scholarly journals Rituximab—A Drug with Many Facets and Cures: A Treatment for Acute Refractory Hypoxemic Respiratory Failure Secondary to Severe Granulomatosis with Polyangiitis

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Braden Powers ◽  
Aditya Uppalapati ◽  
Sindhura Gogineni ◽  
Zafar Akram Jamkhana
Keyword(s):  
Respiratory Failure ◽  
Granulomatosis With Polyangiitis ◽  
Hemorrhagic Cystitis ◽  
Kidney Injury ◽  
Control Mode ◽  
Volume Control ◽  
Hypoxemic Respiratory Failure ◽  
Granulomatous Vasculitis ◽  
Life Threatening ◽  
Pressure Release Ventilation

Granulomatosis with Polyangiitis (GPA) is a rare systemic anti neutrophil cytoplasmic antibody (ANCA-) associated granulomatous vasculitis of the small and medium sized blood vessels. Diffuse alveolar hemorrhage (DAH) is a rare life-threatening complication of GPA. In our patient, cyclophosphamide was held secondary to complications of acute kidney injury, hematuria, and concern for a possible hemorrhagic cystitis. However, during the workup for hematuria the patient acutely developed respiratory failure and was found to have DAH. The patient was initially supported with mechanical ventilation volume control mode, steroids, and plasma exchange. With no improvement of oxygenation, the mode of ventilation was changed to airway pressure release ventilation (APRV) and the patient was started on rituximab. The patient clinically improved over the next few days, was able to be extubated, and was transferred out of the intensive care unit.

scholarly journals A Case of a 34-Year-Old Female with Acute Hypoxemic Respiratory Failure and Proximal Muscle Weakness

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alex Diaz ◽  
Surit Sharma
Keyword(s):  
Respiratory Failure ◽  
Muscle Weakness ◽  
Length Of Hospital Stay ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Wound Botulism ◽  
Life Threatening Illness ◽  
Life Threatening

Wound associated botulism is an unusual presentation. Early detection of this potentially life-threatening illness can significantly shorten length of hospital stay and improve prognosis. We present a case of a 34-year-old female with a history of heroin abuse who presented to the ED with acute respiratory failure, diplopia, and proximal muscle weakness. There was early concern for wound botulism as the instigating process. After discussion with the CDC, she was given equine serum heptavalent botulism antitoxin. Laboratory analysis later confirmed our suspicion. Symptoms improved and the patient was liberated from mechanical ventilation on day 14 and discharged from the hospital on day 23.

PRESSURE AUGMENT MAXIMUM (PAM) VS. VOLUME CONTROL (VC) FOR HYPOXEMIC RESPIRATORY FAILURE: PRELIMINARY TRIAL

1995 ◽  
Vol 23 (Supplement) ◽  
pp. A116
Author(s):  
Mark Lund ◽  
Stephen J. Connell ◽  
Jamie Vaccaro ◽  
Gregory Roach ◽  
Gary Gradwell ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Volume Control ◽  
Hypoxemic Respiratory Failure ◽  
Preliminary Trial

scholarly journals ECMO Rescues Patients With Acute Respiratory Failure Related to GPA

2021 ◽  
Vol 8 ◽  
Author(s):  
Rongjun Wan ◽  
Wenzhe Yang ◽  
Xinhua Ma ◽  
Wei Yang ◽  
Pinhua Pan ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Granulomatosis With Polyangiitis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Systemic Involvement ◽  
Online Databases ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Granulomatosis with polyangiitis (GPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis with a wide range of clinical symptoms related to the systemic involvement of small blood vessels. The respiratory system is one of the most frequently involved, and life-threatening acute respiratory failure could occur due to diffusive alveolar hemorrhage and tracheal stenosis. When maximum mechanical ventilation is unable to maintain oxygenation, extracorporeal membrane oxygenation (ECMO) should be considered as the final respiratory supportive method, if available. Here we present a 32-year-old male patient with acute respiratory failure (ARF) related to GPA, who was rescued by winning time for accurate diagnosis and appropriate treatment. Additionally, we reviewed more than 60 GPA-related ARF cases on multiple online databases, summarized the clinical manifestations of these patients, and concluded that ECMO plays an important role in further respiratory support for ARF patients with GPA and assists in accurate and timely diagnosis and appropriate treatment, thus helping them recuperate.

scholarly journals Recovery from respiratory failure after 49-day extracorporeal membrane oxygenation support in a critically ill patient with COVID-19: case report

2020 ◽  
Author(s):  
Fengwei Guo ◽  
Chao Deng ◽  
Tao Shi ◽  
Yang Yan
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Critically Ill ◽  
Life Support ◽  
Critically Ill Patient ◽  
Hypoxemic Respiratory Failure ◽  
Plasma Therapy ◽  
Form Of Life ◽  
Membrane Oxygenation ◽  
Life Threatening

Abstract Background Respiratory failure is a life-threatening complication of coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) in COVID-19 might offer promise based on our clinical experience. However, few critically ill cases with COVID-19 have been weaned off ECMO. Case summary A 66-year-old Chinese woman presented with fever (38.9°C), cough, dyspnoea, and headache. She had lymphopenia (0.72 × 109/L) and computed tomography findings of ground-glass opacities. Subsequently, she was confirmed to have respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. She was intubated after transfer to the intensive care unit due to respiratory failure and heart failure. However, her condition continued to deteriorate rapidly. Veno-veno ECMO was undertaken for respiratory and cardiac support due to refractory hypoxemic respiratory failure and bradyarrhythmia (45 b.p.m.). During hospitalization, she was also administered anti-viral treatment, convalescent plasma therapy, and continuous renal replacement therapy. She was maintained on ECMO before she had fully recovered from the condition that necessitated ECMO use and had a negative test for the nucleic acids of SARS-CoV-2 twice. Forty-nine days later, this patient was weaned from ECMO. At the most recent follow-up visit (3 months after weaning from ECMO), she received respiratory and cardiac rehabilitation and did not complain of any discomfort. Discussion As far as we know, the longest duration of ECMO treatment in this critical case with COVID-19 is supportive of ECMO as the most aggressive form of life support and the last line of defence during the COVID-19 epidemic.

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