3,117 results match your criteria intrapleural


Intrapleural Steroid Instillation for Critically Ill Patients With Covid-19 Severe Adult Respiratory Distress Syndrome.

Authors:
Pei-Ming Huang

Shock 2021 May;55(5):695-696

Division of Thoracic Surgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

View Article and Full-Text PDF

Intrapleural nasogastric tube placement: An unintentional complication indicating the cause of tension pneumothorax during esophageal balloon dilation.

J Clin Anesth 2021 Apr 7;72:110286. Epub 2021 Apr 7.

Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Electronic address:

View Article and Full-Text PDF

[Ectopic Adrenocorticotropic Hormone-Producing Pulmonary Carcinoid Presenting as Cushing's Syndrome after Intrapleural Hyperthermic Chemotherapy].

Kyobu Geka 2021 Mar;74(3):197-201

Department of Surgery, Okinawa National Hospital, Ginowan, Japan.

The patient was a woman in her 70's was referred to our hospital because of an abnormal shadow on chest roentgenogram at an annual medical checkup. Since preoperative examinations suggested lung cancer in the right middle lobe, thoracoscopic right middle lobectomy was planned. However, pleural dissemination was detected at surgery and we changed the treatment plan to the intrapleural hyperthermic chemotherapy. Read More

View Article and Full-Text PDF

Orphan Designation and Cisplatin/Hyaluronan Complex in an Intracavitary Film for Malignant Mesothelioma.

Pharmaceutics 2021 Mar 9;13(3). Epub 2021 Mar 9.

Department of Life Sciences and Biotechnology, University of Ferrara, Via Fossato di Mortara 17/19, 44121 Ferrara, Italy.

Pleural mesothelioma is a lung diffuse tumor, whose complete resection is unlikely. Consequently, metastases reappear where the primary tumor was removed. This paper illustrates the orphan medicine designation procedure of an intracavitary cisplatin film and related pharmaceutical development aspects requested by the European Medicines Agency (EMA) in its Scientific Advice. Read More

View Article and Full-Text PDF

Intrapleural Fibrinolytics and Deoxyribonuclease for Treatment of Indwelling Pleural Catheter-Related Pleural Infection: A Multi-Center Observational Study.

Respiration 2021 Mar 30:1-9. Epub 2021 Mar 30.

Sir Charles Gairdner Hospital, Perth, Washington, Australia.

Background: Indwelling pleural catheters (IPC) are increasingly used for management of recurrent (especially malignant) effusions. Pleural infection associated with IPC use remains a concern. Intrapleural therapy with tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) significantly reduces surgical referrals in non-IPC pleural infection, but data on its use in IPC-related pleural infection are scarce. Read More

View Article and Full-Text PDF

Study protocol of a phase 1 clinical trial establishing the safety of intrapleural administration of liposomal curcumin: curcumin as a palliative treatment for malignant pleural effusion (IPAL-MPE).

BMJ Open 2021 Mar 29;11(3):e047075. Epub 2021 Mar 29.

Anatomical Pathology, Flinders University, Bedford Park, South Australia, Australia.

Introduction: This is a phase 1, open-label, single-centre, uncontrolled, dose-escalation study to evaluate the feasibility, tolerability and pharmacokinetic profiles of a single dose of liposomal curcumin, administered via an existing tunnelled indwelling pleural catheter (TIPC) directly to the tumour site in individuals with diagnoses of malignant pleural effusion. Primarily, we aim to determine a maximum tolerated dose of liposomal curcumin administered via this method.

Methods And Analysis: We will use a 3+3 expanded cohort for predefined dose-escalation levels or until a predefined number of dose-limiting toxicities are reached. Read More

View Article and Full-Text PDF

Single and Repeated Intrapleural Ropivacaine Administration: A Plasma Concentration and Pharmacodynamics Study.

J Pain Res 2021 19;14:785-791. Epub 2021 Mar 19.

Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Zhejiang, People's Republic of China.

Background: Intrapleural analgesia has been increasingly recommended for postoperative analgesia after thoracic surgery. However, the analgesic effect provided by a single intrapleural administration is time limited. This study reports the efficacy and safety of repeated intrapleural 0. Read More

View Article and Full-Text PDF

The use of intrapleural thrombolytic and/or fibrinolytic therapy via indwelling tunneled pleural catheters with or without concurrent anticoagulation usage.

Chest 2021 Mar 18. Epub 2021 Mar 18.

Thoracic Surgery and Interventional Pulmonology, Swedish Cancer Institute, Seattle, WA.

Background: Indwelling tunneled pleural catheters are commonly used for recurrent pleural effusion management. Catheter obstruction is not uncommon, often requiring intrapleural medications instillation (i.e. Read More

View Article and Full-Text PDF

Distinct phenotypic expression levels of macrophages in neonatal lungs.

