• Tuberculosis and Respiratory Diseases
• /
• 제74권1호
• /
• pp.15-22
• /
• 2013

Background: Differentiating cardiogenic pulmonary edema from other bilateral lung diseases such as pneumonia is frequently difficult. We conducted a retrospective study to identify predictors for cardiogenic pulmonary edema and non-cardiogenic causes of bilateral lung infiltrates in chest radiographs. Methods: The study included patients who had newly developed bilateral lung infiltrates in chest radiographs and patients who underwent echocardiography. Cases were divided into two groups based on the echocardiographic findings: the cardiogenic pulmonary edema group and the non-cardiogenic group. Clinical characteristics and basic laboratory findings were analyzed to identify predictors for differential diagnosis between cardiogenic and non-cardiogenic causes of bilateral chest infiltrates. Results: We analyzed 110 subjects. Predictors of cardiogenic pulmonary edema were higher brain natriuretic peptide (BNP) levels, lower C-reactive protein (CRP) levels on the day of the event (<7 mg/dL), age over 60 years, history of heart disease, and absence of fever and sputum. CRP on the day of the event was an independent factor to differentiate cardiogenic and non-cardiogenic causes of newly developed bilateral chest infiltrates. Also, the validity was comparable to BNP. Conclusion: Clinical symptoms (sputum and fever), medical history (dyslipidemia and heart disease), and laboratory findings (BNP and CRP) could be helpful in the differential diagnosis of patients with acute bilateral lung infiltrates in chest radiographs.

• 대한수의학회지
• /
• 제62권3호
• /
• pp.22.1-22.4
• /
• 2022

This study reports the efficacy of the vasodilator sodium nitroprusside (SNP), for treatment of acute cardiogenic pulmonary edema in dogs. For this study, the patients were divided into the SNP only treatment group, the SNP, furosemide and dobutamine treatment group, and non-SNP treatment group. Seven dogs, 6 dogs and 2 dogs were favorable responders in SNP only group, group with SNP, furosemide and dobutamine and non-SNP treatment group, each. The results of this study suggest that SNP can be an effective alternative therapy for dogs with acute cardiogenic pulmonary edema.

• 대한임상독성학회지
• /
• 제4권2호
• /
• pp.175-179
• /
• 2006

Welders are exposed to a number of hazards including metal fumes, toxic gases, electricity, heat, noise, and radiation such as ultraviolet and infrared light. We encountered a patient who developed non-cardiogenic pulmonary edema within a day after cutting copper pipe with an oxyethylene torch. The patient was a 26-year-old welder. He complained of dyspnea, generalized myalgia, and febrile sensation the following morning. The patient's chest X-ray and chest CT scan showed extensively distributed and ill-defined centrilobular nodules. Both his symptoms and chest X-ray abnormalities improved spontaneously. We attributed the patient's symptoms to non-cardiogenic pulmonary edema due to nitrogen dioxide, reasoning that: 1) the pipe consisted only of copper, according to material safety data sheet (MSDS); 2) a previous report in the literature demonstrated increased nitrogen dioxide levels under similar conditions; 3) the patient's clinical course and radiologic findings were very reminiscent of non-cardiogenic pulmonary edema following accidental exposure to nitrogen dioxide.

• 대한임상독성학회지
• /
• 제8권2호
• /
• pp.113-121
• /
• 2010

Purpose: Drug-induced non-cardiogenic pulmonary edema has been reported on in a drug case series. For most of the agents that cause pulmonary edema, the pathogenic mechanisms that are responsible for the pulmonary edema remain unknown. We report here on the cases of suspected drug-induced pulmonary edema and we analyze the clinical characteristics. Methods: We reviewed the medical records of 1,345 patients who had drug adverse effects and drug poisoning from January 2005 to July 2010, and 480 of these patients were admitted to the EM Department. Among them, 17 patients developed abnormal chest radiological findings and they were analyzed for any clinical characteristics, the initial symptoms, securing the airway and the clinical results. Results: Seventeen patients out of 480 (3.54%) developed drug-induced abnormal chest radiographic pulmonary edema; they displayed initial symptoms that included mental change (41.2%), dyspnea (17.6%), vomiting (11.8%), etc, and some displayed no symptoms at all (11.8%). Only 3 patients out of the 11 who died or had severe pulmonary edema were able to obtain an advanced airway prior to their arrival to the EM Department. Clinical recovery was generally rapid and this was mostly completed within 6 hours. The mortality rate was 11.8% (2 of 17 patients), and the causative drugs were found to be propofol (35.3%, 6 of 17 patients), multiple drugs (41.2% or 7 out of 17) and one patient each with ephedrine, ethylene glycol, doxylamine and an unknown drug, respectively. Conclusion: Drug-induced pulmonary edema and deaths are not uncommon, and recovery is typically rapid with few long-term sequelae when drug administration is discontinued. Oxygen therapy and securing the airway must be performed during transportation for patients with pulmonary edema.

