Ultrasound-guided pleural puncture in supine or recumbent lateral position - feasibility study
نویسندگان
چکیده
BACKGROUND The aim of this study is to evaluate feasibility, safety and efficacy of accessing the pleural space with the patient supine or in lateral recumbent position, under constant ultrasonic guidance along the costophrenic sinus. METHODS All patients with pleural effusion, referred to thoracentesis or pleural drainage from February 2010 to January 2011 in two institutions, were drained either supine or in lateral recumbent position through an echomonitored cannulation of the costophrenic sinus. The technique is described in detail and an analysis of safety and feasibility is carried out. RESULTS One hundred and one thoracenteses were performed on 76 patients and 30 pigtail catheters were inserted in 30 patients (for a total of 131 pleural procedures in 106 patients enrolled). The feasibility of the procedures was 100% and in every case it was possible to follow real time needle tip passage in the pleural space.Ninety eight thoracenteses (97%) and all catheter drainages were successfully completed. Four thoracenteses were stopped because of the appearance of complications while no pigtail drainage procedure was stopped. After 24 hour follow up, one chest pain syndrome (1.3% of completed thoracenteses) and two pneumothoraces (1.4%) occurred. The mean acquisition time of pleural space was 76 ± 9 seconds for thoracentesis and 185 ± 46 seconds for drainage insertion (p < 0.05). CONCLUSIONS This study highlights the safety and efficacy of this technique of real time echo-monitored pleural space puncture, that offers a more comfortable patient position, an easier approach for the operator, a very low rate of complications with short acquisition time of pleural space.
منابع مشابه
What is the best position for preventing ventilator-associated pneumonia?
Preventing aspiration in mechanically ventilated patients continues to be a key component in the battle toward reducing the incidence of ventilator-associated pneumonia (VAP). These aspiration events (especially micro-aspirations) are a major VAP risk factor and thus have become a target of the quality-improvement movement.1 VAP bundles have been introduced into intensive care units worldwide, ...
متن کاملReal-time ultrasound-guided pigtail catheter placement in supine position for drainage of symptomatic pleural effusions in paediatric patients who underwent liver transplantation
متن کامل
Comparative Study between Ultrasound Guided Lateral and Anterior Approach for Stellate Ganglion Block
Background: This study evaluated the safety and complications between the ultrasound guided lateral and anterior approach to administrate the local anesthetic for stellate ganglion block. Methods: Sixty two patients scheduled for ultrasound guided stellate ganglion block randomized into two equal comparable groups. The first group) Group I (received stellate ganglion block through anterior appr...
متن کاملUltrasound evaluation of techniques for internal jugular vein puncture in children.
PURPOSE To determine by ultrasound which access and position the child must stay to obtain the best transversal section of the right Internal Jugular Vein (RIJV) allowing a safer puncture. METHODS Three possible accesses to the RIJV, anterior, lateral and posterior, from 57 healthy children, were analyzed through ultrasound images in a sequence of positions of the head, in supine position, wi...
متن کاملTHE EFFECT OF CHANGE IN POSITION ON INTRATRACHEAL CUFF PRESSURE IN PATIENTS UNDERGOING SURGERY WITH GENERAL ANESTHESIA: A PROSPECTIVE ANALYTICAL STUDY
Background & Aims: Tracheal intubation with a cuffed tube for the administration of general anesthesia is routine. The cuff of the endotracheal tube is inflated with air to achieve an adequate seal to prevent aspiration and leakage of air and anesthetic gases. Whereas over-inflation can decrease the mucosal perfusion, leading to pressure necrosis and nerve palsies. This study aimed to evaluate ...
متن کامل