Pulmonary edema in near hanging

Viswanathan, Stalin; Muthu, Vivekanandan; Remalayam, Bhavith

doi:10.1097/ta.0b013e3182191298

Cited by 12 publications

(10 citation statements)

References 28 publications

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“…Cerebral hypoxia induced in animals has been shown to lead to pulmonary changes consistent with ARDS development[22–24]. During hanging attempts, acute negative intrathoracic pressure developing after upper airway obstruction may cause disruption of the alveolar-capillary membrane[25]; which is termed negative pressure pulmonary edema (NPPE)[7; 8; 26; 27] or post-obstructive pulmonary edema (POPE)[6; 28]. While the pathophysiology of NPPE involves hydrostatic pressure, this is not left atrial hydrostatic pressure, thus defining it as ARDS[25].…”

Section: Discussionmentioning

confidence: 99%

“…Injuries occurring after near-hanging include cervical spine and laryngotracheal fractures, anoxic brain injury, and retinal bleeding[2–4]. Previously, pulmonary complications such as aspiration pneumonia[3], and pulmonary edema[5–8]have been observed. However, the Acute Respiratory Distress Syndrome (ARDS), as defined by modern consensus definition, has not been evaluated as an outcome after near-hanging.…”

Section: Introductionmentioning

confidence: 99%

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Acute respiratory distress syndrome and outcomes after near hanging

Mansoor

Afshar

Barrett

et al. 2015

The American Journal of Emergency Medicine

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Purpose Assess the case rate of Acute Respiratory Distress Syndrome (ARDS) after near-hanging, and the secondary outcomes of traumatic and/or anoxic brain injury, and death. Risk factors for the outcomes were assessed. Method Single-center, state-wide retrospective cohort study of consecutive patients admitted between August, 2002, and September, 2011, with a primary diagnosis of non-judicial "hanging injury". Results Of 56 patients, 73% were male. The median age was 31 (IQR: 16–56). Upon arrival, 9% (5/56) did not have a pulse, and 23% (13/56) patients were intubated. The median Glasgow Coma Scale (GCS) was 13 (IQR: 3–15); 14% (8/56) had a GCS=3. ARDS developed in 9% (5/56) of patients. Traumatic anoxic brain injury resulted in 9% (5/56) of patients. The in-hospital case fatality was 5% (3/56). Lower median GCS [3 (IQR: 3–7) vs. 14 (IQR: 3–15), p=0.0003] and intubation in field or in trauma resuscitation unit [100% (5/5) vs. 16% (8/51), p=0.0003] were associated with ARDS development. Risk factors of death were GCS=3 [100% (3/3) vs. 9% (5/53), p=0.002]; pulselessness upon arrival of emergency medical services [100% (3/3) vs. 4% (2/53), p<0.001]; and abnormal neurologic imaging [50% (1/2) vs. zero, p=0.04]. Conclusions The ARDS case rate after near-hanging is similar to the general trauma population. Low GCS and intubation are associated with increased risk of ARDS development. The rate of traumatic and/or anoxic brain injury in this population is low.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute respiratory distress syndrome and outcomes after near hanging

Mansoor

Afshar

Barrett

et al. 2015

The American Journal of Emergency Medicine

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“…Acute pulmonary edema predominantly occurs following acute extensive myocardial infarction, acute myocarditis, severe hypertension, aortic or mitral stenosis, infective endocarditis and cardiac trauma (9). Its onset is rapid, often inducing cardiac and respiratory failure; therefore, the mortality rates are high (10).…”

Section: A B C D Discussionmentioning

confidence: 99%

“…In recent years, the incidence of acute pulmonary edema has gradually increased (3). Prevention and treatment can significantly increase the survival rate of patients with pulmonary edema and reduce the sequelae and complications (9). Since this disease has important social significance, it has been increasingly investigated by the medical community (11,12).…”

Section: A B C D Discussionmentioning

confidence: 99%

Levels of interleukin-6, superoxide dismutase and malondialdehyde in the lung tissue of a rat model of hypoxia-induced acute pulmonary edema

Gao

Tian

Wang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. The present study aimed to investigate the levels of malondialdehyde (MDA), superoxide dismutase (SOD) and interleukin (IL)-6 in the lung tissue of a rat model of acute pulmonary edema induced by acute hypoxia, and its pathophysiological significance. A total of 48 adult Wistar rats were randomly divided into group A, a normal group; group B, a model of acute pulmonary edema induced by hypoxia for 24 h; group C, a model of acute pulmonary edema induced by hypoxia for 48 h; and group D, a model of acute pulmonary edema induced by hypoxia for 72 h. The rats in groups B-D were intraperitoneally injected with 6% ammonium chloride to establish the model of acute pulmonary edema, and were subsequently sacrificed following successful modeling for 24, 48 and 72 h. The plasma of rats was isolated and the lungs of the rats were removed. Subsequently, a 10% lung homogenate was prepared and the contents and the activities of MDA, SOD and IL-6 in the lung tissue and IL-6 in the plasma were detected by enzyme-linked immunosorbent assay. MDA and IL-6 expression levels increased and SOD activity decreased in the lung tissue in group B as compared with group A; however the difference did not reach significance (P>0.05). MDA, IL-6 and SOD levels in the lung tissue of rats were significantly altered following the increased duration of pulmonary edema in groups C and D, as compared group A (P<0.05). The plasma IL-6 levels of the rats in groups B-D significantly increased, as compared with those in group A (P<0.05). In conclusion, the results of the present study demonstrated that the incidence of acute pulmonary edema may be associated with oxidative stress. Furthermore, decreased antioxidant capacity and increased free radical levels may be associated with pulmonary edema, as in the present study the levels of IL-6, SOD and MDA in the lung tissue were observed to be associated with the pathological changes of the disease.

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“…Injuries occurring after near-hanging include cervical spine and laryngotracheal fractures, anoxic brain injury, and retinal bleeding [2][3][4]. Previously, pulmonary complications such as aspiration pneumonia [3], and pulmonary edema [5][6][7][8]have been observed. However, the Acute Respiratory Distress Syndrome (ARDS), as defined by modern consensus definition, has not been evaluated as an outcome after near-hanging.…”

Section: Introductionmentioning

confidence: 99%