scholarly journals A possible, non-invasive method of measuring dynamic lung compliance in patients with interstitial lung disease using photoplethysmography

2020 ◽  
Author(s):  
Kenichiro Atsumi ◽  
Yoshinobu Saito ◽  
Toru Tanaka ◽  
Takeru Kashiwada ◽  
Hiroki Hayashi ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Compliance ◽  
Non Invasive ◽  
Invasive Method ◽  
Dynamic Lung Compliance

Pazopanib-associated interstitial lung disease in a patient with renal cell carcinoma

2020 ◽  
Vol 13 (7) ◽  
pp. e235177 ◽  
Author(s):  
Yukinori Harada ◽  
Shintaro Kakimoto ◽  
Taro Shimizu
Keyword(s):  
Renal Cell Carcinoma ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Kinase Inhibitor ◽  
Lung Metastases ◽  
Soft Tissue Sarcomas ◽  
Positive Pressure ◽  
Non Invasive

Pazopanib is a multi-targeted tyrosine kinase inhibitor, which is indicated for use in patients with advanced renal cell carcinoma or advanced soft-tissue sarcomas. Although rare, interstitial lung disease has been reported as among the adverse sequelae of pazopanib therapy. We report the case of a 75-year-old man who developed interstitial lung disease during treatment with pazopanib for renal cell carcinoma with multiple lung metastases. The patient presented with dry cough and new-onset fatigue 3 months after initiation of pazopanib. He had mild hypoxia with bilateral ground-glass opacities on chest CT. He was treated with antibiotics for presumptive pneumonia, but his respiratory status rapidly deteriorated, and he required non-invasive positive pressure ventilation. He recovered on discontinuation of pazopanib and systemic steroids. Clinicians should recognise that interstitial lung disease can occur in patients who are undergoing treatment with pazopanib.

Comparison of Forceps, Cryoprobe, and Thoracoscopic Lung Biopsy for the Diagnosis of Interstitial Lung Disease − The CHILL Study

Respiration ◽  
2021 ◽  
pp. 1-7
Author(s):  
Momen M. Wahidi ◽  
Angela Christine Argento ◽  
Kamran Mahmood ◽  
Scott L. Shofer ◽  
Coral Giovacchini ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Diagnostic Yield ◽  
Final Diagnosis ◽  
Cohen’S Kappa ◽  
Cohen's Kappa ◽  
Invasive Method ◽  
Transbronchial Lung Cryobiopsy ◽  
Multidisciplinary Conference

Rationale: Transbronchial lung cryobiopsy (TBLC) has emerged as a less invasive method to obtain a tissue diagnosis in patients with interstitial lung disease (ILD). The diagnostic yield of TBLC compared to surgical lung biopsy (SLB) remains uncertain. Objectives: The aim of this study was to determine the diagnostic accuracy of forceps transbronchial lung biopsy (TBLB) and TBLC compared to SLB when making the final diagnosis based on multidisciplinary discussion (MDD). Methods: Patients enrolled in the study underwent sequential TBLB and TBLC followed immediately by SLB. De-identified cases, with blinding of the biopsy method, were reviewed by a blinded pathologist and then discussed at a multidisciplinary conference. Main Results: Between August 2013 and October 2017, we enrolled 16 patients. The raw agreement between TBLC and SLB for the MDD final diagnosis was 68.75% with a Cohen’s kappa of 0.6 (95% CI 0.39, 0.81). Raw agreement and Cohen’s kappa of TBLB versus TBLC and TBLB versus SLB for the MDD final diagnosis were much lower (50%, 0.21 [95% CI 0, 0.42] and 18.75%, 0.08 [95% CI −0.03, 0.19], respectively). TBLC was associated with mild bleeding (grade 1 bleeding requiring suction to clear) in 56.2% of patients. Conclusions: In patients with ILD who have an uncertain type based on clinical and radiographic data and require tissue sampling to obtain a specific diagnosis, TBLC showed moderate correlation with SLB when making the diagnosis with MDD guidance. TBLB showed poor concordance with both TBLC and SLB MDD diagnoses.

