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

The fat embolism syndrome is an uncommon clinical disorder that typically occurs as a complication of severe trauma. We report the case of a 60-year-old single-lung transplant recipient who died of massive fat emboli. Before lung transplantation, the patient had been treated with corticosteroids for at least 1 year because of chronic obstructive pulmonary disease caused by centrilobular emphysema and asthmatic bronchitis. After receiving his lung transplant, he was treated with triple-drug immunosuppression, which included 25 mg of prednisone per day. He was discharged from the hospital 2 months after transplantation only to be readmitted 2 weeks later with cytomegalovirus pneumonia, from which he recovered. Concomitantly, he had new lumbar compression fractures with severe back pain and lost approximately 3 cm in height during a 3-week period. On the eleventh day after hospital readmission, he suddenly had a "sepsis-like" illness without a known infectious cause, numerous petechiae and ecchymoses, marked pulmonary edema with worsening diffuse pulmonary infiltrates, profound hypoxemia, decreased mentation, and mild thrombocytopenia. He died 3 days later. With the exception of a positive sputum culture for cytomegalovirus, all cultures were negative. The postmortem examination showed severe osteoporosis, multiple vertebral compression fractures, and widespread massive fat emboli. This is the first reported case of fat emboli as the cause of death in a lung transplant recipient, and the case suggests that the fat embolism syndrome should be considered in the differential diagnosis of a sepsis-like illness in patients who have received steroids during a long period, particularly in the setting of vertebral compression fractures.
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PMID:Fatal fat embolism syndrome after numerous vertebral body compression fractures in a lung transplant recipient. 780 19

"At first glance the lungs may seem uncomplicated, but many wise men have gone astray in their labyrinths." These words were written by Dr. A.A. Liebow, a famous pathologist, in a foreword to the first edition of Pathology of the Lung by H. Spencer. This same thought can also be applied to the field of medicolegal autopsies. 1. The gross appearance of the lungs in medicolegal autopsies Plucks consisting of the lungs, neck organs, the esophagus and the aorta were removed from human cadavers and after taking photos of the frontal and rear view, the lungs were carefully examined to reveal whether the lung shows characteristic morphological changes depending on causes of death. Based on their appearance, the lungs were classified into the 3 following types: a collapsed, a non-collapsed and an inflated type, each of these types reflecting the probable cause of death. The collapsed type of lung was seen in cases of death from exanguination, and the lung falling into shrinkage due to traumatic pneumo- and/or hemo-thorax was also classified into the collapsed type. The non-collapsed type of lung was seen in cases whose lungs were thermo-coagulated and in a case of death from a pulmonary embolism. Also, the deflating lungs of drowning victims before falling into collapse, were classified into a non-collapsed type. The inflated type of lung consisted of lungs that showed ballooning soon after death by drowning, and lungs that had inflated due to emphysema or edema from various causes. This lung study has reconfirmed that the lungs show hypostatic changes more clearly than any other organs of the body, and in the absence of skin color changes reflecting hypostasis, the settling of the blood in the lung could be detected in most cases. 2. Early histopathological lung changes induced by shock One hundred and thirty medicolegal cases were reviewed to detect early histopathological changes of the lung induced by shock. In many cases of death from various causes, pulmonary edema and hemorrhage were noted, but the incidence of such changes did not reveal any significant differences among the causes of death. When death had resulted from a hemorrhage or occurred during a state of shock, megakaryocytes in the pulmonary vessels tended to increase. However, if death from such causes had occurred shortly after the event, no increase in megakaryocytes was noted.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Some findings of the lung in medicolegal autopsy cases]. 786 36

Bronchopulmonary dysplasia is a most frequent contemporary lesion of the lung in early childhood. It is characterized by clinical symptoms (neonatal respiratory distress syndrome) and by X-ray picture reflecting progressive morphological changes in the respiratory tract, i.e. in trachea, bronchi, bronchioles, and pulmonary acini, followed by interstitial pulmonary lesion. As usual, bronchopulmonary dysplasia is forerun by hyaline membranes and may be associated with or followed by interstitial emphysema. Pathogenetic participants are toxicity of highly concentrated and long administered oxygen, artificial mechanical ventilation with an intermittently positive pressure, barotrauma first of immature lung causing emphysema and pneumothorax and pneumomediastinum, lung edema, shortage of A and E vitamins and ceruloplasmin deficiency. Morphological changes in bronchopulmonary dysplasia are alike diffuse alveolar damage in bigger children or adults. Nevertheless, neonatal changes differ from later pulmonary lesion by evolving in an immature tissue and by being complicated with necrotizing "obstructive" bronchiolitis.
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PMID:[Bronchopulmonary dysplasia]. 833 23

Mechanical ventilation may have adverse effects on the lung. The appearance of extra-alveolar air, either as a pneumothorax or as subcutaneous emphysema along with other manifestations, is a complication of barotrauma which has been known for a long time. Recent experimental studies have clearly shown that mechanical ventilation can also lead to alterations in the blood gas barrier. Mechanical ventilation with high inflation pressure and elevated tidal volumes induces pulmonary oedema; the genesis of which results principally from anomalies of alveolar capillary permeability. These anomalies are made as a result of pulmonary distension and not as a result of elevated pressures in the airways, thus justifying the term "volume traumatism". The existence of previous acute pulmonary injury considerably worsens the deleterious pulmonary effect of mechanical ventilation. Although the direct clinical implications of these experimental studies are difficult to confirm, these latter have nevertheless lead to profound changes in ventilatory strategy during the course of acute pulmonary disease such as the adult respiratory distress syndrome.
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PMID:[Deleterious effects of mechanical ventilation on the lower lung]. 867 49

