MedLung Talks🫁
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About MedLung Talks🫁
*MedLung Talks Channel* is made for all the Healthcare professionals including Pulmonologists, Internists, Respiratory therapists, Family Physicians and General practitioners. We will try to keep you all updated about the recent advances and novel approaches in the field of Pulmonary and Internal medicine . ________________________________ *WhatsApp Channel* https://whatsapp.com/channel/0029VaE5h43I7BeBgMGvMB3W *Instagram* https://www.instagram.com/medlung_talks?igsh=MThlOWw0M292dmswcg%3D%3D&utm_source=qr *YouTube* https://www.youtube.com/@Medlung_Talks
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Posts
A 26-year-old woman with stable Crohn's disease was admitted with a 4-day history of dyspnoea and haemoptysis. She required an FiO2 of 0.5 to maintain arterial saturation at 93% (94–98) with a normal PCO2. Investigations:* haemoglobin 88 g/L (115–165) MCV 90 fL (80–96) white cell count 10.0 × 109/L (4.0–11.0) platelet count 522 × 109/L (150–400) ESR 102 mm/1st h (<20) INR 1.2 serum creatinine 67 µmol/L (60–110) serum albumin 36 g/L (37–49) serum CRP 290 mg/L (<10) CT scan of chest see image
*Algorithmic approach to diagnose Bilateral Diaphragmatic Dysfunction* *Parameters:* 1. VC < 50% predicted (and) 2. Decrease in VC> 30% on supine or MIP <30% predicted. *Ultrasound* Diaphragmatic Thickening Fraction (TFDi) <20%. *Unilateral phrenic stimulation* shows Twitch Diaphragmatic pressure (Pdi tw) <20 cm H20. *Management* 1. Non Invasive positive pressure ventilation if the patient has any of the following - PaCo2 > 45mmHg - Spo2 < 88% for more than 5 minutes. - MIP < 60% or VC < 50% predicted. 2. Phrenic Nerve pacing if patient has - Upper level spinal injury with intact phrenic nerve stimulation - persistent respiratory failure. *#MedLung Talks 🫁* *#Decode & Learn*
*What investigation is most likely to establish a diagnosis?*
NICE/BTS/SIGN Guidelines on Asthma 2024. *Pharmacological management of asthma in people aged 12 and over.* *#MedLung Talks 🫁*
*Algorithmic approach to diagnose Unilateral Diaphragmatic Dysfunction* *Parameters:* 1. VC < 80% predicted (and) 2. Decrease in VC> 15% or MIP <60% predicted. *Ultrasound* Diaphragmatic Fraction Thickening (TFDi) <20%. *Unilateral phrenic stimulation* shows Twitch Diaphragmatic pressure (Pdi tw) <10 cm H20. *Management* 1. Observation if asymptomatic 2. Surgical diaphragmatic plication if symptomatic or persistent. 3. NIPPV if meeting indication *#MedLung Talks 🫁*
