tailieunhanh - Báo cáo khoa học: "Should central venous catheters be used to drain pleural effusion"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Should central venous catheters be used to drain pleural effusions? | Critical Care February 2004 Vol 8 No 1 Macduff and Grant Letter Should central venous catheters be used to drain pleural effusions Andrew MacDuff1 and Ian S Grant2 1 Locum Registrar Respiratory Medicine Western General Hospital Edinburgh Scotland 2Consultant Intensive Care Medicine Western General Hospital Edinburgh Scotland Correspondence Ian S Grant Published online 2 January 2004 Critical Care 2004 8 56 DOI cc2447 This article is online at http content 8 1 56 2004 BioMed Central Ltd Print ISSN 1364-8535 Online ISSN 1466-609X We read with interest the article by Singh and coworkers 1 describing the use of central venous catheters to drain pleural effusions. We agree that the use of small-bore catheters has a number of advantages compared with repeated thoracocentesis or the use of traditional large-bore drains inserted by blunt dissection. Indeed recent guidelines 2 support the use of smaller bore tubes 8-14 Fr except for haemothorax in both pleural effusions and pneumothorax. However we have reservations regarding the routine use of central venous catheters to drain pleural effusions. Several manufacturers including the Sims-Portex Seldinger Chest Drainage Kit and Cook Quick-Thal Chest Tube have specific chest drainage systems that take advantage of the Seldinger dilator over a wire method of insertion. These have the advantage of having a number of side ports two to four which reduces the possibility of blockage by debris and they are available in a range of sizes 8-36 Fr . While we applaud innovation in today s medico-legal climate it is surely wiser to use specifically designed equipment if it is available. References 1. Singh K Loo S Bellom R Pleural drainage using central venous catheters. Crit Care 2003 7 R191-R194. 2. Laws D Neville E Duffy J on behalf of the British Thoracic Society Pleural Disease Group BTS guidelines on the insertion of a chest drain. Thorax 2003 Suppl II ii53-ii59. .

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