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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Hazards of tube thoracostomy in patients on a ventilator. | Shaikhrezai and Zamvar Journal of Cardiothoracic Surgery 2011 6 39 http www.cardiothoracicsurgery.Org content 6 1 39 JCTS JOURNAL OF CARDIOTHORACIC SURGERY CASE REPORT Open Access Hazards of tube thoracostomy in patients on a ventilator Kasra Shaikhrezai and Vipin Zamvar Abstract A patient with post-pneumonia empyema complicated by type-2 respiratory failure required mechanical ventilation as part of his therapy. A pneumothorax was noted on his chest radiograph. This was treated with an intercostal chest drain ICD . Unfortunately he was still hypoxic his subcutaneous emphysema was worsening and the ICD was bubbling. A computed tomography CT scan of chest demonstrated that the ICD has penetrated the right upper lobe parenchyma. A new ICD was inserted and the previous one was removed. Although both hypoxia and subcutaneous emphysema improved the patient chronically remained on mechanical ventilation. Background Tube thoracostomy is a common procedure to drain fluids and or air from the pleural space via an ICD. The British Thoracic Society BTS has published a guideline 1 for ICD insertion which in many institutions has been deployed as a standard approach to tube thoracostomy in both practice and training programs. Recently there is an increasing concern regarding the training of doctors with regard to precise and methodological ICD insertion 2 3 . Harris et al 4 conducted a national survey among chest physicians in the UK recording their experiences regarding complications and serious harms following ICD insertion. The study revealed 67 of NHS trusts have experienced major complications of ICD insertion. Case presentation A 51-year-old man with history of chronic obstructive pulmonary disease COPD and cigarette smoking presented with a shortness of breath chronic pneumonia and empyema involving the right side of his chest. Soon after admission his condition deteriorated developing type-2 respiratory failure necessitating intubation and commencement of mechanical .
