Rev Pneumol Clin
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Mechanical ventilation is a fundamental treatment of acute respiratory distress syndrome (ARDS). Despite compliance with the recommendations of protective mechanical ventilation, it can results in serious complications including the pulmonary barotrauma. ⋯ This observation describes an unusual aspect of barotrauma which is pneumomediastinum. The authors also point out the role of chest imaging in the management of mechanical ventilation during ARDS.
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Obstructive sleep apnea syndrome (OSAS) is underdiagnosed in cardiologist daily practice, especially in patients with acute coronary syndrome. Its diagnosis is based on a polysomnography study. The Epworth Sleepiness Scale (ESS) stands as a simple and rapid means to select patients for the sleep investigation. ⋯ The prevalence of OSA in patients with acute myocardial infarction was very high. ESS score ≥ 4 was an independent predictive factor for severe OSA. Despite its subjective feature, the ESS seems to be an interesting score for screening patients to undergo polysomnography.
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We report the case of a patient aged 23, admitted for bilateral intrathoracic tumor, including a giant right. Surgery was performed by right sternothoracotomy. After 7 days, she presented an irreversible cardiac arrest. ⋯ These tumors are characterized by their risk of recurrence and poor prognosis. The treatment is the surgical resection. We analyze incidence, diagnosis and prognosis of these tumors.
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Idiopathic pulmonary fibrosis (IPF), the etiopathogeny of which is still unknown, is the most frequent and severe of idiopathic interstitial pneumonias. It progressively leads, sometimes more acutely when exacerbations occur, to a restrictive respiratory insufficiency. Its prognosis is very dark with a median survival of 3-5 years. ⋯ No specific treatment is efficient in this context. Several comorbidities, particularly frequent in IPF, should be treated when present: gastro-oesophageal reflux, obstructive sleep apnea, emphysema. The particular high frequency of bronchopulmonary cancer should be highlighted.
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We report the case of a 57-year-old woman who presented with massive hemoptysis and thoracic pain 3 years after the endovascular treatment of a thoracic aortic aneurysm. Emergency work up revealed the presence of an endoleak, leading to the pressurization of the aneurysm sac and its subsequent rupture into the lung parenchyma. The discussion includes presentation, clinical course, diagnosis, complications and new therapeutic options in the management of a massive hemoptysis secondary to aortic rupture. All together, the case and discussion highlight the classical rules of critical care and the recent advances in endovascular treatment of thoracic aortic rupture.