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Biomedical subjects

J E Dalen

Publications and source records attributed to J E Dalen.

At least 19 recordsLinked to original sources
PubMed1979

Fatal pulmonary hemorrhage after use of the flow-directed balloon-tipped catheter.

The flow-directed balloon-tipped catheter is extensively used in intensive care units, catheterization laboratories, operating rooms, and emergency wards. Major complications associated with its use have not been frequently reported. In a recent 2-year period in four hospitals, we identified five cases of fatal pulmonary hemorrhage resulting from balloon-tipped catheters. We review here four additional cases previously cited in the literature and discuss possible mechanisms and predisposing factors associated with this complication and guidelines for safe use of these catheters. Pulmonary artery rupture is probably commoner than previously reported.

Adult↗
PubMed1978

Basic life support.

Explore the source record for details and available documents.

Education, Medical↗
PubMed1978

Pulmonary hypertension secondary to minor pulmonary embolism.

The response of pulmonary arterial pressure to minor degrees of pulmonary embolism was examined in 18 patients with embolic occlusion of less than 25% of the pulmonary vascular bed. Patients with pulmonary embolism were compared to normal controls matched for age and sex and to patients with a variety of acute pulmonary disorders without pulmonary embolism. Patients with pulmonary embolism and patients with other acute pulmonary diseases had significantly higher pulmonary arterial pressures and significantly lower values for arterial oxygen tension (PaO2) than did normal subjects. The degree of pulmonary hypertension correlated with the PaO2. Pulmonary hypertension occurring after minor degrees of pulmonary embolism may be a response to mild arterial hypoxemia.

Adult↗
PubMed1977

Syncope in patients with pulmonary embolism.

A review of 132 consecutive cases of acute pulmonary embolism (PE) documented by pulmonary angiography indicated that syncope was the initial or predominant clinical feature in 17 (13%). When massive PE causes syncope in a nonhospitalized patient, the diagnosis of PE is frequently overlooked. Hypotension after PE may resolve spontaneously after a short interval. In this circumstance, the syncopal episode might easily be attributed to another cause. The appropriate diagnosis can be established only if other clues, suggestive of PE, are sought. Both arterial blood gas determinations and pulmonary scintigraphy are helpful in making this diagnosis.

Adult↗
PubMed1977

Pulmonary embolism, pulmonary hemorrhage and pulmonary infarction.

We compared 41 patients with angiographic proof of pulmonary embolism and clinical signs of pulmonary infarction (as evidenced by an infiltrate on x-ray study and pleuritic pain in the area of the embolus) with 24 patients with pulmonary embolism but without infarction. Only 18 of the 41 patients with pulmonary infarction had associated heart disease. Pulmonary infarction was uncommon when emboli obstructed central arteries but frequent when distal arteries were occluded. Follow-up x-ray examination showed that the infiltrates resolved in the patients with pulmonary infarction without heart disease, but persisted when heart disease was present. We suggest that obstruction of distal arteries results in pulmonary hemorrhage owing to an influx of bronchial arterial blood at systemic pressure. Hemorrhage causes symptoms and x-ray changes usually attributed to pulmonary infarction. However, hemorrhage resolves without infarction in patients without, but progresses to infarction in those with, heart disease.

Angiography↗
PubMed1977

Anomalous pulmonary venous return with intact atrial septum: diagnosis and pathophysiology.

Twenty-one patients with partial anomalous pulmonary venous drainage with intact atrial septum have been studied. These include 13 patients not previously reported from our laboratories and eight patients with complete hemodynamics reported by others. Methods for identification of this abnormality and for identification of an intact atrial septum are described, including differential indicator dilution curves, catheter probing of the atrial septum and pulmonary angiography. Blood flow through anomalously draining lobes of the lung is usually higher than through normally drainage lobes attributable to the higher pressure differences across the anomalous lung, right atrial pressure being uniformly lower than left atrial pressure. The pulmonary vascular resistance when "standardized" to the flow of blood normally present in different portions of the lung indicated that no significant differences existed between normally and anomalously draining lobes. Six patients had coexisting rheumatic mitral stenosis and one had congenital mitral stenosis. Its influence on the hemodynamic changes produced by PAPVD is discussed.

Adolescent↗
PubMed1977

Mitral regurgitation due to intermittent prosthetic valvular dysfunction.

A second case of malfunction of a Harken disk valve due to undue disk wear is reported. Two and one-half years after aortic and mitral valvular replacement, the patient had paraprosthetic aortic insufficiency and physical findings suggesting intermittent dysfunction of his prosthetic mitral valve. Catheterization showed intermittent hemodynamic abnormalities; fluoroscopic and cineangiographic findings indicated intermittent mitral regurgitation secondary to undue mitral disk wear. At operation, the excised valve showed normal struts and sewing ring but severe disk wear. There was loss of disk substance and rim notching.

Cardiac Catheterization↗
PubMed1977

Hyperpyrexia complicating low fixed cardiac output.

A 41-year-old woman with end-stage mitral and aortic stenosis developed the cycle of low cardiac output, peripheral vasoconstriction, increased core temperature, and cardiac decompensation. This was interrupted by core cooling utilizing iced gastric lavage. We propose that her severe hyperthermia was caused or abetted by her low cardiac output.

Adult↗