1/15. Pulmonary interstitial fibrosis following near-drowning and exposure to short-term high oxygen concentrations.Following near-drowning in fresh water, a 19-year-old man experienced severe adult respiratory distress syndrome, necessitating ventilatory support with positive end-expiratory pressure and high oxygen concentrations. Post-extubation, his course was highlighted by persistent hypoxemia and interrupted by a lung abscess which responded promptly to antibiotics. Pulmonary function tests were consistent with severe restrictive disease and chest radiograph revealed persistent bilateral alveolar and interstitial infiltrates. An open lung biopsy on the 26th hospital day showed interstitial fibrosis. Over the ensuing two months, the chest radiograph and pulmonary function tests returned towards normal. We attribute the pulmonary fibrosis to incomplete resolution of the alveolar interstitial pathology secondary to the near-drowning and exposure to high oxygen mixtures.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/15. Airway pressure release ventilation in a patient with acute pulmonary injury.Airway pressure release ventilation is a recently described method of ventilatory support. It allows spontaneous ventilation with CPAP but differs from conventional ventilatory modes because, with APRV, peak inflation pressure never exceeds the level of CPAP, and airway pressure decreases, rather than increases, when tidal volume is delivered. The risk of pulmonary barotrauma and adverse hemodynamic effects associated with conventional modes of positive-pressure mechanical ventilation may be decreased because of lower peak inflation and mean airway pressures. We describe a patient in whom several risk factors for these complications were present who was treated successfully with APRV.- - - - - - - - - - ranking = 9keywords = pressure (Clic here for more details about this article) |
3/15. A delayed drowning death with histological findings of shock.A delayed drowning death case with histological findings of shock was described. The person was sustained by continuous positive-pressure respiration and died 2 days after resuscitation from drowning. The histological findings were intravascular microthrombi, hyaline bodies and fibrin thrombi in the brain, multiple megakaryocytes in the pulmonary capillaries, hyaline membranes of the lung, multiple small hyaline bodies in the liver sinusoids, and erosion of the mucous membrane of the stomach as well as histological findings of shock kidney. drowning and systemic hypotension during resuscitation seemed to cause irreversible oxygen debt of the organs and the tissues to lead to shock.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
4/15. temporal bone histopathologic findings in drowning victims.The human temporal bones of five drowning victims, the largest such series, to our knowledge, were evaluated to determine what histopathologic changes occurred. Thickening of the periosteal epithelium, especially on the surgical dome of the otic capsule, was evident in all cases. There was also hemorrhage in the middle ear cavity in four of the cases. In the fifth case, a cholesteatoma and ruptured tympanic membrane were observed, but there was no evidence of hemorrhage. It is proposed that an intact tympanic membrane is needed to create sufficient negative pressure in the middle ear cavity to cause rupture of the blood vessels and hemorrhage. Such bleeding is indicative of drowning when the tympanic membrane is intact.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/15. nitrogen narcosis and alcohol consumption--a scuba diving fatality.nitrogen narcosis can cause death among experienced scuba divers. nitrogen under pressure affects the brain by acting as an anesthetic agent. Furthermore, the consumption of ethanol along with diving will cause the symptoms of nitrogen narcosis to occur at depths less than 30 m. Our case deals with an experienced diver who drank alcoholic beverages before diving and developed symptoms of nitrogen narcosis at a shallow depth. These two conditions contributed to his death by drowning.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
6/15. drowning and near-drowning: current concepts and neutrophil function studies.A near-drowning by a young man in an indoor pool is reported, and the current concepts of therapy are discussed. Laboratory studies of the patient's neutrophil function and chemotactic response were performed on the day of admission and on hospital days 2 and 4. Neutrophil function and chemotaxis were equal to control values, indicating no effect of near-drowning on these aspects of the host immune system. Hospital admission and supportive therapy including intubation, positive end-expiratory pressure, steroids, and antibiotics are recommended, if necessary, in management of the nearly drowned patient.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/15. swimming and loss of consciousness.Under certain circumstances, even a good swimmer may drown during swimming exercise. Two cases of drowning, a survivor and a dead, during swimming exercise in swimming-pool are described. These cases and experimental researches with dogs indicate that the initial aspiration of water may cause extremely low heart rate and low blood pressure by reflex vagal inhibition, which deprive a good swimmer of his consciousness and make him drown.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/15. survival after 40 minutes; submersion without cerebral sequeae.cardiopulmonary resuscitation and rewarming were successful in a 5-year-old boy who had been submerged for 40 minutes in ice-cold fresh water. Severe metabolic acidosis was corrected by intravenous infusion of sodium bicarbonate solution before spontaneous circulation could be re-established. Fulminant pulmonary oedema developed after re-establishment of spontaneous circulation. This was efficiently reversed by positive-end-expiratory-pressure ventilation. During 2 days of treatment of a respiratory the patient gradually regained consciousness; the endotracheal tube was then removed and the patient immediately started talking intelligently. The patient went through a period of slow cerebration and motor dysfunction but recovered rapidly, and on examination 13 months after the accident all findings were normal.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/15. Fulminant pulmonary edema after near-drowning: remarkably high colloid osmotic pressure in tracheal fluid.A 44-year-old man developed severe permeability pulmonary edema associated with septic shock after near-drowning. Colloid osmotic pressure (COP) of deep tracheal fluid was persistently higher than plasma COP. Tracheal/plasma COP ratio reached a peak value of 1.75. A massive colloid infusion of 5% protein solution was incriminated in the development of this markedly elevated COP in the tracheal fluid.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
10/15. Near-drowning in Canadian waters.Near-drowning is a subject of ever-increasing importance. Two recent cases are presented that illustrate many of the problems encountered. For a current understanding of the etiologic and pathophysiologic aspects and of the prognosis of near-drowning, an updated review of the literature is provided. The importance in treatment of the recognition of hypothermia, the use of positive end-expiratory pressure and the controversy over the role of corticosteroid therapy are discussed.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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