Anti-synthetase syndrome-associated pulmonary veno-occlusive disease.

Pulmonary arterial hypertension has been reported with a prevalence of 7.9% in patients with anti-synthetase syndrome; however, anti-synthetase syndrome associated with pulmonary veno-occlusive disease (PVOD) has never before been described in the literature. We present a novel case of anti-synthetase syndrome-associated PVOD in a patient who presented with hypoxic respiratory failure associated with right heart failure and was diagnosed with anti-synthetase syndrome based on his autoimmune serology and pre-capillary pulmonary hypertension on right heart catheterization.

Introducing Critical Care Outreach: a ward-randomised trial of phased introduction in a general hospital.

Objective: The purpose of the study was to investigate the effects of introducing a critical care outreach service on in-hospital mortality and length of stay in a general acute hospital.

Design: A pragmatic ward-randomised trial design was used, with intervention introduced to all wards in sequence. No blinding was possible.