Respiration; international review of thoracic diseases
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Case Reports
Amiodarone-related acute respiratory distress syndrome following sudden withdrawal of steroids.
Acute lung toxicity is a rare but classical complication of amiodarone therapy. We report the case of a patient who developed an optic neuropathy after 15 years of amiodarone administration, and who was treated for 2 weeks with steroids. ⋯ Postmortem lung histologic examination was consistent with amiodarone-induced pneumonitis. Since this complication is thought to be of immunological origin, we speculate that the sudden withdrawal of steroids was implicated in the development of the acute lung injury.
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There are no recommendations about admission to an ICU after a major lung resection and there are considerable differences among institutions in this respect. ⋯ This empirical protocol was useful in identifying patients not likely to need admission to the ICU. ASA score, predictive postoperative DL(CO), and PPP are independent predictors of a need for admission to an ICU.
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Long-term oxygen therapy (LTOT) is the cornerstone mode of treatment in patients with chronic obstructive pulmonary disease (COPD). ⋯ We conclude that stationary liquid oxygen seems to be a satisfactory alternative mode for LTOT treatment in COPD patients, with higher patient compliance to therapy in comparison with concentrators.
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Ventilator-associated pneumonia (VAP) is the most frequent infection with high mortality rates in intensive care units (ICUs) and the prediction of outcome is important in the decision-making process. ⋯ These results suggest that APACHE II determined at the time of VAP diagnosis may be useful in predicting mortality in the pulmonary ICU patient population who develops VAP.
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Pulmonary lymphangiectasis is a rare anomaly in infancy that is characterized by dilatation of pulmonary lymphatic vessels resulting in fetal respiratory distress. Pulmonary lymphangiectasis is considered to occur exclusively in young children and neonates, and very few survive beyond an early age. ⋯ An exploratory video-assisted thoracoscopy revealed multiple yellowish cysts on the visceral pleura, which were histologically diagnosed as lymphangiectasis. In the present study, the pathogenesis and clinical characteristics are discussed.