Tanaffos
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Early detection of pneumothorax is critically important. Several studies have shown that chest ultrasonography (CUS) is a highly sensitive and specific tool. The present systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of CUS and chest radiography (CXR) for detection of pneumothorax. ⋯ The present meta-analysis showed that the diagnostic accuracy of CUS was higher than supine CXR for detection of pneumothorax. It seems that CUS is superior to CXR in detection of pneumothorax, even after adjusting for possible sources of heterogeneity.
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Intubation stylets are still being used in many medical centers for difficult intubations. Although very rare, it may break inside the trachea during endotracheal intubation despite routine pre-assessments by anesthesiologists and may surprisingly move deep into the tracheobronchial tree. In this case report, we describe a rare complication after stylet or guide-wire intubation in a patient in whom, a broken piece of metal guide remained in his tracheobronchial tree for 3 days. ⋯ Despite precise evaluation before use, signs of breakage in the stylet may be missed and consequently, it may break inside the trachea and result in serious complications. It is strongly recommended that the anesthesiologists pay attention to the sounds and movements of the instruments. This article also briefly reviews the most serious reported complications due to stylet breakage.
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Non-invasive ventilation (NIV) has been used for acute respiratory failure to avoid endotracheal intubation and intensive care admission. Few studies have assessed the usefulness of NIV in patients with severe community acquired pneumonia (CAP). The use of NIV in severe CAP is controversial because there is a greater variability in success compared to other pulmonary conditions. ⋯ NIV treatment had high rate of success. Successful treatment is related to less lung involvement and to early good response to NIV and continuous improvement in clinical response.
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Bronchoscopy is a technique of visualizing the inside of the airways for diagnostic and therapeutic purposes. This study was performed to determine the complications of bronchoscopy in a tertiary health-care center. ⋯ According to the obtained results, it may be concluded that bronchoscopy can be performed safely whenever indicated. Complications occurred were minor and self limiting.
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Case Reports
A 58-year-old woman with recurrent hemoptysis after successful bronchial artery embolization.
Massive hemoptysis is a life-threatening complication of respiratory disease. It is an emergency requiring immediate medical attention. A 58 year-old woman with bronchiectasis was admitted to the hospital following episodes of massive hemoptysis. ⋯ Few days after the embolization, the patient reported pleuritic and epigastric pain and also complained of odynophagia and dysphagia; which were managed conservatively. Four days later, her symptoms improved and she was discharged subsequently. At 40-day follow up, she was still symptom-free with no hemoptysis.