Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 5 de 5
Filtrar
Mais filtros








Base de dados
Intervalo de ano de publicação
1.
BMJ Case Rep ; 20092009.
Artigo em Inglês | MEDLINE | ID: mdl-21734915

RESUMO

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was sent into a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise largely recovered. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. At 4 months after the accident, she developed a psychological reaction consisting of nightmares, with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning strike were retrospectively retraced.

2.
J Neurol Neurosurg Psychiatry ; 78(4): 423-6, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17369595

RESUMO

The case of a 23-year-old mountaineer who was hit by a lightning strike to the occiput causing a large central visual field defect and bilateral tympanic membrane ruptures is described. Owing to extreme agitation, the patient was set to a drug-induced coma for 3 days. After extubation, she experienced simple and complex visual hallucinations for several days, but otherwise recovered largely. Neuropsychological tests revealed deficits in fast visual detection tasks and non-verbal learning, and indicated a right temporal lobe dysfunction, consistent with a right temporal focus on electroencephalography. Four months after the accident, she developed a psychological reaction consisting of nightmares with reappearance of the complex visual hallucinations and a depressive syndrome. Using the European Cooperation for Lightning Detection network, a meteorological system for lightning surveillance, the exact geographical location and nature of the lightning flash were retrospectively retraced.


Assuntos
Alucinações/etiologia , Lesões Provocadas por Raio/complicações , Córtex Visual/lesões , Adulto , Depressão/etiologia , Sonhos , Feminino , Humanos , Deficiências da Aprendizagem/etiologia , Montanhismo , Lobo Temporal/lesões , Fatores de Tempo , Perfuração da Membrana Timpânica/etiologia , Transtornos da Visão/etiologia
3.
Intensive Care Med ; 32(5): 740-9, 2006 May.
Artigo em Inglês | MEDLINE | ID: mdl-16534568

RESUMO

OBJECTIVE: In clinical lung injury areas of inflammation and structural alveolar alteration are unevenly distributed and interspaced between healthy or less injured lung areas. Positive end-expiratory pressure (PEEP) applied with mechanical ventilation (MV) may affect injured and healthy lung areas differently. We compared the effects of PEEP on the inflammatory response in injured and noninjured regions of the lung in an animal model of unilateral lung acid instillation. SUBJECTS: Anesthetized, paralyzed, and ventilated rats. INTERVENTIONS: Rats underwent left-endobronchial instillation with either hydrochloric acid or isotonic saline and were randomized 24 h later to MV using constant tidal volume (16 ml/kg) with either ZEEP, PEEP at 5 mmHg, or PEEP at 10 mmHg. After 4 h of MV the animals (n=9 or 10 per group) were killed and inflammatory markers assessed in left- and right-lung lavage fluid samples. In four additional animals per group differential lung perfusion was assessed. RESULTS: Unilateral acid injury alone worsened oxygenation, decreased left-lung perfusion, and increased left-lung lavage neutrophil and macrophage counts and cytokine levels. MV with ZEEP further impaired oxygenation and further decreased left-lung perfusion in acid-injured animals. MV with high PEEP preserved oxygenation and significantly decreased left-lung lavage protein content and cell counts in acid-injured animals and had no deleterious effect on the right (noninjured) lung. CONCLUSION: In this model of unilateral lung acid injury high PEEP attenuates the inflammatory cell response in the acid-injured lung, preserved oxygenation and has no deleterious effects in the opposite lung.


Assuntos
Ácido Clorídrico/efeitos adversos , Pneumonia/imunologia , Respiração com Pressão Positiva , Respiração Artificial/efeitos adversos , Administração por Inalação , Animais , Citocinas/análise , Ácido Clorídrico/administração & dosagem , Unidades de Terapia Intensiva , Masculino , Pneumonia/diagnóstico , Radiografia , Distribuição Aleatória , Ratos , Ratos Wistar , Síndrome do Desconforto Respiratório/diagnóstico por imagem , Síndrome do Desconforto Respiratório/patologia
4.
Anesth Analg ; 100(2): 335-339, 2005 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15673852

