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Revista Espanola de Cardiologia Sep 2001
Review
Topics: Acute Disease; Humans; Positive-Pressure Respiration; Pulmonary Disease, Chronic Obstructive; Pulmonary Edema; Respiration, Artificial
PubMed: 11693091
DOI: No ID Found -
Canadian Respiratory Journal 2014
Topics: Aged; Angiography; Diagnosis, Differential; Diuretics; Female; Hemoptysis; Humans; Lung; Multiple Pulmonary Nodules; Pulmonary Edema; Radiographic Image Enhancement; Treatment Outcome
PubMed: 24524111
DOI: 10.1155/2014/283673 -
International Journal of Cardiology Nov 2021
Gravitational ischemia in the brain - may be exacerbated by high altitude and reduced partial pressure of oxygen, inducing lung changes mimicking neurogenic pulmonary edema.
Topics: Altitude; Altitude Sickness; Brain; Humans; Ischemia; Lung; Oxygen; Partial Pressure; Pulmonary Edema
PubMed: 34555443
DOI: 10.1016/j.ijcard.2021.09.034 -
Diving and Hyperbaric Medicine Sep 2021The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers.
INTRODUCTION
The aim of reporting these two cases is to present visual evidence by bronchoscopy of the origin of haemoptysis in two elite breath-hold divers.
CASE REPORTS
Two male elite breath-hold divers of similar physical characteristics presented to our clinic after performing dives of up to 75 and 59 meters of seawater depth for 2:30 and 2:35 (minutes:seconds) respectively. Both patients presented with haemoptysis. Lung ultrasound was performed. The first patient had crackles on chest auscultation, overt pulmonary oedema clinically and 90 ultrasound lung comets. The second patient had no oedema or crackles, but presented with 20 ultrasound lung comets. Video bronchoscopy was performed which showed traces of blood coming from all three segments of the right upper lobe in both patients. The rest of the airways and lungs were intact.
CONCLUSIONS
These finding suggest that the apical parts of the lungs are the most prone to deep-dive induced damage. The precise mechanism of lung barotrauma and haemoptysis in breath-hold divers remains to be elucidated. These findings may be of importance for a better understanding of the underlying pathology of haemoptysis.
Topics: Breath Holding; Diving; Hemoptysis; Humans; Lung; Male; Pulmonary Edema; Ultrasonography
PubMed: 34547782
DOI: 10.28920/dhm51.3.299-302 -
Polskie Archiwum Medycyny Wewnetrznej Jun 2009In contrast to a series of recent meta-analyses (MAs), the 3CPO (Three Interventions in Cardiogenic Pulmonary Oedema) randomized controlled trial (RCT) reported in 2008... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
In contrast to a series of recent meta-analyses (MAs), the 3CPO (Three Interventions in Cardiogenic Pulmonary Oedema) randomized controlled trial (RCT) reported in 2008 did not find a significant mortality benefit of noninvasive positive pressure ventilation (NPPV) in acute cardiogenic pulmonary edema (ACPE).
OBJECTIVES
This paper combines data collected in the 3CPO trial together with data from recent MAs and calculates a revised risk ratio for NPPV in ACPE. Reasons for the discrepancy in mortality estimates are identified and discussed through contrasting the methodology and results of the 3CPO trial with previous RCTs.
PATIENTS AND METHODS
Patients included adults with ACPE secondary to a variety of insults such as hypertension, acute coronary syndromes, dietary indiscretion, arrhythmias and valvular lesions and assessed by clinical parameters (respiratory rate, crackles, oxygen saturation) and chest radiograph. Data was collected from MAs published after 2005 and their respective RCTs. As opinions regarding RCTs worthy of inclusion in the analyses were varied, 3 sets of RCTs were combined with the 3CPO data. The first set of data duplicated the RCTs chosen in the Cochrane; the second set, a comprehensive set, included all RCTs cited in any of the MAs reviewed; and the third set, a high quality RCT set, assessed data from only those RCTs included in at least 4 out of the 5 MAs reviewed. Data were analyzed with both fixed and variable effect modes using Revman software.
RESULTS
All combinations of RCTs and modes of analysis predict a significant mortality benefit. The combined data predicts a risk ratio for mortality using NPPV of 0.75 (95% CI: 0.61-0.92).
CONCLUSIONS
An analysis of the existing RCT data, inclusive of the 3CPO trial, predicts a continued and significant mortality benefit of NPPV in ACPE.
Topics: Acute Disease; Adult; Aged; Confidence Intervals; Continuous Positive Airway Pressure; Heart Failure; Humans; Middle Aged; Pulmonary Edema; Randomized Controlled Trials as Topic; Survival Analysis
PubMed: 19694215
DOI: No ID Found -
Critical Care (London, England) Feb 2022An abrupt lung deflation in rodents results in lung injury through vascular mechanisms. Ventilator disconnections during endo-tracheal suctioning in humans often cause...
