TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY最新文献_第2页

Average Volume-Assured Pressure Support Improves Oxygenation and Decreases Hypercarbia in a Patient with Congenital Heart Disease and Bilateral Diaphragmatic Paralysis 平均容量保证压力支持改善先天性心脏病和双侧膈肌麻痹患者的氧合并降低高碳血症

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3441

J. Bradford, S. Bhargava

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Should I Bronch or Should I Go: The Need for Bronchoscopy in an Immunosuppressed Child with COVID-19 我应该支气管还是应该去:COVID-19免疫抑制儿童是否需要支气管镜检查

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3443

K. W. Malloy, L. Howard, M. O'Connor, C. Rosas-Salazar

{"title":"Should I Bronch or Should I Go: The Need for Bronchoscopy in an Immunosuppressed Child with COVID-19","authors":"K. W. Malloy, L. Howard, M. O'Connor, C. Rosas-Salazar","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3443","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3443","url":null,"abstract":"Introduction: Flexible bronchoscopy with bronchoalveolar lavage (FB+BAL) is routinely used for diagnostic evaluation in immunocompromised patients with pulmonary infiltrates. However, during the current COVID-19 pandemic, this procedure has usually been deferred in those with suspected or known diagnosis of COVID-19, given the risk of aerosolization and subsequent transmission of SARS-CoV-2 to healthcare personnel. We report the case of an immunosuppressed teenager with persistent fever and progressive respiratory symptoms after an initial diagnosis of COVID-19 in whom the need of FB+BAL represented a clinical dilemma. Description: A 14-year-old female on treatment for relapsed acute lymphoblastic leukemia was diagnosed with SARS-CoV-2 infection by polymerase chain reaction (PCR) in a nasal sample after having a positive household contact. Her symptoms were initially mild until she developed fever, cough, and dyspnea ∼2 weeks after diagnosis. Her laboratory evaluation was notable for lymphopenia and her chest CT revealed extensive lower lobe consolidations with scattered ground-glass opacities (Figure A), prompting hospitalization. Despite broad-spectrum antibiotics, her respiratory status worsened and she eventually required high-flow nasal cannula support. Pediatric pulmonology was consulted for consideration of FB+BAL to rule out opportunistic infections. Her repeat SARSCoV-2 PCR nasal test at that time, done ∼3 weeks after her initial diagnosis, was inconclusive. Because of this, as well as her tenuous respiratory status, it was decided not to proceed with FB+BAL. She then received steroids, remdesivir, and immunoglobulin, with gradual resolution of her hypoxemia. She was subsequently discharged home. Unfortunately, her fever and dyspnea returned ∼1 week after, prompting re-admission. Her repeat SARS-CoV-2 PCR nasal test was positive and her chest CT demonstrated shifting consolidative and ground-glass opacities, now more predominant in the upper and mid-lung fields (Figure B). We then proceeded with FB+BAL, which was unremarkable. Evaluations for a broad range of viral, bacterial, and fungal pathogens were negative, except for positive SARS-CoV-2 by PCR from BAL fluid. Her symptoms slowly improved with supportive treatment, so she was again discharged home. Her SARS-CoV-2 PCR nasal testing ∼2 months after initial diagnosis continued to be positive. Discussion: There is limited evidence regarding the safety and utility of FB+BAL in those with suspected or diagnosed COVID-19, particularly in the pediatric population. This case highlights an immunosuppressed child with prolonged viral shedding and emphasizes that in certain clinical situations FB+BAL may be required for further microbiologic data, especially when illness is protracted, the differential diagnosis is broad, and imaging findings are non-specific for COVID-19.","PeriodicalId":403993,"journal":{"name":"TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123169666","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}

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Isolated Endobronchial Pulmonary Arteriovenous Malformation Presenting with Massive Hemoptysis 孤立支气管内肺动静脉畸形表现为大量咯血

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3426

S. Bhela, E. de la Riva-Velasco, A. Singh, K. Harris, S. Krishnan, M. Arkovitz

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Super-Selective Embolization of Unusual Systemic Vascularizatioin of the Lung Without Sequestration 非隔离异常全身血管化肺的超选择性栓塞

