scholarly journals ECMO Rescues Patients With Acute Respiratory Failure Related to GPA

2021 ◽  
Vol 8 ◽  
Author(s):  
Rongjun Wan ◽  
Wenzhe Yang ◽  
Xinhua Ma ◽  
Wei Yang ◽  
Pinhua Pan ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Granulomatosis With Polyangiitis ◽  
Clinical Symptoms ◽  
Clinical Manifestations ◽  
Systemic Involvement ◽  
Online Databases ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Granulomatosis with polyangiitis (GPA) is a subtype of anti-neutrophil cytoplasmic antibody-associated vasculitis with a wide range of clinical symptoms related to the systemic involvement of small blood vessels. The respiratory system is one of the most frequently involved, and life-threatening acute respiratory failure could occur due to diffusive alveolar hemorrhage and tracheal stenosis. When maximum mechanical ventilation is unable to maintain oxygenation, extracorporeal membrane oxygenation (ECMO) should be considered as the final respiratory supportive method, if available. Here we present a 32-year-old male patient with acute respiratory failure (ARF) related to GPA, who was rescued by winning time for accurate diagnosis and appropriate treatment. Additionally, we reviewed more than 60 GPA-related ARF cases on multiple online databases, summarized the clinical manifestations of these patients, and concluded that ECMO plays an important role in further respiratory support for ARF patients with GPA and assists in accurate and timely diagnosis and appropriate treatment, thus helping them recuperate.

Hematologic and Oncologic Emergencies

2019 ◽  
pp. 170-177
Author(s):  
James McCue
Keyword(s):  
Emergency Department ◽  
Standardized Tests ◽  
Tumor Lysis Syndrome ◽  
Clinical Effects ◽  
Tumor Lysis ◽  
Oncologic Emergencies ◽  
First Response ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Life Threatening

Hematologic and oncologic emergencies are an uncommon reason for people to present to the emergency department (ED), but when they do, it is important to know how to diagnose and treat these conditions because many of them are life threatening. Whether it is bleeding due to conditions such as hemophilia, von Willebrand’s disease, warfarin use, or dangerous conditions related to cancer such as tumor lysis syndrome or neutropenic fever, knowing the basics will help you manage these patients and also ace the standardized tests. This chapter presents questions related to the diagnosis, clinical effects, best first response in the ED, and most appropriate treatment of a wide range of these hematologic and oncologic emergencies.

scholarly journals Emergent thyroidectomy with sternotomy due to acute respiratory failure with severe thyroid storm

2018 ◽  
Vol 100 (8) ◽  
pp. e223-e225
Author(s):  
A Matsushita ◽  
S Hosokawa ◽  
D Mochizuki ◽  
J Okamura ◽  
K Funai ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Airway Obstruction ◽  
Total Thyroidectomy ◽  
Upper Airway ◽  
Thyroid Storm ◽  
Graves Disease ◽  
Nasal Intubation ◽  
Threatening Condition ◽  
Life Threatening

Huge cervical and mediastinal masses may lead to acute respiratory failure caused by laryngotracheal compression and airway obstruction. Thyroid storm is also a life-threatening endocrine emergency originating almost exclusively from uncontrolled Graves’ disease. We report a case of a 42-year-old man with acute upper airway obstruction and tachycardia from progressive swelling of a giant thyroid, in conjunction with thyroid storm resulting from uncontrolled Graves’ disease. Fibreoptic-assisted nasal intubation was performed while the patient was awake, immediately followed by emergency total thyroidectomy via a cervical and sternal approach. The patient had an uneventful postoperative course and recovered well. Respiratory failure due to swelling of a giant thyroid is a life-threatening condition and should be treated immediately with endotracheal intubation while the patient is awake following emergent total thyroidectomy, even with a sternotomy.

scholarly journals Ankle edema after administration of selective serotonin reuptake inhibitors

2018 ◽  
Vol 10 (1) ◽  
pp. 25-26
Author(s):  
Konstantinos Kontoangelos ◽  
Marina Ecomomou ◽  
Charalambos Papageorgiou
Keyword(s):  
Psychotropic Medication ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Manifestations ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin ◽  
Drug Induced ◽  
Skin Reactions ◽  
Wide Range ◽  
Life Threatening

Clinical manifestations of drug-induced skin reactions include a wide range of symptoms, from mild drug-induced exanthemas to dangerous and life-threatening generalized systematic reactions. Drug-induced skin reactions to psychotropic medication are usually associated with antiepileptic drugs. However, a significant role can be assigned to selective serotonin reuptake inhibitors. We report a case of a female patient, who after approximately one month therapy with escitalopram developed a bilateral ankle edema, which resolved completely within the first week following its discontinuation. Although serious complications are rare, clinicians should be aware of severe skin complications in patients treated with antidepressants, which necessitate careful clinical monitoring and management. Individualization of pharmacotherapy is crucial, together with regular evaluation of safety and tolerance of the treatment.

