Automated Examination of CT Chests To Determine Optimal Placement of Needle Thoracostomy
Principal Investigator
Name
Matt Strickland
Degrees
BASc, MD
Institution
University of Toronto, Harvard University
Position Title
General Surgery Resident
Email
About this CDAS Project
Study
NLST
(Learn more about this study)
Project ID
NLST-201
Initial CDAS Request Approval
Mar 25, 2016
Title
Automated Examination of CT Chests To Determine Optimal Placement of Needle Thoracostomy
Summary
Needle thoracostomy (NT) is a life saving procedure used to treat tension pneumothorax it is performed by both hospital and pre-hospital personnel and is a skill taught in ATLS (Advanced Trauma Life Support) and ATCN (Advanced Trauma Care for Nurses). The location of needle placement in NT is important as failure to safely enter the thoracic cavity could lead to continue patient deterioration or patient harm. It has classically been taught that placement in the 2nd intercostal space at the midclavicular line is ideal but a number of recent studies have cast doubt on this "surgical dogma". These previous attempts to find the optimal position have been performed on a limited number of cadavers or CT chests. With this study, we propose creating an automated algorithm that can find chest thickness and other parameters across the full thoracic cavity. We hope to settle the debate surrounding optimal needle length and position.
The proposed objective of this study is to investigate the optimal placement of a needle thoracostomy by using an automated program that measures chest wall thickness by using CT chest images. We hypothesize that the shortest distance will be in the patient's back but that the optimal location considering other parameters will be in the axillary region.
The proposed objective of this study is to investigate the optimal placement of a needle thoracostomy by using an automated program that measures chest wall thickness by using CT chest images. We hypothesize that the shortest distance will be in the patient's back but that the optimal location considering other parameters will be in the axillary region.
Aims
We aim to provide rich, descriptive data of the thickness of chest walls to help inform practice in performing needle thoracostomy.
We will report chest wall thickness across a range of locations, genders, and age. This will allow us to make recommendations as to the optimal site but also the optimal catheter length that needs to be stocked in order to assure success in a reasonable proportion of the population.
Collaborators
Dr. Homer Tien - Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Dr. Madeleine Woods - University of Toronto, Toronto, ON, Canada