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3433

R. Mohamed, A. AL-NAIMI, W. Mubarak, M. Abu-Hasan

引用次数: 0

Informed Consent Comprehension and Satisfaction Associated with Pediatric Flexible Bronchoscopy 儿童柔性支气管镜检查的知情同意理解和满意度

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3427

R. Simpson, G. Burg

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Recurrent Hemoptysis After Bi-Directional Glenn Procedure in a 4 Year Old 1例4岁儿童双向Glenn手术后咯血复发

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3439

M. Al-humiari, D. Gupta, C. Leon Astudillo

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Aerosol Delivery via Heated High Flow Nasal Cannula System in a Pediatric Model 通过加热高流量鼻插管系统在儿科模型中的气溶胶输送

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3442

D. Willis, A. Berlinski

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Pediatric Endobronchial Ultrasound Transbronchial Biopsy 小儿支气管超声经支气管活检

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3431

S. D. Franklin, J. Piccione, E. Hysinger, D. Dibardino, A. Haas, S. Goldfarb

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Successful Application of Long-Term Negative Pressure Ventilation in a Pediatric Patient with Congenital Muscular Dystrophy 长期负压通气在小儿先天性肌营养不良患者中的成功应用

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3440

S. Kim, J. Velasco

引用次数: 0

How Was Pediatric Flexible Bronchoscopy Implementation Affected During COVID-19 Era?: A Retrospective Study COVID-19时代小儿柔性支气管镜检查实施的影响?一项回顾性研究

TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY Pub Date : 1900-01-01 DOI: 10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3425

G. Özcan, Selvi Can, F. Zirek, M. Tekin, B. Bakırarar, N. Cobanoglu

{"title":"How Was Pediatric Flexible Bronchoscopy Implementation Affected During COVID-19 Era?: A Retrospective Study","authors":"G. Özcan, Selvi Can, F. Zirek, M. Tekin, B. Bakırarar, N. Cobanoglu","doi":"10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3425","DOIUrl":"https://doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a3425","url":null,"abstract":"Rationale: As application of flexible bronchoscopy (FB) has a high risk for infection transmission, it is recommended to postpone elective FB procedures during COVID-19 pandemic. We aimed to determine how COVID-19 pandemic affected pediatric FB implementation. Methods: Medical records of patients who underwent FB from March 11, 2015 to September 11, 2020 were examined retrospectively. Records of post-COVID-19 period (March 11, 2020 to September 11, 2020) were compared with records of pre-COVID-19 (consists of each six-month time window from March 11 to September 11 of each year from 2015 to 2019) period in terms of hospitalization status of the patients, with numbers and indications of FB. Some additional measures were taken during FB procedure in post-COVID-19 period. Number of health workers infected during FB procedures in post-COVID-19 period was reviewed. Results: Of total 182 procedures, the least FB was performed in post-COVID-19 period (34, 30, 36, 36, 25 and 21 procedures respectively from 2015 to 2020). Ninetythree (51.1%) patients were male. The median age of the patients was 48 months (range, 1-204 months). Eighty-two (45.0%) patients had chronic diseases. While 62 (34.2%) patients were hospitalized for another reason before FB, 120 (65.9%) patients were outpatient who applied for FB. Three most common indications for FB were atelectasis (n=39, 21.4%), chronic cough (n=32, 17.5%) and stridor (n=27, 14.8 %). While microbiological sampling with bronchoalveolar lavage was the most common indication in post-COVID-19 period, atelectasis was leading in pre-COVID-19 period (p<0.001). In post-COVID-19 period most of the patients were inpatients while outpatient predominance was determined in pre-COVID-19 period (p<0.001) (Table 1). None of the health workers was infected during FB procedure. Conclusion: Postponing elective FB procedures decreased the numbers and affected the indications of procedures in our center during COVID-19 era. Taking additional measures are of great importance and effective to prevent transmission of infection during FB.","PeriodicalId":403993,"journal":{"name":"TP76. TP076 PEDIATRIC INTENSIVE CARE AND INTERVENTIONAL PULMONOLOGY","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129669647","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}

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