The efficacy of bronchoscopic intratumoral chemotherapy in palliation of inoperable lung cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17556-e17556
Author(s):  
Hesham El Ghazaly ◽  
Tamer Mohammed ◽  
Ashraf Madkour ◽  
Emad Koraa
Keyword(s):  
Lung Cancer ◽  
Airway Obstruction ◽  
Invasive Procedure ◽  
Blood Gases ◽  
Karnofsky Performance Scale ◽  
Bronchial Obstruction ◽  
Systemic Complications ◽  
Intratumoral Chemotherapy ◽  
Arterial Blood ◽  
Life Threatening

e17556 Background: Endobronchial obstruction is a common complication of advanced-stage lung cancer. Patients presenting with severe bronchial obstruction are at a high risk for developing haemoptysis, post-obstructive pneumonia, or respiratory failure, this often leads to death in weeks to months.Tumor debulking and airway re-canalization has a considerable role in increasing survival in patients with inoperable non-small cell lung cancer (NSCLC). Bronchoscopic endobronchial intratumoral chemotherapy (EITC) is a new intervention to treat airway obstruction. This work aims to determine the efficacy of EITC in palliative care for patients with inoperable NSCLC. Methods: Between April 2009 and June 2011, patients with newly diagnosed non metastatic inoperable symptomatic non-life threatening airway obstruction secondary to NSCLC were selected for tumor debulking via EITC through flexible bronchoscopy. EITC of maximum 20mL cisplatin with the concentration of 50 mg/50 mL was injected into the tumor bulk through flexible needle (weekly for 4 sessions). Patients were followed according to the symptoms, performance and functional status and endobronchial lesions changes after EITC. Results: Forteen male and 1 female were studied in which 7 cases had squamous cell carcinoma, 5 cases had adenocarcinoma and 3 cases had unspecified NSCLC. After 4 sessions of EITC, the involved lumen was considerably opened (> 25%) in 80% of cases in which 7 cases >50% and 5 cases showed a 25–50% luminal opening. Significant improvement was found in dyspnea score, Karnofsky performance scale as well as spirometric and arterial blood gases indices after than before the 4 sessions of EITC. Conclusions: EITC was well tolerated by most of the patients with minimal non systemic complications. In conclusion, EITC is a promising, safe, effective and less invasive procedure for palliative treatment of obstructive non-life threatening endobronchial NSCLC lesions.

scholarly journals The Use of Milrinone Versus Conventional Treatment for the Management of Life-Threatening Bronchial Asthma

2019 ◽  
Vol 13 (1) ◽  
pp. 12-17 ◽  
Author(s):  
Amr Sobhy ◽  
Doaa M. K. Eldin ◽  
Hany V. Zaki
Keyword(s):  
Bronchial Asthma ◽  
Conventional Treatment ◽  
Controlled Trial ◽  
Blood Gases ◽  
Categorical Variables ◽  
Chi Square ◽  
Arterial Blood ◽  
Number Of Patients ◽  
Significant Difference ◽  
Life Threatening

Background and Aims: In our study, we investigated the effectiveness of intravenous milrinone in life-threatening bronchial asthma as compared to conventional treatment. Methods: Fifty patients aged 18-50 years, presenting with life-threatening asthma were enrolled in a Randomised Controlled Trial (RCT). They were randomly allocated into Group C (25 patients): who received the standard pharmacotherapy and placebo, and Group M (25 patients): who in addition to the standard therapy, received 25 μg milrinone as an initial slow IV bolus diluted in 10 ml of normal saline. The following data were recorded: PEFR (Peak Expiratory Flow Rate) expressed as a percentage of the patient’s previous value, Respiratory Rate (RR), MABP (Mean Arterial Blood Pressure), arterial blood gases, and the number of patients requiring mechanical ventilation. Differences between groups were tested using Analysis of Variance (ANOVA) for quantitative variables with post hoc using the Least Significant Difference (LSD) test, and Chi square test for categorical variables. Results: Group M showed marked improvement in PEFR that was highly significant (P < 0.001) 10 min after injection and significant after one hour from the start of treatment in comparison to Group C. There was also an improvement in RR and PO2 that was significant in group M. Milrinone was associated with a reduction in MABP only after 10 min from injection, and showed a statistically significant decrease in the number of patients requiring mechanical ventilator support (P ˂ 0.05). Conclusion: Milronine is a promising agent as a rescue drug in the treatment of life-threatening bronchial asthma.

