Safety and Risk Factors of Needle Thoracentesis Decompression in Tension Pneumothorax in Patients over 75 Years Old.

IF 2.1 4区医学 Q3 RESPIRATORY SYSTEM

Canadian respiratory journal Pub Date : 2023-01-01 DOI:10.1155/2023/2602988

Yanhu Wang, Lei Wang, Cheng Chen, Yifan Que, Yinyi Li, Jiang Luo, Ming Yin, Miao Lv, Guogang Xu

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引用次数: 0

Abstract

Background: There are very few professional recommendations or guidelines on the needle thoracentesis decompression (NTD) for the tension pneumothorax in the elderly. This study aimed to investigate the safety and risk factors of tension pneumothorax NTD in patients over 75 years old based on CT evaluation of the chest wall thickness (CWT).

Methods: The retrospective study was conducted among 136 in-patients over 75 years old. The CWT and closest depth to vital structure of the second intercostal space at the midclavicular line (second ICS-MCL) and the fifth intercostal space at the midaxillary line (fifth ICS-MAL) were compared as well as the expected failure rates and the incidence of severe complications of different needles. We also analyzed the influence of age, sex, presence or absence of chronic obstructive pulmonary disease (COPD), and body mass index (BMI) on CWT.

Results: The CWT of the second ICS-MCL was smaller than the fifth ICS-MAL both on the left and the right side (P < 0.05). The success rate associated with a 7 cm needle was significantly higher than a 5 cm needle (P < 0.05), and the incidence of severe complications with a 7 cm needle was significantly less than an 8 cm needle (P < 0.05). The CWT of the second ICS-MCL was significantly correlated with age, sex, presence or absence of COPD, and BMI (P < 0.05), whereas the CWT of the fifth ICS-MAL was significantly correlated with sex and BMI (P < 0.05).

Conclusion: The second ICS-MCL was recommended as the primary thoracentesis site and a 7 cm needle was advised as preferred needle length for the older patients. Factors such as age, sex, presence or absence of COPD, and BMI should be considered when choosing the appropriate needle length.

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75岁以上紧张性气胸穿刺减压的安全性及危险因素分析。

背景:目前对于老年人紧张性气胸的针穿刺减压术(NTD)的专业建议和指南很少。本研究旨在通过胸壁厚度(CWT)的CT评价，探讨75岁以上患者紧张性气胸NTD的安全性及危险因素。方法:对136例75岁以上住院患者进行回顾性研究。比较不同针的锁骨中线第二肋间隙(second ICS-MCL)和腋中线第五肋间隙(fifth ICS-MAL)的CWT和最接近重要结构的深度，以及预期失败率和严重并发症的发生率。我们还分析了年龄、性别、是否患有慢性阻塞性肺疾病(COPD)和体重指数(BMI)对CWT的影响。结果:第2个ICS-MCL的左、右侧CWT均小于第5个ICS-MAL (P < 0.05)。7cm针的成功率显著高于5cm针(P < 0.05)， 7cm针的严重并发症发生率显著低于8cm针(P < 0.05)。第2例ICS-MCL的CWT与年龄、性别、有无COPD、BMI显著相关(P < 0.05)，第5例ICS-MAL的CWT与性别、BMI显著相关(P < 0.05)。结论:推荐第二ICS-MCL为主要穿刺部位，老年患者首选针长为7cm。在选择合适的针头长度时，应考虑年龄、性别、是否患有COPD以及BMI等因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Canadian respiratory journal 医学-呼吸系统

CiteScore

4.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Canadian Respiratory Journal is a peer-reviewed, Open Access journal that aims to provide a multidisciplinary forum for research in all areas of respiratory medicine. The journal publishes original research articles, review articles, and clinical studies related to asthma, allergy, COPD, non-invasive ventilation, therapeutic intervention, lung cancer, airway and lung infections, as well as any other respiratory diseases.