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Air Leaks (air + leak)

Distribution by Scientific Domains

Medical Sciences	90%

Selected Abstracts

A DIFFERENT APPLICATION METHOD OF TALC PLEURODESIS FOR THE TREATMENT OF PERSISTENT AIR LEAK

ANZ JOURNAL OF SURGERY, Issue 8 2006
Dalokay Kilic
Persistent air leak is a serious problem that may cause empyema, hypoxia, respiratory insufficiency, and other life-threatening complications. Chemical pleurodesis may be carried out for the treatment of persistent air leak if the lung is fully expanded. However, the standard method of chemical pleurodesis entails clamping the chest tube for a period of time after instillation of the agent. In patients with massive air leak, this would result in a tension pneumothorax. Therefore, standard chemical pleurodesis for persistent air leak is not an appropriate treatment for these patients. In this study, we carried out talc pleurodesis in six patients using an inverted U-shaped chest tube elevated to 60 cm that did not result in tension pneumothorax and mediastinal shift. No recurrence was observed during a mean follow up of 16.2 months. [source]

Anterior infradiaphragmatic free gas following bronchial rupture: Case report and literature review

JOURNAL OF MEDICAL IMAGING AND RADIATION ONCOLOGY, Issue 1 2004
Eamon SC Koh
SUMMARY Bronchial rupture is an uncommon injury that presents clinically and radiologically with tension or non-tension pneumothorax, pneumomediastinum and subcutaneous emphysema caused by air leak and migration of free gas. Infradiaphragmatic gas has previously been demonstrated in mechanically ventilated patients with pneumomediastinum and is secondary to passage of air via anterior and posterior trans-diaphragmatic pathways. We present a case of bronchial rupture complicated by extensive infradiaphragmatic gas following mechanical ventilation that illustrates these pathways and some of the major radiographic signs associated with this injury. [source]

The effect of pilot balloon design on estimation of safe tracheal tube cuff pressure

ANAESTHESIA, Issue 8 2010
K. M. Janossy
Summary We studied the effect of pilot balloon design on the ability of experienced anaesthetists to assess and inflate tracheal tube cuffs to safe pressures. A model trachea was designed, incorporating a degree of compliance and an air leak, to evaluate six different pilot balloons grafted onto identical tracheal tubes. Pilot balloons were inflated to one of four pressures and anaesthetists were asked to estimate whether the pressure was acceptable, too low or too high. Anaesthetists were then asked to inflate the cuff of each tube. Overall, 103 (42.9%) of anaesthetists' assessments of tracheal tube cuff pressures were correct (33% correct would be expected by chance, p = 0.002). Pressures generated by anaesthetists inflating tracheal tube cuffs were very variable. Median (IQR [range]) pressures for each pilot balloon ranged from 29 (17,43 [9,56]) cmH2O to 74 (49,114 [4,140]) cmH2O (p < 0.001). The design of the pilot balloon significantly affects anaesthetists' ability to inflate tracheal tube cuffs to safe pressures. [source]

A DIFFERENT APPLICATION METHOD OF TALC PLEURODESIS FOR THE TREATMENT OF PERSISTENT AIR LEAK

Use of a single silastic chest drain following thoracotomy: initial evaluation

ANZ JOURNAL OF SURGERY, Issue 8 2005
Nand K. Kejriwal
Background: It is standard practice to use multiple large bore semi-rigid chest tubes to drain the pleural cavity following thoracic procedures. These can cause pain and discomfort at the insertion site. Methods: We describe our experience with the use of a single small silastic drain following thoracotomy. From November 2001 to November 2003, size19-F silastic chest tubes (Blake drains) were used for drainage of the pleural cavity in 37 patients at our institution. The patients ranged in age from 18 to 81 years (mean 65). The operations included 22 lobectomies, two bilobectomies, 10 wedge resections, and three other procedures. Results: Total drainage in each patient ranged from 420 to 5440 mL (mean 1387 mL). Tubes were left in place for an average of 4.3 days (range 1,12). The average postoperative length of stay was 7.6 days (range 3,44, median 5). Three patients required insertion of an additional tube for dislodgement, persistent air leak, and bronchopleural fistula, respectively. These complications occurred among the first 15 patients in the present series. None of the patients had persistent pleural effusion. Subjectively, these tubes were more comfortable for the patients and were easier to remove. Summary: The use of a single, small silastic chest drains following thoracotomy may be safe and effective in draining both fluid and air, though an additional tube may be necessary for persistent leaks. [source]

Energy conservation in compressed-air systems

INTERNATIONAL JOURNAL OF ENERGY RESEARCH, Issue 9 2002
Durmus Kaya
Abstract In this paper, we evaluate and quantify the energy losses associated with compressed-air systems, and their costs to manufacturers. We also show how to reduce the cost of compressed air in existing facilities by making some modifications with attractive payback periods. Among the measures, we investigate to reduce the compressed air are: (1) repairing air leaks, (2) installing high-efficiency motors, (3) reducing the average air inlet temperature by using outside air (4) reducing compressor air pressure. We also illustrate the potential saving associated with each measure by using realistic examples. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Review of non-invasive ventilation in the emergency department: clinical considerations and management priorities

