Resp Care
-
P(aCO(2)) as measured during exercise in patients with COPD is poorly predicted (predicted P(aCO(2))) from lung function testing and some noninvasive measurements, such as end-tidal P(CO(2)) (P(ETCO(2))). ⋯ A validated mixed-model regression derived equation yields a predicted P(aCO(2)) trend during exercise that can be helpful when interpreting exercise testing to determine P(aCO(2)) - P(ETCO(2)) and exercise-induced hypercapnia.
-
Co-existence of catamenial pneumothorax and hemoptysis is rare. We present a case of catamenial pneumothorax due to bilateral pulmonary endometriosis in a 45-year-old woman. The patient presented with a 3-year history of intermittent productive cough with blood-tinged sputum, chronic anemia, loss of appetite, and general weakness associated with menstruation. ⋯ CT-guided biopsy revealed chronic inflammation of those pulmonary nodules, and laboratory studies disclosed elevated serum levels of carbohydrate antigen 19-9 (CA 19-9) and CA 125. Thoracoscopic wedge resection of the pulmonary nodules was performed, and histopathological examination of the resected nodules revealed endometriosis. At one-year follow-up there was no evidence of recurrence of gastrointestinal bleeding or pneumothorax.
-
To validate the hypothesis that fat tissue accumulation adjacent to the upper airway contributes to a predisposition to obstructive sleep apnea (OSA), irrespective of body mass index (BMI), as well as investigate the effect of the volume of fat tissue on pharyngeal mechanical loads. ⋯ Patients with OSA have more fat tissue adjacent to the pharyngeal cavity than BMI-matched controls. Fats deposited around the upper airway may contribute to the collapsibility of retropalatal and retroglossal airway in both patients and controls.
-
There is paucity of data from India on the use of noninvasive ventilation (NIV) in acute respiratory failure (ARF). In this observational study, we report the indications and outcomes of patients requiring NIV in the respiratory ICU of a tertiary care hospital. ⋯ NIV was found to be a useful modality in management of patients with hypercapnic versus hypoxemic respiratory failure. The severity of illness at admission, new-onset organ dysfunction, hypoxemic ARF, and delay in improvement in P(aO(2))/F(IO(2)) at 1 hour from baseline are independent predictors of NIV failure.
-
Case Reports
Pulmonary zygomycosis in a non-neutropenic patient with myelodysplastic syndrome on lenalidomide.
Pulmonary zygomycosis is an uncommon infection that occurs mostly in immunocompromised patients. We report the case of a 75-year-old man with myelodysplastic syndrome, treated with lenalidomide for 3 months, who developed respiratory failure and a rapidly progressive left upper lobe consolidation. ⋯ This unique case illustrates the potential risks of lenalidomide therapy in patients with myelodysplastic syndrome and the difficulties in diagnosing pulmonary zygomycosis. To our knowledge this is the first report of a diagnostic in situ post-mortem transbronchial lung biopsy.