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)

This trial prospectively compares two methods of percutaneous tracheostomy, both routinely used in ICU: the Ciaglia progressive dilational tracheostomy and the Griggs forceps dilational tracheostomy. One hundred patients were randomized using a single-blinded envelope method to receive progressive or forceps percutaneous tracheostomy performed at the bedside. Operative time, the occurrence of hypoxaemia or hypercapnia and complications were recorded. The progressive technique took longer than the forceps technique (median 7 (range 2-26) vs. 4 (1-16) minutes, P = 0.0005). Hypercapnia occurred in both groups but was more marked with the progressive technique (56 (16) vs. 49 (13) mmHg, P = 0.0082). Minor complications (minor bleeding, transient hypoxaemia, damage to posterior tracheal wall without emphysema) were also more frequent with the progressive technique (31 vs. 9 complications, P < 0.0001). Six major complications occurred with the progressive technique, none with the forceps technique (P = 0.0085): tension pneumothorax, posterior tracheal wall injury with subcutaneous emphysema, loss of airway with hypoxaemia, loss of stoma with impossible re-catheterization, and two conversions to another technique. In conclusion, progressive dilational tracheostomy took longer, caused more hypercapnia and more minor and major difficulties than forceps dilational tracheostomy.
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PMID:Prospective randomized comparison of progressive dilational vs forceps dilational percutaneous tracheostomy. 1691 63

We report a case of tension pneumothorax, which occurred secondary to colonic perforation during a colonoscopy. The patient was a 77-year-old woman in whom acute respiratory decompensation developed suddenly during a diagnostic colonoscopy for iron deficiency anemia. We diagnosed bilateral pneumothoraces, tension pneumothorax, pneumomediastinum, pneumoperitoneum, and emphysema of the face, neck, and chest. At laparotomy, a posterior colonic perforation was identified at the site of an ileocolic anastomosis performed 3 years earlier. We performed a primary repair and the patient was discharged from hospital 12 days later. Although diagnostic colonoscopy-induced intestinal perforation is rare, it is the most common and serious complication associated with this procedure. Occasionally, air spreads from the retroperitoneum into continuous tissue planes and decompresses into the adjacent structures. To our knowledge, this is the first report of two unique manifestations of diagnostic colonoscopy-induced intestinal perforation: tension pneumothorax and perforation at the site of a previous anastomosis. Both of these conditions should be considered in the event of acute respiratory failure in the endoscopy suite.
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PMID:Tension pneumothorax secondary to colonic perforation during diagnostic colonoscopy: report of a case. 1663 57

Persistent interstitial pulmonary emphysema (PIPE) is a syndrome characterized by air-leakage in the perivascular tissues of the lung, primarily affecting mechanically ventilated neonates. Reports in the literature of infants developing PIPE with no history of respiratory distress syndrome (RDS) or mechanical ventilation are scarce. Here, we present a case of a 3-month-old former full term male infant with no history of RDS or mechanical ventilation who presented with focal cystic lung disease associated with spontaneous tension pneumothorax. He was ultimately found to have PIPE based on pathologic evaluation of the resected cystic region. We believe that focal PIPE should be included in the differential diagnosis of cystic lung disease in a full term, unventilated infant, even when spontaneous pneumothorax is the presenting entity.
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PMID:Localized persistent interstitial pulmonary emphysema presenting as a spontaneous tension pneumothorax in a full term infant. 1663 22

Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related diseases caused by the expansion of gas trapped in the lung, or over-pressurization of the lung with subsequent over-expansion and rupture of the alveolar air sacs. This group of disorders includes arterial gas embolism, tension pneumothorax, mediastinal emphysema, subcutaneous emphysema and rarely pneumopericardium. In the case of diving activities, POIS is rarely reported and is frequently related to unsafe diving techniques. We report a classical case of POIS in an underwater logger while cutting trees for logs in Tasik Kenyir, Terengganu. The patient, a 24-year-old worker, made a rapid free ascent to the surface after his breathing equipment malfunctioned while he was working underwater. He suffered from bilateral tension pneumothoraces, arterial gas embolism giving rise to multiple cerebral and cerebellar infarcts, mediastinal and subcutaneous emphysema as well as pneumopericardium. He was treated in a recompression chamber with hyperbaric oxygen therapy and discharged with residual weakness in his right leg.
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PMID:Pulmonary overinflation syndrome in an underwater logger. 1724 32

Congenital lobar emphysema (CLE) and tension pneumothorax (TPT) are rarely reported in dogs. A case of CLE of the right middle lung lobe predisposing to air trapping, alveolar hyperinflation, and pleural rupture resulting in fatal spontaneous TPT in a 6-month-old mixed breed dog is described. The unique alteration of "bloat line" was observed in this case in addition to compressive atelectasis of all other lung lobes and lack of negative pressure within the thoracic cavity, signifying markedly elevated intrathoracic pressure. Bronchial cartilage hypoplasia and bronchiectasis were confirmed microscopically, which likely led to abnormal dynamic collapse of bronchi during expiration, consequentially leading to increased intrapulmonary pressure, bullous emphysema, and pleural rupture resulting in TPT. TPT consequent to CLE may therefore be considered one of the potential causes of sudden death in young dogs without overt clinical illness.
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PMID:Congenital lobar emphysema and tension pneumothorax in a dog. 1745 68

The trachea of a 39-year-old man ruptured following intubation for fiberoptic bronchoscopy; the complication became evident during surgery as extensive subcutaneous emphysema developed. The emphysema resolved with conservative treatment. Tracheobronchial lesions are generally caused by direct trauma to the chest. Tracheal rupture due to intubation maneuvers is one of the complications anesthetists fear most. Although infrequent, such lesions are potentially fatal. Signs and symptoms can vary widely, from self-limiting asymptomatic subcutaneous emphysema immediately following surgery to severe complications such as tension pneumothorax, acute respiratory failure, pneumomediastinum, or even pneumopericardium. The absence of complications in patients treated conservatively has increased interest in using this approach to management when conditions are favorable, always with fiberoptic assessment to evaluate whether the lesion has resolved completely and without sequelae.
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PMID:[Conservative management of the airway following iatrogenic tracheal rupture]. 1751 76

A number of complications are associated with shoulder arthroscopic surgery. However rare, respiratory complications such as pneumomediastinum and related tension pneumothorax as well as spontaneous pneumothorax in patients undergoing shoulder arthroscopy by endotracheal intubation have been reported in the literature. Although the exact pathogenetic mechanisms remain undetermined, surgery-related factors as well as associated respiratory comorbidity have been hypothesized to intervene in the onset of respiratory complications. We report on one patient who developed subcutaneous and mediastinic emphysema after arthroscopic subacromial decompression performed by loco-regional anesthesia. Pathogenetic hypotheses including potential surgery- and anesthesia-related factors as well as associated respiratory comorbid illness are briefly discussed. Knowledge of potential pathogenetic variables may enable both surgeons and anesthesiologists to set up preventive and early treatment measures. Finally, patients' perception of arthroscopic surgery as a minimally invasive procedure might challenge the patient-surgeon relationship if respiratory complications occur that have not been included in the informed consent.
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PMID:Subcutaneous emphysema and pneumomediastinum following shoulder arthroscopy with brachial plexus block: a case report and review of the literature. 1828 70

Contralateral intraoperative tension pneumothorax is a rare complication of thoracic surgical procedures. Here we present three cases of tension pneumothorax that developed during single-lung transplantation for emphysema and pulmonary fibrosis. To the best of our knowledge, this is only the second report of contralateral intraoperative tension pneumothorax during single-lung transplantation. A high index of clinical suspicion is required for the detection of this potentially catastrophic complication.
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PMID:Intraoperative contralateral pneumothorax during single-lung transplantation. 1856 28

Subcutaneous emphysema is a physical finding that itself is usually perceived as benign yet rarely may, in and of itself, be life-threatening. We present an unusual case of a 67-year-old woman who developed delayed severe subcutaneous emphysema and tension pneumothorax from a rib fracture subsequent to a fall. We review the pathophysiology, manifestations and management options of this disorder. In patients whose clinical condition allows it, chest tube placement prior to intubation should be considered. Furthermore, positive end-expiratory pressure should be minimized. We present a case that illustrates how subcutaneous emphysema itself can be a potential cause of respiratory failure and tamponade physiology. In our case, a patient with traumatic subcutaneous emphysema developed respiratory failure and clinical deterioration after the introduction of positive pressure ventilation. In such rare scenarios, care should be taken to consider the absolute need for positive pressure ventilation without surgical decompression.
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PMID:Traumatic occurrence of chest wall tamponade secondary to subcutaneous emphysema. 1865 32

A 38-year-old male healthy donor for renal transplantation was scheduled to undergo laparoscopic nephrectomy of the left kidney. After commencement of the surgery under general anesthesia, his vital signs were stable. When pneumoperitoneum was commenced using CO2, a rapid increase in the airway pressure was observed, and it became difficult to perform mechanical ventilation. After manual ventilation was initiated, the cause of the increased airway pressure was investigated. As a result, a defective pore, 3 cm in diameter, was confirmed in the left diaphragm and it was determined that pneumothorax developed from the pure CO2. A transient decrease in oxygen saturation was easily restored by manual ventilation. The blood pressure was relatively stable, and tension pneumothorax was not observed. For the defective pore in the diaphragm, endoscopic cerclage of the diaphragm was performed after insertion of a thoracostomy tube. Postoperative chest X-ray showed no signs of atelectasis, mediastinal emphysema, or aerodermectasia, suggesting the development of pneumothorax due to pure CO2. In this case, the defective pore in the diaphragm was caused accidentally by pneumoperitoneum, although the subject had had no prior symptoms. Latent diaphragmatic defect may be an important factor in pneumoperitoneum and other surgical procedures.
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PMID:[A case of pneumothorax during laparoscopic surgery due to latent diaphragmatic defect]. 1922 79


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