scholarly journals Sindrom Hepatopulmoner

2019 ◽  
Vol 1 (2) ◽  
pp. 60
Author(s):  
Kowiy Akbar ◽  
Isnu Pradjoko
Keyword(s):  
Nitric Oxide ◽  
Liver Disease ◽  
Cell Injury ◽  
Clinical Signs ◽  
Supportive Therapy ◽  
Hepatopulmonary Syndrome ◽  
Blood Gas Analysis ◽  
Signs And Symptoms ◽  
Gas Analysis ◽  
Definitive Treatment

Hepatopulmonary syndrome (HPS) is an important complication of liver disease on pulmonary organ; characterized by the triad of liver disease, pulmonary vascular dilatation, and oxygenation defect. Clinical signs and symptoms include dyspnea, platypnea, orthodeoxia, cyanosis, and clubbing finger. The underlying patophysiology involves abnormal vasodilation and angiogenesis in the pulmonary vascular bed, which leads to ventilation-perfusion mismatch, diffusion limitation to oxygen exchange, and arteriovenous shunting. This disorder is thought to be linked to liver cell injury, which stimulates release of endothelin-1 and results in increased expression of endothelin receptors on pulmonary endothelial cells, leading to upregulation of endothelial-nitric-oxide-synthase (eNOS) and subsequent increased production of nitric oxide (NO), ultimately causing vasodilation. Laboratory studies to establish diagnosis includes blood gas analysis and echocardiography, supported by radiology and pulmonary vascular cathetherization. Despite accumulated knowledge about the pathogenesis of HPS, currently there is still no established medical therapy, and liver transplantation remains the definitive treatment for this syndrome. Supportive therapy consists oflong term oxygen administration to prevent desaturation and alleviate dyspnea.

scholarly journals Hepatopulmonary syndrome: which blood gas analysis criteria and position should we use for diagnosis?

2017 ◽  
Vol 109 ◽  
Author(s):  
Israel Grilo ◽  
Juan Manuel Pascasio ◽  
Francisco-Jesús López-Pardo ◽  
Francisco Ortega-Ruiz ◽  
Juan Luis Tirado ◽  
...  
Keyword(s):  
Hepatopulmonary Syndrome ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas

scholarly journals Management of severe baclofen toxicosis using hemodialysis in conjunction with mechanical ventilation in a cat with chronic kidney disease

2021 ◽  
Vol 7 (2) ◽  
pp. 205511692110337
Author(s):  
Levi Hoffman ◽  
Leonel A Londoño ◽  
Jenifer Martinez
Keyword(s):  
Chronic Kidney Disease ◽  
Mechanical Ventilation ◽  
Kidney Disease ◽  
Venous Blood ◽  
Clinical Signs ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Dialysis Session ◽  
History Of ◽  
Venous Blood Gas

Case summary A 2-year-old castrated male domestic shorthair cat was presented for evaluation of acute and progressive neurologic signs 2–4 h after exposure to baclofen. The suspected ingested dose was 2.1 mg/kg. On admission, the cat was tetraplegic with stuporous mentation, and venous blood gas analysis showed mild hypercapnia (PvCO2 43.4 mmHg) raising concern for hypoventilation. Owing to the acute nature of the ingestion, severity of the clinical signs and reported history of chronic kidney disease, hemodialysis was recommended to remove the toxin. A 5 h hemodialysis session was performed using an intermittent platform without hemoperfusion. At the beginning of hemodialysis, worsening hypoventilation and hypercapnia (PvCO2 88.6 mmHg) required endotracheal intubation and manual ventilation initially, followed by mechanical ventilation. At the end of the dialysis session, the cat was breathing spontaneously and disconnected from the ventilator. The cat was ambulatory and alert 1 h after the end of dialysis. After an additional 12 h of monitoring, the cat had full return of neurologic function and was discharged from hospital. Serum baclofen concentration measured prior to, during and after hemodialysis showed a 77.7% reduction in baclofen levels immediately after hemodialysis. Relevance and novel information This is the first report of baclofen toxicity in a cat successfully treated with hemodialysis and mechanical ventilation simultaneously. Treatment with hemodialysis therapy and mechanical ventilation could be considered in cases of acute baclofen toxicosis to improve outcome and reduce the length of the hospital stay.

scholarly journals Relationship of Respiratory Symptoms and Signs with Hypoxemia in Infants Under 2 months of Age

1970 ◽  
Vol 31 (3) ◽  
pp. 202-208
Author(s):  
K Agrawal ◽  
C Mahaseth ◽  
A Rayamajhi
Keyword(s):  
Respiratory Rate ◽  
Clinical Signs ◽  
High Specificity ◽  
Signs And Symptoms ◽  
Acute Illness ◽  
Gas Analysis ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Head Nodding