Pulmonary hypertension in interstitial lung disease: Non-invasive assessment for detection and prognosis

2016 ◽  
Author(s):  
Maria Kokosi ◽  
Greg Keir ◽  
John Wort ◽  
Peter George ◽  
Arjun Nair ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Non Invasive

Enhanced Tissue Factor Pathway Activity and Fibrin Turnover in the Alveolar Compartment of Patients with Interstitial Lung Disease

2000 ◽  
Vol 83 (06) ◽  
pp. 853-860 ◽  
Author(s):  
A. Günther ◽  
P. Mosavi ◽  
C. Ruppert ◽  
S. Heinemann ◽  
B. Temmesfeld ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Plasminogen Activator ◽  
Fibrinolytic Activity ◽  
Lung Compliance ◽  
Tissue Type ◽  
Type Plasminogen Activator ◽  
Order Of Magnitude ◽  
Pai 1 ◽  
D Dimer

SummaryBronchoalveolar lavage fluids (BALF) from patients with hyper- sensitivity pneumonitis (HP; n = 35), idiopathic pulmonary fibrosis (IPF, n = 41) and sarcoidosis (SARC, n = 48) were investigated for alterations in the alveolar hemostatic balance. Healthy individuals (n = 21) served as Controls. Procoagulant activity (PCA), tissue factor (TF) activity and F VII activity were assessed by means of specific recalcification assays. The overall fibrinolytic activity (FA) was measured using the 125I-labeled fibrin plate assay. Fibrinopeptide A (FP-A), D-Dimer, plasminogen activators (PA) of the urokinase (u-PA) or tissue type (t-PA), PA-Inhibitor I (PAI-1) and α2-antiplasmin (α2-AP) were determined by ELISA technique. As compared to Controls, all groups with interstitial lung disease (ILD) displayed an increase in BALF PCA by approximately one order of magnitude, and this was ascribed to enhanced TF activity by >98%. Accordingly, F VII-activity was increased in all ILD groups, and elevated FP-A levels were noted. There was no significant difference in procoagulant activi- ties between the different ILD entities, but the increase in TF was significantly correlated with deterioration of lung compliance. Overall fibrinolytic activity did not significantly differ between ILD entities and Controls, although some reduction in IPF subjects was observed. Nevertheless, changes in the profile of the different pro- and anti- fibrinolytic compounds were noted. U-PA, but not t-PA levels were significantly reduced in all ILD groups. α2-AP was markedly elevated throughout, whereas PAI-1 levels were lowered. As a balance of enhanced procoagulant and sustained overall fibrinolytic activity, lavage D-dimer levels were elevated by more than one order of magnitude in all ILD patients. We conclude that the predominant alteration in alveolar hemostatic balance in all groups of ILD patients is an enhancement in TF factor pathway activity. Concomitantly, various compounds of the (anti-)fibrinolytic pathways present with altered concentrations, but the overall BALF fibrinolytic activity is largely unchanged. The net enhancement of fibrin turnover is significantly correlated with the decrease in lung compliance. Abbreviations: α2-AP – α2-antiplasmin; ARDS – acute respiratory distress syndrome; BAL – bronchoalveolar lavage; BALF – BAL fluids; BSA – bovine serum albumin; FEV1 – forced expired volume within 1 s; FP-A – fibrinopeptide A; FVC – forced vital capacity; ILD – interstitial lung disease; IPF – idiopathic pulmonary fibrosis; HP – hypersensitivity pneumonitis; PAI-1 – plasminogen-activator-inhibitor-1; PBS – phosphate buffered saline; PCA – procoagulant activity; PL – phospholipid; PPQ – phospholipid-proteinquotient; SARC – sarcoidosis; t-PA – tissue-type plasminogen activator; u-PA – urokinase-type plasminogen activator

scholarly journals A new noninvasive method for measurement of dynamic lung compliance from fluctuations on photoplethysmography in respiration.

2020 ◽  
Author(s):  
Haruna Yamazaki ◽  
Keisaku Fujimoto
Keyword(s):  
Interstitial Lung Disease ◽  
Convenient Method ◽  
Healthy Adult ◽  
Esophageal Pressure ◽  
Lung Compliance ◽  
Pressure Probe ◽  
Noninvasive Method ◽  
Esophageal Balloon ◽  
Dynamic Lung Compliance ◽  
Adult Volunteers

