Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Edema”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed2003

Can bone marrow edema be seen on STIR images of the ankle and foot after 1 week of running?

PURPOSE: To evaluate whether initiation of running in sedentary individuals would lead to bone marrow edema on MR images, within the time span of 1 week. MATERIALS AND METHODS: The feet of 10 healthy volunteers were imaged by MR imaging before and after running during 30 min a day for 1 week. The images were evaluated by consensus of 2 musculoskeletal radiologists who graded the presence of bone marrow edema on a 4-point scale. Edema scores and number of bones involved before and after running were compared statistically. RESULTS: Edema was present on the baseline images in 3 subjects. After running edema showed an increase or was present in 5 subjects. The changes after running were statistically significant. Bones involved were the talus, calcaneus, navicular bone, cuboid bone, and 5th metatarsal. CONCLUSION: Edema patterns can be seen in the feet of asymptomatic individuals. During initiation of running an increase of edema or development of new edema areas can be seen.

Adult↗
PubMed1996

Post-pneumonectomy pulmonary edema: analysis and risk factors.

OBJECTIVE: To analyze the risk factors for postpneumonectomy pulmonary edema in 146 consecutive patients. METHODS: In 1992, 146 consecutive patients, aged 60.5 +/- 9.4 years, underwent pneumonectomy, mostly for cancer (n = 136). Pulmonary edema was defined clinically and radiologically in the absence of left ventricular dysfunction or infection. Several parameters, including preoperative functional respiratory values, pulmonary perfusion scan data and intraoperative data were analyzed. Two groups were determined according to the occurrence of pulmonary edema and differences were compared by univariate and multivariate analyses. RESULTS: Twenty-two patients (15%) developed pulmonary edema within the 1st postoperative week. Most cases were mild or moderate. Severe pulmonary edema occurred in five (3.4%) patients requiring mechanical ventilation; among them, two died. Previous chemotherapy (P < 0.01), radiotherapy (P < 0.0001), predictive postoperative forced expiratory volume in the 1st second less than 45% (P < 0.01), a remaining lung perfusion of 55% or less (P < 0,05) and an intraoperative fluid load of 2000 ml fluid or more (P < 0.01) were associated with pulmonary edema in the univariate analysis. Multivariate analysis identified prior radiotherapy, perfusion of the remaining lung of 55% or less and high intraoperative fluid load as independent and significant risk factors for pulmonary edema. CONCLUSIONS: This study demonstrates that previous treatment with radiotherapy resection of well perfused lung parenchyma and excessive fluid load are high risk factors for the development of non-cardiogenic pulmonary edema and that patients for whom these factors are relevant should be closely monitored in their postoperative course.

Analysis of Variance↗
PubMed1999

Diabetic macular edema: risk factors and concomitants.

PURPOSE: To investigate the systemic and ocular factors associated with diffuse macular edema in patients with diabetic retinopathy (DR) and compare with patients with focal or no macular edema. METHODS: From 160 consecutive patients with DR, we obtained medical and ocular histories, blood pressure and visual acuity. Macular edema was determined by biomicroscopy and stereoscopic fundus photography. Fluorescein angiography was used in the characterization of its leakage, and the vitreoretinal relationship was performed by preset lens biomicroscopy. RESULTS: Among adult-onset diabetes mellitus (DM) patients, 55% had diffuse, 23.5% had focal and 21.5% had no macular edema (p=0.01). The risk of developing diffuse macular edema was 3.2 times greater in patients with high blood pressure (HBP) (95% confidence interval (CI), 1.5 to 6.9). Patients with cardiovascular disease (CVD) had a higher prevalence of diffuse (58.0%) than focal (26.0%) or no maculopathy (16.0%) (p=0.01). The odds for development of diffuse macular edema was 3.4 times greater in patients with vitreomacular adhesion (95% CI, 1.15 to 13.30) than in those with complete posterior vitreoretinal attachment or vitreoretinal separation. The odds for development of diffuse macular edema were 6.2 (95% CI, 1.83 to 21.04) and 7.7 times greater (95% CI, 3.12 to 19.12) in patients with PPDR and PDR, respectively, in comparison with those with NPDR. CONCLUSIONS: In this study, adult-onset DM, HBP, CVD, vitreomacular adhesion and advanced retinopathy were associated with increased risk of development of diffuse diabetic macular edema.

