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

Bubbles of either He, N2 or SF6 were infused intravenously into anesthetized dogs at a rate of 0.2 ml/kg/min. Alterations in pulmonary gas exchange were quantitated by the invert gas elimination method during control, steady state infusion and resolution phases. The hypoxemia produced was predominantly due to regions of low VA/Q rather than pure shunt, and the increase in physiological dead space was due to the addition of high VA/Q regions rather than 'pure' dead space. The VA/Q distribution returned to normal within 30 minutes of stopping the He or N2 bubbles, but remained abnormal for longer periods with SF6 bubbles. The net elimination of insoluble gases (such as He or N2) was only slightly impaired by bubble emboli, provided the cardiac output remained constant. Early pulmonary edema from bubble embolization was documented by increased wet weight/dry weight ratio, but the increased lung water was not apparent on histological examination. This form of pulmonary embolus is unique in that there is a constant fraction of the vasculature blocked although any given region with embolus is undergoing continuous resportion of the bubble. This produced a partial obstruction of the affected gas exchange units which manifests as regions of high VA/Q rather than pure dead space.
 ...
PMID:Gas exchange abnormalities produced by venous gas emboli. 21 52

Ten infants and children with respiratory failure, receiving standard maintenance water requirements, were treated on 13 occasions with intravenously given furosemide (1 to 2 mg/kg) because of continued impairment of oxygenation despite conventional therapy. Pulmonary auscultation and radiographs were normal or typical of the primary diagnosis. After a five-fold increase in urine output the mean Po2 rose from 61 mm Hg at a mean FiO2 of 0.7 to 140 mm Hg at an FiO2 of 0.65. The Pco2 decreased from 46 to 38 mm Hg. Interstitial pulmonary edema in these patients can be related to both their lung disease and impaired water tolerance during ventilatory therapy.
 ...
PMID:Edema of the pulmonary interstitium in infants and children. 23 52

Water intoxication during or following oxytocin induced labor, albeit a rare event, can nevertheless cause potentially fatal complications or risk of neurological damage. Large doses of oxytocin plus large volumes of electrolyte-free solutions are the prime factors associated with water intoxication. Suggested treatment consists of hypertonic saline. Although circulatory overload and pulmonary oedema can occur from saline treatment it is believed that the risk of cerebral oedema is greater than risk from saline treatment. Prevention of water intoxication includes: 1) restriction of fluid intake; 2) monitoring of analgesia given; 3) interruption of continuous infusion; 4) fluid balance with control of serum electrolytes and osmolality; and 5) use of electrolyte-containing fluid as a vehicle for the oxytocin.
 ...
PMID:Water intoxication after oxytocin-induced midtrimester abortion. 28 25

To evaluate methods for detecting pulmonary edema, pulmonary extravascular water volume was measured at 24 hour intervals (total 72 hours) in 25 patients with acute myocardial infarction. Measured lung water was compared with results of clinical, blood gas, X-ray and hemodynamic methods for detecting pulmonary edema. Increased pulmonary extravascular water volume on one or more measurements was observed in 18 of the 25 patients and was associated with an abnormal chest radiograph and increased pulmonary arterial wedge, pulmonary arterial diastolic and right atrial pressures. It was associated less well with clinical, blood gas and other hemodynamic measurements. Pulmonary arterial diastolic or pulmonary wedge pressure was a significant predictor of lung water 24 hours later. Both "preclinical pulmonary edema" and the "therapeutic phase lag" could be predicted from the pulmonary wedge pressure. Clinical, blood gas, radiographic and other hemodynamic measurements were not predictive.
 ...
PMID:Detection of pulmonary edema in acute myocardial infarction. 31 45

Hypoxic pulmonary disorders and head injuries associated with increased intracranial pressure (ICP) frequently co-exist. Positive end-expiratory pressure (PEEP) improves hypoxemia but has been reported to impede cerebral venous return, potentially causing a further increase in ICP. This study examined the effects of PEEP on ICP at different levels of brain compliance. continuous ICP recordings were obtained after insertion of Scott cannulas to the lateral ventricles of seven comatose patients. Brain compliance was assessed by calculation of the pressure volume index. Patients were maintained in a 30 degrees head-up position. Maintenance of PEEP to levels of 40 cm H2O pressure for as long as 18 hours did not increase ICP in patients with either normal or low intracranial compliance, and did not increase ICP in the absence of pulmonary disease. Central venous pressure and pulmonary artery wedge pressure increased proportionately as PEEP was increased. No consistent changes were found in blood pressure recordings, nor were there any reductions in cardiac output found during the studies. Abrupt discontinuation of PEEP did not result in increased ICP except for a transient rise on two occasions when respiratory secretions became copious and the patients were inadequately ventilated. Improved oxygenation in two patients as a result of PEEP was concomitant with improved intracranial compliance and neurological status. In patients with brain injuries, PEEP improves arterial oxygenation without increasing ICP as previously supposed. Consequently, PEEP is a valuable form of therapy for the comatose patient with pulmonary disorders such as pneumonia or pulmonary edema.
 ...
PMID:Effects of positive end-expiratory pressure on intracranial pressure and compliance in brain-injured patients. 32 31

