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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with a history of tachycardiac atrial fibrillation and pulmonary embolism was admitted to the emergency unit with acute shortness of breath. The patient was on coumarin medication. Pulmonary embolism, heart failure, or pulmonary edema could be ruled out. Laryngoscopy revealed a huge hematoma of both valleculae extending to the lateral pharyngeal wall and the epiglottis. The epiglottic cartilage was displaced to the posterior pharyngeal wall. The INR was > 6. Prothrombin complex, vitamin K1, corticoids, and fresh frozen plasma were administered immediately. The patient was monitored--without tracheotomy--in the intensive care unit and received oxygen. In a patient with dyspnea, impaired ventilation has to be considered besides impaired perfusion or diffusion.
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PMID:[Dyspnea caused by spontaneous hematoma of the oropharynx and larynx during marcumar therapy]. 1132 Jun 26

We report the complication of hemopericardium following superior vena cava (SVC) stenting with an uncovered Wallstent in a patient with malignant SVC obstruction. The patient collapsed acutely 15 min following stent placement with hypoxemia and hypotension. A CT scan demonstrated a hemopericardium which was successfully treated with a pericardial drain. The possible complications of SVC stenting, including hemopericardium, pulmonary embolism, mediastinal hematoma, and pulmonary edema from increased venous return resulting from improved hemodynamics, ensure a wide differential diagnosis in the postprocedural collapsed patient and this case emphasizes the important role of contrast-enhanced CT in the peri-resuscitation assessment of these patients.
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PMID:Hemopericardium after superior vena cava stenting for malignant SVC obstruction: the importance of contrast-enhanced CT in the assessment of postprocedural collapse. 1181 46

Dental treatment is usually conducted in the oral cavity and in very close proximity to the upper respiratory airway. The possibility of unintentionally compromising this airway is high in the dental environment. The accumulation of fluid (water or blood) near to the upper respiratory airway or the loosening of teeth fragmentations and fallen dental instruments can occur. Also, some of the drugs prescribed in the dental practice are central nervous system depressants and some are direct respiratory drive depressors. For this reason, awareness of the respiratory status of the dental patient is of paramount importance. This article focuses on several of the more common causes of respiratory distress, including airway obstruction, hyperventilation, asthma, bronchospasm, pulmonary edema, pulmonary embolism and cardiac insufficiency. The common denominator to all these conditions described here is that in most instances the patient is conscious. Therefore, on the one hand, valuable information can be retrieved from the patient making diagnosis easier than when the patient is unconscious. On the other hand, the conscious patient is under extreme apprehension and stress under such situations. Respiratory depression which occurs during conscious sedation or following narcotic analgesic medication will not be dealt with in this article. Advanced pain and anxiety control techniques such as conscious sedation and general anesthesia should be confined only to operators who undergo special extended training.
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PMID:[Respiratory distress]. 1185 48

High-altitude pulmonary edema (HAPE) is a recognized risk of rapid ascent to high altitude. Since the recognition of this entity more than 30 years ago, most pulmonary deaths at high altitude have been attributed to HAPE. However, as the bodies can almost never be recovered for postmortem examination, rare diagnoses that appear clinically similar to HAPE will not be recognized. A 33-year-old woman climbing on Mt. Everest, and taking oral contraceptive pills, developed what seemed to be severe HAPE. Examination after she was evacuated from the mountain revealed a deep venous thrombosis in her left leg and multiple pulmonary emboli. We propose that multiple pulmonary emboli at high altitude can mimic HAPE, and fatal pulmonary embolism may be an explanation for some alleged victims of HAPE who died despite what should have been adequate descent.
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PMID:Pulmonary embolism presenting as high-altitude pulmonary edema. 1199 10

In order to verify the safety of an ideal length of hospital stay (5-6 days) after open colectomy, we reviewed complications after 371 consecutive, elective colorectal resections for cancer at our institution between April 1991 and December 1998. Specifically, age of the patient, length of hospital stay and when the complication was diagnosed were registered. The median postoperative hospital stay was 9 days (range, 4-34 days). No difference in length of hospital stay was detected in patients < or = 65 years old versus > 65 years old (P = NS). All major complications (anastomotic leak, intestinal bleeding, intestinal occlusion, pneumonia, pulmonary embolism, pulmonary edema, stroke, angina pectoris, and fascial dehiscence) were diagnosed before the fifth postoperative day (P < 0.05). Among the minor complications (vomiting, packed red blood cells transfusion, diarrhea, wound infection, urinary tract infection, and pleural effusion), none requiring hospitalization was detected later then 5 days after the operation. We conclude that postoperative length of stay after colorectal resection for cancer can be reduced safely to five to six days after the operation.
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PMID:[The ideal length of hospital stay in the surgical treatment of colorectal cancer]. 1214 16

