It is never too late. A call for research in pleural medicine
Twenty-five years have passed since the publication of the guidelines of the American College of Chest Physicians (ACCP)1 for the management of parapneumonic pleural effusion. Despite being based on expert consensus, the classification remains a current reference for the treatment of pleural infections because it follows the pathophysiology of the disease step by step. In […]
Clinical features associated with risk category 4 in pleural infection: an application of the ACCP classification
Introduction Parapneumonic pleural effusion and thoracic empyema are dynamic inflammatory processes that develop in the space between the parietal and visceral pleura. This is a complex entity that encompasses clinical, imaging, and laboratory elements. Globally, its incidence has increased in recent years1 and at our institution, it is one of the leading causes of hospitalization. […]
Pulmonary nodules in extrapulmonary cancer: a clinical problem to be answered
Introduction Pulmonary nodules are focal lesions smaller than 3 cm in diameter, which are detected in up to 30% of all chest computed tomography scans, frequently occurring as multiple lesions and becoming increasingly common in patients with a prior diagnosis of cancer.1 A percentage of these nodules in subjects with cancer are of indeterminate characteristics, […]
Evaluation and management of the patient with severe COVID-19
Introduction The clinical spectrum of COVID-19 is highly variable, ranging from asymptomatic to critical disease. The objective of this article is to analyze the identified risk factors for severe disease and to establish the clinical approach to patients presenting with severe and critical COVID-19. Severe disease is defined when the patient presents with fever, dyspnea, […]
Mechanical ventilation in COVID-19
Introduction COVID-19 can progress to acute respiratory distress syndrome (ARDS), characterized by alveolar collapse, exudative consolidation, and pulmonary inflammation that may progress to biotrauma and multiple organ failure. In this context, mechanical ventilation is an essential supportive therapy that maintains gas exchange while allowing the lung to recover, through careful adjustment of volume and pressure […]
Acute kidney injury in patients with COVID-19 receiving mechanical ventilation
Introduction In December 2019, a novel coronavirus was identified, subsequently designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), whose capacity to produce severe respiratory illness and acute respiratory distress syndrome (ARDS) abruptly transformed clinical practice worldwide.1, 2 Within months, the rapid spread of the virus and the high proportion of patients requiring hospitalization and […]
Cardiovascular complications of COVID-19
Introduction The American College of Cardiology and the American Heart Association recognize that COVID-19 causes various cardiovascular complications affecting patients with or without pre-existing cardiovascular disease. Approximately 10 to 20% of hospitalized patients present evidence of myocardial injury.1 Myocardial damage or injury was a concept established in the 2018 European Society of Cardiology consensus on […]
Bronchoscopy and tracheostomy in COVID-19 patients
Introduction The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), led to an unprecedented increase in the number of critically ill patients requiring mechanical ventilation, fundamentally transforming medical practice and, in particular, the management of respiratory diseases worldwide. It is estimated that between 5% and 20% of patients hospitalized for COVID-19 developed […]
Empyema
Radiologically, an empyema initially appears as a typical pleural effusion (usually unilateral). As it reaches the fibrinopurulent stage, the empyema assumes a loculated configuration, with a characteristic lenticular shape and smooth margins that is convex toward the lung and forms an obtuse angle with the chest wall. In contrast to a pulmonary abscess, empyema shows […]