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

Two patients with primary spontaneous pneumothorax died despite intensive treatment. In the first the pneumothorax had been present for 10 days, and, after insertion of a chest drain, pulmonary oedema developed unilaterally, followed by cardiac arrest. She was resuscitated, but later died of a tension pneumothorax on the other side, probably due to cardiac massage and artificial ventilation. In the second patient, after insertion of a chest drain, mediastinal emphysema spread to the head and neck, causing fatal obstruction of the hypopharynx.
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PMID:Two unexpected deaths from pneumothorax. 8 5

Three cases are reported of unilateral pulmonary edema, two following rapid reexpansion after prolonged tension pneumothorax, with total collapse of the right lung and one after reexpanded atelectasis following left intrabronchial obstruction. In all cases decrease of blood pressure and tachycardia not responding to intravenous fluid substitution were already present within the first 15 min after chest drainage or after removal of the intrabronchial obstruction. The preexistent dyspnea failed to improve. A cloudy opacity of the reexpanded lung was found immediately after drainage in 2 cases. After immediate application of a continuous positive airway pressure mask no more extensive therapy was necessary in one patient. The two others in whom treatment was begun with more than 1 hour delay required artificial ventilation and adrenergics for 2 and 4 days, respectively.
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PMID:The importance of early detection and therapy of reexpansion pulmonary edema. 188 81

There is evidence from pediatric tertiary care centers in the United States that childhood deaths from asthma in hospitalized patients are becoming increasingly rare, while asthma mortality outside the hospital appears to be on the rise. When a young outpatient with asthma dies, the event is apt to be sudden and unanticipated and the victim is likely to be a preadolescent or adolescent who has suffered from asthma most of his or her life and who, despite ongoing bronchodilator therapy, requires hospitalizations for treatment of status asthmaticus. Patients in this age cohort have a strong tendency to underuse, overuse, or neglect to use prescribed medications, possibly as a gesture of emerging independence or because of the depression engendered by a chronic illness. In some instances serious psychosocial pathology accounts for noncompliance. For a patient with chronic asthma with a high-risk profile, any departure from an ongoing treatment regimen may result in respiratory failure. Pathologic complications of asthma may also act to upset the precarious physiologic equilibrium these patients have established. Unsuspected chronic pneumonia may lead to further increases in a chronically high degree of oxygen desaturation. Hypoxic seizures during an asthma attack may precipitate pulmonary edema. Tension pneumothorax has an even greater fatality potential for high-risk patients with asthma than it has for other patients with asthma, and pulmonary hypertension with cor pulmonale may develop because of chronic hypoxia. Some sudden deaths in children with chronic, severe asthma are unassociated with any of the above, making it necessary to entertain still other hypotheses.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:An analysis of fifteen childhood asthma fatalities. 362

The first 2000 incidents reported to the Australian Incident Monitoring Study were analysed with respect to the role of the pulse oximeter. Of these 184 (9%) were first detected by a pulse oximeter and there were a further 177 (9%) in which desaturation was recorded. Of the 1256 incidents which occurred in association with general anaesthesia 48% were "human detected" and 52% "monitor detected". The pulse oximeter was ranked first and detected 27% of these monitor detected incidents; this figure would have been over 40% if an oximeter had always been used and its more informative modulated pulse tone relied upon instead of that of the "bleep" of the ECG. The pulse oximeter is the "front-line" monitor for endobronchial intubation, the fourth most common incident in association with general anaesthesia (it detected 87% of the 76 cases in which it was in use). It also played an invaluable role as a "back-up" monitor in 40 life-threatening situations in which "front-line" monitors (e.g. oxygen analyser, low pressure alarm, capnograph) were either not in use, were being used incorrectly or failed. Other situations detected, in order of frequency of detection, were: circuit disconnection, circuit leak, desaturation (severe shunt), oesophageal intubation, aspiration and/or regurgitation, pulmonary oedema, endotracheal tube obstruction, severe hypotension, failure of oxygen delivery, hypoxic gas mixture, hypoventilation, anaphylaxis, air embolism, bronchospasm, malignant hyperthermia, and tension pneumothorax.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The Australian Incident Monitoring Study. The pulse oximeter: applications and limitations--an analysis of 2000 incident reports. 827 73

We present the case of a 19-year-old woman who developed sudden severe left-sided tension pneumothorax in the recovery room after undergoing a 6-hour open reduction and internal fixation of an anterior and posterior pelvic fracture sustained in a motor vehicle accident 4 days prior to surgery. Additional preoperative injuries included a right-sided hemopneumothorax, right lung contusion, and liver laceration. The left lung was rapidly reexpanded using tube thoracostomy. The patient subsequently developed ipsilateral pulmonary edema and ultimately acute respiratory distress syndrome, which required vigorous treatment over the next several days. It is postulated that a variety of intraoperative and immediate postoperative maneuvers may have contributed to the development of this near fatal complication.
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PMID:Reexpansion pulmonary edema after resolution of tension pneumothorax in the contralateral lung of a previously lung injured patient. 1526 22

