By A. F. Junod (auth.), Dr. J. L. Vincent (eds.)
Read Online or Download 6th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium, April 15–18, 1986 PDF
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Extra resources for 6th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium, April 15–18, 1986
Special Tests for Lung Injury Lung Water There may be changes in lung impedance but these tend to reflect radiographic changes . Most procedures for measuring lung water rely on indicator dilution methods. One approach is to use an inhalation of gases of different water solubility and from the relative clearance of these gases in the lung to calculate lung water. The limitation of this approach is that it cannot measure fluid in alveoli already filled with liquid and therefore unventilated. Unventilated but perfused regions can be studied by intravascular injection of two indicators, one diffusible and the other non-diffusible.
Some form of mechanical ventilation may be instituted either to improve alveolar ventilation or to achieve lung inflation and thus possibly recruit alveoli im- Near-Drowning: A Model for Acute Respiratory Failure 35 proving oxygenation . Those individual who suffer bronchospasm should be treated with a bronchodilator, either by inhalation of newer beta-2 agonists or by infusion of theophylline. If particulate matter obstructs the airway or has been aspirated, bronchoscopy is in order to clear the airway and provide bronchopulmonary tiolet.
Indium-labelled leucocytes, 3. Lung lavage. The Gallium scan localises areas of acute or chronic inflammation at the alveolar level and is not influenced by inflammatory airway disease. Gallium - 67 citrate is given intravenously and the patient is scanned 48 hours later. The mechanisms of gallium - 67 uptake in regions of inflammation are unknown but most of the gallium is taken up in macrophages with only a small uptake in neutrophils. Most studies of Gallium - 67 uptake have been reported in patients with sarcoidosis or in fibrosing alveolitis.