Chest
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Case Reports
Pulmonary hemorrhage and air embolism complicating transbronchial biopsy in pulmonary amyloidosis.
We describe a fatal complication of transbronchial biopsy in a patient with pulmonary parenchymal amyloidosis. Hemorrhage after biopsy required intubation and positive-pressure ventilation that resulted in massive arterial air embolism. Postmortem findings suggested that the bleeding and air embolism were related to persistent patency of biopsied blood vessels infiltrated with amyloid. Patients with pulmonary amyloidosis may be at increased risk of major complications after transbronchial biopsy.
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The efficacy of long-term oxygen therapy for hypoxemic COPD patients is well established. However, oxygen is expensive and the portability of home oxygen is limited by the weight and bulk of the oxygen source. As a result, there has been a recent surge of interest in creating oxygen-conserving devices and methods. ⋯ Each has its own set of advantages and disadvantages. By using oxygen conservation methods, the oxygen required to achieve adequate blood oxygenation can be reduced by a factor of 2:1 to 7:1 compared to steady flow. Thus, the cost of oxygen can be substantially reduced while increasing the portability and range of home oxygen therapy.
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Case Reports
Acute pulmonary edema caused by venous air embolism after removal of a subclavian catheter.
A 17-year-old boy, who had received chemotherapy for a relapse of acute myelogenous leukemia, manifested a brief loss of consciousness and acute pulmonary edema immediately after the removal of a triple-lumen subclavian catheter. This complication was attributed to a venous air embolism.