A 73-year-old male developed intra-operative pulmonary air embolism during cervical tumor resection under general anesthesia. Just after unexpected bleeding (about 700 ml) from the left subclavian vein, PetCO2 decreased suddenly from 32 mmHg to 22 mmHg, SpO2 decreased from 99% to 87% and systolic blood pressure decreased from 110 mmHg to 80 mmHg. Nitrous oxide was discontinued immediately, and blood transfusion and continuous infusion of dopamine (5 micrograms.kg-1.min-1) were started. In spite of the recovery of PetCO2 and blood pressure, hypoxemia (PaO2 54 mmHg at 100% oxygen) continued. The operation was discontinued and the patient was transferred to the intensive care unit. Postoperative chest radiograph showed findings of pulmonary edema. We suspected that the air embolism would have been induced by spontaneous respiration associated with the injury of the subclavian vein. Pulmonary edema may have been induced by pulmonary embolism and volume overload for the acute hemorrhage. The intra-operative pulmonary air embolism can be accelerated by use of nitrous oxide and spontaneous respiration.
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PMID:[Intra-operative pulmonary air embolism caused by left subclavian vein injury, during cervical tumor resection: a case report]. 1216 89

Three patients with acute pulmonary thromboembolism, who had fallen into cardiopulmonary arrest or severe respiratory failure, were treated and saved in our intensive care unit. Two patients were resuscitated with percutaneous cardiopulmonary support device. Two patients underwent surgical embolectomy and we carefully applied positive pressure ventilation to prevent postoperative reperfusion pulmonary edema. Early diagnosis and treatment are essential for saving critically ill patients with acute pulmonary embolism. However, cardiopulmonary resuscitation is often difficult and unsuccessful. Therefore prophylaxis is strongly recommended especially in patients with known risk factors of venous thrombosis. Since reperfusion pulmonary edema is a serious complication after surgical pulmonary embolectomy, careful postoperative respiratory care is needed.
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PMID:[Intensive care management of acute pulmonary thromboembolism]. 1263 14

We report the case of a patient with a febrile acute respiratory failure associated with alveolar opacities localized in the left upper lobe on chest-X-ray. Diagnosis was related to pulmonary embolism with overflow pulmonary edema. Complete recovery was obtained after mechanical ventilation, anticoagulation and a short course of intra venous dobutamine.
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PMID:[Pulmonary embolism with overflow pulmonary edema]. 1474 42

MODALITIES FOR THE DIAGNOSIS OF VENOUS THROMBOEMBOLISM: Currently rely on the confrontation of the initial clinical data and the results of D-dimer measurements, a venous Doppler, although reliable, is not a first-line exploration. REGARDING TREATMENT: Indications for thrombolysis are currently limited to massive pulmonary oedema with shock. Alteplase added to heparin improves the progression of severe embolism; it spares the patients from heavy interventions of resuscitation but the mortality remains the same. Concerning anticoagulant treatments, prolonged antivitamin K at classical doses is more effective than low doses and for limited duration if phlebitis is an idiopathic one. FOR HEART FAILURE WITH PRESERVED EJECTION FRACTION: Treatment of these heart failures, formerly know as 'diastolic' is similar to that of the acute phase of systolic heart failure. However, care should be taken with vasodilatators. CONCERNING HEART FAILURE IN GENERAL: The brain natriuretic peptide (BNP) represents a remarkable progress for the aetiological diagnosis of dyspnoea (inferior to 80 pg/ml in the case of pulmonary origin, superior to 300 pg/ml in the case of cardiac origin or severe pulmonary embolism). Regarding treatment, for acute heart failure, it is still the association of nitrates and diuretics, with oxygen therapy and eventually inotropics. Beta-blockers, which have revolutionized the treatment of chronic heart failure, must be maintained whenever possible in the case of the onset of acute pulmonary oedema. Multisite pacing is increasingly used in refractory chronic heart failure. Implantable defibrillation has become common practice. Non-invasive ventilation (Bi or C-PAP) is interesting in acute cardiogenic pulmonary oedema. THE PREVENTIVE ROLE OF N ACETYL-CYSTEINE: N acetyl cysteine reduces the incidence of nephropathies induced by the radio contrast products in patients with chronic kidney failure. Combined with hydratation, it must be proposed the day before and on the day of the procedure in any patient with diabetes or kidney failure.
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PMID:[Diagnostic and therapeutic progress. Venous thromboembolism, cardiac insufficiency and radio contrast agents]. 1522 98

A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death.
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PMID:Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog. 1523 66


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