Chest
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Comparative Study
Cardiorespiratory effects of pressure controlled ventilation in severe respiratory failure.
Cardiorespiratory values were measured in ten patients with severe respiratory failure on volume controlled and pressure controlled ventilation. Tidal volume, respirator rate, PEEP, auto-PEEP, inspiratory:expiratory ratio (1:2) and FIo2 were maintained at the same value for both ventilatory modalities. ⋯ There were no significant changes in other cardiorespiratory values, such as arterial blood pressure, nor in ventilatory measurements, such as mean airway pressure, associated with the use of PCV. These results suggest that PCV may be a beneficial ventilatory modality in the treatment of severe respiratory failure since it results in improvement in arterial oxygenation, tissue oxygen delivery and utilization without any concomitant adverse effects on other hemodynamic or ventilatory factors.
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Mediastinal and subcutaneous emphysema have been reported as a consequence of deliberate manipulations of the breathing pattern producing a Valsalva-like maneuver in healthy subjects. We present a case of pneumomediastinum, pneumothorax and subcutaneous emphysema occurring in a normal volunteer after repeated measurements of the PEmax.
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A 23-year-old healthy woman in her third trimester of pregnancy developed adult respiratory distress syndrome secondary to Blastomyces dermatitides. Pregnancy-related immunosuppression was believed to be responsible for the fungal infection. ⋯ Although the fetal and maternal sides of the placenta demonstrated fungal spores, the child remained healthy. To our knowledge, this is the first report of blastomycosis-associated adult respiratory distress syndrome occurring during pregnancy.
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Bacteremia is a recognized complication in patients with indwelling central venous catheters. More recently pulmonary embolism in such patients has also been described. Despite abundant clinical experience with these devices, to our knowledge, septic pulmonary embolism has not been reported in adult patients. This case illustrates such a complication.