Reperfusion pulmonary edema

Article Abstract:

During vascular surgery, the compression (clamping) of arteries causes a temporary cessation of blood circulation in the lower trunk. This leads to respiratory collapse when the blood flow is restored; the effect is called reperfusion damage. Recent experimental work, particularly in sheep, has led to a better understanding of the problem. The clinical correlates of reperfusion damage are described and a physiologic explanation is presented. In sheep, the mechanism of injury has been traced to pathologic changes in the ability of material to pass through the thin walls of capillaries (the smallest blood vessels) which serve the microscopic air spaces (alveoli) of the lung. This results in an accumulation of fluid in the lungs, or pulmonary edema, and the inability to adequately exchange gases. The authors provide a new hypothesis which links the inflammatory lung reaction to the tissue release of powerful biologic agents (chemoattractants, including thromboxane) which act to attract white blood cells, but not platelets, into the lungs. These chemicals are formed because of oxygen deprivation during vascular clamping and they are ultimately dumped into the circulation upon the removal of the clamp.

Research, Causes of, Complications and side effects, Laboratory animals, Lung diseases, Sheep, Thromboxanes, Ischemia, Respiratory insufficiency, Sheep as laboratory animals

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Patent foramen ovale and high-altitude pulmonary edema

Article Abstract:

A study was conducted on mountaineers to examine whether patent foramen ovale (PFO) is more frequent in high-altitude pulmonary edema (HAPE)-susceptible individuals and may contribute to more severe arterial hypoxemia at high altitude. Results revealed that PFO was more frequent in HAPE-susceptible mountaineers who also displayed more severe hypoxemia than in participants resistant to the condition, suggesting that a large PFO may contribute to more severe arterial hypoxemia and facilitate HAPE at high altitude.

Diagnosis, Medical examination, Mountaineers, Heart septum, Clinical report

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Noninvasive ventilation in acute cardiogenic pulmonary edema

Article Abstract:

A study aims to systematically review and quantitatively synthesize the short-term effect of noninvasive ventilation on major clinical outcomes. Noninvasive ventilation reduces the need for intubation and mortality in patients with acute cardiogenic pulmonary edema.

United States, Patient outcomes, Risk factors, Diagnosis, Noninvasive, Noninvasive diagnosis

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