Hypoxemia in acute pulmonary embolism.


:Most patients with severe, acute pulmonary embolism (PE) have arterial hypoxemia. To further define the respective roles of ventilation to perfusion (VA/Q) mismatch and intrapulmonary shunt in the mechanism of hypoxemia, we used both right heart catheterization and the six inert gas elimination technique in seven patients with severe, acute PE (mean vascular obstruction, 55 percent) and hypoxemia (mean PaO2, 67 +/- 11 mm Hg). None had previous cardiopulmonary disease, and all were studied within the first ten days of initial symptoms. Increased calculated venous admixture (mean QVA/QT 16.6 +/- 5.1 percent) was present in all patients. The relative contributions of VA/Q mismatching and shunt to this venous admixture varied, however, according to pulmonary radiographic abnormalities and the time elapsed from initial symptoms to the gas exchange study. Although all patients had some degree of VA/Q mismatch, the two patients studied early (ie, less than 48 hours following acute PE) had normal chest x-ray film findings and no significant shunt; VA/Q mismatching accounted for most of the hypoxemia. In the others a shunt (3 to 17 percent of cardiac output) was recorded along with radiographic evidence of atelectasis or infiltrates and accounted for most of the venous admixture in one. In all patients, a low mixed venous oxygen tension (27 +/- 5 mm Hg) additionally contributed to the hypoxemia. Our findings suggest that the initial hypoxemia of acute PE is caused by an altered distribution of ventilation to perfusion. Intrapulmonary shunting contributes significantly to hypoxemia only when atelectasis or another cause of lung volume loss develops.






Huet Y,Lemaire F,Brun-Buisson C,Knaus WA,Teisseire B,Payen D,Mathieu D




Has Abstract


1985-12-01 00:00:00
















  • Azathioprine-associated pulmonary dysfunction.

    abstract::We present a case of azathioprine-associated alveolitis diagnosed by gallium-67 scanning and transbronchial biopsy. The patient denied respiratory symptoms, exhibited spiking fevers, and had normal chest roentgenograms. Allopurinol inhibition of azathioprine metabolism may have been a contributing factor. ...


    pub_type: 杂志文章


    authors: Krowka MJ,Breuer RI,Kehoe TJ

    更新日期:1983-04-01 00:00:00

  • High-frequency modulation of heart rate variability during exercise in patients with COPD.

    abstract:STUDY OBJECTIVES:To evaluate cardiac autonomic modulation in patients with COPD during peak exercise. METHODS:Fifty-three patients with COPD (mean FEV(1), 35% predicted [SD, 11% predicted]; mean PaO(2), 68 mm Hg [SD, 11 mm Hg]; mean PaCO(2), 40 mm Hg [SD, 7 mm Hg]; mean age, 61 years [SD, 10 years]; 26 women and 27 me...


    pub_type: 杂志文章


    authors: Bartels MN,Jelic S,Ngai P,Basner RC,DeMeersman RE

    更新日期:2003-09-01 00:00:00

  • Phospholipid biosynthesis: the activity of phosphatidic acid phosphohydrolase in the developing lung and amnionic fluid.

    abstract::The presented data suggest that PAPase may, indeed, be important in the biosynthesis of lung phospholipids. The observed increase in the specific activity of rabbit lung precedes the "surge" of phosphatidylcholine concentration and surfactant biosynthesis by at least 24 hours. In human amnionic fluid, PAPase specific ...


    pub_type: 杂志文章


    authors: Johnston JM,Schultz M,Jimenez JM,MacDonald PC

    更新日期:1975-02-01 00:00:00

  • Synchronized intermittent mandatory ventilation with and without pressure support ventilation in weaning patients with COPD from mechanical ventilation.

    abstract::This prospective study compared two weaning modalities in COPD patients requiring mechanical ventilation (MV) for acute respiratory failure. Nineteen patients with COPD were studied when their precipitating illness was controlled. Although they satisfied the conventional bedside weaning criteria, they could not tolera...


    pub_type: 临床试验,杂志文章,随机对照试验


    authors: Jounieaux V,Duran A,Levi-Valensi P

    更新日期:1994-04-01 00:00:00

  • Identification of early interstitial lung disease in an individual with genetic variations in ABCA3 and SFTPC.

    abstract::A man with usual interstitial pneumonia (age of onset 58 years) was previously found to have an Ile73Thr (I73T) surfactant protein C (SFTPC) mutation. Genomic DNA from the individual and two daughters (aged 39 and 43 years) was sequenced for the I73T mutation and variations in ATP-binding cassette A3 (ABCA3). All thre...


