Pulmonary Lesions Associated with Oxygen Therapy and Artificial Ventilation

Nash, Gerald D.; Blennerhassett, John B.; Pontoppidan, Henning

doi:10.1056/nejm196702162760702

Cited by 472 publications

(105 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As these cells disrupt, the pulmonary interstitium becomes edematous and the fibrin membrane may be formed along the alveolar lining. This is followed by a diffuse parenchymal lung lesion associated with congestion, edema, bleeding, and fibrosis (9,30,31). Our histological findings of hemorrhage and atelectasis in the lungs after oxygen exposure is fundamentally in agreement with the views cited in these reviews.…”

Section: Resultssupporting

confidence: 92%

Oxygen Poisoning and Vitamin E Deficiency

Mino

1973

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

View full text Add to dashboard Cite

Section: Resultssupporting

confidence: 92%

Oxygen Poisoning and Vitamin E Deficiency

Mino

1973

Journal of Nutritional Science and Vitaminology, J Nutr Sci Vit

View full text Add to dashboard Cite

“…Fluid and electrolyte ther¬ apy was guided by concur¬ rent laboratory data, in¬ take and output balance, The hemoglobin values and hematocrit readings were normal in all patients, despite free plasma hemoglobin values ranging from 8 to 500 mg/100 ml, indicating significant hemolysis in some. Three patients (cases 6, 9, and 12) showed a fall in hemo¬ globin concentration to 10.6 to 11 gm/100 ml, and in the hematocrit reading to 32% to 33% within 24 hours. The serum concentrations of sodium and chloride were found to be normal in all but one patient (case 9, sodium, 131 mEq/liter).…”

Section: General Clinical Course Of Victims Rescued Frommentioning

confidence: 93%

“…Once the shunt through atelectatic al¬ veoli has subsided, it is frequently still necessary to supply the patient with an oxygen-enriched atmosphere. Since prolonged exposure to high concentrations of oxygen may cause extensive pulmo¬ nary damage,23 24 Consciousness at the time of admission is not synonymous with recovery in all patients. One of the two patients who died in this series was the only patient who was not initially apneic or un¬ conscious.…”

Section: Report Of Casesmentioning

confidence: 99%

Blood Gas and Electrolyte Changes in Human Near-Drowning Victims

Modell¹,

Davis²,

Giammona³

et al. 1968

JAMA

View full text Add to dashboard Cite

Twelve human near-drowning victims were treated, and their clinical courses were studied with particular attention given to electrolyte and blood gas changes. Ten of these patients made complete uneventful recoveries. The primary pathophysiological disturbance which necessitated emergency therapy was acute asphyxia with persistent arterial hypoxemia and acidosis. Initially the hypoxia appeared to be due to perfusion of nonventilated alveoli. Persistent arterial hypoxemia was present, however, even after a significant intrapulmonary shunt could no longer be demonstrated. The plan of management for each patient should be determined by individual laboratory and clinical studies.During the past few decades, considerable em¬ phasis has been placed on the serum elec¬ trolyte changes that occur during drowning.' '* In a retrospective study published in 1963, however, Fuller was unable to document significant electro¬ lyte changes in human near-drowning victims.7 Recent experiments with animals have shown that the electrolyte changes following aspiration of both fresh water8 and sea water" are related directly to the quantity of water aspirated. In untreated ani¬ mals which survived these experiments, electrolyte values spontaneously returned to normal. The com¬ mon denominator in all animals, regardless of the composition or volume of fluid aspirated, was the onset of acute asphyxia with persistent arterial hypoxemia and acidosis.'" The following clinical study was undertaken to correlate laboratory find¬ ings of studies of animals with changes observed in human near-drowning victims.Methods.-Twelve human near-drowning victims, six who had aspirated chlorinated fresh water, and six who had aspirated sea water, have been treated during the past three years at the University of Miami-Jackson Memorial Hospital. The sea-water victims were retrieved from the Atlantic Ocean beaches of southeastern Florida, and the fresh wa¬ ter victims were rescued from chlorinated fresh wa¬ ter pools. For all patients who had nearly drowned in fresh water, a sample of pool water was obtained and analyzed for electrolyte concentrations. Medi¬ cal therapy was supervised by the authors for 11 patients from the moment they first entered the hospital. Consultation was not obtained until 18 hours after admission for the 12th victim (case 4). Initial emphasis was on immediate therapy, and the data were obtained without compromising the clinical course of the patients. Aliquots of venous blood were drawn within min¬ utes of each patient's arrival to the emergency room and were placed in tubes containing sodium citrate for whole blood studies, or in dry tubes for serum studies. Whole blood was analyzed for hemo¬ globin concentration by the cyanmethemoglobin method, and for hematocrit value with a GuestWeichselbaum microcapillary centrifuge. The blood was then centrifuged, and the plasma was removed and analyzed for hemoglobin content by a modifica¬ tion of the Bing and Baker technique." Serum concentrations of sodium and potassium were deter¬ mined o...

show abstract

“…Mechanical ventilation (MV) with high peak inspiratory pressures (PIP), large tidal volumes (V T ), and high inspiratory oxygen concentrations (FIO 2 ) have been shown to be harmful to the diseased lung, contributing to further progression of the pulmonary injury [2][3][4][5][6]. Several treatment options have been proposed to improve the impaired gas exchange and to reduce injurious levels of PIP, V T , and FIO 2 .…”

Section: Introductionmentioning

confidence: 99%