RESUMO
Oxygen toxicity was studied in 26 canine isolated, perfused lung lobes which included nine control lobes, 13 lungs ventilated with FIO2 1.0 for 4 hours, and four lobes ventilated with FIN2 1.0 for 1 hour prior to 4 hours of FIO2 1.0 to evaluate the postulated protective effect of anoxia. A significant increase in wet weight was seen in the O2 ventilated lungs which did not alter pulmonary capillary isogravimetric pressure (PCI), alveolar-arterial oxygen gradient, or pulmonary vascular resistance. In contrast, preliminary N2 ventilation resulted in a significant increase in PCI and greater weight gain while pulmonary vascular resistance was reduced. Pulmonary compliance was reduced minimally in all groups. Anoxic ventilation not only failed to protect the isolated canine lung from presumed increased capillary permeability of oxygen toxicity, but seemed to contribute to the formation of interstitial pulmonary edema.
Assuntos
Pulmão/efeitos dos fármacos , Oxigênio/toxicidade , Animais , Permeabilidade Capilar/efeitos dos fármacos , Cães , Oxigênio/administração & dosagem , Perfusão , Edema Pulmonar/induzido quimicamente , Resistência Vascular/efeitos dos fármacosAssuntos
Embolia Pulmonar/cirurgia , Veia Cava Inferior/cirurgia , Adolescente , Adulto , Idoso , Gasometria , Cateterismo/instrumentação , Equipamentos e Provisões , Feminino , Hemodinâmica , Humanos , Hipertensão Pulmonar/complicações , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Embolia Pulmonar/complicações , Embolia Pulmonar/diagnóstico por imagem , Radiografia , Cintilografia , Choque/complicações , Veia Cava Inferior/diagnóstico por imagemRESUMO
A rapid and safe method for the placement of No 7 French flow-directed thermodilution catheters via an infraclavicular subclavian approach is described.
Assuntos
Cateterismo Cardíaco/métodos , Veia Subclávia , Cateterismo Cardíaco/instrumentação , Cuidados Críticos , Estudos de Avaliação como Assunto , Humanos , Modelos Biológicos , Termodiluição/instrumentação , Termodiluição/métodosRESUMO
Over a four year period in two institutions, 85 Kim-Ray Greenfield vena caval filters were inserted in 76 patients who have been followed for a minimum of 6 to 53 months. The most frequent indication for placement was pulmonary embolism during anticoagulant therapy. Both femoral and jugular routes were used for transvenous insertion, and fewer complications were associated with the jugular approach. Surgical mortality within two weeks of operation occurred in three patients (4%), none from recurrent embolism. Late complications included recurrent thrombophlebitis in 7% and persistent extremity edema in 12% of patients. Two patients developed recurrent embolism (2.6%) which also was seen in 2 patients after clips were placed on the vena cava above the filter after misplacement. Venacavagrams in 31 patients an average of 11 months postoperative showed patency in 30 (97%) and lysis of trapped thrombi in four patients. No episodes of migration have occurred and the filter offers the advantages of sustained patency and effective filtration without vena caval occlusion.
