scholarly journals Assessment of Ventilation and Perfusion in Patients with COVID-19 Discloses Unique Information of Pulmonary Function to a Clinician: Case Reports of V/P SPECT

2021 ◽  
Vol 15 ◽  
pp. 117954842110301
Author(s):  
Marika Bajc ◽  
Fredrik Hedeer ◽  
Ari Lindqvist ◽  
Elin Trägårdh
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Function ◽  
Case Reports ◽  
Pulmonary Inflammation ◽  
Lung Perfusion ◽  
Pulmonary Vasculature ◽  
Severe Hypoxemia ◽  
Poor Ventilation ◽  
Ventilation And Perfusion ◽  
Dead Space Ventilation

V/P SPECT from 4 consecutive patients with COVID-19 suggests that ventilation and perfusion images may be applied to diagnose or exclude pulmonary embolism, verify nonsegmental diversion of perfusion from the ventilated areas (dead space ventilation) that may represent inflammation of the pulmonary vasculature, detect the reversed mismatch of poor ventilation and better preserved perfusion (shunt perfusion) in bilateral pulmonary inflammation and indicate redistribution of lung perfusion (antigravitational hyperperfusion) due to cardiac congestion. V/P mismatch and reversed mismatch may be extensive enough to diminish dramatically preserved matching ventilation/perfusion and to induce severe hypoxemia in COVID-19.

COMPARISON OFDUAL ENERGY CT LUNG PERFUSION VERSUS LUNG VENTILATION/PERFUSION SCINTIGRAPHY IN PULMONARY EMBOLISM

2020 ◽  
Vol 71 (2) ◽  
pp. 399-410
Author(s):  
Khaled Abdelghany ◽  
Noha Osman ◽  
Eman Geneidi ◽  
Hala Abou Senna ◽  
Ahmed Nasr ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Lung Ventilation ◽  
Lung Perfusion ◽  
Perfusion Scintigraphy

scholarly journals EXPRESS: Rapid dynamic bedside assessment of pulmonary perfusion defect by electrical impedance tomography in a patient with acute massive pulmonary embolism

2020 ◽  
pp. 204589402098404
Author(s):  
Siyi Yuan ◽  
Huaiwu He ◽  
Yun Long ◽  
Yi Chi ◽  
Inéz Frerichs ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Electrical Impedance Tomography ◽  
Perfusion Defect ◽  
Electrical Impedance ◽  
Massive Pulmonary Embolism ◽  
Lung Perfusion ◽  
Regional Perfusion ◽  
Pulmonary Perfusion ◽  
Impedance Tomography ◽  
Regional Lung

Background: Several animal studies have shown that regional lung perfusion could be effectively estimated by the hypertonic saline contrast electrical impedance tomography (EIT) method. Here, we reported an application of this method to dynamically assess regional pulmonary perfusion defect in a patient with acute massive pulmonary embolism. Case presentation: A 68-year-old man experienced sudden dyspnea and cardiac arrest during out-of-bed physical activity on the first day after partial mediastinal tumor resection. Acute pulmonary embolism (PE) was suspected due to acute enlargement of right heart and fixed inferior venous cava measured with bedside ultrasound. The computed tomography pulmonary angiography further confirmed large embolism in both left and right main pulmonary arteries and branches. The regional time impedance curves, which were obtained by a bolus of 10ml 10% NaCl through the central venous catheter, were then analyzed to quantitatively assess regional perfusion. Normal ventilation distribution with massive defects in regional perfusion in both lungs was observed, leading to a ventilation-perfusion mismatch and low oxygenation index (PaO2/FiO2=86 mmHg) at the first day of PE. The anticoagulation was performed with heparin, and the patient’s condition (such as shock, dyspnea, hypoxemia etc.), regional lung perfusion defect and ventilation-perfusion mismatch continuously improved in the following days. Conclusions: This case implies that EIT might have the potential to assess and monitor regional perfusion for rapid diagnosis of fatal PE in clinical practice.

PULMONARY FUNCTION, DEDUCED FROM URINARY NITROGEN TENSIONS

PEDIATRICS ◽  
1967 ◽  
Vol 40 (6) ◽  
pp. 937-938
Author(s):  
M. E. A.
Keyword(s):  
Carbon Dioxide ◽  
Blood Flow ◽  
Pulmonary Function ◽  
Partial Pressure ◽  
Urine Sample ◽  
Pulmonary Blood Flow ◽  
Lung Perfusion ◽  
Alveolar Ventilation ◽  
Arterial Oxygen ◽  
Urinary Nitrogen

THE elegant studies reported by Led-better, Homma, and Farhi in this issue are entitled `'Readjustment in Distribution of Alveolar Ventilation and Lung Perfusion in the Newborn." It must come as a great surprise to the reader to discover that the only measurement actually made was the partial pressure of nitrogen in the infants' urine. How could one conclude that there were significant imbalances between the distribution of alveolar ventilation and pulmonary blood flow (VA/Q) in the first days of life in normal infants from a urine sample? It is all the more astounding in the light of previous (and seemingly more direct) studies of alveolar-arterial oxygen and carbon dioxide differences which led others to consider the differences largely explained by anatomical right-to-left shunts.

