Archive for May, 2011

Previously, an anomalous inferior venacava with azygos continuation, congenital deficiency of the left pericardium, or dysgenesis of the lung was thought to be quite a rare combination of malformations, but owing to recent devel­opments in diagnostic technique, the number of cases diagnosed during life has increased. The incidence of anomalous inferior vena cava was reported [...]

The bronchogram (Fig 3) was consistent with the findings of bronchoscopy and the tomograms. The left upper lobe bronchus was absent, leaving only a dimple at the usual site of its takeoff. There were two right upper bronchi, one from the trachea and the other from right main bronchus. Cytologic studies of bronchial lavage and [...]

Owing to recent developments in roentgenographic tech­nique, the number of reported cases of congenital anomalies such as anomalous inferior vena cava with azygos continuation, congenital deficiency of left pericardium, or dysgenesis of lung diagnosed individually has increased. Thus, such anomalies are now listed in the differential diagnosis of the abnormal lung shadow. Recently, we ob­served [...]

Other maneuvers during both CV and HFV can be potentially helpful in patients with BPF. Selective intubation and CV of the unaffected lung in patients with a unilateral BPF may be useful but will predispose to the collapse of the nonintubated lung. The use of differential lung ventilation with CV may be of benefit in [...]

High frequency ventilation (HFV) is a generic term applied to several types of ventilation: high frequency positive pressure ventilation, high frequency jet ven­tilation, and high frequency oscillation ventilation. Complete discussion of the general principles of HFV and specific details of different types and applications of HFV have been detailed elsewhere. Despite mechanical differences in the [...]

As with the chest tube, the resistance to flow of gases is an integral consideration in the choice of the drainage system connected with the chest tube in a patient with a BPF. The size of air leak and the flow that the drainage device can accommodate are necessary considerations when choosing the drainage system. [...]

Patients with chest trauma, adult respiratory dis­tress syndrome (ARDS)-related barotrauma, and pa­tients undergoing invasive chest procedures, including thoracotomy and central line placement, are general categories of patients in whom the potential for the development of a BPF exists and who are fre­quently encountered by the critical care specialist. A chest tube placed to manage a [...]

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