1/7. acute lung injury as a possible adverse drug reaction related to gefitinib.Gefitinib is a potent drug used in the treatment of nonsmall-cell lung cancer (NSCLC). Gefitinib acts by inhibition of the epidermal growth factor receptor tyrosine kinase. Clinical trials have confirmed the efficacy of gefitinib for NSCLC. Adverse drug reactions, although frequent, are mild, and include acne-like skin rash and diarrhoea. The present study describes the case of a 56-yr-old male with NSCLC who, 4 weeks after treatment with gefitinib, suffered from a severe alveolar haemorrhage diagnosed by bronchoalveolar lavage. This is the first case report of an acute life-threatening lung injury in a patient with nonsmall-cell lung cancer who had been given gefitinib.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/7. Recombinant activated factor vii for exsanguinating haemorrhage post bilateral lung transplantation for extra-corporeal lung support-dependent respiratory failure.Following three weeks of extracorporeal lung support for acute respiratory distress syndrome, a 15-year-old male underwent bilateral lung transplantation. This procedure was complicated by massive postoperative haemorrhage. The administration of recombinant activated factor vii was associated with improved haemostasis. However, development of cardiac tamponade soon after injection required emergency exploration and evacuation of a large mediastinal clot.- - - - - - - - - - ranking = 5keywords = haemorrhage (Clic here for more details about this article) |
3/7. Tamponade as a rare complication of CPAP use following cardiac surgery.A 64-year-old woman developed tamponade more than 48 hours following cardiac surgery. The cause for this was haemorrhage from the site of multiple attempted cannulations of the right internal jugular vein. However this was a secondary haemorrhage and appeared to be precipitated by the use of CPAP on the second postoperative day. CPAP should be used with caution following difficult neckline insertions.- - - - - - - - - - ranking = 2keywords = haemorrhage (Clic here for more details about this article) |
4/7. Extending the limits of extracorporeal membrane oxygenation: lung rest for a child with non-specific interstitial pneumonia.OBJECTIVE: Veno-venous extracorporeal membrane oxygenation (ECMO) is an established therapy for the treatment of respiratory failure. Traditionally ECMO has been used to support patients with an acute, reversible disease process, with a predictable outcome. We report the successful use of veno-venous ECMO for an unusual indication. PATIENT: A 10-year old girl was admitted to intensive care with severe, hypoxic respiratory failure on the background of a 2-month history of worsening respiratory symptoms. She required high levels of conventional positive pressure ventilation, and high frequency oscillation. Lung biopsy confirmed a non-specific interstitial pneumonia, and the patient was commenced on immune suppressive therapy. Her clinical course was further complicated by pulmonary haemorrhage and severe air leak. INTERVENTIONS: On day 20 after admission the patient was placed on veno-venous ECMO for lung rest while awaiting a response to continued medical treatment. She required ECMO for 20 days, during which time sedation was reduced, and she was able to interact with those around her. The patient's ventilatory requirements after decannulation were minimal, and she subsequently made a steady clinical recovery. CONCLUSIONS: ECMO was safely and successfully used to provide a period of lung rest and time for medical therapy to take effect in a child with an unusual indication for support: a rare disease with an uncertain outcome on the background of prolonged mechanical ventilation.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
5/7. Acute respiratory failure from tracheopathia osteoplastica.Tracheopathia osteoplastica is a benign cartilaginous and osseous metaplasia of the laryngo-tracheobronchial tree diagnosed more commonly in adults over 50 years of age. We report here the case of a 54-year-old man who underwent thyroidectomy for multinodular goiter. Immediately after an uneventful surgery, he developed an acute respiratory failure with radiologic picture of adult Respiratory Distress syndrome. Mechanical ventilation was set up again, bronchoscopy with biopsy disclosed a massive tracheobronchial haemorrhage from a tracheopathia osteoplastica. Supportive treatment was successfully provided and the patient resumed to a normal life 14 days after the operation.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
6/7. Fatal pancytopenia in falciparum malaria.Various pernicious syndromes in plasmodium falciparum infection are being reported with increasing frequency from tropical countries. A rare case of fatal pancytopenia associated with falciparum malaria is described. The patient developed fulminant aspiration bronchopneumonia which was unresponsive to antibiotic therapy and contributed to the development of adult respiratory distress syndrome. He also had severe uncontrolled gastrointestinal bleeding and possibly an intracerebral haemorrhage. Anaemia and thrombocytopenia are well known in malaria but severe leucopenia is very rare and pancytopenia has not been reported.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
7/7. Early, fatal disseminated intravascular coagulation in a patient with 60 per cent burns.A 23-year-old, previously fit and healthy young man was admitted to the West Midlands Regional burns Unit at the Birmingham Accident Hospital, with 60 per cent body surface area burns and smoke inhalation. On arrival, he was briskly tachycardiac, hypotensive and disorientated. He was admitted to the intensive care unit, intubated and started on intermittent positive pressure ventilation. Despite prompt commencement of resuscitation and the infusion of enormous volumes of colloids, the patient remained oliguric. He soon developed severe haemorrhage from his gastrointestinal, urinary and respiratory tracts. He required several units of blood, but was persistently hypotensive. His condition deteriorated rapidly despite intensive supportive measures. He developed metabolic acidosis, refractory hypotension and died anuric, 20 h later. The post-mortem examination showed the presence of disseminated intravascular coagulation and adult respiratory distress syndrome.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |