1/95. pulmonary edema: a complication following dental treatment under general anesthesia.This article describes pulmonary edema in two young, physically healthy individuals following routine intensive dental treatment under general anesthesia. The etiology, diagnosis, prognosis, and treatment are discussed. This paper demonstrates that young, healthy patients may develop pulmonary edema in the perianesthesia period or even during anesthesia itself. Obstructive events, which occur especially in the post extubation period, may trigger this condition, as may other well-known phenomena. early diagnosis and intensive treatment are mandatory in order to effectively resolve the situation.- - - - - - - - - - ranking = 1keywords = health (Clic here for more details about this article) |
2/95. Management of severe and complicated malaria in the intensive care unit.malaria remains today one of the major health problems in the tropics with increased morbidity and mortality. The most serious complications are caused by plasmodium falciparum, which, in contrast to the benign malarias, may progress to a life-threatening multi-system disease. Our case concerns a young woman in the 14th week of pregnancy, admitted to the ICU in a coma, with pulmonary oedema, haemolytic anaemia, renal failure and thrombocytopenia as complications of P. falciparum malaria. The case is discussed and possible explanations for the clinical picture and complications of P. falciparum malaria are given in the light of experiences from the literature.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
3/95. Acute infection with Sin Nombre hantavirus without pulmonary edema.Acute infection with sin nombre virus has been associated with development of hantavirus cardiopulmonary syndrome (HCPS), a severe cardiopulmonary illness with respiratory failure and shock. We present two cases of Sin Nombre hantavirus infections that did not lead to marked pulmonary complications in two otherwise healthy young adults from utah and california. sin nombre virus causes a wider spectrum of disease severity than has been previously reported.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
4/95. Neurogenic pulmonary edema induced by primary medullary hemorrhage: a case report.We report a case of neurogenic pulmonary edema occurring in association with primary medullary hemorrhage. A pervious healthy 28-year-old man suddenly developed severe dyspnea without cardiac failure. Radiographs and computed tomography of the chest showed pulmonary edema. A diagnosis of primary medullary hemorrhage was made some weeks later by cranial magnetic resonance imaging showing an area of low signal intensity in both T1- and T2-weighted images in the right ventrolateral, medial, and dorsal medulla, extending from low to mid levels. We suspect that edema surrounding the lesion had superimposed an element of left dorsal medullary dysfunction and that bilateral dorsal medullary involvement had induced neurogenic pulmonary edema.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
5/95. Biting the laryngeal mask: an unusual cause of negative pressure pulmonary edema.PURPOSE: To describe negative pressure pulmonary edema due to biting of the laryngeal mask tube at emergence from general anesthesia. CLINICAL FEATURES: A healthy patient underwent general anesthesia using a laryngeal mask airway and mechanical ventilation. During recovery, the patient strongly bit the laryngeal mask and made very forceful inspiratory efforts until the mask was removed. Five minutes later, the patient developed dyspnea and had an hemoptysis of 50 ml fresh blood. Chest radiograph showed bilateral alveolar infiltrates. Pharyngo-laryngeal examination was normal. bronchoscopy revealed no injury but diffuse pink frothy edema fluid. Clinical examination and chest radiograph became normal after 12 hr of nasal oxygen therapy confirming airway obstruction as the most available cause of this pulmonary edema. CONCLUSION: airway obstruction due to biting of a laryngeal mask tube may result in negative pressure pulmonary edema.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
6/95. Postobstructive pulmonary oedema--a case series and review.Six cases of post-extubation pulmonary oedema in otherwise healthy patients are reported. All were preceded by an episode of laryngospasm and followed a clinical course similar to that previously documented in cases of post-obstructive pulmonary oedema. Frank haemoptysis was a feature of five of the presentations. One patient was reintubated and ventilated, two were admitted to the intensive care unit for mask CPAP, one was managed with CPAP in the recovery ward and two with supplemental oxygen only. All cases resolved fully within 24 hours. Some evidence points to the syndrome being the result of airway bleeding rather than true pulmonary oedema. The literature suggests that it occurs more commonly than is generally thought, with a frequency of 0.05 to 0.1% of all anaesthetics, and is often unrecognised or misdiagnosed. Most cases occur in the early postoperative period, so anaesthetists are well placed to witness, investigate and manage this interesting condition.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
