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Martínez Redondo M, Carpio Segura C, Zamarrón De Lucas E, Álvarez-Sala Walther R, Prados Sánchez C. Should atelectasis be considered a pulmonary complication and indicator of poor prognosis in cystic fibrosis? J Int Med Res 2024; 52:3000605241233520. [PMID: 38546237 PMCID: PMC10981250 DOI: 10.1177/03000605241233520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/29/2024] [Indexed: 04/01/2024] Open
Abstract
OBJECTIVE This study examined whether bronchoscopy leads to clinicoradiological improvement in cystic fibrosis (CF) and the predictive factors. The study also investigated whether pulmonary atelectasis is a poor prognostic factor in CF. METHODS This multicenter, case-control, observational, retrospective study included two groups of patients with CF: a case group (patients with persistent atelectasis who were followed-up at least for 2 years) and a control group (patients without atelectasis matched 1:1 by sex and age [±3 years]). We recorded demographic data, lung function test results, pulmonary complications, comorbidities, treatments (including bronchoscopies, surgery and transplantation), and deaths. RESULTS Each group included 55 patients (case group: 20 men, mean age 25.4 ± 10.4 years; control group: 20 men, mean age 26.1 ± 11.4 years). Bronchoscopy did not lead to clinicoradiological improvement. Allergic bronchopulmonary aspergillosis (ABPA) was more frequent in the case group. Patients in the case group more frequently used inhaled steroids, their pre-atelectasis lung function was statistically worse, and they had more exacerbations during follow-up. CONCLUSION Moderate-to-severe pulmonary disease and ABPA can favor atelectasis. Pulmonary atelectasis can be a poor prognostic factor in CF because it increases exacerbations. Despite our results, we recommend enhancing treatment, including bronchoscopy, to prevent persistent atelectasis.
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Affiliation(s)
- María Martínez Redondo
- Respiratory Department, CIBERES, Hospital La Paz Institute for Health Research-IdiPAZ, La Paz University Hospital-Autónoma University of Madrid, Madrid, Spain
| | - Carlos Carpio Segura
- Respiratory Department, CIBERES, Hospital La Paz Institute for Health Research-IdiPAZ, La Paz University Hospital-Autónoma University of Madrid, Madrid, Spain
| | - Ester Zamarrón De Lucas
- Respiratory Department, CIBERES, Hospital La Paz Institute for Health Research-IdiPAZ, La Paz University Hospital-Autónoma University of Madrid, Madrid, Spain
| | - Rodolfo Álvarez-Sala Walther
- Respiratory Department, CIBERES, Hospital La Paz Institute for Health Research-IdiPAZ, La Paz University Hospital-Autónoma University of Madrid, Madrid, Spain
| | - Concepción Prados Sánchez
- Respiratory Department, CIBERES, Hospital La Paz Institute for Health Research-IdiPAZ, La Paz University Hospital-Autónoma University of Madrid, Madrid, Spain
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Larsson A, Östberg E, Edmark L. Arterial partial pressure of oxygen as a marker of airway closure does not correlate with the efficacy of pre-oxygenation: A prospective cohort study. Eur J Anaesthesiol 2023; 40:699-706. [PMID: 37395501 DOI: 10.1097/eja.0000000000001869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
BACKGROUND The prerequisites for the early formation of anaesthesia-related atelectasis are pre-oxygenation with its resulting high alveolar oxygen content, and airway closure. Airway closure increases with age, so it seems counterintuitive that atelectasis formation during anaesthesia does not. One proposed explanation is that pre-oxygenation is impaired in the elderly by airway closure present in the waking state. The extent of airway closure cannot be assessed at the bedside, but arterial partial pressure of oxygen ( Pa O 2 ) as a surrogate variable of the resulting ventilation to perfusion mismatch can. OBJECTIVE The primary aim was to test the hypothesis that a decreased efficacy of pre-oxygenation, measured as the fraction of end-tidal oxygen (F E' O 2 ) after 3 min of pre-oxygenation, correlates with decreased Pa O 2 on room air. We also re-investigated the influence on F E' O 2 by age. DESIGN Prospective observational study. SETTING Two regional hospitals, Västerås and Köping County Hospitals, Västmanland, Sweden, between 30 October 2018 and 17 September 2021. PARTICIPANTS We included 120 adults aged 40 to 79 years presenting for elective noncardiac surgery. INTERVENTION An arterial blood gas was sampled before commencing pre-oxygenation. RESULTS No linear correlation was found between F E' O 2 at 3 min and Pa O 2 or age (Pearson's r = -0.038, P = 0.684; and Pearson's r = -0.113, P = 0.223, respectively). The mean ± SD F E' O 2 at 3 min for the population studied was 0.87 ± 0.05. CONCLUSION The lack of correlation between F E' O 2 at 3 min and Pa O 2 or age during pre-oxygenation has implications for further studies concerning the interaction between airway closure and atelectasis. After 3 min of pre-oxygenation, F E' O 2 , even in the elderly, indicated a high enough alveolar oxygen concentration to promote atelectasis after induction, therefore, it is still unclear why atelectasis formation diminishes after middle age. TRIAL REGISTRATION ClinicalTrials.gov NCT03395782.
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Affiliation(s)
- Alexander Larsson
- From the Department of Anaesthesia and Intensive Care (AL, EÖ, LE) and Region Vastmanland - Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Sweden (AL, EÖ, LE)
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Chen Q, Wu GH, Huang T, Zou LP, Liang L, Wu SX, Tang SJ, Lu XL, Sun JY, Dai L, He W. [Risk factors for pulmonary atelectasis in adults with tracheobronchial tuberculosis]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:674-679. [PMID: 37402657 DOI: 10.3760/cma.j.cn112147-20230120-00032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Objective: To investigate the risk factors for pulmonary atelectasis in adults with tracheobronchial tuberculosis(TBTB). Methods: Clinical data of adult patients (≥18 years old) with TBTB from February 2018 to December 2021 in Public Health Clinical Center of Chengdu were retrospectively analyzed. A total of 258 patients were included, with a male to female ratio of 1∶1.43. The median age was 31(24, 48) years. Clinical data including clinical characteristics, previous misdiagnoses/missed diagnoses before admission, pulmonary atelectasis, the time from symptom onset to atelectasis and bronchoscopy, bronchoscopy and interventional treatment were collected according to the inclusion and exclusion criteria. Patients were divided into two groups according to whether they had pulmonary atelectasis. Differences between the two groups were compared. Binary logistic regression was used to analyze the risk factors for pulmonary atelectasis. Results: The prevalence of pulmonary atelectasis was 14.7%, which was most common in the left upper lobe (26.3%). The median time from symptom onset to atelectasis was 130.50(29.75,358.50)d, and the median time from atelectasis to bronchoscopy was 5(3,7)d. The median age, the proportion of misdiagnosis of TBTB before admission, and the time from symptom onset to bronchoscopy in the atelectasis group were higher than those without atelectasis, and the proportion of receiving bronchoscopy examination and interventional therapy previously, and the proportion of pulmonary cavities were lower than those without atelectasis (all P<0.05). The proportions of cicatrices stricture type and lumen occlusion type in the atelectasis group were higher than those without atelectasis, while the proportions of inflammatory infiltration type and ulceration necrosis type were lower than those without atelectasis (all P<0.05). Older age (OR=1.036, 95%CI: 1.012-1.061), previous misdiagnosis(OR=2.759, 95%CI: 1.100-6.922), longer time from symptom onset to bronchoscopy examination (OR=1.002, 95%CI: 1.000-1.005) and cicatrices stricture type (OR=2.989, 95%CI: 1.279-6.985) were independent risk factors for pulmonary atelectasis in adults with TBTB (all P<0.05). Of the patients with atelectasis who underwent bronchoscopy interventional therapy, 86.7% had lung reexpansion or partial reexpansion. Conclusions: The prevalence of pulmonary atelectasis is 14.7% in adult patients with TBTB. The most common site of atelectasis is left upper lobe. The TBTB type of lumen occlusion is complicated by pulmonary atelectasis in 100% of cases. Being older, misdiagnosed as other diseases, longer time from onset of symptoms to bronchoscopy examination, and being the cicatrices stricture type are factors for developing pulmonary atelectasis. Early diagnosis and treatment are needed to reduce the incidence of pulmonary atelectasis and increase the rate of pulmonary reexpansion.
