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Porcel JM, Lee YCG. Advances in pleural diseases. Eur Respir J 2024; 63:2400593. [PMID: 38901889 DOI: 10.1183/13993003.00593-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 05/03/2024] [Indexed: 06/22/2024]
Affiliation(s)
- José M Porcel
- Pleural Medicine and Clinical Ultrasound Unit, Department of Internal Medicine, Arnau de Vilanova University Hospital, IRBLleida, University of Lleida, Lleida, Spain
| | - Y C Gary Lee
- University of Western Australia; Institute for Respiratory Health and Respiratory Department, Sir Charles Gairdner Hospital, Perth, Australia
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Lee YCG. Primary Spontaneous Pneumothorax: Treat the Patient, Not the X-Ray. Am J Respir Crit Care Med 2023; 207:1416-1417. [PMID: 36892609 PMCID: PMC10263137 DOI: 10.1164/rccm.202302-0273ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023] Open
Affiliation(s)
- Y C Gary Lee
- Respiratory Medicine Sir Charles Gairdner Hospital Perth, Western Australia, Australia
- Faculty of Health & Medical Sciences University of Western Australia Perth, Western Australia, Australia and Pleural Medicine Unit Institute for Respiratory Health Perth, Western Australia, Australia
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Lee YCG, Singh B. Reply to Albert and Dhooria et al.. Am J Respir Crit Care Med 2023; 207:225-226. [PMID: 36070599 PMCID: PMC9893335 DOI: 10.1164/rccm.202207-1450le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Y. C. Gary Lee
- Sir Charles Gairdner HospitalNedlands, Western Australia, Australia,University of Western AustraliaPerth, Western Australia, Australia,Institute for Respiratory HealthPerth, Western Australia, Australia,Corresponding author (e-mail: )
| | - Bhajan Singh
- Sir Charles Gairdner HospitalNedlands, Western Australia, Australia,University of Western AustraliaPerth, Western Australia, Australia,QE II Medical CentreNedlands, Western Australia, Australia
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Dhooria S, Sehgal IS, Aggarwal AN, Agarwal R. The Answer May Lie in Avoiding the Underwater Seal Rather Than the Chest Drainage Tube. Am J Respir Crit Care Med 2023; 207:224-225. [PMID: 36070594 PMCID: PMC9893316 DOI: 10.1164/rccm.202208-1457le] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Albert RK. Pneumothorax: Challenging the Paradigm of Persistent Air Leak, but Where Is the Leak? Am J Respir Crit Care Med 2023; 207:223. [PMID: 36070602 PMCID: PMC9893329 DOI: 10.1164/rccm.202207-1388le] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Ma L, Yin M, Yang XL, Xu W. Risk factors for air leakage during invasive mechanical ventilation in pediatric intensive care units. Eur J Med Res 2022; 27:218. [DOI: 10.1186/s40001-022-00858-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/16/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
This study aimed to investigate air leakage during invasive mechanical ventilation (IMV) in a pediatric intensive care unit (PICU) and explore potential risk factors.
Methods
We conducted a retrospective cohort study of children who underwent IMV in a single-center PICU in a tertiary referral hospital. Air leakage risk factors and factors associated with an improved outcome were assessed.
Results
A total of 548 children who underwent IMV were enrolled in this study. Air leakage occurred in 7.5% (41/548) of the cases in the PICU. Air leakage increased the duration of IMV and hospitalization time. Multivariate logistic regression analysis showed a higher risk of air leakage during IMV for PICU patients with acute respiratory dyspnea syndrome (ARDS) (OR = 4.38), a higher pediatric critical illness score (PCIS) (OR = 1.08), or a higher peak inspiratory pressure (PIP) (OR = 1.08), whereas the risk was lower for patients with central respiratory failure (OR = 0.14). The logistic model had excellent predictive power for air leakage, with an area under the curve of 0.883 and tenfold cross-validation. Patients aged between 1 and 6 years who were diagnosed with measles or pneumonia and had a low positive end-expiratory pressure (PEEP) or high PaO2/FiO2 ratio were associated with improved outcomes. Patients diagnosed with central respiratory failure or congenital heart diseases were associated with less desirable outcomes.
Conclusions
Patients with ARDS, a higher PCIS at admission or a higher PIP were at higher risk of air leakage.
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