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Related Concept Videos

Pneumothorax-II01:27

Pneumothorax-II

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Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
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Flail Chest-II01:26

Flail Chest-II

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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
136
Oxygen Delivering System III: Tracheostomy and T-piece01:23

Oxygen Delivering System III: Tracheostomy and T-piece

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Oxygen delivery is critical in clinical care, especially for patients with respiratory disorders or those undergoing surgical procedures. Various systems, such as tracheostomy and the T-piece, deliver oxygen to the lungs, ensuring adequate arterial oxygenation.
Tracheostomy
A tracheostomy is a surgically created opening (stoma) in the anterior part of the trachea. It is used to establish a patient airway, bypass an upper airway obstruction, simplify the removal of secretions, permit long-term...
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Pneumothorax-I01:26

Pneumothorax-I

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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
154
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

174
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
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Pneumonia V: Nursing management and Prevention01:30

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Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
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Trauma Pneumonectomy: Has Survival Improved Over Two Decades?

Seema P Anandalwar1, Amar Deshwar1, Elizabeth Powell1

  • 1Department of Trauma, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, MD, USA.

The American Surgeon
|April 23, 2025
PubMed
Summary

Recent advances in trauma pneumonectomy care, including thoracic damage control and venovenous extracorporeal membrane oxygenation (VV-ECMO), significantly reduced late mortality. Early mortality remains high, but improved management strategies offer hope for better long-term survival in these critical patients.

Keywords:
pneumonectomythoracic surgerytrauma

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Area of Science:

  • Trauma Surgery
  • Cardiopulmonary Support
  • Critical Care Medicine

Background:

  • Trauma pneumonectomy is a life-threatening procedure with historically high mortality rates.
  • Advances in critical care and surgical techniques may impact outcomes for these patients.
  • Evaluating changes in management over time is crucial for understanding survival trends.

Purpose of the Study:

  • To test the hypothesis that improved mechanical cardiopulmonary support and operative management have enhanced survival in trauma pneumonectomy patients.
  • To compare outcomes between two distinct time periods (2003-2010 and 2011-2023) to identify trends in survival and management.

Main Methods:

  • Retrospective single-center study of 20 patients undergoing pneumonectomy for trauma between 2003 and 2023.
  • Data collected included demographics, physiological parameters, use of venovenous extracorporeal membrane oxygenation (VV-ECMO), and mortality (early and late).
  • Outcomes were analyzed and compared between the first (2003-2010) and second (2011-2023) decades.

Main Results:

  • While Injury Severity Score (ISS) and overall/early mortality showed no significant difference between decades, late mortality dramatically decreased in the second decade (9% vs 50%).
  • The second decade saw increased use of thoracic damage control surgery (100% vs 33%) and VV-ECMO with lung rest ventilation (64% vs 22%).
  • Patients in the second decade presented with more severe physiological derangements (lower pH, higher base deficit), indicating more critical illness at presentation.

Conclusions:

  • Despite persistent high early mortality, the combination of thoracic damage control surgery and early initiation of VV-ECMO appears to be a key factor in the significant reduction of late mortality.
  • These findings suggest that modern critical care and surgical strategies have improved long-term survival for patients requiring trauma pneumonectomy.
  • Further research into optimizing these interventions is warranted to further improve outcomes in this high-risk patient population.