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Affiliation(s)
- Q Chen
- The 3rdDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - G H Wu
- The 4thDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - T Huang
- The 5thDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - L P Zou
- The 4thDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - L Liang
- The 4thDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - S X Wu
- The 4thDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - S J Tang
- Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
| | - X L Lu
- The 3rdDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - J Y Sun
- The 3rdDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - L Dai
- The 3rdDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
| | - W He
- The 3rdDepartment of Tuberculosis, Public Health Clinical Center of Chengdu, Chengdu 610000, China
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Thimmesch M, Tuerlinckx D, Habay M, Lebecque P. [Recurrent atelectasis in an infant : about one case of false-negative newborn screening for cystic fibrosis]. Rev Med Liege 2023; 78:436-440. [PMID: 37560957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
In infants as well as in older children, persistent or recurrent atelectasis remains a classic indication for sweat testing, even if neonatal screening for cystic fibrosis has been considered normal. Atelectasis is a common complication of cystic fibrosis. Yet, it has rarely been reported in infants. In cystic fibrosis, chronic atelectasis worsens the prognosis, especially when involving a lower lobe. Therefore, early and effective intervention is required. Antibiotic therapy, intensive chest physiotherapy together with inhaled mucolytics often allow to relieve bronchial obstruction but bronchoscopy with local aspiration and Dornase alpha instillation is sometimes necessary. In a two-month-old infant, we describe here the first reported case of false-negative cystic fibrosis newborn screening in Belgium.
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Affiliation(s)
- Matthieu Thimmesch
- Pneumologie pédiatrique et Centre de Référence liégeois de la Mucoviscidose, CHC MontLégia, Liège, Belgique
| | | | - Marie Habay
- Radiologie, CHU Dinant-Godinne, UCL Namur, Belgique
| | - Patrick Lebecque
- Pneumologie pédiatrique et Centre de Référence liégeois de la Mucoviscidose, CHC MontLégia, Liège, Belgique
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Hassannia F, D Carr S, A Rutka J. Transient Vertigo with Horizontal Nystagmus to Loud Noise and Pressure: Utricular Hydrops or Vestibular Atelectasis? J Int Adv Otol 2020; 16:127-129. [PMID: 32401208 PMCID: PMC7224419 DOI: 10.5152/iao.2019.6283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 03/13/2019] [Indexed: 11/22/2022] Open
Abstract
We present an unusual case of a patient with a positive Tullio phenomenon, brief Valsalva-induced transient horizontal nystagmus, reduced left caloric response, and bilateral vestibulo-ocular reflex loss. This study discusses the pathophysiology and differential diagnosis concerning the suspected pathology for the phenomenon of utricular hydrops or vestibular atelectasis and presents a literature review.
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Affiliation(s)
- Fatemeh Hassannia
- Department of Otolaryngology, Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
| | - Simon D Carr
- Department of Otolaryngology, Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
| | - John A Rutka
- Department of Otolaryngology, Head and Neck Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada
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Affiliation(s)
- B J Akhavan
- Division of Internal Medicine, The University of Texas Health-McGovern Medical School, Houston, TX, USA
| | - A S Sagar
- Divisions of Pulmonary, Critical Care Medicine and Sleep Medicine, The University of Texas Health-McGovern Medical School, Houston, TX, USA
| | - P P Jani
- Divisions of Pulmonary, Critical Care Medicine and Sleep Medicine, The University of Texas Health-McGovern Medical School, Houston, TX, USA
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Critchley LAH, Ho AMH, Ho M, Lee SY. Right Upper Lobe Collapse Secondary to an Anomalous Bronchus after Endotracheal Intubation for Routine Surgery. Anaesth Intensive Care 2019; 35:274-7. [PMID: 17444320 DOI: 10.1177/0310057x0703500219] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Perioperative hypoxaemia is a common but serious problem with well recognised causes. However, an anomalous bronchus causing lobar collapse as a cause is seldom mentioned. A healthy young male patient was anaesthetised for a knee operation. He required reintubation immediately postoperatively for hypoxia. He was found to have right upper lobe collapse. Fibreoptic examination of the trachea demonstrated an anomalous bronchus as the cause. Intra-operatively, the endotracheal tube had been inserted too deeply and the bronchial orifice had been obstructed by the tip. It took several hours for the lung to re-expand. Greater awareness of this potential complication is needed.
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Affiliation(s)
- L A H Critchley
- Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
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Gorospe L, Jover-Díaz R, Muñoz-Molina GM, Cabañero-Sánchez A, Gambí-Pisonero E, Barbolla-Díaz I. Round atelectasis: PET/CT findings. Intern Emerg Med 2018; 13:1127-1128. [PMID: 29705885 DOI: 10.1007/s11739-018-1867-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/23/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Luis Gorospe
- Departments of Radiology, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, 28034, Madrid, Spain.
| | - Raquel Jover-Díaz
- Department of Nuclear Medicine, Rey Juan Carlos I University Hospital, Madrid, Spain
| | | | | | - Esther Gambí-Pisonero
- Departments of Radiology, Ramón y Cajal University Hospital, Ctra. de Colmenar Viejo Km 9.100, 28034, Madrid, Spain
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Attarian A, Benvenuto P. Hiding behind the veil: an ominous chest X-ray. Intern Emerg Med 2018; 13:623-624. [PMID: 29388064 DOI: 10.1007/s11739-018-1797-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 01/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Armen Attarian
- Department of Radiology, Royal Victoria Hospital, McGill University Health Centre (MUHC), 1001, Decarie Blvd, Montreal, H4A 3J1, Canada.
| | - Paul Benvenuto
- Department of Radiology, Royal Victoria Hospital, McGill University Health Centre (MUHC), 1001, Decarie Blvd, Montreal, H4A 3J1, Canada
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Ferrando C, Romero C, Tusman G, Suarez-Sipmann F, Canet J, Dosdá R, Valls P, Villena A, Serralta F, Jurado A, Carrizo J, Navarro J, Parrilla C, Romero JE, Pozo N, Soro M, Villar J, Belda FJ. The accuracy of postoperative, non-invasive Air-Test to diagnose atelectasis in healthy patients after surgery: a prospective, diagnostic pilot study. BMJ Open 2017; 7:e015560. [PMID: 28554935 PMCID: PMC5623366 DOI: 10.1136/bmjopen-2016-015560] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To assess the diagnostic accuracy of peripheral capillary oxygen saturation (SpO2) while breathing room air for 5 min (the 'Air-Test') in detecting postoperative atelectasis. DESIGN Prospective cohort study. Diagnostic accuracy was assessed by measuring the agreement between the index test and the reference standard CT scan images. SETTING Postanaesthetic care unit in a tertiary hospital in Spain. PARTICIPANTS Three hundred and fifty patients from 12 January to 7 February 2015; 170 patients scheduled for surgery under general anaesthesia who were admitted into the postsurgical unit were included. INTERVENTION The Air-Test was performed in conscious extubated patients after a 30 min stabilisation period during which they received supplemental oxygen therapy via a venturi mask. The Air-Test was defined as positive when SpO2 was ≤96% and negative when SpO2 was ≥97%. Arterial blood gases were measured in all patients at the end of the Air-Test. In the subsequent 25 min, the presence of atelectasis was evaluated by performing a CT scan in 59 randomly selected patients. MAIN OUTCOME MEASURES The primary study outcome was assessment of the accuracy of the Air-Test for detecting postoperative atelectasis compared with the reference standard. The secondary outcome was the incidence of positive Air-Test results. RESULTS The Air-Test diagnosed postoperative atelectasis with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.82 to 0.98) with a sensitivity of 82.6% and a specificity of 87.8%. The presence of atelectasis was confirmed by CT scans in all patients (30/30) with positive and in 5 patients (17%) with negative Air-Test results. Based on the Air-Test, postoperative atelectasis was present in 36% of the patients (62 out of 170). CONCLUSION The Air-Test may represent an accurate, simple, inexpensive and non-invasive method for diagnosing postoperative atelectasis. TRIAL REGISTRATION NCT02650037.
