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Pulmonary edema low flow treatment

Hongju Kim, Jung-Hee Lee
BACKGROUND: Severe aortic stenosis (AS) may lead to acute decompensated heart failure resistant to medical treatment. Here, we report a successful emergent transcatheter aortic valve replacement (TAVR) in a patient presenting with decompensated severe AS accompanied by cardiorenal syndrome. CASE PRESENTATION: A 82-year-old man presented at our emergency department with aggravated dyspnea. His chest X-ray showed bilateral pulmonary edema, and laboratory examination revealed acute kidney injury...
March 20, 2018: BMC Cardiovascular Disorders
Anton Lund, Mette B Damholt, Ditte G Strange, Jesper Kelsen, Hasse Møller-Sørensen, Kirsten Møller
Dialysis disequilibrium syndrome (DDS) is a serious neurological complication of hemodialysis, and patients with acute brain injury are at increased risk. We report a case of DDS leading to intracranial hypertension in a patient with anoxic brain injury and discuss the subsequent dialysis strategy. A 13-year-old girl was admitted after prolonged resuscitation from cardiac arrest. Computed tomography (CT) revealed an inferior vena cava aneurysm and multiple pulmonary emboli as the likely cause. An intracranial pressure (ICP) monitor was inserted, and, on day 3, continuous renal replacement therapy (CRRT) was initiated due to acute kidney injury, during which the patient developed severe intracranial hypertension...
2017: Case Reports in Critical Care
S Tyler Constantine, Anand Gopalsami, Gregg Helland
BACKGROUND: Recurrent priapism secondary to sickle cell trait in an African-American male has been reported in the literature. A common treatment for these low-flow priapism cases is aspiration and injection of the corpus cavernosum with a sympathomimetic agent. We report a rare complication not described previously in the literature of ST-elevation myocardial infarction (STEMI) and cardiogenic shock in a 29-year-old male with sickle cell trait undergoing a routine detumescence procedure...
June 2017: Journal of Emergency Medicine
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
Kyu-Hyun Han, Ki Won Kim, Ji-Jing Yan, Jae-Ghi Lee, Eun Mi Lee, Miyeon Han, Eun Jin Cho, Seong Sik Kang, Hye Jin Lim, Tai Yeon Koo, Curie Ahn, Jaeseok Yang
BACKGROUND: Current therapies for advanced renal cell carcinoma (RCC) have low cure rates or significant side effects. It has been reported that complexes composed of interleukin (IL)-2 and stimulating anti-IL-2 antibody (IL-2C) suppress malignant melanoma growth. We investigated whether it could have similar effects on RCC. METHODS: A syngeneic RCC model was established by subcutaneously injecting RENCA cells into BALB/c mice, which were administered IL-2C or phosphate-buffered saline every other day for 4 weeks...
January 16, 2016: BMC Urology
Manuela Berto Pucca, Felipe Augusto Cerni, Ernesto Lopes Pinheiro Junior, Karla de Castro Figueiredo Bordon, Fernanda Gobbi Amorim, Francielle Almeida Cordeiro, Heloisa Tavoni Longhim, Caroline Marroni Cremonez, Guilherme Honda Oliveira, Eliane Candiani Arantes
Tityus serrulatus (Ts) is the main scorpion species of medical importance in Brazil. Ts venom is composed of several compounds such as mucus, inorganic salts, lipids, amines, nucleotides, enzymes, kallikrein inhibitor, natriuretic peptide, proteins with high molecular mass, peptides, free amino acids and neurotoxins. Neurotoxins are considered the most responsible for the envenoming syndrome due to their pharmacological action on ion channels such as voltage-gated sodium (Nav) and potassium (Kv) channels. The major goal of this review is to present important advances in Ts envenoming research, correlating both the crude Ts venom and isolated toxins with alterations observed in all human systems...
December 15, 2015: Toxicon: Official Journal of the International Society on Toxinology
Giulia Spoletini, Mona Alotaibi, Francesco Blasi, Nicholas S Hill
Traditionally, nasal oxygen therapy has been delivered at low flows through nasal cannulae. In recent years, nasal cannulae designed to administer heated and humidified air/oxygen mixtures at high flows (up to 60 L/min) have been gaining popularity. These high-flow nasal cannula (HFNC) systems enhance patient comfort and tolerance compared with traditional high-flow oxygenation systems, such as nasal masks and nonrebreathing systems. By delivering higher flow rates, HFNC systems are less apt than traditional oxygenation systems to permit entrainment of room air during patient inspiration...