Most of the patients with spontaneous pneumothorax are young male adults without significant pulmonary disease and the prognosis in these patients is usually very good. But in a few cases when tension pneumothorax develops, immediate diagnosis and chest tube drainage is required to avoid life-threatening emergency. Needless to say mechanical ventilation with tracheal intubation is contraindication even if the patient has severe respiratory distress or hypoxia. Re-expansion pulmonary edema is another severe complication. This occurs to a long-term (over 1 week) complete collapse lung when it is rapidly re-expanded with high negative pressure. To treat such patient it is necessary to decompress the lung slowly using lower negative pressure or water seal suction. When persistent bleeding of hemothorax is present, it is important to decide to perform open thoracotomy or video-assisted thoracoscopic surgery to avoid blood transfusion. The diagnosis of pneumothorax is simply done by chest X-ray film. When the pneumothorax is suspected, chest X-ray examination has to be done first. A scheduled operation to prevent recurrence of pneumothorax has to be performed under relative indication in consideration of both the medical factor and the social factor of the patient.
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PMID:[Pneumothorax]. 1536 55

Acute respiratory distress is a common cause of emergency admission to hospital. Clinicians may face difficulties in terms of diagnosis (etiology), especially in older subjects, often presenting with multiple medical conditions. The Brain Natriuretic Peptid (BNP) assay is an interesting new diagnostic tool in this context, since it differentiates pulmonary dyspnea from pulmonary edema in these patients. However, this laboratory examination should be used with discretion and analyzed according to the clinical setting to avoid possible false positive results. Symptomatic treatment of respiratory distress (oxygen therapy and/or respiratory support) is essential. Except from some clearly identified medical conditions (for instance cardiogenic pulmonary edema in hypertensive subjects, acute asthma attacks or tension pneumothorax), the effect of a specific treatment is often limited, at least in terms of immediate outcome.
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PMID:[Acute respiratory distress]. 1673 6

Tension gastrothorax is herniation of abdominal viscera, stomach in particular, into the thorax that can simulate acute tension pneumothorax. This case reports an acute condition in which percutaneous needle decompression of the distended stomach, through the chest wall, allowed rapid decompression of the tension gastrothorax. After thoracotomy and repair of the ruptured diaphragm, the patient developed re-expansion pulmonary edema that was managed by differential lung ventilation.
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PMID:Tension gastrothorax: a rare complication. 1940 71

We report a case of 46-year-old male with simultaneous bilateral spontaneous tension pneumothorax. Severe reexpansion pulmonary edema developed after bilateral tube thoracoscomy, but he was recovered after 2 days ventilator care. After bilateral wedge resection and talc pleurodesis, he was discharged without complications and had remained well and without recurrence during the 8-year follow-up.
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PMID:Reexpansion pulmonary edema after treatment of simultaneous bilateral spontaneous tension pneumothorax. 2355 79

We report the case of a woman in her late twenties with anorexia nervosa who was difficult to treat both psychologically and physically because she resisted being treated despite presenting with various and severe physical complications, such as a refractory tracheoesophageal fistula. On admission, she weighed 24.8 kg and her body mass index was 9.6 kg/m2. Treatment on a medical ward was not possible due to her resistance to being fed and repeated secretive and deviant behaviors. Therefore, she was treated mainly on a psychiatric ward, with a psychiatrist as the attending doctor. After hospitalization for more than 3 years, she had sufficiently recovered to leave the hospital. She was discharged weighing 37.7 kg and her body mass index was 14.5 kg/m2. As physical complications, the patient manifested with a tracheoesophageal fistula, duodenal bulb perforation, and tension pneumothorax, which were considered to reflect the vulnerability of the intrapleural and intraperitoneal soft tissue. She also manifested with lower limb edema, pulmonary edema, pleural effusion, overreaction to a diuretic, dehydration, and hypernatremia, which were considered to reflect the disturbances of water balance. As seen in this case, a patient with anorexia nervosa who resists being fed, even though treatment of the physical complications requires an improved nutritional status above all, may require treatment on a psychiatric ward even at the risk of providing less than ideal care for the physical complications. We discuss "medical psychiatry" as a model for treating anorexia nervosa patients with severe physical complications. In this concept of "medical psychiatry", it is the most important that staff on the psychiatric ward take an interest in and have concerns about the patient's physical complications. If the psychiatrist as the attending doctor actively and continuously participates in the treatment of physical complications, it should be possible to create a treatment plan that, although complex due to its multidisciplinary nature, is followed smoothly and consistently, and, therefore, provide patients with trustworthy and appropriate medical treatment.
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PMID:[A case of anorexia nervosa with severe physical complications resulting in long-term hospitalization]. 2405 15


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