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Affiliation(s)
- Carlos Ferrando
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Carolina Romero
- Anesthesiology and Critical Care, Consorci Hospital General Universitari de Valencia, Valencia, Spain
| | - Gerardo Tusman
- Department of Anesthesiology, Hospital Privado de Comunidad, Mar de Plata, Argentina
| | - Fernando Suarez-Sipmann
- Uppsala Universitet, Uppsala, Sweden
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Jaume Canet
- Anesthesiology and Critical Care, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Rosa Dosdá
- Department of Radiology, Hospital Clinico Universitario Valencia, Valencia, Spain
| | - Paola Valls
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Abigail Villena
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Ferran Serralta
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Ana Jurado
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Juan Carrizo
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Jose Navarro
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Cristina Parrilla
- Department of Radiology, Hospital Clinico Universitario Valencia, Valencia, Spain
| | - Jose E Romero
- ITACA Institute (Group IBIME), Universidad Politécnica, Valencia, Spain
| | | | - Marina Soro
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
| | - Jesús Villar
- CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
- Research Unit, Hospital Universitario Dr. Negrin, Las Palmas de Gran Canaria, Spain
| | - Francisco Javier Belda
- Anesthesiology and Critical Care, Hospital Clínico Universitario Valencia, Valencia, Spain
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Abstract
Objective: To investigate the accuracy and reliability of lung ultrasound in diagnosis of pulmonary hemorrhage of the newborn infants. Method: From January 2014 to May 2016, 142 neonates from the Army General Hospital of the Chinese PLA were enrolled in the study. They were divided into two groups: a study group of 42 neonates, who were diagnosed with pulmonary hemorrhage according to their medical history, clinical manifestations and chest X-ray findings, and a control group of 100 neonates with no lung disease. All subjects underwent bedside lung ultrasound in a quiet state in a supine, lateral or prone posture, performed by a single experienced physician. The ultrasound findings were compared between the two groups.Fisher's exact test was uesd for comparison between two groups. Result: The lung ultrasound main findings associated with pulmonary hemorrhage included: (1) Shred sign: which was seen in 40 patients(95%). (2) Lung consolidation with air bronchograms: which were seen in 35 patients(83%). (3) Pleural effusion: which was seen in 34 infants(81%), pleurocentesis confirmed that the fluid was really bleeding.(4)Atelectasis: which was seen in 14 cases(33%). (5) Pleural line abnormalities and disappearing A-lines with an incidence of 100%. (6) Alveolar-interstitial syndrome: 5 patients(12%)had the main manifestations of alveolar-interstitial syndrome. The above signs were not seen in normal controls (all P<0.01) and the normal lung mainly manifested with clear pleural line and A-lines under ultrasound. Conclusion: Lung ultrasonography is accurate and reliable for diagnosing pulmonary hemorrhage, which is suitable for routine application for the diagnosis of pulmonary hemorrhage in the neonatal intensive care unit.
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Affiliation(s)
- J Liu
- Department of Neonatology and Neonatal Intensive Care Unit of Bayi Children's Hospital, the Army General Hospital of the Chinese PLA, Beijing 100700, China
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Şişmanlar T, Aslan AT, Öztunalı Ç, Boyunağa Ö. Left upper lobe atelectasis due to plastic bronchitis. Turk J Pediatr 2017; 59:207-209. [PMID: 29276877 DOI: 10.24953/turkjped.2017.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Şişmanlar T, Aslan AT, Öztunalı Ç, Boyunağa Ö. Left upper lobe atelectasis due to plastic bronchitis. Turk J Pediatr 2017; 59: 207-209. Plastic bronchitis is a rare condition in children, characterized by expectoration of branching bronchial casts. It can cause atelectasis in the lung. Herein we reported a 4.5-year-old boy with left upper lobe atelectasis due to plastic bronchitis. Although his chest X-ray is specific for left upper left atelectasis, thoracic computerized tomography had been performed and was compatible with obliterated left upper lobe bronchus. Typical radiological appearance of the left upper lobe atelectasis is not well known by clinicians which results unnecessary further examinations such as computerized tomography which exposes high dose radiation. We want to emphasize the long-term side effects of radiation and avoid unnecessary examinations in children.
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Affiliation(s)
- Tuğba Şişmanlar
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ayşe Tana Aslan
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Çiğdem Öztunalı
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Öznur Boyunağa
- Department of Radiology, Gazi University Faculty of Medicine, Ankara, Turkey
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Qanneta R. [A complete atelectasis of the left lung due to a central bronchial mucous plug resembling an endobronchial neoplasia]. Rev Esp Geriatr Gerontol 2016; 51:357-358. [PMID: 27132062 DOI: 10.1016/j.regg.2016.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Revised: 03/10/2016] [Accepted: 03/11/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Rami Qanneta
- Unidad de Subagudos, Hospital Sociosanitario Francolí, Tarragona, España.
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Cichocki BN, Dugat DR, Snider TA. Traumatic lung injury attributed to tornadic activity-induced barometric pressure changes in two dogs. J Am Vet Med Assoc 2016; 248:1274-9. [PMID: 27172344 DOI: 10.2460/javma.248.11.1274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION A 7-year-old castrated male Italian Greyhound (dog 1) and an approximately 1-year-old female Labrador Retriever (dog 2) were evaluated because of respiratory distress 8 and 10 days, respectively, after a tornado. CLINICAL FINDINGS No obvious external injuries were identified auscultation revealed decreased bronchovesicular sounds in the affected hemithorax of both dogs. Clinicopathologic changes were mild, with evidence of inflammation in both dogs. Thoracic radiography of both dogs revealed pneumothorax and pleural effusion with effacement of the diaphragm; findings on CT included severe pulmonary atelectasis of affected lung lobes with normal bronchial tree configurtion and no evidence of diaphragmatic hernia. TREATMENT AND OUTCOME Exploratory thoracotomy of both dogs confirmed CT findings Pulmonary parenchymal damage consistent with a large rupture was found in both patients. A large hematoma was adhered to the ruptured lung lobe of dog 1. Grossly affected lung tissue was removed; histologic examination revealed atelectasis, pulmonary fib osis, thrombosis, and minimal (dog 1) to marked (dog 2) inflammation Microbial culture of lung tissue yielded no growth for dog 1 and Streptococcus spp and Escherichia coli susceptible to amoxicillin-clavulanic acid for dog 2. Dog 1 had a recurrence of pneumothorax treated by drainage with a thoracostomy tube 1 month after surgery. Eighteen months after surgery, both dogs were reportedly doing well. CLINICAL RELEVANCE Development of clinical signs after a tornado, together with clinical, diagnostic imaging, surgical, and histologic findings led to a presumptive diagnosis of pulmonary barotrauma for both dogs. Long-term outcome for these dogs, treated at a referral hospital, was good.
