What is it about?
In this letter, the authors provide their perspective on the use of point of care ultrasound (performed by the surgeon) to reduce complications while inserting drainage tubes in the thorax of the patients. The focus of this manuscript is on finding the safest and lowermost site to insert the tube in order to avoid injuries to the diaphragm or unintended intrabdominal insertions.
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Why is it important?
Chest drainages are common procedures performed by physicians. Nevertheless, this procedures carries a high complication rate of approximately 25%. The most common complications are related to the insertion of the drain, which may result in lung and chest wall injuries, diaphragmatic trauma or ectopic positioning of the drain. Ultrasound can be used to mitigate such complications, by identifying the diaphragm and chest wall neurovascular bundle, and by poviding timely diagnosis of an extrapleural drain positioning.
Perspectives
Surgeons are still not broadly incoporating point of care ultrasound in their practice routinely. This manuscript may help elicit a wider understanding of the benefits of ultrasound as an adjunct for surgical procedures, focusing on tube thoracostomies.
Carlos Augusto Menegozzo
Hospital das Clinicas da Universidade de Sao Paulo
Read the Original
This page is a summary of: Point-of-care ultrasound as a tool to prevent insertional complications during tube thoracostomy, Trauma, December 2019, SAGE Publications, DOI: 10.1177/1460408619893901.
You can read the full text:
Resources
Steering the wheel towards the standard of care: Proposal of a step-by-step ultrasound-guided emergency chest tube drainage and literature review
Article published in 2018 describing a step-by-step technique for ultrasound-guided tube thoracostomy.
Can ultrasound be used as an adjunct for tube thoracostomy? A systematic review of potential application to reduce procedure-related complications
Systematic review of the literature regarding potencial uses of point of care ultrasound as an adjunct for tube thoracostomy.
How to reduce pleural drainage complications using an ultrasound-guided technique.
This manuscript focuses on a previously published article about complications of tube thoracostomy. The authors provide insights on how the incorporation of ultrasound in such procedures might have reduced the incidence of insertional complications.
Link to the manuscript
Link to the TRAUMA website - direct link to this publication.
Contributors
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