scholarly journals Arterial blood gases predict long-term prognosis in stage I non-small cell lung cancer patients

BMC Surgery ◽  
2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Shinjiro Mizuguchi ◽  
Takashi Iwata ◽  
Nobuhiro Izumi ◽  
Takuma Tsukioka ◽  
Shoji Hanada ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Blood Gases ◽  
Small Cell ◽  
Arterial Blood Gases ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
Arterial Blood ◽  
Long Term Prognosis

scholarly journals Interpretation of arterial blood gases

Pulse ◽  
1970 ◽  
Vol 3 (1) ◽  
pp. 15-19
Author(s):  
CP Dokwal
Keyword(s):  
Blood Gases ◽  
The Body ◽  
Respiratory Physiology ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Acid Base ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Base Balance ◽  
Life Threatening

Measuring arterial blood gas is routinely performed in critically ill patients, and may unravel severe life-threatening acid-base disorders or hypoxemia. It provides the vital information about ventilation, oxygenation, and acid-base status in such persons. These three processes are intimately related to each other in achieving normal oxygenation and acid-balance in the body.The interpretation of arterial blood gas requires a reasonable understanding of respiratory physiology and acid-base balance in the body. Hence, in the following section, first the role of alveolar ventilation, oxygenation, and the maintenance of acid-base homeostasis have been discussed. This is followed by a step-wise approach to analyze the acid-base disorders, if present.DOI: 10.3329/pulse.v3i1.6547Pulse Vol.3(1) July 2009 p15-19

Using the pathophysiology of obstructive sleep apnea to teach cardiopulmonary integration

2008 ◽  
Vol 32 (3) ◽  
pp. 196-202 ◽  
Author(s):  
Michael G. Levitzky
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Blood Gases ◽  
Upper Airway Obstruction ◽  
Systemic Hypertension ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Obstructive Sleep

Obstructive sleep apnea (OSA) is a common disorder of upper airway obstruction during sleep. The effects of intermittent upper airway obstruction include alveolar hypoventilation, altered arterial blood gases and acid-base status, and stimulation of the arterial chemoreceptors, which leads to frequent arousals. These arousals disturb sleep architecture and cause hypersomnolence. Chronic intermittent alveolar and systemic arterial hypoxia-hypercapnia can cause pulmonary and systemic hypertension, with effects on the right and left ventricles, and even the renal system. The pathophysiology of OSA can therefore be used to review and integrate many topics in pulmonary and cardiovascular physiology in the context of problem-based learning, a guided discussion, or a formal lecture. The discussion begins with a case scenario, followed by a definition of the disorder, the common symptoms and signs of OSA, and a description of an apneic event. These are related to the physiology of the upper airway in OSA, normal alterations in the respiratory system during sleep, the effects of apnea on gas exchange and arterial blood gases, and the cardiovascular consequences of alterations in alveolar and systemic arterial Po2 and Pco2. The treatment of OSA, particularly how the use of continuous positive airway pressure relates to the pathophysiology of the disorder, is discussed briefly.

A dangerous cause of airway obstruction: deep neck infection

2020 ◽  
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Deep Neck Infection ◽  
Jugular Vein Thrombosis ◽  
Neck Infection ◽  
Vein Thrombosis ◽  
Lethal Complications ◽  
Life Threatening ◽  
Fascial Spaces ◽  
Emergency Doctors

Deep neck infection (DNI) is an infection in the fascial spaces of the neck. Complications of DNI, including mediastinitis, internal jugular vein thrombosis, and upper airway obstruction, are severe and potentially life threatening. Therefore, early identification and accurate management of DNI are essential. We review the anatomy of the deep spaces of the neck to determine the route of DNI spread so that emergency doctors, physicians, and otorhinolaryngologists can quickly recognize the development of lethal complications of DNI, such as asphyxia from airway obstruction.

