scholarly journals Different presentation of pulmonary parenchymal disruption in COVID-19 pneumonia. Case series of Sub-Intensive Care Unit in Naples, Italy

2020 ◽  
Vol 90 (4) ◽  
Author(s):  
Giorgio E. Polistina ◽  
Francesca Simioli ◽  
Pasquale Imitazione ◽  
Maurizia Lanza ◽  
Anna Annunziata ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
High Resolution ◽  
Oxygen Therapy ◽  
Case Series ◽  
Single Center ◽  
High Resolution Computed Tomography ◽  
Pneumonia Case ◽  
Typical Sign

The coronavirus disease 2019 (COVID-19) is a recent pandemic that affected more than 5 million people worldwide. Chest high resolution computed tomography (HRCT) is an essential tool in diagnosis and management of the disease. Pulmonary parenchymal opacity is a typical sign of the disease, but not the only one. Pneumothorax, pneumomediastinum, bronchiectasis and cysts are probably underrated complications of COVID-19 that can worsen prognosis, in terms of prolonged hospitalization and need of oxygen therapy. In our single center case series, we outline four different manifestations of pneumothorax, pneumomediastinum and cysts in hospitalized patients with COVID-19 pneumonia.

S162 – Chronic Aspiration after Supracricoid Partial Laryngectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P130-P131
Author(s):  
Andrea Gallo ◽  
Giovanni Ruoppolo ◽  
Marco Di Mario ◽  
Calcagno Paola ◽  
Manciocco Valentina ◽  
...  
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Case Series ◽  
Control Group ◽  
Chronic Obstructive ◽  
Partial Laryngectomy ◽  
High Resolution Computed Tomography ◽  
Obstructive Pulmonary Disease ◽  
Supracricoid Partial Laryngectomy ◽  
Control Evaluation

Objectives The aim of this study is to evaluate the long-term swallowing status and the high resolution computed tomography (HRCT) pulmonary findings of chronic aspiration in patients who have undergone supracricoid partial laryngectomy (SCPL), to demonstrate that SCPL causes a mild and well-tolerated degree of chronic aspiration, allowing the patient to avoid a nothing-by-mouth status. Methods Retrospective medical record review. Cohort study. Case series. The follow-up period ranged from 3 to 13 years. 116 patients treated with SCPL were analyzed. The patients included in the study were NED, were followed for more than 3 years, were without tracheal cannula or nasogastric tube, and able to feed orally. A group of 20 patients with chronic obstructive pulmonary disease and normal deglutition was used as a control. Evaluation of postoperative swallowing disorders included a careful observation of the patients by the physician, fiberoptic endoscopic evaluation of swallowing (FEES), and videofluoroscopy (VFS). Clinical grading of postoperative aspiration was assessed according to the Leipzig and Pearson scale. The radiological manifestations of chronic aspiration were recorded at high resolution computed tomography (HRCT). Results A higher incidence of pulmonary consolidation was found in the patients affected by postoperative chronic aspiration, compared to the control group (p<0.001). No significant differences were noted between the control group and the dysphagic group regarding the remaining radiological findings. Conclusions SCPL causes a mild and well-tolerated degree of chronic aspiration, determining low functional impairment and allows the patient a good quality of life.

scholarly journals Evaluation of pulmonary involvement in systemic rheumatic diseases with high resolution computed tomography and pulmonary function test: A single-center experience

2021 ◽  
Vol 69 (2) ◽  
pp. 125-132
Author(s):  
Ahmet Cemal Pazarlı ◽  
Halil İbrahim Yakar ◽  
Handan İnönü Köseoğlu ◽  
Ruken Yüksekkaya Çelikyay ◽  
Timur Ekiz
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Pulmonary Involvement ◽  
Single Center ◽  
High Resolution Computed Tomography ◽  
Single Center Experience ◽  
Function Test ◽  
Systemic Rheumatic Diseases

scholarly journals Prevalence and clinical consequences of atelectasis in SARS-CoV-2 pneumonia: a computed tomography retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Álvaro Mingote ◽  
Andrea Albajar ◽  
Paulino García Benedito ◽  
Jessica Garcia-Suarez ◽  
Paolo Pelosi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Hospital Stay ◽  
Lung Volume ◽  
Oxygen Therapy ◽  
Admission Rate ◽  
Clinical Severity ◽  
Mortality Data

