Canadian respiratory journal : journal of the Canadian Thoracic Society
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Case Reports
Pulmonary ossification syndrome in a patient with chronic thromboembolic pulmonary hypertension.
Pulmonary ossification syndrome is a rare disease characterized by bone tissue formation in the lung parenchyma with or without bone marrow elements. This disorder, often under-recognized, can be idiopathic or secondary to an underlying chronic disorder such as chronic thromboembolic pulmonary hypertension. The pathogenesis involves tissue injury and an alkaline environment in which the precipitation of calcium salts enables alkaline phosphatase activity. ⋯ Diagnosis can prove challenging and is based on clinical, radiographic and functional tests, and by tissue biopsy. Achieving an accurate and timely diagnosis is essential to avoid erroneous treatments due to misdiagnosis and to expand knowledge of its progression, prognosis and treatment. As the population and prevalence of chronic lung disease increases, it is likely that physicians will encounter more cases of pulmonary ossification.
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Observational Study
Airway pressure and transpulmonary pressure during high-frequency oscillation for acute respiratory distress syndrome.
High-frequency oscillation (HFO) is used for the treatment of refractory hypoxic respiratory failure. ⋯ The present report is the first to describe measuring Pes and calculating Ppl during HFO for acute respiratory distress syndrome. While both current guidelines and recent trials have titrated treatment based on mPaw and oxygenation, there is wide variability in PL during HFO and PL cannot be predicted from mPaw.