Broncho-alveolar lavage in the severe toxic pulmonary edema caused by irritative gas / 中国基层医药

Objective To discuss the feasibility and curative effect of broncho-alveolar lavage(BAL)through bronchofiberscope in the treatment of severe toxic pulmonary edema caused by irritative gas.Methods 16 cases se- vere toxic pulmonary edema caused by irritative gas were performed BAL through bronchofiberseope.The index of oxygen in arterial blood,clinical and radiological changes before,during and 2 hours after BAL were observed.Results 2 hours after BAL through bronchofiberscope,the partial pressure of oxygen in arterial blood(PaO2)obviously in- creased,the partial pressure of carbon dioxide in arterial blood(PaCO_2)did not change much.PaO_2 and PaCO_2 had no obvious change before and during BAL.The shadow area in the X-ray film of chest obviously decreased 24 hours af- ter BAL.In all 16 cases,13 cases were cured,1 case got improvement,and 2 cases died.The curative rate was 81%. Conclusion BAL through bronchofiberscope could clear the noxious substance in airway and improve the ventilation function.It was safe and had confirmed curative effect.

Study of the curative effect of modified tracheal in acute respiratory failure caused by central airway stenosis / 中华全科医师杂志

Objective To investigate the curative effect of modified tracheal catheter in acute respiratory failure caused by central airway stenosis.Methods 16 cases inpatient with acute respiratory failure caused by central airway stenosis were involved.Found out the position and range of stenosis of central airway by X-ray and CT of chest and fiberbronchoscope,chose the suitable silicon suction tube and cut it to make a tracheal catheter,then guided the catheter through the stenosis by fiberbronchoscope to construct artificial airway.Results The dyspnea of all 16 cases of acute respiratory failure caused by central airway stenosis could by relieved in short time,the PaO_2 raised from(39?12)mm Hg to(72?10)mm Hg,SaO_2 raised from(75?13)% to(93?3)%,PaCO_2 dropped from(102?21)mm Hg to(62?13)mm Hg after therapy.The effective rate is 100%.There was no other serious complication except for 2 cases of little amount of bleeding in trachea.15 cases survived and one died of serious muhisystem organ failure.Conclusions The use of modified tracheal catheter in treatment of acute respiratory failure caused by central airway stenosis can relieve the acute dyspnea in short time,it also can dilate central airway,save the cost of tracheal balloon dilatation for the follow-up therapy.