Abstract Background The aim of the study is to estimate the prevalence of atelectasis assessed with computer tomography (CT) in SARS-CoV-2 pneumonia and the relationship between the amount of atelectasis with oxygenation impairment, Intensive Care Unit admission rate and the length of in-hospital stay. Patients and methods Two-hundred thirty-seven patients admitted to the hospital with SARS-CoV-2 pneumonia diagnosed by clinical, radiology and molecular tests in the nasopharyngeal swab who underwent a chest computed tomography because of a respiratory worsening from Apr 1 to Apr 30, 2020 were included in the study. Patients were divided into three groups depending on the presence and amount of atelectasis at the computed tomography: no atelectasis, small atelectasis (< 5% of the estimated lung volume) or large atelectasis (> 5% of the estimated lung volume). In all patients, clinical severity, oxygen-therapy need, Intensive Care Unit admission rate, the length of in-hospital stay and in-hospital mortality data were collected. Results Thirty patients (19%) showed small atelectasis while eight patients (5%) showed large atelectasis. One hundred and seventeen patients (76%) did not show atelectasis. Patients with large atelectasis compared to patients with small atelectasis had lower SatO2/FiO2 (182 vs 411 respectively, p = 0.01), needed more days of oxygen therapy (20 vs 5 days respectively, p = 0,02), more frequently Intensive Care Unit admission (75% vs 7% respectively, p < 0.01) and a longer period of hospitalization (40 vs 14 days respectively p < 0.01). Conclusion In patients with SARS-CoV-2 pneumonia, atelectasis might appear in up to 24% of patients and the presence of larger amount of atelectasis is associated with worse oxygenation and clinical outcome.

scholarly journals Safety of Bedside Placement of Tunneled Hemodialysis Catheters In The Intensive Care Unit: Translating From The Covid-19 Experience – Retrospective Single-Center Case Series

2021 ◽  
Author(s):  
Mohammad Ahsan Sohail ◽  
Tarik Hanane ◽  
James Lane ◽  
Tushar Vachharajani
Keyword(s):  
Intensive Care Unit ◽  
Blood Flow ◽  
Intensive Care ◽  
Case Series ◽  
Air Embolism ◽  
Fluoroscopic Guidance ◽  
Single Center ◽  
Anatomic Landmarks ◽  
Hemodialysis Catheter ◽  
Venous Air Embolism

Abstract Background: Critically-ill patients with coronavirus disease-2019 (COVID-19) and kidney dysfunction often require tunneled hemodialysis catheter (TDC) placement for kidney replacement therapy (KRT), typically under fluoroscopic guidance to minimize catheter-related complications. This entails transportation of patients outside the intensive care unit (ICU) to a fluoroscopy suite, which may potentially expose many healthcare providers to COVID-19. One potential strategy to mitigate the risk of viral transmission is to insert TDCs at the bedside, using ultrasound (US) and anatomic landmarks only, without fluoroscopic guidance. Methods: We reviewed all COVID-19 patients in the ICU who underwent right internal jugular (RIJ) TDC insertion at the bedside between April and December 2020. Outcomes included procedural complications such as bleeding, venous air embolism, arrhythmias, pneumothorax and catheter tip malposition. TDC insertion was considered successful if the catheter was able to achieve blood flow sufficient to perform a single hemodialysis treatment. Results: We report a retrospective single-center case series of 25 patients with COVID-19 who had RIJ TDCs placed at the bedside, 10 of whom underwent simultaneous insertion of small-bore RIJ tunneled central venous catheters (T-CVC). Continuous veno-venous hemodialysis was the KRT modality employed in all patients. A median catheter blood flow rate of 200 ml/min (IQR:200-200) was achieved in all patients without any deviation from the dialysis prescription. No catheter-related complications were observed and none of the catheter tips were mal-positioned. Conclusions: Bedside RIJ TDC placement in COVID-19 patients, using US and anatomic landmarks without fluoroscopic guidance, may potentially reduce the risk of COVID-19 transmission amongst healthcare workers without compromising patient safety or catheter function.

