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Refractory respiratory failure

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https://www.readbyqxmd.com/read/29765783/multiorgan-failure-and-refractory-lactic-acidosis-due-to-pasteurella-multocida-septicemia-in-a-patient-with-no-animal-exposure
#1
Damaris Pena, Yaneidy Santana, Jose Perez Lara, Efrain Gonzalez, Misbahuddin Khaja
Introduction: Pasteurella multocida is a gram-negative coccobacillus pathogenic to animals. It can cause infection in humans by a bite, scratch, or lick from a cat or dog. P. multocida can cause a variety of infections in humans, including cellulitis, osteomyelitis, endocarditis, peritonitis, and septic shock. Case Presentation: A 56-year-old male presented to our hospital with a 2-day history of fever, abdominal pain, nausea, and vomiting. He denied exposure to cats, dogs or other pets...
2018: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29742224/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#2
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29732190/hybrid-extracorporeal-membrane-oxygenation
#3
REVIEW
Alexandre Brasseur, Sabino Scolletta, Roberto Lorusso, Fabio Silvio Taccone
Veno-venous (VV) and veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) therapy is widely used in critically ill patients with refractory cardiogenic shock and cardiac arrest or suffering from severe respiratory failure. Besides traditional ECMO cannulation, changes in patients' conditions or the occurrence of specific complications (i.e., cerebral hypoxia or left ventricular dilation) may require modifications in cannulation strategies or the combination of ECMO with additional invasive or minimally invasive procedures, to improve organ function and ECMO efficiency...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29708916/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#4
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#5
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29625772/pulmonary-sarcoidosis
#6
REVIEW
Paolo Spagnolo, Giulio Rossi, Rocco Trisolini, Nicola Sverzellati, Robert P Baughman, Athol U Wells
Sarcoidosis is a granulomatous disease of unknown cause, occurs worldwide and has a highly variable prevalence. The disease is typically dominant in the lungs, although it can affect virtually any organ and is unpredictable in its clinical course. The severity of pulmonary sarcoidosis ranges from incidentally discovered radiographic abnormalities in asymptomatic patients to a chronic progressive disease that is refractory to treatment. Mortality from sarcoidosis appears to have increased in the past three decades, with respiratory failure being the most common cause of sarcoidosis-related death...
April 3, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29616915/refractory-hypoxemia-in-a-patient-with-submassive-pulmonary-embolism-and-an-intracardiac-shunt-a-case-report-and-review-of-the-literature
#7
REVIEW
Jean Liew, Janelle Stevens, Christopher Slatore
INTRODUCTION: Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt...
March 2, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29607415/small-cell-lung-cancer-presenting-as-fatal-pulmonary-hemorrhage
#8
Jun Hyeok Lim, Jeong-Seon Ryu, Sang Yong Cho, Hyun-Jung Kim, Sang Hoon Jeon, Jung Soo Kim, Hae-Seong Nam, Jae Hwa Cho, Seung Min Kwak, Hong Lyeol Lee
Small-cell lung cancer (SCLC) is a lung cancer histological subtype unusual in its favorable response to cytotoxic chemotherapy. Life-threatening manifestations at presentation are rarely reported and should be an important clinical concern. We report a case of a 63-year-old man presenting with rapid-onset refractory severe thrombocytopenia, development of massive hemoptysis, and death from respiratory failure. This case provides clinicians a reference for this unusual presentation and carries clinical implications for managing SCLC patients...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#9
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29588907/disseminated-toxoplasmosis-in-a-patient-with-advanced-acquired-immunodeficiency-syndrome
#10
Ricardo Garcia Pastorello, Anderson da Costa Lino Costa, Marcio Valente Yamada Sawamura, Antonio Carlos Nicodemo, Amaro Nunes Duarte-Neto
Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis...
