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

1. The ventilatory response to severe metabolic acidosis was studied by measuring arterial blood carbon dioxide tension and pH in sixty-seven patients with blood pH less than 7-10, none of whom had hypercapnia, pulmonary oedema, or chronic pulmonary insufficiency. The results were compared with those previously found in patients with uncomplicated diabetic ketoacidosis. 2. By that comparison, fifty-two of the sixty-seven patients with blood pH less than 7-10 were judged to have "appropriate hypocapnia", and fifteen had "submaximal hypocapnia". Thirteen of the latter fifteen had circulatory failture and/or acute hypoxia, and seven of nine in whom it was measured had plasma lactate greater than 9 mmol/1. 3. Hyperventilation was therefore usually well sustained in these patients with severe metabolic acidosis, except in most of those with acute tissue hypoxia. The latter may have had insufficient time to achieve maximum hyperventilation in response to their acidosis, or perhaps their submaximal hypercapnia presaged imminent failure of the hyperventilatory response.
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PMID:The ventilatory response in severe metabolic acidosis. 0 84

We describe the first recorded case from Africa of malarial lung, acute pulmonary insufficiency in Plasmodium falciparum malaria. The patient was successfully treated with intermittent positive pressure ventilation (IPPV). There was heavy parasitemia, preceding cerebral complications and rapid onset of pulmonary edema in the absence of fluid overload or cardiac failure. A further complication of polyuria from tubular dysfunction developed whilst the patient was being ventilated. IPPV may have an important place in the management of this rare and usually fatal complication of falciparum malaria.
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PMID:Malarial lung: report of a case from Africa successfully treated with intermittent positive pressure ventilation. 32 Aug 93

Near-hanging and strangulation injuries can result in multiorgan failure. A 13-year-old male sustained an ischemic anoxic cerebral injury that was followed by an encephalopathy lasting approximately 30 hours and pulmonary edema lasting more than 48 hours. The patient was treated with continuous positive pressure ventilation followed by spontaneous breathing with continuous positive airway pressure by a mask; shock was reversed. The loss of cardiovascular competency and pulmonary insufficiency are problems frequently encountered in the patient who has sustained an hypoxic insult. Cerebral injury can result from hypoxemia related to tracheal compression, aspiration, and pulmonary edema; cerebral vascular engorgement secondary to venous compression; and ischemic anoxia related to arterial compression. Cerebral changes continue after circulatory and pulmonary competence has been restored. Multiorgan monitoring and control including intracranial pressure monitoring may be required to guide therapy. Respiratory distress syndrome may develop secondary to multiple factors including autonomic reflexes triggered by cerebral hypoxia and edema.
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PMID:Multiple organ failure after near-hanging. A case report. 72 97

The advantages of a bloodless field and total cardiac relaxation have popularized the technique of deep hypothermia and total circulatory arrest for the correction of complex congenital cardiac defects in infancy. There is, however, a significant potential for cerebral and pulmonary complications. Presently, the most common technique is that of using a combination of surface cooling and cardiopulmonary bypass cooling and rewarming. Normal neurological development has been claimed with the present technique of hypothermia at 20 degrees C and total circulatory arrest for periods up to an hour; however, there are reports of seizure activity in the early postoperative period. There is also a disturbing incidence of respiratory insufficiency and, occasionally, hemorrhagic pulmonary edema. This study, using growing puppies and subjecting them to deep hypothermia and total circulatory arrest for varying periods of time, disclosed that animals subjected to 60 min of circulatory arrest recovered neurologically; however, there were histological changes of anoxia in the brain. Animals subjected to 30 min of total circulatory arrest were normal neurologically and there was no histological evidence of anoxic damage to brain tissue. Puppies that were continuously on cardiopulmonary bypass had no significant pulmonary changes caused by increasing the inspired oxygen tension in the ventilator; however, striking changes were noted when limited cardiopulmonary bypass was employed for core cooling and total circulatory arrest combined with pulmonary ventilation with 100% oxygen. We conclude from this experimental study that the use of surface cooling and core cooling with subsequent total circulatory arrest at 20 degrees C is a safe procedure, providing the period of time of cardiac arrest is kept around 30 min. We also conclude that the alveolar oxygen tension should be maintained at the lowest level possible during the interval of circulatory arrest to avoid the apparent rapid onset of post-traumatic pulmonary insufficiency.
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PMID:Effect of deep hypothermia, limited cardiopulmonary bypass, and total arrest on growing puppies. 120 92

Many questions are raised in this review about the role of adult donor granulocyte transfusions in the setting of overwhelming bacterial neonatal sepsis. There clearly exists a number of variables, which influence the survival and morbidity associated with bacterial sepsis. The important differences in these studies highlight the need for prospective large multicenter studies to definitely clarify these issues. Important criteria, which are yet to be established and which impact significantly, include the time of administration of adjuvant granulocytes, the number of granulocytes that need to be harvested, which group of neonates require early granulocyte transfusions, the best method for optimal and easy granulocyte collection, the frequency and intervals of granulocyte transfusions, and improved methods for the early identification of neonatal candidates who would benefit from the granulocyte transfusions. The benefits of granulocyte transfusions (ie, the improvement in morbidity and mortality) in septic neutropenic neonates must be weighed against the possible and reported side effects associated with such transfusions. Adverse reactions including graft-versus-host disease, CMV, HIV and hepatitis infection, fluid retention and pulmonary edema, blood group sensitization, and pulmonary insufficiency may all result from the use of granulocyte transfusions in a host who has evidence of developmental immaturity. All future studies must continue to evaluate these potential complications to balance and analyze the true benefits of survival with reported treatment results. Recently, a number of investigators including ourselves, have begun to examine the role of alternate adjuvant immunotherapy in enhancing neonatal host defense in the clinical setting of overwhelming bacterial sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The use of granulocyte transfusion in neonatal sepsis. 213 12