Lung compliance is important in interstitial lung disease (ILD) as a marker of lung sclerosis. However, the measurement requires placement of an esophageal pressure probe, and is therefore not done routinely in clinic. This study was performed to develop and verify a new noninvasive method for estimation of dynamic lung compliance (Cdyn) using a photoplethysmograph (PPG), and to examine its usefulness. A system for measuring Cdyn in combination with changes in estimated pleural pressure (Ppl) from the fluctuations on PPG with respiration and lung volume measured simultaneously by spirometry was developed, and verified to show correspondence with the estimated Ppl and the esophageal pressure (Pes) (healthy adult volunteers (HS); n = 3), and estimated Cdyn and Cdyn measured using an esophageal balloon (HS; n = 28, COPD; n = 14, ILD; n = 10). Further, the estimated Cdyn was compared among HS (n = 33), COPD (n = 31), and ILD (n = 30). Both the estimated Ppl and Cdyn were significantly correlated with the Pes (r = 0.89) and measured Cdyn (r = 0.63), respectively. The estimated Cdyn in ILD showed significant lower values than those in HS and COPD. The estimated Cdyn was significantly related to %VC (r = 0.56, P < 0.01) and %DLCO (r = 0.52, P < 0.01) in patients with ILD. These findings suggested that the newly developed noninvasive and convenient method for estimation of Cdyn using a combination of PPG and spirometry may be useful for the assessment of lung sclerosis in ILD.

scholarly journals A Safe and Minimally Invasive Method for Thoracoscopic Lung Biopsy in Interstitial Lung Disease

2019 ◽  
Vol 32 (3) ◽  
pp. 117-120
Author(s):  
Ergun Ergun ◽  
Ufuk Ates ◽  
Kutay Bahadir ◽  
Gulnur Gollu ◽  
Meltem Bingol-Kologlu ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Minimally Invasive ◽  
Lung Disease ◽  
Lung Biopsy ◽  
Invasive Method

scholarly journals P1059ACOULD INFERIOR VENA CAVA DIAMETER REFLECT THE VOLUME STATUS OF THE PATIENT WITH INTERMITTENT HEMODIALYSIS ?

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Salwa Elwasif ◽  
Ahmed Naguib ◽  
Samar Elshahat ◽  
Ibrahim Galalah ◽  
Khaled Eldahshan
Keyword(s):  
Blood Pressure ◽  
Body Weight ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Hemodialysis Patient ◽  
Dry Weight ◽  
Ground Glass ◽  
Volume Status ◽  
Muscle Cramps ◽  
Non Invasive

Abstract Background and Aims In 1960, Clyde shields (1st chronic hemodialysis patient) developed severe hypertension under treatment.His physician “Dr.scribner” decided to treat this complication using ultrafiltration to deplete the extracellular volume which was thought to be responsible for the increased blood pressure.It was successful, blood pressure decreased to normal and Clyde remained alive for 11 years.from these coming the rationale of dry body weight and its value in improving dialysis patient and improving his survival and decreasing his suffering. Several different techniques have been used to derive more standard methods of assessment dry weight, however optimal methods for adjusting fluid volume status and ideal dry weight remain uncertain. AIM To assess value of using IVC diameter and collapsibility index in modification of dry body weight in hemodialysis patient. Method A single center study included 98 patients hemodialysis patient unit in our center. all patients were subjected to assessment of IVC diameter before and after one hour of the first hemodialysis session of the week using ultrasound. We choose muscle cramps as an indicator for hypovolemia . Patients were allocated in two groups. Group 1 : patients with muscle cramps (hypotension) at last hour of session& Group 2 :without muscle cramps (normotensive or hypotensive) at last hour of session. Patients with other causes of muscle cramps rather than hypovolumia were excluded (e.g. hypocalcaemia, l-carnitine deficiency ,etc) . Results Patients with muscle cramps in last hour of session were 8 patients with average ivc diameter 0.7 cm & collapsibility more than 80%.Patients without muscle cramps in last hour of session were 84 patient with average ivc diameter 1.3 cm & collapsibility more than 50%. On interpretation of the eight patient :one patient had bilateral lower limb edema 2ry to local cause (varicose vein) not as a part of overload, three patient had uncontrolled blood pressure cannot tolerate more UF and was hypovolemic but on need to increase antihypertensive medication, two Patients had improved nutritional status with increased lean body mass, one patient had prepare for transplantation and during coarse of preparation NCCT chest showed bilateral diffuse ground glass opacities (overload versus interstitial lung disease). There was marked improvement, however NCCT still revealed ground glass opacities, in spite of patient become hypovolemic (clinically and confirmed by IVC diameter ), so patient investigated for the cause of interstitial lung disease and unfortunately diagnosed by further investigation as latent TB. Conclusions Using of ultrasound in assessment of IVC diameter is a promising method for estimating dry body weight in hemodialysis patient because it is simple, quick ,non-invasive and helpful especially in debatable cases. Conclusion Using of ultrasound in assessment of IVC diameter is a promising method for estimating dry body weight in hemodialysis patient because it is simple, quick ,non-invasive and helpful especially in debatable cases.

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