RESUMO
Epithelioid hemangioendothelioma (EHE) is a rare vascular tumor with variable biological and clinical behavior. There is increasing experience with liver transplantation (LiTx) for hepatic EHE, even in cases of extrahepatic disease localization. Until now, no cases of lung transplantation (LuTx) had been reported for pulmonary EHE. This report describes three cases of EHE with multifocal disease in patients who underwent either serial or combined LiTx and LuTx.
Assuntos
Hemangioendotelioma Epitelioide/cirurgia , Transplante de Fígado , Transplante de Pulmão , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Prognóstico , Tomografia Computadorizada por Raios XRESUMO
Double lumen tubes (DLT) are a cornerstone in thoracic anaesthesia to achieve onelung ventilation. Due to the shape and size of these devices, airway injuries might occur. The reported incidence of tracheobronchial ruptures caused by a DLT is very low (0.005% for single-lumen tubes and 0.05% for double-lumen intubations), but the outcome can be life-threatening (1, 2). In the past, treatment of tracheobronchial ruptures was performed surgically, nowadays conservative treatment can be considered (3, 4). Here, we report a case of tracheobronchial rupture during oesophageal surgery.
Assuntos
Brônquios/lesões , Intubação Intratraqueal/efeitos adversos , Intubação Intratraqueal/instrumentação , Desenho de Equipamento , Humanos , Masculino , Pessoa de Meia-Idade , Ventilação MonopulmonarRESUMO
One lung ventilation (OLV) in children is a challenge and requires creative solutions. A case of OLV with bronchial placement of a fiberscope inspection-guided vascular embolectomy catheter in a three-year-old girl, scheduled for the resection of an intrathoracic tumor through thoracotomy is described. The availability of a broad range of vascular catheters as well as of fiberscope inspection material was decisive in managing the airway intra-operatively. Over the last 20 years, the need for OLV in children has increased, and various methods for performing it have been reported. Knowing all existing strategies in that domain is important to provide optimal perioperative care. In this paper, several methods of OLV in children will be discussed, such as selective endobronchial intubation, types of bronchial blockers, Univent tube, pediatric double lumen tubes, as well as the Marraro double lumen tube.
Assuntos
Ganglioneuroblastoma/cirurgia , Ventilação Monopulmonar/métodos , Neoplasias Torácicas/cirurgia , Cateterismo/instrumentação , Pré-Escolar , Feminino , Seguimentos , Humanos , Intubação Intratraqueal/instrumentação , Ventilação Monopulmonar/instrumentação , Toracotomia/métodos , Resultado do TratamentoRESUMO
In a murine model of lung ischemia-reperfusion injury (IRI), we previously demonstrated that lymphocytes increase in the alveolar space during the ischemic period. We hypothesized that these lymphocytes play an important role during ischemia in the development of lung IRI. In the present study, severe combined immunodeficiency (SCID) mice, lacking T cells, were used to further investigate our hypothesis. SCID and control mice underwent 90 minutes of left lung ischemia followed by 4 hours of reperfusion. A significant decrease in neutrophils, together with lower levels of interleukin-1beta, was found in SCID mice after reperfusion. We concluded that lymphocytes invading the lung during ischemia trigger an inflammatory response upon reperfusion. Antilymphocyte therapies in the donor should be further investigated as treatment strategies against IRI.
