The pulmonary physician in critical care 1: Pulmonary investigations for acute respiratory failure

Dakin, Jonathan; Griffiths, Mark

doi:10.1136/thorax.57.1.79

Cited by 12 publications

(4 citation statements)

References 90 publications

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“…Some diseases with similar clinical presentations, such as cryptogenic organizing pneumonia, diffuse alveolar hemorrhage, hypersensitivity pneumonitis, and acute eosinophilic pneumonia can mimic and/or cause ARDS and may require other specific treatments [20]. Diffuse alveolar damage (DAD) is the histopathologic finding that corresponds to the clinical entity of ARDS [21].…”

Section: Discussionmentioning

confidence: 99%

The utility of surgical lung biopsy in cancer patients with acute respiratory distress syndrome

Chang

Kao

et al. 2013

J Cardiothorac Surg

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BackgroundThis retrospective study evaluated the utility and safety of surgical lung biopsy (SLB) in cancer patients with acute respiratory distress syndrome (ARDS).MethodsAll cases of critically ill patients with cancer and diagnosed with ARDS who underwent SLB in a tertiary care hospital from January 2002 to July 2009 were reviewed. Clinical data including patient baseline characteristics, surgical complications, pathological findings, treatment alterations, and survival outcomes were retrospectively collected and analyzed.ResultsA total of 16 critically ill patients with cancer diagnosed with ARDS who underwent SLB were enrolled. The meantime from ARDS onset to SLB was 3.0 ± 1.5 days. All SLB specimens offered a pathological diagnosis, and specific diagnoses were made in 9 of 16 patients. Biopsy findings resulted in a change in therapy in 11 of 16 patients. Overall, the SLB surgical complication rate was 19% (3/16). SLB did not directly cause the observed operative mortality. The ICU mortality rate was 38% (6/16). Patients who switched therapies after SLB had a trend toward decreased mortality than patients without a change in therapy (27% versus 60%; P = 0.299).ConclusionsIn selected critically ill cancer patients with ARDS, SLB had a high diagnostic yield rate and an acceptable surgical complication rate.

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Section: Discussionmentioning

confidence: 99%

The utility of surgical lung biopsy in cancer patients with acute respiratory distress syndrome

Chang

Kao

et al. 2013

J Cardiothorac Surg

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“…The images were acquired during a single breath-hold lasting five to eight seconds, with nasal cannula (n = 11) or mask with oxygen before the invasive ventilator support (n = 195) or while trying the mask on the non–invasive ventilator set (n = 48) in the early stage of ALI 18 among patients with spontaneous breathing. In the patients without spontaneous breathing, the images were acquired during end phase of inspiration (n = 5) after portable invasive ventilator set was on 40 , 41 . Respiratory motion is greatest at the lung bases and scanning in a caudal-to-cranial direction may help to minimize respiratory artifacts because scans through the lung bases are acquired when the patient is holding his or her breath.…”

Section: Methodsmentioning

confidence: 99%

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

Yeh

2019

Sci Rep

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This study evaluated the diagnostic use of high-resolution computed tomography (HRCT), chest X-ray (CXR), and clinical manifestations (CM) to identify initial smear-negative (iSN) active pulmonary tuberculosis (aPTB) [iSN-aPTB] in patients with iSN-pulmonary diseases (PD) and acute lung injury (ALI). In the derivation cohort, the [iSN-PD] with ALI patients were divided into the [iSN-aPTB] (G1, n = 26) and [non-aPTB-PD] (G2, n = 233) groups. Lung morphology, number, and lobar (segmental) distribution were evaluated using CXR and HRCT. A multivariate analysis was performed to identify independent variables associated with G1, which were used to generate predictive score models for G1. The predictive model was validated in a separate population of patients (n = 372) with [iSN-PD] and (ALI). The validated model for [HRCT (CXR + Hypoalbuminemia)] had 93.5% (25.8%) sensitivity, 99.5% (89.4%) specificity, and a negative predictive value of 99.5% (93.0%). For [iSN-aPTB], the post-test probability in the derivation cohort (prevalence = 10%), validation cohort (prevalence = 8.3%), and the given prevalence (prevalence = 1%) was 88.7%, 94.4%, and 41.5%, respectively. The HRCT model effectively identified the [iSN-aPTB] subjects among the [iSN-PD] with ALI, regardless of CM. The [non-aPTB-PD] were also correctly classified by the HRCT and [CXR + Hypoalbuminemia] models.

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“…In these circumstances BAL for bacteriological, immunological and cytological analysis and TBLB for histological analysis are recommended. The first is well tolerated and relatively safe whereas TBLB can be complicated by pneumothorax and haemorrhage and is reserved for diagnosis in immunocompromised patients and in the early stages of ARDS [35][36][37][38].…”

Section: Disorders Involving the Alveolar-interstitial Interfacementioning

confidence: 99%

Bronchoscopy in Intensive Care Unit

Fecci

Consigli

2015

Monaldi Arch Chest Dis

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The pulmonary physician in critical care 1: Pulmonary investigations for acute respiratory failure

Cited by 12 publications

References 90 publications

The utility of surgical lung biopsy in cancer patients with acute respiratory distress syndrome

The utility of surgical lung biopsy in cancer patients with acute respiratory distress syndrome

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

Bronchoscopy in Intensive Care Unit

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