To determine the clinical relevance of the sympathetic response to out-of-hospital cardiac arrest, we measured plasma concentrations of catecholamine and cortisol in ten such arrested patients on their arrival. The duration of cardiac arrest was estimated from 9 to 200 min before basic life support was initiated by ambulance personnel. Two of the patients developed spontaneous pulses in response to ALS and were resuscitated, and the others were not, although the length and the extent of ALS were not different between the two groups. Plasma concentrations of epinephrine (EN), norepinephrine (NE) and cortisol prior to ALS in both groups were markedly elevated. In particular, the patients who never regained spontaneous pulses showed 58-fold and 12-fold increase in the plasma EN and NE levels, respectively, which were much higher than those in the resuscitated cases; 8- and 1.7-fold increase, respectively. These massive EN and NE discharges correlated well with the arrest time (r = 0.96 and 0.94, respectively) and the degree of acidosis (r = -0.82 and -0.82, respectively).

Adult↗

PubMedDate not supplied

Unilateral pulmonary edema following acute subglottic edema.

Presented here is a case of unilateral pulmonary edema following acute subglottic edema after removal of an endotracheal tube. A 3-year-old boy, diagnosed as having nondiphtheric croup and pectus excavatum deformity, was scheduled for repair of a cleft lip. No complication occurred during the operation. After removal of the endotracheal tube, he showed dyspnea and cyanosis and was later found to have acute subglottic edema. After reintubation of the trachea, frothy pink fluid was discharged from the tube, and chest roentgenogram showed a right-sided alveolar infiltrate. Many factors may cause unilateral pulmonary edema, but it is suggested that acute subglottic edema and unilateral bronchial fragility strongly affected this episode.

Acute Disease↗

PubMedDate not supplied

Effects of hypercapnia on cochlear and cerebral blood flow in rabbits.

Cochlear blood flow (CoBF) and cerebral blood flow (CBF) were measured using laser Doppler flowmetry and the microsphere method during CO2 and O2 gas mixture inhalation in rabbits. Both methods revealed that CBF was increased by CO2 inhalation. CoBF measured by laser Doppler measurement decreased during CO2 inhalation while that measured by the microsphere method showed a slight increase, but lateral wall blood flow in the cochlea measured by the microsphere method showed no significant change. Our results obtained with laser Doppler flowmetry were not inconsistent with those reported in humans. It is considered that the rabbit, in which thick bone surrounds the cochlea, is a good model for the experimental evaluation of the laser Doppler technique used in the clinical measurement of CoBF.

Administration, Inhalation↗