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1.
Rev. chil. obstet. ginecol. (En línea) ; Rev. chil. obstet. ginecol;87(5): 360-364, oct. 2022. ilus
Article in Spanish | LILACS | ID: biblio-1423740

ABSTRACT

El neumotórax espontáneo es una patología extremadamente rara durante la gestación. Se define como la presencia de aire dentro de la cavidad pleural que puede generar principalmente dolor torácico y disnea. Esta patología tiene unas bajas incidencia y prevalencia en el embarazo, pero es relevante por una alta tasa de recurrencia, con un buen pronóstico para la madre y el feto si es tempranamente diagnosticada y oportunamente manejada. Se relaciona con factores de riesgo como las maniobras de Valsalva efectuadas durante el trabajo de parto, además de con comorbilidad como el tabaquismo, y con el biotipo longilíneo, entre otros, por lo que son muy importantes una adecuada anamnesis y la evaluación de la exploración física. El obstetra debe sospecharlo ante la clínica de dolor torácico asociado a disnea en gestantes en el trabajo de parto y el parto, y tenerlo en cuenta como diagnóstico diferencial. Es de vital importancia tener un manejo multidisciplinario compuesto por ginecoobstetra, internista, neumólogo y neonatólogo, incluido el apoyo por una unidad de cuidado intensivo para evitar complicaciones materno-perinatales que se puedan asociar al neumotórax espontáneo.


Spontaneous pneumothorax is an extremely rare pathology during pregnancy. It is defined as the presence of air inside the pleural cavity that can mainly generate chest pain and dyspnea. This pathology has a low incidence and prevalence in pregnancy, but a high rate of recurrence with a good prognosis for the mother and the fetus if it is diagnosed early and managed early. It is related to risk factors such as Valsalva maneuvers performed during labor, in addition to comorbidities such as smoking, longilinear biotype, among others, so it is very important to have an adequate history and evaluation of the physical examination. The obstetrician must be attentive to chest pain symptoms associated with dyspnea in pregnant women during labor and delivery, suspect this pathology and take it into account as a differential diagnosis. It is vitally important to have a multidisciplinary management composed of the gynecologist-obstetrician, internist, pulmonologist, neonatologist, including the support of an intensive care unit to avoid maternal-perinatal complications that may be associated with spontaneous pneumothorax.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Adolescent , Pneumothorax/therapy , Pneumothorax/diagnostic imaging , Labor, Obstetric , Valsalva Maneuver , Pneumothorax/etiology , Radiography, Thoracic , Tomography, X-Ray Computed
2.
Rev. cuba. med. mil ; 50(3): e1414, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1357300

ABSTRACT

Introducción: El neumotórax espontáneo es la causa más frecuente de ingreso urgente en los servicios de cirugía torácica. Objetivo: Caracterizar a pacientes ingresados con diagnóstico de neumotórax espontáneo. Métodos: Se realizó un estudio descriptivo de 93 pacientes con diagnóstico clínico y radiológico de neumotórax espontáneo, se establecieron las variables del estudio y se utilizaron frecuencias absolutas y porcentajes. Para la asociación de las variables se empleó el estadígrafo ji cuadrado con un nivel de confiabilidad del 95 por ciento. Resultados: Predominó el neumotórax espontáneo primario (65,5 por ciento), el sexo masculino fue el más afectado (80,6 por ciento), con mayor frecuencia en el hemitórax derecho (72,2 por ciento) y el tabaquismo como antecedente (83,9 por ciento). La pleurostomía mínima fue el tratamiento definitivo en el 72 por ciento de los pacientes. La complicación más frecuente después de la pleurostomía, fue la fuga persistente de aire. El tratamiento quirúrgico con pleurodesis mecánica, ofreció un 100 por ciento de efectividad. La mortalidad quirúrgica fue nula. Conclusiones: El neumotórax espontáneo predomina en el sexo masculino en una proporción de 4,2:1, en pacientes menores de 40 años de edad. El antecedente patológico personal que más se asocia es la enfermedad pulmonar obstructiva crónica. El síntoma predominante es el dolor torácico. El neumotórax espontáneo primario fue más frecuente y el hemitórax derecho el más afectado. El tabaquismo está presente como antecedente en ambos tipos de neumotórax espontáneo. La modalidad de tratamiento más utilizada es la pleurostomía mínima(AU)


