A 36-year-old female patient with aplastic anemia developed massive hemoptysis and was placed on ventilator support. However, airway obstruction by blood clots triggered desaturation and ventilator malfunction. Manual ventilation was initiated to improve oxygenation, and emergency flexible bronchoscopy was performed to clear the airway. Nevertheless, the patient developed extensive subcutaneous emphysema, pneumothorax, and pneumomediastinum.
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Clinical Approach to Massive Hemoptysis: Perioperative Focus on Causes and Management Timothy Weiquan Toh, Jacqueline Hui Fen Goh, Sui An Lie, Carrie Kah Lai Leong, Nian Chih Hwang Journal of Cardiothoracic and Vascular Anesthesia.2024;[Epub] CrossRef
Experimental validation of a portable tidal volume indicator for bag valve mask ventilation Benjamin S. Maxey, Luke A. White, Giovanni F. Solitro, Steven A. Conrad, J. Steven Alexander BMC Biomedical Engineering.2022;[Epub] CrossRef
Amniotic fluid embolism (AFE) is a rare but potentially fatal complication that occurs acutely during pregnancy or within 12 h of delivery. The management of AFE focuses initially on supportive measures for cardiopulmonary stabilization. Extracorporeal membrane oxygenation should be considered in patients who are unresponsive to medical treatment in order to prevent additional hypoxia and subsequent organ failure. We present a 41-year-old woman with clinical AFE who developed acute respiratory distress syndrome and was treated successfully with extracorporeal membrane oxygenation.
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Amniotic fluid embolism rescued using venoarterial extracorporeal membrane oxygenation without initial anticoagulation: A case report and literature review Hiroshi Araki, Motohiro Sekino, Yuri Hasegawa, Masaya Kurobe, Tetsufumi Motokawa, Akihiko Tanigawa, Takashi Egashira, Naoya Iwasaki, Miki Suzumura, Rintaro Yano, Sojiro Matsumoto, Taiga Ichinomiya, Ushio Higashijima, Naohiro Kanayama, Kiyonori Miura, Tets Medicine.2024; 103(20): e38176. CrossRef
Venous Air Embolism Not Amniotic Fluid Embolism Charles Her Korean Journal of Critical Care Medicine.2016; 31(1): 68. CrossRef
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Colonization of the pre-transplant lung by multidrug-resistant bacteria affects short- and long-term outcomes of lung transplantation. However, there are no case reports on the colonization of a pre-transplant lung by drug-resistant Acinetobacter baumannii. We report a case of extensively drug resistant (XDR) A. baumannii colonization in the tracheobronchial tree that caused severe infectious complications after bilateral lung transplantation. A 23-year-old man diagnosed with bronchiolitis obliterans syndrome (BOS) 4 years earlier with a history of allogenic bone marrow transplantation for acute lymphoblastic leukemia was admitted to the hospital with dyspnea. Due to progressive hypercapnic respiratory failure, long-term mechanical ventilation was started after a tracheostomy was performed, and the patient underwent a bilateral lung transplantation to treat end-stage BOS. After the transplantation, the colonization of XDR A. baumannii caused severe bacterial pneumonia in the early postoperative period. Combined treatment with colistin and meropenem led to recovery from the pneumonia but caused drug-induced renal failure. Because many centers are willing to transplant candidates who are on mechanical ventilation or extracorporeal life support, the incidence of XDR A.
baumannii colonization of pretransplant lungs is expected to increase. Further studies are needed to examine pre-transplant management strategies in patients colonized with XDR A. baumannii.