Positive end-expiratory pressure (PEEP) is effective in improving arterial oxygenation and decreasing intrapulmonary shunt in patients with the adult respiratory distress syndrome [9, 121. PEEP can also cause a significant reduction in cardiac output [6, 8, 13, 15]anddecreaseinoxygendelivery[12]. The decrease in cardiac output may be due to impaired venous return [ 1, 7, 141, pulmonary vascular...

Hepatopulmonary syndrome is a serious complication of liver disease. Type I hepatopulmonary syndrome is associated with diffuse dilatation of the pulmonary vasculature, leading to severe hypoxemia. Liver transplantation is the treatment of choice for this condition. There are limited options for those who are not candidates for liver transplantation. We present the case of a patient who present...

Methods Intrapulmonary shunt was evaluated at the end of 6 hours anaesthesia in 6 horses. EIT measurements were performed before anaesthesia (BL) and hourly 1 to 6 hours after recovery from anaesthesia. Seven regions of interest (ROI) were defined within the EIT lung region. Times for each specified ROI to reach 50% of maximum inspiratory impedance change (tfilling) and to remain above 50% (tin...

Single or multiple large bronchial collateral arteries may provide all or some of the pulmonary arterial blood flow in patients with proximal atresia of the pulmonary artery, and even in patients with only pulmonary stenosis. At the time of corrective surgery such arteries must be ligated in order to provide favorable operating conditions, to avoid cardiac overdistention during repair, and to p...

Single or multiple large bronchial collateral arteries may provide all or some of the pulmonary arterial blood flow in patients with proximal atresia of the pulmonary artery, and even in patients with only pulmonary stenosis. At the time of corrective surgery such arteries must be ligated in order to provide favorable operating conditions, to avoid cardiac overdistention during repair, and to p...

Air embolism following central venous catheter (CVC) removal is a relatively uncommon complication. Despite its rare occurrence, an air embolism can lead to serious outcomes. One of the most fatal complications is cerebral air embolism. We report a case of cerebral air embolism that occurred after the removal of a CVC in a patient with an underlying idiopathic pulmonary fibrosis, subcutaneous e...

One of the highlights of the intensive care unit when I was a resident was the opportunity to place a pulmonary artery catheter and then spend the rest of the day calculating parameters such as oxygen delivery, oxygen consumption, intrapulmonary shunt fraction, and so on. I have noticed in the past few years that the use of these devices in our unit is much less frequent. In our case I am not a...

The first part of this review deals with the basic mechanisms and factors determining hypoxaemia and hypercapnia and the different approaches used in clinical practice and in clinical research to assess the presence of ventilation-perfusion mismatching, shunt and diffusion limitation for oxygen, and more specifically the multiple inert gas elimination technique (MIGET), in pulmonary medicine. T...

Background: The effect of intravenously administered dexmedetomidine on oxygenation during one-lung ventilation has not been studied. The hypothesis of this prospective, randomized study was that dexmedetomidine would be associated with an improvement in oxygenation during onelung ventilation. The secondary outcome was the change in the intrapulmonary shunt. Materials and Methods: Thirty patien...

BACKGROUND Hepatopulmonary syndrome (HPS) is a rare complication of liver diseases of different etiologies and may indicate a poor prognosis. Therefore, a simple non-invasive screening method to detect HPS would be highly desirable. In this study pulse oximetry was evaluated to identify patients with HPS. METHODS In 316 consecutive patients with liver cirrhosis (n = 245), chronic hepatitis (n...