Recent studies have indicated that divers with a patent foramen ovale (PFO) are at risk of developing some forms of decompression sickness. Thus, the objective of the present study was to investigate if the occurrence of paradoxical air embolism (PAE) was enhanced in pigs with a PFO compared to the ...

OBJECTIVE: To examine the existing literature concerning venous air embolism. Causes, pathophysiology, and management are emphasized. DATA SOURCES: The literature that was reviewed was retrieved from the MEDLINE System under the headings "venous air embolism," "air embolism," "therapy of air embolism," "etiology of venous air embolism," and "pathophysiology of venous ...

This study was designed to assess the accuracy of end-tidal PCO2 and transcutaneous PCO2 as measurements of arterial PCO2 in extubated, spontaneously breathing patients recovering from general anesthesia. In 30 patients, measurement of arterial transcutaneous, and end-tidal PCO2 were taken simultaneously with body temperature approximately every 15 minutes over a ...

Venous air embolism is a common potential complication of several surgical procedures and should be understood by anesthesiologists. The first part of this article, which appeared in a previous issue (Sept/Oct 1991;18(5):29-37), reviewed the pathophysiologic aspects. This concluding segment discusses the detection of venous air embolism and its prevention and ...

BACKGROUND: The relation between pulmonary disease and physiological abnormality in patients with hypoxic cor pulmonale is controversial and the association between arterial hypoxaemia and right ventricular hypertrophy has been challenged. To address these problems matched patients treated with and without domiciliary oxygen were studied. METHODS: Necropsy data were obtained on ...

This prospective study evaluated the incidence and severity of arterial oxygen desaturation during esophagogastroduodenoscopy (EGD) and assessed clinical factors in relation to arterial oxygen desaturation. Following pulmonary function testing, 192 patients underwent elective EGD with continuous recording of arterial oxygen saturation (SaO2). 62 patients (32.3%) showed arterial oxygen desaturation (SaO2 ...

Subcutaneous emphysema, pneumomediastinum, and tension pneumothorax are previously unreported complications of shoulder arthroscopy with subacromial decompression. Three patients developed extensive subcutaneous emphysema, pneumomediastinum, and bilateral tension pneumothorax during or immediately after shoulder arthroscopy with subacromial decompression. The procedure was terminated and appropriate treatment was given. All three patients recovered completely ...

Factors determining the outcome of an episode of Pneumocystis carinii pneumonia (PCP) in 149 AIDS patients treated at St Mary's Hospital were identified and their importance on improved survival evaluated between 1984 and 1989. The proportion of fatal episodes of PCP decreased over time. Fatal compared with nonfatal episodes had ...

OBJECTIVE: To determine the relationship of tonometrically measured gastric intramucosal pH to clinically accepted indices of systemic oxygenation. DESIGN: Prospective, nonintervention study. SETTING: Medical and surgical ICUs of a university hospital. PATIENTS: Critically ill patients (n = 22) with pulmonary artery catheters in place who also required nasogastric suctioning. MEASUREMENTS ...

Following a rapid decompression in an altitude chamber for routine training purposes, a 38-year-old altitude chamber technician developed rapid onset of mental dullness, right arm weakness, and sensory deficits. Immediate treatment with compression therapy in a hyperbaric chamber resulted in complete resolution. Ambient pressure changes great enough to result in ...

A case of Cushing's syndrome associated with chronic respiratory failure is presented. Although arterial blood gas analysis showed severe metabolic alkalosis, hypoxemia and mild hypercapnia, the patient had no evidence of pulmonary disease or neuromuscular disorder. Voluntary hyperventilation and inhalation of 100% oxygen (O2) revealed normalized arterial oxygen tension (PaO2). ...

Arterial computed PO2 (PO2 com) was computed from SaO2 ear and finger capillary pH using equations of Severinghaus and Ellis, and compared with measured arterial PaO2 in 100 patients with chronic obstructive pulmonary disease (76 men, aged 42 to 82 yr). SaO2 ear ranged from 73 to 98%. There was ...