Blood Pressure↗
PubMed2002

Demonstration of scolex within calcified cysticercus cyst: its possible role in the pathogenesis of perilesional edema.

PURPOSE: This study was performed to understand the relation between the scolex as demonstrated on gradient echo (GRE) imaging in a calcified cysticercus cyst and the development of perilesional edema that may be of value in understanding the pathogenesis of this entity. METHODS: Twenty-one patients with solitary calcified lesion on computed tomography (CT), with seizures of recent onset (within 15 days), were selected for this study. All the patients were subjected to magnetic resonance imaging (MRI) including GRE imaging. The patients were grouped on the basis of presence or absence of perilesional edema around the calcified lesion on MRI. RESULTS: There were 14 patients with perilesional edema, and seven patients had no evidence of edema. Of these 14 patients with perilesional edema, rim enhancement was detected in 13 patients on postcontrast MRI, whereas no enhancement was observed in one patient. The scolex was seen in all these 14 patients on GRE images. Of the seven patients without evidence of edema, the scolex was not seen in any of these patients on GRE imaging. In addition, there was no evidence of any contrast enhancement on postcontrast study in any of the patients in this group. CONCLUSIONS: We conclude that the calcified cysts with scolex seen on GRE imaging are associated with perilesional edema. This is probably due to preservation of antigenic material in these calcified cysts, the release of which provokes an inflammatory response that may be responsible for the perilesional edema.

Adolescent↗
PubMed2005

[Vitrectomy for diabetic cystoid macular edema -- results of 72 cases].

BACKGROUND: We evaluated visual outcomes after vitrectomy for diabetic cystoid macular edema and factors possibly influencing final visual acuity. MATERIALS AND METHODS: Studied prospectively, pars plana vitrectomy was performed on 72 consecutive eyes of 61 patients with diabetic cystoid macular edema not responsive to laser photocoagulation therapy. Vitreomacular traction was observed on biomicroscopy, B-scan ultrasonography, and optical coherence tomography in 21 eyes, 15 eyes had a complete posterior vitreous detachment (PVD) and 36 eyes had partial peripheral PVD. Vitrectomy with releasing vitreomacular tangential and axial tractional forces was performed. All patients were followed up for at least 6 months. RESULTS: The anatomical results were satisfactory in 69 of 72 eyes (96 %), the final visual acuity improved by 2 or more lines in 45 of 72 eyes (63 %), remained unchanged in 22 of 72 eyes (31 %), and deteriorated after surgery in 5 of 72 eyes (7 %), due to residual cystoid macular edema and massive macular hard exudates. The best results were obtained in edema with tractional predominance and in eyes with a duration of cystoid macular edema shorter than 6 months. CONCLUSIONS: Vitrectomy for diabetic cystoid macular edema is an effective procedure for reducing the edema and improving visual acuity. Surgery was beneficial not only in eyes with vitreomacular traction but also in eyes with complete PVD. Visual improvement after vitrectomy is related to duration of edema, therefore the timing of the surgery is an important prognostic factor.

Diabetic Retinopathy↗
PubMed2004

The role of ischemic mitral regurgitation in the pathogenesis of acute pulmonary edema.

