Cases reported "Acidosis, Respiratory"

Filter by keywords:



Filtering documents. Please wait...

1/10. Pickwickian syndrome, 20 years later.

    The Pickwickian syndrome stimulated new pathophysiological concepts in regard to control of ventilation. With the advent of sleep laboratories, the peculiar sleep apnea occurring in some of these patients has been explained on the basis of intermittent upper airway obstruction. Two patients with different manifestations of the Pickwickian syndrome are presented. The suggestion is made that these two subsyndromes should have unique designations. The Auchincloss syndrome is manifested by right heart failure and respiratory acidosis in obese patients who are alert and have no major abnormality of breathing pattern. The fundamental cause of this abnormality is the increased work of breathing caused by the obesity. The cost of breathing is so high that the ventilatory regulation is compromised and respiratory acidosis results. The Gastaut syndrome is characterized principally by hypersomnia and sleep apnea. The fundamental defect is upper airway obstruction during sleep, resulting in increased work of breathing, which together with the increased work caused by obesity leads to respiratory acidosis and right ventricular failure. Hypersomnia, rather than heart failure or respiratory acidosis, is the major manifestation of this syndrome, and is the result of sleep loss.
- - - - - - - - - -
ranking = 1
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

2/10. Acute respiratory failure precipitated by a carbonic anhydrase inhibitor.

    A 60-year-old white man with chronic bronchitis was noted to develop acute respiratory failure and metabolic acidosis four days after being started on methazolamide (Neptazane) for an ophthalmologic problem. The patient was intubated with ventilator support and improved after his metabolic acidosis resolved. Caution is emphasized in the use of carbonic anhydrase inhibitors in patients with obstructive airway disease.
- - - - - - - - - -
ranking = 0.10716896272028
keywords = airway
(Clic here for more details about this article)

3/10. Arterial to end-tidal CO2 laparoscopic gradient reversal during pheochromocytoma resection.

    PURPOSE: We report the development of severe intraoperative hypercarbia and a pronounced arterial to end-tidal gradient reversal during laparoscopic pheochromocytoma resection. Although complex physiologic mechanisms may be responsible for this finding, anatomic alterations such as a direct communication between a capnoperitoneum and/or capnothorax and the airways resulting from prior pathology and the type of procedure should also be considered. CLINICAL FEATURES: During anesthesia for laparoscopic pheochromocytoma removal we noticed an abrupt, extensive increase of the end-tidal CO(2) accompanied by a change of the capnographic CO(2) tracing and reversal of the normal arterial-to-end-tidal gradient. These changes consistently disappeared by intermittent deflation of the abdomen and at the end of surgery. A chest x-ray revealed a right-sided loculated pneumothorax with pleural thickening. Peritoneo-thoracic CO(2) tracking and pleural scaring with pulmonary adhesions resulting in a unidirectional communication between the pleural space and airways may best explain the chest x-ray and clinical findings. CONCLUSION: Severe intraoperative hypercarbia and arterial to end-tidal CO(2) gradient reversal represents an intraoperative challenge. The possibility of a direct communication between the pleural space and the bronchial tree should be considered when other etiologies have been excluded. Simple maneuvers such as abdominal de- and re-inflation and analysis of the end-tidal capnographic tracing might aid in the differential diagnosis and management.
- - - - - - - - - -
ranking = 0.21433792544056
keywords = airway
(Clic here for more details about this article)

4/10. Respiratory muscle fatigue from functional upper airway obstruction.

    A case of functional upper airway obstruction is presented. The case is unusual because even though no identifiable organic cause could be found for dyspnea and stridor, the patient developed respiratory failure from respiratory muscle fatigue.
- - - - - - - - - -
ranking = 2.5
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

5/10. Hypokalaemia and respiratory acidosis following partial obstruction of the airway.

    An 87-year-old female, with a history of hypertension controlled with hydrochlorothiazide, was scheduled for excision of a cystic mass of the left lobe of the thyroid. In the course of the anaesthetic, she developed partial airway obstruction that resulted in respiratory acidosis (PaCO2 108 mmHg, pH 7.06), developed premature ventricular contractions and experienced a reduction in plasma potassium concentration from 3.9 to 2.9 mmole X L-1. We interpret this hypokalaemia as a consequence of the epinephrine discharge due to hypercapnia. The case is reported to emphasize the importance of minimizing the sympathetic response to induction of anaesthesia, intubation and surgery in patients with marginal potassium stores.
- - - - - - - - - -
ranking = 0.98563641380713
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

6/10. Acute bronchospasm resembling status asthmaticus during the neonatal period.