Venous air embolism (VAE) results in both hypoxemia and hypercapnea with decreased end-tidal carbon dioxide (ETCO 2). Relative sensitivities for VAE detection were determined for (a) continuous oxygen saturation monitoring, as measured by pulse oximetry (SapO 2), an arterial fiberoptic catheter (SacO 2), and a pulmonary artery (PA) fiberoptic catheter ...

Carbon disulfide (CS2) is toxic to the heart and arteries; chronic exposure can result in accelerated atherosclerosis and coronary artery disease in humans and animals. Exposure to CS2 was investigated in normal volunteers working in New York City, using a new and highly sensitive assay. Volatile organic compounds in breath ...

Three cerebral biochemical markers, adenylate kinase (AK), neuron-specific enolase (NSE) and protein S-100, were determined in the cerebrospinal fluid (CSF) of male patients 24 h after coronary artery bypass grafting to investigate the extent of possible center nervous system (CNS) damage and relation to the type of oxygenator and the ...

STUDY OBJECTIVE: To establish the frequency of large visible bubbles or collections of bubbles in the jugular vein during radical neck dissection in the supine position. DESIGN: Prospective observation by at least two investigators of random consecutive patients scheduled for radical neck surgery. SETTING: Operating room suite in a university ...

Measurement of arterial oxygen saturation by pulse oximetry was performed in two patients with acute and chronic anaemia (haemoglobin concentrations: 2.9 mmol/l (4.7 g/dl) and 1.9 mmol/l (3.0 g/dl), respectively) using a Radiometer OXI and a Nellcor N-200 pulse oximeter. The two oximeters read alternating different values in the two ...

A persistent pulmonary air leak, whether as a result of pulmonary surgery or as a result of a traumatic or spontaneous pneumothorax, is a difficult and frustrating problem to manage. Several therapies have been employed, including thoracotomy and repair of the air leak, prolonged tube thoracostomy suction, and chemical pleurodesis. ...

Pulse oximetry is a noninvasive, accurate, and safe method for the measurement of oxygen saturation during intravenous sedation or general anesthesia. Several factors should be considered with its use, since these variables will either alter the accuracy of the readings or may cause harm to the patient. These factors include ...

Increased end-tidal (ET) nitrogen in a patient being ventilated with a nitrogen-free gas mixture through a leak-free circuit has been considered a specific sign of venous air embolism. We hypothesized that increased ETN2 would occur after arterial air emboli, just as following venous air emboli, and that clinically relevant arterial ...

Long-term oxygen is the only therapy that has been shown to improve survival in patients with chronic obstructive pulmonary disease. The aim of this study was to assess the predictors of survival in such patients treated with long-term oxygen therapy. We studied 179 patients who were assessed for long-term oxygen ...

Sixty-three patients undergoing isotope ventilation/perfusion scintigraphy for suspected pulmonary embolism were monitored using pulse oximetry. Xenon inhalation had no adverse effect on arterial oxygen saturation. Fifty-seven per cent of patients demonstrated a drop in oxygen saturation of 2-10% within 5 min of injection of macroaggregates. Small changes in arterial oxygen ...

Transesophageal echocardiography was performed on a patient with critical aortic stenosis and severe three-vessel coronary artery disease. Immediately after the procedure the patient experienced marked cyanosis (oxygen saturation of 53%) secondary to methemoglobinemia (methemoglobin saturation of 45%). Toxic methemoglobinemia was thought to be caused by topical anesthetic. He responded dramatically ...

This study was designed to determine the significance of changes in mixed venous oxygen saturation (SVO2) associated with aortic surgery. In 12 patients undergoing aortic aneurysm repair, SVO2 was monitored using a fiberoptic pulmonary arterial catheter, and oxygen uptake (VO2) was measured at 2-min intervals by a mass-spectrometer system. Excluding ...

