Archive for the ‘Respiratory Failure’ Category

Following air embolism, nonhydrostatic pulmonary edema may develop rapidly, as was observed in this case. The radiographic finding of an air-fluid level within the central pulmonary arteries is quite rare, but has been reported recently in a similar case. Physiologic changes associated with air embolism typically include increased pulmonary artery pressure and pulmonary vascular resistance, normal left atrial pressure, and arterial hypoxemia. Hypotension and cardiovascular collapse may be fatal. Paradoxic systemic embolization may also occur by passage of air through a patent foramen ovale, or across the pulmonary capillaries. (more…)

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  • Mediastinal Air-Fluid Level and Respiratory Failure

    Feb 3, 2015 Author: Walter Mcneil | Filed under: Respiratory Failure

    Mediastinal Air-Fluid Level and Respiratory FailureAn 80-year-old woman was evaluated in the emergency room for a two-day history of passing blood in the stool. She had a history of sigmoid resection for an adenocarcinoma two years previously. A peripheral intravenous line and a left subclavian catheter were placed, and she was taken to the radiology department for a chest film (Fig 1). While sitting for the roentgenogram, she suddenly became hypotensive and unresponsive. She responded quickly to assisted ventilation with oxygen via an anesthesia bag, and was transferred to the intensive care unit. An electrocardiogram showed sinus tachycardia with atrial premature complexes and right bundle branch block. Arterial blood gas levels with the patient breathing oxygen at 4 L/min by nasal cannula showed: Pa02, 66 mm Hg; PaC02, 42 mm Hg; and pH, 7.40. (more…)

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