The Annals of thoracic surgery
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Cases of vaporizer-induced acute lung injury are increasing in frequency as the use of these recreational products have become more popular. Such pathology can result in life-threatening conditions for otherwise healthy patients, with diagnostic difficulties and complex treatment plans. Presented is a case of severe acute lung injury caused by vaporizing substances in a young man requiring extracorporeal membranous oxygenation (ECMO) as a bridge to recovery. Recovery was successful despite rapid-onset of adult respiratory distress syndrome with prompt use of ECMO and appropriate lung-protective strategies.
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When conservative therapy for thoracic outlet syndrome fails, scalenectomy with or without first-rib resection (FRR) is the treatment of choice. We measured pressure in the costoclavicular space before and after FRR at time of neurogenic thoracic outlet syndrome release to evaluate whether FRR is required to completely decompress the costoclavicular space. ⋯ Supraclavicular first rib resection for management of neurogenic thoracic outlet syndrome can be safely performed with favorable outcomes. The pressure increase in the costoclavicular space caused by arm abduction and external rotation was significantly reduced only after FRR, raising concerns about potential incomplete costoclavicular space decompression with scalenectomy alone for neurogenic thoracic outlet syndrome management.
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Outcomes of Adult Patients With Septic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy.
Extracorporeal membrane oxygenation (ECMO) has been shown to provide benefits in children, but not adults, with septic shock. This study described the clinical outcomes of adults in septic shock who underwent ECMO. ⋯ This cohort of patients undergoing ECMO had equivalent median survival compared with literature-based estimates of other cohorts of patients with septic shock.