Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After tripling of baseline lung water (EVLW), decreasing wedge pressure (PWP) alone for two hours did not decrease EVLW. In 11 of 16 dogs, triple baseline EVLW and a decrease in plasma colloid osmotic pressure (COP) from 21.1 +/- 0.8 to 17.8 +/- 0.8 mm Hg resulted from left atrial balloon inflation at PWP of 28 to 30 mm Hg. With subsequent lowering of PWP to 10 mm Hg, intravenously administered furosemide (1 mg/kg) was given to these 11 dogs. One half hour after furosemide, shunt decreased slightly without decreasing EVLW in all 11 dogs, but by two hours, seven dogs (group 1) decreased EVLW (from 23.2 +/- 1.8 to 11.1 +/- 1.4 ml/kg) and shunt (37.4 +/- 2.0 to 12.9 +/- 2.9 percent), while four dogs (group 2) did not (EVLW: 22.3 +/- 1.4 to 22.5 +/- 0.6 ml/kg: shunt, 36.8 +/- 1.7 to 36.5 +/- 1.9 percent). Group 1 had diuresis, maintained normal blood urea nitrogen and creatinine levels, and increased COP from 17.7 +/- 0.7 to 23.6 +/- 0.5 mm Hg while group 2 was oliguric with elevated BUN and creatinine values and showed no change in COP (17.9 +/- 0.9 to 18.3 +/- 0.6 mm Hg) after furosemide. After decreasing PWP in massive pulmonary edema (triple baseline EVLW), furosemide appeared to enhance edema clearance by changes in COP with diuresis.
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PMID:Colloid osmotic pressure in pulmonary edema clearance with furosemide. 362 34

In the last year nine critically ill children with multiple organ system failure (MOSF) were treated by continuous arteriovenous hemofiltration (CAVH). The mean number of organ systems involved was five per patient (range 4 to 7). Mean duration of hemofiltration was 136 hours (range 10 to 432 h.). Mean ultrafiltration rates of 6.4 +/- 3.0 ml/m2 b.s./min achieved mean serum creatinine levels of 2.39 +/- 1.49 mg/dl. Hypervolemia and pulmonary edema were corrected rapidly by CAVH. Total parenteral nutrition with a mean caloric intake of 62 +/- 15 kcal/kg b.w./day was provided throughout the hemofiltration period. In addition high ultrafiltration rates allowed delivery of large amounts of i.v. medications. CAVH is an ideal extracorporeal renal replacement system to control azotemia, fluid, electrolyte, and acid-base status in critically ill children. It carries the potential to improve survival rate in children with MOSF.
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PMID:Arteriovenous hemofiltration in children with multiple organ system failure. 366 76

Seven of 74 patients with early functioning cadaveric renal homografts developed acute oliguric renal failure after the second but before the ninth day post-transplantation. The syndrome characteristically begins with an abrupt and simultaneous decrease in creatinine clearance, urine volume and urine sodium concentration. After a variable period and despite a reduction in immunosuppressive therapy, a diuretic phase ensues and renal function is restored. Complications associated with the syndrome include groin hematoma, pulmonary edema and renal rupture with shock. Renal rupture does not require nephrectomy: if the hemorrhage is controlled, the transplanted organ will resume function. Angiographic studies show normal nephrograms, stretched arterial vasculature and filling defects in the veins. Percutaneous renal biopsy shows interstitial edema and hemorrhage, venous congestion and tubular necrosis. Evidence is presented to support the hypothesis that this is a form of rejection occurring as the result of injury to the renal venous system.
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PMID:Early acute rejection of renal homografts: a characteristic clinical syndrome. 457 54

The effects of long-term infusion of fenoterol (a beta 2-sympathomimetic drug) in combination with the calcium antagonist verapamil on water balance, the renin-angiotensin-aldosterone system and antidiuretic hormone during pregnancy were studied. Within two hours of the start of infusion, plasma renin and antidiuretic hormone levels were significantly increased, but plasma aldosterone was strongly decreased. There was a concomitant marked reduction of urinary, sodium, and potassium excretion and a decreased creatinine clearance. The long-lasting reduction of urinary excretion which resulted in an elevated water retention is apparently due to other unknown factors. Results are discussed with special regard to the relationship between water balance disturbances and pulmonary edema.
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PMID:The renin-angiotensin-aldosterone system, antidiuretic hormone levels and water balance under tocolytic therapy with Fenoterol and Verapamil. 610 79

