Respiratory medicine case reports
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Respir Med Case Rep · Jan 2019
Case ReportsUse of point-of-care ultrasound to assess esophageal insufflation during bag mask ventilation: A case report.
Bag-valve-mask ventilation is a basic airway management technique often used in patients with acute respiratory failure. Although highly effective in providing oxygenation and ventilation, this technique has been associated with gastric regurgitation and tracheal aspiration. In this case, the esophagus visualized with bedside ultrasonography during bag-mask ventilation of an unresponsive and critically ill patient. ⋯ Cricoid pressure did not prevent esophageal insufflation. Ultrasound-guided probe pressure attenuated esophageal insufflation. This case depicts a unique instance of using a novel method to assess breath delivery during bag mask ventilation of a critically ill patient.
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Respir Med Case Rep · Jan 2019
Case ReportsHeat-not-burn cigarettes induce fulminant acute eosinophilic pneumonia requiring extracorporeal membrane oxygenation.
Although the cause of acute eosinophilic pneumonia (AEP) has not yet been fully clarified, cigarette smoking is reported to be a risk factor for developing AEP. The heat-not-burn cigarette (HNBC) was developed to reduce the adverse effects of smoke on the user's surroundings. However, the health risks associated with HNBCs have not yet been clarified. We report a successfully treated case of fatal AEP presumably induced by HNBC use. ⋯ As far as we know, our patient is the first case of AEP induced by HNBC use successfully treated with ECMO. Emergency physicians must be aware that HNBCs can induce fatal AEP.
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Respir Med Case Rep · Jan 2019
Case ReportsDisseminated tuberculosis with severe immune thrombocytopenia.
Immune thrombocytopenia is an autoimmune condition with increased platelet destruction. Immune thrombocytopenic purpura is an uncommon and rare manifestation of tuberculosis. ⋯ Due to severe thrombocytopenia patient was managed with IVIg and steroids along with anti tubercular therapy. Early diagnosis and treatment with Anti tubercular therapy is important for effective control of bleeding manifestations.
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Respir Med Case Rep · Jan 2019
Case ReportsTuberculosis-induced acute respiratory distress syndrome treated with veno-venous extracorporeal membrane oxygenation.
Tuberculosis (TB) is a rare but known cause of acute respiratory distress syndrome (ARDS) with a high mortality. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) may be an alternative option for treating TB-induced ARDS. However, the literature on TB-induced ARDS treated with VV-ECMO is limited and the most of them were prolonged therapy. ⋯ He was weaned from ECMO on the 5th day of ECMO support and was extubated at the 8th day. He was discharged from hospital on the 47th hospitalized day and continued anti-TB medication at home. VV-ECMO is effective for TB-induced ARDS even in short-term administration if progression of ARDS is rapid.
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Respir Med Case Rep · Jan 2019
Case ReportsBilateral pneumothorax after pacemaker placement "Buffalo chest".
Bilateral pneumothoraces following unilateral subclavian vein cannulation is a rare complication. It is usually associated with an intrapleural communication which can be congenital or formed following cardiothoracic and mediastinal surgeries, or trauma. The term Buffalo chest was used to define a single chest cavity with no anatomic separation of the two hemithoraces. ⋯ In distinction, the pleural cavities in humans are entirely separated. We describe an 83-year-old female without prior history of cardiothoracic surgery, trauma or lung disease, who underwent dual chamber pacemaker placement using a left subclavian vein access and developed bilateral pneumothoraces following the procedure. The bilateral pneumothoraces were completely resolved with single left-sided thoracostomy tube placement suggesting the patient had "Buffalo chest".