Category Archives: Respiratory Symptoms - Part 6

Pulmonary Hemorrhage: Recommendation

However, in contrast to aspergillosis infection, hemorrhage due to H capsulatum infection is not usual. A pulmonary-renal syndrome could be postulated in either case, but this is unlikely in view of the clinical recovery in the absence of specific therapy. … Continue reading

Pulmonary Hemorrhage: Conclusion

Pulmonary hemorrhage has been described in association with a number of disorders, including necrotizing pulmonary infection, vasculitis, antibody-mediated disorders, and pulmonary infarction. Often, correction of the underlying disorder results in resolution of the pulmonary hemorrhage. Pulmonary hemorrhage is not commonly … Continue reading

Pulmonary Hemorrhage: Discussion

Despite aggressive diuretic management, subsequent chest radiographs demonstrated progressive diffuse pulmonary air-space disease (Fig 3). Empiric therapy with vancomycin, metronidazole, ceftriaxone, gentamicin, and dihydroxypropoxymethylqua-nine (DHPG) were initiated. Laboratory determinations disclosed the following values: PT, 19.3 s; PTT, 51 s; and … Continue reading

Pulmonary Hemorrhage: Results

A liver biopsy specimen disclosed granulomatous hepatitis, without evidence for AFB or fungal disease. However, symptoms and liver function test abnormalities resolved entirely within 3 weeks of receiving empiric isoniazid, rifampin, and ethambutol. Treatment with these drugs was discontinued 3 … Continue reading

Pulmonary Hemorrhage: Case Reports

The radiographic abnormalities progressed to extensive diffuse bilateral alveolar infiltrates (Fig 1), precipitating respiratory failure requiring intubation and mechanical ventillation. Laboratory data at that time disclosed the following values: hematocrit, 25.3%; prothrombin time (PT), 13.1 s; partial thromboplastin time (PTT), … Continue reading

Pulmonary Hemorrhage

The development of pulmonary infiltrates in individuals infected with human immunodeficiency virus type 1 (HIV) remains a common clinical problem. This presents the clinician with an extensive differential diagnosis with the focus often on infectious etiologies. Pulmonary hemorrhage has been … Continue reading

Combined Pressure Control/High Frequency Ventilation in Adult Respiratory Distress Syndrome and Sickle Cell Anemia: Recommendation

After 5 days of treatment with the PVDV, our patient was much improved, though not quite ready for extubation; he was converted to more conventional volume-limited ventilation because of the extreme variability in delivered tidal volumes as the patient moved … Continue reading

Combined Pressure Control/High Frequency Ventilation in Adult Respiratory Distress Syndrome and Sickle Cell Anemia: Conclusion

Clinical guidelines for the PVDV are somewhat arbitrary and still being developed. Because our strategy for this patient included using HFV to increase alveolar recruitment and oxygenation combined with pressure control to diminish gas trapping and augment carbon dioxide removal, … Continue reading

Combined Pressure Control/High Frequency Ventilation in Adult Respiratory Distress Syndrome and Sickle Cell Anemia: Discussion

The goal of such a strategy is to incorporate the advantages of HFV (improved oxygenation by elevation of the MAP with subsequent sustained alveolar recruitment and diminution of the volutrauma associated with tidal breathing) with those of conventional ventilation (facilitation … Continue reading

Combined Pressure Control/High Frequency Ventilation in Adult Respiratory Distress Syndrome and Sickle Cell Anemia: Results

Throughout the period of mechanical ventilation (both conventional and HFV), oxygen saturation was maintained greater than 90 percent, red blood cell transfusions were used to help maintain an adequate oxygen content, and the blood pressure was supported such that the … Continue reading

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