scholarly journals 1121: RAISING AWARENESS ABOUT MYOSITIS AS A CAUSE OF HYPOXIC RESPIRATORY FAILURE

2021 ◽  
Vol 50 (1) ◽  
pp. 559-559
Author(s):  
HIba Hadid ◽  
Amina Pervaiz
Keyword(s):  
Respiratory Failure ◽  
Raising Awareness ◽  
Hypoxic Respiratory Failure

scholarly journals Focal ST-segment elevation without coronary occlusion: myocardial infarction with no obstructive coronary atherosclerosis associated with COVID-19—a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Casey Meizinger ◽  
Bruce Klugherz
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Respiratory Failure ◽  
Coronary Atherosclerosis ◽  
Myocardial Injury ◽  
Cardiovascular Complications ◽  
St Segment Elevation ◽  
St Segment ◽  
Hypoxic Respiratory Failure ◽  
Artery Disease

Abstract Background While it is understood that coronavirus disease 2019 (COVID-19) is primarily complicated by respiratory failure, more data are emerging on the cardiovascular complications of this disease. A subset of COVID-19 patients present with ST-elevations on electrocardiogram (ECG) yet normal coronary angiography, a presentation that can fit criteria for myocardial infarction with no obstructive coronary atherosclerosis (MINOCA). There is little known about non-coronary myocardial injury observed in patients with COVID-19, and we present a case that should encourage further conversation and study of this clinical challenge. Case summary An 86-year-old man presented to our institution with acute hypoxic respiratory failure and an ECG showing anteroseptal ST-segment elevation concerning for myocardial infarction. Mechanic ventilation was initiated prior to presentation, and emergent transthoracic echocardiography reported an ejection fraction of 50–55%, with no significant regional wall motion abnormalities. Next, emergent coronary angiography was performed, and no significant coronary artery disease was detected. The patient tested positive for COVID-19. Despite supportive management in the intensive care unit, the patient passed away. Discussion We present a case of COVID-19 that is likely associated with MINOCA. It is crucial to understand that in COVID-19 patients with signs of myocardial infarction, not all myocardial injury is due to obstructive coronary artery disease. In the case of COVID-19 pathophysiology, it is important to consider the cardiovascular effects of hypoxic respiratory failure, potential myocarditis, and significant systemic inflammation. Continued surveillance and research on the cardiovascular complications of COVID-19 is essential to further elucidate management and prognosis.

scholarly journals Melon with a Twist: A Case of Nicotine Overdose After Ingestion and Aspiration of Vape Liquid

2020 ◽  
Author(s):  
Joseph Jude ◽  
Hugh Hiller ◽  
Joel Miller
Keyword(s):  
Respiratory Failure ◽  
Similar Case ◽  
Significant Toxicity ◽  
Liquid Products ◽  
Hypoxic Respiratory Failure ◽  
Case Presentations ◽  
Emergent Airway Management ◽  
The Military ◽  
Adequate Oxygenation

ABSTRACT We present the case of an active duty 21-year-old male with severe hypoxic respiratory failure after accidentally ingesting, and subsequently aspirating, vaping liquid while intoxicated. Because of the increasing prevalence of vaping devices, this case highlights a unique risk of vape liquids with concentrated nicotine levels and appetizing labels and aromas. Vaping-associated pulmonary injury has been previously described in multiple publications, but unlike those patients with pathology after inhaling vaping products, our patient ingested and subsequently aspirated the highly nicotinic substance. Most vape liquid products have enough nicotine to result in significant toxicity, which most concerningly can lead to nicotine-induced respiratory failure. This patient’s hypoxia appeared to be multifactorial as a result of both nicotine toxicity and aspiration, but ultimately treatment of both focused on supportive measures.In addition to understanding nicotine toxicity, this patient’s hypoxia secondary to agitation and aspiration requiring emergent airway management illustrates the importance of understanding the technique of Delayed Sequence Intubation and its proper application in the critical airway algorithm. By treating preoxygenation as a procedure, the patient received adequate oxygenation resulting in successful intubation without harmful desaturation during the procedure.Given the prevalence of tobacco use in the military as well as the increasing popularity of vaping devices, future military providers have a responsibility to their patients to be prepared for similar case presentations. Fortunately, this case demonstrates that when managed properly, otherwise healthy patients without comorbidities often recover without significant long-term sequelae.