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Affiliation(s)
- O M P Jolobe
- Manchester Medical Society, Simon Building, Brunswick Street, Manchester M13 9PL, UK
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Wong CF, Lau KK, Fung SL. Response: endobronchial tuberculosis: always a diagnostic challenge. QJM 2015; 108:265-6. [PMID: 25411343 DOI: 10.1093/qjmed/hcu230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- C F Wong
- Tuberculosis and Chest Unit, Grantham Hospital Hong Kong SAR, China e-mail:
| | - K K Lau
- Department of Medicine, Queen Mary Hospital The University of Hong Kong, Hong Kong SAR, China
| | - S L Fung
- Tuberculosis and Chest Unit, Grantham Hospital Hong Kong SAR, China
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Cereda M, Xin Y, Kadlecek S, Hamedani H, Rajaei J, Clapp J, Rizi RR. Hyperpolarized gas diffusion MRI for the study of atelectasis and acute respiratory distress syndrome. NMR Biomed 2014; 27:1468-78. [PMID: 24920074 PMCID: PMC4232982 DOI: 10.1002/nbm.3136] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/03/2014] [Accepted: 04/21/2014] [Indexed: 06/03/2023]
Abstract
Considerable uncertainty remains about the best ventilator strategies for the mitigation of atelectasis and associated airspace stretch in patients with acute respiratory distress syndrome (ARDS). In addition to several immediate physiological effects, atelectasis increases the risk of ventilator-associated lung injury, which has been shown to significantly worsen ARDS outcomes. A number of lung imaging techniques have made substantial headway in clarifying the mechanisms of atelectasis. This paper reviews the contributions of computed tomography, positron emission tomography, and conventional MRI to understanding this phenomenon. In doing so, it also reveals several important shortcomings inherent to each of these approaches. Once these shortcomings have been made apparent, we describe how hyperpolarized (HP) gas MRI--a technique that is uniquely able to assess responses to mechanical ventilation and lung injury in peripheral airspaces--is poised to fill several of these knowledge gaps. The HP-MRI-derived apparent diffusion coefficient (ADC) quantifies the restriction of (3) He diffusion by peripheral airspaces, thereby obtaining pulmonary structural information at an extremely small scale. Lastly, this paper reports the results of a series of experiments that measured ADC in mechanically ventilated rats in order to investigate (i) the effect of atelectasis on ventilated airspaces, (ii) the relationship between positive end-expiratory pressure (PEEP), hysteresis, and the dimensions of peripheral airspaces, and (iii) the ability of PEEP and surfactant to reduce airspace dimensions after lung injury. An increase in ADC was found to be a marker of atelectasis-induced overdistension. With recruitment, higher airway pressures were shown to reduce stretch rather than worsen it. Moving forward, HP MRI has significant potential to shed further light on the atelectatic processes that occur during mechanical ventilation.
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Affiliation(s)
- Maurizio Cereda
- Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA, USA
| | - Yi Xin
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Stephen Kadlecek
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Hooman Hamedani
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennia Rajaei
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Justin Clapp
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Rahim R. Rizi
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
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Castilla-Castilla CMDC, Vidales-Roque LB, Pérez-Durán J, Tena-Reyes D, Tapia-Rombo CA. [Factors associated with atelectasis following extubation in very low weight premature newborns]. Rev Med Inst Mex Seguro Soc 2014; 52:638-643. [PMID: 25354057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Atelectasis is a decrease of lung volume caused by airway obstruction or pressure on the external part of the lung. It is common after surgery and extubation. The purpose of this investigation was to determine factors related with alectasis following extubation in preterm neonates with a weight under 1250 g who were referred to a neonatal intensive care unit. METHODS The study was conducted in neonates admitted to a neonatal intensive care unit requiring mechanically assisted ventilation. Preterm neonates born at 28 to 36 weeks' gestation and with 0 to 28 days' extrauterine life, with mechanically assisted ventilation for at least 24 hours, and that when undergoing planned extubation had a weight under 1250 g were included. Two comparative groups were formed: group A, with alectasis after extubation; group B, without alectasis after extubation. RESULTS As factors associated with alectasis after extubation, reintubation in two or more occasions and cycling higher than 20 per minute, which were statistically relevant, were identified. CONCLUSIONS In addition to previous general measures to prevent alectasis, extubation with ventilation not higher tan 20 cycles per minute should be programmed and reintubation should be avoided as much as possible.
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MESH Headings
- Airway Extubation/methods
- Case-Control Studies
- Female
- Humans
- Infant, Newborn
- Infant, Premature
- Infant, Premature, Diseases/diagnosis
- Infant, Premature, Diseases/etiology
- Infant, Premature, Diseases/therapy
- Intensive Care, Neonatal
- Intubation, Intratracheal
- Male
- Pulmonary Atelectasis/diagnosis
- Pulmonary Atelectasis/etiology
- Pulmonary Atelectasis/prevention & control
- Respiration, Artificial/methods
- Risk Factors
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Affiliation(s)
- K-K Lau
- From the Department of Medicine, Queen Mary Hospital, The University of Hong Kong and Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong SAR, China
| | - S-L Fung
- From the Department of Medicine, Queen Mary Hospital, The University of Hong Kong and Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong SAR, China
| | - C-F Wong
- From the Department of Medicine, Queen Mary Hospital, The University of Hong Kong and Tuberculosis and Chest Unit, Grantham Hospital, Hong Kong SAR, China
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20
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Shan YX, Cui ZZ, Huang Y. [Clinical analysis of pediatric infectious atelectasis]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16:856-859. [PMID: 25140782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Yu-Xia Shan
- Dalian Children's Hospital, Dalian, Liaoning 116000, China
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21
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Cherian SV, Thampy E. A solitary lung mass in a 46-year-old man. Rounded atelectasis. Neth J Med 2014; 72:97-101. [PMID: 24659596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- S V Cherian
- Department of Pulmonary, Critical Care and Sleep Medicine, University of Texas Health Science Center at Houston, TX, USA
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22
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Zuo Y, Yang Y, Hong J, Wu Z, Yu L, Tao J, Gong S. [Analysis on diagnosis and treatment of 15 cases with severe influenza A]. Zhonghua Er Ke Za Zhi 2014; 52:142-145. [PMID: 24739728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To analyze the diagnosis and treatment characteristics of patients with severe Influenza A. METHOD A retrospective investigation on the clinical manifestation, chest radiography, electronic fiber bronchoscopy and the histology of the cast, rescue course and outcome was conducted in 15 children with severe influenza A during January to May of 2013. RESULT Eleven cases were male, the range of age was 2 to 6 years; 5 cases were female, the range of age was 1 month to 6 years, accouting for 4.2% of hospitalized children with influenza. Three patients had an underlying chronic disease, two had nephrotic syndrome, and one had congenital heart disease. All the 15 cases were diagnosed as severe influenza A virus infection complicated with pneumonia and respiratory failure, of whom 10 cases were infected with H1N1 virus , the other 5 cases could not be identified as H1N1 virus by using H1N1 kit, but none of the 15 cases were infected with H7N9 virus. Of 15 cases, 8 had atelectasis, 4 had pneumothorax, 3 had pneumomediastinum, 4 had pleural effusion, 1 had pneumorrhagia; 12 patients required mechanical ventilation. 1 only required noninvasive mask CPAP, 2 did not require assisted ventilation, they were just given mask oxygen. Seven cases' sputum culture showed combined infection with bacteria and fungi, sputum smear examination detected: G(+) cocci in 2 cases, and G(-) bacilli in the other 2. By using electronic fiber bronchoscopy, bronchial cast was detected in 5 patiens. Histological examination of the bronchial cast revealed a fibrinous exudation containing large quantity of eosinophils, neutrophils in 1 patients, fibrinous exudation and necrotic material containing large quantity of neutrophils in 4 patients. After the bronchial casts were removed, 4 patients were improved greatly. All patients were treated with postural drainage of left and right side position, massage of electric oscillation, strengthening the sputum suction aiming to improve pulmonary ventilation function. Three patients died: 1 case was compliicated with nephrotic syndrome, another case had congenital heart disease, and 1 case hads pneumorrhagia, renal failure and multiple organ dysfunction syndrome (MODS). CONCLUSION The mortality of severe Influenza A is higher if it is complicated with underlying chronic diseases. In children undergoing rapid and progressive respiratory distress with lung atelectasis, consolidation or emphysema on chest X-ray, plastic bronchitis should be considered. Electronic fiber bronchoscopy should be performed early Lung physicotherapeutics still are important assistant measures for improving the pulmonary ventilation function.