BACKGROUND: Acute mitral regurgitation may cause pulmonary edema, but the pathogenetic role of chronic ischemic mitral regurgitation, a dynamic condition, has not yet been characterized. METHODS: We prospectively studied 28 patients (mean [+/-SD] age, 65+/-11 years) with acute pulmonary edema and left ventricular systolic dysfunction and 46 patients without a history of acute pulmonary edema. The two groups were matched for all baseline characteristics. Patients underwent quantitative Doppler echocardiography during exercise. Exercise-induced changes in the left ventricular volume, the ejection fraction, the mitral regurgitant volume, the effective regurgitant orifice area, and the transtricuspid pressure gradient were compared in patients with and without acute pulmonary edema. RESULTS: The two groups had similar clinical and baseline echocardiographic characteristics. They also had similar exercise-induced changes in heart rate, systolic blood pressure, and left ventricular volumes. In the univariate analysis, patients with recent pulmonary edema had a much higher increase than did the patients without pulmonary edema in mitral regurgitant volume (26+/-14 ml vs. 5+/-14 ml, P<0.001), the effective regurgitant orifice area (16+/-10 mm2 vs. 2+/-9 mm2, P<0.001), and the transtricuspid pressure gradient (29+/-10 mm Hg vs. 13+/-11 mm Hg, P<0.001). In the multivariate analysis, exercise-induced changes in the effective regurgitant orifice area (P<0.001), in the transtricuspid pressure gradient (P=0.001), and in the left ventricular ejection fraction (P=0.02) were independently associated with a history of recent pulmonary edema. CONCLUSIONS: In patients with left ventricular systolic dysfunction, acute pulmonary edema is associated with the dynamic changes in ischemic mitral regurgitation and the resulting increase in pulmonary vascular pressure.

Acute Disease↗
PubMed2003

Relative odds of temporomandibular joint pain as a function of magnetic resonance imaging findings of internal derangement, osteoarthrosis, effusion, and bone marrow edema.

OBJECTIVE: The purpose of this study was to evaluate whether common magnetic resonance (MR) imaging variables such as temporomandibular joint (TMJ) internal derangement, osteoarthrosis, effusion, and bone marrow edema are predictive of the presence of TMJ pain. STUDY DESIGN: The relationship between TMJ pain and TMJ internal derangement, osteoarthrosis, effusion, and bone marrow edema was analyzed in MR images of 338 TMJs in 169 patients with a clinical diagnosis of TMJ pain and dysfunction. Criteria for including a patient with TMJ pain were a report of orofacial pain referred to the TMJ, with the presence of unilateral or bilateral TMJ pain during palpation, function, or unassisted or assisted mandibular opening. The criteria for including a patient with no pain were the absence of TMJ pain during palpation, function, and unassisted or assisted mandibular opening. Application of the criteria resulted in a study group of 129 patients with unilateral TMJ pain, 18 with bilateral TMJ pain, and 22 without TMJ pain. Bilateral sagittal and coronal MR images were obtained to establish the presence or absence of TMJ internal derangement, osteoarthrosis, effusion, and bone marrow edema. Logistic regression analysis was used to compute the odds ratios for internal derangement, osteoarthrosis, effusion, and bone marrow edema for nonpainful TMJs (n = 173) versus painful TMJs (n = 165). RESULTS: For pairwise comparison, the chi(2) test was used; the resultant data showed a significant relationship between the clinical findings of TMJ pain and the MR imaging diagnoses of internal derangement (P =.000), osteoarthrosis (P =.015), effusion (P =.002), and bone marrow edema (P =.016). Of the MR imaging variables considered simultaneously in multiple logistic regression analysis, osteoarthrosis (P =.405), effusion (P =.131), and bone marrow edema (P =.231) dropped out as nonsignificant in the diagnostic TMJ pain group in comparison with the TMJ no-pain group. Significant increases in risk of TMJ pain occurred with disk displacement without reduction in combination with osteoarthrosis and bone marrow edema (3.7:1 odds ratio; P =.000) and with disk displacement without reduction in combination with osteoarthrosis and effusion (2.8:1 odds ratio; P =.000). CONCLUSIONS: The results suggest that TMJ pain is related to internal derangement, osteoarthrosis, effusion, and bone marrow edema. However, the data reemphasize that these MR imaging variables may not be regarded as the unique and dominant factors in defining TMJ pain occurrence.

Adolescent↗
PubMed2002

Factors associated with adverse outcomes in children with diabetic ketoacidosis-related cerebral edema.

