To explore mechanisms of hypoxemia after acute pulmonary embolism, we measured regional pulmonary blood flow and alveolar ventilation before and after embolization with 780-micrometers beads in five anesthetized, mechanically ventilated pigs. Regional ventilation and perfusion were determined in approximately 2.0-cm3 lung volumes by using 1-micrometers-diameter aerosolized and 15-micrometers-di...

Ventilation/perfusion (V/Q) lung scintigraphy, when used for the clinical determination of the presence or absence of pulmonary embolism, has been much studied by medical imagers. Inherent to a ‘‘cold-spot’’ scan targeting the normal pulmonary tissue, the deck has always been stacked against us and our specialty frequently maligned by the referring physicians as practicing ‘‘unclear’’ and not n...

BACKGROUND AND OBJECTIVES To assess the incidence of tracheostomy in patients submitted to mechanic ventilation (MV); to compare the length of stay (LOS), duration of MV, APACHE II and mortality among patients submitted to tracheostomy, according to the moment of its application (early or late). METHODS A retrospective observation study type cohort was done from April thru October 2005 includ...

The advantages of lung scanning in suspected pulmonary embolism are its diagnostic sensitivity, simplicity and safety. The ability to delineate regional pulmonary ischaemia, to quantitate its extent and to follow its response to therapy provides valuable clinical data available by no other simple means. The negative scan effectively excludes pulmonary embolism but, although certain of its featu...

Objective documentation of pulmonary embolism is an essential prerequisite for appropriate treatment (Figure 7). A chest film, as well as measurement of arterial blood gases, should be obtained immediately, and if the lung fields are essentially normal, a lung scan should then be performed. If the scan shows a definite perfusion defect characteristic of embolism, this provides sufficient eviden...

99mTc-Macroaggregated Albumin (99mTc-MAA) has been used as a perfusion agent. This study described development of the 68Ga-MAA via commercially available kits from Pars-Isotopes Company as a 99mTc-MAA kit. 68Ge/68Ga generator was eluted with suprapure HCl (0.6 M, 6 mL) in 0.5 mL fractions. The two fractions with the highest 68GaCl3 activity were generally used for labeling purposes. After label...

BACKGROUND More aggressive management may be warranted for patients with acute pulmonary embolism (PE) and the greatest pulmonary vascular obstruction. We hypothesized that a scoring system based on the ECG might identify such patients. METHODS Consecutive patients investigated for PE at Christchurch Hospital between 1997 and 2002 with high-probability ventilation/perfusion (V/Q) scan finding...

Pulmonary vein stenosis is a well-established possible complication following an atrial fibrillation ablation of pulmonary veins. Symptoms of pulmonary vein stenosis range from asymptomatic to severe exertional dyspnea. The number of asymptomatic patients with pulmonary vein stenosis is greater than originally estimated; moreover, only about 22% of severe pulmonary vein stenosis requires interv...

'Assistant Professor of Radiology. "Professor of Radiology, Boston University School of Medicine, University Hospital, Department of Radiolo , Boston. Reprint requests: Dr. Ferris, Department of ~ a d i z g y . UnC versity Hospital, 750 Harrison Avenue, Boston 021 18 were no apparent telangiectases. The chest roentgenograms showed no abnormalities. Right heart strain was indicated by electrocar...

Endotoxin increases ventilation-to-perfusion ratio (VA/Q) heterogeneity in the lung, but the precise changes in alveolar ventilation (VA) and perfusion that lead to VA/Q heterogeneity are unknown. The purpose of this study was to determine how endotoxin affects the distributions of ventilation and perfusion and the impact of these changes on VA/Q heterogeneity. Seven anesthetized, mechanically ...