In the present study, 78 patients with a blunt thorax trauma were examined. Fifty-four percent of the patients had been injured in traffic. Creatinine kinase (CK) and its isoenzymes (MM, MB and BB), ASAT, ALAT, ECG and thorax X-ray were taken. In 24% of the patients examined, the activity of serum MB isoenzyme was greater than or equal to 6% of the total activity of CK, and in 40% no MB activity was observed. Pathological ECG changes were detected in 89% in the MB greater than or equal to 6% group and in 32% in the MB = 0% group. ECG changes cannot be regarded as specific indicators of cardiac contusion. Arrhythmias, conduction defects, ST segment and T wave changes, and a pathologically long QTc interval were present significantly more often (P less than 0.01) in the MB greater than or equal to 6% group than in the MB = 0% group. Roentgenologically, pulmonary contusion, cardiac dilatation and venous congestion-pulmonary edema were diagnosed more frequently in the MB greater than or equal to 6% group (P less than 0.01) than in the MB = 0% group. Eleven of the patients died. A forensic autopsy was performed on these patients, and a macroscopic heart injury was detected in five of them. Serum MB activity had been found in all these five.
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PMID:Cardiac damage after blunt chest trauma, diagnosed using CK-MB enzyme and electrocardiogram. 648 Jan 64

The effect on renal function of a combination of a beta 2 receptors stimulating tokolytic agent (Fenoterol) with a so-called cardioselective beta 1 blocker (Metoprolol) which is able to antagonise the cardiac side effects of beta 2 stimulation, was examined in femaLe rabbits in a 24-hour test. Infusing 31.5 ml/h isotonic solution, 20 micrograms/kg/min Fenoterol and 3.125 micrograms/kg/min Metoprolol, excretion, creatinine clearance, electrolyte elimination, the serum electrolyte levels, Hb, HK and the weight were determined. The combination of Fenoterol and Metoprolol antagonised almost completely the massive water retention occurring under Fenoterol alone. At the latest after 12 hours, normal values were obtained in respect of the creatinine clearance reduced under Fenoterol, the urine excretion rate and, consequently, the Hb concentration and haematocrit reading. The reduction of sodium elimination caused by Fenoterol was completely reversed under the combination, whereas the reduced excretion of potassium was not influenced. Water retention in tocolysis with beta 2 stimulants is one of the most important causes for the information of a pulmonary oedema. The danger of the occurrence of such pulmonary oedemas, especially in risk pregnancies (gestosis), is drastically reduced by antagonising water retention, and hence the combination of Fenoterol and Metoprolol seems to be very favourable from both the cardiac and renal viewpoints. In a group of 17 pregnant women, the drastic improvement of urine excretion under the combination could be confirmed.
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PMID:[The effect of metoprolol on fenoterol-induced kidney function disorders]. 655 23

Changes in blood volume were investigated following intravenous injection of a single dose of furosemide in 21 patients with pulmonary edema. In a subset of 10 patients in whom the blood urea nitrogen level was 11.4 +/- 2.2 mg/dl and the serum creatinine level was 1.3 +/- 0.1 mg/dl and in whom total urine output exceeded 1 liter over a four- to six-hour interval ("diuretic" group), no significant change in plasma or total blood volume was observed, nor were there any significant changes in hematocrit. In a "nondiuretic" group of 11 patients who had moderately decreased renal function (blood urea nitrogen level 59.3 +/- 13.0 mg/dl and serum creatinine level 2.3 +/- 0.3 mg/dl) and in whom total urine output was less than 1 liter over the four- to six-hour interval, there was a significant increase in blood volume with a concomitant decrease in hematocrit and hemoglobin levels. Furosemide-induced diuresis therefore did not deplete intravascular volume. To the contrary, actions of furosemide that were independent of its diuretic action were associated with an expansion of plasma volume in the absence of diuresis. This may be related to the venous capacitance effects of furosemide with lowering of venous resistance and, therefore, lowering of the capillary hydrostatic pressure. In addition, there was an increase in colloid osmotic pressure. Both mechanisms increase the effective oncotic pressure gradient, which favors reabsorption of extravascular (edema) fluid. It is concluded that intravascular volume was therefore replenished at a rate equal to or in excess of the volume removed by diuresis.
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PMID:Blood volume following diuresis induced by furosemide. 671 72