Introduction: Spontaneous pneumothorax is the most frequent cause of urgent admission to thoracic surgery services. Objective: To characterize patients admitted with a diagnosis of spontaneous pneumothorax. Methods: A descriptive study of 93 patients with a clinical and radiological diagnosis of spontaneous pneumothorax was carried out, the study variables were established and absolute frequencies and percentages were used. For the association of the variables, the chi square statistic was used with a confidence level of 95 percent. Results: Primary spontaneous pneumothorax predominated (65.5 percent), the male sex was the most affected (80.6 percent), with greater frequency in the right hemithorax (72.2 percent) and smoking as the antecedent (83.9 percent). Minimal pleurostomy was the definitive treatment in 72 percent of the patients. The most frequent complication after pleurostomy was persistent air leak. Surgical treatment with mechanical pleurodesis offered 100 percent effectiveness. There was not surgical mortality. Conclusions: Spontaneous pneumothorax predominated in males in a ratio of 4.2: 1, in patients under 40 years of age. The most associated personal pathological history was chronic obstructive pulmonary disease. The predominant symptom was chest pain. Primary spontaneous pneumothorax was more frequent and the right hemithorax the most affected. Smoking was present as a history in both types of spontaneous pneumothorax. The most widely used treatment modality was minimal pleurostomy(AU)


Subject(s)
Humans , Adolescent , Adult , Pneumothorax/diagnosis , Tobacco Use Disorder , Smoking , Clinical Diagnosis , Pleurodesis/methods , Pulmonary Disease, Chronic Obstructive , Pneumothorax/therapy , Pneumothorax/diagnostic imaging , Epidemiology, Descriptive , Thoracentesis/methods
3.
Rev. cir. (Impr.) ; 73(1): 103-106, feb. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1388776

ABSTRACT

Resumen Objetivo: Comunicar el caso de una paciente de 77 años tratada de un angiosarcoma de cuero cabelludo, que evoluciona con neumotórax bilateral, cuyo estudio histopatológico informa enfermedad metastásica. Materiales y Método: Revisión de ficha clínica electrónica, registro informático de imagenología e informes de biopsias. Seguimiento ambulatorio en policlínico de cirugía. Resultados: Se realiza manejo por videotoracoscopía bilateral, con bulectomía más pleurodesis. Discusión: El neumotórax secundario por enfermedad metastásica es poco frecuente, aproximadamente 1% a 2% de los casos. De los tumores que más frecuentemente metastizan al pulmón se encuentran los sarcomas. Conclusión: El neumotórax metastásico es poco frecuente y requiere un alto índice de sospecha. Su manejo va a depender del pronóstico y de las condiciones generales del paciente.


Aim: To report the case of a 77-year-old patient treated for angiosarcoma of the scalp, who evolves with bilateral pneumothorax, whose histopathological study reports metastatic disease. Materials and Method: Review of electronic clinical record, computerized imaging record and biopsy reports. Outpatient follow-up at the polyclinic of surgery. Results: Management was performed by bilateral videothoracoscopy, with bulectomy plus pleurodesis. Discussion: Secondary pneumothorax due to metastatic disease is rare, approximately 1 to 2% of cases. Sarcomas are among the tumors that most frequently metastasize to the lung. Conclusion: Metastatic pneumothorax is infrequent and requires a high index of suspicion. Its management will depend on the prognosis and the general conditions of the patient.


Subject(s)
Humans , Female , Aged , Pneumothorax/diagnostic imaging , Scalp/pathology , Neoplasm Metastasis/therapy , Pneumothorax/therapy , Hemangiosarcoma/complications , Lung Neoplasms/diagnostic imaging
4.
Rev. chil. anest ; 50(3): 512-519, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1525733

ABSTRACT

It has been described that patients with coronavirus disease 2019 (COVID-19) may present pneumothorax, either spontaneously, primarily due to constant cough, secondary to pneumonia caused by said disease, or iatrogenic due to mechanical ventilation that require high pressures, or traumatic due to urgent approaches, in a difficult airway such as that of these patients. The use of bedside ultrasonography has been gaining great relevance to complement clinical diagnosis, which has become a useful and reliable tool for personnel treating critically ill patients.


