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

Between 1 January 1980, and 30 September 1989, 93 cases of exposure to herbicides containing glyphosphate and surfactant ('Roundup') were treated at Changhua Christian Hospital. The average amount of the 41% solution of glyphosate herbicide ingested by non-survivors was 184 +/- 70 ml (range 85-200 ml), but much larger amounts (500 ml) were reported to have been ingested by some patients and only resulted in mild to moderate symptomatology. Accidental exposure was asymptomatic after dermal contact with spray (six cases), while mild oral discomfort occurred after accidental ingestion (13 cases). Intentional ingestion (80 cases) resulted in erosion of the gastrointestinal tract (66%), seen as sore throat (43%), dysphagia (31%), and gastrointestinal haemorrhage (8%). Other organs were affected less often (non-specific leucocytosis 65%, lung 23%, liver 19%, cardiovascular 18%, kidney 14%, and CNS 12%). There were seven deaths, all of which occurred within hours of ingestion, two before the patient arrived at the hospital. Deaths following ingestion of 'Roundup' alone were due to a syndrome that involved hypotension, unresponsive to intravenous fluids or vasopressor drugs, and sometimes pulmonary oedema, in the presence of normal central venous pressure.
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PMID:Acute poisoning with a glyphosate-surfactant herbicide ('Roundup'): a review of 93 cases. 167 18

A previously healthy 42-year-old woman developed severe dyspnea, chest discomfort, and malaise several hours after prolonged exposure to concentrated vapors from mineral spirits. On the way to the hospital, she sustained a cardiopulmonary arrest; on arrival several minutes later, she was found to be in ventricular fibrillation and was resuscitated. Her hospital course included slowly resolving cardiac abnormalities, amnesia, noncardiogenic pulmonary edema, abrupt hemolytic anemia, sustained rhabdomyolysis, and other metabolic abnormalities. It is highly probable that this syndrome represented acute and near-lethal toxicity caused by the inhalational exposure to the petroleum distillate known as mineral spirits. It is important that physicians be aware of this syndrome in order to recognize it on presentation and to warn patients of the risk of such toxic exposure.
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PMID:Mineral spirits inhalation associated with hemolysis, pulmonary edema, and ventricular fibrillation. 206 97

When patients present with suspected prosthetic valve dysfunction, investigation is usually instituted to delineate the site and cause thereof. Precordial cross-sectional echocardiography is often helpful in this respect, but in the patient with acute pulmonary edema, imaging may be impaired because of discomfort and respiratory distress. The information obtained may also be suboptimal as a result of concomitant obesity, chest wall deformity, and pulmonary disease. In addition, further difficulties may relate to the acoustic shadowing produced by the metallic portion of the valve and its sewing ring, especially with valves in the mitral position. In such patients, cardiac catheterization may cause further decompensation and is associated with a recognized increase in morbidity and mortality. Angiography does not accurately site regurgitant jets in relation to the prosthetic valve concerned and will not detect the presence of vegetations. Transesophageal echocardiography circumvents many of these imaging difficulties and we evaluated its use in five patients with prosthetic heart valves who presented acutely ill, in severe pulmonary edema and suspected prosthetic heart valve failure. In each case, the diagnosis of valve dysfunction was established, and precise information regarding the site and cause of the failure was obtained. No complications or deterioration in patient condition resulted from the procedure and the findings were confirmed at surgery performed within 24 hours in all five patients. Transesophageal echocardiography should be included in the assessment of acute prosthetic heart valve failure.
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PMID:The value of transesophageal echocardiography in the investigation of acute prosthetic valve dysfunction. 239 17