July 2015: Chest
Jason W Smith, Cameron A Ghazi, Brandon C Cain, Ryan T Hurt, R Neal Garrison, Paul J Matheson
BACKGROUND: Brain death in organ donors alters central hemodynamic performance, impairs physiology, exaggerates inflammation, and causes end-organ microcirculatory dysfunction and hypoxia. A new treatment, direct peritoneal resuscitation (DPR), might improve these derangements in acute brain death (ABD). STUDY DESIGN: We studied a standardized rodent model of brain death with matched controls to assess the efficacy of DPR as a resuscitation strategy after ABD. Anesthetized Sprague-Dawley rats were randomized as follows: ABD (supradural balloon inflation) with minimal IV fluid (IVF; 2 mL/h, n = 12); ABD + adequate IVF (5 mL/h, n = 12); ABD with aggressive IVF (goal: mean arterial pressure [MAP] >80 mmHg, n = 15); or ABD + IVF + DPR (goal: MAP >80 mmHg, n = 12)...
July 2014: Journal of the American College of Surgeons
Michele Rossi, Giuseppe Filiberto Serraino, Federica Jiritano, Attilio Renzulli
INTRODUCTION: There is a worldwide trend towards a more liberal use of ventricular assist devices (VADs) as a definitive treatment for patients in end-stage heart failure. This has also led to a new set of complications related to the prolonged interaction between the native heart and the device. METHODS: We report a case of, late, de novo aortic regurgitation (AR), leading to acute pulmonary edema in a 56-year-old man, 20 months after the implantation of a left ventricular assist device (LVAD), the Jarvik 2000 Flowmaker®, as destination therapy for end-stage heart failure...
December 2012: International Journal of Artificial Organs
Atsumori Hamahata, Perenlei Enkhbaatar, Matthias Lange, Robert A Cox, Hal K Hawkins, Hiroyuki Sakurai, Lillian D Traber, Daniel L Traber
Bronchial circulation plays a critical role in the pathophysiology of burn and smoke inhalation-induced acute lung injury. A 10-fold increase in bronchial blood flow is associated with excessive production of nitric oxide (NO) following smoke inhalation and cutaneous burn. Because an increased release of neuropeptides from the airway has been implicated in smoke inhalation injury, we hypothesized that direct delivery into the bronchial artery of low-dose 7-nitroindazole (7-NI), a specific neuronal NO synthase inhibitor, would attenuate smoke/burn-induced acute lung injury...
December 2011: Shock
Idrus Alwi
Acute cardiogenic pulmonary edema (ACPE) is a common cardiogenic emergency with a quite high in-hospital mortality rate. ACPE is defined as pulmonary edema with increased secondary hydrostatic capillary pressure due to elevated pulmonary venous pressure. Increased hydrostatic pressure may result from various causes including excessive administration of intravascular volume, obstruction of pulmonary venous outflow or secondary left ventricular failure due to left ventricular systolic or diastolic dysfunction...
July 2010: Acta Medica Indonesiana
Shannon E G Hamrick, Georg Hansmann
A persistently patent ductus arteriosus (PDA) in preterm infants can have significant clinical consequences, particularly during the recovery period from respiratory distress syndrome. With improvement of ventilation and oxygenation, the pulmonary vascular resistance decreases early and rapidly, especially in very immature infants with extremely low birth weight (<1000 g). Subsequently, the left-to-right shunt through the ductus arteriosus (DA) is augmented, thereby increasing pulmonary blood flow, which leads to pulmonary edema and overall worsening of cardiopulmonary status...
May 2010: Pediatrics
Andrei A Onischuk, Tatjana G Tolstikova, Irina V Sorokina, Natalja A Zhukova, Anatoly M Baklanov, Vladimir V Karasev, Galina G Dultseva, Vladimir V Boldyrev, Vasilii M Fomin
The respiratory system provides entry for drug nanoparticles to cure systemic diseases. The modern devices that are available on the market of therapeutic aerosol delivery systems have a number of disadvantages. There remains a need for an alternative means that is low cost, convenient, and capable of producing small-sized particles. On the other hand, one-third of the modern drugs are poorly water soluble. Many currently available injectable formulations of such drugs can cause side effects that originate from detergents and other agents used for their solubilization...