An efficient and fast multi-band focused bioimpedance solution with EIT-based reconstruction for pulmonary embolism assessment: a simulation study from massive to segmental blockage

2022 ◽  
Author(s):  
Duc Minh Nguyen ◽  
Luong Duong Trong ◽  
Alistair L McEwan
Keyword(s):  
Pulmonary Embolism ◽  
Lung Perfusion ◽  
Lung Field ◽  
Object Boundary ◽  
Non Invasive ◽  
Measurement Strategy ◽  
Time Simulation ◽  
Different Populations ◽  
Acute Condition ◽  
Respiratory Conditions

Abstract Objective: Pulmonary embolism (PE) is an acute condition that blocks the perfusion to the lungs and is a common complication of Covid-19. However, PE is often not diagnosed in time, especially in the pandemic time due to complicated diagnosis protocol. In this study, a non-invasive, fast and efficient bioimpedance method with the EIT-based reconstruction approach is proposed to assess the lung perfusion reliably. Approach: Some proposals are presented to improve the sensitivity and accuracy for the bioimpedance method: (1) a new electrode configuration and focused pattern to help study deep changes caused by PE within each lung field separately, (2) a measurement strategy to compensate the effect of different boundary shapes and varied respiratory conditions on the perfusion signals and (3) an estimator to predict the lung perfusion capacity, from which the severity of PE can be assessed. The proposals were tested on the first-time simulation of PE events at different locations and degrees from segmental blockages to massive blockages. Different object boundary shapes and varied respiratory conditions were included in the simulation to represent for different populations in real measurements. Results: The correlation between the estimator and the perfusion was very promising (R = 0.91, errors < 6%). The measurement strategy with the proposed configuration and pattern has helped stabilize the estimator to non-perfusion factors such as the boundary shapes and varied respiration conditions (3-5% errors). Significance: This promising preliminary result has demonstrated the proposed bioimpedance method’s capability and feasibility, and might start a new direction for this application.

scholarly journals Septic Pulmonary Embolism: three Case Reports

2016 ◽  
Vol 69 (2) ◽  
Author(s):  
Z. Celebi Sözener ◽  
A. Kaya ◽  
C. Atasoy ◽  
M. Kılıckap ◽  
N. Numanoglu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Case Reports ◽  
Pleuritic Chest Pain ◽  
Radiological Findings ◽  
Wound Culture ◽  
Septic Embolism ◽  
First Case ◽  
Septic Pulmonary Embolism ◽  
Fever Response ◽  
Valve Operation

We present three cases of septic pulmonary embolism which occurred as a result of three different causes. The first case, was a 23 year old woman suffering from cough, sputum, hemopthisis and pleuritic chest pain. She had a right subclavian port. On her thorax computed tomography (CT) scans there were widespread bilateral, irregular parenchymal nodular infiltrates and some of them beginning to cavitate. Meticilin resistant stafilococus aureus (MRSA) was isolated from the blood culture and septic embolism was diagnosed. A month after antibiotic theraphy her parenchymal nodules have considerably decreased in size. The second case was a 40 year old woman admitted to our hospital with the same complaints. Her radiological findings were similar. Meticilin sensitive stafilococus aureus (MSSA) was isolated from the blood cultures and antibiotic theraphy was initiated. To investigate the etiology of the nodules due to septic embolism, echocardiography was performed and infective endocarditis was diagnosed. After the antibiotic theraphy and a tricuspid valve operation her parenchymal nodules disappeared. The final case involved a 51 year old man suffering from fever, fatigue, cough and pain in the left arm for one week. His general status was bad. His radiological findings were also similar to the others. Staphillococcus aureus was isolated from blood and wound culture. Following clinical and radiological findings we thought it was a case of septic pulmonary embolism and antibiotic theraphy was started. Despite the therapy we did not take fever response and he died five days after antibiotic therapy. In conclusion, septic pulmonary embolism should be considered in bilateral cavitary nodular infiltrates and must be managed fast.

scholarly journals The role of lung perfusion imaging in predicting the direction of radiation-induced changes in pulmonary function tests

Cancer ◽  
2000 ◽  
Vol 88 (9) ◽  
pp. 2135-2141 ◽  
Author(s):  
Lawrence B. Marks ◽  
Donna Hollis ◽  
Michael Munley ◽  
Gunilla Bentel ◽  
Melahat Garipagaoglu ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Perfusion Imaging ◽  
Pulmonary Function Tests ◽  
Lung Perfusion ◽  
Function Tests ◽  
Radiation Induced ◽  
Lung Perfusion Imaging ◽  
Induced Changes

Pulmonary Embolism

2019 ◽  
Author(s):  
Nadav Granat ◽  
Evan Avraham Alpert
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Blood Clot ◽  
Pretest Probability ◽  
Treatment Modalities ◽  
Pulmonary Vasculature ◽  
Pulmonary Angiogram ◽  
Catheter Directed Thrombolysis ◽  
D Dimer ◽  
Rule Out

Pulmonary embolism is caused by a blood clot that travels from the deep veins through the heart and then lodges in the pulmonary vasculature. Common symptoms include pleuritic chest pain, dyspnea, or palpitations. Clinical scores such as the Wells score and Revised Geneva score can be used to assess the pretest probability of pulmonary embolism (PE) and guide work-up such as deciding to order D-dimer testing or imaging. However, clinical gestalt can also accurately assess the pretest probability of PE. The Pulmonary Embolism Rule-out Criteria is a decision rule that can be used to rule out PE without further testing. Imaging modalities include computed tomography pulmonary angiogram or ventilation/perfusion scanning. Novel or new oral anticoagulants are becoming the mainstay of treatment for the hemodynamically stable patient with pulmonary embolism. For the patient who is hemodynamically unstable, treatment modalities include intravenous alteplase, catheter-directed thrombolysis, surgical embolectomy, and catheter-directed embolectomy. A subset of patients with PE can be treated as outpatients. This review contains 1 figure, 4 tables, and 55 references. Key Words: anticoagulants, antithrombins, D-dimer, low-molecular-weight heparin, mechanical thrombolysis, multidetector computed tomography, radionuclide imaging, unfractionated heparin, pulmonary embolism, tissue plasminogen activator, warfarin

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