    pub_type: 杂志文章


    authors: Crossno PF,Polosukhin VV,Blackwell TS,Johnson JE,Markin C,Moore PE,Worrell JA,Stahlman MT,Phillips JA 3rd,Loyd JE,Cogan JD,Lawson WE

    更新日期:2010-04-01 00:00:00

  • Peripheral nerve function in sepsis and multiple organ failure.

    abstract::Forty-three patients who had sepsis and multiple organ failure (critical illness) were studied prospectively to determine the incidence and severity of peripheral nerve function and to correlate such function with a number of variables. Electrophysiologic studies indicated a primary axonal degeneration of motor and se...


    pub_type: 杂志文章


    authors: Witt NJ,Zochodne DW,Bolton CF,Grand'Maison F,Wells G,Young GB,Sibbald WJ

    更新日期:1991-01-01 00:00:00

  • Clinical similarities and differences between human T-cell lymphotropic virus type 1-associated bronchiolitis and diffuse panbronchiolitis.

    abstract:STUDY OBJECTIVES:Human T-cell lymphotropic virus type 1 (HTLV-1)-associated bronchiolitis and diffuse panbronchiolitis might overlap. We examined whether these conditions can be differentiated by comparing their clinical features and the effect of long-term macrolide treatment. PATIENTS AND METHODS:Fifty-eight Japanes...


    pub_type: 杂志文章


    authors: Kadota J,Mukae H,Fujii T,Seki M,Tomono K,Kohno S

    更新日期:2004-04-01 00:00:00

  • Fatal acute congestive heart failure in a patient with idiopathic hemochromatosis and cocaine use.

    abstract::Cardiovascular complications from cocaine use have been recognized in increasing frequency in recent years. We report the case of a young man with a history of intranasal cocaine use presenting with acute congestive heart failure who, on postmortem examination, was found to have idiopathic hemochromatosis. It is specu...


    pub_type: 杂志文章


    authors: Goldenberg SP,Zeldis SM

    更新日期:1987-08-01 00:00:00

  • Use of an Ultrathin vs Thin Bronchoscope for Peripheral Pulmonary Lesions: A Randomized Trial.

    abstract:BACKGROUND:When evaluating peripheral pulmonary lesions, a 3.0-mm ultrathin bronchoscope (UTB) with a 1.7-mm working channel is advantageous regarding good access to the peripheral airway, whereas a 4.0-mm thin bronchoscope provides a larger 2.0-mm working channel, which allows the use of various instruments including ...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Oki M,Saka H,Asano F,Kitagawa C,Kogure Y,Tsuzuku A,Ando M

    更新日期:2019-11-01 00:00:00

  • Contribution of the Mitochondria to Locomotor Muscle Dysfunction in Patients With COPD.

    abstract::COPD is a significant public health challenge, notably set to become the third leading cause of death and fifth leading cause of chronic disability worldwide by the next decade. Skeletal muscle impairment is now recognized as a disabling, extrapulmonary consequence of COPD that is associated with reduced quality of li...


    pub_type: 杂志文章,评审


    authors: Taivassalo T,Hussain SN

    更新日期:2016-05-01 00:00:00

  • Decrease in beta-adrenergic receptors of lymphocytes in spontaneously occurring acute asthma.

    abstract::To clarify changes in beta-adrenergic receptor (BAR) density in spontaneously occurring acute asthma, BAR binding studies were performed on peripheral blood lymphocytes in eight asthmatic and ten normal subjects. Spirometry also was performed. Maximum binding capacity (Bmax) of BAR in acute asthma was significantly lo...


    pub_type: 杂志文章


    authors: Hataoka I,Okayama M,Sugi M,Inoue H,Takishima T,Shirato K

    更新日期:1993-08-01 00:00:00

  • Effect of acute myocardial infarction on cholesterol ratios.

    abstract:OBJECTIVE:In patients with acute myocardial infarctions (MIs), cholesterol levels are no longer valid after 24 h from presentation because acute MI causes a rapid decline in serum levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol. The objective of thi...


    pub_type: 杂志文章


    authors: Wattanasuwan N,Khan IA,Gowda RM,Vasavada BC,Sacchi TJ

    更新日期:2001-10-01 00:00:00

  • Humidifier lung. An outbreak in office workers.

    abstract::Symptoms consistent with hypersensitivity pneumonitis (HP) occurred in 26 of 50 employees working in a localized area of a large factory. This area was served by a single heating-cooling unit utilizing a water humidification system. The illness consisted of flu-like symptoms with fever, chills, headache, cough, dyspne...


    pub_type: 杂志文章


    authors: Ganier M,Lieberman P,Fink J,Lockwood DG

    更新日期:1980-02-01 00:00:00

  • Respiratory Disease and Lower Pulmonary Function as Risk Factors for Dementia: A Systematic Review With Meta-analysis.

