scholarly journals Effect of Pronation and Postural Changes on Non-intubated Patients with Respiratory Failure Due to Covid-19 Interstitial Pneumonia

2021 ◽  
pp. 94-103
Author(s):  
Lorenzo Porta ◽  
Giulio Cassano ◽  
Silvia Gheda ◽  
Adriano Basile ◽  
Andrea Bellone
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Postural Changes

A Rare Case of Acute Interstitial Pneumonia Diagnosed at Autopsy

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S153-S154
Author(s):  
E Conner ◽  
D Troxclair ◽  
H Khokhar ◽  
W Beversdorf
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
High Dose ◽  
Atypical Pneumonia ◽  
Acute Interstitial Pneumonia ◽  
Diagnostic Role ◽  
History Of

Abstract Introduction/Objective Acute interstitial pneumonia (AIP) is a rare disease clinically characterized by rapidly progressing respiratory failure in individuals with no history of respiratory illness or other inciting factors. While most often diagnosed in middle-aged adults, it may present in any age group. Initial presentation is described as influenza- like, and respiratory failure requiring ventilatory support often progresses within weeks to months. Prognosis is poor, with an estimated mortality rate approaching 80% without treatment. Methods We present the case of a 44-year-old male nonsmoker with no significant medical history, who presented in 2018 with 1.5 months of dyspnea and headache initially diagnosed as atypical pneumonia. Chest imaging revealed bilateral opacities; however, microbial workup revealed no evidence of infectious etiology. Autoimmune serology studies were likewise unrevealing. Despite aggressive supportive and medical management, he deteriorated to respiratory failure and succumbed. Results At autopsy, the lungs were symmetrically congested and edematous (combined weight 2,340 g) but free of evident consolidation or discrete lesions. Microscopic examination revealed diffuse alveolar damage with extensive hyaline membrane formation, interstitial edema, and fibroblastic proliferation. The vasculature was severely congested, and the alveoli contained hemorrhage and scattered macrophages. No fungal or mycobacterial elements were identified by staining. Based on the histologic features and clinical context, the diagnosis of AIP was made. Conclusion AIP is a rare, aggressive, and diagnostically challenging disease that includes a broad range of both clinical and histologic differentials. Timely recognition and intervention with aggressive respiratory support and high- dose glucocorticoids are the mainstays of clinical management. The diagnostic role of histology is significant, but hinges on early clinical consideration of AIP as disease progression may later preclude the biopsy procedure. We share this case to raise awareness of this rapidly progressive and diagnostically troubling interstitial lung disease while emphasizing the importance of clinicopathologic correlation.

Of Circulatory Disorders in the Lungs with the Development of Chronic Respiratory Failure in Patients with Common Interstitial Pneumonia

2019 ◽  
Vol 64 (6) ◽  
pp. 51-56
Author(s):  
V Zolotnitskaia ◽  
V. Amosov ◽  
A. Speranskaia ◽  
Artem Tishkov ◽  
V. Ratnikov
Keyword(s):  
Pulmonary Hypertension ◽  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Photon Emission ◽  
Chronic Respiratory Failure ◽  
Vascular Pathology ◽  
Emission Computed Tomography ◽  
Heterogeneous Structure ◽  
Pulmonary Hemodynamics ◽  
Circulatory Disorders

