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Query: UMLS:C0231835 (tachypnea)
 2,543 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An active duty male presented to the emergency room with dyspnea for 2 days after undergoing liposuction surgery. Upon presentation, the patient was afebrile, tachycardic, tachypneic, and hypoxemic. The initial chest radiograph demonstrated bilateral patchy opacities and the PaO2/FiO2 ratio was <200. The patient was admitted to the medical intensive care unit for supportive care. He was treated empirically for pneumonia. Blood and sputum cultures were negative. A computed tomography angiogram of the chest was negative for pulmonary embolism but did reveal a bilateral, perihilar air space process. The patient's oxygen requirement improved and the abnormal chest radiographic findings resolved over the next 48 hours. Given his clinical presentation, negative workup, and rapid recovery, the patient was given a presumptive diagnosis of pulmonary fat embolism. Fat embolism occurs when adipocytes and small blood vessels are damaged during the liposuction procedure. Patients may present with low-grade fever, tachycardia, tachypnea, hypoxemia, and hypocapnia. The differential diagnosis includes venous thromboembolism, aspiration pneumonitis, and pneumonia. The mainstay of treatment for pulmonary fat embolism is supportive care. The risk of mortality is 5 to 15%.
Mil Med 2007 Jun
PMID:Acute respiratory distress following liposuction. 1761 55

After an 18-hour bus ride, a 29-year-old soldier complained of leg pain. Ten days later, he collapsed. After cardiopulmonary resuscitation (CPR), he revived but complained of chest pain and shortness of breath. Computed tomography revealed massive thrombus in the right pulmonary artery, emboli in the left pulmonary artery, and right ventricle ballooning. Adequate anticoagulation required repeated boluses and continuous infusion (1,600 units/hour) of heparin. Vena caval filter was not available, and possible additional clot in the legs could not be completely assessed. After no improvement in 24 hours, alteplase was given (10 mg IV bolus and 90 mg over 2 hours). At 12 hours, tachycardia, tachypnea, and dyspnea resolved and computed tomography revealed marked resolution. This case illustrates both the value of CPR and aggressive fibrinolytic therapy in patients who suddenly collapse from massive pulmonary embolism. The collapse was likely due to a saddle embolus. Chest compressions probably fractured the large clot. Although not completely reestablished, enough flow occurred for successful resuscitation. Even though delayed, fibrinolytic therapy was effective and should be considered even in patients where vena caval filter placement is not feasible and/or complete evaluation of the extremity deep venous system is not possible.
Mil Med 2011 Dec
PMID:Treatment of massive pulmonary embolism in a soldier in Kosovo: the potential value of cardiopulmonary resuscitation and fibrinolytic therapy. 2233 66