Assessment of blood gas status is important in the management of patients with chronic pulmonary disease. Arterial puncture is often painful and may damage the arterial wall. Measurement of oxygen saturation by transcutaneous oximetry offers a non-invasive alternative to arterial methods but does not allow assessment of partial pressure of ...

A 63-yr-old man was noted to breathe with a periodic pattern of ventilation during sleep, both before and after operation for coronary artery grafting, and 6 weeks later after aortic aneurysm repair. Periodic ventilation was associated with cyclic oxygen desaturations and increases in heart rate and arterial pressure. Administration of ...

A new monitoring technique, based on optical fluorescence chemistry, allows continuous monitoring of all blood gas variables during cardiopulmonary bypass. To evaluate the clinical performance of this monitor, we drew 220 arterial and 216 venous blood samples from 15 patients, and simultaneous blood gas values displayed by the monitor were ...

Laparoscopic cholecystectomy uses carbon dioxide, a highly diffusable gas, for insufflation. With extended periods of insufflation, patient arterial carbon dioxide levels may be adversely altered. Patients were selected for laparoscopic cholecystectomy using the same criteria as for open cholecystectomy. Twenty patients (group 1) had normal preoperative cardiopulmonary status (American Society ...

Investigation into the complex etiology of the postperfusion syndrome (PPS) has been limited by access to only retrospective human case studies, and performance of animal studies that examine biochemical predictors of injury rather than the PPS itself. To determine whether a reproducible canine model of the clinical syndrome was possible, ...

The end-tidal carbon dioxide concentration (ETCO2) of 47 patients undergoing prosthetic knee operations was monitored to detect pulmonary embolism during the anthroplasties. The ETCO2 of one patient dropped suddenly following the release of the tourniquet and insertion of the bone cement. Intracardiac aspiration did not reveal any air. At autopsy ...

STUDY OBJECTIVE: The aim was to determine whether there is a compensatory increase in arterial oxygen content to a hypokinetic circulation in ambulant patients with chronic moderate heart failure caused by dilated cardiomyopathy. DESIGN - Central haemodynamics, arterial oxygen content, arterial haemoglobin concentration, arterial oxygen saturation, and blood gases were ...

Venous air embolism is a well-recognized complication of central venous catheterization. Although previous reports have documented venous air embolism occurring in a number of ways, including during initial catheterization, when catheters crack or are disconnected, and after catheter removal, no reports mention the possibility of air embolism occurring when a ...

Chlorine inhalation may rapidly cause pulmonary edema, leading to acute hypoxemic respiratory failure. We report a 12 year old with acute respiratory failure from inhalation injury after he accidentally dropped chlorine tablets into a swimming pool. Supplemental oxygen alone failed to provide adequate arterial oxygenation. We administered positive end expiratory ...

Pulmonary hypertension resulting from venous air embolism is known to increase after ventilation with highly soluble and diffusible gases. Exacerbation of the hypertension could be due to further blockage of the circulation if the bubbles enlarge as a result of ingress of gas by diffusion. This mechanism has been frequently ...

A 58-year-old man experienced paradoxic air embolism with passage of air from the systemic venous to the systemic arterial circulation with subsequent stroke and death. No intracardiac shunt was present. Pulmonary fibrosis concomitant with severe pulmonary arterial hypertension appears to have been responsible for the air traversing the pulmonary capillary ...

A pulse oximeter was used to monitor arterial oxygen saturations in 11 patients during apparent tonic-clonic seizures. 8 had a clinical diagnosis of genuine fits, 6 of whom showed striking falls in oxygen saturation during the seizures. 3 had a clinical diagnosis of pseudoseizures, none of whom had hypoxia during ...

A preterm infant with severe hyaline membrane disease requiring extreme mechanical ventilation developed pulmonary air leaks with consecutive shock. The chest roentgenogram showed bilateral pulmonary interstitial emphysema and gas within the heart silhouette as well as in the hepatic veins, inferior v. cava, portal vein, and many abdominal vessels. The ...