OBJECTIVE: To investigate the relation between outcomes of children with diabetic ketoacidosis (DKA)-related cerebral edema and baseline clinical features and therapeutic interventions for treatment of cerebral edema. STUDY DESIGN: All children </=18 years old with DKA and cerebral edema (n = 61) were retrospectively identified from 10 pediatric centers between 1982 and 1997. Demographic, biochemical, and therapeutic data were collected. Ordinal logistic regression analysis was used to identify factors associated with the clinical outcome (death or persistent vegetative state; mild to moderate neurological disability; or normal) after adjusting for known risk factors for the development of cerebral edema as well as the degree of neurologic depression at the time of diagnosis of cerebral edema. RESULTS: Seventeen (28%) children died or survived in a vegetative state; 8 (13%) survived with mild to moderate neurologic disabilities; and 36 (59%) survived without sequelae. Factors associated with poor outcomes included greater neurologic depression at the time of diagnosis of cerebral edema, a high initial serum urea nitrogen concentration, and intubation with hyperventilation to a PCO (2) <22 mm Hg. CONCLUSIONS: After adjusting for potential confounding variables and the degree of neurologic compromise at the initiation of therapy, intubation with hyperventilation is associated with adverse outcomes of DKA-related cerebral edema. Greater neurologic depression at the time of diagnosis of cerebral edema and a higher initial serum urea nitrogen concentration are also associated with poor outcome.

Adolescent↗
PubMed1998

Pial arteriovenous malformation with massive perinidal edema.

It is generally considered that perinidal edema in an arteriovenous malformation (AVM) is caused by a concomitant intracerebral hematoma. We report a rare case of AVM with perinidal massive edema which was possibly not due to hemorrhage, and discuss the pathophysiological mechanisms of such edema development. A 60-year-old woman presented with a sudden onset severe headache. Computed tomography (CT) scans obtained two hours after the onset showed an AVM-like lesion with a small hematoma in the right parieto-occipital lobe, and unexpectedly early development of massive edema adjacent to the hematoma. Angiograms demonstrated a medium-sized AVM, and severe stenosis in the draining vein which suggested the presence of venous hypertension at prestenotic sites. Repeated CT scans and magnetic resonance (MR) images in the chronic period after the hemorrhage demonstrated persistence of the perinidal edema with mass effect. Removal of the lesion was achieved 2 months after the onset. MR images 3 months after the operation showed marked reduction of perinidal edema. The time course of the perinidal edema suggests that its development was unrelated to the hemorrhage. The findings indicate that increased venous pressure secondary to severe stenosis of the draining vein may possibly contribute to the development of perinidal edema.

Arteriovenous Malformations↗
PubMed2006

Factors associated with pulmonary edema in severe scorpion sting patients--a multivariate analysis of 428 cases.

OBJECTIVE: To determine clinical and routine laboratory factors associated with pulmonary edema secondary to scorpion envenomation. DESIGN AND SETTING: Retrospective study covering 13 years (1990-2002) in the medical Intensive Care Unit of a university hospital (Sfax-Tunisia). PATIENTS: 428 patients older than 3 years who were admitted to the intensive care unit for scorpion envenomation were included in this study. Patients were stratified into two groups according to the presence or absence of pulmonary edema as assessed by a medical committee. MEASUREMENTS AND RESULTS: The mean (+/- SD) age was 17.5 +/- 17.7 years, ranging from 3 to 76 years. The pulmonary edema group included 294 patients (68.7%). A multivariate analysis found the following factors to be correlated with a pulmonary edema: age less than 5 years (p = 0.04), sweating (p = 0.004), agitation (p = 0.01), leukocytes of 25000 cells/mm3 or more (p = 0.02), and a plasma protein concentration of 72 g/L or more (p < 0.0001). In addition, a plasma protein concentration of 72 g/L or more predicted the presence of pulmonary edema with a sensitivity of 78% a specificity of 88%, a positive predictive value of 93%, and negative predictive value of 64%. Almost 84% of patients having a respiratory rate of > or = 30 breaths/minute associated with agitation and sweating were classified in the pulmonary edema group. This clinical association indicates the presence of pulmonary edema with a specificity of 84.3% and a positive predictive value of 87.5%. CONCLUSION: In scorpion envenomation patients older than 3 years, the association of a respiratory rate of > or = 30 breaths/minute, agitation, sweating, or the presence of high plasma protein concentrations suggest the presence of pulmonary edema.

