Thoracostomy

Thoracostomy is a procedure to decompress the pneumothorax or to drain pleural effusion.. Chest Thoracostomy is a life-saving technique that is resorted to in trauma cases. The tube is inserted into the pleural cavity to drain fluid, pus, blood or air. It is conducted for patients suffering Emphysema (irreversible lung disease where breathing becomes increasingly difficult), Pneumothorax (accumulation of air in pleural space), Chylothorax (milky lymphatic fluid in pleural space), Hydrothorax (accumulation of water in pleural space) and Pleural effusion.

Non invasive ventilation is usually the first line of therapy to avoid the intubation procedure in less severe cases. A peak expiratory flow rate (PEFR) assessment often is an useful adjunct to the physical examination of the patient with COPD (Chronic Obstructive Pulmonary Disease - progressive air way obstruction arising out of inflammatory pulmonary conditions).

Intubation : A tube is inserted into the pleural space by a physician who is trained in the procedure. The location of the insertion depends on whether air or fluid has to be drained. The area is cleaned and numbed. The tube is inserted between the ribs and the patient usually lies on the side or half sits up with the arm raised. The insertion site and the patient position depend on whether air or fluid is being drained. The tube is connected to a cannister into which the fluid or air is drained through suction. Often the chest tube insertion is guided by ultrasound or X-ray. Some of the possible risks of the Thoracostomy include bruising and bleeding of the chest wall and bacterial infection. Pulmonary or diaphragmatic laceration might occur.

Thoracentesis

Thoracentesis or pleural fluid aspiration is a procedure that involves removal of fluid from the space between the lining of the pleura and the chest wall. Fluid is withdrawn with the aid of a needle passed through the skin of the chest wall into the pleural space. An analysis of the pleural effusion can indicate pulmonary embolism, hemothorax, Pancreatitis, pneumonia, heart failure or thyroid disease. Thoracentesis can aid in relieving pressure caused by accumulation of excess pleural fluid. A chest x-ray is taken before and after the Thoracentesis process. Do not move or cough while the diagnostic test is being conducted. Patients who have had lung surgery or lung disease such as emphysema may have difficulty with Thoracentesis. Pneumothorax, pulmonary edema or respiratory distress are rare complications associated with thoracentesis. It is essential to keep the doctor posted of any medications such as blood thinners or known allergies.

Tuberculosis

Tuberculosis, TB or Pulmonary tuberculosis is a bacterial contagious disease caused by Mycobacterium tuberculosis. Persons with weakened immune system, infants and elderly people are at higher risk for tuberculosis. You can be at greater risk if you are in frequent contact with persons suffering TB. Poor nutrition and sanitation contribute to the risk factor. Many drug-resistant strains of TB have made it more difficult to treat the disease. Pulmonary tuberculosis shows up with symptoms like fatigue, fever, cough with mucus and blood, chest pain, difficulty in breathing and unexplained weight loss. A person suffering TB will have enlarged lymph nodes and pleural effusion. Bronchoscopy, chest x-ray and sputum culture can aid diagnosis of pulmonary tuberculosis. Pulmonary TB is treated with Isoniazid, Rifampin, Ethambutol, Streptomycin or Moxifloxacin. Treatment usually lasts for 6 months or longer.

Extra pulmonary tuberculosis or Miliary tuberculosis

Tuberculosis can also affect other parts of the body such as bones, lymphatic system, central nervous system and genital or urinary system. Disseminated tuberculosis or Miliary tuberculosis is a contagious bacterial infection that has spread from the lungs to other parts of the body through the blood or lymph system. This type of TB can also affect the larynx, skin and pericardium too.