    Recently, we encountered four neonates who developed severe reversible partial lower airway obstruction. This communication describes their clinical course and the pathogenesis and treatment of acute bronchospasm resembling status asthmaticus and leading to life-threatening respiratory acidosis.
- - - - - - - - - -
ranking = 0.5
keywords = airway obstruction, airway, obstruction
(Clic here for more details about this article)

7/10. Correction of respiratory acidosis and transient hypomagnesemia.

    Four elderly patients with established chronic obstructive airways disease were admitted with a days' to weeks' history of increasing dyspnea. Acute respiratory acidosis was diagnosed and mechanical ventilation instituted. A few hours after initiation of treatment, arterial pH was normal in all patients, but serum magnesium concentrations decreased over the next 1-3 days. Thereafter, a spontaneous normalization was seen. It is suggested that the transient hypomagnesemia is due to correction of the acidosis per se.
- - - - - - - - - -
ranking = 0.10716896272028
keywords = airway
(Clic here for more details about this article)

8/10. Severe hypophosphataemia during recovery from acute respiratory acidosis.

    Three elderly patients with established chronic obstructive airways disease were admitted with a short history of increasing dyspnoea and tiredness and (in two cases) a deterioration in mental state. Acute respiratory acidosis was diagnosed and mechanical ventilation instituted. Two hours after beginning mechanical ventilation the mean arterial pH had risen to 7.40, but all patients showed a dramatic fall in the serum phosphate concentration (lowest value 0.3 mmol/l (0.9 mg/100 ml] accompanied by a low urinary excretion of phosphate. No patient could tolerate withdrawal of mechanical ventilation until the serum and urinary concentrations of phosphate had returned to normal. Recovery from acute respiratory acidosis should be added to the list of conditions associated with severe hypophosphataemia.
- - - - - - - - - -
ranking = 0.10716896272028
keywords = airway
(Clic here for more details about this article)

9/10. How far can we go with permissive hypercapnia? A case presentation and some biased comments with emphasis on maintaining normal haemoglobin level.

    The respiratory management strategy of small tidal volume with permissive hypercapnia has been adopted to avoid further aggravation of lung injury due to high airway pressure with some impressive success (1). No consensus, however, has been established in terms of the rate of increase in PaCO2 and its upper limit. Recently, our colleague in the intensive care unit experienced a severe case of ARDS successfully treated with the above strategy despite of the fact that during the course of treatment, the highest PaCO2 reached 177 mmHg and the lowest pH, 7.03 (2). The fact that PaCO2 may reach a very high level in the clinical setting and the well-known role of haemoglobin (Hb) in buffering CO2 led us to study effects of different Hb levels on pH and haemodynamic changes in response to acute CO2 loading in the blood. We will summarize the case report first with permission of authors (the case report was published in Japanese) (2) and then discuss the studies conducted in our animal laboratory.
- - - - - - - - - -
ranking = 0.10716896272028
keywords = airway
(Clic here for more details about this article)

10/10. Tension pneumopericardium following tracheoplasty for congenital tracheal stenosis.

    Tension pneumopericardium is a rare complication of mechanical ventilation following tracheoplasty for congenital tracheal stenosis. This case report describes fatal tension pneumopericardium in a three-month-old male infant some 24 hours following tracheoplasty for this condition. Because of persisting stenosis of the left main bronchus, ventilation pressures of PIP 23 cm H2O and PEEP 5 cm, progressing to PIP 28 cm and PEEP 7 cm were needed to maintain adequate respiratory exchange. Partial relief of the pneumopericardium was achieved by vigorous cardiac massage, but three days later the infant died of massive airway haemorrhage.
- - - - - - - - - -
ranking = 0.10716896272028
keywords = airway
(Clic here for more details about this article)
| Next ->


Leave a message about 'Acidosis, Respiratory'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.