Burkitt lymphoma of the nasopharynx causing life-threatening airway obstruction: A case report

2021 ◽  
Vol 42 (4) ◽  
pp. 102977
Author(s):  
Alexander N. Goel ◽  
Andrey Filimonov ◽  
Julie Teruya-Feldstein ◽  
Christian Salib ◽  
Joseph J. Rousso ◽  
...  
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Burkitt Lymphoma ◽  
Life Threatening

scholarly journals Elimination of nasal obstruction improves pulmonary functions and oxygenation

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Eman Sobh ◽  
Fatma Elhussieny ◽  
Taghreed Ismail
Keyword(s):  
Nasal Obstruction ◽  
Blood Gases ◽  
Medical Problem ◽  
Forced Expiratory Volume ◽  
Nasal Packing ◽  
Nasal Pack ◽  
Arterial Blood ◽  
Study Population ◽  
The Mean ◽  
The Impact

Abstract Background Nasal obstruction is a significant medical problem. This study aimed to examine the effect of nasal obstruction and nasal packing on arterial blood gases and pulmonary function indices, and the impact of the elimination of nasal obstruction on preoperative values. Results The mean age of the study population was 26.6 ± 10.1 years, males represented 50.8%. Spirometric indices showed statistically significant improvement (preoperative forced expiratory volume in 1st second 66.9 ± 13.9 vs 79.6 ± 14.9 postoperative and preoperative forced vital capacity 65.5 ± 12.7 vs 80.4 ± 13.8 postoperative). Oxygen saturation was significantly lower during nasal packing (95.6 ± 1.6 preoperative vs 94.7 ± 2.8 with nasal pack), and significant improvement (97.2 ± 1.4) was observed after removal of the nasal pack. Nasal obstruction scores significantly improved. Conclusion The results of this study indicate that either simple nasal obstruction or nasal packing may cause hypoxemia and abnormalities in lung function tests. Hypoxemia was more evident with nasal packing.

scholarly journals Pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest

2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Chiara Robba ◽  
Dorota Siwicka-Gieroba ◽  
Andras Sikter ◽  
Denise Battaglini ◽  
Wojciech Dąbrowski ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Mechanical Ventilation ◽  
Cardiac Arrest ◽  
Oxygen Demand ◽  
Blood Gases ◽  
Metabolic Energy ◽  
High Morbidity ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Clinical Consequences

AbstractPost cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of gas exchange, and in particular oxygenation and carbon dioxide levels, is fundamental in mechanically ventilated patients after resuscitation, as arterial blood gases derangement might have important effects on the cerebral blood flow and systemic physiology.In particular, the pathophysiological role of carbon dioxide (CO2) levels is strongly underestimated, as its alterations quickly affect also the changes of intracellular pH, and consequently influence metabolic energy and oxygen demand. Hypo/hypercapnia, as well as mechanical ventilation during and after resuscitation, can affect CO2 levels and trigger a dangerous pathophysiological vicious circle related to the relationship between pH, cellular demand, and catecholamine levels. The developing hypocapnia can nullify the beneficial effects of the hypothermia. The aim of this review was to describe the pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest.According to our findings, the optimal ventilator strategies in post cardiac arrest patients are not fully understood, and oxygen and carbon dioxide targets should take in consideration a complex pattern of pathophysiological factors. Further studies are warranted to define the optimal settings of mechanical ventilation in patients after cardiac arrest.

scholarly journals Prehospital Diagnosis of Shortness of Breath Caused by Profound Metformin-Associated Metabolic Acidosis

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 74
Author(s):  
Pietro Elias Fubini ◽  
Laurent Suppan
Keyword(s):  
Metabolic Acidosis ◽  
Hospital Setting ◽  
Blood Gases ◽  
Shortness Of Breath ◽  
Potential Harm ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Common Causes ◽  
Prehospital Diagnosis ◽  
Gas Measurement

Shortness of breath is a common complaint among patients in emergency medicine. While most common causes are usually promptly identified, less frequent aetiologies might be challenging to diagnose, especially in the pre-hospital setting. We report a case of prehospital dyspnoea initially ascribed to pulmonary oedema which turned out to be the result of profound metformin-associated metabolic acidosis. This diagnosis was already made during the prehospital phase by virtue of arterial blood gas measurement. Pre-hospital measurement of arterial blood gases is therefore feasible and can improve diagnostic accuracy in the field, thus avoiding unnecessary delay and potential harm to the patient before initiating the appropriate therapeutic actions.

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