“Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes.”
Continue reading“Parapneumonic effusions evolve through a spectrum of three stages. The initial exudative stage (stage 1; analogous to simple parapneumonic effusion) is characterised by an increased outpouring of fluid into the pleural space mediated by capillary permeability. If left
untreated, persistent inflammation with the associated rise in fluid plasminogen activator inhibitor causes a decrease in fluid fibrinolytic concentrations. During this second stage (stage 2; fibrinopurulent stage), as the effusion becomes infected, septations and adhesions
induced by fibrin deposition divide the space into pockets or locules. With the proliferation of fibroblasts and the formation of a pleural peel, lung expansion becomes restricted and can result in a non-expandable lung. It is important to initiate all medical treatment before this
final so-called organising stage (stage 3) ensues.”
“Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), affects ~10 million people worldwide every year, representing the third most
common cardiovascular disease globally. The 30-day case fatality rate after VTE diagnosis is 10.6%, with about 30% to 50% of survivors developing long-term complications that increase
the burden of this disease.”
“Acute respiratory distress syndrome (ARDS) is an intense inflammatory process of the lungs in response to acute pulmonary and systemic insults. There are no proven effective, specific pharmacological therapies for ARDS based on the results of randomised clinical trials. Despite no conclusive results, it remains clinically and biologically plausible that corticosteroids might benefit patients with ARDS in the early phase of their disease process, a situation that has not been evaluated in most randomised controlled trials. Paradoxically,
these hormones are given to patients with septic shock and pneumonia, both causes of ARDS.”
“In ARDS patients, the change from supine to prone position generates a more even distribution of the gas–tissue ratios along the dependent–nondependent axis and a more homogeneous distribution of lung stress and strain. The change to prone position is generally accompanied by a marked improvement in arterial blood gases, which is mainly due to a better overall ventilation/perfusion matching. Improvement in oxygenation and reduction in mortality are the main reasons to implement prone position in patients with ARDS.”
“Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common clinical problem associated with significant mortality and life-long morbidity among hospitalized patients and outpatients. The diagnosis of VTE is challenging because of the non specific signs and symptoms of this disease.”
“The aim of this study was to investigate the clinical presentation and 3-month mortality associated with some forms of VTE: PE with DVT, and PE without DVT.”
Hallifax R, et al. (2022). Pneumothorax. In: Broaeddus CV. (Ed.) Murray & Nadel’s Textbook of Respiratory Medicine, 7th ed.
“Evidence from a small study in 1971 suggests that use of 100% oxygen in patients with spontaneous pneumothorax can increase the rate of absorption fourfold compared to air (on the basis of mean reduction in pneumothorax size of 4.8 and 18 cm 2 /day, respectively). The rationale is that by reducing the partial pressure of nitrogen in the inspired gas, and thus in pleural capillaries, the rate of nitrogen absorption from the pneumothorax is increased, thereby increasing the rate of resolution of the pneumothorax.” (p. 1545)
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