Management of complex pleural disease in the critically ill patient

Journal of Thoracic Disease

article

Kurt Hu¹  Amit Chopra²  Jonathan Kurman¹  J. Terrill Huggins³ 

[1] Division of Pulmonary and Critical Care Medicine, Medical College of Wisconsin;Division of Pulmonary and Critical Care Medicine, Albany Medical College;Division of Pulmonary, Critical Care, and Sleep Medicine, Medical University of South Carolina

关键词: Pleural disease;    empyema;    pneumothorax;    hemothorax;    pleural effusion of extra vascular origin;    criticall illness;   

DOI  :  10.21037/jtd-2021-31

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Disorders of the pleural space are quite common in the critically ill patient. They are generally associated with the underlying illness. It is sometimes difficult to assess for pleural space disorders in the ICU given the instability of some patients. Although the portable chest X-ray remains the primary modality of diagnosis for pleural disorders in the ICU. It can be nonspecific and may miss subtle findings. Ultrasound has become a useful tool to the bedside clinician to aid in diagnosis and management of pleural disease. The majority of pleural space disorders resolve as the patient’s illness improves. There remain a few pleural processes that need specific therapies. While uncomplicated parapneumonic effusions do not have their own treatments. Those that progress to become a complex infected pleural space can have its individual complexity in therapy. Chest tube drainage remains the cornerstone in therapy. The use of intrapleural fibrinolytics has decreased the need for surgical referral. A large hemothorax or pneumothorax in patients admitted to the ICU represent medical emergencies and require emergent action. In this review we focus on the management of commonly encountered complex pleural space disorders in critically ill patients such as complicated pleural space infections, hemothoraces and pneumothoraces.

【 授权许可】

Unknown