January 2018: Autopsy & case reports
https://www.readbyqxmd.com/read/29576824/ventilator-management-for-acute-respiratory-distress-syndrome-associated-with-avian-influenza-a-h7n9-virus-infection-a-case-series
#11
Hui Xie, Zhi-Gang Zhou, Wei Jin, Cheng-Bin Yuan, Jiang Du, Jian Lu, Rui-Lan Wang
BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still lacking. METHODS: We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7N9 admitted to our ICU over a 3-month period. RESULTS: Eight patients (mean age 57.38±16.75; 5 male) were diagnosed with H7N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome (ARDS), which required MV in ICU...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29564137/regional-overdistension-during-prone-positioning-in-a-patient-with-acute-respiratory-failure-who-was-ventilated-with-a-low-tidal-volume-a-case-report
#12
Toru Kotani, Masanori Hanaoka, Shinya Hirahara, Hisashi Yamanaka, Eckhard Teschner, Atsuko Shono
Background: Prone positioning may provide a uniform distribution of transpulmonary pressure and contribute to prevent ventilator-induced lung injury. However, despite moderate positive end-expiratory pressure and low tidal volumes, there is still a risk of regional overdistension. Case presentation: A man with refractory hypoxemia was mechanically ventilated with prone positioning. Although prone positioning with a plateau pressure of 18 cmH2 O and a positive end-expiratory pressure of 8 cmH2 O promptly improved oxygenation, regional ventilation monitoring using electrical impedance tomography initially detected decreased distribution in the dorsal region but increased in the ventral, suggesting overdistension...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29559757/successful-use-of-extracorporeal-life-support-in-a-hematopoietic-stem-cell-transplant-patient-with-neuroblastoma
#13
Feifei Z Williams, Atul Vats, Thomas Cash, James D Fortenberry
Respiratory failure associated with hematopoietic stem cell transplantation (HSCT) has been considered a contraindication for use of extracorporeal membrane oxygenation (ECMO) at many centers. We describe a child with neuroblastoma and hypoxemic respiratory failure following HSCT who was successfully managed with veno-venous (VV) ECMO. The patient was an 18-month-old female with high-risk neuroblastoma status post tumor resection, chemotherapy, autologous HSCT, and primary site radiation. On day 113 posttransplant while receiving maintenance immunotherapy, she had an acute respiratory decompensation because of rhinovirus, aspiration pneumonia, and capillary leak syndrome...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29556790/feasibility-and-safety-of-general-anesthesia-for-bronchial-thermoplasty-a-description-of-early-10-treatments
#14
Mariko Aizawa, Satoshi Ishihara, Takeshi Yokoyama, Katsuyuki Katayama
Bronchial thermoplasty (BT) is a recently introduced bronchoscopic treatment for patients with asthma refractory to pharmacotherapy. Intraprocedural sedation management is important for successful performance of BT. However, the results of general anesthesia in patients undergoing BT have not been well described. The aim of this study was to evaluate the feasibility and safety of general anesthesia in patients undergoing BT. We retrospectively reviewed the records of 10 consecutive BT treatments performed under general anesthesia in 4 patients...
March 20, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29519311/a-24-year-old-woman-with-precipitous-respiratory-failure-after-lung-transplantation
#15
Whittney A Warren, Domingo Franco-Palacios, Christopher S King, Oksana A Shlobin, Steven D Nathan, Shalika B Katugaha, Haresh Mani, A Whitney Brown
A 24-year-old woman with ΔF508/Y1092X cystic fibrosis (CF) complicated by severe obstructive lung disease (FEV1 of 30% predicted) was admitted for IV antibiotics for planned sinus surgery resulting from severe chronic sinusitis causing frequent exacerbations and declining lung function. She had persistent airway infection with multidrug-resistant Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, and growth of a fungus presumed to be an airway colonizer, identified as Stephanoascus ciferrii 1 year before presentation...
