scholarly journals Acute pneumonitis consequent on pleurodesis with Viscum album extract: severe chest images but benign clinical course

2014 ◽  
Vol 9 ◽  
Author(s):  
Suk Ju Cho ◽  
Su Wan Kim ◽  
Jee Wo Chang
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Autologous Blood ◽  
Viscum Album ◽  
Chemical Agent ◽  
Chemical Pleurodesis ◽  
First Case ◽  
Metastatic Lung ◽  
Chest X Ray

Chemical pleurodesis is widely recommended in the treatment of pulmonary air leak of different etiologies as well as malignant pleural effusions and chylothorax. Conventional chemical pleurodesis using erythromycin, tetracycline, hydrophilic fumed silica, autologous blood and talc slurry has been standardized, and its complications, including high fever, intractable chest pain, and acute lung injury, seem to be frequent. Viscum album extract is a new chemical agent for pleurodesis, and only a few studies have reported outcomes of such chemical pleurodesis in the treatment of malignant pleural effusion. Moreover, the complications resulting from pleurodesis using Viscum album extract are very rare, and acute pneumonitis has not been reported. in this paper we report the first case of acute pneumonitis after pleurodesis using Viscum album extract in a 58-year-old man who had prolonged air leaks after a left upper lingularsegmentectomy for metastatic lung cancer. We performed repeated pleurodesis four times with 2 to 4 days intervals. While the patient had no symptoms of pneumonia, such as cough, sputum, chilling, and fatigue, a follow-up chest X-ray revealed increasing peribronchial consolidations and infiltrations in the left upper lobe. A chest tomography showed extensive parenchymal consolidations and ground-glass appearances in the left lungs, representing pneumonia with acute lung injury. The acute pneumonitis was spontaneously resolved with supportive care, and the patient was discharged ten days after the development of pneumonitis. We think that pleurodesis with Viscum album extract is effective, but repeated pleurodesis should be avoided for possible onset of acute pneumonitis.

scholarly journals Chest CT as a Complement to RT-PCR to Confirm and Follow-up COVID-19 Patients

Medicinus ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 31
Author(s):  
Aziza Ghanie Icksan ◽  
Muhammad Hafiz ◽  
Annisa Dian Harlivasari
Keyword(s):  
Chest Ct ◽  
Rt Pcr ◽  
High Resolution Computed Tomography ◽  
X Ray ◽  
First Case ◽  
Chest X Ray ◽  
Polymerase Chain

<p><strong>Background : </strong>The first case of COVID-19 in Indonesia was recorded in March 2020. Limitation of reverse-transcription polymerase chain reaction (RT-PCR) has put chest CT as an essential complementary tool in the diagnosis and follow up treatment for COVID-19. Literatures strongly suggested that High-Resolution Computed Tomography (HRCT) is essential in diagnosing typical symptoms of COVID-19 at the early phase of disease due to its superior sensitivity  (97%) compared to chest x-ray (CXR).</p><p>The two cases presented in this case study showed the crucial role of chest CT with HRCT to establish the working diagnosis and follow up COVID-19 patients as a complement to RT-PCR, currently deemed a gold standard.<strong></strong></p>

scholarly journals Transfusion-related acute lung injury (TRALI) in two thalassaemia patients caused by the same multiparous blood donor

2017 ◽  
Vol 9 (1) ◽  
pp. e2017060
Author(s):  
George J Kontoghiorghes
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Blood Donor ◽  
Intensive Therapy ◽  
Hla Antigens ◽  
Hla Class I ◽  
Intensive Therapy Unit ◽  
X Ray ◽  
Red Blood Cell Transfusions ◽  
Chest X Ray