Purpose: To determine the features of circulatory disorders in the lungs in patients with ordinary interstitial pneumonia (OIP) at different stages of the pathological process and with the development of comorbid conditions. Material and methods: The analysis of the results of radiation research methods: computer tomography, computed angiography and single photon emission computed tomography in 64 patients with common interstitial pneumonia. The selection criteria were the presence of respiratory failure and pulmonary hypertension. Results: The combination of interstitial and alveolar changes, their distribution in the lower parts of both lungs with subpleural localization are mainly pathognomonic for IPI. In 85 % of patients with OIP and the formation of a “cellular lung”, local perfusion disorders of various forms, of small size, subsegmental level, located symmetrically in the diaphragm regions were determined. The main distinctive CT signs of adherence to vascular pathology: pulmonary pattern mosaic; subpleural infiltration sites of the lung tissue of heterogeneous structure; defects in filling the pulmonary artery with a contrast agent during CT angiography; triangular subpleurally located areas of perfusion disturbance on SPECT (when SPECT/CT is combined), localized in the area of lung infarction, or in the zone of no changes on CT. Conclusion: The development of pulmonary hypertension and chronic respiratory failure in OIP is determined by several factors that have an active or passive effect on pulmonary hemodynamics. Worsening of the patient’s condition and an increase in the degree of respiratory failure and pulmonary hypertension, contributes to complication of the pulmonary vascular system – pulmonary thromboembolism and (or) thrombosis in situ, as well as persistent infectious inflammatory processes. In the presence of irreversible morphological changes in the lung parenchyma therapeutic measures do not affect the state of microcirculation in the lungs.

scholarly journals Clinical Case of Idiopathic Interstitial Pneumonia: Expert Approaches

2019 ◽  
Vol 4 (2) ◽  
pp. 29-32
Author(s):  
V. M. Karetnikova ◽  
I. L. Petrunko
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Clinical Case ◽  
The Body ◽  
Idiopathic Interstitial Pneumonia ◽  
External Respiration ◽  
Functional Impairments ◽  
Verification Method ◽  
Radiological Data ◽  
Disability Group

The article describes the criteria for the examination of temporary disability and the establishment of a disability group for idiopathic interstitial pneumonia on the example of a clinical case of nonspecific interstitial pneumonia with a view to a uniform interpretation by clinical physicians and expert doctors of the criteria for persistent functional impairments in the case of respiratory organs and the timeliness of referring to medical and social examination of people suffering from it patients. Temporary disability is caused by the appearance of shortness of breath in patients, which is steadily progressing and leads to a decrease in exercise tolerance. The presence of an unfavorable prognosis in some forms of interstitial pneumonia predetermines the maximum period of temporary disability for 4 months with the subsequent registration of patients for medical and social examination. Restrictive dysfunction of external respiration is not singled out in quantitative criteria of functional persistent disorders of the body to establish the group of disability in the Order of the Ministry of Labor of Russia dated December 17, 2015 No. 1024н, which causes difficulties during the examination. A key sign of persistent respiratory function disorders is respiratory failure, the severity of which is put in its quantitative gradation for recognizing a citizen as disabled. Pulse oximetry is currently available as a verification method for the diagnosis of respiratory failure, which is used for medical and social expertise. The morphological variant of interstitial pneumonia, if histological diagnosis was performed, or the presumptive nosological form diagnosed on the basis of a complex of clinical and radiological data, do not have a direct impact on the result of the examination; just as the volume of drug therapy and the response to it are not taken into account in order to establish the fact of disability.

scholarly journals POSTURAL CHANGES OF FINE CRACKLES IN PATIENTS WITH INTERSTITIAL PNEUMONIA

CHEST Journal ◽  
2020 ◽  
Vol 157 (6) ◽  
pp. A172
Author(s):  
M. Tsuchiya ◽  
Y. Nagasaka ◽  
C. Sakaguchi ◽  
M. Ishida ◽  
J. Suzumoto
Keyword(s):  
Interstitial Pneumonia ◽  
Postural Changes

Extracorporeal Membrane Oxygenation for Refractory Severe Respiratory Failure in Acute Interstitial Pneumonia

2018 ◽  
Vol 42 (5) ◽  
pp. 569-574 ◽  
Author(s):  
Gabriela Gonçalves-Venade ◽  
Nuno Lacerda-Príncipe ◽  
Roberto Roncon-Albuquerque ◽  
José Artur Paiva
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Interstitial Pneumonia ◽  
Severe Respiratory Failure ◽  
Membrane Oxygenation ◽  
Acute Interstitial Pneumonia

scholarly journals Respiratory failure in a patient with dermatomyositis

2013 ◽  
Vol 8 ◽  
Author(s):  
Ivano Salimbene ◽  
Ilaria Leli ◽  
Salvatore Valente
Keyword(s):  
Respiratory Failure ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Interstitial Pneumonia ◽  
Usual Interstitial Pneumonia ◽  
Ventilatory Support ◽  
Pulmonary Complications ◽  
Gas Analysis ◽  
Lower Limbs ◽  
Arterial Blood