Se ha descrito que los pacientes con la enfermedad por coronavirus 2019 (COVID-19), pueden presentar neumotórax, ya sea de forma espontánea, primaria por la tos constante, secundaria a la neumonía causada por dicha enfermedad, o ya sea iatrogénica por la ventilación mecánica que requieren con altas presiones, o traumática por los abordajes urgentes, en una vía aérea difícil como la de estos pacientes. El uso de la ultrasonografía a la cabecera del paciente ha venido cobrando gran relevancia para complementar el diagnóstico clínico, la cual se ha convertido en una herramienta útil y fiable para el personal que atiende pacientes críticamente enfermos.


Subject(s)
Humans , Female , Aged , Pneumothorax/etiology , Pneumothorax/diagnostic imaging , Ultrasonography , COVID-19/complications , Respiration, Artificial/adverse effects
5.
Arch. argent. pediatr ; 117(4): 416-419, ago. 2019. ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1054948

ABSTRACT

El tratamiento de los lactantes con quistes pulmonares congénitos conlleva una resección quirúrgica. Las variaciones en la ubicación y el tamaño del quiste de aire en el pulmón afectado implican la selección de diferentes estrategias quirúrgicas. La presencia de quistes pulmonares congénitos gigantes que imitan un neumotórax a tensión no permitiría tomar una decisión precisa y realizar un tratamiento oportuno durante una emergencia respiratoria. Los escasos informes sobre este tipo de experiencia hacen referencia a quistes a tensión durante la niñez. En este artículo, presentamos el caso de un niño con un quiste pulmonar congénito gigante que imita neumotórax a tensión según las manifestaciones clínicas y las evaluaciones del diagnóstico por imágenes. La descompresión instantánea del neumotórax a tensión no logró aliviar la dificultad respiratoria del niño. En los niños que presentan evidencia clínica de neumotórax a tensión, se debe excluir la posibilidad de un quiste pulmonar congénito gigante.


Treats of symptomatic infants with congenital cystic lung lesions (CCLLs) need surgical resection. Variable location and size of the air cyst of involved lung mean that different surgical strategies must be selected. The presence of huge CCLLs mimicking tension pneumothorax would hamper accurate judgment and timely treatment in dealing with respiratory emergencies. Rare experience reports are coping with childhood tension cystic lung lesion. We present a case of childhood huge CCLLs which was similar to tension pneumothorax based on clinical manifestations and imaging evaluations. Implementation of instant decompression measure against tension pneumothorax failed to alleviate respiratory distress of child. We should exclude the possibility of huge lung cystic lesion in children when clinical evidence inclines to the diagnosis of tension pneumothorax.


Subject(s)
Humans , Male , Infant , Pneumothorax/diagnostic imaging , Cysts/congenital , Lung Diseases , Pneumothorax/complications , Congenital Abnormalities , Cysts/surgery
6.
Rev. inf. cient ; 98(6): 794-801, 2019. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-1049404

ABSTRACT

Se reportó un caso de paciente femenina, mestiza de 29 años de edad con antecedentes de hipotiroidismo y conización por neoplasia intraepitelial cervical grado II, que realizó tres neumotórax en un plazo de 2 años, estando en reposo y durante el segundo día del ciclo menstrual. Es ingresada en la sala de Neumología del Hospital General "Dr. Juan Bruno Zayas Alfonso", con el diagnóstico probable de neumotórax secundario a endometriosis pleural. Se le realizó videotoracoscopia y laparoscopia con toma de muestra para estudio histológico. Se estableció el diagnóstico definitivo de neumotórax catamenial, se le hizo pleurodesis química con talco, tratamiento hormonal y antiinflamatorios no esteroideos (AINES), con lo que presentó una evolución satisfactoria(AU)


A case of a 29-year-old female, mixed race patient with a history of hypothyroidism and conization due to cervical intraepithelial neoplasia grade II was reported, who performed three pneumothorax within 2 years, being at rest and during the second day of the menstrual cycle. She is admitted to the Pulmonology ward of the General Hospital Dr. Juan Bruno Zayas Alfonso, with the probable diagnosis of pneumothorax secondary to pleural endometriosis. He underwent videotoracoscopy and laparoscopy with sampling for histological study. The definitive diagnosis of catamenial pneumothorax was established, chemical pleurodesis was made with talc, hormonal treatment and nonsteroidal anti-inflammatory drugs (NSAIDs), which presented a satisfactory evolution(AU)


Foi relatado o caso de uma paciente do sexo feminino, 29 anos, de raça mista, com história de hipotireoidismo e conização por neoplasia intraepitelial cervical grau II, que realizou três pneumotórax em 2 anos, estando em repouso e durante o segundo dia do ciclo menstrual. Ela é internada na enfermaria de Pneumologia do Hospital Geral "Dr. Juan Bruno Zayas Alfonso", com provável diagnóstico de pneumotórax secundário à endometriose pleural. Foi submetido a videotoracoscopia e laparoscopia com amostragem para estudo histológico. Foi estabelecido o diagnóstico definitivo de pneumotórax catamenial, realizada pleurodese química com talco, tratamento hormonal e antiinflamatórios não esteróides (AINEs), que apresentaram evolução satisfatória(AU)


Subject(s)
Humans , Female , Adult , Pneumothorax/diagnosis , Pneumothorax/therapy , Pneumothorax/diagnostic imaging
7.
Rev. argent. radiol ; 82(4): 154-160, dic. 2018. ilus, tab
Article in Spanish | LILACS | ID: biblio-985210

ABSTRACT

Objetivo Determinar la incidencia de complicaciones con el uso de una aguja gruesa (semiautomática Trucut 18), para punción pulmonar y realizar un análisis exploratorio de las variables inherentes al paciente que probablemente puedan tener relación con el desarrollo de complicaciones. Materiales y Métodos Estudio retrospectivo de una serie de casos de pacientes sometidos a punción percutánea transtorácica (PPT) con aguja gruesa y guiada por tomografía computada (TC) para el estudio de lesiones pulmonares; se realizó un análisis univariado. Resultados Se realizaron 26 punciones, la tasa de incidencia de complicaciones fue del 38,46% en 1 año; los pacientes presentaron: neumotórax leve (n » 7), neumotórax moderado (n » 3) y hemorragia alveolar difusa (n » 1). El análisis estadístico univariado mostró una diferencia estadísticamente significativa en la edad de los pacientes que presentaron complicaciones v/s los pacientes que no presentaron complicaciones (61,18 þ/- 3,6 versus 75,1 þ/- 2,46 años, p » 0,0107). Conclusión La PPT-TC es un procedimiento con una tasa considerable de complicaciones no severas; en nuestra serie de casos, la edad fue la variable que se asoció con mayor fuerza al probable desarrollo de complicaciones.


Objective Establish the incidence of complications with the use of thick needle (Trucut 18) for pulmonary puncture and perform an exploratory analysis of the inherent variables to the patient that may be related to complication development. Materials and Methods Retrospective study of a case series of patients undergoing transthoracic percutaneous puncture (PPT) with thick needle,guided by computed tomography (CT) for the study of pulmonary lesions; a univariate and multivariate analysis was performed. Results 26 punctures were performed, the incidence rate of complications was 38.46% in 1 year: patients presented: mild pneumothorax (n » 7), moderate pneumothorax (n » 3) and diffuse alveolar hemorrhage (n » 1). The univariate statistical analysis showed a statistically significant difference in the age of the patients who presented complications v/s patients who did not present complications (61.18 þ/- 3.6 versus 75.1 þ/- 2.46 years, p » 0.0107). Conclusion PPT-CT is a procedure with a considerable rate of non-severe complications; in our case series, age was the variable that was most strongly associated with the probable development of complications.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Punctures/adverse effects , Punctures/methods , Punctures/statistics & numerical data , Radiology, Interventional/methods , Pneumothorax/diagnostic imaging , Tomography, X-Ray Computed , Retrospective Studies , Risk Factors
10.
Neumol. pediátr. (En línea) ; 12(3): 133-135, jul. 2017. ilus
Article in Spanish | LILACS | ID: biblio-999134