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Affiliation(s)
- Yunlong Zuo
- Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou 510120, China
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23
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24
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Mironov AV, Pinchuk TP, Selina IE, Kosolapov DA. [Emergency fiberoptic bronchoscopy for diagnostics and treatment of lung atelectasis]. Anesteziol Reanimatol 2013:51-54. [PMID: 24749266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The article deals with results of fiberoptic bronchoscopy using during treating of patients suffering atelectasis. According to the research atelectasis is likely to advance in the first three days after serious patients have been admitted to the intensive therapy unit or after operative treatment. Left-sided atelectasis is half as widespread again the right-sided one. The research highlights the effectiveness of atelectasis X-ray diagnosis. Fiberoptic bronchoscopy in almost all the cases allowed diagnosing the degree of tracheobronchial tree obstruction and its causes. Single suction fiberoptic bronchoscopy leads to normalization and encouraged positive dynamics in 76% of all the cases (57 patients). Repeated endoscopic sanation in the first two days was necessary for 25 patients (25.3%) with unresolved or reoccurring atelectasis. The effectiveness of second research was to 84%. It's important to add that mostly patients with serious chest injury were subjected to unresolved or reoccurring atelectasis. And mainly in these cases blood was seen through the tracheobronchial tree lumen.
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Yang RM, Li L, Wei XH, Guo YM, Huang YH, Lai LS, Chen AM, Liu GS, Xiong WF, Luo LP, Jiang XQ. Differentiation of central lung cancer from atelectasis: comparison of diffusion-weighted MRI with PET/CT. PLoS One 2013; 8:e60279. [PMID: 23593186 PMCID: PMC3617228 DOI: 10.1371/journal.pone.0060279] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 02/24/2013] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE Prospectively assess the performance of diffusion-weighted magnetic resonance imaging (DW-MRI) for differentiation of central lung cancer from atelectasis. MATERIALS AND METHODS 38 consecutive lung cancer patients (26 males, 12 females; age range: 28-71 years; mean age: 49 years) who were referred for thoracic MR imaging examinations were enrolled. MR examinations were performed using a 1.5-T clinical scanner and scanning sequences of T1WI, T2WI, and DWI. Cancers and atelectasis were measured by mapping of the apparent diffusion coefficients (ADCs) obtained with a b-value of 500 s/mm(2). RESULTS PET/CT and DW-MR allowed differentiation of tumor and atelectasis in all 38 cases, but T2WI did not allow differentiation in 9 cases. Comparison of conventional T2WI and DW-MRI indicated a higher contrast noise ratio of the central lung carcinoma than the atelectasis by DW-MRI. ADC maps indicated significantly lower mean ADC in the central lung carcinoma than in the atelectasis (1.83±0.58 vs. 2.90±0.26 mm(2)/s, p<0.0001). ADC values of small cell lung carcinoma were significantly greater than those from squamous cell carcinoma and adenocarcinoma (p<0.0001 for both). CONCLUSIONS DW-MR imaging provides valuable information not obtained by conventional MR and may be useful for differentiation of central lung carcinoma from atelectasis. Future developments may allow DW-MR imaging to be used as an alternative to PET-CT in imaging of patients with lung cancer.
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Affiliation(s)
- Rui-Meng Yang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Long Li
- Department of Radiology, Guangdong Provincial Corps Hospital, Chinese People’s Armed Police, Guangzhou, China
| | - Xin-Hua Wei
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Yong-Mei Guo
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Yun-Hai Huang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Li-Sha Lai
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - A-Mei Chen
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Guo-Shun Liu
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Wei-Feng Xiong
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
| | - Liang-Ping Luo
- Department of Radiology, The First Clinic Medical College, Jinan University, Guangzhou, China
- * E-mail: (LPL); (XQJ)
| | - Xin-Qing Jiang
- Department of Radiology, Guangzhou First People’s Hospital, Guangzhou Medical College, Guangzhou, China
- * E-mail: (LPL); (XQJ)
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Harris Nwanyanwu KM, De Lott LB, Cornblath WT, Elner VM. Transient monocular vision loss due to churg-strauss syndrome vasculitis. JAMA Ophthalmol 2013; 131:117-9. [PMID: 23307226 DOI: 10.1001/jamaophthalmol.2013.576] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Chao JX, Hong SX, Zhu ZH, Zhuo ZQ. Clinical application of bedside fiber-optic bronchoscopy in mechanically ventilated children in a pediatric intensive care unit. Chin Med J (Engl) 2013; 126:993-995. [PMID: 23489821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Jian-xin Chao
- Department of Pediatric Intensive Care Unit, Quanzhou Children's Hospital, Teaching Hospital of Fujian Medical University, Quanzhou, Fujian 362000, China.
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28
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Prado Vertiz A. [Pulmonary atelectasis and hyaline membrane disease in children. 1956]. Ginecol Obstet Mex 2012; 80:733-739. [PMID: 23427644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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29
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He RX, Zhao SY. [Analysis of clinical manifestations and diagnosis of 102 children with bronchial tuberculosis]. Zhonghua Er Ke Za Zhi 2012; 50:737-739. [PMID: 23302559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Most of Endobronchial tuberculosis (EBTB) of children is caused by the bronchial erosion from the scrofula close to the bronchus. Due to its complicated mechanism, pediatricians have limited knowledge on the endobronchial tuberculosis, which makes the misdiagnosis rate high. This work explored the clinical features and diagnostic methods of endobronchial tuberculosis (EBTB), to improve the understanding of this disease. METHOD A total of 102 cases with endobronchial tuberculosis (EBTB) were investigated by analyzing clinical and bronchoscopic features, imaging manifestation, PPD results and etiological examination; 71 cases were male, 33 were female, the youngest was 4 months old, and the oldest was 10 years old. The patients were treated in the fourth ward of the Department of Internal Medicine, Beijing Children's Hospital, Capital Medical University. RESULT Of the 102 cases, 71 (69.6 percent) were infants and young children. (1) Age and clinical presentation: Infants and young children were more common, the main clinical manifestations were fever and cough, physical examination may find decreased breath sounds, wet and dry rale and wheezing. (2) In 81 cases who received CT there was bronchial obstruction, in 43 cases there were simultaneous manifestations of primary pulmonary tuberculosis (mediastinal and hilar lymph node enlargement and/or pulmonary consolidation), 21 cases had only manifestations of primary tuberculo. (3) The results of PPD: the positive rate was 95%. (4) Bronchoscopic feature: presence of mucosal swelling, caseous necrosis, bronchial stenosis/extrabronchial compression, granulomatous lesions and lymph node bronchial fistula. (5) Bacteriologic results: 21 patients were bacteriologically positive. CONCLUSION Bronchial tuberculosis was more common in infants and young children, their major clinical manifestations were fever, cough, common findings on lung imaging was mediastinal and hilar lymph node enlargement and/or pulmonary consolidation, bronchial obstruction should be considered manifestations of bronchial tuberculosis, positive PPD should support the clinical diagnosis. Diagnosis can be confirmed by positive bacteriological tests.
