisted of 21 girls and 28 boys, ages 1 to 17 years (mean age, 9.2 years). Thoracoscopic cleaning and Drainage of the pleural cavity was performed for all the patients. Results Intraoperatively, stage I empyema was recognized in 7 children (14.3%), stage II in 30 children (61.2%), and stage III in 12 children (24.5%). Very good results were obtained for all the patients. There were no intra- or postoperative major complications. The Drainage time was less than 5 days for 63.3% of the children. In the remaining group of patients, Drainage exceeded 8 days only for 16.3%. The postoperative time was short. Emptying of the pleural cavity and full lung decompression were achieved in all cases. In four cases, pleural biopsy showed TB, which enabled early proper treatment. Conclusions Thoracoscopy can offer good visualization and cleansing of the empyema chambers, establishing efficient Drainage even for patients with advanced stages of pleural empyema. Thoracoscopy enables collection of material not only for bacteriologic, but also for histopathologic examination. The method is minimally invasive, and risk for complication is comparable with that for classical Thorax Drainage.
S Cooreman - One of the best experts on this subject based on the ideXlab platform.
-
824 Physiotherapy Techniques for Pleural Effusions in a Pediatric Intensive Care Unit (PICU): Which Technique is the Most Efficient?
Archives of Disease in Childhood, 2012Co-Authors: S Cooreman, V Van Gorp, N Najafi, Luc Huyghens, Said Hachimi-idrissiAbstract:Aims To compare different chest physiotherapy techniques in pediatric patient with infectious pleural effusion and Thorax drain admitted in PICU. Methods We conducted a monocentric, randomized, assessor-blind trial. The patients were randomized in three groups: those who have received intrapulmonary percussive ventilation (IPV), those who have received autogene Drainage (AD) and were compared to the control group (CG) which no physiotherapy was administered. Only physiotherapists were aware of the allocation group of the patients. Results 24 patients were included (IPV: 7, AD:8, CG: 9). All patients had a infectious pleural effusion and Thorax Drainage. The occurrence of lung-necrosis, empyema, drained pleural fluid per body area, need of fibroscopy and Video assisted thoracoscopy (VATS), total length of stay in PICU and in hospital, days of oxygenothepy needed and the evolution of CRP were compared in the three groups. No differences on the occurrence of empyema, the need of VATS, length of hospital stay in hospital and in PICU stay, the number of oxygenothepy days and the CRP evolution. But there were less occurrence of lung-necrosis, more drained pleural fluid and less need of fibroscopy in the IPV group. Conclusions These preliminary results show that the different chest physiotherapy has not been effective in reducing hospital stay, length of oxygenotherapy in patients with pleural effusion and Thorax drain when compared to the CG. In the IPV group less complications has occurred.
K.-h. Altemeyer - One of the best experts on this subject based on the ideXlab platform.
-
Präklinische Versorgung von Traumapatienten in der Luftrettung
Der Unfallchirurg, 2002Co-Authors: T. Schlechtriemen, S. Schaefer, E. Stolpe, K.-h. AltemeyerAbstract:In a retrospective study of mission data of ADAC Air Rescue of the years 2000 and 2001 the quality of preclinical care of 1,946 patients with severe head injuries and 1,878 polytraumatized patients was examined. The actual preclinical care of these patients was compared with a catalogue of eleven thesis-like recommendations. These recommendations were previously derived from corresponding publications of national and international specialist companies and were introduced in a binding manner by the senior doctors of the participating air rescue centres. The results of the study show that 73.3% of the severe head injuries were preclinically intubated and 94.4% were supplied with oxygen, 82.2% were analgosedated. 94.8% could be delivered to the hospital of destination. 65.9% had a systolic blood pressure of >120 mmHg upon admission to the hospital. 71.4% of severe head injury victims were equipped with a cervical support, 23.3% had the blood pressure documented. 47.3% reached the hospital of destination in less than 60 minutes. Among polytraumatic patients the intubation was performed in 75.7%, the supply with oxygen in 90.7%, 88.6% of the patients were analgosedated. 78.7% of patients suffering from concomitant head injuries were provided with a cervical support and only 22.8% had a blood sugar measurement documented. A concomitant severe Thorax trauma was treated by a Thorax Drainage in 59.2%. 35.6% of the polytraumata reached the hospital of destination in less than 60 minutes. The work describes the preclinical patient care of severe head injuries and polytraumata, pointing out deficits and presenting optimization possibilities, particularly in the area of training. Furthermore, the work shows the concept of the medical quality management in an air rescue enterprise. The total evaluation of all air rescue centres participating in data collection forms the basis of an external quality comparison. The data evaluation of a single station makes regional strengths and weaknesses visible, deficits can be proven and proposals for optimization be developed. The presentation of the time history of data yields continuous standard information on the state of the patient care at the relevant air rescue location and enables the analysis of improvement concepts based on the updated data.