Laparoscopic surgery is very popular among physicians and patients because this technique is associated with safety, shorter hospital stay, early return to normal activity, and cosmetic acceptance of the operative scar. Although the procedure involves minimal invasion and tissue damage, it has potentially serious complications, including cardiopulmonary effects that result mainly from hypercarbia and raised intraabdominal pressure caused by pneumoperitoneum. Absorbed carbon dioxide from the peritoneal cavity tends to cause acidosis. Leakage of the gas into tissue spaces may induce subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumopericardium. Cardiac effects include arrhythmias, hypotension, cardiac arrest, gas embolism, pulmonary edema, and myocardial ischemia or infarction. Some of these effects, though rare, are serious and potentially fatal. Physicians should anticipate these problems in their patients undergoing laparoscopic procedures. This review discusses the technique of and physiologic considerations in laparoscopic surgery as well as its potential complications.
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PMID:Laparoscopic surgery and its potential for medical complications. 901 21

Application of a modern method of introscopy--electroimpedance tomography (EIT) for diagnosis of different types of lung diseases is described. The EIT system including measurement and collecting data devices, 16-electrodes array and IBM PC 486 computer was used. The results of analysis of electrotomograms have demonstrated that the EIT-system can be introduced for detecting abnormal lung fluid levels, pulmonary edema, diagnosis of lung cancer, emphysema, pleuritis, hydrothorax, sarcoidosis. The method provides high sensitivity to the changes in the body physiological state. Other advantages are: safety, fast measurements, ease of equipment transportation and maintenance, low cost.
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PMID:[Electrical impedance tomography in pulmonology]. 921 60

Mechanical ventilation can have deleterious effects on the lungs. Extra-alveolar escape of air, such as pneumothorax or subcutaneous emphysema, are complications which have long been known. New experimental studies have clearly shown that mechanical ventilation can also result in pathologic changes to the air/blood barrier. Mechanical ventilation with high end-inspiratory pressure and high volume causes lung edema in whose origin abnormal permeability of the alveolo-capillary barrier plays a major role. The abnormalities are in fact the result of pulmonary distention and not of elevated air pressure; this justifies the term "volume traumatism". The presence of a previous acute pulmonary injury considerably increases the deleterious effects of mechanical ventilation on the lungs. Although the clinical implications of these experimental studies are difficult to assess, they have nevertheless resulted in major changes in ventilation strategy for acute lung diseases such as the acute respiratory distress syndrome of the adult.
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PMID:[Experimental changes in the alveolo-capillary barrier induced by artificial ventilation]. 928 29

The aim of this study was to present whether the heparin has on influence on course of experimental acute pancreatitis (AP) and some organ complications. The research referred to histological changes in liver, lungs and kidneys. The study was conducted on 69 rats divided into 5 groups: I--operated, without induction AP, II--control, induction of AP without treatment, III--induction of AP and immediate administration of heparin, IV--induction of AP and administration of heparin 3 hours after, V--induction of AP and administration of heparin 6 hours after. AP was induced by administration 5% sodium taurocholate. In all groups the animals were anesthetised after the period of 3, 6 and 12 hours from the induction of AP respectively. The specimens of mentioned organs were formalinized and stained with hematoxylin/eosin, and in addition specimens of the liver with p.a.S, Sudan IV and Brachets methods. In group I we observed pulmonary oedema after 6 and 12 hours but kidneys and liver were unchanged. In group II pathological changes were most evident in lungs, while we observed on acute passive hyperaemia, pulmonary emphysema and single coagulative thrombosis in vessels. In the liver number of lining cells was increased and minor or major droplets of lipids in hepatocytes were present. Using Brachets method we revealed regular staining of hepatocytes, and p.a.S. method regular staining of their cytoplasm. In group III examined organs do not show any significant differences as compared with group II, except for lungs where the coagulative thrombosis was not present. In groups IV and V changes were similar to those described in group II. This study showed decreased inflammatory and thrombotic process in lungs in experimental AP in rats after heparin treatment.
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PMID:[The effect of heparin on the course of some organ complications in experimental acute pancreatitis in rats]. 942 34

In recent years, lung transplantation (LT) and volume reduction surgery (LVRS) have been proposed for selected patients with end-stage pulmonary emphysema. Retrospectively, we analyzed the perioperative time course of 30 patients with emphysema who underwent either LVRS (n = 17) or LT (n = 13). In the LVRS group, patients were significantly older, presented less severe functional disability and all but one could be extubated at the end of surgery. In contrast, patients undergoing LT required postoperative mechanical ventilation (19 +/- 11 hrs) and had a prolonged hospital stay (37 [25-60] days vs 19 [11-42] days in LVRS patients) due to reperfusion lung edema, infection, hemorrhage and acute rejection. Six months postoperatively, forced expiratory volume in 1 second was improved and was significantly larger after LT compared with LVRS (+200% vs +63%). Our preliminary results suggest that, although LT produces greater functional improvement, LVRS is associated with lower surgical risk and is an alternative therapy in selected patients with severe emphysema.
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PMID:[Surgical treatment of severe emphysema: lung transplantation or volume reduction?]. 956 87

Postpneumonectomy pulmonary edema (PPE) is a rarely reported form of acute lung injury which occurs in up to 4% of all pneumonectomies. The details of two well-documented cases of PPE are described with special emphasis paid to the preoperative lung functions. Both cases illustrated a striking disparity between preserved spirometric lung function and advanced emphysema as detected by quantitative CT emphysema scores and single-breath diffusion of carbon monoxide measurements. Though retrospective in nature, these results suggest a restricted capillary volume plays a critical role in the development of PPE.
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PMID:Postpneumonectomy pulmonary edema: can it be predicted preoperatively? 974 86


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