Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophi...Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.展开更多
Independent lung ventilation,though infrequently used in the critical care setting,has been reported as a rescue strategy for patients in respiratory failure resulting from severe unilateral lung pathology.This involv...Independent lung ventilation,though infrequently used in the critical care setting,has been reported as a rescue strategy for patients in respiratory failure resulting from severe unilateral lung pathology.This involves isolating and ventilating the right and left lung differently,using separate ventilators.Here,we describe our experience with independent lung ventilation in a patient with unilateral diffuse alveolar hemorrhage,who presented with severe hypoxemic respiratory failure despite maximal ventilatory support.Conventional ventilation in this scenario leads to preferential distribution of tidal volume to the nondiseased lung causing over distension and inadvertent volume trauma.Since each lung has a different compliance and respiratory mechanics,instituting separate ventilation strategies to each lung could potentially minimize lung injury.Based on review of literature,we provide a detailed description of indications and procedures for establishing independent lung ventilation,and also provide an algorithm for management and weaning a patient from independent lung ventilation.展开更多
目的观察低剂量丝裂霉素C(M M C)对胸部癌症患者放疗中的降低放射损伤作用。方法100例胸部癌症患者中,食管癌54例、肺癌46例,随机分为研究组和对照组各50例,研究组于常规放疗过程中同时用低剂量M M C0.002m g/kg,每周1次,共5￣7次;对照...目的观察低剂量丝裂霉素C(M M C)对胸部癌症患者放疗中的降低放射损伤作用。方法100例胸部癌症患者中,食管癌54例、肺癌46例,随机分为研究组和对照组各50例,研究组于常规放疗过程中同时用低剂量M M C0.002m g/kg,每周1次,共5￣7次;对照组只接受常规放疗。结果100例全部完成治疗,研究组、对照组急性放射性食管炎发生率分别为30%,48%(χ2=3.897,P=0.048);研究组、对照组急性放射性肺炎发生率分别为4%,16%(χ2=4.001,P=0.045);血液毒性反应研究组、对照组分别为50%,48%(χ2=0.208,P=0.648)。研究组有效率(C R+PR)(84%)明显高于对照组(68%)(χ2=4.089,P=0.043)。结论低剂量M M C配合胸部癌症放疗,明显减轻了急性放射性食管炎及肺炎的发生,无明显的血液毒性反应,同时提高了肿瘤的放疗效果。展开更多
文摘Daptomycin induced acute eosinophilic pneumonia is a rare and potentially life threatening condition characterized by rapid respiratory failure, pulmonary infiltrates and eosinophilia. Risk factors for acute eosinophilic pneumonia include smoking, environmental irritants or inhalants and certain medications such as Daptomycin [1]. In this review of literature, we aim to explore the potential triggers for developing acute eosinophilic pneumonia in patients exposed to Daptomycin. The exact immune mechanism for daptomycin induced AEP is unknown, however the current proposed mechanism describes a T helper 2 lymphocyte response to inactivated daptomycin in the pulmonary surfactant, which leads to eosinophilia. Disordered T regulatory cell function is seen in patients with certain cancers, allergies and autoimmune conditions. We propose that patients with these underlying risk factors may be at increased risk of developing AEP after becoming exposed to Daptomycin. Understanding potential risk factors is crucial for health care workers as it allows them to identify susceptible populations, explore preventative measures and treat accordingly.
文摘Independent lung ventilation,though infrequently used in the critical care setting,has been reported as a rescue strategy for patients in respiratory failure resulting from severe unilateral lung pathology.This involves isolating and ventilating the right and left lung differently,using separate ventilators.Here,we describe our experience with independent lung ventilation in a patient with unilateral diffuse alveolar hemorrhage,who presented with severe hypoxemic respiratory failure despite maximal ventilatory support.Conventional ventilation in this scenario leads to preferential distribution of tidal volume to the nondiseased lung causing over distension and inadvertent volume trauma.Since each lung has a different compliance and respiratory mechanics,instituting separate ventilation strategies to each lung could potentially minimize lung injury.Based on review of literature,we provide a detailed description of indications and procedures for establishing independent lung ventilation,and also provide an algorithm for management and weaning a patient from independent lung ventilation.
文摘目的观察低剂量丝裂霉素C(M M C)对胸部癌症患者放疗中的降低放射损伤作用。方法100例胸部癌症患者中,食管癌54例、肺癌46例,随机分为研究组和对照组各50例,研究组于常规放疗过程中同时用低剂量M M C0.002m g/kg,每周1次,共5￣7次;对照组只接受常规放疗。结果100例全部完成治疗,研究组、对照组急性放射性食管炎发生率分别为30%,48%(χ2=3.897,P=0.048);研究组、对照组急性放射性肺炎发生率分别为4%,16%(χ2=4.001,P=0.045);血液毒性反应研究组、对照组分别为50%,48%(χ2=0.208,P=0.648)。研究组有效率(C R+PR)(84%)明显高于对照组(68%)(χ2=4.089,P=0.043)。结论低剂量M M C配合胸部癌症放疗,明显减轻了急性放射性食管炎及肺炎的发生,无明显的血液毒性反应,同时提高了肿瘤的放疗效果。
