Language:

Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema

Lung, 2017-08, Vol.195 (4), p.477-487 [Peer Reviewed Journal]

Springer Science+Business Media New York 2017 ;COPYRIGHT 2017 Springer ;Lung is a copyright of Springer, 2017. ;ISSN: 0341-2040 ;EISSN: 1432-1750 ;DOI: 10.1007/s00408-017-0011-8 ;PMID: 28455784

Full text available

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema
Author: Contou, Damien ; Voiriot, Guillaume ; Djibré, Michel ; Labbé, Vincent ; Fartoukh, Muriel ; Parrot, Antoine
Subjects: Adolescent ; Adult ; Alveoli ; Anemia ; Anesthesia ; Anesthesia, General - adverse effects ; Anesthesia, General - mortality ; Bronchoscopy ; Bronchus ; Causes of ; Complications and side effects ; Computed tomography ; Diagnosis ; Diagnosis, Differential ; Disease management ; Early Diagnosis ; Edema ; Epilepsy ; Epilepsy, Generalized - complications ; Epilepsy, Generalized - diagnosis ; Epilepsy, Generalized - mortality ; Epilepsy, Tonic-Clonic - complications ; Epilepsy, Tonic-Clonic - diagnosis ; Epilepsy, Tonic-Clonic - mortality ; Female ; Hemoptysis ; Hemoptysis - etiology ; Hemorrhage ; Hemorrhage - diagnosis ; Hemorrhage - etiology ; Hemorrhage - mortality ; Hemorrhage - therapy ; Humans ; Intensive Care Units ; Length of Stay ; Lung diseases ; Male ; Medical diagnosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Patients ; Pneumology/Respiratory System ; Predictive Value of Tests ; Pressure ; Pulmonary edema ; Pulmonary Edema - diagnosis ; Pulmonary Edema - etiology ; Pulmonary Edema - mortality ; Pulmonary Edema - therapy ; Retrospective Studies ; Risk Factors ; Seizures ; Time Factors ; Tomography, X-Ray Computed ; Treatment Outcome ; Young Adult
Is Part Of: Lung, 2017-08, Vol.195 (4), p.477-487
Description: Purpose Diffuse alveolar hemorrhage (DAH) with negative-pressure pulmonary edema (NPPE) is an uncommon yet life-threatening condition. We aimed at describing the circumstances, clinical, radiological, and bronchoscopic features, as well as the outcome of patients with NPPE-related DAH. Methods We performed a retrospective, observational cohort study, using data prospectively collected over 35 years in an intensive care unit (ICU). Results Of the 149 patients admitted for DAH, we identified 18 NPPE episodes in 15 patients, one admitted four times for recurrent NPPE-related DAH. The patients were primarily young, male, and athletic. The NPPE setting was postoperative ( n = 12/18, 67%) or following generalized tonic–clonic seizures ( n = 6/18, 33%). Hemoptysis was almost constant ( n = 17/18, 94%), yet rarely massive (>200 cc, n = 1/18, 6%), with anemia observed in 10 (56%) episodes. The DAH triad (hemoptysis, anemia, and pulmonary infiltrates) was observed in 50% of episodes ( n = 9/18), and acute respiratory failure in 94% ( n = 17/18). Chest computed tomography revealed diffuse bilateral ground glass opacities ( n = 10/10, 100%), while bronchoscopy detected bilateral hemorrhage ( n = 12/12, 100%) and macroscopically bloody bronchoalveolar lavage, with siderophage absence in most ( n = 7/8, 88%), indicating acute DAH. While one episode proved fatal, the other 17 recovered rapidly, with a mean ICU stay lasting 4.6 (2–15) days. Typically, the evolution was rapidly favorable under supportive care. Conclusion NPPE-related DAH is a rare life-threatening condition occurring primarily after tonic–clonic generalized seizure or generalized anesthesia. Clinical circumstances are a key to its diagnosis. Early diagnosis and recognition likely allow for successful management of this potentially serious complication, whereas ictal-DAH appears ominous in epileptic patients.
Publisher: New York: Springer US
Language: English
Identifier: ISSN: 0341-2040
EISSN: 1432-1750
DOI: 10.1007/s00408-017-0011-8
PMID: 28455784
Source: MEDLINE
ProQuest Central

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Clinical Features of Patients with Diffuse Alveolar Hemorrhage due to Negative-Pressure Pulmonary Edema

Springer Science+Business Media New York 2017 ;COPYRIGHT 2017 Springer ;Lung is a copyright of Springer, 2017. ;ISSN: 0341-2040 ;EISSN: 1432-1750 ;DOI: 10.1007/s00408-017-0011-8 ;PMID: 28455784

Searching Remote Databases, Please Wait