To ascertain the long-term effects of ofloxacin (OFX) on clinical parameters in cases of diffuse panbronchiolitis (DPB), we treated 18 patients with this disease with OFX and compared the clinical findings before and after treatment. Pulmonary function tests including percent vital capacity, arterial oxygen tension and arterial-alveolar oxygen tension difference ...

According to conventional wisdom the difference between alveolar and arterial O2 tensions, the AaPO2, should distinguish between hypoxemia caused by alveolar hypoventilation and hypoxemia caused by alveolar hypoventilation complicated by other abnormalities of gas exchange. To test this concept we have calculated the AaPO2 from arterial blood gas measurements, breathing ...

A 34-year-old man developed a nonfatal venous air embolism during arthrography of his post-traumatically contractured knee joint. From the arthrographic findings, injected air was assumed to have entered the great saphenous vein via the venous opening in the knee joint. Venous air embolism is an extremely rare complication of knee ...

Two different methods of CO2-derived non-invasive assessment of the pulmonary blood flow were evaluated. The principle of the formula, as proposed by Gedeon et al., is based on a rapid change in arterial CO2 content and subsequent changes in endtidal PCO2 and CO2 elimination. Both methods were compared to thermodilution ...

1. Rapidly growing broiler chickens fed ad lib. until 56 days, but feed restricted until 60 days of age, had higher arterial oxygen saturations, lower respiratory frequencies, total ventilations that were not different, and higher tidal volumes compared to those fully fed for 56 days. 2. Arterial oxygen saturation correlated ...

A prospective study was designed to measure the P50 in 20 critically ill patients, and compare it with the P50 measured in 20 normal individuals. Arterial blood gases, lactate, haemoglobin (Hb) and phosphate (PO4) levels were also measured and compared with the P50 in the critically ill patients. The mean ...

Significant morbidity results from extremity ischemia after acute arterial occlusion. Reestablishment of arterial flow is considered to be the ideal treatment, yet substantial tissue loss can occur before this is accomplished. Using a rat hindlimb model we investigated whether the administration of 100% oxygen would decrease tissue hypoxia from acute ...

Chronic hemodynamic disturbances are more profound in patients with obstructive sleep apnea when underlying lung disease with abnormal gas exchange (low arterial PO2) is present. Previous studies suggest that pulmonary gas exchange could influence the rate of fall of arterial oxygen saturation (dSaO2/dt) in obstructive sleep apnea. We postulated that ...

This prospective study was designed to test the hypothesis that intraoperative hypothermia occurring during abdominal aortic surgery and vasodilator therapy used to avoid severe consequences of aortic clamping could both disturb the mixed venous oxygen saturation signal (SVO2). Twenty high risk surgical patients, ASA physical status II or III, were ...

This prospective study evaluated the incidence and severity of arterial oxygen desaturation during gastrointestinal endoscopy. Following pulmonary function testing, 115 male patients underwent esophagogastroduodenoscopy (EGD), colonoscopy, or colonoscopy followed by EGD, with continuous recording of arterial oxygen saturation (SaO2). Most patients (80/115, 70%) showed arterial oxygen desaturation (greater than 4% ...

The purpose of this study was to investigate the effects of position changes on mixed venous oxygen saturation (SvO2) and to describe the mechanisms responsible for SvO2 changes reported to occur with position changes. The study was done from 4 to 8 hours after surgery in 34 patients after coronary ...

Systemic arterial air embolism is frequently unrecognized as a cause of death among patients with isolated penetrating lung injury. Between 1975 and 1983 at Parkland Memorial Hospital, the complication of systemic arterial air embolism developed in 9 patients with penetrating lung injury (six gunshots and three stabbings). Eight patients were ...

A 60-year-old man with advanced seminoma was treated with four cycles of a cisplatin, etoposide and bleomycin. He then developed severe pulmonary toxicity with diffuse infiltrates as evidenced on a chest x-ray film. The room air PaO2 value was 32 mm Hg. The patient was treated with steroids and oxygen ...