ABSTRACT

Pneumothorax is defined as the presence of air within the pleural cavity. It may be traumatic, iatrogenic, spontaneous secondary or primary. In the latter cause, the most frequent are subpleural and apical bulla in longiline patients, with connective tissue diseases and smokers. Treatment should be conservative in patients who present a small pneumothorax. Instead, a probe should be installed if it is greater. In the presence of frequent recurrences or persistent air leakage, pleurodesis should be considered, or resection of the bullous should be practiced. In this article we review a patient with Elhers Danlos syndrome, who presents a primary spontaneous pneumothorax due to subpleural bulla


El neumotórax se define como la presencia de aire dentro de la cavidad pleural. Puede ser traumático, iatrogénico, espontáneo secundario o primario, dentro de esta última causa la más frecuente son las bulas subpleurales y apicales, en pacientes longilíneos, portadores de enfermedades del tejido conectivo y fumadores. En neumotórax pequeños el tratamiento debe ser conservador, en cambio en los de mayor cuantía se debe proceder a la instalación de una sonda pleural. Frente a recidivas frecuentes o persistencia del escape aéreo, se debe considerar la pleurodesis o bien practicar la resección de las bulas.En el presente artículo se reporta a un paciente con síndrome de Elhers Danlos que presenta un neumotórax espontáneo primario debido a bulas subpleurales.


Subject(s)
Humans , Male , Pneumothorax/etiology , Pneumothorax/diagnostic imaging , Blister/complications , Pneumothorax/therapy , Radiography, Thoracic , Tomography, X-Ray Computed
12.
Einstein (Säo Paulo) ; 14(3): 443-448, July-Sept. 2016. graf
Article in English | LILACS | ID: lil-796958

ABSTRACT

ABSTRACT Ultrasound examination of the chest has advanced in recent decades. This imaging modality is currently used to diagnose several pathological conditions and provides qualitative and quantitative information. Acoustic barriers represented by the aerated lungs and the bony framework of the chest generate well-described sonographic artifacts that can be used as diagnostic aids. The normal pleural line and A, B, C, E and Z lines (also known as false B lines) are artifacts with specific characteristics. Lung consolidation and pneumothorax sonographic patterns are also well established. Some scanning protocols have been used in patient management. The Blue, FALLS and C.A.U.S.E. protocols are examples of algorithms using artifact combinations to achieve accurate diagnoses. Combined chest ultrasonography and radiography are often sufficient to diagnose and manage lung and chest wall conditions. Chest ultrasonography is a highly valuable diagnostic tool for radiologists, emergency and intensive care physicians.


RESUMO O exame ultrassonográfico do tórax avançou nas últimas décadas, sendo utilizado para o diagnóstico de inúmeras condições patológicas, e fornecendo informações qualitativas e quantitativas. Os pulmões aerados e o arcabouço ósseo do tórax representam barreira sonora para o estudo ultrassonográfico, gerando artefatos que, bem conhecidos, são utilizados como ferramentas diagnósticas. Eco pleural normal, linhas A, linhas B, linhas C, linhas E e Z (conhecidas como falsas linhas B) são artefatos com características peculiares. Os padrões de consolidação e de pneumotórax também são bem estabelecidos. Alguns protocolos têm sido utilizados no manuseio dos pacientes: Blue Protocol, Protocolo FALLS e Protocolo C.A.U.S.E são exemplos de três propostas que, por meio da associação entre os artefatos, permitem sugerir diagnósticos precisos. A ultrassonografia de tórax, aliada à radiografia de tórax, muitas vezes é suficiente para o diagnóstico e a conduta das afecções pulmonares e da parede torácica. Trata-se de ferramenta diagnóstica de grande valia para médicos radiologistas, emergencistas e intensivistas.


