A24. HEART AND LUNGS: "BETTER TOGETHER"最新文献

{"title":"Who's Responsible? Diffuse Alveolar Hemorrhage with Multiple Potential Culprits","authors":"R. Puthumana, C. J. Trujillo","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1129","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1129","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115564120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pneumonitis Due to \"Dabbing\" Successfully Managed via Extracorporeal Membrane Oxygenation","authors":"L. Meece, J. P. Morán, H.M. McConville, S. Velani","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1130","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1130","url":null,"abstract":"INTRODUCTION: E-cigarette or vaping associated lung injury (EVALI) is an uncommon complication of e-cigarettes or vaping. 96% of these cases require hospitalization. The condition is especially associated with tetrahydrocannabinol (THC) products, frequent use, and is found primarily in young adults. “Dabbing” refers to the process of heating THC containing oils or waxes with butane solvents to vaporize cannabinoids for inhalation. CASE REPORT: An obese 20-year-old college male with a history of prematurity and anxiety presented with cough, dyspnea, nausea, vomiting and diarrhea that began 3 days prior. He reported smoking marijuana, but denied vaping. Multiple PCR tests for SARS-CoV-2 were negative. Initial chest radiograph demonstrated multifocal pneumonia. He was hypoxic on presentation requiring two liters of oxygen via nasal cannula. Broad spectrum antibiotics for pneumonia and steroids were initiated. Oxygen requirements rapidly increased and humidified high flow oxygen was instituted and escalated to 60 liters per minute and 90 % FiO2. He remained hypoxic, prompting intubation 48 hours from presentation. His ventilatory settings were steadily escalated to a positive end expiratory pressure of 15 cm H2O with 100% FiO2. Despite this, the patient had oxygenation saturations as low as 57% requiring transition to venovenous extracorporeal membrane oxygenation (VV-ECMO). Computed tomography angiography ruled out pulmonary embolism but redemonstrated extensive alveolar and interstitial infiltrates bilaterally. Bronchoscopy with alveolar lavage was performed with negative cultures and cytology. Blood cultures were also negative and antibiotic therapy was stopped. Extensive laboratory investigation for autoimmune vasculitis was performed and found to be negative. Discussion with family revealed that the patient regularly inhaled concentrated THC wax with butane as a solvent. Treatment continued with high dose intravenous steroids and supportive care. The patient received a total of 5 days of ventilator support after which he was extubated, and an additional 5 days of VV-ECMO. At discharge, the patient required 2 liters of continuous oxygen at rest and 4 liters with activity. He was otherwise asymptomatic and at his baseline level of function. He was discharged on daily steroids with taper and close outpatient follow up. DISCUSSION: While the majority of hospitalized patients with EVALI require intubation, the necessity of VV-ECMO utilization represents a rare severe presentation. Dabbing remains a rare cause of acute respiratory distress syndrome and EVALI, however, dabbing is emerging as a trend among young adults and represents an under-investigated cause of severe inhalational lung injury.","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128240947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Acute Interstitial Pneumonia (AIP)","authors":"S. Jarrett, A. Matta, S. Benzaquen","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1137","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1137","url":null,"abstract":"Introduction: Acute interstitial pneumonia (AIP) also known as Hamman-Rich Syndrome is an uncommon, acute, and rapidly progressive idiopathic pulmonary disease that often leads to acute respiratory distress syndrome (ARDS). We present a case of a 52-year-old male who developed this condition. Case: A 52-year-old male with no past medical history presented to the emergency department with a 3-day history of progressively worsening dyspnea, dry cough, and chills. Prior to symptom onset, he was in his usual state of health but did report having polyarthralgia mainly involving large joints with no other associated symptoms. He denied a history of sick contacts including COVID exposure, sexually transmitted infections, incarceration, intravenous drug abuse, or travel to tuberculosis endemic countries. He denied tobacco use and any other form of illicit drug use. On physical examination, he was afebrile, tachycardic, and hypoxic on room air. He appeared to be in no respiratory distress and chest was clear to auscultation. There were no joint abnormalities, skin rashes, or lymphadenopathy. Lab workup revealed elevated D-Dimer (2140 ng/mL), CRP (50 mg/L), lactate dehydrogenase (296 IU/L), ferritin (578 ng/mL). His SARSCoV2 PCR was negative. Chest X-ray and CT chest both revealed right pleural effusion and diffuse reticular and ground-glass opacities. He underwent thoracentesis and fluid analysis revealed lymphocytic exudate with negative cultures. Antibiotics and steroids were initiated. He underwent a complete rheumatologic workup including myositis panel, due to concern for possible autoimmune etiologies and it was negative. His respiratory status worsened, and he eventually required intubation. At this point given unclear etiology, he underwent bronchoscopy with transbronchial cryobiopsy. Cryobiopsy revealed evidence of organizing phase of diffuse alveolar damage (Figure 1) and in the setting of negative cultures, COVID-19 and autoimmune panel, there was a growing concern for acute interstitial pneumonia. The patient was started on pulse dose of steroids and transferred to a transplant center for lung transplantation evaluation. Discussion: Acute interstitial pneumonia is a rare idiopathic clinicopathological condition that is characterized clinically by rapid onset of respiratory failure in patients with no past medical history of pre-existing lung disease. Histopathological findings are identical to those of diffuse alveolar damage. Closely resembling ARDS, it is frequently confused with other clinical entities characterized by rapidly progressive interstitial pneumonia. Considering this a high index of suspicion is required to diagnose these patients and institute appropriate management as mortality is as high as 70%. (Figure Presented).","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127947212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Monocytic Leukemia: A Rare but Devastating Cause of ARDS","authors":"A. Soleiman, G. Eman, M. Islam","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1141","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1141","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133881937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plastic Bronchitis After Minimally Invasive Mitral Valve Replacement: An Unusual Etiology of Acute Respiratory Failure After Cardiac Surgery","authors":"J.M. Zapata -Canivilo, F. Amin, E. Belley‐Cote, A. Alsagheir, A. Fox-Robichaud, V. Chu, S. Tang","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1143","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1143","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114818980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Cause of Acute Throat Pain: Acute Aortic Dissection","authors":"I.A. Martinez Avalos, V. Hoytfox","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1133","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1133","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129576206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Perfluorocarbon for Pediatric Pulmonary Hemorrhage","authors":"K. Nelson McMillan, V. Dorsey, F. Yousaf, S. Kane, A. Waas, C. Urbas, C. E. El Zein, N. Hibino, J. Sherman, L. Vricella","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1120","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1120","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133957635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hidden Between the Lines: Acute Eosinophilic Pneumonia Masquerading as Heart Failure","authors":"A. Davis, J. Kanne, H. Faust","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1122","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1122","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115224946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac Tamponade - A Rare Complication of Sjogren's Syndrome","authors":"Y. Medik, C. Schooff, W. Khan","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1126","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1126","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116136249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Left-Sided Unilateral Pulmonary Edema in Acute Mitral Regurgitation","authors":"C. Kang, P. Khamooshi, V. Reyes Pinzon, N. Haghani Rad","doi":"10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1131","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2022.205.1_meetingabstracts.a1131","url":null,"abstract":"","PeriodicalId":364486,"journal":{"name":"A24. HEART AND LUNGS: \"BETTER TOGETHER\"","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122953296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}