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Query: UMLS:C0032285 (pneumonia)
 54,520 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The PAO2-PaO2 relationship was studied for the entire therapeutic range of oxygen in patients and animals in acute respiratory failure. The method is based on the assumption that the steady state values of PaO2 may be obtained as a mean of the two PaO2 values at an identical F1O2, one obtained 6 min after the F1O2 was raised from a lower level, the other obtained 6 min after the F1O2 was reduced from the higher level. We found that the shunts were large in the low F1O2 range (170 mmHg and below), took a minimum value in the moderate PAO2 range (170 to 300 mmHg), and increased again in the high PAO2 range (300 to 700 mmHg). A similar pattern was observed in the animal experiments, two or more hr following experimentally produced produced aspiration pneumonitis. In contrast, the dogs with bilateral pneumothorax showed a pattern which followed the isoshunt line closely. It was concluded that patients with acute respiratory failure requiring artificial ventilation have two componenents of the pulmonary shunt, one parallel with and the other inversely related with the PAO2. Possible mechanisms for the former were discussed.
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PMID:PAO2-PaO2 relationship for the entire therapeutic range of oxygen in acute respiratory failure. 91 65

Physiological conditions of respiration in children are defined especially by - relative hyperventilation because of high oxygen uptake per body surface, - relative narrow and soft airways with high tendency to obstruction, causing atelectasis, pneumonia or severe bronchiolitis. It is useful to differentiate between bronchiolitis and spastic or asthmatoid bronchitis, the latter being sensible to Adrenalin and developing to asthma of adults. Characteristical signs of asthmatoid bronchitis are bronchial hyperreactivity, increased airway-resistance and residual volume, decreased FEV 1, pulmonary compliance, arterial PO2 and PCO2 with signs of pulmonary inhomogeneity. Mucviscidosis, starting from abnormal viscosity of bronchial secretion, is functionally characterized by similar signs, so are increased RV with air-trapping, decreased FEV 1, VC, PO2a and pulmonary inhomogeneity. Diffuse progressive interstitial pulmonary fibrosis (HAMMAN-RICH) of acute type being mostly lethal in children up to 2 years of age and of subacute type in older children shows diffusion disturbance and characteristical ventilation disturbance with reduction of inspiratory reserve volume and enlargement of functional residual capacity but normal FEV 1. Disturbances are sensible to corticoid-therapy.
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PMID:[Pathophysiology of respiratory disturbances in children (author's transl)]. 96 Jul 65

A marked increase in the carbon monoxide level in the blood sufficient to interfere with oxygen binding of hemoglobin was observed in a 43-year-old man during the course of extracorporeal membrane oxygenator support for acute respiratory failure from viral pneumonitis. The increased carbon monoxide level in this man was temporally related to the transfusion of large amounts of old bank blood. The etiology of an increased level of carbon monoxide in the blood during extracorporeal circulation is discussed and solutions to this problem are suggested.
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PMID:Carbon monoxide accumulation during extracoporeal membrane oxygenation for acute respiratory failure. 97 68

A comparative estimation of different methods of expanding the collapsed lung for staphylococcic pneumonia in children enabled the author to speak in favour of lung inflation by using an artificial occlusion of the bronchus with a peripheral fistula. This technic seems to be advantageous since a one-moment inclusion of the lung in the process of ventilation is found to contribute to prompt reduction oxygen deficiency of the organism, liquidation of the residual cavity and hemodynamic disturbances, and intoxication. The recovery of children is note din shorter terms. The time of patient's stay at the hospital is also shortened.
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PMID:[Methods for expanding the collapse lung in complicated abscessing pneumonia in children]. 101 26

Pulmonary mechanics and oxygenation were measured in 24 consecutive patients with posttraumatic flail chest requiring continuous mechanical ventilation. The mean duration of mechanical ventilation was fourteen days. Mortality was 38% for all patients, 29% if deaths from head injury are excluded. Pneumonia occurred in 4 patients (17%) and pneumothorax in 1 (4%). Vital capacity and maximal inspiratory force measurements were useful in assessing chest wall stabilization. Total lung compliance correlated negatively with fatal outcome from respiratory failure. The alveolar-arterial oxygen gradient was not useful in assessing chest wall stabilization.
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PMID:Control of respiratory therapy in flail chest. 105 69

The authors report 21 cases of severe interstitial pneumonitis observed in 1974 in Paris, in children with malignancies, either solid tumours or leukemias. Twelve patients died. The incidence of these complications in children with intensive chemotherapy and the clinical symptoms which may reveal them are reviewed; the bad prognosis of measles in these patients is stressed. Radiological findings are described and the possible wrong diagnoses are listed. Among viral infections, measles is the severest and its diagnosis is often difficult. Pneumocystis carinii infection is frequent. The use of surgical pulmonary biopsy and other diagnostic procedures is discussed. The immune status of these patients has been studied, which revealed severe impairement of cellular immunity, including low lymphocyte count, while humoral immunity was not changed. Symptomatic treatment may include oxygen supply and mechanical respiratory help, dietary management, and attempts towards non specific immune system stimulation. Aetiologic treatment is essentially the treatment of Pneumocystis carinii, which is discussed. Diagnosis and treatment of pneumonitis in immunosuppressed patients being very difficult, emphasis is made on the prevention of this accident, including caution in the handling of chemotherapy protocols.
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PMID:[Interstitial pneumopathies in children treated for malignant diseases]. 108 39