Introduction: Hypoxemia is the most serious manifestation of any acute illness in infants less than two months and has shown to be a risk factor for mortality. Hypoxia can be detected using a pulse oxymeter or arterial blood gas analysis. However this facility is not available in most centers of Nepal. This study has correlated different signs and symptoms to predict hypoxia. Methodology: This hospital based prospective cross sectional study included 160 infant < 2 months, presenting to OPD or Emergency department with any acute illness A complete history was taken and weight, temperature, respiratory rate, heart rate and oxygen saturation was recorded. Presence or absence of nasal flaring, cyanosis, chest indrawing, head nodding, grunting, wheezing and crepitations on auscultation was recorded subsequently. Clinical signs of hypoxemic and non hypoxemic infants were compared and then analyzed. Results: 160 infants, 95 (59.4%) were male and 65 (40.6%) were female. Of the total population, 56(35%) were hypoxic where as 104(65%) were non hypoxic. Infants who presented with more than 3 symptoms, were lethargic, tachypneic or had chest indrawing had higher sensitivity(92.8%, 75%, 75% and 89.3 % respectively) where as infants with nasal flaring, grunting, head nodding or central cyanosis had high specificity (91.3%, 87.5%, 98% and 100%) respectively. Conclusion: Infants presenting with ≥ 3 symptoms, lethargy, respiratory rate of ≥ 70/minute or chest indrawing can be used for screening purpose to detect hypoxia and infants showing signs like grunting, head nodding, nasal flaring or central cyanosis should be considered hypoxic and treated with supplemental oxygen. Key words: Hypoxia; Respiratory rate; Chest indrawing; Nasal flaring DOI: http://dx.doi.org/10.3126/jnps.v31i3.5359 J Nep Paedtr Soc 2011;31(3): 202-208  

scholarly journals Pneumonitis Akut dan Gagal Napas Setelah Mendapatkan Injeksi Silikon Cair di Payudara

2019 ◽  
Vol 1 (2) ◽  
pp. 48
Author(s):  
Cut Diana Laili ◽  
Daniel Maranatha
Keyword(s):  
Supportive Therapy ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Pleuritic Chest Pain ◽  
Silicone Injection ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Liquid Silicone ◽  
Silicone Injections

Background; Liquid silicone is a synthetic polymer incorporating oxygen and the semimetallic element silicon. It is widely  used in plastic and reconstructive surgery as it displays little change in physical characteristicswith temperature and age, is poorly  immunogenic, and is not carcinogenic. Case; We report a case of a 27-year-old woman presented to the hospital with the chief complain  progressive shortness of breath, pleuritic chest pain, productive cough, hemoptysis and fever after liquid silicone injections to the  mammae for cosmetic augmentation. Physical examination: tachycardia, tachypneu, hypertermia and diffuse rhonchi throughout the  lungs. Abnormalities laboratory tests gave leuchositosis, granulositosis, increasing trassaminase serum, D-dimer elevation, Arterial  blood gas analysis results respiratory disstres tipe 1. Chest radiograph showed difus bilateral infiltrates, CT angiography was negative  for an acute embolus but demonstrated infiltrates in superior lobus dextra, segment lateral lobus medius dan segment apicoposterior  Sinistra. Conclusion;  Patients with diagnosis of acut pneumonitis and respiratory disstres syndroma after liquid silicone injection to  the mammae, supportive therapy with O2 Ventilator and methylprednisolon low dose gives satisfactory result with radiological and  clinical  

scholarly journals Non-clinical safety study of a sugarcane bacterial cellulose hydrogel

2020 ◽  
Vol 9 (9) ◽  
pp. e960997932
Author(s):  
Jaiurte Gomes Martins da Silva ◽  
Flávia Cristina Morone Pinto ◽  
Glícia Maria de Oliveira ◽  
Anderson Arnaldo da Silva ◽  
Olávio Campos Júnior ◽  
...  
Keyword(s):  
Bacterial Cellulose ◽  
Cell Injury ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Abnormal Behavior ◽  
Clinical Safety ◽  
Routes Of Administration ◽  
Two Samples ◽  
Renal Histology ◽  
Cellulose Hydrogel

A hydrogel of bacterial cellulose of 0.8%, biopolymer produced from sugarcane molasses and synthesized from a bacteria called Zoogloea sp., was analyzed for its composition and tested by two routes of administration, subcutaneous and intraperitoneal, to clarify the local and systemic adverse effects after skin implantation in Wistar rats (24 males, 24 females, 55 days old). Analysis of two samples of BC films indicates carbon (42.94%; 43.43%), hydrogen (6.73%; 6.76%), nitrogen (0.28%, 0.23%) and oxygen (50.05%, 49.58%). No abnormal behavior, clinical signs of chronic toxicity or inflammation were observed. There was no change in liver injury biomarker levels (ALT, AST and ALP), as well as in renal histology, where it was evaluated to signs of tubular cell injury, glomerular or vascular damage, and renal morphometry, in which it was quantified the number of renal corpuscles, the number of cells per glomerulus and the capsular space area. Thus, the absence of signs and symptoms of toxicity suggests that subcutaneous or intraperitoneal injections of these polymers may be used in clinical situations.