September 2008: Journal of Aerosol Medicine and Pulmonary Drug Delivery
B A Kaufmann, A M Bernheim, S Kiencke, M Fischler, J Sklenar, H Mairbäurl, M Maggiorini, H P Brunner-La Rocca
An exaggerated increase in pulmonary arterial pressure is the hallmark of high-altitude pulmonary edema (HAPE) and is associated with endothelial dysfunction of the pulmonary vasculature. Whether the myocardial circulation is affected as well is not known. The aim of this study was, therefore, to investigate whether myocardial blood flow reserve (MBFr) is altered in mountaineers developing HAPE. Healthy mountaineers taking part in a trial of prophylactic treatment of HAPE were examined at low (490 m) and high altitude (4,559 m)...
April 2008: American Journal of Physiology. Heart and Circulatory Physiology
Chiara Giannarelli, Antonio De Giorgi, Ferdinando De Negri, Franco Carmassi
We report a case of decompensated porto-pulmonary hypertension closely associated with the development of intra-portocaval shunt thrombosis. A woman with Laennec's cirrhosis was hospitalized because of severe dyspnea and edema. She underwent surgical portocaval anastomosis ten years ago. Imaging studies showed massive intra-shunt thrombosis, portal hypertension, ascites, pleuro-pericardial effusions and enlargement of right cardiac cavities. Cardiac catheterization allowed to rule out coronary and left-sided heart abnormalities and led to the diagnosis of pre-capillary pulmonary hypertension...
December 21, 2007: World Journal of Gastroenterology: WJG
Xiao-Wei Dang, Pei-Qin Xu, Xiu-Xian Ma
BACKGROUND: Budd-Chiari syndrome (BCS) refers to posthepatic portal vein hypertension and/or inferior vena cava hypertension syndrome caused by obstruction of the blood flow at the portal cardinal hepatic vein and/or posterior hepatic inferior vena cava. The main surgical treatments of BCS include operations on pathological lesioned membrane, shunt, and combined operations. There are more than ten treatments available and reports on their therapeutic effects vary. As to operations on lesioned membrane, there are Kimura's finger rupture, balloon dilatation and membrane removal...
April 2007: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Scott F Nadler, Kurt Weingand, Roger J Kruse
Cryotherapy and thermotherapy are useful adjuncts for the treatment of musculoskeletal injuries. Clinicians treating these conditions should be aware of current research findings regarding these modalities, because their choice of modality may affect the ultimate outcome of the patient being treated. Through a better understanding of these modalities, clinicians can optimize their present treatment strategies. Although cold and hot treatment modalities both decrease pain and muscle spasm, they have opposite effects on tissue metabolism, blood flow, inflammation, edema, and connective tissue extensibility...
July 2004: Pain Physician
Hua Ren, Pi-Xiong Su, Chao-Ji Zhang, Song Gu, Heng Zhang, Chen Wang
OBJECTIVE: To evaluate the improving reliability and safety of thromboendarterectomy and perioperative management for chronic pulmonary thromboembolism. METHODS: The clinical data of 12 cases with chronic pulmonary thromboembolism, who underwent thromboendarterectomy assisted by low flow or circulation arrest with deep hypothermia, were reviewed retrospectively. RESULTS: Pulmonary artery pressure decreased 20 to 40 mmHg immediately after surgical procedures in 9 cases...
September 2005: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Kyle T S Pattinson, Ron B Somogyi, Joseph A Fisher, Arthur R Bradwell
We describe a case report of a subject suffering high-altitude cerebral and pulmonary edema successfully treated with low flow rates of supplemental oxygen administered with a breathing system designed to conserve oxygen supplies at high altitude.
2005: Wilderness & Environmental Medicine
Hua Ren, Pi-xiong Su, Chao-ji Zhang, Song Gu, Guo-tao Ma, Heng Zhang, Chen Wang
OBJECTIVE: To evaluate the perioperative management and safety of pulmonary thromboendarterectomy for chronic pulmonary thromboembolism. METHODS: From March 1999 to March 2004, 12 patients with chronic pulmonary thromboembolism received thromboendarterectomy. The operation was performed under cardio-pulmonary bypass with low flow or circulative arrest and deep hypothermia. The clinical data of the 12 cases were reviewed retrospectively. RESULTS: Pulmonary pressure immediately decreased 20 to 40 mm Hg (1 mm Hg = 0...
March 15, 2005: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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