scholarly journals Veno-venous extracorporeal membrane oxygenation in the management of refractory bilateral bronchial dehiscence after lung transplant: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Makiko Tani
Keyword(s):  
Lung Transplant ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Case Presentation ◽  
Life Threatening ◽  
Pulmonary Arterial ◽  
Bilateral Lung ◽  
Bridge Therapy ◽  
Extracorporeal Oxygenation ◽  
Vv Ecmo

Abstract Background Bronchial dehiscence is a life-threatening complication after lung transplant. If it is not treated by placement of stent or reanastomosis, the chance of survival will depend on the availability of a new graft. However, retransplant is not a practical management option in Japan, where waiting time for lung transplant is extensive. We described a case of refractory bilateral bronchial dehiscence managed by veno-venous extracorporeal oxygenation membrane (VV ECMO) while allowing the dehiscence to heal. Case presentation A 25-year-old man with idiopathic pulmonary arterial hypertension underwent a bilateral lung transplant. The patient developed bilateral bronchial dehiscence. Open reanastomosis was not successful, and air leakage recurred under low positive pressure ventilation. VV ECMO was established to maintain oxygenation with spontaneous breathing until both dehiscence were closed by adhesions. Conclusion In a patient with refractory bilateral bronchial dehiscence, VV ECMO may provide bronchial rest and serve as a bridge therapy to recovery.

scholarly journals Primary alveolar hypoventilation and XXXXY chromosopathy

2016 ◽  
Vol 65 (3) ◽  
Author(s):  
D. Samolski ◽  
A. Antón ◽  
M. Mayos ◽  
M. Subirana ◽  
R. Güell
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Positive Pressure Ventilation ◽  
Cor Pulmonale ◽  
Positive Pressure ◽  
Hypercapnic Respiratory Failure ◽  
Non Invasive ◽  
Alveolar Hypoventilation ◽  
Pulmonary Arterial

The association of primary alveolar hypoventilation (PAH) and chromosomic diseases has not been described previously. A 19 year-old man with Fraccaro’s syndrome (XXXXY karyotype) was admitted to evaluate chronic hypercapnic respiratory failure, pulmonary arterial hypertension and cor pulmonale. PAH was diagnosed. As effective treatment, such as non-invasive positive pressure ventilation (NIPPV), is available for this disorder we should intensify the search for PAH in patients with chromosome disease.

Pathophysiology and causes of pulmonary hypertension

2016 ◽  
Author(s):  
Laura Price ◽  
S. John Wort
Keyword(s):  
Pulmonary Hypertension ◽  
Critical Illness ◽  
Positive Pressure Ventilation ◽  
Massive Pulmonary Embolism ◽  
Positive Pressure ◽  
Vasoactive Drugs ◽  
Acute Decompensation ◽  
Prognostic Feature ◽  
Pulmonary Arterial ◽  
Poor Prognostic Feature

Pulmonary hypertension (PH) in the setting of critical illness may reflect the acute syndrome itself (such as acute massive pulmonary embolism or acute lung injury), and/or pre-existing ‘chronic’ causes of PH. To compound this, iatrogenic factors may also contribute to PH including the effects of positive pressure ventilation and certain vasoactive drugs. The presence of PH, especially when complicated by resulting right ventricular (RV) dysfunction and failure, is a poor prognostic feature in all settings. This chapter reviews the pathophysiology of acute PH in critical illness, and pre-existing chronic causes of PH, including acute decompensation in patients with pre-existing pulmonary arterial hypertension.

scholarly journals Respiratory Management of Acute Cardiogenic Pulmonary Edema: A Review

2020 ◽  
Author(s):  
Khosro Barkhordari ◽  
Zahid Hussain Khan ◽  
Akbar Shafiee
Keyword(s):  
Pulmonary Edema ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Cardiogenic Pulmonary Edema ◽  
Positive Pressure ◽  
Acute Cardiogenic Pulmonary Edema ◽  
Respiratory Management ◽  
Threatening Condition ◽  
Ventilator Management ◽  
Life Threatening

Acute cardiogenic pulmonary edema (ACPE) is a common and life-threatening condition among patients with heart failure. The literature contains a large number of reviews discussing the respiratory management aspect of this entity; nonetheless, none of these studies has thoroughly probed into the respiratory management of different cardiac pathologies ending with ACPE, together with the different modes of ventilation and invasive and noninvasive ventilation in the same discussion. The present review seeks to discuss the physiologic bases of lung-heart interactions, the hemodynamic effects of positive pressure ventilation, and the results of studies on the effects of the various modes of ventilation having been used until the writing of this article. Also discussed herein are ACPE in different heart pathologies and their respective ventilator management, as well as the indications, complications, and contraindications of noninvasive positive pressure ventilation and intermittent mandatory ventilation.

