Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six full-term newborn infants are described who suffered from severe adult respiratory distress syndrome (ARDS). The triggering event was intrauterine/perinatal asphyxia in five, and group B streptococcal (GBS) septicemia in three. All had severe respiratory distress/failure and were ventilated mechanically with high concentrations of inspired oxygen and positive end-expiratory pressure. Radiography of the chest showed dense bilateral consolidation with air bronchograms and reduced lung volume. Persistent pulmonary hypertension (PPH) was documented in all cases. The coincidence of ARDS and PPH rendered respiratory management extremely difficult. For this reason high-frequency ventilation was instituted in all patients in order to improve CO2 elimination and induce respiratory alkalosis. Acute complications of respiratory therapy were encountered in five patients (pneumothorax, pulmonary interstitial emphysema, pneumopericardium). Three infants died (irreversible septic shock, progressive severe hypoxemia, and sudden cardiac arrest) after 17, 80, and 175 h of life. Histologic examination of the lungs was possible in all fatal cases and revealed typical changes of acute to subacute stages of ARDS. Three infants survived, the mean time of mechanical respiratory support being 703 h. Two patients were still dependent on oxygen after 1 month of life, and all survivors had increased interstitial markings and increased lung volumes on their chest roentgenograms at this time.
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PMID:The paradox of adult respiratory distress syndrome in neonates. 200 41

A case of colonic perforation followed by the development of pneumopericardium, pneumomediastinum and subcutaneous emphysema as complications of colonoscopic polypectomy is described. Surgical intervention with primary closure was successfully performed 24 hours after perforation.
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PMID:Pneumopericardium and pneumomediastinum after polypectomy. 200 39

Infants presenting with pneumothorax within the first 24 hours of life were studied in an attempt to produce a reliable index of the severity of the disease. Of these 54 patients, 46 infants required intubation and ventilator support; 18 (39%) survived and 28 (61%) died. Overall mortality in this series was 52%. We have been able to define clearly the two groups (survivors and nonsurvivors) based on their response to ventilatory parameters. The nonsurvivor group displayed CO2 retention associated with pneumopericardium and pulmonary interstitial emphysema. This group was unresponsive to high fraction of inspired oxygen and high positive end expiratory pressure. The survivor group responded well to a fraction of inspired oxygen of less than 70% and a positive end expiratory pressure of 6 cm or less. Arterial CO2, pneumopericardium, pulmonary interstitial emphysema, pneumomediastinum, and birthweight are useful in predicting the severity of the respiratory distress in these infants and in evaluating the nonsurvivors from the survivors.
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PMID:Arterial blood gas and expiratory pressure monitoring in infants with pneumothorax: prognostic predictability. 210 36

Emphysemas of the skin in the region of the cheek and face after surgical tooth extraction are relatively rare complications that can eventually lead to formation of an emphysema of the mediastinum and very rarely also to a pneumopericardium. The reason for this is often an instrumentally conditioned pressure increase in the oropharynx if this pressure increase leads to the entry of air into the wound region. There are also other mechanisms resulting in the formation of spontaneous mediastinal emphysema that can lead to a secondary emphysema. Possible reasons for the occurrence of a combined emphysema of the skin, the mediastinum and the pericardium are discussed.
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PMID:[Pneumopericardium with combined emphysema of the skin and mediastinum following tooth extraction]. 239 45

Pneumopericardium is a rare condition, most frequently reported in connection with prolonged artificial ventilation in infants with hyaline membrane disease. No reports of pneumopericardium after pulmonary surgery have been published. Two cases of pneumopericardium are reported, one of tension pneumopericardium after pneumonectomy and artificial ventilation and one that followed radical lobectomy and artificial ventilation. The radiographic findings included pneumopericardium and subcutaneous emphysema and the patient who had had a pneumonectomy had severe symptoms of cardiac tamponade. Prolonged artificial ventilation in patients after pulmonary surgery and in the presence of an intrathoracic air leak may be a hazard. The importance of prompt surgical intervention in cases of tension pneumopericardium is underlined; the treatment of choice is thoracotomy with pericardiotomy.
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PMID:Pneumopericardium after pneumonectomy and lobectomy. 301 Apr 83

