Long-term and high-dose allopurinol therapy significantly improved endothelial function in diabetic normotensive patients. In addition, allopurinol therapy contributes to the lower HbA1c levels.
Atrial EMD is prolonged in patients with SLE. We have also shown that PWD, intra-atrial EMD, and interatrial EMD were significantly correlated with disease duration. This study calls attention to the following: the measurement of atrial conduction time may be clinically helpful in the definition of cardiac involvement.
Negatif basınçlı pulmoner ödem (NBPÖ) genel anestezi sonrasında erken postoperatif dönemde laringospazma bağlı olarak gelişebilen, hayatı tehdit eden ve nadir gözlenen nonkardiyojenik bir pulmoner ödem sebebidir. Otuz üç yaşında erkek ve kırk üç yaşında kadın hastaya genel anestezi altında apendektomi ve kolesistektomi operasyonu uygulandı. Entübasyon ve operasyon süresince hemodinamik ve solunumsal sıkıntı yaşanmadı. Birinci olguda ekstubasyon sonrasında birkaç dakika içerisinde ciddi laringospazm ve şiddetli inspiratuvar efor sonrası satürasyonunda düşme saptandı. İkinci olguda ise operasyondan 45dk sonra nefes darlığı ve satürasyonda düşme saptandı. Her iki olgunun da fiziki muayenesinde bilateral orta ve alt zonda ralleri mevcuttu. Postoperatif çekilen akciğer ve toraks tomografilerinde akciğer ödemi ile uyumlu bulgular saptandı. Postoperatif ekokardiyografik bulguları normaldi. Her iki olguya da beta-2 agonist, inhale steroid, oksijen ve diüretik tedavisi verildi. Postoperatif erken dönemde satüras-yon düşüklüğü olan hastalarda ayırıcı tanıda negatif basınçlı pulmoner ödem de akılda tutulmalıdır.
Anahtar Sözcükler: Negatif basınçlı pulmoner ödem, anestezi, nonkardiyojenik ödem.Negative pressure pulmonary edema (NPPE) is a life threatening rare cause of non-cardiogenic pulmonary edema that can occur due to laryngospasm in the early postoperative period after general anesthesia. A 33-year-old male and a 43-year-old female appendectomy and cholecystectomy were performed under general anesthesia. Hemodynamic and respiratory distress were not experienced during intubation and operation. Serious laryngospasm and a reduction in saturation after severe inspiratory effort were detected in the first patient within a few minutes after extubation. Dyspnea and a reduction in saturation were established after 45 minutes of the operation in the second patient. Patients had bilateral middle and lower zone crackles upon physical the examination. Postoperative chest and thorax tomography revealed findings consistent with pulmonary edema. Postoperative echocardiographic findings were normal. Beta-2 agonists, inhaled steroids, oxygen, and diuretic therapy were administered to patients. NPPE should also be kept in mind in the differential diagnosis in patients with low saturation in the early postoperative period.
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