scholarly journals Standard Care Versus Awake Prone Position in Adult Nonintubated Patients With Acute Hypoxemic Respiratory Failure Secondary to COVID-19 Infection—A Multicenter Feasibility Randomized Controlled Trial

2021 ◽  
pp. 088506662110144
Author(s):  
Devachandran Jayakumar ◽  
Pratheema Ramachandran, DNB ◽  
Ebenezer Rabindrarajan, DNB ◽  
Bharath Kumar Tirupakuzhi Vijayaraghavan, MD ◽  
Nagarajan Ramakrishnan, AB ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Prone Position ◽  
Feasibility Study ◽  
Standard Care ◽  
Controlled Trial ◽  
Prone Positioning ◽  
Hypoxemic Respiratory Failure ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Hypoxic Respiratory Failure

Rationale: The feasibility and safety of awake prone positioning and its impact on outcomes in non-intubated patients with acute respiratory distress syndrome secondary to COVID-19 is unknown. Results of the observational studies published during this pandemic have been conflicting. In this context, we conducted a multi-center, parallel group, randomized controlled feasibility study on awake prone positioning in non-intubated patients with COVID-19 pneumonia requiring supplemental oxygen. Methods: 60 patients with acute hypoxic respiratory failure secondary to COVID-19 pneumonia requiring 4 or more liters of oxygen to maintain a saturation of ≥92% were recruited in this study. Thirty patients each were randomized to either standard care or awake prone group. Patients randomized to the prone group were encouraged to self-prone for at least 6 hours a day. The primary outcome was the proportion of patients adhering to the protocol in each group. Results: In the prone group, 43% (13 out of 30) of patients were able to self-prone for 6 or more hours a day. In the supine group, 47% (14 out of 30) were completely supine and 53% spent some hours in the prone position, but none exceeded 6 hours. There was no significant difference in any of the secondary outcomes between the 2 groups and there were no adverse events. Conclusions: Awake prone positioning in non-intubated patients with acute hypoxic respiratory failure is feasible and safe under clinical trial conditions. The results of our feasibility study will potentially help in the design of larger definitive trials to address this key knowledge gap.

Pembrolizumab Induced Acute Persistent Airway Disease in a Patient with Recurrent Respiratory Papillomatosis (RRP)

2021 ◽  
pp. 000348942110212
Author(s):  
Kathryn Marcus ◽  
Daniel J. Lee ◽  
Jeffrey S. Wilson ◽  
Richard J. H. Smith ◽  
Michael Puricelli
Keyword(s):  
Respiratory Failure ◽  
Inhaled Corticosteroids ◽  
Checkpoint Inhibitor ◽  
Ventilatory Support ◽  
Airway Disease ◽  
Recurrent Respiratory Papillomatosis ◽  
Pulmonary Function Testing ◽  
Hypoxic Respiratory Failure ◽  
Checkpoint Inhibitor Therapy ◽  
Function Testing

Objective: To present an uncommon but serious, recently identified complication of checkpoint inhibitor therapy in a patient treated with pembrolizumab infusion for disseminated recurrent respiratory papillomatosis (RRP). Methods: Case report. Results: A 43-year-old woman with underlying asthma developed acute hypoxic respiratory failure within 24 hours of her third infusion of pembrolizumab for treatment of intractable, disseminated recurrent respiratory papillomatosis. Pulmonary function testing revealed a severe intra-thoracic obstructive ventilatory defect. Discontinuation of pembrolizumab, ventilatory support, and treatment with systemic and inhaled corticosteroids resulted in resolution of respiratory failure; however, her underlying asthma remains poorly controlled. Conclusion: To our knowledge, this case is the first report of pembrolizumab-induced obstructive respiratory failure in a patient being treated for RRP.

scholarly journals Hypoxic Respiratory Failure in Term and Near Term Newborns: Perspective from the Neonatal Transfer Service

2011 ◽  
Vol 70 ◽  
pp. 505-505
Author(s):  
S Davidson ◽  
N Ratnavel ◽  
S Mohinuddin ◽  
M F Hird ◽  
A Sinha
Keyword(s):  
Respiratory Failure ◽  
Hypoxic Respiratory Failure ◽  
Term Newborns ◽  
Near Term
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