Subject(s)
Humans , Thorax/diagnostic imaging , Ultrasonography/trends , Lung/diagnostic imaging , Pleura/diagnostic imaging , Pneumothorax/diagnostic imaging , Ultrasonography/standards , Artifacts , Practice Guidelines as Topic/standards , Emphysema/diagnostic imaging
13.
Rev. méd. Chile ; 144(7): 903-909, jul. 2016. ilus, tab
Article in Spanish | LILACS | ID: lil-794004

ABSTRACT

The use of thoracic ultrasound as a diagnostic tool in the emergency department, intensive care unit or in patients with pulmonary diseases is increasing steadily. It is used to guide percutaneous tracheostomies, to assess pleural effusions, to rule out pneumothorax, and to guide the placement of endovascular and pleural catheters. It is also useful in the assessment of patients with dyspnea. The aim of this review is to provide the practical and technical basics for the use of this diagnostic tool among internists and specialists in pulmonary diseases.


Subject(s)
Humans , Pleural Effusion/diagnostic imaging , Pneumothorax/diagnostic imaging , Pulmonary Edema/diagnostic imaging , Ultrasonography/methods , Thoracostomy/methods , Tracheostomy/methods , Acute Disease
14.
J. bras. pneumol ; J. bras. pneumol;42(3): 222-226, graf
Article in English | LILACS | ID: lil-787493

ABSTRACT

ABSTRACT With the advent of HRCT, primary spontaneous pneumothorax has come to be better understood and managed, because its etiology can now be identified in most cases. Primary spontaneous pneumothorax is mainly caused by the rupture of a small subpleural emphysematous vesicle (designated a bleb) or of a subpleural paraseptal emphysematous lesion (designated a bulla). The aim of this pictorial essay was to improve the understanding of primary spontaneous pneumothorax and to propose a description of the major anatomical lesions found during surgery.


RESUMO Com o advento da TCAR, o pneumotórax espontâneo primário passou a ser mais bem entendido e conduzido, pois sua etiologia pode ser atualmente identificada na maioria dos casos. O pneumotórax espontâneo primário tem como principal causa a rotura de uma pequena vesícula enfisematosa subpleural, denominada bleb ou de uma lesão enfisematosa parasseptal subpleural, denominada bulla. O objetivo deste ensaio pictórico foi melhorar o entendimento do pneumotórax espontâneo primário e propor uma descrição das principais lesões anatômicas encontradas durante a cirurgia.


Subject(s)
Humans , Pneumothorax/etiology , Pulmonary Emphysema/etiology , Blister/diagnostic imaging , Lung/diagnostic imaging , Lung/surgery , Medical Illustration , Pneumothorax/diagnostic imaging , Pneumothorax/surgery , Pulmonary Emphysema/diagnostic imaging , Pulmonary Emphysema/surgery , Thoracic Surgery, Video-Assisted
17.
Pulmäo RJ ; 25(1): 5-10, 2016. il.
Article in Portuguese | LILACS | ID: biblio-848783

ABSTRACT

A Ultrassonografia tem grande valor na avaliação das doenças da pleura. Trata-se de um método não invasivo e isento de riscos que permite a realização de exame em tempo real e à beira do leito. Ela é útil na análise dos derrames pleurais, inclusive podendo ser utilizada como guia para procedimentos invasivos. Na suspeita de pneumotórax a US também tem grande utilidade assim como na análise das alterações sólidas das superfícies pleurais e das estruturas adjacentes. AU


The ultrasound has great value in the evaluation of diseases of the pleura. This is a non-invasive and risk--free method that allows the realization of examination in real time and at the bedside. It is useful in the analysis of pleural effusions, even can be used as a guide to invasive procedures. In suspected cases of pneumothorax US also has great utility as well as the analysis of the solid changes in pleural surfaces and adjacent structures AU


Subject(s)
Humans , Male , Female , Pleural Effusion/diagnostic imaging , Pneumothorax/diagnostic imaging , Ultrasonography
18.
Rev. chil. enferm. respir ; Rev. chil. enferm. respir;30(3): 156-165, set. 2014. ilus, tab
Article in Spanish | LILACS | ID: lil-728324

