RESUMO
The efficacy of streptokinase was studied in an open trial on 30 consecutive patients with major pulmonary embolism, affecting at least three lobar arteries in pulmonary angiography. Streptokinase was started on average 26 hours from the onset of symptoms and usually given directly to the pulmonary artery. Conventional dosage was used and adjusted by thrombin time. The average treatment period was 32 hours. 26 patients (87%) survived and made a good clinical recovery. Improvement occurred early: signs of improved pulmonary perfusion appeared usually within four hours. Repeat angiograms in 20 patients showed remarkable increase in pulmonary perfusion and partial but not complete lysis of the emboli. Four patients (13%) died, three of them because of no response and one due to late cardiac arrhythmia. Bleeding requiring blood transfusion occurred in four patients, but caused no late sequelae. It is concluded that streptokinase treatment of major pulmonary embolism is effective and safe in rapidly restoring pulmonary perfusion.
Assuntos
Embolia Pulmonar/tratamento farmacológico , Estreptoquinase/uso terapêutico , Adulto , Idoso , Pressão Sanguínea/efeitos dos fármacos , Ensaios Clínicos como Assunto , Feminino , Hemorragia/induzido quimicamente , Humanos , Pulmão/irrigação sanguínea , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Embolia Pulmonar/mortalidade , Radiografia , Estreptoquinase/efeitos adversosAssuntos
Medidas de Volume Pulmonar/métodos , Capacidade de Difusão Pulmonar/métodos , Adolescente , Adulto , Monóxido de Carbono/análise , Feminino , Hélio/análise , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia Total/métodos , Valores de Referência , Volume Residual , Espirometria/métodos , Capacidade Pulmonar TotalRESUMO
Reference spirometric values for vital capacity (VC), forced expiratory volume in one second (FEV1), forced vital capacity (FVC), forced expiratory volume in one second as percentage of vital capacity or of forced vital capacity (FEV%), the highest flow during forced inspiration (Vmax insp), the highest forced expiratory flow at 50% vital capacity (Vmax 50%), the highest forced expiratory flow when 75% of vital capacity has been expired (Vmax 25%), Vmax insp/Vmax 50% and peak expiratory flow (PEF) were determined in a series of 296 males and 257 females, 18-65 years old, who have never smoked. Equations were derived using height and age as predictors. The reproducibility was tested.
Assuntos
Testes de Função Respiratória , Adolescente , Adulto , Fatores Etários , Feminino , Fluxo Expiratório Forçado , Volume Expiratório Forçado , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Espirometria , Capacidade VitalRESUMO
Seventy-nine patients suffering from severe bronchial asthma were treated in the intensive care unit (ICU) between 1970 and 1978. This was 0.8% of the total number of asthmatic patients treated in Meilahti hospital during the same period. The major indication for admission to the ICU was severe airway obstruction leading to respiratory failure. In 65% tracheal intubation and mechanical ventilation were needed besides the conventional treatment. In spite of intensive care 9% of the patients died.