treatment of chylothorax乳び胸の治療は胸腔ドレナージと栄養管理が基本である．胸腔ドレナージにより貯留した乳びを排出し，肺の圧迫を解除する．栄養管理では☆絶食＋中心静脈栄養とし，乳びの産生を抑制する．このとき，胸管を介さずに門脈系に取りこまれる中鎖脂肪酸（MCT）の割合を増やすことで，乳びを減らす方法も試みられる．また，近年,オクトレオチド（ソマトスタチンアナログ）が有効であるとの報告もある．
treatment of pneumothorax■ stable, small (<2 cm between lung and chest wall on x-ray), minimal symptoms: observation + O2
■ symptomatic or large (>2 cm): aspiration
■ unstable/tension pneumothorax: needle decompression then chest tube, and VATS if unsuccessful
(25-50%) respiratorysurgery卒試 HirotoShishido
definition of massive hemoptysis, and management for thatbleeding more than 600 mL/24hr or 100 mL/hr
secure airway first,and treat cause; persistent bleeding treated via ★bronchoscopic interventions, embolization, or resection
★Urgent thoracotomy and surgical intervention are reserved for patients with unilateral bleeding who continue to bleed despite initial bronchoscopy and/or pulmonary artery embolization. respiratorysurgeryUWorld step2CK HirotoShishido
N-acetylcysteineNAC
Mucolytic - liquifies mucus in chronic bronchopulmonary diseases (eg, COPD, CF) by disrupting disulfide bonds. Also used as an antidote for acetaminophen overdose. respiratorypharmacology HirotoShishido
