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Gomes da Silva DA, D'Ambrosio PD, Minamoto FEN, Pessoa BMDL, Rocha Junior E, Lauricella LL, Terra RM, Pêgo-Fernandes PM, Mariani AW. Resident physician training in bedside pleural procedures: A one-year experience at a teaching hospital. Clinics (Sao Paulo) 2024; 79:100399. [PMID: 38834010 PMCID: PMC11178978 DOI: 10.1016/j.clinsp.2024.100399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 04/08/2024] [Accepted: 05/18/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND AND OBJECTIVE This study aims to quantify bedside pleural procedures performed at a quaternary teaching hospital describing technical and epidemiological aspects. MATERIALS AND METHODS The authors retrospectively reviewed consecutive patients who underwent invasive thoracic bedside procedures between March 2022 and February 2023. RESULTS 463 chest tube insertions and 200 thoracenteses were performed during the study period. Most procedures were conducted by 1st-year Thoracic Surgery residents, with Ultrasound Guidance (USG). There was a notable preference for small-bore pigtail catheters, with a low rate of immediate complications. CONCLUSION Bedside thoracic procedures are commonly performed in current medical practice and are significant in surgical resident training. The utilization of pigtail catheters and point-of-care ultrasonography by surgical residents in pleural procedures is increasingly prevalent and demonstrates high safety.
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Affiliation(s)
- Diego Arley Gomes da Silva
- Divisao Cirurgia Toracica, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
| | - Paula Duarte D'Ambrosio
- Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Fabio Eiti Nishibe Minamoto
- Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Bernardo Mulinari de Lacerda Pessoa
- Divisao Cirurgia Toracica, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Eserval Rocha Junior
- Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Leticia Leone Lauricella
- Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Ricardo Mingarini Terra
- Instituto do Câncer, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (HCFMUSP), São Paulo, SP, Brazil
| | - Paulo Manuel Pêgo-Fernandes
- Divisao Cirurgia Toracica, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - Alessandro Wasum Mariani
- Divisao Cirurgia Toracica, Instituto do Coracao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
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Heraganahally SS, Silva SAMS, Howarth TP, Kangaharan N, Majoni SW. Comparison of clinical manifestation among Australian Indigenous and non- Indigenous patients presenting with pleural effusion. Intern Med J 2021; 52:1232-1241. [PMID: 33817935 DOI: 10.1111/imj.15310] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/24/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is sparse evidence in the literature in relation to the nature and causes of pleural effusion among Australian Indigenous population. METHODS In this retrospective study, Indigenous and non-Indigenous adults diagnosed to have pleural effusion over a two-year study period were included for comparative analysis. RESULTS Of the 314 patients, 205 (65%) were non-Indigenous and 52% were males. In comparison to non-Indigenous, the Indigenous patients were younger (50 years (IQR 39,60) vs 63 years (IQR 52,72), p<0.001), females (61% vs 41%, p=0.001), have higher prevalence of renal and cardiovascular disease and tend to have exudative effusion (93% vs 76%, p=0.032). Infections was judged to be the most common cause for effusion in both groups, more so among the Indigenous cohort. Effusion secondary to renal disease was higher (13% vs 1%, p<0.001) among Indigenous Australians, in contrast malignant effusions were higher (13% vs 4%, p=0.004) among non-Indigenous. Length of hospital stay was longer for Indigenous patients (p=0.001), and a greater proportion received renal dialysis (13% vs 1%, p<0.001). Intensive care unit (ICU) admissions rates were higher with infective etiology of pleural effusion (82% vs. 53% Indigenous & 44% vs. 39% non-Indigenous respectively). Re-presentations to hospital were higher among Indigenous patients (46% vs 33%, p=0.046) and were associated with renal and cardiac disease and malignancy in non-Indigenous. CONCLUSION There are significant differences in the way pleural effusion manifests among Australian Indigenous patients. Understanding these differences may facilitate approaches to the management and to implement strategies to reduce morbidity and mortality in this population. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Subash Shanthakumar Heraganahally
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia.,Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
| | - Sampathawaduge Anton Mario Shemil Silva
- Department of Respiratory and Sleep Medicine, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia.,College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia
| | - Timothy Paul Howarth
- Darwin Respiratory and Sleep Health, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia.,College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia
| | - Nadarajah Kangaharan
- Department of General Medicine, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia.,NT Cardiac service, Darwin Private Hospital, Tiwi, Darwin, Northern Territory, Australia
| | - Sandawana William Majoni
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia.,Department of Nephrology, Royal Darwin Hospital, Tiwi, Darwin, Northern Territory, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
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