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• W4387248515 abstract "SESSION TITLE: Diffuse Lung Disease Case Report Posters 6 SESSION TYPE: Case Report Posters PRESENTED ON: 10/09/2023 12:00 pm - 12:45 pm INTRODUCTION: Alveolar hemorrhage refers to bleeding within the alveoli, which are tiny air sacs within the lungs.Cardiac arrest can cause a lack of oxygen to the body, tissues and organs, including the lungs, which can lead to damage and bleeding. In some cases, alveolar hemorrhage can occur after cardiac arrest due to a variety of factors, including lung injury from CPR or ventilator support, decreased blood flow to the lungs, or pre-existing lung disease. Life-threatening alveolar hemorrhage can cause a rapid and severe decline in respiratory function, leading to respiratory failure, hypoxia, and shock. CASE PRESENTATION: Case 1:A 34-year-old-female with the past medical history of hypertension, antiphospholipid syndrome, COPD was brought to the hospital after being intubated in the field secondary to hypoxia and ROSC was achieved after 3 rounds of CPR. While the patient was in ICU, she had hemoptysis, falling hematocrit, diffuse pulmonary infiltrates on Chest imaging, and hypoxemic respiratory failures even being onventilator. Blood transfusion was initiated. Fiberoptic bronchoscopy revealed diffuse and profuse blood in all bronchopulmonary segments consistent with diffuse alveolar hemorrhage. Patients started on high dose corticosteroids, cyclophosphamide, High-frequency oscillatory ventilation (HFOV) to improve oxygenation. Alveolar Lavage was repeated twice due to persistent hemoptysis complicated due to antiphospholipid syndrome. The patient was extubated on day 14 and had improved outcomes and survival on the close follow up after 3 and 6 months.Case 2:75 years old male with PMHx of COPD, CAD, Hypertension was admitted on floors for acuteexacerbation of COPD. On day 2, the patient had cardiac arrest secondary to hypoxia, patient was intubated, and ROSC was achieved after 4 rounds of CPR. The patient was shifted to ICU. Post-Cardiac arrest Chest imaging was consistent with rib fractures initially and later showed bilateral pulmonary infiltrates. On day 4, a patient developed severe hemoptysis and diffuse alveolar hemorrhage was confirmed on emergent bronchoscopy and alveolar lavage was done. Patient died on day 6 after second cardiac arrest despite aggressive treatment with ventilatory support and medical management with Corticosteroids, and Rituximab. Bronchial artery embolization was planned on Day 6, but he could not survive due to life threatening alveolar hemorrhage. DISCUSSION: Several case reports have described the occurrence of alveolar hemorrhage following CPR in patients with pre-existing lung disease. These reports highlight the need for careful evaluation and monitoring of these patients during CPR, as well as prompt recognition and treatment of any associated complications. Overall, the management of alveolar hemorrhage after CPR requires a multidisciplinary approach involving critical care physicians, pulmonologists, and cardiologists. CONCLUSIONS: Further research is needed to determine the optimal management strategies for these patients and to develop preventive measures to minimize the risk of alveolar hemorrhage during CPR. REFERENCE #1: 1. Boland, Lori L., Paul A. Satterlee, Jonathan S. Hokanson, Craig E. Strauss, and Dana Yost. Chestcompression injuries detected via routine post-arrest care in patients who survive to admission afterout-of-hospital cardiac arrest. Prehospital Emergency Care 19, no. 1 (2015): 23-30. REFERENCE #2: 2. Friberg, Niklas, Simon Schmidbauer, Charles Walther, and Elisabet Englund. Skeletal and soft tissueinjuries after manual and mechanical chest compressions. European Heart Journal-Quality of Care andClinical Outcomes 5, no. 3 (2019): 259-265. REFERENCE #3: 3. Milling, Louise, Peter Mygind Leth, and Birgitte Schmidt Astrup. Life-threatening and suspiciouslesions caused by mechanical cardiopulmonary resuscitation. The American Journal of ForensicMedicine and Pathology 38, no. 3 (2017): 219-221. DISCLOSURES: No relevant relationships by Noreena Aslam No relevant relationships by Karen Avgush No relevant relationships by Aamir Hayat" @default.
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• W4387248515 date "2023-10-01" @default.
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• W4387248515 title "REALITY OF LIFE-THREATENING ALEVOLAR HEMORRHAGE POST-CARDIAC ARREST" @default.
• W4387248515 doi "https://doi.org/10.1016/j.chest.2023.07.2210" @default.
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