Critical Care, Hemothorax, Interprofessional Approach, Intervention, Pneumothorax, Ultrasound
Conditions
Brief summary
Investigate the efficacy of interprofessional team approach to ultrasound guided diagnosis and intervention (pigtail or chest tube insertion) in critical care patients with Pneumothorax and/or hemothorax. Evaluate the safety of the procedure {Insertion- related complications. Assess the Duration of chest tube insertion
Detailed description
Pneumothorax is defined as the presence of air in the pleural cavity; it can be secondary to underlying pulmonary pathology or trauma. In trauma, about 40-50% of thoracic injuries develop pneumothorax. Traditionally, following the suggestion of the American College of Chest Physicians and the Advanced Trauma Life Support (ATLS), all traumatic pneumothoraxes must be treated with a pleural drainage that could be chest tube (CT) or pigtail catheter (PC). Insertion of pleural drains is a common surgical procedure. Percutaneous pleural drainage is the third most performed procedure in the intensive care unit (ICU) after vascular catheterization and tracheal intubation. Bedside-ultrasound is introducing the advantage of at-time diagnosis and evaluation of different parameters without the need for risky transport of critical patients outside ICU and also guiding safe and successful intervention without complications and good learning. .
Interventions
DIAGNOSTIC_TESTChest-Tube Insertion
The technique was performed according to a combination of the Chest-Tube Insertion (BTS) guidelines for chest tube insertion and ultrasound (US)-guided technique for chest tube insertion and US-guided pigtail insertion.
Sponsors
Tanta University
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age from 21 to 65 years * Both sexes. * Patients with pneumothorax or hemothorax indicated for chest tube or pig tail insertion according to British Thoracic Society (BTS) June 2022 guidelines for pleural procedures.
Exclusion criteria
* Absolute contraindication: patients in which the lung is completely adherent to the chest wall throughout the hemithorax. * Relative contraindications: patients with risk of bleeding in patients: * Taking anticoagulant medication. * Patients with abnormal clotting profiles, coagulopathies, and platelet defects.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of ultrasound diagnosis | Diagnosis 24 hours | Efficacy of ultrasound in intervention by Diagnosis of pneumothorax/hemothorax starting by physical examination followed by bed side ultrasound examination according to the international consensus conference recommendations (international evidence-based recommendations for point-of-care lung ultrasound) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy of ultrasound in intervention | 10 days after intervention | Efficacy of ultrasound in intervention used (chest tube /pigtail) was recoeded. |
| Monitoring team performance | 24 hours after intervention | Monitoring team performance: team satisfaction was recorded using a 5-point Likert scale team satisfaction (1, very dissatisfied; 2, dissatisfied; 3, Okey; 4, satisfied; 5, very satisfied) in our study as an item related to team performance |
| Duration of insertion | 30 minutes intervention | Duration of insertion was recorded |
| Incidence of complications | 72 hours after intervention | Incidence of complication were recorded such as infection, bleeding, visceral injury, and visceral injury. |
Countries
Egypt
Outcome results
None listed