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

The effect of PEEP in retarding the development of pulmonary edema produced by elevation of left atrial (LA) pressure to 25cm water was studied in dogs, Using two synchronized volume respirators connected to a double lumen endotracheal tube, 10 or 25cm H2O PEEP was applied to one lung while the contralateral lung was ventilated with an equal tidal volume without PEEP. LA pressure was then elevated by inflating a Foley catheter ballon in the LA until the desired LA pressure was reached. After three hours of pulmonary edema with ventilation of one lung with PEEP lung water was quantitated by wet-to-dry weights. There were no differences in wet to dry weights of PEEP and nonPEEP lungs at either 10 or 25cm H2O level. Additional blood flow studies showed that 25cm H2O of PEEP reduced blood flow to the PEEP lung by 25% and to the nonPEEP lung by 7%. This study shows that PEEP will not mechanically retard the accumulation of lung water due to increased pulmonary capillary hydrostatic pressure.
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PMID:Experimental pulmonary edema. The effect of unilateral PEEP on the accumulation of lung water. 37 52

The insecticide Endrin is a highly toxic chlorinated hydrocarbon which can cause severe CNS and respiratory derangement. Death usually follows intoxication within 24 hours. A 19-year-old male developed convulsions and gross pulmonary edema after the ingestion of Endrin. His trachea was intubated and constant positive pressure ventilation with PEEP of up to 28 cm H2O was instituted. The patient survived and recovery appeared to be complete. Severe pulmonary edema is not a common finding in patients who have Endrin poisoning. The use of PEEP above 15 cm H2O is a controversial issue; however, we believe that it contributed significantly to the survival of our patient.
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PMID:The successful use of "high level" PEEP in near fatal Endrin poisoning. 37 25

In human kidney transplantation, a high blood flow established through the graft immediately upon clamp release is usually associated with immediate satisfactory renal function. One hundred consecutive kidney transplant patients were thus provided with a large volume of fluid during surgery. To avoid pulmonary edema, fluid load was given under mean pulmonary arterial pressure (PAP) monitoring, and controlled ventilation was maintained during the early postoperative period. Whether initial PAP value was within normal range or elevated, all patients required an equivalent fluid load to reach the best hemodynamic condition upon clamp removal. The mean intraoperative fluid load consisted of 2406 +/- 968 ml of water with 22.8 +/- 9.4 g of sodium chloride, 5.9 +/- 1.8 units of albumin, and 2.6 +/- 1.8 units of packed red blood cells. Immediately before clamp release patients were given furosemide and mannitol. During the postoperative period, i.v. infusions consisted of water and sodium chloride (6 g/liter) to match urine output, provided that diuresis was equal to or above 400 ml/hr. If diuresis remained or decreased below this level, diuresis replacement was associated with PAP-controlled infusion of saline, albumin, and red blood cells if needed. Furosemide was eventually given if diuresis did not increase above 400 ml/hr with fluid loading. With this protocol a good early diuresis was established in 95% of the cases. Ten patients required dialysis before the 5th postoperative day, one of them because of fluid overload and anuria. Concurrently, a decreased mortality rate and an increased graft survival rate were observed.
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PMID:Early anuria prevention in human kidney transplantation. Advantage of fluid load under pulmonary arterial pressure monitoring during surgical period. 38 63

The effect of 10 cm H2O of positive end-expiratory pressure (PEEP) on pulmonary extravascular water volume (PEWV) was measured in an animal model of noncardiogenic pulmonary edema. Three groups of animals were studied: (1) controls, (2) those given a saline infusion plus alloxan, and (3) those which received saline infusion plus alloxan and PEEP. All animals were ventilated with a constant volume ventilator. Mean PEWV (+/- SEM) in milliliters per gram of dry lung weight was 4.00 +/- 0.21 for group 1, 6.01 +/- 0.70 for group 2, and 5.77 +/- 0.83 for group 3. Mean PEWV increased significantly in both alloxan groups (groups 2 and 3) as compared to the control group (for both, p less than 0.05); however, PEWV did not differ significantly in the group that received PEEP, as compared to the group ventilated without PEEP. Arterial PO2 and airway pressure required to deliver a constant tidal volume did not change significantly in the experimental groups as compared to the control group. It was concluded that PEEP does not decrease lung water content in pulmonary edema caused by damage to fluid-exchanging vessels.
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PMID:Failure of positive end-expiratory pressure to decrease lung water content in alloxan-induced pulmonary edema. 38 15

The renal response to left atrial balloon inflation in normal dogs was compared with that in dogs with chronic congestive heart failure (CHF). CHF was induced by the production of an aortocaval fistula below the level of the renal arteries. CHF dogs showed elevated left ventricular end-diastolic pressure, enlarged hearts, a depression of myocardial contractility, pulmonary edema, ascites, and peripheral edema. They also showed significant decreases in urine flow, creatinine clearance, para-aminohippurate clearance, sodium and potassium excretion, fractional sodium excretion, osmolar clearance, arterial blood pressure, and heart rate. Balloon distension of the left atrium evoked a significant increase in urine flow and free-water clearance in the normal group. The reflex nature of this response was indicated by its blockade after bilateral cervical vagotomy. In contrast, the CHF group did not exhibit significant changes in urine flow or free-water clearance during balloon inflation. Plasma antidiuretic hormone (ADH) was significantly elevated in the CHF group; however, balloon distension reduced plasma ADH in both groups of dogs. Plasma renin activity was significantly elevated in the CHF dogs and was not changed by balloon distension in either group of dogs. It is concluded that animals with high-output CHF do not exhibit the atrial-diuretic reflex in spite of their ability to reduce ADH levels by atrial distension.
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PMID:Renal effects of left atrial distension in dogs with chronic congestive heart failure. 43 20

