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Cardiothoracic
Published in Kelvin Yan, Surgical and Anaesthetic Instruments for OSCEs, 2021
The main indication is for a chest drain as aforementioned. It creates an airtight system to prevent trapping of air or fluids into the pleural cavity. It also allows the monitoring of drainage. The continuous bubbling may mean a visceral pleural air leak or that the tube site has been moved to a point in contact with air.
Thymectomy
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
A sternotomy is a relatively standard and straightforward approach. The patient is in the supine position with the arms at the side. The incision runs in the midline from the sternal notch to the xiphoid. The sternum is split using an oscillating sternal saw and exposure of the thymus is obtained by use of a sternal retractor (Figure 23.2a). The dissection is relatively easy and can begin with either the lower or upper horns. The thymus is relatively easily dissected off the pericardium and great vessels. Care must be taken to protect the phrenic nerve, which runs along the lateral border of the thymus, down the pericardium. Care should also be taken to avoid entering the pleural cavity if possible.
The patient with acute respiratory problems
Published in Peate Ian, Dutton Helen, Acute Nursing Care, 2020
The difference between sub-atmospheric pressure (negative) in the pleural cavity and atmospheric pressure (positive) in the lungs promotes lung inflation. A pneumothorax occurs when atmospheric air enters the pleural cavity and the pressure becomes positive, resulting in elastic recoil of the lung and either partial or total collapse. It may be spontaneous with no cause, a complication in chronic lung disease, or may follow trauma or occur inadvertently during hospital treatment (e.g., insertion of central line or mechanical ventilation). The visceral pleural membrane in the apices of either lung is usually involved, as a result of gravitational forces and a small tear in the visceral pleura allows air to leak into the pleural space.
Pinealectomy and melatonin administration in rats: their effects on pulmonary edema induced by α-naphthylthiourea
Published in Drug and Chemical Toxicology, 2023
Mohammed Raed Abdullah Al Gburi, Eyup Altinoz, Hulya Elbe, Melike Ozgul Onal, Umit Yilmaz, Nesibe Yilmaz, Melike Karayakali, Mehmet Demir
ANTU of 4 mg/ml suspension in olive oil was freshly prepared before injection and 10 mg/kg suspension was administered to the rats i.p. (Bakhle and Grantham 1987). All animals were decapitated under anesthesia four hours after the ANTU injection, blood was taken from the abdominal aorta to the tubes (Książek et al. 2018). The thorax was carefully opened. Effusion fluid that accumulated in the pleural cavity was drawn with an injector by preventing surrounding tissue bleeding and diffusion of the blood into the effusion fluid. The lungs were removed and weighed on a precision balance (Atalay et al. 2012). The effusion fluid volume (PE, ml), lung weight/body weight (LW/BW), and PE/body weight (PE/BW) ratios were calculated and employed as lung damage indicators. Lungs were divided into two pieces. One piece was preserved in 10% formaldehyde and histopathological analyses were conducted (Erdem et al. 2014). The other piece was kept in deepfreeze (–80 °C).
Endometriotic lung cyst causing catamenial hemoptysis; a case report and review of literature
Published in Acta Chirurgica Belgica, 2022
Evelyne Verhulst, Celine Bafort, Carla Tomassetti, Albert Wolthuis, Didier Bielen, Johan Coolen, Birgit Weynand, Lieven Platteeuw, Christel Meuleman, Dirk Van Raemdonck
Because of great suspicion that the cystic lesion was the origin of her hemoptysis, video-assisted thoracoscopic surgery (VATS) with excision of the lesion was proposed after a multidisciplinary discussion based on symptoms, signs and wishes of the patient. Pulmonary function tests prior to surgery demonstrated normal spirometry and diffusion capacity. Exploratory VATS was performed on 31st August 2020. The patient was installed in left lateral decubitus with left single-lung ventilation using a double-lumen endotracheal tube. Thoracoscopy was performed using two small intercostal incisions. A 30-degree 10 mm endoscope was used. Inspection of the pleural cavity showed no sign of pleural abnormalities, no diaphragmatic lesions or fenestrations and no pleural effusion. A bullous cystic mass was seen next to the right pulmonary ligament corresponding with the abnormality on CT. After the division of the pulmonary ligament, a wedge resection in the lower lobe was performed taking care not to damage the inferior pulmonary vein. A chest drain was inserted upon closure.
Daptomycin for the successful treatment of postoperative methicillin-resistant Staphylococcus aureus empyema: a case report
Published in Journal of Chemotherapy, 2021
Yusuke Yagi, Michiro Iizuka, Moemi Okazaki, Kohei Jobu, Yasuyo Morita, Mitsuhiko Miyamura
The postoperative course after segmental resection of the left lung is shown in Figure 1 and Table 1. Although the patient’s postoperative course following the resection was uneventful and the drain was removed on postoperative day (POD) 5, he experienced left dorsal pain and developed a fever of 38.4 °C on POD 7. Furthermore, his WBC and PLT counts were 11,600/μL and 184,000/μL, respectively, and CRP, BUN, SCr, eGFRcreat, albumin, and CK levels were 8.32 mg/dL, 23 mg/dL, 1.48 mg/dL, 39.6 mL/min, 2.7 g/dL, and 30 U/L, respectively. A chest X-ray revealed pleural effusion in the left pleural cavity, and therefore we commenced left pleural cavity drainage on suspicion of postoperative empyema. A 20-Fr double-lumen tube (10 cm) was inserted into the lower left chest, and approximately 400 mL of turbid yellow pleural effusion was drained. Thereafter, 1 g of ceftriaxone was intravenously administered twice daily as an empiric antimicrobial therapy.