Flexible bronchoscopy is an important diagnostic (and sometimes therapeutic) tool that is underutilized in infants and children in many centers today. It is a relatively simple technique, but the unwary or inexperienced bronchoscopist can readily get into trouble, as there are many potential pitfalls. This article will review some of these pitfalls from the perspective [...]
Diagnosis: Benign intrapulmonary teratoma and ipsilateral cystic bronchiectasis Intrathoracic teratomas almost always occur in the mediastinum, and only very rarely arise within the lung. By 1978, Holt et all found 13 histologically confirmed lung teratomata in the world literature. Since then, three have been added to the English, and one to the German literature. Seven [...]
A 31-year-old black nurse was most recently admitted for assessment of recurrent hemoptysis and severe bronchiectasis. The patient had been well to age 15, when she began suffering recurrent respiratory tract infections and fevers. At ages 20 and 22 years, partial right pneumonectomies were performed for recurring hemoptysis. Chest radiographs demonstrated extensive bronchiectasis in the [...]
The lack of change in parameters of pulmonary function and arterial blood gas values during a period of 11 h of spontaneous breathing in four of our patients indicates that our patients remained stable off the ventilator and that blood gas levels obtained at midday or late during the period of spontaneous ventilation are representative [...]
In our series of eight patients with Duchenne or Duchenne-type muscular dystrophy with respiratory failure, we found, as others have, that nocturnal ventilatory assistance using noninvasive ventilators brought about a sustained reversal of hypoventilation and improvement in symptoms of chronic hypercarbia. The clinical course was stabilized in most patients who required infrequent hospitalizations despite minimal [...]
Following initiation of nocturnal ventilatory assistance, five of our eight patients required only one hospitalization for respiratory problems and one patient had no hospitalizations in more than five years. Patient 6 required repeated hospitalizations because of inability to clear secretions and patient 2 had multiple hospitalizations, several related to his severe underlying cardiomyopathy. Three patients [...]
Table 1 shows age at initiation of assisted ventilation, respiratory parameters at initiation of assisted ventilation and at times of early and extended follow-up and clinical outcome in the eight patients comprising our series. Most patients developed respiratory failure at approximately 20 years of age, as is typical for Duchenne muscular dystrophy. Delayed onset in [...]