Two separate episodes of transfusion-related acute lung injury (TRALI) in thalassaemia patients caused by red blood cell transfusions from the same multiparous blood donor are reported. Both cases had the same symptomatology and occurred 10-60 minutes of transfusion. The patients presented dyspnea, sweating, fatigue, dizziness, fever, and sense of losing consciousness. The chest x-ray showed a pulmonary oedema-like picture with both lungs filled with fluid. The patients were treated in the intensive therapy unit. They were weaned off the ventilator and discharged following hospitalization 7 and 9 days respectively. The TRALI syndrome was diagnosed to be associated with HLA-specific donor antibodies against mismatched HLA-antigens of the transfused patients. Haemovigilance improvements are essential for reducing the morbidity and mortality in transfused patients. Blood from multiparous donors should be tested for the presence of IgG HLA-Class I and –Class II antibodies before being transfused in thalassaemia and other chronically transfused patients.

scholarly journals Pulmonary Hyalinising Granuloma: A report of two cases

2019 ◽  
Vol 19 (2) ◽  
pp. 157
Author(s):  
Ameen Kamona ◽  
Fatma Al Lawati ◽  
Atheel Kamona ◽  
Nasser Al Busaidi ◽  
Yaqoob Al Mahrooqi ◽  
...  
Keyword(s):  
Male Patient ◽  
Pulmonary Nodules ◽  
Definitive Treatment ◽  
X Ray ◽  
Multiple Pulmonary Nodules ◽  
First Case ◽  
Lung Condition ◽  
Chest X Ray ◽  
X Ray Computed

ABSTRACT: Pulmonary hyalinising granuloma (PHG) is a rare fibrosclerosing inflammatory lung condition of unknown aetiology. It is characterised by solitary or multiple pulmonary nodules that are usually found incidentally while imaging the chest for other reasons. We report two cases of histologically proven PHG diagnosed at the Royal Hospital, Muscat, Oman. The first case was a 71-year-old male patient who presented in 2010 with a dry cough, weight loss and bilateral pulmonary nodules. The second case was a 58-year-old male patient who presented in 2012 and was found to have incidental bilateral pulmonary nodules on chest X-ray. Both patients were started on prednisolone and on follow-up the PHG nodules remained stable. Although there is no definitive treatment, PHG generally has an excellent prognosis.Keywords: Granuloma; X-Ray Computed Tomography; Multiple Pulmonary Nodules; Lung; Case Report; Oman.

Long-term follow-up of survivors of acute lung injury: Lack of effect of a ventilation strategy to prevent barotrauma

1999 ◽  
Vol 27 (12) ◽  
pp. 2616-2621 ◽  
Author(s):  
Andrew B. Cooper ◽  
Niall D. Ferguson ◽  
Patrick J. Hanly ◽  
Maureen O. Meade ◽  
John R. Kachura ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Ventilation Strategy ◽  
Long Term Follow Up

scholarly journals Vaping Related Acute Lung Injury: First Case from Our Hospital

2020 ◽  
Author(s):  
T. Alexander ◽  
S.M. Farooqui ◽  
K.R. Jones ◽  
N.F. Mehdi ◽  
R. Katz
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
First Case

scholarly journals Transfusion related acute lung injury-TRALI: a review

2019 ◽  
Vol 7 (5) ◽  
pp. 1985
Author(s):  
Javier Alcazar-Castro ◽  
Alejandro Zarate-Aspiros ◽  
Elias Andrade-Cuellar ◽  
Brenda Alvarez-Perez ◽  
Alan I. Valderrama-Treviño ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Bacterial Contamination ◽  
Biological Response ◽  
Sudden Onset ◽  
X Ray ◽  
Pulmonary Damage ◽  
Hemodynamic Overload ◽  
Chest X Ray ◽  
Complications Of Blood Transfusion

Acute pulmonary damage caused by transfusion is characterized by the sudden onset of respiratory distress in newly transfused patients within 6 hours after the transfusion, bilateral infiltrative changes in chest X-ray, PaO2/FIO2 <300 mmHg, absence of other risk factors for acute lung injury and absence of signs suggesting cardiogenic origin of pulmonary edema. Being one of the most serious complications of blood transfusion, plasma is the most involved factor, although all blood components can cause it, and is caused by antigen reactions/leukocyte antibody and lipid activity with ability to modify the biological response on primitive leukocytes. The diagnosis is based on the integration of clinical, radiological and gasometric elements, ruling out the rest of the possible causes of acute lung injury. Its differential diagnosis should include hemodynamic overload, anaphylactic reaction, bacterial contamination of transfused blood products and transfusion hemolytic reaction. The treatment is supportive measures based on the needs and does not differ from the treatment of acute lung injury secondary to other etiologies, severe cases require endotracheal intubation and mechanical ventilation while the non-severe can be managed with oxygen therapy.

scholarly journals Acute Lung Injury – From Pathophysiology to Treatment

2021 ◽  
pp. S353-S366
Author(s):  
D Mokra
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Lung Compliance ◽  
Acute Onset ◽  
Consensus Conference ◽  
Response To Treatment ◽  
Lung Protective Ventilation ◽  
General Description ◽  
X Ray ◽  
Chest X Ray

Acute lung injury is characterized by acute respiratory insufficiency with tachypnea, cyanosis refractory to oxygen, decreased lung compliance, and diffuse alveolar infiltrates on chest X-ray. The 1994 American-European Consensus Conference defined “acute respiratory distress syndrome, ARDS” by acute onset after a known trigger, severe hypoxemia defined by PaO2/FiO2≤200 mm Hg, bilateral infiltrates on chest X-ray, and absence of cardiogenic edema. Milder form of the syndrome with PaO2/FiO2 between 200-300 mm Hg was named „acute lung injury, ALI“. Berlin Classification in 2012 defined three categories of ARDS according to hypoxemia (mild, moderate, and severe), and the term “acute lung injury” was assigned for general description or for animal models. ALI/ARDS can originate from direct lung triggers such as pneumonia or aspiration, or from extrapulmonary reasons such as sepsis or trauma. Despite growing understanding the ARDS pathophysiology, efficacy of standard treatments, such as lung protective ventilation, prone positioning, and neuromuscular blockers, is often limited. However, there is an increasing evidence that direct and indirect forms of ARDS may differ not only in the manifestations of alterations, but also in the response to treatment. Thus, individualized treatment according to ARDS subtypes may enhance the efficacy of given treatment and improve the survival of patients.

scholarly journals Application of autologous blood patch in patients with non-expanded lungs and persistent air leak

2020 ◽  
Vol 28 (3) ◽  
pp. 521-526
Author(s):  
Burhan Apilioğulları
Keyword(s):  
Autologous Blood ◽  
Lung Parenchyma ◽  
X Rays ◽  
Poor General Condition ◽  
Air Leak ◽  
Chemical Pleurodesis ◽  
Study Results ◽  
Blood Patch ◽  
Persistent Air Leak

Background: This study aims to evaluate the effectiveness of pleurodesis procedure by ensuring the expansion of the lung and occluding lung parenchyma leaks with an autologous blood patch. Methods: A total of 24 patients (17 males, 7 females; mean age 59.9±12.2 years; range, 30 to 86 years) who underwent autologous blood patch pleurodesis in our clinic between November 2015 and November 2019 were retrospectively analyzed. The patients were not eligible to undergo chemical pleurodesis due to a non-expandable lung or poor general condition. Demographic and clinical characteristics of the patients and postoperative data were evaluated. Results: The air leak stopped within 48 h after autologous blood patch pleurodesis in seven patients. The air leak significantly decreased in 13 patients, while it remained unchanged in four patients. A Heimlich valve was placed in the patients in whom the air leak stopped or significantly decreased. The follow-up chest X-rays showed that the respective lungs of these patients became completely expandable. Conclusion: Our study results suggest that the autologous blood patch procedure is a favorable option for the patients who are unable to benefit much from the conventional chemical pleurodesis methods due to contraindications to surgery or the presence of non-expandable lungs.

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