    abstract:BACKGROUND:In addition to affecting the oxygen supply to the brain, pulmonary function is a marker of multiple insults throughout life (including smoking, illness, and socioeconomic deprivation). In this meta-analysis of existing longitudinal studies, the hypothesis that lower pulmonary function and respiratory illness...


    pub_type: 杂志文章


    authors: Russ TC,Kivimäki M,Batty GD

    更新日期:2020-06-01 00:00:00

  • The endocrinometabolic effects of beclomethasone dipropionate in asthmatic patients.

    abstract::The endocrinometabolic effects of the aerosol administration of beclomethasone dipropionate (100 microng four times daily) were evaluated in 20 asthmatic patients (11 corticodependent and nine noncorticodependent) during one month. In the noncorticodependent group, aerosol administration of beclomethasone had no stati...


    pub_type: 杂志文章


    authors: Yernault JC,Leclercq R,Schandevyl W,Virasoro E,De Coster A,Copinschi G

    更新日期:1977-06-01 00:00:00

  • Trends in physician-diagnosed asthma prevalence in Manitoba between 1980 and 1990.

    abstract::We attempted to assess recent changes in the prevalence of physician-diagnosed asthma and the possible influence of diagnostic exchange on these trends. The routinely collected data of the provincial Health Insurance Plan (physicians' claims) were used to determine the annual prevalence of physician-diagnosed asthma i...


    pub_type: 杂志文章


    authors: Manfreda J,Becker AB,Wang PZ,Roos LL,Anthonisen NR

    更新日期:1993-01-01 00:00:00

  • Linezolid vs vancomycin: analysis of two double-blind studies of patients with methicillin-resistant Staphylococcus aureus nosocomial pneumonia.

    abstract:OBJECTIVE:To assess the effect of baseline variables, including treatment, on outcome in patients with nosocomial pneumonia due to methicillin-resistant Staphylococcus aureus (MRSA). DESIGN:Retrospective analysis of data from two prospective, randomized, double-blind studies. SETTING:Multinational study with 134 site...


    pub_type: 杂志文章


    authors: Wunderink RG,Rello J,Cammarata SK,Croos-Dabrera RV,Kollef MH

    更新日期:2003-11-01 00:00:00

  • Pulmonary infiltrates in leukemia.

    abstract::We reviewed the inpatient records of 139 adult patients with leukemia to determine the incidence of opportunistic infections in immunocompromised patients and the pattern of roentgenographic involvement of such infections. There were 98 parenchymal infiltrates identified, including 43 episodes of local disease and 55 ...


    pub_type: 杂志文章


    authors: Tenholder MF,Hooper RG

    更新日期:1980-09-01 00:00:00

  • Palliative Care in Advanced Lung Disease: The Challenge of Integrating Palliation Into Everyday Care.

    abstract::The tendency toward "either/or" thinking (either cure or comfort) in traditional biomedical care paradigms does little to optimize care in advancing chronic illness. Calls for improved palliation in chronic lung disease mandate a review of related care gaps and current clinical practices. Although specialist palliativ...


    pub_type: 杂志文章


    authors: Rocker GM,Simpson AC,Horton R

    更新日期:2015-09-01 00:00:00

  • Modafinil as adjunct therapy for daytime sleepiness in obstructive sleep apnea: a 12-week, open-label study.

    abstract:STUDY OBJECTIVES:The purpose of this 12-week study was to evaluate the efficacy and safety of adjunct modafinil to treat excessive sleepiness in patients with obstructive sleep apnea (OSA) who experience residual sleepiness despite regular nasal continuous positive airway pressure (nCPAP) use. DESIGN:Twelve-week, open...


    pub_type: 临床试验,杂志文章,多中心研究


    authors: Schwartz JR,Hirshkowitz M,Erman MK,Schmidt-Nowara W

    更新日期:2003-12-01 00:00:00

  • Miliary PCP in AIDS.

    abstract::The most frequent radiographic presentation of (PCP) is bilateral interstitial or alveolar infiltrates. Atypical features include lobar distribution, pleural effusions, hilar adenopathy, cyst formation and spontaneous pneumothorax. A diffuse miliary pattern has not been described previously for PCP. A 30-year-old male...


    pub_type: 杂志文章


    authors: Wasser LS,Brown E,Talavera W

    更新日期:1989-09-01 00:00:00

  • Successful balloon aortic valvuloplasty in a patient with mitral valve endocarditis.

    abstract::A critically-ill 73-year-old man was admitted with simultaneous mitral valve endocarditis and aortic stenosis. Balloon aortic valvuloplasty was performed successfully and without complications and was followed by prompt clinical improvement. Balloon aortic valvuloplasty should be considered in patients with aortic ste...


