Computed tomography of the chest: an update.
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Biomedical subjects
Publications and source records attributed to T S Sekar.
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Support with extracorporeal membrane oxygenation (ECMO) can sustain life for a substantial period of time, but the role of long-term ECMO support is limited. The National Institutes of Health ECMO collaborative study revealed no significant reduction in mortality in adults with severe respiratory distress syndrome treated with ECMO. The value of ECMO in the treatment of transient, severe acute respiratory insufficiency has been demonstrated in patients after cardiac operations, in patients with Pneumocystis carinii pneumonia, and in patients following trauma. We present an example of refractory respiratory failure in a young asthmatic with massive atelectasis in whom the institution of ECMO allowed us to perform adequate pulmonary lavage. It resulted in improvement in gas exchange and the patient's survival.
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We describe two patients who suffered prolonged (greater than four minutes) submersion in cold water (25 minutes, 32 s, and six minutes, respectively), with complete neurologic recovery. We postulate that hypothermia served to protect the brain from hypoxic injury. These cases also serve to emphasize the need for vigorous one-the-scene resuscitative efforts. We review the problems associated with the treatment of hypothermia and drowning.
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In 13 guinea pigs the pulmonary circulation was isolated from the systemic circulation and perfused with Tris buffer alone or with isoproterenol. The lungs were initially ventilated with 100% O2 and then switched to 100% N2 to induce alveolar hypoxia. The effluent was collected from the aorta and assayed for histamine. In the control group (n = 7) the histamine levels rose markedly with hypoxia. In the group perfused with Tris buffer and isoproterenol (n = 6) the rise in histamine levels was markedly diminished. Therefore, the authors conclude that isoproterenol, in their in vivo model, had a dramatic effect on hypoxia (non-immunologic) mediated histamine release.
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