Adolescent↗
PubMed1996

Effect of difluoromethylornithine treatment on regional ornithine decarboxylase activity and edema formation after experimental brain injury.

This study examined the effect of difluoromethylornithine (DFMO) on regional activities of ornithine decarboxylase (ODC) and edema formation in bilateral cerebral cortex and hippocampus after a unilateral controlled cortical-impact (CCI) injury in rats. To measure the activity of ODC, the brains of injured and control rats were frozen in situ at 30 min, 3, 6, and 24 h after CCI brain injury of moderate severity. The specific gravity, an indicator of edema formation, was examined in decapitated animals at corresponding time points. Brain injury induced significant increases of ODC in the ipsilateral hippocampus, adjacent and injury-site cortices, and in the contralateral cortex and hippocampus at 3 and 6 h after injury. No significant edema formation was found in any brain region at 30 min after injury. A significant edema formation was first found only in the injury-site cortex at 3 h after injury. At 6 and 24 h after injury, significant edema was found in all regions ipsilateral to the injury-site. At 24 h after injury, significant but less severe edema was also found in the contralateral cortex and hippocampus. DFMO, an irreversible inhibitor of ODC, abolished the increase in ODC in all regions. It also attenuated edema formation in the adjacent cortex and in the contralateral cortex and hippocampus. These findings indicate that polyamines may play a role in posttraumatic brain edema formation, particularly in important brain regions remote from the injury-site.

Animals↗
PubMed1990

Reduction of chronic posttraumatic hand edema: a comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments.

The purpose of this study was to compare the efficacy of intermittent pneumatic compression (IPC) and high voltage pulsed current (HVPC) in reducing chronic posttraumatic hand edema. Thirty patients with posttraumatic hand edema were randomly assigned to IPC, HVPC, or placebo-HVPC groups (10 patients in each group). Patients received a single application of the respective treatment for 30 minutes. Measurements were made before and after a 10-minute rest period and after the 30-minute treatment. A volumetric method was used to quantify edema reduction. Reduction in hand edema was significant between the IPC and placebo-HVPC groups (p = .01). Differences in edema reduction between the HVPC and placebo-HVPC groups did not reach statistical significance (p = .04), but were considered clinically significant. There was no significant difference between the IPC and HVPC groups. A single 30-minute administration of IPC produced a significant reduction in hand edema. Additional clinical studies are needed to delineate maximally effective treatment protocols for reduction of chronic posttraumatic hand edema. [Griffin JW, Newsome LS, Stralka SW, et al: Reduction of chronic posttraumatic hand edema: A comparison of high voltage pulsed current, intermittent pneumatic compression, and placebo treatments.

Adult↗
PubMed1997

Augmenting cardiac contractility hastens myocardial edema resolution after cardiopulmonary bypass and cardioplegic arrest.

UNLABELLED: Although myocardial edema is associated with cardiopulmonary bypass (CPB) and cardioplegic arrest (CPA), interventions to expedite edema removal have not been investigated. The primary mechanism for the removal of excess interstitial fluid in the heart is myocardial lymphatic drainage, but lymphatic function can be impaired by decreased contractility because of edema. The purpose of this study was to determine whether enhancing cardiac contractility would increase myocardial lymphatic function and hasten edema resolution after CPB. Sixteen dogs were subjected to CPB and 1 h of hypothermic CPA. After weaning from CPB, 10 dogs received an intravenous dobutamine infusion and 6 dogs received no inotropic support. We determined myocardial lymph driving pressure from the major cardiac lymphatic, myocardial water content by using microgravimetry, and the peak rate of left ventricular pressure increase (dP/dmax) by using micromanometry. Measurements were taken at baseline, during CPA, and 60 min after CPB. Compared with controls, dobutamine-treated dogs had an increased dP/dmax (P < 0.05), which was associated with higher lymph driving pressures (P < 0.05), resulting in lower myocardial water gain 1 h after CPB (P < 0.05). We conclude that the resolution of myocardial edema after CPB was hastened by dobutamine. Organized ventricular contraction and myocardial contractility seem to be important determinants of myocardial lymphatic function and myocardial edema removal. These findings suggest that the administration of inotropic drugs after CPB may hasten cardiac recovery. IMPLICATIONS: Myocardial edema, which develops during cardiopulmonary bypass and cardioplegic arrest, contributes to cardiac dysfunction after heart surgery. This study demonstrated that enhancement of cardiac contractility by the administration of dobutamine after cardiopulmonary bypass and cardioplegic arrest was associated with increased myocardial lymphatic function and hastened edema resolution in dogs.

