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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Positive end expiratory pressure (PEEP) is an accepted treatment for children with acute respiratory failure secondary to restrictive lung diseases. Using a simple technique based on open circuit nitrogen washout, we determined the functional residual capacity (FRC) in 25 ventilated children (age 3 wk-10 y) with acute respiratory failure secondary to restrictive lung disease (pulmonary edema, bilateral pneumonia). FRC measured at a physiologic level of PEEP (2-4 cm H2O) was 45.0 +/- 3.6% (mean +/- SEM; range 12-80%) lower than normal predicted values. At the PEEP level chosen clinically (4-10 cm H2O, mean = 6.0), the FRC was below normal predicted values for nonintubated children by a mean of 31.8% (range 0-73%) (p = 0.0001) and only seven patients (28%) had FRC within 20% below predicted normal values. FRC normalized at PEEP levels of 6-18 cm H2O (mean = 11.6), which was up to 200% above the clinically chosen PEEP level. In six children without lung disease who were ventilated at a PEEP level of 2-4 cm H2O, the FRC was within normal range in two, but significantly higher (by 45%) in the other four. We conclude that FRC in ventilated children with acute restrictive lung disease is significantly lower than normal and the clinically chosen PEEP fails to normalize the FRC in most of the cases.
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PMID:Functional residual capacity in ventilated infants and children. 225 67

There is a growing number of drugs with lung toxicity, and radiologists are increasingly confronted with nonspecific patterns of possibly drug-induced lung disease. The present article reviews clinical symptoms, pathological findings and radiographic features associated with drugs causing lung disease. Roentgen-morphological categorization is based on the predominant pattern and distinguishes five groups of drugs that cause interstitial opacities, air space consolidation, mixed interstitial and consolidating opacities, pulmonary edema and alterations associated with pulmonary vessels. Clinical, pathological and radiological findings are nonspecific in the majority of cases, and clinicians and radiologists can only hope to assess the probability of drug-induced lung disease by correlating radiographic and clinical data. Useful clinical data include respiratory symptoms, results of respiratory function tests, dose and schedule of drug administration, and information concerning concomitant or previous administration of drugs or radiation therapy. Useful radiographic data include the distribution of densities seen on the chest radiograph, the presence or absence of thoracic adenopathy and pleural effusion. Drug-induced lung disease frequently simulates disseminated opportunistic infections (particularly pneumocystis carinii) and must be differentiated from these because the treatment is completely different. Since early recognition and withdrawal of the noxious agent constitute the best treatment for drug-induced disease, the physician's alertness to drug toxicity is most important.
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PMID:[Drug-induced changes in the lungs]. 229 Sep 25

Between February 1988 and December 1989, 15 combined heart-lung, 2 double lung and 5 single lung transplants were performed at our institution for end stage lung disease. The indication for heart-lung transplantation was primary lung disease with associated secondary heart failure in 11 cases, diffuse pulmonary disease with extensive adenopathy of the hilum in 2 cases and profuse and antibiotic-resistant tracheobronchial infection due to Pseudomonas in 2 cases. A double lung transplant was performed in 2 patients with hypertensive emphysema. The indication for a single lung transplantation was emphysema in 2 cases and pulmonary fibrosis in 3 cases; in this last indication, transplantation should be performed on the right side with a slight lengthening of the main bronchus to avoid the side-effects of mediastinal shift. There were 2 early deaths, 7 secondary deaths (from the 2nd to the 5th month) due to viral or bacterial infectious complications, and 1 late death in the 7th month (infection due to a syncitial virus). All 12 surviving patients have an excellent functional result; the size of the tracheal or bronchial anastomosis ranges from 85% to 100% of normal. From this experience, we conclude that specificity and severity of lung hazards are mainly related to bronchial infection, dependence on steroids and pleural adhesions. Moreover, posttransplant pulmonary oedema, mucociliary dysfunction and the differential diagnosis between rejection and infection require careful endobronchial suction and periodical sampling.
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PMID:Lung and heart-lung transplantation for end-stage lung disease. The Bordeaux Lung and Heart-Lung Transplant Group. 236 Oct 20

Focal patterns of pulmonary edema are confusing and often mistaken for the more common causes of focal lung disease, pneumonia, infarction, or aspiration. The authors report four cases of right upper lobe edema secondary to mitral regurgitation. The pathogenesis believed to be responsible for this condition is the vector of blood flow from the left ventricle to left atrium, which may be targeted at the right superior pulmonary vein, locally accentuating the forces for edema formation in the right upper lobe. Pulmonary edema accompanying mitral regurgitation should be suspected whenever right upper lobe consolidation develops in a patient with known or suspected mitral valve disease. The presence of interstitial edema in the remainder of the lungs can help in the differentiation of this condition from pneumonia and other disorders.
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PMID:Pulmonary edema localized in the right upper lobe accompanying mitral regurgitation. 270 4

Unilateral pulmonary edema is uncommon and is usually associated with prolonged surgical procedures or rapid evacuation of a hydro- or pneumothorax. Unilateral pulmonary edema due to left heart failure in the absence of known lung disease is rare. It is therefore not readily recognized and is often confused with other unilateral alveolar or interstitial infiltrates. We describe 2 patients, a 69-year-old man and a 78-year-old woman, who had repeated episodes of unilateral pulmonary edema due to left heart failure. In both cases several other diagnoses were considered, but the cardiac origin of the infiltrates was supported by the rapid clearing of the lung after diuretic therapy. Awareness of this unusual clinical condition is important for the early institution of proper therapy.
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PMID:[Recurrent unilateral pulmonary edema due to left heart failure]. 271 94