Inhaled nitric oxide reverses hypoxic pulmonary vasoconstriction without impairing gas exchange

1993 ◽  
Vol 74 (3) ◽  
pp. 1287-1292 ◽  
Author(s):  
U. Pison ◽  
F. A. Lopez ◽  
C. F. Heidelmeyer ◽  
R. Rossaint ◽  
K. J. Falke
Keyword(s):  
Nitric Oxide ◽  
Gas Exchange ◽  
Hypoxic Pulmonary Vasoconstriction ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Pulmonary Gas Exchange ◽  
Blood Gas ◽  
Hemodynamic Effects ◽  
Pulmonary Vasoconstriction ◽  
Inhaled No

Nitric oxide (NO) is an endogenous endothelium-derived relaxing factor that participates in the regulation of vascular tone. We studied the effects of inhaled NO gas on transient hypoxic pulmonary vasoconstriction and normal lungs in mechanically ventilated sheep. We measured hemodynamics and pulmonary gas exchange. For gas exchange measurements we used conventional blood gas analysis and the multiple inert gas elimination technique to estimate ventilation-perfusion heterogeneity. Our hypotheses were 1) inhaled NO reverses hypoxic pulmonary vasoconstriction, 2) the hemodynamic effects of inhaled NO are limited to the pulmonary circulation, and 3) inhaled NO does not impair pulmonary gas exchange and may redistribute blood flow to better ventilated areas of the lungs. Hypoxic pulmonary vasoconstriction was induced by using a hypoxic inspiratory gas mixture. The addition of 20 ppm NO to the hypoxic inspiratory gases returned pulmonary arterial pressure to baseline values. Systemic hemodynamics and gas exchange indexes derived from conventional blood gas analysis remained constant. Gas exchange indexes for ventilation-perfusion ratios and gas dispersions improved. The addition of 20 ppm NO to medical air (21% O2) had no such significant effects on hemodynamics or pulmonary gas exchange. Our findings show that inhaled NO reverses transient hypoxic pulmonary vasoconstriction. The hemodynamic effects of NO are limited to the pulmonary circulation; it does not impair pulmonary gas exchange. Moreover, it redistributes blood flow to better ventilated alveoli. As such, NO has potential in the treatment of lung diseases associated with pulmonary hypertension.

scholarly journals Case Report: Hepatopulmonary syndrome as the first clinical manifestation of cirrhosis in a patient with underlying chronic lung disease

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1175
Author(s):  
Charles Murphy ◽  
Danit Arad
Keyword(s):  
Lung Diseases ◽  
Hepatopulmonary Syndrome ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Rare Presentation ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Chronic Lung Diseases ◽  
Arterial Blood

An 86 year old woman with multiple chronic lung diseases (including chronic obstructive pulmonary disease, bronchiectasis, and untreated mycobacterium avium-intracellulare) presented with two weeks of increased shortness of breath, notably worse when seated as compared to when lying down. After treatments focused on her known conditions did not resolve her dyspnea, the differential diagnosis was broadened and she was found to have cirrhosis. As a result of this new diagnosis, transthoracic echocardiography and arterial blood gas analysis were performed and together yielded the diagnosis of hepatopulmonary syndrome. We describe a rare presentation of hepatopulmonary syndrome manifesting as a patient’s first clinical evidence of cirrhosis, a diagnosis made difficult by this patient’s numerous other lung diseases which muddied the picture.

scholarly journals The Effectiveness of Anti-R. equiHyperimmune Plasma againstR. equiChallenge in Thoroughbred Arabian Foals of Mares Vaccinated withR. equiVaccine

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Osman Erganis ◽  
Zafer Sayin ◽  
Hasan Huseyin Hadimli ◽  
Asli Sakmanoglu ◽  
Yasemin Pinarkara ◽  
...  
Keyword(s):  
Vaccine Candidate ◽  
Complete Blood Count ◽  
Protein A ◽  
Clinical Signs ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Interleukin 4 ◽  
Passive Immunity ◽  
Serological Response ◽  
Blood Gas