Animals↗
PubMed1983

Postcardiopulmonary resuscitation pulmonary edema.

Although severe pulmonary edema is encountered occasionally in patients needing CPR, there has been no definitive description on the mortality and morbidity of pulmonary edema after CPR. The author experienced severe pulmonary edema after standard CPR in 20 of 71 patients who suffered sudden, unexpected cardiac arrest and regained heart function by CPR. The varied onset of pulmonary edema, which may have developed when massive pink frothy secretions exited from the endotracheal tube, ranged from a few minutes to 45 min after the re-establishment of heart beat. These 20 patients showed a significantly higher P(A-a)O2, insignificant lower plasma protein concentrations, and high plasma osmolarities as compared with those who did not develop pulmonary edema. Only 2 patients with pulmonary edema survived. During CPR, many factors could cause pulmonary edema, including external cardiac massage (ECM), administration or release of catecholamines, hypoxia, acidosis, overhydration, etc. This study indicates that patients who need CPR have a high likelihood of developing pulmonary edema.

Adolescent↗
PubMed1996

Increased interleukin-8 concentrations in the pulmonary edema fluid of patients with acute respiratory distress syndrome from sepsis.

OBJECTIVE: To test the hypothesis that significantly higher concentrations of interleukin-8 (IL-8) are found in the pulmonary edema fluid and plasma of patients with a septic vs. a nonseptic etiology of acute respiratory distress syndrome (ARDS). DESIGN: Prospective measurement of IL-8 concentrations in previously collected edema fluid and plasma. SETTING: Adult intensive care units at a university medical center. PATIENTS: There were 27 patients with ARDS (16 patients with a septic etiology and nine patients with a nonseptic etiology) plus eight control patients with hydrostatic pulmonary edema. MEASUREMENTS AND MAIN RESULTS: IL-8 was present in the pulmonary edema fluid of all patients with ARDS, but the median IL-8 concentration was higher in the edema fluid of patients with ARDS associated with sepsis (84.2 ng/mL, n = 16) compared with the ARDS patients without sepsis (14.8 ng/mL, n = 11) (p < .05). In patients with cardiogenic edema, IL-8 concentration (5.0 ng/mL,n = 8, p < .05) was significantly lower than those values in patients with ARDS. Median plasma concentration of IL-8 was increased in septic individuals (1.3 ng/mL), but these concentrations were not significantly higher than in patients with a nonseptic etiology of ARDS (0.35 ng/mL) (p = .14) or those patients with cardiac failure (0.21 ng/mL). CONCLUSIONS: The high concentrations of IL-8 in pulmonary edema fluid, coupled with the relatively low concentrations of IL-8 in the plasma, suggest that the lung was the primary source of IL-8 in the patients with ARDS. The markedly increased concentrations of IL-8 in the pulmonary edema fluid of patients with ARDS from sepsis suggests that this group of patients may be particularly suitable for potential trials directed at inhibiting the activity of this important chemokine.

Adolescent↗
PubMed1998

Use of hypertonic (3%) saline/acetate infusion in the treatment of cerebral edema: Effect on intracranial pressure and lateral displacement of the brain.

