Steering the wheel towards the standard of care: Proposal of a step-by-step ultrasound-guided emergency chest tube drainage and literature review

International Journal of Surgery
Carlos Augusto Metidieri Menegozzo, Edivaldo Massazo Utiyama

Abstract

Chest tube drainage is a common procedure performed by physicians in the emergency setting. Complications may arise in up to 25% of the cases. These vary from drain misplacement to lethal iatrogenic injuries. Ultrasound provides adequate visualization and correct identification of the insertion site, allows the exclusion of a vulnerable intercostal artery, and enables timely diagnosis of drain malpositioning. Although feasible, ultrasound-guided techniques are underused and seldom applied during chest drainage. One reason for that is the lack of a comprehensive step-by-step description incorporating these techniques. This article aims to describe a standardized ultrasound-guided chest tube drainage technique, and also review the evidence supporting its potential benefits. we conducted a thorough literature search on ultrasound techniques regarding the identification of the diaphragm, the neurovascular intercostal bundle, and the position of the chest drain. Also, we analyzed published articles about complications of chest drainage. we propose a feasible step-by-step ultrasound-guided technique of chest drainage and discuss why this technique should be incorporated in the routine practice. ultrasound guidance should be incorpora...Continue Reading

Citations

Sep 20, 2018·Revista do Colégio Brasileiro de Cirurgiões·Carlos Augusto Metidieri MenegozzoEdivaldo Massazo Utiyama
Nov 28, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Alexandre Zanchenko FonsecaMarcelo Augusto Fontenelle Ribeiro
Dec 9, 2020·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Carlos Augusto Metidieri Menegozzo, Edivaldo Massazo Utiyama

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