This study aimed to determine the effectiveness of a pregnant mare immunization of aRhodococcus equi(R. equi) vaccine candidate containing a water-based nanoparticle mineral oil adjuvanted (Montanide IMS 3012) inactive bacterin and virulence-associated protein A (VapA), as well as the administration of anti-R. equihyperimmune (HI) plasma againstR. equichallenge in the mares’ foals. The efficacy of passive immunizations (colostral passive immunity by mare vaccination and artificial passive immunity by HI plasma administration) was evaluated based on clinical signs, complete blood count, blood gas analysis, serological response (ELISA), interleukin-4 (IL-4) and interferon gamma (IFN-γ), total cell count of the bronchoalveolar lavage fluids (BALF) samples, reisolation rate ofR. equifrom BALF samples (CFU/mL), lung samples (CFU/gr), and lesion scores of the organs and tissue according to pathological findings after necropsy in the foals. The vaccination of pregnant mares and HI plasma administration in the foals reduced the severity ofR. equipneumonia and lesion scores of the organs and tissue by 3.54-fold compared to the control foals. This study thus indicates that immunization of pregnant mares withR. equivaccine candidate and administration of HI plasma in mares’ foals effectively protect foals againstR. equichallenge.

scholarly journals Case Report: Hepatopulmonary syndrome as the first clinical manifestation of cirrhosis in a patient with underlying chronic lung disease

F1000Research ◽  
2019 ◽  
Vol 7 ◽  
pp. 1175 ◽  
Author(s):  
Charles Murphy ◽  
Danit Arad
Keyword(s):  
Lung Diseases ◽  
Hepatopulmonary Syndrome ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Rare Presentation ◽  
Obstructive Pulmonary Disease ◽  
Arterial Blood Gas ◽  
Chronic Lung Diseases ◽  
Arterial Blood

An 86 year old woman with multiple chronic lung diseases (including chronic obstructive pulmonary disease, bronchiectasis, and untreated mycobacterium avium-intracellulare) presented with two weeks of increased shortness of breath, notably worse when seated as compared to when lying down. After treatments focused on her known conditions did not resolve her dyspnea, the differential diagnosis was broadened and she was found to have evidence of cirrhosis on imaging. As a result of this new diagnosis, transthoracic echocardiography and arterial blood gas analysis were performed and together yielded the diagnosis of hepatopulmonary syndrome. We describe a rare presentation of hepatopulmonary syndrome manifesting as a patient’s first clinical evidence of suspected cirrhosis, a diagnosis made difficult by this patient’s numerous other lung diseases which muddied the picture.

scholarly journals Pulmonary Manifestations and Management of COVID-19 Pediatric Patients Admitted in a Tertiary Government Hospital

2021 ◽  
Vol 55 (2) ◽  
Author(s):  
Wright H. Alborote ◽  
Maria Cristina Lozada ◽  
Kevin Bautista
Keyword(s):  
Pediatric Patients ◽  
Ventilatory Support ◽  
Blood Gas Analysis ◽  
Signs And Symptoms ◽  
The Philippines ◽  
Gas Analysis ◽  
Factors Affecting ◽  
Radiologic Findings ◽  
Pulmonary Manifestations ◽  
Respiratory Signs And Symptoms

Background. Coronavirus Disease 2019 (COVID-19) presents with respiratory signs and symptoms in children. Presently, there are no local studies on the pulmonary manifestations and management of COVID-19 among children. Objective. Our study aimed to identify and describe the presenting respiratory signs and symptoms, oxygenation status, radiologic findings, blood gas analysis, and pulmonary interventions among children admitted for COVID-19. We also analyzed the clinical and radiologic variables associated with mortality. Methodology. This is a retrospective study using data obtained from a review of medical records from April 1, 2020, to June 30, 2020, at a tertiary government institution in the Philippines. All pediatric patients (0-18 years) hospitalized for probable or confirmed COVID-19 during the said time period were included in this study. Univariate and multivariate logistic regression was applied to determine factors affecting mortality. Results. A total of 25 pediatric patients with a mean age of 7 years old (age range: 11 days to 18 years) were admitted for COVID-19. Cough (44%) and dyspnea (24%) were the most common presenting respiratory symptoms, while tachypnea (68%), crackles (36%), and peripheral oxygen desaturation (36%) were the most common respiratory signs. Indeterminate findings for COVID-19 such as multifocal or diffuse ground-glass opacities and/or consolidations were the most common radiographic abnormalities. Invasive ventilatory support was administered to 6 cases of severe COVID-19 and 4 critical cases. There were no variables that correlated significantly with mortality. Conclusion. Respiratory signs and symptoms were prominent in our cohort of children admitted due to COVID-19. Mechanical ventilation was required in more severe cases. Larger prospective studies may help identify variables that significantly correlate with poor outcomes among children with COVID-19.

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