OBJECTIVE: To determine the effect of continuous hypertonic (3%) saline/acetate infusion on intracranial pressure (ICP) and lateral displacement of the brain in patients with cerebral edema. DESIGN: Retrospective chart review. SETTINGS: Neurocritical care unit of a university hospital. PATIENTS: Twenty-seven consecutive patients with cerebral edema (30 episodes), including patients with head trauma (n = 8), postoperative edema (n = 5), nontraumatic intracranial hemorrhage (n = 8), and cerebral infarction (n = 6). INTERVENTION: Intravenous infusion of 3% saline/acetate to increase serum sodium concentrations to 145 to 155 mmol/L. MEASUREMENTS AND MAIN RESULTS: A reduction in mean ICP within the first 12 hrs correlating with an increase in the serum sodium concentration was observed in patients with head trauma (r2 = .91, p = .03), and postoperative edema (r2 = .82, p = .06), but not in patients with nontraumatic intracranial hemorrhage or cerebral infarction. In patients with head trauma, the beneficial effect of hypertonic saline on ICP was short-lasting, and after 72 hrs of infusion, four patients required intravenous pentobarbital due to poor ICP control. Among the 21 patients who had a repeat computed tomographic scan within 72 hrs of initiating hypertonic saline, lateral displacement of the brain was reduced in patients with head trauma (2.8 +/- 1.4 to 1.1 +/- 0.9 [SEM]) and in patients with postoperative edema (3.1 +/- 1.6 to 1.1 +/- 0.7). This effect was not observed in patients with nontraumatic intracranial bleeding or cerebral infarction. The treatment was terminated in three patients due to the development of pulmonary edema, and was terminated in another three patients due to development of diabetes insipidus. CONCLUSIONS: Hypertonic saline administration as a 3% infusion appears to be a promising therapy for cerebral edema in patients with head trauma or postoperative edema. Further studies are required to determine the optimal duration of benefit and the specific patient population that is most likely to benefit from this treatment.

Adult↗
PubMed1992

Hydrostatic pulmonary edema in sheep. Effects of bronchial artery embolization on the plain chest radiograph.

RATIONALE AND OBJECTIVES: The bronchial circulation may influence pulmonary edema. This study evaluates possible effects of bronchoesophageal artery embolization on the plain film manifestations of hydrostatic pulmonary edema in sheep. METHODS: Anteroposterior and lateral chest radiographs were obtained during the induction of pulmonary edema both before and after embolization of the bronchoesophageal artery in six adult sheep. Interstitial lines and perivascular, segmental bronchial, proximal bronchial, carinal, tracheal, and parenchymal edema were evaluated. RESULTS: Only parenchymal edema was graded consistently. Though edema increased with left atrial pressure before embolization (P < .001), there was no similar change afterward. The embolized animals tended to be more edematous by the first film. CONCLUSION: Rather than any protective effect, bronchoesophageal artery embolization may increase edema. This model may be inappropriate for further investigation of the bronchial circulation in the development of human pulmonary edema.

Animals↗
PubMed1978

The role of edema in diffuse sclerosis and other leukoencephalopathies.

The pathologic changes associated with broad zones of demyelination of the cerebral white matter, the diffuse sclerosis group, are analyzed with respect to the contribution of cerebral edema to their pathogenesis. The characteristics of cerebral edema in general are reviewed, and the interpretation offered that only one type of cerebral edema, that characterized by an extracellular accumulation of fluid, occurs in man. In the diffuse sclerosis group, edema is most readily recognized by the tendency for the arcuate zone of the white matter to be spared when the deeper white matter is severely degenerated. Edema is demonstrated in metachromatic leukodystrophy, globoid cell leukodystrophy, adrenoleukodystrophy, disorders of amino acid metabolism, trauma, hypertensive disease, radiation effect, diffuse hypoxia with acidosis, and other conditions, i.e., both in disorders of myelin metabolism and in conditions in which normal myelin is injured by extrinsic influences. These groups cannot be consistently distinguished morphologically, in part because the injury by edema often obscures any primary morphologic change which may have been present. A familial tendency does not necessarily denote a metabolic abnormality specifically related to the chemistry of a myelin constituent, since the lesions might result from edema induced by some other type of familial process. Such familial processes might be metabolic, but are not specifically related to myelin formation or catabolism, as might be true of diseases like phenylketonuria or maple syrup urine disease. Edema may also occur in instances in which a familial disease induces diffuse hypoxia and acidosis, as exemplified by two instances of severe white matter degeneration in subacute necrotizing encephalomyelopathy; one of these is an additional instance of apparent "crib death" by this cause.

Adolescent↗