Control of Life-threatening Air Leak after Gastrostomy in an Infant with Respiratory Distress Syndrome and Tracheoesophageal Fistula

Abstract Mediastinal teratomas are uncommon, fast-growing thoracic tumours, which are usually diagnosed in childhood or adolescence. Neonatal forms are the rarest and often present with life-threatening respiratory distress syndrome. In our case, respiratory failure in a neonate was aggravated by severe cardiogenic shock due to aortic and systemic venous compression, extreme heart displacement and rotation, necessitating an emergency operation on the first day of life.

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A case of acute respiratory distress syndrome associated with congenital H-type tracheoesophageal fistula and gastroesophageal reflux

Korean Journal of Pediatrics ◽

10.3345/kjp.2008.51.8.892 ◽

2008 ◽

Vol 51 (8) ◽

pp. 892 ◽

Cited By ~ 2

Author(s):

Heewon Chueh ◽

Myo Jing Kim ◽

Jin-A Jung

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Gastroesophageal Reflux ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Tracheoesophageal Fistula ◽

Distress Syndrome

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Acute respiratory distress syndrome in a case of diabetic ketoacidosis requiring ECMO support

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-20-0192 ◽

2021 ◽

Vol 2021 ◽

Author(s):

Milad Darrat ◽

Brian Gilmartin ◽

Carmel Kennedy ◽

Diarmuid Smith

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Diabetic Ketoacidosis ◽

Distress Syndrome ◽

Early Recognition ◽

Ecmo Support ◽

List Type ◽

Life Threatening ◽

Life Threatening Complication

Summary Acute respiratory distress syndrome (ARDS) is a rare but life-threatening complication of diabetic ketoacidosis (DKA). We present the case of a young female, with no previous diagnosis of diabetes, presenting in DKA complicated by ARDS requiring extra corporeal membrane oxygenation (ECMO) ventilator support. This case report highlights the importance of early recognition of respiratory complications of severe DKA and their appropriate management. Learning points ARDS is a very rare but life-threatening complication in DKA. The incidence of ARDS remains unknown but less frequent than cerebral oedema in DKA. The mechanism of ARDS in DKA has multifactorial aetiology, including genetic predisposition. Early recognition and consideration of rare pulmonary complication of DKA can increase survival rate and provide very satisfactory outcomes. DKA patients who present with refractory ARDS can be successfully rescued by ECMO support.

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Diagnosis-Related Criteria in the Consideration of Extracorporeal Membrane Oxygenation in Neonates Previously Treated With High-Frequency Jet Ventilation

PEDIATRICS ◽

10.1542/peds.89.3.491 ◽

1992 ◽

Vol 89 (3) ◽

pp. 491-494

Author(s):

Stephen Baumgart ◽

Ronald B. Hirschl ◽

Sharon Z. Butler ◽

Christine E. Coburn ◽

Alan R. Spitzer

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

High Frequency ◽

Distress Syndrome ◽

Air Leak ◽

Jet Ventilation ◽

Meconium Aspiration ◽

High Frequency Jet Ventilation ◽

Membrane Oxygenation

High-frequency jet ventilation (HFJV) is one of several high-frequency techniques that are particularly valuable for treating the neonate with lung disease refractory to conventional ventilation or with pulmonary air leak. Extracorporeal membrane oxygenation (ECMO) has also emerged as a valuable rescue therapy for neonates of more than 2000 g birth weight and 34 weeks's gestation with intractable respiratory failure. With the concurrent introduction of HFJV and ECMO, the authors sought to evaluate the role of HFJV prior to the institution of ECMO therapy. The data base for 2856 neonates receiving mechanical ventilation in one unit was used to identify 73 (of 298 total) neonates treated with HFJV, who were eligible by age and weight criteria for ECMO. Patients were grouped by diagnosis, and the oxygenation index (OI) was calculated during therapy. Outcome was evaluated for mortality, and the sensitivity of the OI for predicting mortality was calculated. Neonates who survived with HFJV alone presented with an OI of 0.30 ± 0.03 (SEM), significantly less than nonsurvivors (0.42 ± 0.04, P = .016). Survivors responded to HFJV with a rapid decrease in OI at 1 hour (0.19 ± 0.02, P < .001) and 6 hours (0.15 ± 0.01, P < .001). Nonsurvivors did not respond significantly at 1 hour (OI = 0.33 ± 0.04, P = not significant [NS]) or at 6 hours (OI = 0.40 ± 0.06, P = NS). By diagnosis, neonates with respiratory distress syndrome survived more often with HFJV (28/34, 82%) than neonates with meconium aspiration (10/26, 38%) or diaphragmatic hernia (3/9, 33%). Neonates with respiratory distress syndrome seldom presented with high OI values, but the majority of those who did survived (5/7 survived with initial OI ≥ 0.40). Neonates with meconium aspiration and a single OI ≥ 0.40 on presentation fared much worse: 13 (87%) of 15 died. From these results, it appears that neonates with severe intractable respiratory distress syndrome and/or air leak are most likely to respond favorably within 6 hours of starting HFJV. In contrast, neonates with meconium aspiration respond far less well and may require early ECMO intervention, particularly with a single OI ≥ 0.40.

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Rationale for the Use of Radiation-Activated Mesenchymal Stromal/Stem Cells in Acute Respiratory Distress Syndrome

Cells ◽

10.3390/cells9092015 ◽

2020 ◽

Vol 9 (9) ◽

pp. 2015 ◽

Cited By ~ 3

Author(s):

Isabel Tovar ◽

Rosa Guerrero ◽

Jesús J. López-Peñalver ◽

José Expósito ◽

José Mariano Ruiz de Almodóvar

Keyword(s):

Stem Cells ◽

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Human Umbilical Cord ◽

Annexin A1 ◽

Significant Difference ◽

Life Threatening ◽

Stromal Stem Cells

We have previously shown that the combination of radiotherapy with human umbilical-cord-derived mesenchymal stromal/stem cells (MSCs) cell therapy significantly reduces the size of the xenotumors in mice, both in the directly irradiated tumor and in the distant nonirradiated tumor or its metastasis. We have also shown that exosomes secreted from MSCs preirradiated with 2 Gy are quantitatively, functionally and qualitatively different from the exosomes secreted from nonirradiated mesenchymal cells, and also that proteins, exosomes and microvesicles secreted by MSCs suffer a significant change when the cells are activated or nonactivated, with the amount of protein present in the exosomes of the preirradiated cells being 1.5 times greater compared to those from nonirradiated cells. This finding correlates with a dramatic increase in the antitumor activity of the radiotherapy when is combined with MSCs or with preirradiated mesenchymal stromal/stem cells (MSCs*). After the proteomic analysis of the load of the exosomes released from both irradiated and nonirradiated cells, we conclude that annexin A1 is the most important and significant difference between the exosomes released by the cells in either status. Knowing the role of annexin A1 in the control of hypoxia and inflammation that is characteristic of acute respiratory-distress syndrome (ARDS), we designed a hypothetical therapeutic strategy, based on the transplantation of mesenchymal stromal/stem cells stimulated with radiation, to alleviate the symptoms of patients who, due to pneumonia caused by SARS-CoV-2, require to be admitted to an intensive care unit for patients with life-threatening conditions. With this hypothesis, we seek to improve the patients’ respiratory capacity and increase the expectations of their cure.

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Rituximab Twice Weekly for Refractory Thrombotic Thrombocytopenic Purpura in a Critically Ill Patient with Acute Respiratory Distress Syndrome

Case Reports in Oncology ◽

10.1159/000505236 ◽

2020 ◽

Vol 13 (1) ◽

pp. 153-157

Author(s):

Bahjat Azrieh ◽

Arwa Alsaud ◽

Khaldun Obeidat ◽

Amr Ashour ◽

Seham Elebbi ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Thrombotic Thrombocytopenic Purpura ◽

Distress Syndrome ◽

Standard Of Care ◽

Critically Ill Patient ◽

Microangiopathic Hemolytic Anemia ◽

Thrombocytopenic Purpura ◽

Life Threatening

Thrombotic thrombocytopenic purpura (TTP) is a rare, serious, life-threatening disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and hypercoagulability. The etiology is a deficiency of ADAMTS13 which is usually caused by acquired antibodies. Plasma exchange and steroids is the standard of care in the treatment of TTP. However, there are refractory cases of TTP which require further management. Rituximab appears to be a safe and effective therapy for refractory and relapsing TTP. Here we report a challenging case of TTP that responded to treatment with rituximab twice weekly. According to our knowledge, rituximab twice weekly has never been used for TTP before.

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Customization of an Open-Lung Ventilation Strategy to Treat a Case of Life-Threatening Acute Respiratory Distress Syndrome

Respiratory Care ◽

10.4187/respcare.00867 ◽

2011 ◽

Vol 56 (4) ◽

pp. 514-519 ◽

Cited By ~ 1

Author(s):

D. A. Grooms ◽

S. H. Sibole ◽

J. R. Tomlinson ◽

P. E. Marik ◽

R. L. Chatburn

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Lung Ventilation ◽

Ventilation Strategy ◽

Open Lung ◽

Life Threatening

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Pneumopericardium

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v34i2.11152 ◽

2014 ◽

Vol 34 (2) ◽

pp. 163-165 ◽

Cited By ~ 1

Author(s):

Meen Raj Pathak ◽

Disuja Shakya

Keyword(s):

Chest Pain ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Subcutaneous Emphysema ◽

Distress Syndrome ◽

Paediatric Population ◽

Male Child ◽

Pericardial Cavity ◽

Life Threatening ◽

Tension Pneumopericardium

Pneumopericardium may be defined as the presence of air within pericardial cavity which results due to spontaneous or iatrogenic cause. It is rare but life threatening entity, commonly caused by respiratory distress syndrome and vigorous resuscitation, in the paediatric population. Although, pneumopericardium is often asymptomatic, it may cause chest pain, dyspnoea and subcutaneous emphysema. The course of pneumopericardium is usually benign and self-limited. Treatment is crucial in tension pneumopericardium, a complication of pneumopericardium. Here, we report a case of pneumopericardium in a nine month old male child after vigorous resuscitation and intubation for respiratory distress syndrome. DOI: http://dx.doi.org/10.3126/jnps.v34i2.11152 J Nepal Paediatr Soc 2014;34(2):163-165

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Ketorolac may control more than pain

Clinical Science ◽

10.1042/cs20030275 ◽

2003 ◽

Vol 105 (5) ◽

pp. 549-550 ◽

Cited By ~ 1

Author(s):

Frank ISIK

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Inhalation Injury ◽

Clinical Science ◽

Inflammatory Cascade ◽

Life Threatening

Life-threatening acute respiratory distress syndrome (ARDS) complicates the recovery of patients with burn and inhalation injury. The study by Enkhbaatar and co-workers in this issue of Clinical Science suggests that reducing the early and robust inflammatory cascade may provide patients with protection from developing cardiopulmonary compromise seen early after burn and inhalation injury.

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Air Leak in Neonatal Respiratory Distress Syndrome

Anaesthesia and Intensive Care ◽

10.1177/0310057x8401200108 ◽

1984 ◽

Vol 12 (1) ◽

pp. 41-45 ◽

Cited By ~ 9

Author(s):

P. D. Sly ◽

J. H. Drew

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Hyaline Membrane Disease ◽

Maternity Hospital ◽

Assisted Ventilation ◽

Air Leak ◽

Mechanical Ventilators ◽

Hyaline Membrane ◽

Neonatal Respiratory Distress

A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. Air leak developed in 22% of infants with respiratory distress, 8% had pulmonary interstitial emphysema alone, 14% had pneumomediastinum or pneumothorax and 7% had emphysema with pneumomediastinum or pneumothorax. Mortality increased from 12% in infants without air leak to 31% (p < 0.001) in infants with air leak. Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.

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