Since its original description in 1956 the association between interstitial lung disease and polymyositis (PM) and dermatomyositis (DM) has become well established. Interstitial lung disease (ILD) can be a significant complication in rheumatic diseases (RDs). Although most patients with RD do not develop clinically evident ILD, these systemic autoimmune disorders are estimated to be responsible for approximately 25% of all ILD deaths and 2% of deaths due to all respiratory causes. Radiologic abnormalities in DM are characterized by a high incidence of airspace consolidation. Non-Specific Interstitial Pneumonia (NSIP) is the most common form of lung disease, with a frequency in biopsies 4-fold greater than that of Usual Interstitial Pneumonia (UIP) in PM and a slightly smaller predominance in DM. We report a case of a female patient, 57 years old, no former smoker, whose clinical history was onset in November 2008 with asthenia with muscle and osteoarticular pain especially located in the upper limbs and then also expanded to the lower limbs. The EMG was compatible with dermatomyositis in the acute phase. The patient received therapy with steroids and tacrolimus, also making several rounds of treatment with immunoglobulin. Given the recurrence of myositis in association with signs of poorly controlled interstitial lung disease, immunosuppressive therapy with Rituximab was administered. The Computed Tomography (CT) scans showed "bronchiectasis and traction bronchiolectasis, hypodense areas consistent with the phenomena of air trapping. The pattern of interstitial lung disease with fibrotic evolution seems consistent with NSIP. The arterial blood gas analysis showed a pattern of hypoxic-hypercapnic respiratory failure (pH: 7,34, PaO2: 67 mmHg; PaCO2: 55 mmHg). As a result of an episode of marked desaturation unresponsive to supplemental oxygen at high flows we proceeded to noninvasive mechanical ventilation with Helmet for 24 hours/24. This ventilatory support was maintained for a week, with resolution of the respiratory failure. In this brief case report we want to highlight various pulmonary complications as a result of dermatomyositis. The progression of respiratory complications may also lead to a situation of respiratory failure, as in our patient, and require a noninvasive ventilatory treatment.

scholarly journals Hantavirus pulmonary syndrome in Brazil: clinical aspects of three new cases

2000 ◽  
Vol 42 (1) ◽  
pp. 41-46 ◽  
Author(s):  
Marcelo S. FERREIRA ◽  
Sérgio de A. NISHIOKA ◽  
Thogo L. SANTOS ◽  
Rubens P. SANTOS ◽  
Paulo S. SANTOS ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Mononuclear Cells ◽  
Histopathological Examination ◽  
Febrile Illness ◽  
The United States ◽  
Hantavirus Pulmonary Syndrome ◽  
Clinical Aspects ◽  
Sin Nombre Virus ◽  
Laboratory Findings

Hantavirus pulmonary syndrome (HPS) has been recognized recently in Brazil, where 28 cases have been reported as of September 1999. We report here the clinical and laboratory findings of three cases whose diagnoses were confirmed serologically. All the patients were adults who presented a febrile illness with respiratory symptoms that progressed to respiratory failure that required artificial ventilation in two of them. Laboratory findings were most of the time consistent with those reported in the United States in patients infected with the Sin Nombre virus, and included elevated hematocrit and thrombocytopenia; presence of atypical lymphocytes was observed in one patient. The chest radiological findings observed in all the patients were bilateral, diffuse, reticulonodular infiltrates. Two patients died. Histopathological examination of the lungs of these patients revealed interstitial and alveolar edema, alveolar hemorrhage, and mild interstitial pneumonia characterized by infiltrate of immunoblasts and mononuclear cells. In the epidemiologic investigation of one of the cases, serologic (ELISA) tests were positive in 3 (25%) out of 12 individuals who shared the same environmental exposure. HPS should be included in the differential diagnosis of interstitial pneumonia progressing to acute respiratory failure.

Sign in / Sign up

Export Citation Format

Share Document