pulmonary embolism/hypoxia

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Postoperative hypoxemia from clinically suspected pulmonary embolism complicated by patent foramen ovale.

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Postoperative hypoxemia can be a challenging diagnostic and management dilemma for the clinician. We present here a case of postoperative hypoxemia following laparoscopic gastric bypass surgery secondary to presumed pulmonary embolism complicated with a patent foramen ovale. The diagnostic pitfalls

Endothelin receptor blockade does not improve hypoxemia following acute pulmonary thromboembolism.

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We studied the roles of endothelins in determining ventilation (Va) and perfusion (Q) mismatch in a porcine model of acute pulmonary thromboembolism (APTE), using a nonspecific endothelin antagonist, tezosentan. Nine anesthetized piglets (approximately 23 kg) received autologous clots (approximately

Atrial septal aneurysm plus a patent foramen ovale. A predisposing factor for paradoxical embolism and refractory hypoxemia during pulmonary embolism.

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We report three consecutive cases of patients who had refractory hypoxemia and paradoxical embolism during the course of pulmonary embolism. Transesophageal echocardiography showed an atrial septal aneurysm and a patent foramen ovale in all patients. The latter was detected by an early and massive

Hypoxia as an independent predictor of adverse outcomes in pulmonary embolism.

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Background The purpose of this study was to investigate the correlation between the computed tomography pulmonary artery obstruction index and parameters of functional lung impairment in acute pulmonary embolism, and establish the value of these parameters in prognosticating right ventricular

Overdiagnosis of pulmonary embolism: evaluation of a hypoxia algorithm designed to avoid this catastrophic problem.

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BACKGROUND We observed a substantial increase in the incidence of pulmonary embolism (PE) after total joint arthroplasty (TJA) when multidetector computerized tomography (MDCT) replaced ventilation-perfusion (V/Q) scans as the diagnostic modality of choice. We questioned whether this resulted from

Refractory Hypoxemia in a Patient with Submassive Pulmonary Embolism and an Intracardiac Shunt: A Case Report and Review of the Literature.

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Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. A 46-year-old man experienced acute hypoxemic respiratory

Intractable intraoperative hypoxemia secondary to pulmonary embolism in the presence of undiagnosed patent foramen ovale.

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The management of a patient with hip fracture during general anesthesia, who developed severe intractable hypoxemia caused by intraoperative pulmonary embolism in the presence of undiagnosed patent foramen ovale, is described. The role of urgent intraoperative transesophageal echocardiography in

Delayed intracardial shunting and hypoxemia after massive pulmonary embolism in a patient with a biventricular assist device.

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We describe the interdisciplinary management of a 34-year-old woman with dilated cardiomyopathy three months postpartum on a cardiac biventricular assist device (BVAD) as bridge to heart transplantation with delayed onset of intracardial shunting and subsequent hypoxemia due to massive pulmonary

Impact of altitude-adjusted hypoxia on the Pulmonary Embolism Rule-out Criteria.

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BACKGROUND The Pulmonary Embolism Rule-out Criteria (PERC) defines hypoxia as an oxygen saturation (O2 sat) < 95%. Utilizing this threshold for hypoxia at a significant elevation above sea level may lead to an inflated number of PERC-positive patients and unnecessary testing. The aim of this study

[Hypoxemia in pulmonary embolism--the occurrence, patomechanism and significance].

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Blood gas analysis is often performed in the initial diagnosis of acute pulmonary embolism (APE), and it is recognized that hypoxemia (H) strengthen its suspicion. However, the diagnostic power of hypoxemia is very week. Hypoxemia, usually deep, occurs in almost all patients with massive APE whereas

Hypoxemia in acute pulmonary embolism.

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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

[Pulmonary embolism in patients with chronic hypoxemia].

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BACKGROUND The aim of this prospective, originally designed, clinical--diagnostic study including 200 chronic hypoxemic patients was to assess the possibility of implementation of noninvasive diagnostic strategy and to investigate the incidence of pulmonary embolism and parameters of diagnostic

Hemodynamic factors influencing arterial hypoxemia in massive pulmonary embolism with circulatory failure.

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Arterial hypoxemia is a common finding in acute pulmonary embolism, and its severity is generally assumed to be proportional to the extent of pulmonary artery obstruction. We studied blood gases (during room air breathing and 100% oxygen breathing) and hemodynamic data is seven patients with massive

Persistent hypoxia after diagnosis and treatment of pulmonary thromboembolism.

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Acute respiratory failure in the perioperative period represents a frequent challenge to the anesthesiologist. The differential diagnosis is extensive and includes alterations on the pulmonary parenchyma, pulmonary vessels, airway, and cardiac system. Occasionally, two or more pathophysiological

Worsening Hypoxemia in the Face of Increasing PEEP: A Case of Large Pulmonary Embolism in the Setting of Intracardiac Shunt.

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BACKGROUND Patent foramen ovale (PFO) are common, normally resulting in a left-to-right shunt or no net shunting. Pulmonary embolism (PE) can cause sustained increased pulmonary vascular resistance (PVR) and right atrial pressure. Increasing positive end-expiratory pressure (PEEP) improves

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