March 2018: Chest
https://www.readbyqxmd.com/read/29513890/massive-hemoptysis-successfully-treated-with-extracorporeal-membrane-oxygenation-and-endobronchial-thrombolysis
#16
Antônio Aurélio de Paiva Fagundes Júnior, Renato Bueno Chaves, Amanda Robassini Dos Santos, Humberto Alves de Oliveira, Marcello Henrique Paschoal
Extracorporeal membrane oxygenation has been used to treat refractory hypoxemia in numerous clinical scenarios. The fundamental principles for the management of massive hemoptysis patients include protecting the airway and healthy lung, locating the source of bleeding and controlling the hemorrhage. We report the case of a patient with acute respiratory failure associated with massive hemoptysis secondary to lung laceration during cardiac surgery. The use of extracorporeal membrane oxygenation allowed patient survival...
March 1, 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29503232/potentially-fatal-outcomes-associated-with-clozapine
#17
Kevin J Li, Ronald J Gurrera, Lynn E Delisi
Clozapine has been shown to be the most efficacious therapy for treatment resistant schizophrenia, estimated at one third of all schizophrenia cases. There is significant morbidity and mortality associated with clozapine including risk of agranulocytosis, aspiration pneumonia, bowel ischemia, myocarditis, seizures, and weight gain. Here we present a case of a 62-year-old man with chronic paranoid schizophrenia refractory to numerous antipsychotics who was started on clozapine therapy during an acute inpatient psychiatric admission...
March 1, 2018: Schizophrenia Research
https://www.readbyqxmd.com/read/29502890/issues-to-resolve-with-the-use-of-extracorporeal-membrane-oxygenation-during-interfacility-transportation
#18
P Burgueño, C González, A Sarralde, F Gordo
Extracorporeal membrane oxygenation (ECMO) support is indicated in patients who are refractory to treatment, those with cardiogenic shock or respiratory failure and those with exacerbations eligible for heart and lung transplantation. Physician experience and quantity of necessary resources are reasons why regionalization could benefit patients of this kind, establishing ECMO reference centers and integrating a transportation network specialized in ECMO. This type of transportation is a challenge for healthcare systems and physicians, given its greater complexity, requiring a multidisciplinary and inter-territorial approach...
March 1, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29500057/nondiabetic-ketoacidosis-in-a-pregnant-woman-due-to-acute-starvation-with-concomitant-influenza-a-h1n1-and-respiratory-failure
#19
G Skalley, S Rodríguez-Villar
Threatening refractory metabolic acidosis due to short-term starvation nondiabetic ketoacidosis is rarely reported. Severe ketoacidosis due to starvation itself is a rare occurrence, and more so in pregnancy with a concomitant stressful clinical situation. This case report presents a nondiabetic woman admitted in intensive care for respiratory failure type 1 during the third trimester of pregnancy with a severe metabolic acidosis refractory to medical treatment. We diagnosed the patient with acute starvation ketoacidosis based on her history and the absence of other causes of high anion gap metabolic acidosis after doing a rigorous analysis of her acid-base disorder...
February 27, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29478218/mitochondrial-encephalopathy-first-portuguese-report-of-a-vars2-causative-variant
#20
Sandra Pereira, Mariana Adrião, Mafalda Sampaio, Margarida Ayres Basto, Esmeralda Rodrigues, Laura Vilarinho, Elisa Leão Teles, Isabel Alonso, Miguel Leão
INTRODUCTION: Combined oxidative phosphorylation deficiency 20 (COXPD20) is a mitochondrial respiratory chain complex (RC) disorder, caused by disease-causing variants in the VARS2 gene, which encodes a mitochondrial aminoacyl-tRNA synthetase. Here we describe a patient with fatal mitochondrial encephalopathy caused by a homozygous VARS2 gene missense variant. CASE REPORT: We report the case of a girl, the first child of non-consanguineous and healthy parents, born from an uneventful term pregnancy, who presented, in the neonatal period, major hypotonia and microcephaly...
February 25, 2018: JIMD Reports
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