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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pneumothorax during operation is always clinically serious. The symptoms are usually sudden cyanosis, accompanied by cardio-vascular collapse and difficulty or even impossibility to ventilate owing to increased pressures of insufflation. Immediate or secondary bilateral pneumothorax is relatively common, then may appear associated complications such as subcutaneous emphysema or pneumo-mediastinum. Early diagnosis is necessary to apply simple treatment and avoid a course which may be rapidly fatal. The authors report 3 cases of pneumothorax during anesthesia and consider the clinical forms, the mechanisms and causes of this accident.
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PMID:[Peroperative pneumothorax]. 2 55

Two patients with primary spontaneous pneumothorax died despite intensive treatment. In the first the pneumothorax had been present for 10 days, and, after insertion of a chest drain, pulmonary oedema developed unilaterally, followed by cardiac arrest. She was resuscitated, but later died of a tension pneumothorax on the other side, probably due to cardiac massage and artificial ventilation. In the second patient, after insertion of a chest drain, mediastinal emphysema spread to the head and neck, causing fatal obstruction of the hypopharynx.
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PMID:Two unexpected deaths from pneumothorax. 8 5

Thirty one cases of pharyngeal pseudodiverticulum have been reported in the literature; twenty nine were diagnosed during the neonatal period. Respiratory distress, increased oral secretions, difficulty with feeding and the impossibility of passing a nasogastric catheter were the most common symptoms and/or signs. Pneumomediastinum, pneumothorax, cervical emphysema and ectopic location of a feeding catheter, alone or in combination, were identified in the chest roentgenograms of 16 patients. Esophagography and/or endoscopy were the diagnostic methods of choice. The exact location of the perforation was identified in 18 patients. Most of the perforations were in either the posterior pharyngeal wall or in the pyriform sinuses. The survival rate was as good amongst the medically treated patients as in those who underwent surgery.
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PMID:Traumatic pharyngeal pseudodiverticulum in neonates and infants. Two case reports and review of the literature. 10 5

The removal of one lung from a beagle puppy results in minimal interference with lung function or the arterial gases. The removal of air from the empty pleural cavity results in a shift of the mediastinum and overdistention of the contralateral lung. An immediate decrease in the PO2 and increase in the PCO2 is seen. Significant increase in the alveolar-arterial CO2 gradient reflected marked increase in dead space ventilation. Biopsies of the overdistended lung demonstrated emphysema and disruption of alveoli. These changes may explain some of the deterioration of lung function and the complication of contralateral pneumothorax following repair of a Bochdalek diaphragmatic hernia. Our study suggests that the mediastinum should be stabilized in the midline after repair of a diaphragmatic hernia or after a pneumonectomy in an infant or small child.
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PMID:The effect of overdistention of the lung on pulmonary function in beagle puppies. 12 44

The authors make an analysis of 455 cases of spontaneous pneumothorax hospitalized and treated in the Clinic for Thoracic Surgery from Bucharest between 1952 and 1974. The therapeutic attitude recommended in such cases is the aspiration drainage through minimal pleurotomy (aspiration being carried out in relation with the parenchymal aerial losses). Introduction through the drainage tube of irritating substances will enhance pleural symphisis. The drainage will be maintained for 7--8 days. In the recidivating pneumothorax, or in cases where recovery is not achieved by aspiration drainage, thoracotomy becomes necessary for performing total pleurectomy and atypical resection of emphysema bubbles from the pulmonary cortical, since these are at the origin of the aerorrhagies (the Coman procedure). With the aid of these surgical techniques very good results have been obtained in all cases of spontaneous pneumothorax.
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PMID:[Treatment of spontaneous pneumothorax due to emphysema]. 13 40

Spontaneous pneumomediastinum is a relatively rare disease, the clinical signs of which may be misleading, and the physiopathology is still unknown. The authors report 7 cases collected over a period of 3 years and note the etiology, the clinical findings and the X-ray findings. The disease often affectsyoung sybjects, without any sex predominance. The initial symptom is thoracic pain and is often accompanied by dispnea. Subcutaneous emphysema only appears secondarily and may be mild. The association with pneumothorax is not rare. Among the etiological circumstances, pneumomediastinum often occurs after an effort or a respiratory infection with dyspnea. The diagnosis depends on the discovery of subcutaneous emphysema and on radiological signs in A.P. and lateral chest views. Treatment should be as conservative as possible in the usual benign forms. It should be limited to bed rest, analgesics and sedatives. In severe cases, supra-sternal drainage permits decompression of the mediastinum. The physiopathological mechanisms are discussed, but the usually accepted theory is rupture of an alveolus into the pulmonary interstitial tissue. The pressure gradient necessary for this rupture may be due to variations in alveolar or vascular pressure.
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PMID:[Spontaneous pneumomediastinum]. 17 Jun 84