Progressive pulmonary insufficiency appears to be a universal response to the lung to a variety of injuries which damage the pulmonary-capillary emdothelium. Persistent hyperventilation, unresponsive to the administration of oxygen, is the earliest clinical sign of this complication of trauma and should prompt close monitoring of pulmonary function (measurement of arterial blood gas and pH levels, Vd/Vt A-aDo2, minute ventilation, vital capacity and inspiratory force) to assess the severity of the disease, the need for mechanical ventilatory support and the effectiveness of treatment. Other pulmonary complications of burn injury range from carbon monoxide poisoning and narcotics overdosage in the immediate postburn period through marked hyperventilation directly related to burn size occurring in the absence of significant parenchymal change to later occurring hematogenous and airborne pneumonia. Inhalation injury, a chemical tracheobronchitis which significantly increases the mortality of a given-sized burn, may be present immediately postburn but clinically inapparent for 48-72 hours. 133Xenon lung scans permit early diagnosis of this pulmonary injury and the timely institution of a graduated therapeutic response keyed to the severity of pulmonary disability. Knowledge of the pathogenesis of each of these complications is requisite for the physician caring for burn patients and permits the employment of rational preventive and therapeutic measures.
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PMID:Progressive pulmonary insufficiency and other pulmonary complications of thermal injury. 109 77

An 11-year-old boy with acute lymphoblastic leukemia in remission developed a bilateral pneumonia which rapidly progressed to acute respiratory failure. During 9 days of intensive therapy the patient's respiratory status progressively deteriorated. When it became impossible to maintain the arterial oxygen tension (PAO2) above 40 mm.Hg by conventional means, extracorporeal blood-gas exchange with a membrane lung was begun. After 5 days of bypass the patient's respiratory function began to improve, and he was weaned from the membrane lung on the tenth day. Seven days later he was discharged from the hospital and is currently in excellemt health 23 months after bypass. This perfusion, the longest successful effort to provide respiratory assist with a membrane lung, attests to the efficacy of this therapeutic modality.
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PMID:Acute respiratory failure. Survival following ten days' support with a membrane lung. 113 20

The heart and the lung make up an inseparable anatomic and functional unit. The changes in one affect the other and vice versa. In acute myocardial infarction a heart failure syndrome develops. This syndrome is characterized by passive pulmonary congestion, which leads to hypoxemia. This hypoxemia indicate the functional disturbance of the lung, and the hemodinamic evolution of the disease. Arterial gases determination is the best way to assess the sickness progression. A certain paralelism exists among the central venous saturation, cardiac insufficiency and the degree of pulmonary disfunction. Such a procedure is not very appreciable and does not substitute the direct analysis of the arterial PO2. The pulmonary complications in the myocardial infarction shock are directly responsable of death in 50% of the patients. To heart failure and shock, hipperfusion and hypoxia are added. Many vessels close due to the decrease in the pulmonary flow. This brings about the release of substances that are toxic to the vessel causing an inflammatory vascular reaction. The decrease in the flow harms the lung cell and for this reason atelectasia or alveolar colapse occur; besides inducing the formation of shunts. Under these conditions the lung compliance decreases. The areas that are badly ventilated and hypoperfused can easily become infected and pneumonitis and abscesses cause even more harm to the tissue. The decrease in the speed of circulation and hematologic changes of shock, induce a diseminated intravascular coagulation. What was stated before leads to an important reduction of the lung as a depurating organ and makes the shock irreversible. As far as therapy is concerned in the prevention of vascular colaps and the improvement of the oxemia, oxygen is very useful when there is a venous congestion (clinically, X rays, and oxemia). When the concentration of O2 is lower than 50% in the cases with slight cardiac failure; do not use oxygen in higher concentrations unless the hypoxia is associated to acute pulmonary edema and shock. Mechanic ventilators, and intermitent possitive pressure are recommended even though they have a posenous effect on the cardiac output. Always keep the air ways permeable: changing position, breathing exercises, humidifications, aspiration of secretions, intubation, or traqueostomy depending upon the various cases.
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PMID:[Pulmonary complications of acute myocardial infarct. Therapeutic orientation]. 115 8

Four cases of adult respiratory distress syndrome secondary to viral interstital pneumonia were treated successfully. The illnesses started with a prodrome of upper respiratory symptoms. The development of dyspnea was a key symptom from which point respiratory failure developed within 24 to 48 hours. Chest roentgenograms showed alveolar infiltrative patterns which later became coalescent. The clinical course consisted of fever, dyspnea, hypoxia and acidosis, There was no response to therapy with antibiotics, 100 per cent oxygen by mask and intermittent positive pressure breathing (IPPB) over the first 24 hours. Supportive therapy then initiated included endotracheal intubation, the administration of humidified oxygen by volume cycled respirator with positive end expiratory pressures of 10 to 15 cm H2O and corticosteroids. It is concluded that early recognition of the syndrome, coupled with prompt insituition of aggressive supportive respiratory management may be lifesaving in patints with severe interstitial pneumonia.
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PMID:Recognition and treatment of adult respiratroy distress syndrome secondary to viral interstitial pneumonia. 117 23


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