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Affiliation(s)
- Ru-xuan He
- The Fourth Department of Intermal Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China
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Zheng YJ, Deng JK, Lu ZW, Ma HL, Li J, Wang L. [Clinical analysis of 8 children with plastic bronchitis associated with influenza A virus (H1N1) infection]. Zhonghua Er Ke Za Zhi 2012; 50:521-524. [PMID: 22932014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To analyze the clinical characteristics of plastic bronchitis associated with 2009 influenza A virus (H1N1) infection. METHOD A retrospective investigation of the clinical manifestation, bronchoscopy, and the histology of the cast, clinical course and outcome of 8 children with plastic bronchitis associated with influenza A virus (H1N1) infection during winter of 2009 and 2010 was performed. RESULT All 8 cases were boys, the range of age was 3 to 6 years. Five cases occurred in 2009 winter, accounting for 3.3% (5/150) of hospitalized children with influenza A (H1N1) infection; 3 cases occurred in 2010 winter, accounting for 15.8% (3/19) of hospitalized children with influenza A (H1N1) infection. Two patients had an underlying chronic disease, 1 had asthma, and the other had allergic rhinitis and atopic dermatitis. All the 8 cases had fever, cough and sputum; 2 had wheezing; 5 had respiratory distress. All 8 cases were diagnosed as influenza A virus (H1N1) infection complicated with pneumonia, of whom 5 patients had atelectasis, 2 had pneumothorax, 1 had pneumomediastinum, 1 had parapneumonic effusion, 2 patients were suspected of foreign body aspiration. Seven cases were admitted to an ICU, 5 patients developed respiratory failure, and 3 patients required mechanical ventilation. Flexible bronchoscopy and bronchial lavage was performed in all cases and showed bronchial cast. Histological examination of the bronchial cast revealed a fibrinous material containing large quantity of eosinophils, neutrophils, and lymphocytes in 7 patients, fibrinous material and necrotic material without inflammatory cells in 1 patient. After the bronchial cast was removed, all patients were improved greatly, no patients died. CONCLUSION Plastic bronchitis is a life-threatening complication associated with 2009 influenza A (H1N1) virus infection in children. In children with rapid and progressive respiratory distress with lung atelectasis or consolidation on chest radiograph, plastic bronchitis should be considered. Bronchoscopic extraction of casts should be carried out early.
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Gupta A, Jamieson K, Bush A. A run too far? Pediatr Pulmonol 2012; 47:727-8. [PMID: 22170813 DOI: 10.1002/ppul.21596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 10/31/2011] [Indexed: 11/09/2022]
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Stevic R, Milenkovic B, Stojsic J, Pesut D, Ercegovac M, Jovanovic D. Clinical and radiological manifestations of primary tracheobronchial tumours: a single centre experience. Ann Acad Med Singap 2012; 41:205-211. [PMID: 22760718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Tracheobronchial tumours usually cause an airway obstruction and secondary pulmonary infections. Although rare, they are an important differential diagnosis as they may mimic other conditions and diseases. This paper aims to analyse clinical, radiological and histological characteristics of the patients with tracheobronchial tumours diagnosed for a period of 7 years. MATERIALS AND METHODS In this retrospective, observational study, we carefully reviewed 65 patients who were diagnosed with tracheal and endobronchial tumours, and performed statistical analysis on the results. RESULTS Among these 65 patients (36 men and 29 women) with a mean age of 48.8 years (range, 15 to 75), 50 had malignant tumours while 15 had benign ones. The most common symptoms were cough, chest pain and haemoptysis. Cough was a more frequent symptom in patients with benign tumours (P <0.0014). Only 2 patients were asymptomatic. Tumours were predominantly localised in the large airways (46 in large bronchi and 2 in trachea). The most common radiological manifestation of malignant tumours was tumour mass (46%) followed by atelectasis. One third benign tumour caused atelectasis, while tumour mass and consolidation were found in 3 patients each. Computerised tomography revealed endoluminal tumour mass in 29.2% of the cases, which was more frequently found in benign than malignant tumours (47% vs 24%, respectively). On bronchoscopy, tumours were visible in 73% and 70% benign and malignant cases respectively. CONCLUSION Tracheobronchial tumours should be ruled as a possible diagnosis in patients with cough, haemoptysis, dyspnoea and chest pain. The imaging techniques and histological examination of the tissue would subsequently lead to correct diagnosis and proper treatment can be administered.
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Affiliation(s)
- Ruza Stevic
- Faculty of Medicine, University of Belgrade, Serbia.
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Gómez-Laberge C, Arnold JH, Wolf GK. A unified approach for EIT imaging of regional overdistension and atelectasis in acute lung injury. IEEE Trans Med Imaging 2012; 31:834-842. [PMID: 22249646 PMCID: PMC7176466 DOI: 10.1109/tmi.2012.2183641] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 12/27/2011] [Indexed: 05/31/2023]
Abstract
Patients with acute lung injury or acute respiratory distress syndrome (ALI/ARDS) are vulnerable to ventilator-induced lung injury. Although this syndrome affects the lung heterogeneously, mechanical ventilation is not guided by regional indicators of potential lung injury. We used electrical impedance tomography (EIT) to estimate the extent of regional lung overdistension and atelectasis during mechanical ventilation. Techniques for tidal breath detection, lung identification, and regional compliance estimation were combined with the Graz consensus on EIT lung imaging (GREIT) algorithm. Nine ALI/ARDS patients were monitored during stepwise increases and decreases in airway pressure. Our method detected individual breaths with 96.0% sensitivity and 97.6% specificity. The duration and volume of tidal breaths erred on average by 0.2 s and 5%, respectively. Respiratory system compliance from EIT and ventilator measurements had a correlation coefficient of 0.80. Stepwise increases in pressure could reverse atelectasis in 17% of the lung. At the highest pressures, 73% of the lung became overdistended. During stepwise decreases in pressure, previously-atelectatic regions remained open at sub-baseline pressures. We recommend that the proposed approach be used in collaborative research of EIT-guided ventilation strategies for ALI/ARDS.
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Affiliation(s)
- Camille Gómez-Laberge
- Harvard Medical SchoolDepartment of AnesthesiologyPerioperative and Pain MedicineChildren’s Hospital BostonBostonMAUSA02115
| | - John H. Arnold
- Harvard Medical SchoolDepartment of AnesthesiologyPerioperative and Pain MedicineChildren’s Hospital BostonBostonMAUSA02115
| | - Gerhard K. Wolf
- Harvard Medical SchoolDepartment of AnesthesiologyPerioperative and Pain MedicineChildren’s Hospital BostonBostonMAUSA02115
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Fatimi SH, Riaz M, Hanif HM, Muzaffar M. Asymptomatic presentation of giant bulla of the left apical and anterior segment of the left upper lobe of the lung with near complete atelectasis of the remaining left lung. J PAK MED ASSOC 2012; 62:165-166. [PMID: 22755381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Giant bullae may be found in association with emphysema. They present as pockets of entrapped air which grow as the surrounding lung retracts away. As they do not take part in gas exchange and merely occupy space, their presence leads to severe impediment of mechanical ventilation in the adjacent lung parenchyma. Patients may present with dyspnoea, exercise intolerance and a feeling of pressure in the chest. The case of a 54 year old gentleman is presented, who was found to have a giant bulla occupying his left hemithorax on a routine chest X-ray. The patient remained asymptomatic despite the large size of the bulla and was treated with surgical resection via thoracotomy i.e. Bullectomy which is the treatment of choice. If left untreated the condition can be complicated by pneumothorax, infection and a slow progression to malignant changes.