    pub_type: 杂志文章


    authors: Burket MW

    更新日期:1991-06-01 00:00:00

  • The effect of a computerized reminder system on the prevention of postoperative venous thromboembolism.

    abstract:STUDY OBJECTIVE:To measure the effect of an altered process of care, directed by a computerized reminder system, on rates of symptomatic postoperative venous thromboembolism. DESIGN:Comparisons of preintervention and postintervention measurements. SETTING:A university-affiliated community hospital in Utah. PATIENTS:...


    pub_type: 临床试验,杂志文章


    authors: Mosen D,Elliott CG,Egger MJ,Mundorff M,Hopkins J,Patterson R,Gardner RM

    更新日期:2004-05-01 00:00:00

  • Preoperative pulmonary function and complications after cardiovascular surgery.

    abstract::Results of preoperative pulmonary function tests were evaluated in 106 patients who had major thoracic or upper abdominal cardiovascular surgery. These results were related to the occurrence of postoperative complications by comparison of pulmonary function data in patients with an ICU stay of less than 5 days versus ...


    pub_type: 杂志文章


    authors: Cain HD,Stevens PM,Adaniya R

    更新日期:1979-08-01 00:00:00

  • Inhalation provocation tests in chronic bird fancier's lung.

    abstract:BACKGROUND:Patients with chronic bird fancier's lung (BFL) can be classified into two types. One group of patients develops chronic disease with fluctuating acute episodes, including low-grade fever, mild exertional dyspnea, and cough (fluctuating chronic BFL; formerly termed recurrent and relapsing chronic BFL). The o...


    pub_type: 杂志文章


    authors: Ohtani Y,Kojima K,Sumi Y,Sawada M,Inase N,Miyake S,Yoshizawa Y

    更新日期:2000-11-01 00:00:00

  • Bosentan therapy for inoperable chronic thromboembolic pulmonary hypertension.

    abstract:BACKGROUND:Bosentan, an oral endothelin (ET)-A/ET-B receptor antagonist, is effective in the treatment of pulmonary arterial hypertension. OBJECTIVE:To investigate the safety and efficacy of bosentan therapy in patients with inoperable chronic thromboembolic pulmonary hypertension (CTEPH). DESIGN:Case series. SETTIN...


    pub_type: 临床试验,杂志文章


    authors: Bonderman D,Nowotny R,Skoro-Sajer N,Jakowitsch J,Adlbrecht C,Klepetko W,Lang IM

    更新日期:2005-10-01 00:00:00

  • Complementary therapies and integrative medicine in lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines.

    abstract:BACKGROUND:Physicians are often asked about complementary therapies by patients with cancer, and data show that the interest in and use of these therapies among patients with cancer is common. Therefore, it is important to assess the current evidence base on the benefits and risks of complementary therapies (modalities...


    pub_type: 杂志文章,实务指引


    authors: Deng GE,Rausch SM,Jones LW,Gulati A,Kumar NB,Greenlee H,Pietanza MC,Cassileth BR

    更新日期:2013-05-01 00:00:00

  • Primary coronary artery dissection.

    abstract::Three patients had angiographic appearance of chronic primary coronary artery dissection with features that differed from other patients with this entity studied at autopsy; they were men, greater than or equal to 40 years of age, had angina pectoris and severe coronary artery disease. The right coronary artery, which...


    pub_type: 杂志文章


    authors: Iskandrian AS,Bemis CE,Kimbiris D,Mintz GS,Hakki AH

    更新日期:1985-02-01 00:00:00

  • Unruptured congenital aneurysm of the left sinus of Valsalva presenting as acute right ventricular failure.

    abstract::A patient with unruptured congenital aneurysm of the left coronary sinus of Valsalva presented with acute right-sided heart failure due to right ventricular outflow tract obstruction. The mechanism for such an acute presentation may have been a sudden increase in the size of the aneurysm. The surgical importance of th...


    pub_type: 杂志文章


    authors: D'Silva SA,Dalvi BV,Lokhandwala YY,Kale PA,Tendolkar AG

    更新日期:1992-02-01 00:00:00

  • Pulmonary venous infarction secondary to squamous cell carcinoma.

    abstract::This type of pulmonary venous infarction has not been previously reported, namely: pulmonary vein obstruction from squamous cell carcinoma. Furthermore, this case is unique in that the characteristic pathologic vascular changes observed with pulmonary venous infarction were contrasted with a noninfarcted upper lobe th...


    pub_type: 杂志文章


    authors: Williamson WA,Tronic BS,Levitan N,Webb-Johnson DC,Shahian DM,Ellis FH Jr

    更新日期:1992-09-01 00:00:00