tailieunhanh - Difficult Decisions in Thoracic Surgery - part 9

Hệ thống thoát nước của MPE sử dụng ống thoát nước nhỏ mang và pleurodesis nhanh chóng đạt được kết quả tương tự như hệ thống thoát nước kéo dài trước khi pleurodesis (mức độ 1b bằng chứng đến 3, đề nghị cấp B). | 416 . Putnam Jr. less than 150 mL day median chest tube duration 7 days . The recommended approach would be the one which would minimize In summary drainage of MPE using small bore catheter drainage and rapid pleurodesis achieves results similar to prolonged drainage prior to pleurodesis level of evidence 1b to 3 recommendation grade B . Drainage of MPE using small bore catheter drainage and rapid pleurodesis achieves results similar to prolonged drainage prior to pleurodesis level of evidence 1b to 3 recommendation grade B . . Pleurodesis Sclerosis Pleurodesis pleuro Greek desis binding together from dein to bind . Pleurodesis is generally considered standard treatment for recurrent MPE. Many agents have been used with variable success. Additional factors that impact on the success of pleurodesis include initial drainage time chest drain diameter management of the chest drain suction no suction etc. Pleurodesis is performed to inflame the visceral and parietal pleura and to fuse the pleura together obliterating the potential pleural space. A sclerosing agent instilled within the ipsilateral thorax induces an inflammatory reaction. With pleurodesis the pleural fluid cannot accumulate or compress the functioning lung or at the extreme the . Sclerosing Agents Almost all sclerosing agents can produce fever tachycardia chest pain and As sclerosing agents may cause pain talc doxycycline tetracycline etc. the patient should be premedicated with pain medication usually narcotics prior to instillation of the sclerosing agent. Talc is a common inexpensive and effective sclerosing With complete expansion of the lung and apposition of the visceral and parietal pleura pleural symphysis can occur. Talc may cause adverse reactions such as microemboli and granulomatous tissue Although many agents have been evaluated for pleurodesis talc is the most common agent used today. It is generally considered .