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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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Surgical intervention for thoracic infections.

Daniel Raymond1

  • 1Thoracic & Cardiovascular Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, J4-1, Cleveland, OH 44195, USA.

The Surgical Clinics of North America
|December 3, 2014
PubMed
Summary

Optimal outcomes for thoracic infections, such as parapneumonic effusion and empyema, rely on multidisciplinary management. Treatment focuses on pleural space drainage, lung reexpansion, and appropriate antibiotic or surgical interventions based on the specific condition.

Keywords:
AspergillomaEmpyemaInfectionParapneumonic effusionPulmonary abscessSternoclavicular joint infectionTuberculosis

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Area of Science:

  • Thoracic Surgery
  • Pulmonology
  • Infectious Diseases
  • Radiology

Background:

  • Thoracic infections necessitate a comprehensive approach involving multiple medical specialties for effective management.
  • Parapneumonic effusion and empyema require prompt diagnostic evaluation, including imaging and fluid analysis.
  • Pulmonary abscesses can often be managed non-surgically, while complex infections like fungal or tuberculous lung disease demand specialized surgical expertise.

Purpose of the Study:

  • To outline the multidisciplinary approach for managing various thoracic infections.
  • To detail the diagnostic and therapeutic strategies for parapneumonic effusion and empyema.
  • To emphasize the importance of specialized surgical care for specific lung infections.

Main Methods:

  • Computed tomographic (CT) evaluation for initial assessment of parapneumonic effusion and empyema.
  • Fluid sampling or drainage procedures for diagnostic and therapeutic purposes.
  • Antibiotic therapy and observation for pulmonary abscesses.
  • Surgical intervention by experienced surgeons for fungal or tuberculous lung disease.
  • Joint resection for sternoclavicular joint infections.

Main Results:

  • Multidisciplinary management is associated with optimal outcomes in thoracic infections.
  • CT scans and fluid analysis guide the treatment of parapneumonic effusion and empyema.
  • Complete lung reexpansion and pleural space drainage are key treatment goals.
  • Antibiotics and observation are effective for pulmonary abscesses.
  • Specialized surgical expertise is crucial for complex thoracic infections.

Conclusions:

  • A collaborative, multidisciplinary approach involving thoracic surgery, pulmonology, infectious disease, and radiology is essential for optimal thoracic infection management.
  • Effective treatment of parapneumonic effusion and empyema involves prompt diagnosis, pleural space drainage, and lung reexpansion.
  • While pulmonary abscesses may respond to conservative treatment, specific fungal or tuberculous lung diseases and sternoclavicular joint infections require expert surgical intervention.