From 1972 through 1975, a total of 6,196 patients were admitted to San Francisco General Hospital Trauma Service, of whom 908 required admission to an intensive care unit and 390 required mechanical ventilation. Duration of mechanical ventilation was one week or less for 76%, two weeks or less for 90%, and four weeks or less for 97%. Survival in patients ventilated seven days or less was 64%, in patients ventilated 8 to 14 days it was 55%, and in patients ventilated 15 to 30 days it was 55%. The mortality for ventilated patients aged 20 to 49 years was 23% while for ventilated patients older than age 60 it was 53%. The average age of ventilated patients was 43. Use of controlled-pressure soft-cuff endotracheal tubes has eliminated tracheal-esophageal fistula and tracheal stenosis as causes of morbidity and mortality. Appropriate ventilator alarms have minimized fatalities due to mechanical equipment failure. Complications related to positive pressure ventilation, such as pneumothorax and subcutaneous emphysema, still occur in 12% to 18% of patients. In our patients who survived the acute respiratory distress syndrome, recovery of lung function was universal, and permanent disability was less than 1%.
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PMID:Incidence and outcome of posttraumatic respiratory failure. 32 44

Six months after right-sided spontaneous pneumothorax developed in a 56-year-old man, squamous cell carcinoma was discovered in the ipsilateral lung. Fifteen cases of bronchogenic carcinoma presenting as spontaneous pneumothorax have been reported in the English language literature. Possible pathogenetic mechanisms include: direct tumor invasion of pleura; rupture of a subpleural bleb (in an area of obstructive emphysema) or an emphysematous bulla (in an overexpanded portion of the lung associated with lobar or segmental collapse); or unknown. Patients with spontaneous pneumothorax who fail to achieve complete expansion after three weeks of therapy or who have persistent roentgenographic pulmonary infiltration should undergo further investigation for bronchogenic carcinoma.
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PMID:Bronchogenic carcinoma presenting as spontaneous pneumothorax: case reports with review of literature. 32 55

The authors describe a case of fatal air embolism in a patient with an endovenous catheter introduced into the subclavian vein through a supraclavicular way. The opening of pleura caused by the needle during the thrusting of the needle caused a subcutaneous supraclavicular and laterocervical emphysema during ventilation with intermittent positive pressure (IPPV). The authors suggest that IPPV, in the postoperative period following kidney removal, was the main ancillary reason of the air embolism since opening of pleura, in a patient who breathes spontaneously, only induces pneumothorax according to the majority of the authors.
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PMID:Fatal air embolism after subclavian vein catheterization. Case report. 34 67

The effect of pressure-limited (PL) and volume-limited (VL) ventilation on mortality and morbidity in infants with severe hyaline membrane disease (HMD) was examined in a prospective controlled study. Criteria for mechanical ventilation were PaO2 value of 50 mm Hg or less or a Paco2 value of 70 mm Hg or greater, while the infant was receiving nasal continuous positive airway pressure (CPAP) at oxygen concentrations (FIO2) of 0.8 or greater and CPAP of 8 cm H2O or greater; HMD associated with severe perinatal asphyxia requiring mechanical ventilation in the delivery room. Consecutive patients were alternately assigned to receive either PL or VL ventilation. Twenty infants were ventilated with PL machines using low peak inspiratory pressures (mean maximum inspiratory pressure of 28 cm H2O) and prolonged inspiratory times. Twenty other infants were ventilated with VL machines, using essentially unlimited peak inspiratory pressures (mean maximum inspiratory pressure of 62 mm H2O) and prolonged expiratory times. There were no significant differences in survival, incidence of pneumothorax or pulmonary interstitial emphysema, or noteworthy bronchopulmonary dysplasia.
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PMID:Mortality and morbidity associated with pressure- and volume-limited infant ventilators. 35 90


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