Pulmonary & Respiratory Medicine

Acute Respiratory Distress Syndrome (ARDS) develops when fluid accumulates in your lungs' small, elastic air sacs (alveoli). Because the fluid prevents your lungs from filling with enough air, less oxygen reaches your circulation. This deprives your organs of the oxygen they require to perform properly. ARDS is a potentially fatal form of respiratory failure that affects around 200,000 individuals in the United States each year, resulting in nearly 75,000 deaths. Globally, ARDS accounts for 10% of intensive care unit admissions, resulting in about 3 million ARDS patients each year.

Awareness among clinicians about idiopathic Pleuroparenchymal Fibroelastosis (PPFE) is lacking and by the time patients are diagnosed with it, they were seen by multiple physicians and misdiagnosed multiple times. It is a rare condition that is characterized by fibrosis of the pleura and subpleural lung parenchyma, predominantly affecting the upper lobes. Most common cause of fibrosis in other processes is collagen predominant but in PPFE fibrosis is usually caused by elastic fibers. Verhoeff van Gieson stain from lung biopsies in patients who presented with fibrosis in the upper pleural and parenchymal areas will help in establishing the diagnosis by demonstrating the elastic fibers. We also need to rule out the possibility of other lung parenchymal conditions like usual interstitial pneumonia, nonspecific interstitial pneumonitis, pulmonary apical cap etc. We have presented a case report on PPFE to bring attention to clinicians so that patients are diagnosed early.

Physiotherapy plays a crucial role in pre-habilitation, post-operative care, and rehabilitation to reduce postoperative pulmonary complications. The use of various devices like incentive spirometers, and respiratory muscle training devices is an integral part of chest physiotherapy. Currently, there are many devices available in the market, which have been used in physiotherapy. Despite their regular use in the clinical setup, many clinical practitioners do not have thorough knowledge about their functioning and effect. This article intends to make physiotherapists aware of the types, components, teaching techniques, and uses of such devices, to have optimal and specific benefits. The knowledge of these devices may help professionals to select the best device to be used. To select the most appropriate one, it is also necessary to consider the specific health condition, the nature of the impairments, the purpose of the training, and whether its use is within a research or clinical context.