The effects of positive end-expiratory pressure (PEEP) at 5, 10, 15, and 20 cm H2O on the distribution of ventilation-perfusion (VA/Q) ratios was determined in four normal dogs and in ten with oleic acid-induced acute hemorrhagic pulmonary edema. Tidal volume and frequency were held constant at all times with mechanical ventilation during intravenous pentobarbital and gallamine anesthesia. Normal dogs had little or no shunt, and no areas of low (less than 0.1) or high VA/Q (greater than 10.0) at zero end-expiratory pressure (intermittent positive-pressure breathing). In these animals increasing PEEP caused progressive depression of cardiac output, associated with an increase in ventilation to both high VA/Q and unperfused regions. PEEP greater than or equal to 10 cm H2O resulted in a reduction in Pao2 and an increase in PaCO2. In dogs with pulmonary edema, PEEP's of 5 and 10 cm H2O resulted in dramatic reductions in shunt, virtual obliteration of low VA/Q regions, and market improvement in Pao2. However, at 15 and 20 cm H2O PEEP's high VA/Q and dead space ventilation with CO2 retention again developed in all but the most severely affected (shunt greater than 40%) dogs.
 ...
PMID:Effects of positive end-expiratory pressure on gas exchange in dogs with normal and edematous lungs. 33 16

Thirty-seven of 100 consecutive patients with fulminant hepatic failure had clinical and radiological evidence of pulmonary edema. None of them had clinical evidence of left heart failure, and the pulmonary artery wedge pressure measured in 12 patients was normal. Similarly, there was no evidence to incriminate renal failure, endotoxemia, or hypoalbuminemia. However, there was a significantly higher incidence of pulmonary edema in patients with cerebral edema, suggesting either a central origin for the pulmonary edema or common factors predisposing to edema in both sites. An additional local factor may have been the presence of intrapulmonary vasodilatation. Detailed isotope studies in 11 patients showed a significantly increased pulmonary extravascular water volume in the patients with pulmonary edema which was in keeping with the severity of the radiological changes. Although the over-all mortality was higher in those patients with pulmonary edema than in those without, the difference was not significant, and early ventilation with positive and expiratory pressure achieved adequate oxygenation in all but 3 patients.
 ...
PMID:Incidence and pathophysiology of pulmonary edema in fulminant hepatic failure. 34 31

The effect of 10 cm of positive end-expiratory pressure (PEEP) on lung water was studied during pulmonary edema induced in dogs by inflating a Foley balloon placed in the left atrium. Colloid oncotic pressure (COP) was measured directly. Intrapleural pressure (IPP) was measured after surgical closure of the chest. Transmural left atrial (LA) pressure (LA minus IPP) minus COP was considered to be the net force driving water out of the capillaries. LA pressure was elevated so that transmural LA pressure minus COP averaged +7.5 mm Hg. Water accumulation was expressed as the ratio of wet to dry weight. The control ratio of wet to dry lung weight was 4.30 +/- 0.10 (+/- SE). After 2 hours of standardized pulmonary edema and ventilation without PEEP, wet-to-dry lung weight was 5.63 +/- 0.24. In animals ventilated with 10 cm of PEEP through 2 hours of pulmonary edema the ratio was 5.36 +/- 0.14. Animals ventilated with 10 cm of PEEP showed a significant increase in functional residual capacity and decreased intrapulmonary shunt. Ten centimeters of PEEP, however, had no statistically significant effect on water accumulation during experimental pulmonary edema.
 ...
PMID:Experimental pulmonary edema: the effect of positive end-expiratory pressure on lung water. 35 87

The effects of hyperinflation and of atelectasis on accumulation of fluid in the lung was studied in 12 anesthetized spontaneously breathing puppies. Vascular pressures were raised and the plasma colloid osmotic pressure was reduced by the infusion of 0.9% saline thus promoting the formation of pulmonary edema. A tracheostomy was performed and the left lower lobe catheterized in all puppies. In five puppies hyperinflation of the left lower lobe was achieved by applying a continuous positive airway pressure (CPAP) of 10 Torr. In seven other puppies the left lobe was made atelectatic by occluding its bronchus after ventilating the lungs with 100% oxygen. The right lung was ventilated to ambient pressure in all puppies. The extravascular lung water content was determined by the difference in wet and dry lung weights corrected for residual blood. We found that hyperinflation produced by CPAP enhanced and atelectasis opposed fluid accumulation in the puppy lung.
 ...
PMID:Effect of hyperinflation and atelectasis on fluid accumulation in the puppy lung. 35 14

Positive end-expiratory pressure (PEEP) has been extensively utilized in the treatment of severe hypoxemia from noncardiogenic pulmonary edema. The usefulness of therapy with PEEP in the management of lobar atelectasis has not been previously stressed. Recently, we observed four patients with lobar atelectasis who failed to respond to the usual conservative measures of endotracheal suctioning and thoracic physiotherapy. Atelectasis was confirmed by physical examination and chest x-ray films, and three of the four patients subsequently underwent fiberoptic bronchoscopic examination. Endobronchial obstruction was not found, and despite extensive irrigation and suctioning, the atelectasis failed to resolve. Therapy with PEEP was then added, with pressures of 5 to 15 cm H2O. Serial chest x-ray films disclosed resolution of the atelectasis within 4 1/2 hours in two patients, within 14 hours in one patient, and within 24 hours in the remaining patient.
 ...
PMID:Positive end-expiratory pressure in the management of lobar atelectasis. 36 22


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>