Hemofiltration (HF) is an established method for treating patients with impaired renal function and excessive fluid retention. In cardiac surgery fluid accumulation during extracorporeal circulation (ECC) may contribute to postoperative organ dysfunction, leading to severe pulmonary insufficiency. In this study our experiences with hemofiltration installed in the cardiopulmonary bypass are demonstrated in patients with preoperative pulmonary edema, impaired renal function, and long-term ECC, proving its efficacy by measurement of extravascular lung water (EVLW) in the early post-bypass period. EVLW-measurement was performed using the thermal-dye technique with indocyanine green and a microprocessed lung water computer. Our data demonstrate that hemofiltration during ECC is a valuable method for controlling fluid balance. It facilitates the intra- and postoperative management of patients with end-stage renal failure or with preoperative pulmonary edema. HF seems to be helpful by decreasing the risk of complications such as fluid overload, which is demonstrated by measurement of EVLW.
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PMID:Extravascular lung water and hemofiltration during complicated cardiac surgery. 244 35

In experimental anthrax intoxication, a highly important stage of its pathogenesis consists in microcirculatory disturbances with the phenomena of blood sludge, accompanied by the increased permeability of blood vessels not only for plasma, but also for red blood cells. These disturbances result in perivascular hemorrhages, hemorrhagic infiltrations, edema and cavitary transudates. Pulmonary edema and, as a consequence, the accumulation of fluid in pulmonary alveoli and the respiratory tract are of particular importance and, probably, can be considered the basic cause of the ensuing acute and fatal asphyxia. Such vascular and pulmonary insufficiency is accompanied by a decrease in the content of macroergic compounds (and in particular ATP), the characteristic deformation of red blood cells and disturbances in their oxygen transport function, which is linked with the decreased content of 2,3-diphosphoglycerate.
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PMID:[Experimental characteristics of anthrax intoxication]. 244 50

Inhalation injuries most often occur with cutaneous burns, and the likelihood of an inhalation injury increases incrementally with age of the patient and size of the burn. Damage to the pulmonary parenchymal tissue manifests as increased capillary permeability leading to excessive lung fluid formation and increasing hypoxia. An inhalation injury may be diagnosed using observation of indirect criteria in conjunction with fiberoptic bronchoscopy, xenon 133 radiospirometry, and/or measurement of extravascular lung water. Initially, carbon monoxide poisoning threatens the patient's oxygenation capacity. High-flow oxygen therapy reduces the half-life of carbon monoxide to an acceptable period. The patient proceeds through three stages: pulmonary insufficiency, pulmonary edema, and bronchopneumonia. Treatment is directed toward supporting oxygenation using endotracheal intubation with mechanical ventilation, humidification of inspired air, early mobilization, chest physiotherapy, antibiotics for documented infection, and adequate systemic hydration.
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PMID:Managing smoke inhalation injuries. 258 65

Two cases of smoke inhalation injury are reported with a brief review of the pertinent literature. The frequency of occurrence, the mortality rate, the clinical course of this common event are discussed with emphasis on the following facts: 1) Pulmonary injury is often associated with skin burns and, conversely, skin burns, particularly when severe, are accompanied by significant effects on pulmonary function; 2) Domestic fires, which account for most of these casualties, may involve complex exposure to a variety of aggressive agents (CO, HCN, NOx, etc.), causing systemic effects; 3) The clinical course of the most severe occurrences characteristically consists of three phases, namely acute pulmonary insufficiency, pulmonary edema and bronchopneumonia, in sequence; 4) The mortality rates of these clinical phases range at or about 50 per cent; 5) Significant laryngeal edema and even pulmonary edema may follow an interval of several hours, during which both subjective and objective evidence of injury may be minimal or unnoticed; and 6) The determination of carboxyhemoglobin levels often helps in gauging the severity of the exposure and related effects of either immediate or delayed appearance.
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PMID:Smoke inhalation. 260 55

Inhalation injuries occur in approximately one-third of all major burns and account for a significant number of deaths in those burn patients each year. Victims die as a result of carbon monoxide poisoning, hypoxia, and smoke inhalation. These deaths can occur without thermal wounds as well as with burn injuries. There are three distinct problems with inhalation injuries: thermal burns of the upper airway, carbon monoxide poisoning, and smoke inhalation. Each has different symptoms and signs, different treatment, and different prognosis. Thermal burns occurring in the upper airway are usually manifested within 48 hours of injury. Diagnosis is made by direct visualization of the upper airway, looking for signs of thermal injury. Admission for observation with humidified oxygen, attentive pulmonary toilet, bronchodilators as needed, and prophylactic endotracheal intubation as indicated are the mainstays of treatment. Resolution of the injury usually occurs within days. Carbon monoxide poisoning, the most common cause of death in inhalation injury, is a result of combustion. Symptoms and signs correlate with blood levels, but arterial blood gases are used to determine the degree of carbon monoxide intoxication. Treatment is based on the principle that carbon monoxide dissociation occurs much faster if the patient is placed on 100% oxygen. Occasionally the patient's symptoms may persist or get worse despite adequate treatment. Smoke inhalation significantly damages normal respiratory physiology, resulting in injury progressing from acute pulmonary insufficiency to pulmonary edema to bronchopneumonia, depending on the severity of exposure. Diagnosis is based on history, but clinical findings, arterial blood gases, and fiberoptic bronchoscopy are helpful. Treatment is supportive with careful attention paid to fluid resuscitation in the patient with burns.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Inhalation injuries. 261 27


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