scholarly journals Non-Cardiogenic Pulmonary Oedema Following the Use of Gadolinium-Based Contrast Medium: A Case Report

2020 ◽  
Vol 6 (3) ◽  
pp. 181-185
Author(s):  
Chilan Nguyen ◽  
Tho Pham
Keyword(s):  
Pulmonary Oedema ◽  
Positive Pressure Ventilation ◽  
Rare Complication ◽  
Positive Pressure ◽  
Cardiogenic Pulmonary Oedema ◽  
Contrast Administration ◽  
Prompt Treatment ◽  
Appropriate Treatment ◽  
Life Threatening ◽  
Life Threatening Complication

AbstractNon-cardiogenic pulmonary oedema can be life threatening and requires prompt treatment. While gadolinium-based contrast is generally considered safe with a low risk of severe side effects, non-cardiogenic pulmonary oedema has become increasingly recognised as a rare, but possibly life-threatening complication. We present a case of a usually well, young 23-year-old female who developed non-cardiogenic pulmonary oedema with a moderate oxygenation impairment and no mucosal or cutaneous features of anaphylaxis following the administration of gadolinium-based contrast. She did not respond to treatment of anaphylaxis but made a rapid recovery following the commencement of positive pressure ventilation. Our case highlights the importance of recognising the rare complication of non-cardiogenic pulmonary oedema following gadolinium-based contrast administration in order to promptly implement the appropriate treatment.

scholarly journals Implantable System for Treprostinil and Lung Transplantation: Case Series from Delivery for Pulmonary Arterial Hypertension Study

2021 ◽  
pp. 204589402199929
Author(s):  
Jeremy Feldman ◽  
Mardi Gomberg-Maitland ◽  
Shelly M Shapiro ◽  
Amy Lautenbach ◽  
Marty Morris ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Lung Transplantation ◽  
Lung Transplant ◽  
Case Series ◽  
Patient Characteristics ◽  
Effective Strategies ◽  
Transplant Program ◽  
Pulmonary Arterial ◽  
Bilateral Lung

Background The implanted system for treprostinil (IST) has been described in previous publications. There is no information published about how to handle this system around lung or heart lung transplantation. We present the experience from the DelIVery for Pulmonary Arterial Hypertension (PAH) study. Methods Of the 60 subjects enrolled in the DelIVery study, seven subjects from five pulmonary arterial hypertension (PAH) centers had been listed for bilateral lung or heart and lung transplant, and were included in this analysis. All subjects were participating in the previously described DelIVery for PAH study. 1,2 Results Seven subjects with implanted pumps have been listed for lung or heart-lung transplant. Six subjects underwent lung or heart lung transplantation and one remains on the transplant list. Three different methods of patient management for transplant were used. In three subjects the implanted system was filled with saline prior to transplantation and treprostinil was infused via an external system. Three subjects had their drug-filled implanted pump and catheter system explanted at the time of transplant. One patient had the drug-filled implanted system removed prior to being listed for transplantation. Four subjects were hospitalized while waiting for transplantation. Conclusion The eight year experience from the DelIVery for PAH study confirms that the IST is not a barrier to safe lung or heart lung transplantation. The experience described here provides three effective strategies for managing the implanted system around lung or heart lung transplantation. The optimal strategy will depend on patient characteristics and lung transplant program preferences and wait list times.

RECURRENCE OF IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION AFTER BILATERAL LUNG TRANSPLANT

CHEST Journal ◽  
2008 ◽  
Vol 134 (4) ◽  
pp. 16C
Author(s):  
Saeher A. Muzaffar ◽  
Jennifer L. Snow ◽  
Leslie A. Litzky ◽  
Carney C. Kevin ◽  
Chris Archer-Chicko ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Lung Transplant ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Pulmonary Arterial ◽  
Bilateral Lung

scholarly journals Tracheal Diverticulum in SARS-CoV-2 Patients on Non-Invasive Ventilation A not so “Spontaneous” Cause of Pneumomediastinum? An imaging Pictorial Presentation of Two Cases with Review of Literature

2021 ◽  
Vol 28 (2) ◽  
pp. 19
Author(s):  
Veena Mariam Joseph ◽  
Donboklang Lynser ◽  
Iadarilang Tiewsoh ◽  
Kaustuv Dutta ◽  
Pranjal Phukan ◽  
...  
Keyword(s):  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Non Invasive ◽  
Pictorial Presentation ◽  
Tracheal Diverticulum ◽  
Free Air ◽  
Non Invasive Ventilation ◽  
Threatening Condition ◽  
Life Threatening

Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.

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