RESUMO

During experimental one-lung ventilation (OLV), the type of anesthesia may alter systemic hemodynamics, lung perfusion, and oxygenation. We studied whether xenon (Xe) or nitrous oxide (N(2)O) added to propofol anesthesia would affect oxygenation, lung perfusion, and systemic and pulmonary hemodynamics during OLV in a pig model. Nine pigs were anesthetized, tracheally intubated, and mechanically ventilated. After placement of arterial and pulmonary artery catheters, a left-sided double-lumen tube was placed via tracheotomy. IV anesthesia with propofol was supplemented in random order with N(2)O/O(2) 60:40 or Xe/O(2) 60:40 or N(2)/O(2) 60:40. All measurements were made after stabilization at each concentration. Differential lung perfusion was measured with colored microspheres. Oxygenation (Pao(2): 90 +/- 17, 95 +/- 20, and 94 +/- 20 mm Hg for N(2)/O(2), N(2)O/O(2), and Xe/O(2)) and left lung perfusion (16% +/- 5%, 14% +/- 6%, and 18.8% for N(2)/O(2), N(2)O/O(2), and Xe/O(2)) during OLV did not differ among the 3 groups. However, mean arterial blood pressure (78 +/- 25, 62 +/- 23, and 66 +/- 23 mm Hg for N(2)/O(2), N(2)O/O(2), and Xe/O(2)) and mixed venous saturation (55% +/- 12%, 48% +/- 12%, and 50% +/- 12% for N(2)/O(2), N(2)O/O(2), and Xe/O(2)) were reduced during N(2)O/O(2) as compared with the control group (N(2)/O(2)). Supplementation of IV anesthesia with Xe or N(2)O does not impair oxygenation nor alter lung perfusion during experimental OLV.


Assuntos
Anestésicos Inalatórios/farmacologia , Óxido Nitroso/farmacologia , Consumo de Oxigênio/efeitos dos fármacos , Circulação Pulmonar/efeitos dos fármacos , Respiração Artificial , Xenônio/farmacologia , Anestésicos Intravenosos , Animais , Dióxido de Carbono/sangue , Hemodinâmica/efeitos dos fármacos , Perfusão , Piperidinas/farmacologia , Propofol/farmacologia , Remifentanil , Testes de Função Respiratória , Mecânica Respiratória/efeitos dos fármacos , Suínos
5.
Resuscitation ; 56(3): 329-33, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-12628564

RESUMO

The application of percutaneous transtracheal jet ventilation for emergency ventilation depends on special equipment which is often not available outside the operating room. The oxygen flow modulator is a new specially designed device for emergency ventilation using a low pressure oxygen supply. We studied the effects of the new device in comparison with a hand triggered emergency jet injector on oxygenation and ventilation in six pigs (21+/-1 kg). The animals were anaesthetized, tracheally intubated, and mechanically ventilated. Following central venous and pulmonary artery catheterization, a Paratrend 7 sensor was placed in the left femoral artery for continuous measurements of PaO(2) and PaCO(2). Then an emergency transtracheal airway catheter was inserted into the trachea after surgical exposure. In randomized order each animal was ventilated via the transtracheal airway catheter with the hand triggered emergency jet injector (inspiratory/expiratory (I/E) ratio of 1:1; respiratory rate of 60 min(-1); driving pressure 1.5 bar; FjetO(2) 1.0) and the oxygen flow modulator (FiO(2) 1.0 at an oxygen flow of 15 l min(-1); respiratory rate of 60 min(-1); I/E ratio of approximately 1:1) for 15 min each. After each phase of the experiment respiratory and hemodynamic variables were measured. Whereas PaO(2) was not significantly different between the two devices, PaCO(2) was higher during the hand-triggered jet ventilation. Thus, the efficacy of the oxygen flow modulator during the experiment was comparable with the efficacy of the hand triggered emergency jet injector.


Assuntos
Ventilação em Jatos de Alta Frequência/instrumentação , Intubação Intratraqueal , Oxigênio/sangue , Animais , Dióxido de Carbono/sangue , Emergências , Hemodinâmica , Respiração Artificial/instrumentação , Suínos , Traqueotomia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA