Asphyxia Neonatorum ; therapy ; Humans ; Infant, Newborn ; Resuscitation ; methods

Abnormalities, Multiple ; diagnosis ; therapy ; Asphyxia ; pathology ; Female ; Humans ; Infant ; Musculoskeletal Abnormalities ; diagnosis ; therapy ; Syndrome ; Thorax ; abnormalities

Pericardial drainage is an important diagnostic and therapeutic option in the symptomatic patient with large amount of pericardial effusion (PE). However, when the amount of PE is relatively small, physicians are often reluctant to perform the invasive drainage of the fluid due to the increased risk of causing myocardial injury during the procedure. Even in some cases of suspected pericarditis with small amount PE, an initial empirical anti-inflammatory therapy is often recommended. A 65-year-old woman presented with mild dyspnea for two weeks. The echocardiography revealed small amount of PE. A careful fluoroscopy-guided pericardiocentesis, subsequent pericardial fluid cytology, and thorough whole body check-up demonstrated adenocarcinoma with no proven primary site. After the palliative chemotherapy, she had survived for 15 months until her death due to asphyxia. Although pericardiocentesis is considered dangerous in small amount of PE, a prompt and careful drainage may provide early detection of hidden malignancy and better survival outcome.
Adenocarcinoma* ; Aged ; Asphyxia ; Drainage ; Drug Therapy ; Dyspnea ; Echocardiography ; Female ; Humans ; Pericardial Effusion* ; Pericardial Fluid ; Pericardiocentesis* ; Pericarditis

Asphyxia Neonatorum ; therapy ; Humans ; Infant, Newborn ; Infant, Newborn, Diseases ; Neonatology ; methods ; Resuscitation ; methods

Tracheal tumors are very rare disease, which may cause dyspnea, obstructive pneumonia and life-threatening hypoxemia, depending on the site of the lesion and the severity of the narrowing. Such patients frequently die within hours or days due to suffocation. Patients who expressed upper airway stenosis, should be secured the airways prior to the diagnosis and treatment commonly. Then, treatment plan should be determined. For the relief of such stenosis, various modalities of therapy including surgery, laser photoresection, balloon dilatation and sometimes stent insertion have been used. Tracheobronchial stent insertion has been a good therapeutic option in these patients in point of avoiding morbidities associated with surgery. We report a case of repeated tracheobronchial stenosis by infiltrating tumor mass after metallic stent insertion in a 48-year-old man. The patient was treated successfully by Natural stent insertion with rigid bronchoscopy after removal of previous inserted metallic stent.
Anoxia ; Asphyxia ; Bronchoscopy ; Constriction, Pathologic ; Dilatation ; Dyspnea ; Humans ; Laser Therapy ; Middle Aged ; Pneumonia ; Rare Diseases ; Stents

Asphyxia Neonatorum ; epidemiology ; etiology ; therapy ; Female ; Humans ; Incidence ; Infant, Newborn ; Male ; Risk Factors

Asphyxia ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Retropharyngeal Abscess ; complications ; therapy ; Subphrenic Abscess ; complications ; therapy ; Treatment Outcome

OBJECTIVETo find out optional resuscitation gas for asphyxiated newborn infants based on a systemic review of the published studies that compared the effects of resuscitation of asphyxiated newborn infants with room air or pure oxygen.

METHODSInclusion criteria were randomized or pseudo-randomized studies of asphyxiated newborn infants resuscitated with room air or pure oxygen. The studies published between Jan. 1966 and June. 2005 were searched in PubMed/EMBASE/the Cochrane library databases. All identified studies that fulfilled our inclusion criteria were included. We did a systemic review and a meta-analysis of studies that compared parameters of efficacy, such as mortality, incidence of hypoxic ischemic encephalopathy (HIE) and the rate of resuscitation failure of newborn infants resuscitated with room air or pure oxygen.

RESULTSSix identified studies were included, in which 988 infants were resuscitated with room air and 952 infants with pure oxygen. The mortality of asphyxiated newborn infants within the first week was 8.7% versus 13.4% in room air and pure oxygen groups, respectively, OR = 0.64, 95% CI 0.44 - 0.94. In 5 of the 6 studies, the mortality of term asphyxiated newborn infants was 5.9% versus 9.8% in room air and pure oxygen groups, OR = 0.59, 95% CI 0.40 - 0.87. The result for premature asphyxiated newborn infants was similar. In 4 studies, the incidence of moderate to severe neonatal HIE was 17.5% versus 20.1% in room air and pure oxygen groups, respectively, OR = 0.91, 95% CI 0.68 - 1.21. In 3 studies, the rate of resuscitation failure was 26.9% versus 29.1% in room air and pure oxygen groups, respectively, OR = 0.92, 95% CI 0.70 - 1.19.

CONCLUSIONThe systemic review and the meta-analysis demonstrated that the mortality of asphyxiated newborn infants was significantly lower when resuscitated with room air, and no significant differences were found in the incidence of neonatal HIE and the rate of resuscitation failure. However, this conclusion should be used cautiously because of the limited number of studies.

Air ; Asphyxia Neonatorum ; mortality ; therapy ; Humans ; Infant, Newborn ; Neonatology ; Oxygen ; therapeutic use ; Oxygen Inhalation Therapy ; Resuscitation ; methods ; Treatment Outcome

Perinatal asphyxia can cause ischemic injury to immature kidney of neonates. Proximal renal tubule is the most sensitive area, showing various manifestations ranging from mild reversible injury to irreversible tubular necrosis. Aminoglycosides can be nephrotoxic in therapeutic range in immature or damaged kidney. Thess are the very important factors to be taken into corsideration on fluid therapy and nephrotoxic drugs in neonates. The purpose of this study is to detect renal dysfunction resulting from asphyxia and gentamicin treatment. The results were as follows; 1) Urinary 2-microglobulin concentration was significantly higher in neonatal asphyxia group irrespective of meconium stain (p<0.05). The group with neonatal asphyxia only (Ia) showed a gradual decline in urinary 2-microglobulin concentration and no significant difference shown when compared with control group on 7 days old (p>0.05). The group with neonatal asphyxia and meconium stain (Ib) received gentamicin for 7 days. Their urinary 2-microglobulin concentration dropped on 4 the day and increased again on 7 th day (p<0.05). The group with meconium stain only(3) showed no significant difference in urinary 2-microglobulin concentration when compared with control group (p>0.05). 2) No differences were shown in serum creatinine, serum sodium level and urinary creatinine concentrations between each group (p>0.05). 3) No differences were shown in creatinine clearance between each group (p>0.05).Fractional excretion of urinary sodium (FENa) was significantly higher on lst day in group, I, but no differences were shown afterwards (p>0.05). 4) There is no relationship between urinary 2-microglobulin concentration and serum creatinine level, creatinine clearance of FENa. 5) No differences were shown in incidence of renal dysfunction between each group. In conclusion, acute tubular injury by perinatal asphyxia recovered soon after birth. But nephrotoxic gentamicin worsened the recovering tubular injury. In case of mild fetal hypoxia without neonatal asphyxia, proximal tubular injury was not significant.
Aminoglycosides ; Asphyxia* ; Creatinine ; Fetal Hypoxia ; Fluid Therapy ; Gentamicins* ; Humans ; Incidence ; Infant, Newborn* ; Kidney ; Kidney Tubules, Proximal ; Meconium ; Necrosis ; Parturition ; Sodium

OBJECTIVETo Evaluate the effects of different oxygen therapies on the rats with acute nitrogen asphyxia and to study the best oxygen therapic protocol for patients with acute nitrogen asphyxia on the spot.

METHODSSixty healthy male Wistar rats were divided into 5 groups: control, exposure to nitrogen, 33% oxygen treatment, 50% oxygen treatment and hyperbaric oxygen treatment groups. The behavioral performance, arterial oxygen pressure (PO2), carbon dioxide partial pressure (PCO2) and oxygen saturation (SPO2), biochemical changes in liver and kidney function and myocardial enzymes in 5 groups were measured.

RESULTSThe rats exposed to nitrogen firstly were excited then inactive symptoms, but consciousness was recovered after oxygen therapy. The PO2 and SPO2 in nitrogen exposure group were (79.67 +/- 9.12) and (94.92 +/- 2.78) mm Hg, respectively, which were significantly lower than those in control group (P<0.01). The PO2 and SPO2 of 3 oxygen treatment groups were (94.75 +/- 7.24), (94.92 +/- 8.98), (104.58 +/- 7.12)mm Hg and (97.17 +/- 0.83), (96.92 +/- 1.16), (97.42 +/- 0.67)mm Hg, respectively, which were significantly higher than those in nitrogen exposure group (P<0.05). The PO2 in hyperbaric oxygen treatment group was significantly higher than those in other 2 oxygen treatment groups (P<0.05). The SPO2 in hyperbaric oxygen treatment group was (51.42 +/- 6.60) mm Hg which was significantly higher than that [(44.58 +/- 3.42)mm Hg] in 50% oxygen treatment groups (P< 0.05). AST [(270.50 +/- 49.05 )U/L], ALT [(122.67 +/- 55.44 )U/L], BUN [(7.31 +/- 0.93 )mmol/L], Cr[(28.32 +/- 4.35) micromol/L], CK [(1808.42 +/- 582.05)U/L] and CtnI [(22.52 +/- 14.29 )ng/ml] in nitrogen exposure group were significantly higher than those in control group (P<0.05). AST [(165.25 +/- 30.87) U/L], HBDH [(350.83 +/- 103.00)U/L] and CtnI [(11.23 +/- 5.38) ng/ml] in hyperbaric oxygen treatment group were significantly lower than those in other 2 oxygen treatment groups (P<0.05).

CONCLUSIONTimely and effective oxygen therapy can significantly increase arterial pressure of oxygen and oxygen saturation in the rats with acute nitrogen asphyxia, and can improve liver function and cardiac damage. The hyperbaric oxygen chamber can significantly increase the therapeutic effects on rats with acute nitrogen asphyxiation.

Animals ; Asphyxia ; blood ; chemically induced ; Blood Gas Analysis ; Hyperbaric Oxygenation ; Male ; Nitrogen ; toxicity ; Oxygen Inhalation Therapy ; Rats ; Rats, Wistar