{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T11:43:38Z","timestamp":1782301418655,"version":"3.54.5"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"5-6","license":[{"start":{"date-parts":[[2023,12,11]],"date-time":"2023-12-11T00:00:00Z","timestamp":1702252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The incidence and management outcomes of COVID-19 patients with acute respiratory distress syndrome (ARDS) on veno-venous extracorporeal membrane oxygenation (V-V ECMO) requiring chest tubes are not well-described. This study sought to explore differences in tube thoracostomy rates and subsequent complications between patients with and without COVID-19 ARDS on V-V ECMO.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>This study is a single institution, retrospective cohort study of patients with COVID-19 ARDS requiring V-V ECMO. The control cohort consisted of patients who required V-V ECMO for ARDS-related diagnoses from January 2018 to January 2021. The primary outcome was any complication following initial tube thoracostomy placement. Study approval was obtained from the Brooke Army Medical Center Institutional Review Board (C.2017.152d).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-five COVID-19 patients and 38 controls were included. Demographic parameters did not differ between the groups. The incidence of pneumothorax was not significantly different between the two groups (44% COVID-19\u2009vs. 22% control, OR 2.8, 95% CI 0.95\u20137.9, P\u2009=\u20090.09). Patients with COVID-19 were as likely to receive tube thoracostomy as controls (36% vs. 24%, OR 1.8, 95% CI 0.55\u20135.7). Complications, however, were more likely to occur in the COVID-19 group (89% vs. 33%, OR 16, 95% CI, 1.6\u2013201, P\u2009=\u20090.0498).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Tube thoracostomy placement in COVID-19 patients with ARDS requiring V-V ECMO is common, as are complications following initial placement. Clinicians should anticipate the need for re-intervention in this patient population. Small-bore (14Fr and smaller) pigtail catheters appeared to be safe and efficacious in this setting, but further study on tube thoracostomy management in ECMO patients is needed.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad454","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T01:45:48Z","timestamp":1702345548000},"page":"e1016-e1022","source":"Crossref","is-referenced-by-count":1,"title":["Tube Thoracostomy Complications in\u00a0Patients With ARDS Requiring ECMO: Worse in\u00a0COVID-19 Patients?"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4092-5660","authenticated-orcid":false,"given":"Robert B","family":"Laverty","sequence":"first","affiliation":[{"name":"Department of Surgery, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M","family":"Ivins-O\u2019Keefe","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, US Army Institute of Surgical Research Burn Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra M","family":"Adams","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meaghan J","family":"Flatley","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5060-0352","authenticated-orcid":false,"given":"Michal J","family":"Sobieszczyk","sequence":"additional","affiliation":[{"name":"Department of Medicine, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip E","family":"Mason","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie G","family":"Sams","sequence":"additional","affiliation":[{"name":"Department of Surgery, Brooke Army Medical Center , JBSA Fort Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,12,11]]},"reference":[{"issue":"3","key":"2025012315140633400_R1","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1097\/ccm.0000000000005283","article-title":"Barotrauma in\u00a0coronavirus disease 2019 patients undergoing invasive mechanical ventilation: a systematic literature review","volume":"50","author":"Belletti","year":"2022","journal-title":"Crit Care Med"},{"key":"2025012315140633400_R2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.amsu.2021.103221","article-title":"Pulmonary barotrauma in\u00a0COVID-19: a systematic review and\u00a0meta-analysis","volume":"73","author":"Shrestha","year":"2022","journal-title":"Ann Med Surg"},{"issue":"1","key":"2025012315140633400_R3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13613-017-0275-4","article-title":"Systematic review and\u00a0meta-analysis of\u00a0complications and\u00a0mortality of\u00a0veno-venous extracorporeal membrane oxygenation for\u00a0refractory acute respiratory distress syndrome","volume":"7","author":"Vaquer","year":"2017","journal-title":"Ann Intensive Care"},{"key":"2025012315140633400_R4","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.clinimag.2022.02.029","article-title":"Incidence, clinical associations and\u00a0outcomes of\u00a0intrathoracic complications with and\u00a0without ARDS in\u00a0COVID-19 pneumonia","volume":"85","author":"Escalon","year":"2022","journal-title":"Clin Imaging"},{"issue":"8","key":"2025012315140633400_R5","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1177\/08850666221091441","article-title":"Incidence and\u00a0clinical features of\u00a0pneumomediastinum and\u00a0pneumothorax in\u00a0COVID-19 pneumonia","volume":"37","author":"Muhammad","year":"2022","journal-title":"J Intensive Care Med"},{"issue":"4","key":"2025012315140633400_R6","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1177\/0885066620954364","article-title":"Incidence of\u00a0barotrauma in\u00a0patients with COVID-19 pneumonia during prolonged invasive mechanical ventilation - 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