BACKGROUND
An abrupt lung deflation in rodents results in lung injury through vascular mechanisms. Ventilator disconnections during endo-tracheal suctioning in humans often cause cardio-respiratory instability. Whether repeated disconnections or lung deflations cause lung injury or oedema is not known and was tested here in a porcine large animal model.
METHODS
Yorkshire pigs (~ 12 weeks) were studied in three series. First, we compared PEEP abruptly deflated from 26 cmHO or from PEEP 5 cmHO to zero. Second, pigs were randomly crossed over to receive rapid versus gradual PEEP removal from 20 cmHO. Third, pigs with relative volume overload, were ventilated with PEEP 15 cmHO and randomized to repeated ETT disconnections (15 s every 15 min) or no disconnection for 3 h. Hemodynamics, pulmonary variables were monitored, and lung histology and bronchoalveolar lavage studied.
RESULTS
As compared to PEEP 5 cmHO, abrupt deflation from PEEP 26 cmHO increased PVR, lowered oxygenation, and increased lung wet-to-dry ratio. From PEEP 20 cmHO, gradual versus abrupt deflation mitigated the changes in oxygenation and vascular resistance. From PEEP 15, repeated disconnections in presence of fluid loading led to reduced compliance, lower oxygenation, higher pulmonary artery pressure, higher lung wet-to-dry ratio, higher lung injury score and increased oedema on morphometry, compared to no disconnects.
CONCLUSION
Single abrupt deflation from high PEEP, and repeated short deflations from moderate PEEP cause pulmonary oedema, impaired oxygenation, and increased PVR, in this large animal model, thus replicating our previous finding from rodents. Rapid deflation may thus be a clinically relevant cause of impaired lung function, which may be attenuated by gradual pressure release.
Topics: Animals; Lung Injury; Positive-Pressure Respiration; Pulmonary Edema; Respiration, Artificial; Respiratory Distress Syndrome; Swine
PubMed: 35180891
DOI: 10.1186/s13054-022-03924-2 -
Respiratory Care Sep 2020
Topics: Cannula; Emergency Service, Hospital; Humans; Light; Noninvasive Ventilation; Pulmonary Edema; Respiratory Insufficiency
PubMed: 32879038
DOI: 10.4187/respcare.08361 -
Intensive Care Medicine Aug 2014
Topics: Adult; Airway Obstruction; Humans; Pressure; Pulmonary Edema
PubMed: 24797685
DOI: 10.1007/s00134-014-3307-7 -
Liver Transplantation : Official... Jul 2003We investigated the clinical significance of time of onset, duration, and type of pulmonary edema after orthotopic liver transplantation by retrospectively reviewing 93...
We investigated the clinical significance of time of onset, duration, and type of pulmonary edema after orthotopic liver transplantation by retrospectively reviewing 93 consecutive recipients. Pulmonary edema was diagnosed by means of radiographic criteria and Pao(2)/Fio(2) ratio <300. Type was identified by pulmonary artery wedge pressure (hydrostatic, >18 mm Hg; permeability, < or =18 mm Hg). Of 91 evaluable patients, 44 (48%) had no pulmonary edema, 23 (25%) had immediate pulmonary edema resolving within 24 hours, 8 (9%) had late pulmonary edema (developing de novo in the first 16 to 24 hours), and 16 (18%) had persistent pulmonary edema (developing immediately and persisting for at least 16 hours). At 16 to 24 hours, mean arterial pressure was lower with persistent permeability-type edema than without pulmonary edema (75 versus 87 mm Hg, P <.01). Patients with persistent permeability-type edema had higher mean pulmonary arterial pressure (23 versus 16 mm Hg, P <.01) and higher pulmonary vascular resistance (103 versus 53 dyn. second. m(-5), P <.05), consistent with a resistance-dependent mechanism. Patients with persistent hydrostatic-type edema did not differ from those without edema in mean arterial pressure (84 versus 87 mm Hg, P >.05) or pulmonary vascular resistance (67 versus 53 dyn. second. m(-5), P >.05), but had increased mean pulmonary arterial pressure (27 versus 16, P <.01), suggesting a flow volume-dependent mechanism. Duration of mechanical ventilation, intensive care, and hospital stay were prolonged in patients with late or persistent permeability-type edema but not in patients with immediate pulmonary edema of any type. In conclusion, immediate pulmonary edema resolving within 24 hours after liver transplantation had little clinical consequence; persistent permeability-type pulmonary edema portended a worse outcome.
Topics: Adolescent; Adult; Aged; Female; Hemodynamics; Humans; Liver Transplantation; Male; Middle Aged; Outcome Assessment, Health Care; Postoperative Complications; Pulmonary Edema; Retrospective Studies; Time Factors
PubMed: 12827567
DOI: 10.1053/jlts.2003.50103 -
Thorax Dec 1988
Topics: Humans; Pneumonectomy; Postoperative Complications; Pulmonary Edema
PubMed: 3238637
DOI: 10.1136/thx.43.12.1026