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Affiliation(s)
- Saulat Hasnain Fatimi
- Department of Surgery, Division of Cardiothoracic Surgery, Aga Khan University, Karachi, Pakistan
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Panigada S, Ullmann N, Gardella C, Ferrari C, Sacco O, Rossi GA. Bilobar atelectasis as clinical presentation of Mycoplasma pneumoniae infection. Pediatr Int 2011; 53:1100-1. [PMID: 22181573 DOI: 10.1111/j.1442-200x.2011.03495.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dalar L, Karasulu L, Sökücü S, Düger M, Altın S. [Total atalectasis of the left lung developing during the third month of treatment in a case of pulmonary tuberculosis]. Rev Mal Respir 2011; 28:1158-61. [PMID: 22123143 DOI: 10.1016/j.rmr.2011.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Accepted: 04/12/2011] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Pulmonary tuberculosis and lung cancer are still important public health problems and can occur simultaneously. In this article, we present the case of a 38-year-old patient treated for smear positive pulmonary tuberculosis. CASE REPORT During the third month of treatment, the patient developed respiratory distress and was found to have total atelectasis of the left lung. At rigid bronchoscopy, a lesion obstructing the left main bronchus was removed with a diode laser. Oncological treatment was started following the histological diagnosis of small cell bronchial carcinoma. CONCLUSION Pulmonary tuberculosis and bronchial carcinoma can occur at the same time and cause diagnostic confusion. The possibility should be considered in situations where both diseases are endemic.
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Affiliation(s)
- L Dalar
- Unité de pneumologie interventionnelle de l'hôpital Yedikule, Yedikule Göğüs Hastalıkları Hastanesi, Zeytinburnu 34000 Istanbul, Turquie.
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van der Veldt AAM, Lubberink M, Lammertsma AA, Smit EF. Comment on Cho et al.: Usefulness of FDG PET/CT in determining benign from malignant endobronchial obstruction. Eur Radiol 2011; 21:2148-9; author reply 2150. [PMID: 21681575 PMCID: PMC3165116 DOI: 10.1007/s00330-011-2172-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Accepted: 04/23/2011] [Indexed: 11/29/2022]
Affiliation(s)
- Astrid A. M. van der Veldt
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Mark Lubberink
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Adriaan A. Lammertsma
- Department of Nuclear Medicine & PET Research, VU University Medical Center, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Egbert F. Smit
- Department of Pulmonary Diseases, VU University Medical Center, Amsterdam, The Netherlands
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38
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Bezzi M, Noppen M. It is tough to make predictions, especially about the future. Respiration 2010; 80:369-71. [PMID: 20948241 DOI: 10.1159/000320726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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39
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Tepavac A, Secen N, Sazdanic Velikic D, Popovic G, Perin B. Atelectasis: positive or negative prognostic factor on outcome of patients with non-small cell lung cancer? J BUON 2010; 15:679-683. [PMID: 21229629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE the aim of this study was to evaluate the influence of atelectasis (AT) on overall survival of patients with non small cell lung cancer (NSCLC). METHODS the study included patients of both sexes with unresectable stage III and IV NSCLC with good performance status (PS) (ECOG ≤ 2). Patients were divided into two groups: with AT (AT+) and without AT (AT-): Factors analyzed included sex, age, histologic type, ECOG performance status, stage of disease and treatment modality. Overall survival was estimated according to Kaplan-Meier method, and multivariate analysis was used to identify independent prognostic factors. RESULTS we evaluated 247 patients (83% males and 17% females); 47/247 (19%) of patients belonged to AT+ group. In this group 21% of patients had stage IIIA, 46% IIIB stage, and 33% IV stage. Overall survival was significantly longer in the AT+ group (15.23 vs. 9.03 months, p=0.001). AT+ patients in stages III and IV had significantly longer overall survival than AT- patients in the same stages (p=0.001, p=0.002, respectively). Multivariate analysis showed that atelectasis (p=0.001), stage of disease (p=0.001), and treatment modality (p=0.005) were independent prognostic factors associated with survival. CONCLUSION atelectasis is favorable prognostic factor concerning overall survival in patients with NSCLC.
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Affiliation(s)
- A Tepavac
- Department of Chemotherapy, Institute of Pulmonary Diseases of Vojvodina, Sremska Kamenica, Medical Faculty, University of Novi Sad, Serbia.
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40
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Wang J, Yang Y, Zhao SY. [Bronchitis obliterans in children: report of two cases and literature review]. Zhonghua Er Ke Za Zhi 2010; 48:764-766. [PMID: 21176486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Bronchitis obliterans is a severe and extremely rare complication of respiratory tract infections in children and is characterized by massive atelectasis and collapse of the affected lung. METHOD The clinical manifestations, characteristic imaging of two cases with bronchitis obliterans were summarized. RESULT These two cases complained of cough and episodes of wheezing with exercise. Chest auscultation revealed bronchial breath sounds on the right side. High-resolution computed tomography (HRCT) scan showed atelectasis of the right lung and dilated central airways. Mycoplasma complement fixation antibody (CF-Ab) titer was 1:320. The diagnosis of bronchitis obliterans was made according to the current diagnostic criteria. They were treated with low-dose erythromycin [5 mg/(kg × d)], ultrasonically nebulized Pulmicort inhalation, and regular bronchoscopic lavage. Follow-up of the two cases showed that case one had a partial lung re-expansion after six months, but case two had no significant improvement. CONCLUSION In the process of diagnosis of atelectasis, bronchitis obliterans should be noticed. A conservative treatment is effective in certain cases, but pneumonectomy or lobectomy should only be considered as the last option.
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Affiliation(s)
- Jing Wang
- Department of Traditional Chinese Medicine, Beijing Children Hospital, Capital Medical University, Beijing 100045, China
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41
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Zhang DJ, Zhao DY, Liang H, Tian M, Han Q. [Application of flexible bronchoscopy in diagnosis and treatment of 104 children with pulmonary atelectasis]. Zhonghua Er Ke Za Zhi 2010; 48:767-770. [PMID: 21176487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVE To evaluate the value of flexible fiberoptic bronchoscopy in diagnosis and treatment of pulmonary atelectasis in children. METHOD Totally 104 patients with pulmonary atelectasis, who were admitted to this department, received flexible fiberoptic bronchoscopy from January 2006 to May 2010, were enrolled in a retrospective analysis. RESULT The analysis on causes of pulmonary atelectasis showed that 76 cases (73%) of the 104 patients had sputum obstructions, which was the main cause of atelectasis. Thirteen cases (13%) had bronchopulmonary dysplasia, 9 cases among these were infants. Twelve cases (12%) had foreign body aspiration, 8 cases among these were under the age of 3-year. After flexible fiberoptic bronchoscopy, 100 cases got expansion of pulmonary atelectasis. Sixty-five of the sputum obstruction cases got atelectasis reexpansion after one time of flexible fiberoptic bronchoscopy. Eight of the sputum obstruction cases got atelectasis reexpansion after two times of flexible fiberoptic bronchoscopy. Two of the sputum obstruction cases got atelectasis reexpansion after three times of flexible fiberoptic bronchoscopy. The rate of atelectasis reexpansion after one time of alveolus lavement was higher in the cases whose courses of disease were under 3 weeks, than in the cases whose courses of disease were beyond 3 weeks. CONCLUSION Etiology of pulmonary atelectasis varied at different age. The morbidity of bronchopulmonary dysplasia was high in infants. Foreign body aspiration was the common cause of pulmonary atelectasis in children from 1 to 3-year of age. Sputum obstruction was the main cause of pulmonary atelectasis in over 3-year-old children. Most cases got atelectasis reexpansion after alveolar lavage. The patients who had shorter course of disease might have higher rate of atelectasis reexpansion after alveolar lavage once. Flexible fiberoptic bronchoscopy plays an important role in diagnosis and treatment of pulmonary atelectasis.