7/95. Negative pressure pulmonary edema after a tonsillectomy and adenoidectomy in a pediatric patient: case report and review.Negative pressure pulmonary edema (NPPE) continues to be reported as a complication of upper airway obstructions seen by anesthesia providers during induction or emergence. The majority of patients reported to have experienced NPPE have been healthy, without underlying pulmonary or cardiac disease. Factors associated with the formation of NPPE include young male patients and patients with long periods of airway obstruction. Overzealous intraoperative fluid administration and preexisting heart and lung disease also have been implicated as predisposing factors. Negative pressure pulmonary edema is the result of a marked decrease in intrathoracic pressure caused by ventilatory efforts against a closed glottis resulting in a disruption of the normal intravascular Starling mechanism, ultimately leading to the transudation of intravascular proteins and fluid into the pulmonary interstitium. The onset of NPPE is usually rapid, and without prompt recognition and intervention, the outcome can be fatal. A case of NPPE in a pediatric patient after an otherwise uncomplicated surgical procedure was observed in our institution and is described in this report.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
8/95. bupivacaine-induced myocardial depression and pulmonary edema: a case report.central nervous system and cardiovascular toxicity are well-known side effects of bupivacaine. We report a case of bupivacaine-induced myocardial depression and cardiogenic pulmonary edema. A previously healthy woman developed soon after bupivacaine epidural injection of 5 mL 0.5% (25 mg) cardiogenic shock complicated with pulmonary edema. There were pronounced rales on auscultation with a butterfly sign on chest radiograph. A cardiac ultrasound showed reduced myocardial contractility, diffuse hypokinesia, left ventricular ejection fraction (LVEF) 25%, mitral and pulmonary insufficiency. Right heart catheterization showed increased pulmonary artery wedge pressure (34 mm Hg) and a pulmonary artery pressure of 48 over 33 mm Hg. These findings suggest myocardial depression owing to bupivacaine sodium channel blocking of myocardial nerve and tissue and subsequent reduction of myocardial contractility. The patient completely recovered with normalization of clinical, roentenographic, ultrasound, and hemodynamic findings and discharged 10 days later in good condition.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
9/95. Fulminant pulmonary edema after intramuscular ketamine.PURPOSE: To report an unusual case of pulmonary edema following intramuscular ketamine administration. CLINICAL FEATURES: An eight-year-old, healthy girl presented for dressing of first degree burns on dorsum of hand. Ten minutes after administration of 125 mg ketamine im, she developed laboured breathing, cyanosis, and bilateral crepitations and arterial blood gas analysis showed PaO2 55 mmHg. There was no evidence of upper airway obstruction. On intubating the trachea, pink frothy fluid emerged from the tube. She was diagnosed as a case of neurogenic pulmonary edema. She was managed with positive pressure ventilation with positive end expiratory pressure, morphine and furosemide. With this treatment she showed a favourable recovery. CONCLUSION: ketamine was given im to aid burns dressing in this case because it has distinct advantages above the other anesthetic agents including that of being a good analgesic which is absorbed by im route. Its use led to the development of pulmonary edema.- - - - - - - - - - ranking = 0.5keywords = health (Clic here for more details about this article) |
10/95. pulmonary edema in 6 children with down syndrome during travel to moderate altitudes.OBJECTIVE: Children with down syndrome (DS) are living longer and are increasingly participating in recreational activities. When a child with DS was diagnosed with high-altitude pulmonary edema (HAPE), this study was undertaken to determine whether and under what circumstances children with DS develop HAPE. DESIGN: A retrospective review of the medical records of Children's Hospital, Denver, colorado was performed for children with a discharge diagnosis of HAPE. Diagnostic criteria for HAPE included the presence of crackles or frothy sputum production on examination, hypoxemia, chest radiograph findings consistent with pulmonary edema, and rapid clinical improvement after descent or oxygen therapy. RESULTS: A total of 52 patients with HAPE were found of whom 6 also had DS. The age range of the children with DS was 2 to 14 years. HAPE developed at altitudes ranging from 1738 to 3252 m. Four children developed HAPE within 24 hours of arrival to altitude. Three children had chronic pulmonary hypertension, and 4 had either an existing cardiac defect with left-to-right shunt or previously had a defect with left-to-right shunt that had been repaired. One child had Eisenmenger syndrome with chronic right-to-left shunting of blood. Five children had preexisting illnesses before travel to altitude. CONCLUSION: Children with DS often have medical problems such as chronic pulmonary hypertension, frequent infections, and pulmonary vascular overperfusion and injury from existing or previous cardiac defects. These problems all may be viewed as risk factors for HAPE and thus result in the rapid development of HAPE at low altitudes. Care should be taken when traveling to even moderate altitudes with children with DS.- - - - - - - - - - ranking = 1.717818075185keywords = record (Clic here for more details about this article) |
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