RESUMEN
Although COVID-19 coagulopathy typically manifests with thrombotic complications, hemorrhagic complications also occur and must be considered when making decisions about anticoagulation in these patients. Here, we report a case of massive hemoptysis occurring in a recently post-partum woman via Cesarean section with COVID-19 who was managed via bronchial artery embolization while on extracorporeal membrane oxygenation.
Asunto(s)
COVID-19 , Embolización Terapéutica , Oxigenación por Membrana Extracorpórea , Arterias Bronquiales/diagnóstico por imagen , Cesárea/efectos adversos , Embolización Terapéutica/efectos adversos , Oxigenación por Membrana Extracorpórea/efectos adversos , Femenino , Hemoptisis/diagnóstico por imagen , Hemoptisis/etiología , Hemoptisis/terapia , Humanos , Periodo Posparto , Embarazo , SARS-CoV-2RESUMEN
The coronavirus disease 2019 (COVID-19) is characterized by respiratory infection which can show very different clinical pictures, somewhat changing medical paradigm. Hemoptysis defined as idiopathic can be seen as much as 15%. Currently, increasing hemoptysis cases are being reported in medical coronavirus literature. We here present a hemoptysis case that would be defined as idiopathic before the COVID-19 era. After the first clinical picture, the case turned into a life-threatening hemoptysis. We studied the case comprehensively as clinical, pathogenetical, therapeutic and clinical practical aspects. Thus, we hypothesized that especially in the pandemic era, all hemoptysis cases must be evaluated as a possible life threatening infectious disease with unpredictable prognosis.
Asunto(s)
COVID-19 , Embolización Terapéutica , Arterias Bronquiales , Hemoptisis/diagnóstico , Hemoptisis/etiología , Hemoptisis/terapia , Humanos , SARS-CoV-2Asunto(s)
Arterias Bronquiales , COVID-19 , Angiografía , Arterias Bronquiales/diagnóstico por imagen , Hemoptisis , Humanos , SARS-CoV-2Asunto(s)
Arterias Bronquiales/patología , COVID-19/sangre , Pulmón/irrigación sanguínea , Neumonía Viral/sangre , Circulación Pulmonar , SARS-CoV-2 , Remodelación Vascular , Anciano , Anastomosis Arteriovenosa/patología , Humanos , Masculino , Microscopía de Contraste de Fase , Persona de Mediana Edad , Tomografía Computarizada por Rayos XAsunto(s)
Aneurisma Falso , COVID-19/complicaciones , Embolización Terapéutica , Subtipo H1N1 del Virus de la Influenza A , Aneurisma Falso/diagnóstico por imagen , Aneurisma Falso/terapia , Arterias Bronquiales/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , SARS-CoV-2 , Síndrome Post Agudo de COVID-19RESUMEN
We present to you a case of life-threatening haemoptysis secondary to non-cystic fibrosis bronchiectasis complicated by bronchial artery pseudoaneurysms. We discuss this patient's emergency medical management using intravenous tranexamic acid, which resulted in successful resuscitation and eventual survival, and evaluate the need for urgent anaesthetic and interventional radiology input in such a case.
Asunto(s)
Bronquiectasia , Embolización Terapéutica , Arterias Bronquiales/diagnóstico por imagen , Hemoptisis/etiología , Hemoptisis/terapia , Humanos , Resultado del TratamientoAsunto(s)
Arterias Bronquiales/diagnóstico por imagen , COVID-19/diagnóstico por imagen , COVID-19/terapia , Angiografía por Tomografía Computarizada , Embolización Terapéutica/métodos , Neumonía Viral/diagnóstico por imagen , Neumonía Viral/terapia , Anciano , Anciano de 80 o más Años , Prueba de COVID-19 , Medios de Contraste , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Estudios Retrospectivos , SARS-CoV-2Asunto(s)
Aneurisma Falso/diagnóstico , Arterias Bronquiales/patología , Hemoptisis/diagnóstico , Aneurisma Falso/terapia , Angiografía por Tomografía Computarizada/métodos , Tomografía Computarizada de Haz Cónico/métodos , Medios de Contraste/administración & dosificación , Tos/diagnóstico , Tos/etiología , Embolización Terapéutica/métodos , Servicio de Urgencia en Hospital , Procedimientos Endovasculares/instrumentación , Hemoptisis/etiología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoAsunto(s)
Arterias Bronquiales/diagnóstico por imagen , Arterias Bronquiales/fisiopatología , COVID-19/complicaciones , Embolización Terapéutica/métodos , Hemoptisis/etiología , Hemoptisis/terapia , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Angiografía de Substracción Digital , COVID-19/fisiopatología , Femenino , Hemoptisis/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto JovenRESUMEN
More than 1,200 active or recruiting clinical trials for novel coronavirus disease 2019 (COVID-19) treatments and vaccines are registered. Many drugs have shown promise for treatment of COVID-19. Nevertheless, up to date, no drugs have been confirmed as a definitive treatment for COVID-19. Trials such as the SOLIDARITY and RECOVERY are ongoing, and first results were announced in favour of therapy with dexamethasone with a significant trend showing greatest benefit among those patients requiring ventilation. The drawbacks of these trials include exposing the patients to drugs with well-documented systemic adverse effects or unknown complications of novel therapies without proof of clinical benefit. We present here the hypothesis that bronchial artery infusion could be an alternative for systemic drug infusion in COVID-19 trials with superadded benefits of high drug concentration and low systemic adverse effects. The concept of this idea has many uncertainties and no current clinical data to support. Perhaps, the technique should be first applied in animal models to determine its safety and calculate the effective dose of the drugs. Guidelines and reviews of pharmacotherapy for COVID-19 should be implemented for this fiction to come true.