The purpose of this study was to see if lung vascular protein permeability is greater in preterm lambs with respiratory distress than it is in lambs without lung disease. We measured pulmonary vascular pressures, lung lymph flow, and concentrations of protein in lymph and plasma of 10 chronically catheterized preterm lambs (gestation 133 +/- 1 d) for 2-4 h before and for 4-8 h after delivery by cesarean section. All lambs were treated with mechanical ventilation after birth and received a constant intravenous infusion of glucose-saline solution at an hourly rate of 10 ml/kg. Respiratory failure developed in six lambs, in which there was a sustained threefold postnatal increase in lung lymph flow and lymph protein flow, with an even greater increase in pleural liquid drainage. Concentrations of protein in lymph and pleural liquid were almost identical, averaging approximately 75% of the plasma protein concentration. In the four preterm lambs without lung disease, lymph flow and lymph protein flow were either near or below fetal values by 6-8 h after birth, and there was little or no pleural liquid drainage. Extravascular lung water averaged 7.3 +/- .8 g/g dry lung in lambs with respiratory failure compared to 4.8 +/- .5 g/g dry lung in lambs without lung disease. Thus, pulmonary edema with abnormal leakage of protein-rich liquid from the lung microcirculation into the interstitium is an important pathological feature of the respiratory disease that often occurs after premature birth.
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PMID:Lung fluid balance in lambs before and after premature birth. 276 Feb 1

The smoking of clove cigarettes has been associated with 13 cases of serious illness in the United States, including hemorrhagic pulmonary edema, pneumonia, bronchitis, and hemoptysis. We describe a patient in whom, after she smoked a clove cigarette, pneumonia complicated by lung abscess developed. Her lung disease may have been caused by aspiration pneumonia as a consequence of pharyngolaryngeal anesthesia from clove cigarette smoke. Clove cigarettes appeal to adolescents experimenting with smoking practices and may influence the development of later smoking habits.
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PMID:Clove cigarettes. The basis for concern regarding health effects. 277 82

Administration of more than 40 separate pharmacologic agents has been associated with some form of pulmonary toxicity. This problem is becoming more significant every year. Occasionally, effective modes of therapy must be withdrawn because of undesirable pulmonary side effects, putting patients at risk for potentially lethal diseases. Pulmonary parenchymal damage due to drugs is an especially troublesome problem because irreversible pulmonary disease may occur. Mechanisms of pulmonary parenchymal tissue damage by drugs are unclear. It appears that some drugs induce direct tissue injury in addition to indirect tissue damage through amplification of pulmonary inflammation; other drugs cause pulmonary alterations solely through indirect mechanisms. Common clinical syndromes associated with drug-induced pulmonary parenchymal disease include pneumonitis/fibrosis, hypersensitivity lung disease, and noncardiogenic pulmonary edema. Less common patterns of pulmonary parenchymal injury by drugs include bronchiolitis obliterans and a pulmonary renal syndrome. Risk factors for pulmonary injury due to pharmacologic agents are partially defined but not entirely understood. To date, there are no adequate tests for early detection of pulmonary damage by drugs, although research into this area is active. This review discusses mechanisms and clinical features of drug-induced pulmonary parenchymal injury to aid the clinician in recognizing and understanding these syndromes.
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PMID:Drug-induced pulmonary disease. 288 62

The radiologic appearance of atypical cardiogenic pulmonary edema (ACPE) is presented in 10 cases admitted from 1983 to 1985, with age ranges from 74 to 89, and with diagnosis of ischemic heart disease, with myocardial infarction in 50% of them. Clinically they had asthenia, adynamia and anorexia in 80%, cough and weight loss in 50%. All of them had tachycardia, pulmonary rales and 50% pericardial rub. ECG showed in 80% anterior subepicardial ischemia, 60% posteroinferior subepicardial ischemia, 60% bifascicular block, and 50% left anterior fascicular block. Chest films were interpreted at first as pulmonary fibrosis in 90% of the cases with superior lobe involvement in 50%. Heart enlargement was present in 50%. A chronic lung disease was disclosed on clinical and pulmonary physiological grounds. It is concluded that asthenia, adynamia and anorexia were atypical manifestations of heart failure in the elderly. Silent myocardial infarction was observed in half of our patients and it was complicated with pericardial involvement in 50%. Irregular distribution of fluids in pulmonary edema was attributed to anatomic changes in elder lung. These atypical behaviour of pulmonary edema, has been misinterpreted on radiologic basis with pulmonary infection, tumours, metastasis or fibrosis. Those radiologic changes disappeared or improved in 72 hrs. with treatment of left ventricular failure.
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PMID:[Radiologic characteristics of cardiogenic pulmonary edema in the elderly]. 296 66

Pulmonary complications of lymphography are usually described as radiological infiltrates without clinical symptoms. However, a case is here reported of an adult respiratory distress syndrome occurring after lymphography in a 60 year old female lymphoma patient. Pulmonary oedema developed within 48 h; haemodynamic study showed a normal capillary wedge pressure. The patient died from intractable low cardiac output within 24 h. Post-mortem examination showed pulmonary lymphocytic infiltration and multiple fat emboli. The lack of lymphatic drainage was probably responsible for the intravascular passage of lipid-soluble contrast medium, this giving endothelial lesions. In such patients with preexisting lung disease or pulmonary involvement in haematological disease, lymphography has to be considered carefully.
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PMID:[Acute adult respiratory distress syndrome after lymphography]. 298 65


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