• Tuberculosis and Respiratory Diseases
• /
• 제87권1호
• /
• pp.1-11
• /
• 2024

Acute respiratory distress syndrome (ARDS) is a common cause of severe hypoxemia defined by the acute onset of bilateral non-cardiogenic pulmonary edema. The diagnosis is made by defined consensus criteria. Supportive care, including prevention of further injury to the lungs, is the only treatment that conclusively improves outcomes. The inability to find more advanced therapies is due, in part, to the highly sensitive but relatively non-specific current syndromic consensus criteria, combining a heterogenous population of patients under the umbrella of ARDS. With few effective therapies, the morality rate remains 30% to 40%. Many subphenotypes of ARDS have been proposed to cluster patients with shared combinations of observable or measurable traits. Subphenotyping patients is a strategy to overcome heterogeneity to advance clinical research and eventually identify treatable traits. Subphenotypes of ARDS have been proposed based on radiographic patterns, protein biomarkers, transcriptomics, and/or machine-based clustering of clinical and biological variables. Some of these strategies have been reproducible across patient cohorts, but at present all have practical limitations to their implementation. Furthermore, there is no agreement on which strategy is the most appropriate. This review will discuss the current strategies for subphenotyping patients with ARDS, including the strengths and limitations, and the future directions of ARDS subphenotyping.

• Tuberculosis and Respiratory Diseases
• /
• 제60권5호
• /
• pp.564-570
• /
• 2006

화상환자에서의 흡입화상은 이환률 및 사망률에 영향을 미치는 중요한 인자이다. 호흡기계의 손상은 침범 부위 및 정도에 따라 매우 다양하게 나타나는데, 기도 손상의 경우 성문하 협착 등의 기도폐색을 일으킬 수 있으며, 폐실질의 손상은 저산소증, 폐렴, 호흡부전 및 급성호흡곤란증후군의 병태생리를 제공하게 된다. 흡입화상의 초기 방사선소견으로는 정상, 경화, 기관지주위 비후, 심인성 및 비심인성 폐부종, 무기폐, 간질성 혹은 폐포성 폐 침윤의 형태로 나타날 수 있다. 후기 변화로는 기관지확장증, 폐쇄 기관지염 및 폐 섬유화 등이 증례 보고된 바 있다. 하지만 성인 흡입화상 환자에서의 공동성 병변에 대해서는 보고 된 바 없다. 저자들은 44세 남자로 얼굴 및 양손에 9%의 경미한 피부 화염화상을 입었으나 흡입화상으로 인한 호흡기 합병증에 대한 치료가 더 중요시 되었던 환자로 치료 과정에서 좌상엽의 공동성 병변을 관찰하게 되었다. 추적 과정에서 이 공동은 계속 변화하는 양상이었으며 한차례 대량 객혈이 있었으나 그 후로는 다른 호흡기계 합병증 없이 저절로 소실해 가는 과정을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한임상독성학회지
• /
• 제4권1호
• /
• pp.44-47
• /
• 2006

Symptoms of aspirin overdose may vary from acid-base disturbance, electrolyte abnormality, non-cardiogenic pulmonary edema, chemical hepatitis, seizure to cardiac toxicity. Cardiac adverse effects from aspirin are uncommon but there are reports of arrhythmia, cardiopulmonary arrest, and myocardial infarction. We report 2 cases of young women with aspirin overdose who exhibited ischemic changes on their ECGs a few hours after the ingestion with spontaneous recovery in a few days. First case, a 29 year old woman, presented to the emergency department 6 hours after ingesting 250 tablets of aspirin (325 mg/T). On examination, the temperature was $36.3^{\circ}C$: blood pressure, 105/72mmHg; Pulse, 111/min and respiratory rate, 24/min. Second case, a 27 year old woman, an hour after ingesting 60 tablets (325mg/T). On examination, the temperature was $36.0^{\circ}C$: blood pressure, 102/72 mmHg; pulse, 89/min and respiratory rate, 25/min. In both cases, ECG after 6 hours of ingestion had sinus tachycardia and developed T wave inversion on the anterior leads in the following ECGs. Their initial serum salicylate levels after 6 hours of ingestion were 71.2 mg/dL and 28.4 mg/dL respectively. These salicylate levels were resolving when these ECGs were observed. The ECG changes resolved in the following days and they were discharged without any further symptoms. Further studies are needed, but for the time being, when dealing with salicylate overdose, transient cardiac depression should be kept in mind to avoid adverse ischemic cardiac events.