Pulmonary Complications in Diabetes Mellitus

Hansen, Lori A.; Prakash, Udaya B. S.; Colby, Thomas V.

doi:10.1016/s0025-6196(12)61752-2

Cited by 49 publications

(26 citation statements)

References 43 publications

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“…Many risk factors have been defined for the development of empyema following a resection, especially bronchopleural fistula and prolonged air leakage. Risk factors for postoperative empyema include advanced age, malnutrition, systemic diseases, induction chemoradiotherapy, use of steroids, obesity, right pneumonectomy, pneumonectomy complementary therapy, foreign body in pleural space, intrathoracic hematoma, prolonged operation duration, contamination of the pleural space during the operation, emergency operation after a trauma, inappropriate antibiotic therapy, postoperative pneumonia and postoperative follow-up with a ventilator [5][6][7][8][9][10][11][12]. In general, development of empyema due to these factors is seen in the early period, although it may also occur in the late period.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors in Development of Postoperative Empyema

Özkan¹

2014

Ann Clin Anal Med

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Anahtar KelimelerAmpiyem; Risk Faktörleri; Postoperatif Abstract Aim: Many etiological factors play a role in the occurrence of postoperative empyema. We aimed to define the effects of these factors on the development of empyema. Material and Method: Two hundred and eighty-eight cases from our clinic who underwent tube thoracostomy and/or were operated due to any cause out of the primary empyema between August 2009 and May 2010 were prospectively studied in terms of empyema development. Data comprised gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, sharing the same room with other cases with empyema, primary disease, additional comorbidity, operation duration, drain number, complication, number of patients in the room, and drain discontinuation and hospitalization duration. Blood leukocyte-neutrophil count was ordered in all cases at 3-day intervals, and fluid culture specimens were simultaneously collected from cases with drains. Drainage fluid culture specimens were evaluated with "Automated Identification and Antibiotic Susceptibility Testing" using standard procedures. Empyema cases who developed clinical manifestation and/or with bacterial growth in culture specimens were studied in terms of risk factors. The findings were analyzed using SPSS (version 16). Results: The results showed that gender, age, chemoradiotherapy, surgical procedure, intraoperative thoracic lavage with povidone-iodine, emergency surgery status, and sharing a same room with other empyema cases were not significantly correlated with the risk of empyema development. Contribution of the primary disease (p<0.05), additional comorbidity (p<0.05), operation duration (p<0.05), drain number (p<0.05), complication (p<0.05), number of people in the room (p<0.05), drain discontinuation time (p<0.05) and hospitalization duration (p<0.05) were found to be significant in the development of postoperative empyema. Discussion: Postoperative development of empyema is one of the most serious problems encountered in patients who have undergone tube thoracostomy. Therefore, current risks should be thoroughly assessed in the preoperative period and approaches to minimize these risks should be adopted.

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Section: Discussionmentioning

confidence: 99%

Risk Factors in Development of Postoperative Empyema

Özkan¹

2014

Ann Clin Anal Med

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“…In Case 2, the aetiology of the patient's extracranial epidural emphysema is owing to pneumomediastinum from barotraumas induced by hyperpnoea or severe vomiting from diabetic ketoacidosis. Diabetic ketoacidosis is a rare cause of pneumomediastinum and therefore a rarer cause of extracranial epidural emphysema; however, the actual incidence of pneumomediastinum complicating diabetic ketoacidosis is unknown [13,14].…”

Section: Discussionmentioning

confidence: 99%

Extracranial epidural emphysema: pathway, aetiology, diagnosis and management

Cloran¹,

Bui-Mansfield²

2011

BJR

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ABSTRACT. Extracranial epidural emphysema is an uncommon phenomenon that refers to the presence of gas within the epidural space. As an isolated finding, it is typically benign, but it can be a secondary sign of more ominous disease processes, such as pneumothorax, pneumoperitoneum and epidural abscess. Although the phenomenon has been cited in case reports, a comprehensive review of this topic is lacking in the radiology literature. The authors' aim is to report our experience with extracranial epidural emphysema, illustrating the spectrum of its clinical presentation. We also review the aetiology, pathophysiology, diagnosis and management of extracranial epidural emphysema. Pneumorrhachis (also known as aerorachia) is a term that has been used to describe air within the spinal canal. It can be separated into two distinct entities, epidural and intradural. In general, the presence of intradural intraspinal air has been associated with significant morbidity, while the presence of epidural air is typically more benign [1]. Epidural air within the spinal canal is best descriptively termed extracranial epidural emphysema and has been described sporadically in case reports. The purpose of this pictorial review is to present a diversity of clinical scenarios that can give rise to extracranial epidural emphysema and to discuss its pathophysiology, diagnosis and management. Methods and materialsA comprehensive literature search was conducted on the MEDLINE database using PubMed. Keywords including pneumorrhachis, pneumosaccus, aerorachia, intraspinal pneumocele, pneumomyelogram, epidural emphysema and epidural pneumatosis were used in the literature search. In addition to a review of the literature, four cases of extracranial epidural emphysema collected at our institution are also reported. They illustrate the common pathways of extracranial epidural emphysema.All the clinical records were reviewed for demographic data, symptoms and duration of symptoms. The study did not require approval from the institution's Investigation Review Board. However, the Brooke Army Medical Center Department of Clinical Investigation reviewed and approved the manuscript for publication. Results Case 1A 59-year-old male complained of left flank pain. He had a non-contrast CT of the abdomen and pelvis that showed a left ureterovesical junction stone. The examination also revealed severe degenerative disc disease at L4-5 and L5-S1 disc spaces with vacuum disc phenomenon and extracranial epidural emphysema behind the L5 vertebral body (Figure 1a,b). Case 2A 20-year-old male presented with diabetic ketoacidosis and crepitus in the neck and upper chest. He had palpable crepitus over his jaw and a friction rub on cardiac examination. A CT scan of the chest showed severe pneumomediastinum tracking from the mediastinum into the soft tissues of the neck, anterior and posterior chest wall with pneumopericardium and extracranial epidural emphysema (Figure 2a,b). Case 3A 49-year-old male with Crohn's disease presented with abdominal pain and distensi...

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“…Al analizar este grupo de 6 pacientes, se puede resaltar que 3 de ellos eran diabéticos, posiblemente presentaron recaída por pobre TOBÓN A., PANIAGUA L., HENAO M., ARCILA V., MAYA J., et al respuesta al tratamiento antituberculoso al tener alteraciones de tipo inmune y mayor riesgo para multirresistencia (28)(29)(30). Dos pacientes presentaban lesiones fibrocavitarias bilaterales y uno abandonó el tratamiento luego de la cirugía.…”

Section: Discussionunclassified

Cirugía en tuberculosis pulmonar multirresistente.

Tobón¹,

Paniagua²,

Henao³

et al. 2004

biomedica

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La aparición de Mycobacterium tuberculosis multirresistente constituye un serio problema para el control de la tuberculosis, por lo que se ha considerado que la resección quirúrgica del tejido pulmonar afectado, junto con el tratamiento médico adecuado, podría proporcionar la curación en algunos pacientes con tuberculosis pulmonar multiresistente. En este estudio de tipo descriptivo, retrospectivo, se evaluaron los resultados clínicos y bacteriológicos de la resección quirúrgica en un grupo seleccionado de pacientes con tuberculosis pulmonar multirresistente. Se revisaron las historias clínicas del Hospital La María de Medellín de 1990 a 2000, y se encontró que se habían sometido a cirugía 73 pacientes con diagnóstico de tuberculosis durante este periodo, 28 de los cuales tenían como indicación quirúrgica tuberculosis multirresistente (resistencia a isoniacida y rifampicina), 21 de los cuales habían recibido tratamiento prequirúrgico. En 14 (50%) se había practicado lobectomía superior y en 10 (36,7%), neumonectomía. Todos recibieron tratamiento posquirúrgico por un periodo promedio de 12,5 meses. En 88,9% (25/27) de los casos, la baciloscopia fue negativa después de 6 semanas de la cirugía y hasta finalizar el tratamiento antituberculoso; 6 pacientes presentaron nuevamente baciloscopia positiva, aunque 4 tuvieron baciloscopia negativa después de un nuevo esquema de tratamiento. Los pacientes, de acuerdo con las normas del ministerio, fueron seguidos con baciloscopia mensual y no con cultivo como es lo indicado en los casos de multirresistencia. La cirugía junto con el tratamiento médico adecuado constituye una buena alternativa de curación para algunos pacientes con tuberculosis pulmonar multirresistente.

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Pulmonary Complications in Diabetes Mellitus

Cited by 49 publications

References 43 publications

Risk Factors in Development of Postoperative Empyema

Risk Factors in Development of Postoperative Empyema

Extracranial epidural emphysema: pathway, aetiology, diagnosis and management

Cirugía en tuberculosis pulmonar multirresistente.

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