scholarly journals Acute Respiratory Failure Due to Hypokalaemic Muscular Paralysis from Renal Tubular Acidosis

2005 ◽  
Vol 33 (5) ◽  
pp. 656-658 ◽  
Author(s):  
S. Gombar ◽  
P. J. Mathew ◽  
K. K. Gombar ◽  
S. D'Cruz ◽  
G. Goyal
Keyword(s):  
Mechanical Ventilation ◽  
Metabolic Acidosis ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Renal Tubular Acidosis ◽  
Cardiac Arrhythmias ◽  
Distal Renal Tubular Acidosis ◽  
Life Threatening ◽  
Renal Tubular ◽  
Potassium Replacement

We report a case of hypokalaemic quadriplegia with acute respiratory failure and life-threatening cardiac arrhythmias in a 26-year-old woman who was diagnosed to have distal renal tubular acidosis. She had persistent metabolic acidosis with severe hypokalaemia and required mechanical ventilation and potassium replacement. The anaesthetic implications of renal tubular acidosis are also discussed.

Pulmonary aspergilloma: from classification to management

2019 ◽  
Vol 28 (1) ◽  
pp. 33-38 ◽  
Author(s):  
Hicham Harmouchi ◽  
Rabiou Sani ◽  
Ibrahim Issoufou ◽  
Marouane Lakranbi ◽  
Yassine Ouadnouni ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Respiratory Failure ◽  
Clinical Symptoms ◽  
Therapeutic Option ◽  
Severe Respiratory Failure ◽  
Poor General Condition ◽  
Thoracic Computed Tomography ◽  
Life Threatening ◽  
Pulmonary Aspergilloma ◽  
Pulmonary Cavity

Pulmonary aspergilloma is a form of aspergillosis characterized by the colonization of a preexisting pulmonary cavity, most often of tuberculosis origin. Clinical symptoms are predominately hemoptysis that can be life-threatening, and thoracic computed tomography can distinguish simple from complex pulmonary aspergilloma. The best therapeutic option remains surgery which allows surgical resection of the mycetoma and the underlying cavity. Nonsurgical treatment is performed in inoperable patients because of severe respiratory failure or a poor general condition.

scholarly journals Retrospective study of clinical profile and outcome of pediatric dengue cases in a teaching hospital

2016 ◽  
Vol 4 (1) ◽  
pp. 226
Author(s):  
Alok Kumar M. K. ◽  
Timmangouda R. Patil ◽  
Santhosh Veerabadhraiah
Keyword(s):  
Retrospective Study ◽  
Respiratory Distress ◽  
Dengue Fever ◽  
Clinical Symptoms ◽  
Fluid Management ◽  
Clinical Manifestations ◽  
Warning Signs ◽  
Severe Dengue ◽  
Study Results ◽  
Wide Range

Background: Dengue fever is an acute febrile illness caused by 4 closely related viral serotypes of the genus Flavivirus. Dengue has a broad range of clinical manifestations and often with unpredictable clinical evaluation and outcome. So this study has been done to see the wide range of clinical presentation of dengue and its outcome.Methods: It is a retrospective study done in tertiary hospital during the period of 8 months. Study was done by collecting the previous records from hospital record section. There were 48 cases of serologically confirmed cases of dengue which satisfied the inclusion and exclusion criteria were included in the study. Results: In our study there were 52% of the cases of dengue fever, 16.6% of cases were dengue fever with warning signs and remaining 31.4% of patients were severe dengue. Common Clinical symptoms at admission were fever (100%), vomiting (77%), respiratory distress (56.25%), generalised weakness (54.1%) and pain abdomen (33.3%). Less common symptoms were loose stools (6.25%), periorbital puffiness (6.25%), altered sensorium (4.1%), oliguria (2%) and bleeding manifestations (2%). Out of these dengue children 70.8% of these children improved without complication, 20.8 % of children improved with complication, in the form of ARDS, acute liver failure, DSS, meningitis, 6.25 % of these children went DAMA and  2 % of children expired.Conclusions: In our study atypical presentations like respiratory distress, loose stools meningitis were commonly noted and bleeding manifestation at admission was rare in our study. Platelet transfusions have little role in management of dengue patients. Early diagnosis, careful monitoring and proper fluid management goes a long way in reducing the mortality due to dengue hemorrhagic fever and shock syndrome.  

