Severe Edema After Sclerotherapy of Labial Hemangioma With Ethamolin Oleate in a Young Child.

Adverse reactions related to ethanolamine oleate (EO) include pain during injection, redness, inflammation, tissue necrosis, and allergic reaction. The authors report a patient of exuberant facial edema after the injection of EO used in sclerotherapy of lip hemangioma in a child. A 9-year-old boy was referred to authors' oral and maxillofacial surgery unit to treat a vascular lesion of the upper lip. The lesion has causing enlargement of the middle area of the upper lip, being sessile and resilient by palpation. It was decided to employ sclerotherapy aiming to reduce the size for posterior surgical excision of the residual lesion. The day after the injection, the patient presented intense edema limited to the upper lip, complaining of mild pain. Although side effects reported of EO injection are mild and with almost no clinical significance, major complications like anaphylaxis and severe edema can occur, such in the patient here presented.

Efficacy of inhaled nitric oxide in a porcine model of adult respiratory distress syndrome.

OBJECTIVE: To assess the efficacy of inhaled nitric oxide (NO) in reducing pulmonary hypertension in a porcine model of adult respiratory distress syndrome. DESIGN: Nonrandomized, controlled experiment without blinding. SETTING: Surgical research laboratory. PARTICIPANTS: Twelve pigs, matched equally for body weight. INTERVENTION: Acute lung injury was induced by intravenous injection of oleic acid. Animals were then divided into either a control group, for monitoring without any further intervention, or a NO-treatment group, in which NO was administered at concentrations of 10 to 80 ppm, with each step separated by a NO-free interval to assess duration of effect. MAIN OUTCOME MEASURES: Pulmonary artery pressure, systemic blood pressure, PaO2, intrapulmonary shunt fraction, and extravascular lung water. Nitrosylated hemoglobin, arterial methemoglobin, and plasma nitrite and nitrate concentrations. RESULTS: All animals responded to oleic acid injection with rapid development of pulmonary hypertension and deterioration of PaO2 and intrapulmonary shunt fraction. Inhaled NO reversed these changes in a concentration-dependent manner. Cessation of NO administration led to a prompt return of pulmonary hypertension. A small but significant drop in systemic blood pressure was observed only at the highest concentration of NO administered (80 ppm). Extravascular lung water almost doubled following oleic acid injury. This increase was sustained in all animals for the remainder of the experiment. Significant increases in circulating methemoglobin and plasma nitrite and nitrate concentrations were measured during NO inhalation. CONCLUSION: Inhaled NO appears to be a selective pulmonary vasodilator and may prove to be useful in improving gas exchange in adult respiratory distress syndrome.

Utilidad de la presión parcial de oxígeno en la sangre de la aurícula derecha en el cálculo del cortocircuito intrapulmonar / Usefulness of partial pressure of oxygen in right atrial blood in the calculation of the intrapulmonary shunt

Se valoró la utilidad de las muestras de sangre de la Aurícula Derecha (AD) en el cálculo del corto circuito intrapulmonar (Qs/Qt). Se estudiaron 6 perros mestizos con pesos corporales entre 15 y 23 kg. (media de 19 kg.) a los que se anestesió y ventiló artificialmente. Se les tomaron muestras simultáneas de sangre de la arteria sistémica, de la Arteria Pulmonar (AP) y de la AD, antes y despupes de provocarles edema pulmonar mediante la infusión de una dosis de ácido oléico por la vía intravenosa, así como tambiém después de provocalres modificaciones del gasto cardiaco por medios tanto mecánicos como farmacológicos. Además de la correlación del Qs/Qt, se hicieron las correlaciones para la saturación de oxígeno de la hemoglobina (Sat%) y para la presión parcial de oxígeno (RvO2) entre las muestras de sangre de la AP y de la AD. Se obtuvieron las siguientes correlaciones: para el Qs/Qt r= 0.039 (p<0.001); para la Sat % r =0.870 (p>0.001); y para la PvO2 = 0.910 (p<0.001). La adecuada correlación de estos parámetros se matuvo independientemente del nivel del gasto cardiaco. Se concluye que la sangre obtenida de la AD es útil para la cálculo del Qs/Qt