-
Präklinische Versorgung von Traumapatienten in der Luftrettung
Der Unfallchirurg, 2002Co-Authors: T. Schlechtriemen, S. Schaefer, E. Stolpe, K.-h. AltemeyerAbstract:In einer retrospektiven Studie an Einsatzdaten der ADAC-Luftrettung der Jahre 2000 und 2001 wurde die Qualität der präklinischen Versorgung von 1.946 Patienten mit schwerem Schädel-Hirn-Trauma und 1.878 polytraumatisierten Patienten untersucht. Verglichen wurde die tatsächliche präklinische Versorgung dieser Patienten mit einem Katalog von jeweils 11 thesenartig formulierten Empfehlungen. Diese Empfehlungen waren zuvor aus entsprechenden Veröffentlichungen nationaler wie internationaler Fachgesellschaften abgeleitet und von den leitenden Ärzten der beteiligten Luftrettungszentren als verbindlich eingeführt worden. Die Ergebnisse der Untersuchung zeigen, dass 73,3% der schweren Schädel-Hirn-Traumen präklinisch intubiert und 94,4% beatmet wurden, 82,2% waren analgosediert. 94,8% der Patienten konnten mit einer psaO2 >95% in der Zielklinik übergeben werden. 65,9% hatten bei Klinikaufnahme einen systolischen Blutdruck >120 mmHg. 71,4% der schweren SHT waren mit einer Zervikalstütze versehen, bei 23,3% wurde der Blutzucker dokumentiert. 47,3% erreichten die Zielklinik in weniger als 60 min. Bei polytraumatisierten Patienten erfolgte die Intubation in 75,7%, die Beatmung in 90,7%, 88,6% der Patienten wurden analgosediert. Bei begleitendem SHT waren 78,7% mit einer Zervikalstütze versorgt und nur bei 22,8% der Patienten ist eine Blutzuckermessung dokumentiert. Ein begleitendes schweres Thoraxtrauma wurde in 59,2% mit einer ThoraxDrainage therapiert. Die Zielklinik erreichten 35,6% der Polytraumen in einer Zeit von weniger als 60 min. Die Arbeit beschreibt die präklinische Patientenversorgung von schweren Schädel-Hirn-Traumen und Polytraumen, weist auf Defizite hin und stellt Optimierungsmöglichkeiten – insbesondere im Schulungsbereich – vor. Zudem zeigt die Arbeit das Konzept des medizinischen Qualitätsmanagement in einem Luftrettungsunternehmen auf. Die Gesamtauswertung aller an der Datenerfassung beteiligten Luftrettungszentren bildet die Grundlage für einen externen Qualitätsvergleich. Die Datenauswertung einer einzelnen Station lässt regionale Stärken und Schwächen erkennen, Defizite können nachgewiesen, Optimierungsvorschläge erarbeitet werden. Die Darstellung des zeitlichen Verlaufs der Daten liefert kontinuierliche Standardinformationen zum Zustand der Patientenversorgung im jeweiligen Luftrettungsstandort und ermöglicht das Hinterfragen von Verbesserungskonzepten anhand der fortgeführten Daten. In a retrospective study of mission data of ADAC Air Rescue of the years 2000 and 2001 the quality of preclinical care of 1,946 patients with severe head injuries and 1,878 polytraumatized patients was examined. The actual preclinical care of these patients was compared with a catalogue of eleven thesis-like recommendations. These recommendations were previously derived from corresponding publications of national and international specialist companies and were introduced in a binding manner by the senior doctors of the participating air rescue centres. The results of the study show that 73.3% of the severe head injuries were preclinically intubated and 94.4% were supplied with oxygen, 82.2% were analgosedated. 94.8% could be delivered to the hospital of destination. 65.9% had a systolic blood pressure of >120 mmHg upon admission to the hospital. 71.4% of severe head injury victims were equipped with a cervical support, 23.3% had the blood pressure documented. 47.3% reached the hospital of destination in less than 60 minutes. Among polytraumatic patients the intubation was performed in 75.7%, the supply with oxygen in 90.7%, 88.6% of the patients were analgosedated. 78.7% of patients suffering from concomitant head injuries were provided with a cervical support and only 22.8% had a blood sugar measurement documented. A concomitant severe Thorax trauma was treated by a Thorax Drainage in 59.2%. 35.6% of the polytraumata reached the hospital of destination in less than 60 minutes. The work describes the preclinical patient care of severe head injuries and polytraumata, pointing out deficits and presenting optimization possibilities, particularly in the area of training. Furthermore, the work shows the concept of the medical quality management in an air rescue enterprise. The total evaluation of all air rescue centres participating in data collection forms the basis of an external quality comparison. The data evaluation of a single station makes regional strengths and weaknesses visible, deficits can be proven and proposals for optimization be developed. The presentation of the time history of data yields continuous standard information on the state of the patient care at the relevant air rescue location and enables the analysis of improvement concepts based on the updated data.
J. Dzielicki - One of the best experts on this subject based on the ideXlab platform.
-
The role of thoracoscopy in the treatment of pleural empyema in children
Surgical Endoscopy And Other Interventional Techniques, 2006Co-Authors: J. Dzielicki, W. KorlackiAbstract:Background The treatment of empyema with pleural Drainage is a widely accepted surgical procedure. Currently, thoracoscopy often is used to treat this disease in some thoracic surgery centers. This report aims to present the authors’ experience with the treatment of pleural empyema and the benefits of thoracoscopy. Methods From 1997 to 2005, 49 children with a diagnosis of pleural empyema were treated by means of thoracoscopy in the authors’ department. The study group consisted of 21 girls and 28 boys, ages 1 to 17 years (mean age, 9.2 years). Thoracoscopic cleaning and Drainage of the pleural cavity was performed for all the patients. Results Intraoperatively, stage I empyema was recognized in 7 children (14.3%), stage II in 30 children (61.2%), and stage III in 12 children (24.5%). Very good results were obtained for all the patients. There were no intra- or postoperative major complications. The Drainage time was less than 5 days for 63.3% of the children. In the remaining group of patients, Drainage exceeded 8 days only for 16.3%. The postoperative time was short. Emptying of the pleural cavity and full lung decompression were achieved in all cases. In four cases, pleural biopsy showed TB, which enabled early proper treatment. Conclusions Thoracoscopy can offer good visualization and cleansing of the empyema chambers, establishing efficient Drainage even for patients with advanced stages of pleural empyema. Thoracoscopy enables collection of material not only for bacteriologic, but also for histopathologic examination. The method is minimally invasive, and risk for complication is comparable with that for classical Thorax Drainage.