hypoxic respiratory failure
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2022 ◽  
Vol 13 (1) ◽  
Author(s):  
Shasha Li ◽  
Hecheng Zhu ◽  
Ming Zhao ◽  
Weidong Liu ◽  
Lei Wang ◽  
...  

AbstractCoronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory coronavirus 2 is currently spreading throughout the world with a high rate of infection and mortality and poses a huge threat to global public health. COVID-19 primarily manifests as hypoxic respiratory failure and acute respiratory distress syndrome, which can lead to multiple organ failure. Despite advances in the supportive care approaches, there is still a lack of clinically effective therapies, and there is an urgent need to develop novel strategies to fight this disease. Currently, stem cell therapy and stem cell-derived organoid models have received extensive attention as a new treatment and research method for COVID-19. Here, we discuss how stem cells play a role in the battle against COVID-19 and present a systematic review and prospective of the study on stem cell treatment and organoid models of COVID-19, which provides a reference for the effective control of the COVID-19 pandemic worldwide.


2021 ◽  
Vol 2021 ◽  
pp. 1-3
Author(s):  
Hassam Ali ◽  
Rahul Pamarthy ◽  
Nayab Ahsan ◽  
WashmaAwan ◽  
Shiza Sarfraz

Myasthenia gravis is a neuromuscular autoimmune disease that results in skeletal muscle weakness that worsens after periods of activity and improves after rest. Myasthenia gravis means “grave (serious), muscle weakness.” Although not completely curable, it can be managed well with a relatively high quality of life and expectancy. In myasthenia gravis, antibodies against the acetylcholine receptors at the neuromuscular junction interfere with regular muscular contraction. Although most commonly caused by antibodies to the acetylcholine receptor, antibodies against MuSK (muscle-specific kinase) protein can also weaken transmission at the neuromuscular junction. Muscle-specific tyrosine kinase myasthenia gravis (MuSK-Ab MG) is a rare subtype of myasthenia gravis with distinct pathogenesis and unique clinical features. Diagnosis can be challenging due to its atypical presentation as compared to seropositive myasthenia gravis. It responds inconsistently to steroids, but plasma exchange and immunosuppressive therapies have shown promising results. We report a case of a 49-year-old female who presented with acute hypoxic respiratory failure. Our patient experienced progressive, undiagnosed MuSK-Ab MG for years without a diagnosis.


2021 ◽  
Vol 50 (1) ◽  
pp. 570-570
Author(s):  
Necia Hunter ◽  
Nana Matsumoto ◽  
Andres Mora Carpio ◽  
Astha Chichra

2021 ◽  
pp. 106689692110642
Author(s):  
Joseph M. Rohr ◽  
Heather Strah ◽  
David Berkheim ◽  
Aleem Siddique ◽  
Stanley J. Radio ◽  
...  

COVID-19, the syndrome caused by the novel coronavirus SARS-CoV-2, has spread throughout the world, causing the death of at least three million people. For the over 81 million who have recovered, however, the long-term effects are only beginning to manifest. We performed a bilateral lung transplant on a 31-year-old male patient for chronic hypoxic respiratory failure, severe pulmonary hypertension and radiographically identified pulmonary fibrosis five months after an acute COVID-19 infection. The explant demonstrated moderate pulmonary vascular remodeling with intimal thickening and medial hypertrophy throughout, consistent with pulmonary hypertension. The parenchyma demonstrated an organizing lung injury in the proliferative phase, with severe fibrosis, histiocytic proliferation, type II pneumocyte hyperplasia, and alveolar loss consistent with known COVID-19 pneumonia complications. This report highlights a novel histologic finding in severe, chronic COVID-19. Although the findings in acute COVID-19 pneumonia have been well-examined at autopsy, the chronic course of this complex disease is not yet understood. The case presented herein suggests that COVID-induced pulmonary hypertension may become more common as more patients survive severe SARS-CoV-2-related pneumonia. Pulmonologists and pulmonary pathologists should be aware of this possible association and look for the clinical, radiographic, and histologic criteria in the appropriate clinical setting.


BioMed ◽  
2021 ◽  
Vol 1 (2) ◽  
pp. 126-135
Author(s):  
Sara Jimeno ◽  
Máximo Gómez ◽  
Paula Sol Ventura ◽  
Ángeles Calle ◽  
Elena Núñez ◽  
...  

Background: The worldwide COVID-19 pandemic has created a shortage of ICU beds and ventilators. The objective was to assess whether administration of high-flow nasal cannula (HFNC) in patients with acute hypoxic respiratory failure due to COVID-19 averted mechanical ventilation (MV). Methods: Prospective observational study performed at Hospital Universitario HM Puerta del Sur (Madrid). The protocol included early administration of HFNC in clinically suspected COVID-19 patients with progressive desaturation. Results: Twenty patients were started on respiratory support with HFNC. Hospital admission took place after a median of 7 days since symptom onset and clinical deterioration was apparent at 9 days after symptom onset. Anti-inflammatory treatment with methylprednisolone and tocilizumab was initiated at 9 days (6.5–12), followed by HFNC at 9.5 days (7–12). HFNC was maintained for an average of 4.5 days (2.8–6.3), was successful in eighteen patients (90%), as defined by not needing invasive MV, and failed in two cases (10%) resulting in death. Since HFNC was implemented, there has been a decrease in the number of patients admitted to the ICU and treated with MV for acute hypoxic respiratory failure. Conclusions: HFNC administration may represent a viable therapeutic option for patients in the early stages of severe respiratory failure due to clinically suspected COVID-19.


