Lung
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The pulmonary artery catheter (PAC) may be helpful in determining the etiology of shock, lactic acidosis, pulmonary edema, oliguric renal failure, pulmonary hypertension, and a number of cardiac abnormalities. In addition, it may also be useful in guiding fluid and vasoactive therapy. However, although hemodynamic data from the pulmonary artery catheter (PAC) is widely used diagnostically and therapeutically in the care of critically ill patients, the use of the catheter has not been shown to provide outcomes benefit. ⋯ Presently, there are a number of ongoing randomized, controlled trials investigating the use of the PAC in specific clinical situations and/or patient populations as well as using specific treatment strategies. In the meantime, if any benefit is to be achieved, it is imperative that clinicians have a thorough understanding of the indications, contraindications, complications, and pitfalls of data interpretation prior to using the catheter. These are reviewed in this article.
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Chlorine is a widely used industrial chemical. Individuals can be exposed to chlorine through transportation accidents, industrial exposures or misuse of domestic cleaners. ⋯ Residual effects of chlorine exposure are a function of intensity of exposure, minute ventilation during exposure, and host characteristics such as cigarette smoking and atopy. This monograph will summarize uses of chlorine, the potential for accidents, the mechanism of chlorine toxicity in the lung, and review acute and chronic effects of chlorine exposure on the lung, as well as systemic effects of massive chlorine exposure.