OBJECTIVE A prospective randomized study was conducted in order to analyze the role of fibrinolytics in the treatment of complicated parapneumonic effusion. METHODS From 2001 to 2004, 127 consecutive patients were managed for thoracic empyema. In all cases the cause was bacterial pneumonia. Seventy patients were managed with sole tube thoracostomy (group A) and 57 with combination of tube tho...

STUDY OBJECTIVES To evaluate the clinical safety, efficacy, and cost of a small indwelling pleural catheter (7F, Turkel Safety Thoracentesis System [Sherwood, Davis, and Geck; St. Louis]) vs repeated needle thoracentesis or closed tube thoracostomy as a means to drain a large-volume pleural effusion. SETTING Inpatients in a tertiary care university teaching hospital in urban Chicago. DESIGN...

Successful treatment of traumatic hemothoraces is imperative to reduce morbidity and mortality among patients. Treatment modalities range from more conservative to invasive measures, including antibiotic therapy, thoracostomy tube placement, video-assisted thoracoscopic surgery, or thoracotomy. Various studies have documented success in using fibrinolytics such as tissue plasminogen activator (...

OBJECTIVE to investigate the effect of standardized interventions in the management of tube thoracostomy patients and to assess the independent effect of each intervention. METHODS A chest tube management protocol was assessed in a retrospective cohort study. The tube thoracostomy protocol (TTP) was implemented in August 2012, and consisted of: antimicrobial prophylaxis, chest tube insertion ...

hest injury is a common problem in patients sustaining blunt or penetrating trauma.1 Thoracic wounds account for 20-25% of all trauma deaths. Only 10-15% of all chest wounds require tube thoracostomy, whereas the remaining 85% can be managed with a closed tube thoracostomy.2 A major morbidity associated with this therapeutic device is empyema. The role of prophylactic antibiotics in reducing th...

BACKGROUND Prolonged chest tube duration is less well studied in patients who are supported by mechanical ventilation and have acquired pneumothorax. We investigated the impact of prolonged chest tube duration on patient outcomes and the risk factors associated with prolonged chest tube duration. METHODS This retrospective observational study included 106 ventilated subjects who had been trea...