Journal of bronchology & interventional pulmonology
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J Bronchology Interv Pulmonol · Apr 2013
Changes in quality of life, dyspnea scores, and lung function in lung cancer patients with airway obstruction after a therapeutic bronchoscopy.
Quality of life (QoL) has been closely linked with symptom intensity in lung cancer patients. It is therefore important to relieve respiratory distress in these severely ill patients, especially because their short life expectancy. This prospective study aimed to evaluate the impact of a therapeutic bronchoscopy on QoL, dyspnea, and lung function in patients with malignant airway obstruction. ⋯ Therapeutic bronchoscopy has a positive impact on QoL, dyspnea scale values, and lung function in patients with advanced lung cancer and airway obstruction.
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J Bronchology Interv Pulmonol · Apr 2013
Case ReportsPulmonary alveolar microlithiasis and probe-based confocal laser endomicroscopy.
Pulmonary alveolar microlithiasis (PAM) is a rare disease in which calcium-phosphate microliths accumulate within the alveolar space. We report cases of 2 siblings with PAM, presenting differently as regards the distribution and clinical severity. Immune cytologic analysis of bronchoalveolar lavage showed a CD4 alveolitis in the radiologically most affected patient, whereas the least affected had a normal bronchoalveolar lavage analysis, demonstrating the low specificity of immune cytologic lavage analysis in diagnosing familial PAM. For the first time, we describe the endoscopic findings using a probe-based confocal laser endomicroscopy.
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J Bronchology Interv Pulmonol · Jan 2013
Case ReportsObstructive fibrinous tracheal pseudomembrane.
Obstructive fibrinous tracheal pseudomembrane (OFTP) is a relatively rare cause of failed extubation. OFTP may be more common than described in the literature. OFTP results from ischemic injury to tracheal mucosa and may be the initial stage of the development of tracheal stenosis. ⋯ The patient was seen the second time in the emergency room and was treated for asthma exacerbation on the same day. Because of persistent symptoms after 3 days, CT scan of the chest was performed, which indicated necrotizing tracheitis with gas formation within the tracheal wall. Bronchoscopy showed no evidence of necrosis, but there was a thick white plaque toughly adherent to the tracheal wall.
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J Bronchology Interv Pulmonol · Jan 2013
Case ReportsExtracorporeal membrane oxygenation to support whole-lung lavage in pulmonary alveolar proteinosis: salvage of the drowned lungs.
Pulmonary alveolar proteinosis is a rare lung disease characterized by accumulation of lipoproteinaceous material within the alveoli. Therapeutic whole-lung lavage (WLL) under general anesthesia is the standard treatment in patients with progressive symptomatic disease. ⋯ Rarely, hyperbaric chamber or extracorporeal membrane oxygenation (ECMO) has been utilized to perform WLL to manage severe hypoxemia, with venovenous ECMO being used more often. We present a case of hypoxemic and hypercarbic respiratory failure from pulmonary alveolar proteinosis successfully managed by placing the patient on venoarterial ECMO to facilitate the performance of bilateral WLL.
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J Bronchology Interv Pulmonol · Jan 2013
Case ReportsEndobronchial ultrasound diagnosis of pulmonary embolism.
A 68-year-old woman presented for mediastinal lymph node sampling while undergoing work up for a solitary pulmonary nodule. During endobronchial ultrasound examination of the airways, an echogenic abnormality was noted within the right pulmonary artery. The patient underwent computed tomography angiography of the chest, and diagnosis of pulmonary embolism was confirmed. We describe endobronchial ultrasound evaluation of a pulmonary embolus.