Respiratory medicine case reports
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Respir Med Case Rep · Jan 2018
Case ReportsAn autopsy case of bird-related chronic hypersensitivity pneumonitis presenting with repeated acute exacerbation.
A 68-year-old woman was admitted to our hospital with a dry cough in 2010. Chest computed tomography showed the appearance of a nonspecific interstitial pneumonia (NSIP) pattern. Video-assisted thoracoscopic surgery (VATS) was performed, and the specimens prominently showed a usual interstitial pneumonia (UIP) pattern. ⋯ Even though she was treated with corticosteroids and immunosuppressants and recommended to avoid bird-related antigens, she had a progressive course with repeated acute exacerbation episodes and died of respiratory failure. The autopsy findings showed diffuse alveolar damage superimposed on UIP. Clinicians should be aware that BRCHP patients especially with histopathologically UIP pattern may experience acute exacerbation.
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Respir Med Case Rep · Jan 2018
Case ReportsUse of high-flow nasal cannula in obese patients receiving colonoscopy under intravenous propofol sedation: A case series.
Intravenous sedation during colonoscopy has become the standard practice in the United States given its higher patient satisfaction and procedural quality. This practice is not free of side effects as a significant proportion of patients undergoing this procedure tend to have respiratory depression and desaturation events. ⋯ Here we present 3 cases of patients undergoing adjunctive oxygen therapy with HFNC during colonoscopy with intravenous sedation. We found patients to have lower number of desaturation events and were satisfied with their experience.
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Respir Med Case Rep · Jan 2018
Case ReportsAcute exacerbation of idiopathic pulmonary fibrosis triggered by Aspergillus empyema.
Acute exacerbation (AE) is a severe and life-threatening complication of idiopathic pulmonary fibrosis (IPF). In 2016, the definition and diagnostic criteria for AE-IPF were updated by an international working group. ⋯ This is the first report describing AE-IPF triggered by Aspergillus empyema, which was improved by a combination of corticosteroid, systemic antifungal therapy, local antifungal therapy, and additional pharmacological therapies. Future research may reveal optimal strategies for both idiopathic and triggered AE-IPF.
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Respir Med Case Rep · Jan 2018
Case ReportsPartial neuromuscular blockage to promote weaning from mechanical ventilation in severe ARDS: A case report.
Spontaneous breathing efforts during mechanical ventilation can lead to patient self-inflicted lung injury (P-SILI). In order to prevent P-SILI, patients are generally heavily sedated and receive muscle relaxation, resulting in a slower weaning process. We present a case in which we applied partial neuromuscular blockage in order to prevent P-SILI while allowing spontaneous breathing but with limited efforts during assist mechanical ventilation.
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Respir Med Case Rep · Jan 2018
Case ReportsDeep accidental hypothermia accompanied with cardiac arrest after alcohol and drug poisoning treated with extracorporeal life support.
Deep accidental hypothermia is an unusual clinical entity in developed countries. We report a case of a 30 year old male Caucasian patient with accidental severe hypothermia who was transferred to the emergency department of our hospital after prolonged exposure in the urban city's night environment cold as a result of alcohol and drugs abuse. The patient was found unconscious in the first early hours from onlookers. ⋯ In the emergency department an extracorporeal life support system (ECLS) was implanted under cardiopulmonary resuscitation in order to achieve hemodynamic stabilization and rapid and safe rewarming. The patient's rewarming lasted 6 hours. The patient was extubated the next day.