Interprofessional Approach to Ultrasound Diagnosis and Intervention in Critical Care Patients With Pneumothorax and/or Hemothorax (Steering the Eagerness Towards Standardization of the Third Core Competency in ICU)
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 50
- 试验地点
- 1
- 主要终点
- Efficacy of ultrasound diagnosis
研究概览
简要总结
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
详细描述
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.
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研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 21 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •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.
排除标准
- •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.
研究组 & 干预措施
Group I
The Technique was performed according to combination of the BTS guidelines for chest tube insertion and US-guided technique for chest tube insertion by Dev et al. and Menegozzo et al. and US-guided pigtail insertion by Vetrugno et al
干预措施: Chest-Tube Insertion (Diagnostic Test)
结局指标
主要结局
Efficacy of ultrasound diagnosis
时间窗: 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)
次要结局
- Incidence of complications(72 hours after intervention)
- Duration of insertion(30 minutes intervention)
- Monitoring team performance(24 hours after intervention)
- Efficacy of ultrasound in intervention(10 days after intervention)
研究者
Nader Salama Gaber
Resident of Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of Medicine,Tanta University, Tanta, Egypt.
Tanta University