We report an observation of pneumopericardium occurring, without iatrogenic trauma in the preceding days, during the course of an epidermoid bronchial carcinoma, treated for a year by radio- and chemotherapy. The pneumopericardium produced a very attenuated clinical picture and was resorbed without incidence. But the patient died a few weeks after an overwhelming haemoptysis. The radiological picture is very characteristic. The differential diagnosis is above all that of a pneumo-mediastinum. But in the latter case, the clear zone exceeds the level of the great vessels and subcutaneous cervical emphysema in generally very clear both clinically and radiologically.
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PMID:[Pneumopericardium complicating bronchial cancer]. 380 1

The incidence of pulmonary air leak in 230 infants with a birth weight of 500-999 g who were ventilated was 41%. Pulmonary interstitial emphysema occurred in 35%, pneumothorax in 20%, pneumomediastinum in 3%, and pneumopericardium in 2%. The survival rates in those with or without pulmonary air leak were not significantly different in the first four years of the study period (46% v 53%). As the survival improved in infants without air leak during the second four years the difference in survival rates in infants with or without air leak became significant (30% v 71%). Effective measures of preventing pulmonary air leak are required before further improvement in the outcome of these extremely low birthweight infants can be achieved.
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PMID:Pulmonary air leak in extremely low birthweight infants. 396 66

Pneumomediastinum has numerous etiologies and its pathways of spread are multiple and well defined. Knowledge of these anatomic pathways and possible etiologies is important in order to avoid extensive and unnecessary evaluations. For example, if there is a known reason for pneumomediastinum, and pneumoperitoneum is present without associated abdominal findings, further evaluation for perforated viscus is unnecessary. In a patient who is an asthmatic or a diabetic, the presence of pneumomediastinum should not lead to work-up with contrast studies unless there are specific clinical reasons to do so. In critically ill infants and adults, pulmonary interstitial emphysema is an important warning sign for impending pneumothorax or pneumomediastinum and the patient's physicians should be alerted. There are occasional difficulties in differentiating pneumomediastinum from pneumopericardium and from a medial pneumothorax. Analysis of anatomic details and decubitus views are helpful in this regard.
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PMID:Pneumomediastinum: a diagnostic problem. 639 15

Case report of a 17-year-old man with acute bridging hepatitis in whom laparoscopy was followed by subcuteneous emphysema, penumomediastinum and pneumopericardium. No previous report has been published on pneumopericardium as a complication of laparoscopy.
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PMID:An unusual complication of laparoscopy: pneumopericardium. 644 43

Pneumopericardium, a complication of ventilatory management of neonatal respiratory distress syndrome, may result in cardiac tamponade. Pneumopericardium occurred in 47 premature infants (mean birth weight, 1,894 gm) at the University of Minnesota Hospital between July, 1972, and January, 1981. At the onset of pneumopericardium, 44 of 46 intubated patients were on positive end-expiratory pressure (PEEP) and 1 patient was ventilated using a mask. Five infants were asymptomatic, while 42 were seen with sudden hypotension, bradycardia, and hypoxia an average of 57 hours (range, 1 to 312 hours) after the commencement of ventilatory support. Pneumothorax (38 instances), pneumomediastinum (21), pulmonary interstitial emphysema (29), pneumoperitoneum (6), or a combination of these conditions was noted prior to or simultaneously with pneumopericardium in 46 infants. Pneumopericardium was not treated in 14 patients, 10 of whom were symptomatic and 4 asymptomatic; there were 5 deaths in this group. The group of 33 infants treated for this complication underwent either pericardial aspiration (2 patients), aspiration followed by pericardial tube placement (12 patients), or pericardial tube placement alone (19 patients). All 33 patients who underwent treatment had resolution of symptoms, but pneumopericardium recurred in 13 with 5 deaths. Causes of recurrence were tube or aspiration failure in 10 infants and tube removal prior to cessation of PEEP in the other 3. There were five complications related to tube placement, resulting in 2 deaths due to myocardial laceration following percutaneous insertion. Of 35 neonates surviving pneumopericardium, 12 were discharged from the hospital and 23 died of complications of respiratory distress syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Neonatal pneumopericardium: a surgical emergency. 669 45


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