Twenty patients admitted to hospital with congestive heart failure were evaluated for severe concomitant lumbosacral and leg pain. In each instance the discomfort was worse at night and progressively decreased with a resolution of the pulmonary edema. Neurologic and electromyographic examinations in all but four patients were normal with reflexes, strength and straight leg raising testing normal. An absent Achilles reflex was recognized in two, a diminished knee jerk reflex in one and in a third, weakness in the extensor hallucis longus. Lumbar spinal stenosis was identified in all of the patients with a concomitant degenerative spondylolisthesis present in nine instances and in an additional two a spondylolisthesis with interruption of the neural arch. It is theorized that diminished right heart compliance can induce a sufficient increase in venous volume and pressure within the paravertebral plexus of Batson to acutely exacerbate a chronic lumbar spinal stenosis. In support of this hypothesis, the multiple factors involved in the pathomechanics and physiology of lumbar radiculopathy, spinal stenosis and the role of the paravertebral plexus of veins are examined. Specifically, their response to altered volume and pressure gradients tending to induce venous "creep" as well to alterations in posture and diurnal cycles are reviewed.
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PMID:Night pain associated with diminished cardiopulmonary compliance. A concomitant of lumbar spinal stenosis and degenerative spondylolisthesis. 340 61

In this two year retrospective review, 86 cases of chlorine gas inhalation from 49 medical facilities were treated with nebulized sodium bicarbonate on the recommendation of the Kentucky Regional Poison Center. Typical manifestations included cough, chest discomfort, shortness of breath, and wheezing. No patients developed pulmonary edema or respiratory insufficiency requiring ventilatory support. Sixty-three cases (73.3%) were exposures to chlorine producing acid/hypochlorite mixtures. Six (7.0%) were exposed to chlorine gas in industrial settings. Twelve (14.0%) were exposed to chlorine gas in swimming pool settings. Sixty-nine (80.2%) were treated and released from the emergency department. In 53 patients, clinical condition was clearly improved on emergency department discharge. Seventeen (19.8%) were admitted to the hospital. All admitted patients gradually improved and had a mean hospital stay of 1.4 days (range 1 to 3 days). No patients in this study deteriorated clinically after nebulized sodium bicarbonate use. Nebulized sodium bicarbonate appears safe and merits prospective evaluation in the therapy of chlorine gas inhalation.
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PMID:Nebulized sodium bicarbonate in the treatment of chlorine gas inhalation. 800 31

When first developed in the fifties and sixties during the major polio epidemics, artificial ventilation was a major advance in medical care. The negative pressure perithoracic "iron lungs" had however many disadvantages and were widely replaced by positive pressure ventilation with intubation. This invasive technique allows normalization of gas exchange but has the disadvantage of requiring artificial sedation of the respiratory muscles in many cases in addition to the risk of secondary complications. Several authors have recently shown that in many cases, intubation may not be necessary since nasal mask positive pressure ventilation can provide satisfactory results in selected patients. Basically, indications involve patients suffering from acute decompensation of chronic obstructive respiratory failure. Prospective studies have demonstrated beneficial effects in terms of dyspnea and patient discomfort. A clear improvement over the classical medical care (oxygen, bronchodilators, antibiotics) has been observed. Other indications include certain cases of acute neuromuscular diseases, cardiogenic pulmonary edema or severe acute pneumonia. The technique can rarely be used 24 hours a day, at least during the first days of therapy and cannot provide total respiratory support in case of acute respiratory failure. Other inconveniences include leaks around the mask and the need for careful surveillance by the health care workers. Today, there are several arguments based on prospective clinical studies showing that intubation may be avoided in certain patients by using non-invasive positive pressure ventilation with a nasal mask. Careful patient selection is however essential in addition to knowledge of the limitations of the technique.
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PMID:[Non-invasive modalities of mechanical ventilation]. 895 65