Furosemide which is claimed to prevent acute mountain sickness and pulmonary oedema of high altitude was tried in experimental animals to evaluate its usefulness or otherwise as a measure of prophylaxis. 90 mice, 128 rats and 44 guinea pigs--all males--were used for the studies. Half the number in each species were kept as controls. The remaining half were further divided into two batches. The first batch was given furosemide 10 mg/kg body weight. Two h later they were exposed to simulated altitude of 30,000 ft for 6 h. The second batch was given two injections of furosemide at intervals of 24 h before exposure to simulated altitude. The controls were given distilled water. Our results show that the death rate was more in the furosemide-treated groups, both under mild as well as severe dehydration in all species. The present study does not substantiate the claim than the drug can be used as prophylactic against acute mountain sickness and pulmonary oedema of high altitude.
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PMID:Effect of furosemide on altitude tolerance in experimental animals. 44 33

The possibility that surface tension may affect the hydrostatic transmural pressure of pulmonary vessels and the development of pulmonary edema was studied in anesthetized, open-chested dogs. Isogravimetric pressure (the static intravascular pressure at which transmural osmotic and hydrostatic pressures are balanced such that net fluid flux is zero and lung weight is constant) was measured in nine animals under three conditions: (a) control, normal surface tension, at an alveolar pressure of 30 cm H2O with the apenic lung at room temperature; (b) after increasing surface tension by cooling and ventilating at a low functional residual capacity, at an alveolar pressure sufficient to produce the same lung volume present during control measurements; and (c) after restoring surface tension by rewarming while holding the lung at a high inflation volume, again at the control lung volume. Lung volumes were established from external dimensions and confirmed +/- 10% by deflation spirometry. The isogravimetric pressure (relative to alveolar pressure) was significantly less with increased surface tension than during either the initial control condition (P less than 0.01), or when the surface tension has been restored (P less than 0.01). Similar changes occurred in each of three additional studies performed with control alveolar pressures of 10 cm H2O. Thus, increased surface tension favors fluid leakage presumably because it increases the microvascular transmural pressure.
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PMID:Increased surface tension favors pulmonary edema formation in anesthetized dogs' lungs. 44 23

The noninvasive quantification of pulmonary edema could be of importance in patient management. We have developed a portable Compton-scatter densitometer capable of measuring density in the range of 0.1-1 g/cm3 independently of the chest wall. Change in lung density was investigated in 19 dogs with pulmonary edema induced by a combination of raised left atrial pressure and hemodilution. The increase in lung density correlated with the postmortem assessment of lung water (r = 0.862, p less than 0.01) and with hemodynamic indicators of pulmonary edema (r = 0.749, p less than 0.01). Subtracting the intravascular component of lung density did not improve the correlation with postmortem lung water (r = 0.850, p less than 0.01). The measurement of absolute lung density by a Compton-scatter technique may be a potentially useful method of quantifying pulmonary edema.
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PMID:Absolute lung density in experimental canine pulmonary edema. 48 68

The effects of d,l-alpha-tocopheryl nicotinate (EN) on model hypertension in rats were studied in comparison with d,l-alpha-tocopheryl acetate (EA). The progress of hypertension in young SHR during the 9th to 15th weeks after birth was markedly accelerated by replacing their driking water with 1% saline. The highly-developed hypertension in old SHR (9 months of age) was further advanced by salt-loading. Oral administration of 20 or 100 mg/kg of EN or 88 mg/kg of EA, once a day, delayed the progress of hypertension in young SHR and reduced advanced hypertension in old SHR. An antihypertensive effect of tocopheryl esters was also found in DOCA-salt hypertensive rats. The treatment with EN or EA definitely reduced the incidence of pathological changes accompanying model hypertension such as suppressed weight gain, pulmonary edema, myocardial fibrosis, cerebral hemorrhage and protected the animals from death. In antihypertensive effect, EN was about 5 times more active than EA in molecular base, and the effects of EN protecting from pathological changes associated with model hypertension were more definite than those of EA. The treatment with EN or EA reduced water and sodium retention in the DOCA-salt hypertensive animals. This fact may suggest the implication of a mechanism through electrolyte metabolism in the antihypertensive action of these tocopheryl esters.
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PMID:Antihypertensive action of d,l-alpha-tocopheryl nicotinate in rats. 50 48

After the acute onset of heart failure and in the absence of acute myocardial infarction, plasma volume may occasionally be depleted to the extent that the patient presents with clinical signs of circulatory shock. In five patients, the acute onset of clinical and radiographic signs of cardiogenic pulmonary edema were associated with reduction in arterial blood pressure and cardiac output. The pulmonary arterial wedge pressure was within normal limits but a reduction in plasma volume was demonstrated, which is best explained by the rapid translocation of plasma water that represented pulmonary (and most likely also peripheral) edema fluid. The infusion of 5 percent albumin solution significantly increased cardiac output, mean arterial pressure and cardiac work, reversed lactic acidosis, enhanced furosemide-induced diuresis and was followed by a decrease in both clinical and radiographic signs of pulmonary edema. These observations confirm that volume expansion may constitute appropriate treatment for some patients with cardiogenic pulmonary edema who may present with hypotension and who are unresponsive to conventional therapy.
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PMID:Hypovolemia and hypotension complicating management of acute cardiogenic pulmonary edema. 50 39


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