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Tuberculous pneumonia-induced severe ARDS complicated with DIC in a female child: a case of successful treatment

Overview of attention for article published in BMC Infectious Diseases, July 2018
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4 Dimensions

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Title
Tuberculous pneumonia-induced severe ARDS complicated with DIC in a female child: a case of successful treatment
Published in
BMC Infectious Diseases, July 2018
DOI 10.1186/s12879-018-3215-5
Pubmed ID
Authors

Dong Tien Ngo, Phuc Huu Phan, Shoji Kawachi, Noriko Nakajima, Naoyuki Hirata, Akira Ainai, Thuy Thi Bich Phung, Dien Minh Tran, Hai Thanh Le

Abstract

Tuberculous (TB) pneumonia can induce acute respiratory distress syndrome (ARDS). Although TB pneumonia is one of the causes of disease and death among children worldwide, the literature on TB pneumonia-induced ARDS is limited. We report herein on the successful treatment of a two-year-old female child with TB pneumonia-induced severe ARDS complicated with disseminated intravascular coagulation (DIC). A two-year-old Vietnamese female child with sustained fever and cough for 20 days was transferred to our hospital. She had severe dyspnea and a chest X-ray showed bilateral infiltration without findings of heart failure. After tracheal intubation, her oxygenation index (OI) and PaO2/FiO2 (PF) ratio were 29 and 60 mmHg, respectively. Mycobacterium tuberculosis was detected by real-time polymerase chain reaction (rPCR) assay of tracheal lavage fluid. She was diagnosed as having severe ARDS that developed from TB pneumonia. Anti-tuberculous therapy and cardiopulmonary support were started. However, her respiratory condition deteriorated despite treatment with high-frequency oscillating ventilation (HFO), vasopressor support, and 1 g/kg of immunoglobulin. On the third day after admission, her International Society on Thrombosis and Hemostasis DIC score had increased to 5. Recombinant human soluble thrombomodulin (rTM) was administered to treat the DIC. After the administration of rTM was completed, OI gradually decreased, after which the mechanical ventilation mode was changed from HFO to synchronized intermittent mandatory ventilation. The DIC score also gradually decreased. Plasma levels of soluble receptor for advanced glycan end products (sRAGE) and high mobility group box 1 (HMGB-1), which are reported to be associated with ARDS severity, also decreased. In addition, inflammatory biomarkers, including interferon-gamma (IFN-γ) and interleukin-6 (IL-6), decreased after the administration of rTM. Although severe ARDS (P/F ratio ≦ 100 mmHg) continued for 19 days, the patient's OI and P/F ratio improved gradually, and she was extubated on the 27th day after admission. The severe ARDS with DIC was successfully treated, and she was discharged from hospital on day 33 post-admission. We successfully treated a female child suffering from TB pneumonia-induced severe ARDS complicated with DIC using multimodal interventions. (338/350).

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The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 52 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 52 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 13 25%
Researcher 5 10%
Student > Postgraduate 3 6%
Lecturer 2 4%
Librarian 2 4%
Other 8 15%
Unknown 19 37%
Readers by discipline Count As %
Medicine and Dentistry 14 27%
Biochemistry, Genetics and Molecular Biology 4 8%
Nursing and Health Professions 3 6%
Pharmacology, Toxicology and Pharmaceutical Science 2 4%
Immunology and Microbiology 2 4%
Other 5 10%
Unknown 22 42%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 July 2018.
All research outputs
#15,956,756
of 24,286,850 outputs
Outputs from BMC Infectious Diseases
#4,399
of 8,125 outputs
Outputs of similar age
#202,574
of 331,832 outputs
Outputs of similar age from BMC Infectious Diseases
#79
of 163 outputs
Altmetric has tracked 24,286,850 research outputs across all sources so far. This one is in the 32nd percentile – i.e., 32% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,125 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 10.5. This one is in the 41st percentile – i.e., 41% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 331,832 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 35th percentile – i.e., 35% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 163 others from the same source and published within six weeks on either side of this one. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.