1/5. Persistent hypoxia after diagnosis and treatment of pulmonary thromboembolism.Acute respiratory failure in the perioperative period represents a frequent challenge to the anesthesiologist. The differential diagnosis is extensive and includes alterations on the pulmonary parenchyma, pulmonary vessels, airway, and cardiac system. Occasionally, two or more pathophysiological process superimpose. We present a patient who suffered from a left pulmonary embolism that was appropriately diagnosed and treated. However, the hypoxemia persisted and a second pathology was suspected. After careful evaluation and differential diagnosis, we drained a right pleural effusion, which had been present preoperatively, with resolution of the hypoxemia. There is controversy in the literature as to the role of drainage of pleural effusions on improving oxygenation. We present this case as an example of successful management of perioperative respiratory failure by thoracentesis in the presence of a second concurrent pathologic process.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/5. hemorrhage into the brain abscess cavity with Fallot's tetralogy.hemorrhage into the abscess cavity is a complication of brain abscess. It has been reported to be due to inflammation which results in the damage of the fragile neovasculature of the abscess wall. Hypoxia caused by Fallot's tetralogy or other congenital heart diseases facilitates the damage of these vessels with the lacking supportive tissues, and in turn intracavital bleeding.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/5. Hypoxia and cyanosis in alpha-1-antitrypsin deficiency. Cirrhosis as an unusual etiologic factor.A patient with type PiZZ alpha-1-antitrypsin deficiency was found to have severe hypoxia despite normal pulmonary function testing and a normal chest radiograph. A nuclear medicine ventilation-perfusion study revealed a right-to-left shunt. Computed tomography showed minimal bleb formation, no diffuse changes, and hepatic changes of cirrhosis with portal hypertension. No nodular pulmonary masses or enlarged peripheral pulmonary vessels were found. The diagnosis of diffuse intrapulmonic arteriovenous shunts ("pulmonary spiders of cirrhosis") was suggested and then confirmed with a dynamic radionuclide flow study.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/5. Pulmonary blood vessels and endocrine cells in subacute infantile mountain sickness.A male infant of 16 months, of the Han race, died from subacute infantile mountain sickness in Lhasa (3600 m). At necropsy there was right ventricular hypertrophy secondary to muscularization of the pulmonary arteries and arterioles thought to have been induced by hypobaric hypoxia. In addition, there was intimal proliferation of myofibroblasts in the pulmonary arterioles, venules and veins. There were increased numbers within the bronchioles of pulmonary endocrine cells, containing calcitonin and bombesin, which could be related to hypoxia or trophic effects on the pulmonary vasculature. The relation of delayed effects of hypoxia to primary pulmonary hypertension is considered in this study.- - - - - - - - - - ranking = 4keywords = vessel (Clic here for more details about this article) |
5/5. The use of adjuvant hyperbaric oxygen in treatment of the diabetic foot.Hypoxia in the relatively ischemic diabetic foot impairs leukocyte bacterial killing and fibroblast-collagen support for capillary angiogenesis. infection in even the relatively young, "warm-foot" diabetic with microangiopathy, neuropathy, and infection leads to hypoxia due to local high oxygen consumption. The 1100 to 1300 mm Hg arterial PO2 achievable with hyperbaric oxygen results in elevation of wound PO2. Periodic correction of wound hypoxia improves leukocyte bacterial killing and support for capillary angiogenesis. Hyperbaric oxygen is usually futile in the elderly diabetic with significant and generalized large-vessel occlusion.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |