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array:23 [ "pii" => "S0300289624001236" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.015" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3543" "copyright" => "SEPAR" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:533-4" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0300289624001133" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.005" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3533" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:535-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Arthritis, Pulmonary Cysts and Renal Insufficiency: COPA Syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "535" "paginaFinal" => "536" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 833 "Ancho" => 1000 "Tamanyo" => 162076 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Renal biopsy with crescents. (B–D) Thoracic computed tomography with multiple subpleural pulmonary cysts, small, peripheral and in cystic of small size, peripheral and in fissures arranged in a single row. Multiple small, low-density, centrolobulillary pulmonary nodules with mosaic pattern.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "María Nieves Balaguer Cartagena, Carles Fonfría Esparcia, Gabriel Anguera de Francisco" "autores" => array:3 [ 0 => array:2 [ "nombre" => "María Nieves" "apellidos" => "Balaguer Cartagena" ] 1 => array:2 [ "nombre" => "Carles" "apellidos" => "Fonfría Esparcia" ] 2 => array:2 [ "nombre" => "Gabriel" "apellidos" => "Anguera de Francisco" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001133?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001133/v1_202408020536/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0300289624001224" "issn" => "03002896" "doi" => "10.1016/j.arbres.2024.04.014" "estado" => "S300" "fechaPublicacion" => "2024-08-01" "aid" => "3542" "copyright" => "SEPAR" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Arch Bronconeumol. 2024;60:531-2" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Primary Pulmonary Artery Sarcoma: A Rare Tumor Diagnosed by EBUS Guided Mediastinal Cryobiopsy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "531" "paginaFinal" => "532" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 843 "Ancho" => 2000 "Tamanyo" => 249830 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(1a) Contrast-enhanced CT reveals a mild enhanced mass in the left pulmonary artery. (1b) 18F-fluorodeoxyglucose (FDG) positron emission tomography with integrated CT shows a positive uptake of FDG to the pulmonary artery mass. (2) Ultrasound image of fine needle (2a) and cryoprobe (2b) in the middle of the mass. (3) Hemtoxylin–eosin: atypical spindle cells with irregular, pleomorphic, large spindle-shaped nuclei, with elongated cytoplasms (3a,3b). Immunocytochemical study: MDM2++ positive tumor cells (3c) and negative for actine (3d).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Selene Cuenca Peris, Mónica Bauza, Andrés Briones Gómez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Selene" "apellidos" => "Cuenca Peris" ] 1 => array:2 [ "nombre" => "Mónica" "apellidos" => "Bauza" ] 2 => array:2 [ "nombre" => "Andrés" "apellidos" => "Briones Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001224?idApp=UINPBA00003Z" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001224/v1_202408020536/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Clinical Letter</span>" "titulo" => "Successful Conservative Treatment in a Long Iatrogenic Rupture of the Membranous Tracheal Wall" "tieneTextoCompleto" => true "saludo" => "To the Director," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "533" "paginaFinal" => "534" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Maria Bragança, Júlio Semedo, Fernanda Paula" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Maria" "apellidos" => "Bragança" "email" => array:1 [ 0 => "maria.luis.braganca@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Júlio" "apellidos" => "Semedo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Fernanda" "apellidos" => "Paula" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Interventional Pulmonology Unit, Hospital Pulido Valente – Unidade Local de Saúde Santa Maria, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Medical-Surgical Intensive Care Unit, Hospital Pulido Valente – Unidade Local de Saúde Santa Maria, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 464 "Ancho" => 1340 "Tamanyo" => 91603 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) 3<span class="elsevierStyleHsp" style=""></span>cm longitudinal laceration of the tracheal posterior wall, up to the submucosa; (B) bronchofibroscopy at 4 days; signs of healing; (C) bronchofibroscopy at 1 month; signs of granulation tissue.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Female, 72 year-old, non-smoker, autonomous, with a 5-year history of exposure to birds and known diagnoses of asthma, essential hypertension, dyslipidemia, and type 2 diabetes. She was hospitalized for moderate SARS-CoV2 infection, 2 years ago.</p><p id="par0010" class="elsevierStylePara elsevierViewall">She presented with worsening fatigue and dyspnea for 2 years. Imaging exams showed ground-glass reticular densification, traction bronchiectasis and “honeycomb”. Functionally, she presented moderated restriction and DLCO of 48% (ERS/ATS 2021). The echocardiogram showed PSAP 41<span class="elsevierStyleHsp" style=""></span>mmHg without other alterations. Chronic interstitial pneumonia was suspected and cryobiopsy was requested.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The cryobiopsy was performed under general anesthesia with placement of an endotracheal tube (ETT). After the procedure, residual but persistent bleeding was identified, and bronchofibroscopy revealed a 3<span class="elsevierStyleHsp" style=""></span>cm longitudinal tear in the posterior wall of the trachea, up to the submucosa (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was admitted to the Intensive Care for clinical and imaging surveillance, with no evidence of pneumomediastinum, pneumothorax or subcutaneous emphysema. Conservative therapy was chosen (monitoring). Endoscopic reassessment after 4 days showed a laceration on the posterior wall of the trachea with signs of flap healing (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The injury was classified as grade I according to Cardillo et al.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> She was discharged after 4 days, with indication for monitoring. Endoscopic reassessment after 1 month showed complete healing of the tear, without interruption of continuity (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C).