An 18-year-old man with no prior medical history presented to the tertiary care center with a 6-month history of progressively worsening bone pain. The pain was localized to the right posterior ribs, mid-thoracic spine, and right iliac bone and was described as deep, throbbing, and exacerbated by physical activity, which significantly limited his mobility. Concurrently, he reported recurrent episodes of dyspnea and chest tightness, particularly in the supine position. Physical examination revealed reduced tactile fremitus and diminished breath sounds over the bilateral lower lung fields, with dullness to percussion. Bilateral pitting edema extended from the ankles to the knees (grade 1+), with no signs of joint swelling, skin rash, or lymphadenopathy. Vital signs were notable for low-grade fever (38.2 °C) and tachycardia (heart rate: 92 beats/min).

A 55-year-old woman presented to the emergency department with fever, cough, and progressive dyspnea for 3 days. Chest CT scan showed diffuse pulmonary lesions, and arterial blood gas analysis showed a Pao2 of 56 mm Hg on room air. Consequently, she was transferred to the respiratory ICU because of rapidly progressing respiratory failure. Her medical history indicated a 20-year history of psoriasis. She initiated treatment with ixekizumab (an interleukin-17 inhibitor) 3 months ago. A chest radiograph before ixekizumab treatment showed no abnormalities. After administration of ixekizumab therapy, her skin lesions demonstrated significant improvement. She denied any history of tobacco use or chronic lung disease.

An 81-year-old woman was referred to our Cardiomyopathy Clinic for unexplained asymmetric left ventricular hypertrophy. She was asymptomatic, with no family history of cardiac disease nor of sudden cardiac death. The patient's medical history included a hepatitis C virus infection, successfully eradicated with antiviral therapy, and a hysterectomy for multiple uterine leiomyomas at the age of 36. Moreover, she underwent thoracoscopic right upper and right lower wedge resection for multiple pulmonary masses, consistent with metastatic benign leiomyomas, at the age of 63. Three years before the current evaluation, a recurrence of pulmonary leiomyomas, not affecting respiratory dynamics, nor causing any symptom, was diagnosed but not treated with surgery. Follow-up evaluations by CT scan showed slow progression of pulmonary lesions over the years in the absence of clinical manifestations.

Flow-controlled ventilation (FCV) is characterized by a bidirectional linearized gas flow translating into a constant flow. We report the prolonged use of FCV in a 30-year-old patient with major trauma, including severe traumatic brain injury and posttraumatic ARDS, because the patient sustained other severe injuries such as those to the spine and pelvis. Conventional mechanical ventilation failed to attain normoxia and normocapnia, leading to hemodynamic compromise and refractory intracranial hypertension. FCV was used as an off-label rescue therapy because prone positioning and extracorporeal membrane oxygenation were contraindicated. Within a few hours, ventilation improved despite lower minute volumes. This was paralleled by a reduction in norepinephrine requirements and normalization of intracranial pressure. FCV was continued for 96 hours. This case report underlines the potential benefits of FCV as a novel ventilation mode in patients with ARDS and justifies future studies evaluating the outcome effects of FCV in this complex population.