Loculated pneumothoraces in patients with acute respiratory disease treated with mechanical ventilation: preliminary observations after image-guided drainage.
OBJECTIVE
To report the clinical impact of image-guided percutaneous drainage of loculated pneumothoraces in patients with acute respiratory disease treated with mechanical ventilation.


METHODS
Sixteen loculated pneumothoraces were seen in nine patients. Twelve of the 16 lesions were considered suitable for drainage because of their size and location. They were percutaneously drained by means of image-guided placement of catheters that ranged in size from 16 F to 24 F. Gas exchange was assessed clinically, and follow-up chest radiographs and computed tomographic scans were evaluated.


RESULTS
Loculated pneumothoraces were reduced in all patients. Improvement in the ratio of arterial oxygen pressure to fraction of inspired oxygen was identified in eight patients. All patients showed an improved arterial oxygen pressure.


CONCLUSIONS
Image-guided catheter placement may play a role in the acute management of loculated pneumothorax and adult respiratory distress syndrome. This type of therapy may reverse the deterioration of gas exchange and reduce the risk of further pulmonary compromise.
Boland
G W
GW
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA.
Lee
M J
MJ
Sutcliffe
N P
NP
Mueller
P R
PR
D000328:Adult; D000368:Aged; D004322:Drainage / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011030:Pneumothorax / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed