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Respiratory
Published in Faye Hill, Sash Noor, Neel Sharma, Tiago Villanueva, Medical and Surgical Emergencies for Students and Junior Doctors, 2021
Faye Hill, Sash Noor, Neel Sharma
Management for a primary spontaneous pneumothorax depends on clinical assessment. For those with a small primary spontaneous pneumothorax without significant shortness of breath, observation is recommended. Those who are symptomatic with a pneumothorax ³2 cm should undergo needle aspiration with a 16–18 G cannula. If unsuccessful, a chest drain should be inserted, typically size 8–14 Fr.
Inhalation Toxicity of Metal Particles and Vapors
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Shaver's disease is the only aluminum-induced industrial disease. It may be the result of bauxite (the principal ore of aluminum) fume and the use of abrasive wheels containing aluminum. Exposure to the fume may produce weakness, fatigue, and chest x-rays may reveal extensive fibrosis with large blebs. Spontaneous pneumothorax is a frequent complication. Silicon may also play a contributing role in the disease because it is frequently inhaled along with aluminum in workers exposed to bentonite (an aluminosilicate clay). Fibrosis has also been noted after aluminum dust inhalation, but the mean exposure level recorded was 95 mg/m3 respirable dust.
Birt–Hogg–Dubé Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Marianne Geilswijk, Mette Sommerlund, Mia Gebauer Madsen, Anne-Bine Skytte, Elisabeth Bendstrup
There are limited data on the risk of pneumothorax during air travel or scuba diving. Patients have complained of chest pressure (52%), anxiety (9%–50%), headache (3%–31%), shortness of breath (4%–28%), chest pain (6%–28%), nausea (4%–20%), fatigue (3%–7%), oxygen desaturation by handheld pulse oximetry (4%), palpitations (2.8%), peripheral cyanosis (2%), abnormal chills (1.4%), and dizziness (0.7%) during air travel. Symptoms were similar between patients with and without a previous spontaneous pneumothorax. The flight-related pneumothorax risk has been calculated to range between 0.12%–0.63% per flight during or within 1 month after air travel. Patients with a prior pleurodesis are less likely to develop a flight-related pneumothorax [44,99]. Patients may develop a pneumothorax up to 1 month after air travel, and accordingly, they should be informed to consult a physician if they experience any symptoms such as dyspnea or chest pain during or shortly after a flight. If experiencing such symptoms before air travel, they should be advised to seek medical consultancy and to have a clinical checkup before flying [44,99]. There are no firm guidelines on the interval from a spontaneous pneumothorax to air travel. Recommendations vary from no time to 3 weeks after radiographic remission.
Clinical characterisation and management outcome of obstetric patients following intensive care unit admission for COVID-19 pneumonia
Published in Journal of Obstetrics and Gynaecology, 2023
Esra Aktiz Bıçak, Süleyman Cemil Oğlak
The CT reports of patients interpreted by the radiology unit revealed that 17 (54.8%) had mild pulmonary involvement, 6 (19.4%) had moderate pulmonary involvement and 8 (25.8%) had severe pulmonary involvement (Figures 2, 3). Sixteen (51.6%) patients required HFOT, 6 (19.3%) patients required CPAP, and 5 (16.1%) patients required invasive mechanical ventilation. One intubated patient was extubated, and the others resulted in mortality. Six patients were transferred to the tertiary ICU due to the need for advanced follow-up and treatment. Sepsis complicated by septic shock and multiorgan failure occurred in 4 of those. Renal replacement therapy was performed on two of the patients with acute renal failure. Spontaneous pneumothorax developed in one patient and a left chest tube was inserted. Vasopressor therapy was performed in 3 patients with developed septic shock. The mean length of stay in the ICU and hospital was 4.9 ± 4.3 (1–18) days and 10.4 ± 5.1 (3–21) days, respectively (Table 2).
A teenaged patient with spontaneous pneumopericardium after hookah smoking
Published in Clinical Toxicology, 2022
To our knowledge, the present case appears to be the first documented of SPP associated with smoking a hookah, which was the only causal factor identified with his condition. There are a few case reports of spontaneous pneumothorax and spontaneous pneumomediastinum associated with hookah smoking [1]. We know of no data reporting the incidence of barotrauma after hookah use either in adult or pediatric patients. The pathogenesis of SPP is likely related to the technique associated with hookah smoking; characterized as deep and prolonged inspiration, followed by forced exhalation. Increased alveolar pressure significantly above normal peak inspiratory pressures can induce alveolar rupture, leading to air leakage into the broncho-vascular sheath, and tracking along broncho-vascular bundles; this can dissect/deposit in the subcutaneous tissues. Air deposit can occur in the thorax, neck, pericardium, retroperitoneum; or even the epidural space via the posterior mediastinum and intervertebral foramen [2]. Various precipitating factors associated with airway rupture involve voluntary and involuntary alterations in breathing patterns, such as bronchial asthma, cannabis smoking, cocaine inhalation, and barotrauma occurring with a Valsalva maneuver [3,4].
Invasive pulmonary aspergillosis in an immunocompetent, heavy smoker of marijuana with emphysema and chronic obstructive pulmonary disease
Published in Canadian Journal of Respiratory, Critical Care, and Sleep Medicine, 2021
Vincenzo Zagà, Mohamed Abdelrazek, Sarah Shalhoub, Marco Mura
Although 10 cases of invasive pulmonary aspergillosis related to marijuana inhalation have been described in immunocompromised subjects,10–17 including cases in subjects with poorly controlled diabetes,16,17 this is the first report of invasive pulmonary aspergillosis in an immunocompetent patient exposed to large quantities of inhaled marijuana, although with underlying emphysema and COPD, but not on any maintenance oral corticosteroids. The patient also experienced another known complication of excessive marijuana smoking, which is spontaneous pneumothorax,18 although his preexisting emphysema would also predispose to this complication. Not surprisingly, reported cases were associated with exposure to moldy, street-purchased marijuana.15,16 It is important to note that, although both tobacco and marijuana are often contaminated by heavy burden fungi, marijuana joints, unlike cigarettes, are usually smoked without any filter.15