2021 ◽  
Vol 14 (12) ◽  
pp. e246223
Author(s):  
Kevin M Coy ◽  
Andrii Maryniak ◽  
Thomas Blankespoor ◽  
Adam Stys

Since the start of the COVID-19 pandemic, several cases have reported extensive multivessel coronary thrombosis as a cardiovascular manifestation of SARS-CoV-2 infection. This case describes a patient who developed non-ST elevation myocardial infarction during hospitalization for acute hypoxic respiratory failure due to COVID-19. We review the immediate and delayed revascularisation strategies of culprit and non-culprit lesions in the setting of high intracoronary thrombus burden induced by SARS-CoV-2. Successful percutaneous intervention and stenting of a culprit lesion and resolution of an intracoronary thrombus using a delayed strategy of lesion passivation with adjuvant pharmacotherapy are demonstrated on index and follow-up angiography.


Author(s):  
Priyanjali Pulipati ◽  
◽  
Cecilia Cosma ◽  

Background: Solid dry ice undergoes sublimation to gaseous carbondioxide (CO2 ) at room temperature. Symptoms of exposure include headache, dizziness, unconsciousness, seizures, even coma and death based on concentrations of CO2 inhaled. We present a case of accidental poisoning due to dry ice inhalation. Case: 35-year-old Caucasian male with a history of depression and tobacco use was brought into the emergency department after he was found unconscious in the walk-in freezer at the fast-food center he was working at. On contacting his coworkers, we were told that the walk-in freezer was out of order, and they had packed it with dry ice. On examination, the patient was tachypneic, tachycardic and was saturating at 89% on room air. Physical examination was normal. Blood work showed acute hypoxic respiratory failure with metabolic acidosis with lactic acid 13.1 mmol/l. Carboxyhemoglobin level was elevated at 5.3% (normal level and smokers 3 to 5%). The patient significantly improved with supplemental oxygen and fluid boluses and was discharged in the next 24 hours. Conclusion: Exposure to dry ice in confined spaces and warm temperatures can lead to carbon dioxide poisoning. Accurate and detailed history taking helps recognize this potentially fatal medical emergency Keywords: dry ice poisoning; carbon dioxide poisoning; accidental poisoning; inhalation toxicity.


Author(s):  
Jacques Scharoun

Nitric oxide has been used to treat respiratory failure in post-pediatric cardiac surgical patients. High frequency oscillator ventilation is used to rescue infants who have failed conventional ventilation. In this issue a study is presented showing the benefit of combining these two therapies for improved outcomes in infants with hypoxic respiratory failure after congenital heart surgery


Circulation ◽  
2021 ◽  
Vol 144 (Suppl_2) ◽  
Author(s):  
Mian Tanveer Ud Din ◽  
Palash Asawa ◽  
Namita Joseph ◽  
Anita Radhakrishnan

Case Presentation: A 27-year-old female with no prior medical history was diagnosed with metastatic paraganglioma in 2016. She was started on Cyclophosphamide, Vincristine and Dacarbazine and eventually transitioned to Pembrolizumab for 2 years. Due to progression of disease, she was started on compassionate 40 mg daily Cabozantinib in 2019. Echocardiogram at that time revealed normal ventricular function. One month later, she presented with new onset hypoxic respiratory failure. ProBNP was elevated to 7854 pg/nl. TTE showed moderate pericardial effusion with cardiac tamponade physiology and LVEF of 30%. Cabozantinib was discontinued due to elevated LFT. Repeat TTE after 1 month showed recovery of LVEF to 55% and only trace pericardial effusion. Due to her aggressive malignancy Cabozantinib was reinitiated at 20mg daily. Her LVEF remained stable on multiple serial TTE for 1 year so an attempt at Cabozantinib 40 mg was made once again. One month later, she had worsening dyspnea and TTE showed LVEF drop to 35%. Cardiac MRI revealed LVEF 37% with a moderate pericardial effusion along with gadolinium uptake consistent with perimyocarditis. Cabozanitib was discontinued and Colchicine 0.6 mg daily started. Eventually, LVEF normalized and pericardial effusion resolved. Patient was restarted on Cabozanitib 20mg and has remained stable from a cardiovascular standpoint Discussion: In the past decade the rise of tyrosine kinase inhibitors, like Cabozantinib, have transformed the scope of medical oncology. In 2019 Al hussein et al described the first case of Cabozantinib induced cardiomyopathy. We present, to our knowledge, the second reported case. This case identifies a strong temporal relationship between Cabozantinib, LV systolic dysfunction and perimyocarditis with higher doses. Interestingly, our patient received Pembrolizumab for 2 years, but had heart failure symptoms only 1 month after Cabozanitib initiation. Although theoretically possible, it is unlikely Pembrolizumab was the cause, given normal TTE 2 years after initiation and strong temporal relationship to Cabozantinib. Further studies are required to establish the cardiotoxic side effects of Cabozantinib and inform guidance on cardiac monitoring.


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