Taek Yoon

Pulmonary artery catheter coiled in the main pulmonary artery trunk.

Pulmonary artery (PA) catheterisation has been performed for over four decades. It is utilised in intensive care units and perioperatively to titrate fluid and pressor therapy. Major and minor complications have been reported. The catheter can infrequently loop and coil in the right atrium, right ventricle and superior vena cava .We report a case of coiling of the PA catheter in the main PA. A 33-year-old woman was admitted with multiorgan failure and shock. She required mechanical ventilation, was in severe pulmonary oedema and required vasopressors for shock. We placed a PA catheter to assist in the management of her haemodynamic collapse. The catheter coiled in the main pulmonary trunk, which is extremely rare. The catheter was removed without any complications.

Enterovirus-Human Rhinovirus: A Rare Cause of Acute Respiratory Distress Syndrome:

A 22-year-old Asian woman presented with respiratory distress, cough, and wheezing for 1 week. Prior history included asthma and Turner syndrome. On presentation to the emergency department, the patient was hypotensive, tachycardic, tachypneic, with an oxyhemoglobin saturation in the mid 80% range while breathing ambient air. Chest radiograph revealed pulmonary vascular congestion and a left lower lobe infiltrate. Endotracheal intubation, mechanical ventilation, and vasopressors were initiated. Empiric therapy for community-acquired pneumonia was administered utilizing broad-spectrum intravenous antibiotics. Routine sputum culture was negative for pathogens. Nasopharyngeal swab submitted for multiplex amplified nucleic acid testing yielded enterovirus-human rhinovirus (EV-HRV). Thus, the diagnosis of EV-HRV pneumonia complicated by acute respiratory distress syndrome (ARDS) was established. Multiple attempts to wean from the ventilator were unsuccessful, and a tracheostomy was performed. This report highlights EV-HRV as a cause of severe ARDS and prolonged respiratory failure in adults.