Gray-Scale Inversion on High Resolution Computed Tomography of the Temporal Bone: An Observational Study

2021 ◽  
pp. 000348942199684
Author(s):  
Tyler R. Schwartz ◽  
Timothy Logan Lindemann ◽  
Gino Mongelluzzo ◽  
P. Ashley Wackym ◽  
Arun K. Gadre
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Temporal Bone ◽  
Case Series ◽  
Vestibular Evoked Myogenic Potentials ◽  
Gray Scale ◽  
High Resolution Computed Tomography ◽  
Superior Semicircular Canal Dehiscence ◽  
Tertiary Referral Center ◽  
Temporal Bone Anatomy

Objectives: This is a qualitative study to explore the utility of gray-scale inversion or the “invert” function of high-resolution computed tomography (HRCT) scans in the diagnosis of temporal bone anatomy and pathology. Methods: This is a case series describing an innovative application of an existing image processing tool to visualize temporal bone anatomy and pathology. Illustrative patients at a tertiary referral center with otologic symptoms and findings leading to HRCT scans of the temporal bone were included. Diagnostic HRCT scans were evaluated utilizing the gray-scale inversion function (invert function). Results: Nine illustrative cases which demonstrate conditions such as persistent stapedial artery, membranous stapes footplate, total ossicular prosthesis migration into the vestibule, third window syndrome such as superior semicircular canal dehiscence (SSCD) and cochlea-facial nerve dehiscence, otosclerosis, and ossicular chain discontinuity are included. The enhanced visualization was confirmed surgically in 3 cases, and 1 had physiological confirmation using cervical vestibular evoked myogenic potentials (cVEMP). Conclusions: Gray-scale inversion can be used to improve visualization of temporal bone anatomy and pathologic changes when diagnoses are in doubt. The invert function is a useful adjunct in the armamentarium of both radiologists and otologists when evaluating HRCT of the temporal bone.

scholarly journals Hypercoagulopathy in Overweight and Obese COVID-19 Patients: A Single-Center Case Series

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azza Sarfraz ◽  
Zouina Sarfraz ◽  
Aman Siddiqui ◽  
Ali Totonchian ◽  
Syed Hashim Abbas Ali Bokhari ◽  
...  
Keyword(s):  
United States ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Venous Thromboembolism ◽  
Gastrointestinal Bleeding ◽  
Clinical Outcomes ◽  
Disseminated Intravascular Coagulation ◽  
Case Series ◽  
Obese Patients ◽  
Single Center

Abstract A case series is presented of five overweight or obese patients with confirmed coronavirus disease 2019 (COVID-19) in South Miami, Florida, United States. A multitude of coagulation parameters was suggestive of a hypercoagulable state among the hospitalized COVID-19 patients. This article reports various manifestations of hypercoagulable states in overweight and obese patients, such as overt bleeding consistent with disseminated intravascular coagulation, venous thromboembolism, gastrointestinal bleeding as well as retroperitoneal hematoma. All of the required admission to the intensive care unit and subsequently patients died. The characteristics of COVID-19-associated coagulopathy are atypical and warrant a further understanding of the pathophysiology to improve clinical outcomes, specifically in overweight or obese patients.

Computed Tomography of the Chest in the Intensive Care Unit

1994 ◽  
Vol 10 (2) ◽  
pp. 267-275 ◽  
Author(s):  
Barry H. Gross ◽  
David L. Spizarny
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Intensive Care
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