Pulmonary and Critical Care, Abington Jefferson Health, Abington, USA.
Published: June 2018
AI Article Synopsis
Article Abstract
Spontaneous lung herniation is a rare phenomenon in which the lung parenchyma along with the pleural membranes protrudes outside their usual boundaries and can lead to a wide variety of complications. We are reporting a case of a middle-aged male who presented with chronic obstructive pulmonary disease (COPD) exacerbation with severe bouts of cough. Initial computed tomography (CT) chest was unrevealing, but two days later, he developed spontaneous lung herniation, which was initially managed conservatively, but later it progressed to pneumothorax, pneumomediastinum, with striking CT scan images showing extensive subcutaneous emphysema. Blowhole incisions were done on the anterior chest wall which led to ultimate recovery.
Background: Serpentine supravenous hyperpigmentation (SSH) is known as a phenomenon occurring during the infusion of chemotherapy agents in the underlying veins. Chemotherapy agents have potential to cause infusion reactions when used systematically. Linear hyperpigmentation and reticular hyperpigmentation are the differential diagnosis for this phenomenon.
Perioperative and critical care management following penetrating thoracic trauma represents a complex challenge. Those who survive the early trauma approach and reach the hospital alive often remain in critical condition, with cardiocirculatory complications and major pulmonary injuries. Additional difficulty arises from the presence of a weapon , particularly in a dorsal location, which limits patient positioning, and the safe manipulation of both the weapon and the patient.
Hermansky-Pudlak syndrome (HPS) is a genetic disorder of endosomal protein trafficking associated with pulmonary fibrosis in specific subtypes, including HPS-1 and HPS-2. Single mutant HPS1 and HPS2 mice display increased fibrotic sensitivity while double mutant HPS1/2 mice exhibit spontaneous fibrosis with aging, which has been attributed to HPS mutations in alveolar epithelial type II (AT2) cells. We utilized HPS mouse models and human lung tissue to investigate mechanisms of AT2 cell dysfunction driving fibrotic remodeling in HPS.
Objectives: Here, we investigated the effects of hyperventilation on acute lung injury (ALI) in spontaneously breathing rats.
Methods: Wistar rats were randomized to receive either intraperitoneal lipopolysaccharides (LPS) or saline, and intravenous infusion of NH4Cl (to induce metabolic acidosis and hyperventilation) or saline. Four groups were established: control-control (C-C), control-hyperventilation (C-HV), LPS-control (LPS-C), and LPS-hyperventilation (LPS-HV).
The study aimed to assess factors affecting the implementation of ventilator liberation guidelines for pediatric patients and create a strategy for an international collaborative effort called VentLib4Kids.
The survey involved 26 pediatric intensive care units (PICUs) across 18 centers, gathering 409 responses from various healthcare professionals, such as doctors, nurses, and respiratory therapists.
Three implementation tiers were established based on consensus about various practices, showing that extubation readiness testing was well-agreed upon, while more complex practices like respiratory muscle strength testing had significant gaps in perception and agreement among respondents.