scholarly journals Superior sagittal sinus thrombosis in a case of beta thalassaemia major

2017 ◽  
Vol 4 (2) ◽  
pp. 585
Author(s):  
Syed Md Azad ◽  
Anwesha Mukherjee ◽  
Rohit Kapoor ◽  
Rohit Bannerji ◽  
Jaydeb Ray
Keyword(s):  
Clinical Symptoms ◽  
Sinus Thrombosis ◽  
Incidental Finding ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Thalassaemia Major ◽  
Beta Thalassaemia ◽  
Sagittal Sinus ◽  
Life Threatening ◽  
Transfusion Dependency

Patients with beta- thalassaemia major have a wide spectrum of clinical manifestations, from transfusion dependency to asymptomatic anaemia. Some may just have incidental finding of anaemia with splenomegaly during physical examination. Most of them require regular blood transfusion and their haemoglobin is maintained at an acceptable level. However they are at risk for multiple complications such as thrombo-embolic events which may be life threatening. We report here a case of beta- thalassaemia major complicated by cerebral sinus thrombosis, who had minimal clinical symptoms and signs at presentation. This case reiterates the importance of increased vigilance in the clinical management of this vulnerable group of patients. 

scholarly journals Computed tomography angiography findings of abdominal aortic disease: A review of emergencies

2020 ◽  
Vol 73 (11-12) ◽  
pp. 393-400
Author(s):  
Mirela Jukovic ◽  
Aleksandra Mijatovic ◽  
Ivana Stojic ◽  
Ljiljana Drazetin ◽  
Maja Stankov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Aorta ◽  
Computed Tomography Angiography ◽  
Clinical Manifestations ◽  
Aortic Disease ◽  
Occlusive Disease ◽  
Tunica Media ◽  
Abdominal Aortic ◽  
Wide Range ◽  
Life Threatening

Introduction. The aorta is a major blood vessel that supplies all segments of the human body. Acute aortic syndrome is a term that implies a life-threatening aortic disease. Due to the speed of examination and widespread availability, computed tomography angiography is a front-line diagnostic modality for emergencies and diseases of the abdominal aorta. The aim of this study was to provide a wide range of potentially life-threatening abnormalities of the abdominal aorta in daily clinical and radiological practice through a series of computed tomography angiography images and three-dimensional virtual reconstruction. Abdominal aortic aneurysm is defined as a 50% increase in diameter more than the normal arterial diameter. One of the most important complications of an aneurysm is a rupture that can be acute or chronic, presenting with various clinical manifestations. Aortic dissections are caused by abnormality of the tunica media layer, forming an intimal-medial flap and two types of lumen. A penetrating aortic ulcer may erode through the internal elastic lamina of the aortic wall and allow formation of hematoma within the tunica media. Occlusive disease of the abdominal aorta may refer to the late stage of chronic aortoiliac occlusive disease, whereas the acute and/or subacute form occurs due to sudden thrombosis or occlusion. Conclusion. The recognition of specific radiological signs of abdominal aortic disease using computed tomography angiography contributes to optimal treatment of patients and reduces mortality.

scholarly journals Devils and Angels: Ozonetherapy for microcirculation in covid-19

2020 ◽  
Author(s):  
Giovanni Tommaso Ranaldi ◽  
Emanuele Rocco Villani ◽  
Laura Franza ◽  
Giulia Motola
Keyword(s):  
Lung Inflammation ◽  
Microvascular Complications ◽  
Clinical Manifestations ◽  
Severe Respiratory Failure ◽  
Ozone Therapy ◽  
Risk Of Mortality ◽  
Wide Range ◽  
Life Threatening ◽  
Medical Ozone ◽  
Infusion Technique

COVID-19 is the respiratory disease caused by the new coronavirus SARS-CoV-2 and is characterized by clinical manifestations ranging from mild, flu-like symptoms, to severe respiratory failure and multi-organ failure. Patients with more severe symptoms may require intensive care treatments and have a high risk of mortality. COVID 19 is characterized by an abnormal inflammatory response similar to a cytokine storm, which is associated with endothelial dysfunction and microvascular complications. To date, no specific treatments are available for COVID-19 and its potentially life-threatening complications.Ozone therapy is the administration of a mixture of ozone and oxygen, or Medical Ozone (MO), which produces a series of benefits capable of counteracting a wide range of pathologies, in use for over a century as an unconventional medicine practice.The use of Ozone therapy with the large auto-hemo-infusion technique could help oxygenate the tissues better, decrease lung inflammation and regulate the immune response, help slow down viral growth, regulate lung circulation and avoid or slow down vascular hypertrophy and consequent hyperemia, especially in the early stages

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