Exp Ther Med 2021 Apr 19;21(4):369. Epub 2021 Feb 19.

Department of Anesthesiology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan, R.O.C.

Alveolar macrophages are the front-line defense against environmental pathogens. However, to the best of our knowledge, differences in function and phenotypic expression levels of macrophages between neonatal and adult lungs have not previously been determined. The present study investigated lung tissues and analyzed blood samples to find cell markers of M1 and M2 macrophages in neonatal and adult rats. Read More

View Article and Full-Text PDF

Clinical application of a digital thoracic drainage system for objectifying and quantifying air leak versus the traditional vacuum system: a retrospective observational study.

J Thorac Dis 2021 Feb;13(2):1020-1035

Department of Thoracic and Cardiovascular Surgery, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju-si, Chungbuk, Republic of Korea.

Background: Digital thoracic drainage systems have recently been introduced and widely used in clinical practices in developed countries. These systems can monitor intrathoracic pressure changes and air leaks in real time, and also allow for objective and quantitative analyses, which aid in managing patients with a prolonged persistent air leak into the pleural space. We investigated the feasibility and effectiveness of such a new device versus the traditional vacuum system for treating patients with pneumothorax. Read More

View Article and Full-Text PDF
February 2021

A novel model for extrapleural cavity metastasis assessment in patients with lung cancer.

Biomark Med 2021 Apr 12;15(6):389-399. Epub 2021 Mar 12.

Department of Clinical Research Center, Dazhou Central Hospital, Dazhou, Sichuan, China.

To investigate the clinical value of tumor markers in extrapleural tumor metastasis assessment of newly diagnosed lung cancer patients. This study retrospectively analyzed 306 patients diagnosed with lung cancer accompanied by tumor metastasis. Patients were grouped into extrapleural tumor metastasis and intrapleural tumor metastasis. Read More

View Article and Full-Text PDF

Allosteric and ATP-Competitive MEK-Inhibition in a Novel Spitzoid Melanoma Model with a RAF- and Phosphorylation-Independent Mutation.

Cancers (Basel) 2021 Feb 16;13(4). Epub 2021 Feb 16.

Department of Thoracic Surgery, University Medicine Essen-Ruhrlandklinik, Tüschener Weg 40, 45239 Essen, Germany.

Spitzoid melanoma is a rare malignancy with histological characteristics similar to Spitz nevus. It has a diverse genetic background and in adults, a similarly grim clinical outcome as conventional malignant melanoma. We established a spitzoid melanoma cell line (PF130) from the pleural effusion sample of a 37-year-old male patient. Read More

View Article and Full-Text PDF
February 2021

Effects of postural differences on intrapleural pressure during chest wall compression in healthy males.

J Phys Ther Sci 2021 Feb 13;33(2):132-136. Epub 2021 Feb 13.

Department of Anesthesiology and Critical Care Medicine, Kobe Century Memorial Hospital, Japan.

[Purpose] This study aimed to investigate the difference in intrapleural pressure between the supine and lateral decubitus positions during manual chest wall compression. [Participants and Methods] Eight healthy males participated in this study. The same physiotherapist performed chest wall compression on participants lying supine, and on their right and left sides. Read More

View Article and Full-Text PDF
February 2021

Endothelial Cell Protein C Receptor Deficiency Attenuates induced Pleural Fibrosis.

Am J Respir Cell Mol Biol 2021 Apr;64(4):477-491

Department of Cellular and Molecular Biology.

is the leading cause of hospital community-acquired pneumonia. Patients with pneumococcal pneumonia may develop complicated parapneumonic effusions or empyema that can lead to pleural organization and subsequent fibrosis. The pathogenesis of pleural organization and scarification involves complex interactions between the components of the immune system, coagulation, and fibrinolysis. Read More

View Article and Full-Text PDF

Effectiveness of Delayed Intrapleural Alteplase Instillation for Infected Residual Traumatic Hemothorax. Case Report.

SN Compr Clin Med 2021 Feb 5:1-4. Epub 2021 Feb 5.

Intensive Care Medicine 1, Hospital de Faro, Centro Hospitalar Universitário do Algarve, Faro, Portugal.

In thoracic trauma, many cases may present with hemothorax, and, of those, a portion can complicate in empyema. These cases can reveal themselves to be of difficult management, particularly in peripheral hospitals with complicated access to thoracic surgery. Intrapleural fibrinolytic instillation can be of use and has been widely reported, mostly in the case of empyema. Read More

View Article and Full-Text PDF
February 2021

Serum soluble mesothelin-related protein (SMRP) and fibulin-3 levels correlate with baseline malignant pleural mesothelioma (MPM) tumor volumes but are not useful as biomarkers of response in an immunotherapy trial.