Hyperthermia is a totally different modality from existing treatment modalities. Systemic hyperthermia (S-HT) is effective against advanced tumors which make resistance to conventional cancer therapies. In S-HT, it is essential and very important to manage cardio-pulmonary function in good condition. Especially, PEEP (about 7 cm H2O) is very effective to prevent lung edema. Fifty-four patients with a variety of neoplasms were subjected to S-HT, alone or in combination with chemotherapy, radiotherapy, and immunotherapy. S-HT was performed under general anesthesia by using extracorporeal circuit in corporating a heat exchanger. Usually, S-HT was given for 4-8 hours with 41.5-42.0 degrees C at 2 weeks intervals. Out of 25 evaluable cases, response was obtained in 11 cases (44%) including 2 cases of complete response. Cardio-pulmonary performance was evaluated using a flow directed pulmonary artery catheter (Swan-Ganz catheter). At treatment temperature, all patients showed hyperdynamic conditions and developed a two-fold mean increase in cardiac index. Altogether 172 treatment sessions were associated with sinus tachycardia and a reduction in diastolic pressures. Laboratory abnormalities included thrombocytopenia without sign of D.I.C., moderate hyperglycemia, mild degree of hypophosphatemia, hypolcalemia and transient elevations in liver enzymes. Serum creatinine levels were elevated in all treatment sessions without elevation of serum BUN. Serum levels of calcium and magnesium were stable. All of abnormalities and toxicities were decreased within 1 to 2 weeks after treatments. It is suggested that with carefully monitored conditions S-HT be performed safely without heart failure.
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PMID:[Clinical practice of systemic hyperthermia therapy and physiological responses of the host]. 687 Feb 90

Tumoricidal reactions in dogs with spontaneous breast carcinoma occur after perfusion of plasma over protein A derived from Staphylococcus aureus and immobilized in collodion charcoal. When this treatment was extended to humans with breast cancer, hemodynamic and physiologic changes were noted. The evolution and spectrum of these reactions were evaluated during 47 plasma infusions in five patients. Initial treatment conditions consisting of rapid perfusion of plasma over high quantities of immobilized protein A were employed for 12 treatments in two patients. Within 30 minutes after treatments were begun, mean blood pressure, systemic vascular resistance, and stroke volume increased, as did heart rate, cardiac output, and rectal temperature; however, mean pulmonary artery pressure and total pulmonary resistance did not change. At 90 minutes, hypotension developed (lowest mean blood pressure was 59 +/- 14 mm Hg) that was associated with a decrease in systemic vascular resistance and total pulmonary resistance (536 +/- 66 and 146 +/- 44 dynes . second . cm-5, respectively). Cardiac output increased, tachycardia developed, stroke volume decreased, and rectal temperature increased. During the hypotensive phase, values of creatinine clearance and fractional excretion of sodium diminished. Noncardiogenic pulmonary edema appeared occasionally, with bronchospasm noted once. No hemodynamic changes were seen when saline solution was passaged over protein A immobilized in collodion charcoal or when autologous plasma was given without passage over protein A immobilized in collodion charcoal. Treatment conditions were modified by diminishing protein A quantity and plasma volume and slowing plasma perfusion rate, which resulted in significant attenuation of all cardiopulmonary responses. This report, then, defines for the first time the physiologic basis of the cardiopulmonary toxicity in humans after plasma perfusion over immobilized protein A.
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PMID:Cardiopulmonary toxicity in patients with breast carcinoma during plasma perfusion over immobilized protein A. Pathophysiology of reaction and attenuating methods. 688 Nov 80

Two children and 29 of 31 crew members aboard a grain freighter became acutely ill after inhaling the toxic fumigant phosphine; one child died. Predominant symptoms were headache, fatigue, nausea, vomiting, cough, and shortness of breath. Abnormal physical findings included jaundice, paresthesias, ataxia, intention tremor, and diplopia. Focal myocardial infiltration with necrosis, pulmonary edema, and widespread small-vessel injury were found at postmortem examination of the dead child. The surviving child showed ECG and echocardiographic evidence of myocardial injury and transient elevation of the MB fraction of serum creatinine phosphokinase. Illness was significantly associated with living or working amidships or on the forward deck areas of the vessel. Phosphine gas was found to have escaped from the holds through a cable housing located near the midships ventilation intake and around hatch covers on the forward deck. The outbreak illustrates the hazards associated with shipboard fumigation.
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PMID:Acute phosphine poisoning aboard a grain freighter. Epidemiologic, clinical, and pathological findings. 738 74


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