The American review of respiratory disease
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Am. Rev. Respir. Dis. · Dec 1975
Comparative StudyValue of capillary blood gas analyses in the management of acute respiratory distress.
A comparative study of blood gases and acid-base parameters, obtained simultaneously from arterial and finger capillary samples, was performed in 45 patients in acute respiratory distress without circulatory shock. Although small and significant differences were found between the 2 sample pH, Po2, Pco2, and bicarbonate values, the correlations between the 2 were greater than or equal to 0.97 for each variable. It was concluded that although the arterial blood is the preferred sample for evaluation of blood gases and acid-base status of patients in acute respiratory distress, capillary blood appears to be a valid substitute in the management of these patients. This technique is particularly valuable in pediatric practice, where repeated arterial samples are less easily obtained.
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In this review, an attempt has been made to select, evaluate, and interpret the pertinent literature relative to general anesthesia and the lung. Concepts of intrapulmonary gas exchange and respiratory system mechanics were synthesized, emphasizing the importance of changes in intrapulmonary gas distribution that are induced by general anesthesia and exploring the possible underlying mechanisms of these changes. ⋯ Numerous questions regarding the effect of anesthesia on the lung remain unanswered. The close relationship between advances in pulmonary physiology and the pulmonary effects of anesthetic actions is increasingly apparent, as is the importance of this knowledge in applying mechanical ventilation and end-expiratory pressure to patients with pulmonary disease.
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Am. Rev. Respir. Dis. · Jun 1975
Case ReportsFatal pulmonary hemorrhage after transbronchial lung biopsy through the fiberoptic bronchoscope.
A case is reported in which transbronchial lung biopsy using the fiberoptic bronchoscope was complicated by massive, fatal hemorrhage. This previously unreported complication occurred despite normal prothrombin and partial thromboplastin times and platelets of 93,000. ⋯ Although severe complications are undoubtedly rare, this report suggests that the transbronchial lung biopsy is not a totally benign procedure. Suggestions are made to prevent future similar occurrences in very ill patients or in patients with coagulative abnormalities or blood dyscrasias.