A syndrome of acute pulmonary edema has been previously reported among scuba divers in cold, European waters. Because of the temperatures involved, the name "cold-induced pulmonary edema" was coined in the original 1989 description. We report six individuals who developed the identical syndrome, five while diving in Puget Sound and one in the Gulf of Mexico. The four women and two men ranged in age from 24 to 60 yr. They experienced one to six episodes apiece, each with the development severe dyspnea at depth without excessive exertion. Associated symptoms included cough, weakness, expectoration of froth, chest discomfort, orthopnea, wheezing, hemoptysis, and dizziness. Emergency medical evaluation of four divers revealed rales on examination and pulmonary edema on chest radiograph. In one diver with pulmonary edema on chest radiograph, pulmonary capillary wedge pressure was normal when measured acutely. Symptoms resolved either spontaneously over 1-2 days or with standard medial treatment for pulmonary edema. Prior history of cardiovascular disease was negative except for hypertension and mitral valve prolapse in one diver. Cardiac evaluations following recovery from the acute episodes were normal. Episodes in the cold waters of Puget Sound sometimes occurred despite the use of dry suits. Furthermore, one diver developed recurrent episodes in 27 degrees C water off Cozumel, Mexico. Development of pulmonary edema while scuba diving constitutes a distinct clinical entity which may occur in either "cold" or "warm" water. It is not associated with a decompression mechanism. Personnel caring for divers should be aware of the syndrome in order to provide optimal medical management.
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PMID:Pulmonary edema of scuba divers. 906 53

Sleeve pneumonectomy is a technically demanding procedure, the indications of which include non-small bronchogenic tumors extending to the tracheobronchial bifurcation without diseased mediastinal nodes. Right sleeve pneumonectomies are best approached through an ipsilateral thoracotomy in the fifth (or fourth) intercostal space. Median sternotomy for left sleeve pneumonectomy gives outstanding exposure to the tracheobronchial bifurcation, and less incisional discomfort and ventilatory restriction than an ipsilateral thoracotomy. If a tracheobronchial anastomosis is under tension, excessive tracheobronchial and mediastinal dissection and perioperative fluid overload are avoided, then the most common and often fatal early (noncardiogenic pulmonary edema) and late (anastomotic dehiscence) complications are significantly lowered. If these guidelines are respected, this operation generates 5-year survival rates exceeding 40%.
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PMID:Techniques of pneumonectomy. Sleeve pneumonectomy. 1036 72

Electroconvulsive therapy (ECT) was scheduled for a 61-yr-old woman with major depression who had been taking a beta-blocker for hypertension. She underwent the first ECT under thiamylal anesthesia uneventfully. The second ECT was performed under propofol anesthesia on the next day. Immediately after ECT, the heart rate dropped from 56 to 19 beats.min-1, which was remedied by intravenous atropine. Then, the blood pressure increased to 204/108 mmHg but it was controlled by nicardipine. However, the SpO2 decreased to 84-88% under oxygen administration by mask at a rate of 3 l.min-1. The patient complained of chest discomfort and had a bloody secretion from the trachea. A chest X-ray showed a butterfly shadow. The patient was diagnosed as having neurogenic pulmonary edema and was treated in the ICU by artificial ventilation and administration of diuretics and catecholamines. These treatments proved to be successful, and the patient was discharged from the ICU 4 days later uneventfully. This case indicates that hemodynamics should be carefully monitored following ECT and that care should be taken to prevent the occurrence of complications after ECT.
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PMID:[A case of pulmonary edema after electroconvulsive therapy under propofol anesthesia]. 1142 71

We describe a 72-year-old woman with hypertension who developed acute neurogenic pulmonary edema and giant negative T waves on electrocardiography (ECG) due to subarachnoid hemorrhage. The patient was alert and complained of precordial chest discomfort, dyspnea and shoulder stiffness. Echocardiography demonstrated normal left ventricle contraction with hypertrophy. Computed tomography (CT) and subsequent cerebral angiography revealed subarachnoid hemorrhage and saccular aneurysm at the anterior communicating artery. It is important to consider the possibility of subarachnoid hemorrhage when a patient shows pulmonary edema and ECG abnormalities even without typical clinical signs of subarachnoid hemorrhage.
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PMID:Neurogenic pulmonary edema and large negative T waves associated with subarachnoid hemorrhage. 1151 36


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