</p><p id="par0025" class="elsevierStylePara elsevierViewall">The pathology of the cryobiopsy suggested chronic hypersensitivity pneumonitis.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Iatrogenic injuries of the trachea and main bronchi (IIT) are complications associated with invasive medical–surgical procedures, especially orotracheal intubation or percutaneous tracheostomy, which are defined as post-intubation IIT.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The epidemiology is unknown, presumably underdiagnosed extremely rare, with most publications being of isolated cases or small series with few patients.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a> Known risk factors for IIT include advanced age, women, obesity, anatomical variations, multiple intubation attempts, rigid guidance and incorrect ETT size.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2,4</span></a> Clinical presentation can be variable, ranging from asymptomatic to subcutaneous emphysema, pneumothorax, pneumomediastinum and acute respiratory failure.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Imaging exams (CT with IV or double contrast) and endoscopic exams (gold standard) are essential to assess the size of the lesion, and the involvement of other organs.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> Based on the extent of the lesion, in 2010 Cardillo et al. (revised in 2022) proposed a morphological classification for risk stratification.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">IIT has significant morbi-mortality rates, requiring early diagnosis and effective treatment, followed by close monitoring. There are no guidelines for the treatment, which must be individualized.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">3,5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Traditionally, surgical treatment has been the gold standard (especially in symptomatic patients with IIT grade IIIa to IV, or any lesion with mediastinitis).<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,4</span></a> However, less invasive options are increasingly being considered, such as endoscopic treatment (stenting over the tear) or conservative treatment.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,4</span></a> Conservative treatment consists of a multiplicity of options – observation, intubation, tracheostomy, and fibrin glue. Initially proposed for asymptomatic IIT grade I lesions, its indications are being extended to wider and deeper tears (up to 9<span class="elsevierStyleHsp" style=""></span>cm or IIIa).<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">1,4</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The current evidence is non-consensual on the approach, even within the conservative aspect, with a variety of choices. It is therefore essential to create joint guidelines for the treatment of these injuries.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0070" class="elsevierStylePara elsevierViewall">This article had no funding sources.</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflict of interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 464 "Ancho" => 1340 "Tamanyo" => 91603 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) 3<span class="elsevierStyleHsp" style=""></span>cm longitudinal laceration of the tracheal posterior wall, up to the submucosa; (B) bronchofibroscopy at 4 days; signs of healing; (C) bronchofibroscopy at 1 month; signs of granulation tissue.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Post-intubation tracheal lacerations: risk-stratification and treatment protocol according to morphological classification" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Cardillo" 1 => "S. Ricciardi" 2 => "A.R. Forcione" 3 => "L. Carbone" 4 => "F. Carleo" 5 => "M. Di Martino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fsurg.2022.1049126" "Revista" => array:5 [ "tituloSerie" => "Front Surg" "fecha" => "2022" "volumen" => "9" "paginaInicial" => "1049126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36504581" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Postintubation iatrogenic tracheobronchial injuries: the state of art" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Passera" 1 => "R. Orlandi" 2 => "M. Calderoni" 3 => "E.M. Cassina" 4 => "U. Cioffi" 5 => "A. Guttadauro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3389/fsurg.2023.1125997" "Revista" => array:5 [ "tituloSerie" => "Front Surg" "fecha" => "2023" "volumen" => "10" "paginaInicial" => "1125997" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36860949" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tracheal rupture after endotracheal intubation: a literature systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Miñambres" 1 => "J. Búron" 2 => "M.A. Ballesteros" 3 => "J. Llorca" 4 => "P. Muñoz" 5 => "A. González-Castro" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Eur J Cardio-thorac Surg" "fecha" => "2009" "volumen" => "35" "paginaInicial" => "1056" "paginaFinal" => "1062" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of tracheobronchial injuries a contemporary review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H.S. Grewal" 1 => "N.S. Dangayach" 2 => "U. Ahmad" 3 => "S. Ghosh" 4 => "T. Gildea" 5 => "A.C. Mehta" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Chest" "fecha" => "2019" "volumen" => "155" "paginaInicial" => "595" "paginaFinal" => "604" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Conservative versus surgical management of iatrogenic tracheal rupture" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Panagiotopoulos" 1 => "D. Patrini" 2 => "M. Barnard" 3 => "E. Koletsis" 4 => "D. Dougenis" 5 => "D. Lawrence" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000455859" "Revista" => array:6 [ "tituloSerie" => "Med Princ Pract" "fecha" => "2017" "volumen" => "26" "paginaInicial" => "218" "paginaFinal" => "220" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28208144" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03002896/0000006000000008/v1_202408020536/S0300289624001236/v1_202408020536/en/main.assets" "Apartado" => array:4 [ "identificador" => "97872" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Clinical Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000006000000008/v1_202408020536/S0300289624001236/v1_202408020536/en/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289624001236?idApp=UINPBA00003Z" ]