JOURNAL OF CLINICAL NURSING, Issue 23 2009
Louise Rose
Aims and objectives., We aimed to synthesise evidence from published literature on non-invasive ventilation to inform nurses involved in the clinical management of non-invasive ventilation in the emergency department. Background., Non-invasive ventilation is a form of ventilatory support that does not require endotracheal intubation and is used in the early management of acute respiratory failure in emergency departments. Safe delivery of this intervention requires a skilled team, educated and experienced in appropriate patient selection, available devices and monitoring priorities. Design., Systematic review. Method., A multi-database search was performed to identify works published in the English language between 1998,2008. Search terms included: non-invasive ventilation, continuous positive airway pressure and emergency department. Inclusion and exclusion criteria for the review were identified and systematically applied. Results., Terminology used to describe aspects of non-invasive ventilation is ambiguous. Two international guidelines inform the delivery of this intervention, however, much research has been undertaken since these publications. Strong evidence exists for non-invasive ventilation for patients with acute exacerbation of congestive heart failure and chronic obstructive pulmonary disease. Non-invasive ventilation may be delivered with various interfaces and modes; little evidence is available for the superiority of individual interfaces or modes. Conclusions., Early use of non-invasive ventilation for the management of acute respiratory failure may reduce mortality and morbidity. Though international guidelines exist, specific recommendations to guide the selection of modes, settings or interfaces for various aetiologies are lacking due to the absence of empirical evidence. Relevance to clinical practice., Monitoring of non-invasive ventilation should focus on assessment of response to treatment, respiratory and haemodynamic stability, patient comfort and presence of air leaks. Complications are related to mask-fit and high air flows; serious complications are few and occur infrequently. The use of non-invasive ventilation has resource implications that must be considered to provide effective and safe management in the emergency department. [source]

Thoracoscopic cell sheet transplantation with a novel device

JOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE, Issue 4 2009
Masanori Maeda
Abstract Regenerative medicine with transplantable cell sheets fabricated on temperature-responsive culture surfaces has been successfully achieved in clinical applications, including skin and cornea treatment. Previously, we reported that transplantation of fibroblast cell sheets to wounded lung had big advantages for sealing intraoperative air leaks compared with conventional materials. Here, we report a novel device for minimally invasive transplantation of cell sheets in endoscopic surgery, such as video-assisted thoracoscopic surgery (VATS). The novel device was designed with a computer-aided design (CAD) system, and the three-dimensional (3D) data were transferred to a 3D printer. With this rapid prototyping system, the cell sheet transplantation device was fabricated using a commercially available photopolymer approved for clinical use. Square cell sheets (24 × 24 mm) were successfully transplanted onto wound sites of porcine lung placed in a human body model, with the device inserted through a 12 mm port. Such a device would enable less invasive transplantation of cell sheets onto a wide variety of internal organs. Copyright © 2009 John Wiley & Sons, Ltd. [source]

The ProSealTM laryngeal mask airway in children

PEDIATRIC ANESTHESIA, Issue 3 2005
M. LOPEZ-GIL MD
Summary Background :,The ProSealTM (PLMA) is a new laryngeal mask device with a modified cuff to improve the seal and a drain tube to provide access to the gastrointestinal tract. We assessed the performance of the size 2 (which has no dorsal cuff) and size 3 (which has a dorsal cuff) in terms of insertion success, efficacy of seal, tidal volume, gas exchange, fiberoptic position, gastric tube placement and frequency of problems. Methods :,Eighty children undergoing minor surgery were studied (n = 40, size 2 PLMA, weight 10,25 kg; n = 40, size 3 PLMA, weight >25,50 kg). Induction was with remifentanil and propofol. Insertion was with the introducer tool and by experienced users. Maintenance was with propofol or sevoflurane and pressure controlled ventilation. Results :,The first-time and overall insertion success rate was 84 and 100%, respectively. Oropharyngeal leak pressure was 31 ± 5 cmH2O. There were no gastric or drain tube air leaks. Tidal volume and gas exchange was adequate in all patients, other than two brief episodes of hypoxia because of airway reflex activation. The vocal cords and epiglottis were visible in 99 and 80%, respectively, via the airway tube. The first-time and overall insertion success rate for gastric tube insertion was 87 and 100%, respectively. During maintenance, the PLMA was removed in one patient with airway reflex activation and another required epinephrine for bronchospasm. There were no differences in performance between the sizes 2 and 3 PLMA. Conclusion :,The PLMA is an effective airway device in children and isolates the glottis from the esophagus when correctly positioned. Despite the lack of a dorsal cuff, the performance of the size 2 was similar to the size 3 PLMA in the age groups tested. [source]

Langerhans cell histiocytosis presenting as recurrent air leaks in young children

ACTA PAEDIATRICA, Issue 4 2010
S Saharan
No abstract is available for this article. [source]