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Affiliation(s)
- Dai-jia Zhang
- Division of Pediatric Pulmonary Diseases, Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing 210008, China
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42
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Sisu RC, Bicescu G, Vinereanu D. Massive atelectasis with acute respiratory failure in postpartum misdiagnosed as pulmonary embolism. Am J Emerg Med 2010; 28:842.e1-4. [PMID: 20837267 DOI: 10.1016/j.ajem.2009.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Accepted: 11/07/2009] [Indexed: 11/18/2022] Open
Affiliation(s)
- Roxana C Sisu
- Department of Cardiology, University and Emergency Hospital of Bucharest, 169 Splaiul Independentei, sector 5, 050098, Bucharest, Romania
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43
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Zhang XT, Jin Z, Zhang Q, Li RM, Xu M, Babak F, Anniko M, Duan M. Congenital unilateral pulmonary malformation misdiagnosed as bronchial foreign body: a review of 14 cases. Acta Otolaryngol 2010; 130:971-6. [PMID: 20105106 DOI: 10.3109/00016480903515386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION Congenital unilateral pulmonary malformation can easily be misdiagnosed as a bronchial foreign body. Although rigid bronchoscopy helps the proper diagnosis, high risks associated with anesthesia and operative complications may limit its application. However, high-resolution computed tomography (CT) and three-dimensional lung reconstruction provide a non-invasive tool to improve the diagnosis of congenital unilateral pulmonary malformation. OBJECTIVES To compare clinical manifestations, physical signs, and radiological examinations of congenital unilateral pulmonary malformation and bronchial foreign body, and summarize the characteristics and methods for diagnosis of congenital unilateral pulmonary malformation. METHODS Fourteen patients (five males and nine females, aged from 3 months to 14 years) with congenital unilateral pulmonary malformation, who were misdiagnosed or suspected as having bronchial foreign body or bronchial foreign body with pulmonary atelectasis, were analyzed retrospectively. Three typical cases are presented in detail. RESULTS All patients were previously misdiagnosed and treated as having pneumonia. From onset to final diagnosis, the longest misdiagnosis time was 10 years, and the shortest was 2 days. Only three patients presented with a history of foreign body inhalation. Six cases were finally diagnosed as having unilateral pulmonary malformation by rigid bronchoscope, five cases by X-ray and high-resolution CT scan, two cases by CT and three-dimensional lung reconstruction, and one case by autopsy. The malformation of left and right lungs was present in five and nine cases, respectively. Among these patients, four patients also had congenital cardiovascular diseases and other malformations, two patients underwent tracheotomy, and one patient died during salvage surgery.
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Affiliation(s)
- Xiao-Tong Zhang
- Department of Otorhinolaryngology, 2nd Affiliated Hospital of Xi'an JiaoTong University, Xi'an, ShanXi, PR China
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Baril R, Yusupov A, Jesinger RA, Huynh B, Kelley TC. Radiology corner. Tight left upper lobe collapse from lung cancer. Mil Med 2010; 175:v-vi. [PMID: 20684462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Affiliation(s)
- Robert Baril
- Department of Radiology, David Grant USAF Medical Center, Travis AFB, CA 94535, USA
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45
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Krivokuca I, Lammers JWJ. [A man with consolidation of the right lung]. Ned Tijdschr Geneeskd 2010; 154:A498. [PMID: 20356435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
A 68-year-old man, who had been exposed to asbestos in the past, presented with pleural effusion and right lower lobe consolidation due to rounded atelectasis.
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Affiliation(s)
- Igor Krivokuca
- Universitair Medisch Centrum Utrecht, afd. Longziekten, Utrecht, The Netherlands.
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46
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Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a complex immune hypersensitivity reaction to Aspergillus fumigatus, usually complicating the course of patients with asthma and cystic fibrosis. The common radiological manifestations encountered are fleeting pulmonary opacities, bronchiectasis and mucoid impaction. Uncommon radiological findings encountered in ABPA include pulmonary masses, perihilar opacities simulating hilar adenopathy, miliary nodules and pleural effusions. Herein, we describe a 22-year-old female patient who presented with acute hypoxaemic respiratory failure secondary to left lung collapse, which necessitated rigid bronchoscopy for management. On further evaluation, she was diagnosed to have ABPA. This is the first documented report of ABPA presenting as acute hypoxaemic respiratory failure secondary to lung collapse.
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47
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Yap KH, Sulaiman S. Pulmonary atelectasis from compression of the left main bronchus by an aortic aneurysm. Singapore Med J 2009; 50:e247-e249. [PMID: 19644610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Pulmonary atelectasis may be caused by endobronchial lesions or by extrinsic compression of the bronchus. However, lung collapse due to compression from a thoracic aneurysm is uncommon. We report a 76-year-old hypertensive female patient who has pulmonary atelectasis due to an extrinsic compression from a descending thoracic aortic aneurysm, and discuss possible treatment options.
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Affiliation(s)
- K H Yap
- Department of Medicine, Hospital Serdang, Jalan Puchong, Serdang 43300, Malaysia.
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48
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SCHMID PC. Lungenverschattungen, die das Bild einer Pleuritis mediastinalis oder interlobaris vortäuschen können. Dtsch Med Wochenschr 2009; 77:772-5. [PMID: 14936620 DOI: 10.1055/s-0028-1116089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kato K, Sato N, Takeda S, Yamamoto T, Munakata R, Tsurumi M, Suzuki D, Yagi K, Tanaka K, Mizuno K. Marked improvement of extensive atelectasis by unilateral application of the RTX respirator in elderly patients. Intern Med 2009; 48:1419-23. [PMID: 19687590 DOI: 10.2169/internalmedicine.48.1988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The RTX respirator is a biphasic external cuirass-style ventilator that supports both inspiration and expiration at various cycle rates and pressures, as well as allowing application of the vibration and cough modes. With this respirator, the duration and pressure can be altered in both the inspiratory and expiratory phases, and it can promote the removal of secretions by switching between the vibration mode (which involves external high-frequency oscillation: EHFO) and the cough mode. We used this respirator to remove secretions in two elderly patients with extensive atelectasis. They were nursed in the lateral decubitus position with the cuirass attached to one side of the chest only. The vibration mode removed secretion to reduce the viscosity of secretions and loosen impacted bronchial secretions. The cough mode interrupts the vibration mode and forces secretions towards the pharynx. The lateral decubitus position was useful for postural drainage. The extensive atelectasis of both patients was improved by this procedure. The RTX respirator may be a useful tool for the management of elderly patients with sputum retention.
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Affiliation(s)
- Koji Kato
- Intensive and Cardiac Care Unit, Nippon Medical School, Tokyo.
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50
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Kikuchi N, Kodama T, Satoh H. Positron emission tomography findings in rounded atelectasis. Tuberk Toraks 2009; 57:483-484. [PMID: 20037866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
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