Lung Cancer 2021 Apr 14;154:5-12. Epub 2021 Jan 14.

Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.

Objectives: Soluble mesothelin-related protein (SMRP) and fibulin-3 serum levels may serve as diagnostic and prognostic biomarkers of malignant pleural mesothelioma (MPM). Here, we evaluate these markers for correlation to tumor volume, prognosis and response assessment in a clinical trial of immunogene therapy in combination with chemotherapy.

Materials And Methods: Serial serum levels of SMRP and fibulin-3 were measured in adult patients with biopsy-proven MPM enrolled in two prospective clinical trials. Read More

View Article and Full-Text PDF

Quantifying mitochondrial volume density in phrenic motor neurons.

J Neurosci Methods 2021 Apr 4;353:109093. Epub 2021 Feb 4.

Department of Physiology & Biomedical Engineering, Mayo Clinic, Rochester, MN, 55905, United States. Electronic address:

Background: Previous assessments of mitochondrial volume density within motor neurons used electron microscopy (EM) to image mitochondria. However, adequate identification and sampling of motor neurons within a particular motor neuron pool is largely precluded using EM. Here, we present an alternative method for determining mitochondrial volume density in identified motor neurons within the phrenic motor neuron (PhMN) pool, with greatly increased sampling. Read More

View Article and Full-Text PDF

Late Diagnosis of a Large Extrapleural Hematoma in a Patient With Stanford Type B Aortic Dissection: A Case Report and Review of Literature.

J Cardiothorac Vasc Anesth 2021 Jan 12. Epub 2021 Jan 12.

Department of Anesthesiology and Critical Care Medicine, Lahey Hospital and Medical Center, Burlington, MA.

Acute aortic dissection is a rare but catastrophic condition. When the dissection extends through the adventitia, blood can extravasate into the extrapleural or intrapleural spaces, causing an extrapleural hematoma or hemothorax. The early recognition of extrapleural hematoma and distinguishing it from hemothorax is critical because the management of those two entities is different. Read More

View Article and Full-Text PDF
January 2021

Successful drainage of complex haemoserous malignant pleural effusion with a single modified low-dose intrapleural alteplase and dornase alfa.

BMJ Case Rep 2021 Feb 5;14(2). Epub 2021 Feb 5.

Pulmonology, Hospital Serdang, Kajang, Selangor, Malaysia.

Patients with symptomatic complex malignant pleural effusion (MPE) are frequently unfit for decortication and have a poorer prognosis. Septations can develop in MPE, which may lead to failure of complete drainage and pleural infection. Intrapleural fibrinolytic therapy (IPFT) is an alternative treatment. Read More

View Article and Full-Text PDF
February 2021

Use of fibrinolytics and deoxyribonuclease in adult patients with pleural empyema: a consensus statement.

Lancet Respir Med 2021 Feb 2. Epub 2021 Feb 2.

Oxford Respiratory Trials Unit, University of Oxford, Oxford, UK.

Although our understanding of the pathogenesis of empyema has grown tremendously over the past few decades, questions still remain on how to optimally manage this condition. It has been almost a decade since the publication of the MIST2 trial, but there is still an extensive debate on the appropriate use of intrapleural fibrinolytic and deoxyribonuclease therapy in patients with empyema. Given the scarcity of overall guidance on this subject, we convened an international group of 22 experts from 20 institutions across five countries with experience and expertise in managing adult patients with empyema. Read More

View Article and Full-Text PDF
February 2021

Hyperthermic intrathoracic chemotherapy combined to iterative cytoreductive surgery to treat a pleural carcinosis from psudomixoma peritonei. A case report.

Eur Rev Med Pharmacol Sci 2021 Jan;25(1):362-365

Unit of Thoracic Surgery, General Surgery, Oncology Unit, Anaesthesiology Unit, Fondazione Policlinico Universitario "A. Gemelli", IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

Pseudomyxoma peritonei (PMP) is an uncommon disease with locally-invasive attitude. Intrathoracic spread is rarely reported and its management extremely challenging. A 51-year-old Caucasian female presented with left pleural carcinosis 9-months after two sequential abdominal surgical procedures combined with HIPEC for low-grade PMP. Read More

View Article and Full-Text PDF
January 2021

Intrapleural interleukin-2-expressing oncolytic virotherapy enhances acute antitumor effects and T-cell receptor diversity in malignant pleural disease.

J Thorac Cardiovasc Surg 2020 Dec 13. Epub 2020 Dec 13.

Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, Pa; Surgical Services Division, VAPHS, Pittsburgh, Pa. Electronic address:

Objective: The mainstay of treatment for patients with malignant pleural disease is fluid drainage and systemic therapy. A tumor-specific oncolytic virus or T-cell-activating interleukin-2 immunotherapy may provide an opportunity for local control. We previously developed a vaccinia virus-expressing interleukin-2, an oncolytic virus that mediated tumor regression in preclinical peritoneal tumor models with expansion of tumor-infiltrating lymphocytes. Read More

View Article and Full-Text PDF
December 2020

Intrapleural alteplase and DNase for complex tuberculous pleurisy: a medical approach.

Respirol Case Rep 2021 Feb 3;9(2):e00706. Epub 2021 Jan 3.

Respiratory Unit University Kebangsaan Malaysia Medical Centre Kuala Lumpur Malaysia.

Tuberculous pleurisy is extra-pulmonary tuberculosis caused by (MTB), which is one of the main cause of pleural effusions in developing countries. Intercostal chest catheter is useful for drainage of infected pleural fluid and facilitates sepsis control. However, management might be challenging in complex tuberculous pleural effusion as the septations within the effusion hinder pleural drainage. Read More

View Article and Full-Text PDF
February 2021

Bronchopleural Fistula in the Mechanically Ventilated Patient: A Concise Review.

Crit Care Med 2021 Feb;49(2):292-301

Department of Pulmonary and Critical Care Medicine, University of Michigan, Ann Arbor, MI.

Objective: To describe the physiology of air leak in bronchopleural fistula in mechanically ventilated patients and how understanding of its physiology drives management of positive-pressure ventilation. To provide guidance of lung isolation, mechanical ventilator, pleural catheter, and endobronchial strategies for the management of bronchopleural fistula on mechanical ventilation.

Data Sources: Online search of PubMed and manual review of articles (laboratory and patient studies) was performed. Read More

View Article and Full-Text PDF
February 2021

Lung white out: haemothorax after intrapleural tPA and DNase administration.

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

Pulmonary and Critical Care Medicine, Ozarks Medical Center, West Plains, Missouri, USA

View Article and Full-Text PDF
December 2020

Fibrinolysis with Lower Dose Urokinase in Patients with Complicated Parapneumonic Effusion.

Tuberc Respir Dis (Seoul) 2021 Apr 17;84(2):134-139. Epub 2020 Dec 17.

Pulmonology Division, Department of Internal Medicine, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea.

Background: Intrapleural urokinase is one of the most widely used fibrinolytic agents in the treatment of complicated parapneumonic effusion (CPPE). However, little research has been performed on the optimal urokinase dosage. The aim of this study was to evaluate the treatment efficacy of half dose urokinase compared with conventional dose urokinase. Read More

View Article and Full-Text PDF

Management of Pleural Infection.

Pulm Ther 2020 Dec 9. Epub 2020 Dec 9.

Oxford Centre for Respiratory Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.

Pleural infection is a millennia-spanning condition that has proved challenging to treat over many years. Fourteen percent of cases of pneumonia are reported to present with a pleural effusion on chest X-ray (CXR), which rises to 44% on ultrasound but many will resolve with prompt antibiotic therapy. To guide treatment, parapneumonic effusions have been separated into distinct categories according to their biochemical, microbiological and radiological characteristics. Read More

View Article and Full-Text PDF
December 2020

Cost-Effectiveness Analysis of Fibrinolysis versus Thoracoscopic Decortication for Early Empyema.

Ann Thorac Surg 2020 Nov 27. Epub 2020 Nov 27.

Vanderbilt University Medical Center, Nashville, TN; Tennessee Valley Healthcare System, Nashville, TN. Electronic address:

Background: Surgical decortication is recommended by national guidelines for management of early empyema, but intrapleural fibrinolysis is frequently used as a first-line therapy in clinical practice. This study compared the cost effectiveness of video-assisted thoracoscopic surgery (VATS) decortication with intrapleural fibrinolysis for early empyema.

Methods: A decision analysis model was developed. Read More

View Article and Full-Text PDF
November 2020

Protective measures undertaken during chest tube thoracostomy in COVID-19 outbreak.

Indian J Thorac Cardiovasc Surg 2020 Nov 24:1-4. Epub 2020 Nov 24.

Department of Thoracic Surgery, Çanakkale Onsekiz Mart University Faculty of Medicine, Çanakkale, Turkey.

Background: Coronavirus disease 2019 (COVID-19) is a newly emerging infectious disease that was first reported in China and has become a worldwide pandemic. Many surgical procedures are continuing to be performed during this state of pandemic as is thoracic surgery. We present six cases of tube thoracostomy in COVID-19 patients and the modifications to the routine surgical technique. Read More

View Article and Full-Text PDF
November 2020