ABSTRACT

The use of Platelet-rich plasma (PRP) involves a very complex network of molecular effects favoring tissue regeneration, due the presence of multiple mediators and growth factors. There are several communications about its use on the dental implantology field, plastic surgery and orthpedics. Besides, its utility has been suggested on peripheral nerves regeneration after trauma. In this article we present our experience on the use of PRP on acute injury of the respiratory system. We present a clinical series of 8 patients treated with PRP with positive response. Four of them presenting a massive hemoptysis were treated by direct endoscopic instillation of autologous PRP on the site of lesion; an immediate favorable result was obtained in all of them, without recurrence of bleeding on the follow-up period. A fifth case was a HIV seropositive patient with a spontaneous pneumothorax on intersticial pneumonia. He was treated by direct instillation of PRP through a thoracic tube. Full lung reexpansion was achieved within 72 h. Finally two patients with a respiratory fistula and another patient who suffered a traumatic tracheal rupture were treated with PRP endoscopic instillation, all of them with favorable clinical outcome. The use of autologous products as PRP has shown a good performance in all the clinical situations described, proposing it as a potentially very useful technique, particularly when a minimally invasive approach is required.


El uso de plasma rico en plaquetas (PRP) involucra una compleja red de efectos moleculares que favorecerían la regeneración tisular, dada la presencia en él de múltiples mediadores y factores de crecimiento. Se ha comunicado su uso con éxito en implantología odontológica, cirugía plástica y ortopedia como también se ha sugerido su utilidad en la regeneración de nervios periféricos posterior a trauma. No existe difusión acerca de su uso en patología respiratoria. Comunicamos nuestra experiencia en el uso de PRP en daño agudo del aparato respiratorio. En esta serie de casos, se trataron 4 pacientes con hemoptisis masiva mediante preparación de PRP autólogo previo al procedimiento e instilación vía endoscópica en el sitio del defecto, con buen resultado inmediato y sin recidiva del sangrado al seguimiento; 1 caso de neumotórax espontáneo con infiltrados pulmonares con fracaso del manejo con sonda endopleural (SEP), que resultó ser una neumonía intersticial con quistes pulmonares en un paciente VIH sero-positivo, instilándose PRP por SEP, reexpandiendo el pulmón a las 72 h; 2 pacientes portadores de fístula respiratoria y 1 paciente portador de ruptura traqueal traumática, todos con buena respuesta. El uso de productos autólogos como PRP ha logrado un favorable rendimiento en todas las situaciones clínicas planteadas, lo que lo sitúa como una herramienta con notable potencial de desarrollo particularmente en casos que por sus características particulares requieren de un manejo mínimamente invasivo.


Subject(s)
Humans , Male , Female , Adolescent , Middle Aged , Aged , Tissue Engineering , Platelet-Rich Plasma , Pneumothorax/diagnostic imaging , Regeneration/genetics , Bronchoscopy/methods , Bronchial Fistula , Tracheoesophageal Fistula , Intercellular Signaling Peptides and Proteins , Hemoptysis/pathology
20.
Article in English | IMSEAR | ID: sea-154399

ABSTRACT

Emerging evidence suggests that ultrasonography of lung is a fast, inexpensive, widely available bed-side diagnostic tool which is useful for quick and early diagnosis of respiratory diseases. It is useful in the differential diagnosis of pulmonary infiltrates and has good accuracy in identifying consolidation and alveolar-interstitial syndrome. This technique can also be useful in the immediate evaluation of patients with dyspnoea or acute respiratory failure in the respiratory intensive care unit and helps in monitoring treatment response. Ultrasonography of lung has also been found to be useful in the diagnosis of pulmonary embolism, traumatic lung contusion and lung consolidation as well. There is a need for developing specific guidelines for establishing the standards of training and education regarding lung ultrasonography in India.


Subject(s)
Early Diagnosis , Humans , India , Lung Diseases/diagnosis , Lung Diseases/diagnostic imaging , Pneumothorax/diagnostic imaging , Predictive Value of Tests , Pulmonary Atelectasis/diagnostic imaging , Respiratory Care Units , SENSITIVITY &
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