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The airway obstruction - important abrupt condition for pediatrics

100%

Tomaszewski M., Banakiewicz K., Jajko K., Szypowski R., Zielinski P., Zalewski G., Spisacka S., Olchowik G.

Health Problems of Civilization

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2015

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tom 09

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nr 1

The ability of fast response in case of increasing health problems of a child which lead directly to life-threatening situations is a necessary condition for creating opportunity of child’s survival until it will be transported to intensive care unit, where it will be provided with care by a specialist. In case of healthy children the most common cause of acute respiratory failure is obstruction of upper respiratory tract. There is an enormous variety of causes of upper airway obstruction, but the most important are the result of congenital defects, acute inflammation, anaphylactic reactions, foreign body aspiration and injuries. Consequence of the hypoventilation resulting from significant impediment of airflow through the obstructed airways is impaired gas exchange in the lungs. This leads to the increasing hypoxemia (PaO 2 <60 mmHg) and hypercapnia (PaCO2> 45 mmHg). This condition is called the total respiratory failure. The persistence of hypoventilation leads to hypoxia of vital organs (heart muscle, brain), increased anaerobic metabolism, acidosis, and inevitably to cardiac arrest as a result of homeostasis disorders. Respiratory failure is defined as acute when developing suddenly and is potentially reversible. We can find such a situation in the fast-increasing stenosis of the larynx. Symptoms of severe dyspnoea occur in a short time, but can be interrupted by an effective airway patency. Acute respiratory failure is a state of direct threat to life, which is why it is crucial to give a prompt aid to the sick child. The aim of this paper is to discuss the signs and symptoms, knowledge of which is essential for rapid identification and initial differentiation of the causes of acute upper airway obstruction in children. The principles of first-aid for children with acute respiratory failure and above all the description of life-saving procedures will be presented.

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Positron emission tomography findings in obstructive sleep apnea patients with residual sleepiness treated with continuous positive airway pressure

84%

Antczak J., Popp R., Hajak G., Zulley J., Marienhagen J., Geisler P.

Journal of Physiology and Pharmacology. Supplement

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2007

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tom 58

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nr 5

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Gas exchange abnormalities in patients listed for liver transplantation

84%

Przybylowski T., Krenke R., Fangrat A., Nasilowski J., Grabczak E. M., Styczynski G., Pruszczyk P., Krawczyk M., Chazan R.

Journal of Physiology and Pharmacology. Supplement

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2006

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tom 57

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nr 4

313-323

Abnormalities of pulmonary gas exchange are common in patients with advanced liver disease. Since arterial blood hypoxemia is an important issue in the preoperative evaluation of liver transplant candidates, the study was undertaken to determine the incidence and severity of lung function impairment with a special emphasis on pulmonary gas exchange abnormalities in this group of patients. 104 consecutive patients (47 F and 57 M, mean age 46 ±11 yr) listed for orthotopic liver transplantation participated in this prospective study. All patients underwent evaluation including: clinical assessment (Child-Pough and MELD classification), chest X-ray, chest sonography, lung function tests, arterial blood gases measurement, and transthoracic contrast enhanced echocardiography. There were 2 patients with acute hepatic failure, 6 patients with primary or metastatic liver carcinoma, and 96 patients with chronic liver disease. The mean PaO2 and lung function parameters for the entire group were within normal limits. There were 29 hypoxemic patients (PaO2< 80 mmHg) and 40 patients with widened (>20 mmHg) P(A-a)O2. DLCO was significantly lower in cirrhotic vs. non-cirrhotic patients (76.5 ±19.3 vs. 92.4 ±19.0% predicted; P<0.001). Hepatopulmonary syndrome (HPS) was recognized in 23 (24%) patients. 91% of patients with HPS showed mild to moderate stage of disease. There were significant difference between differences HPS patients and non-HPS patients in DLCO (69.0 ±14.5 vs. 83.5 ±20.7, P<0.01). In conclusion, all patients referred for OLT should be screened for gas exchange abnormalities. Such a workup should include not only PAO2 but also DLCO and P(A-a)O2 measurement together with contrast enhanced echocardiography.

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In vitro angiomodulatory activity of sera from type 2 diabetic patients with background retinopathy

67%

Chorostowska-Wynimko J., Skopinski P., Szaflik J., Partyka I., Duda-Krol B., Anuszewska E., Skopinska-Rozewska E.

Journal of Physiology and Pharmacology. Supplement

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2005

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tom 56

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nr 4

65-70

Diabetic retinopathy is the leading cause of adult vision loss and blindness. The most important contributors to the development of diabetic retinopathy are hyperglycemia and hypoxemia that lead to increased vasopermeability, endothelial cell proliferation, and pathological neovascularization. In our previous studies, close relationship between proangiogenic activity of sera from type 2 diabetes mellitus patients (DM2) with background retinopathy, assessed in the in vivo serum-induced mouse cutaneous test (SIA), and VEGF and IL-18 serum concentration were observed. Moreover, it was clearly shown that IGF-1 might play an important role in the negative regulation of neoangiogenesis induced by DM2 patients' sera by diminishing the VEGF stimulatory effect. To confirm the observed phenomenon we evaluated the effect of DM2 patients' sera on the in vitro proliferative activity of human endothelial cells, which is critical for the sprouting and generation of new blood capillaries. Endothelial proliferative activity was significantly higher in the presence of sera from DM2 patients than from healthy controls (P<0.001), as estimated by the MTT test. Moreover, the examined sera from DM2 patients were characterized by increased IL-18 (P<0.05), diminished IGF-1 (P<0.02), and unchanged VEGF levels compared with those in controls. In conclusion, the present study showed a strong stimulatory effect of DM2 patients' sera on the proliferation of endothelial cells, which, along with the findings of our previous studies, proves that the described phenomenon is universal and valid for both animal and human endothelium.

Ograniczanie wyników

The airway obstruction - important abrupt condition for pediatrics

Positron emission tomography findings in obstructive sleep apnea patients with residual sleepiness treated with continuous positive airway pressure

Gas exchange abnormalities in patients listed for liver transplantation

In vitro angiomodulatory activity of sera from type 2 diabetic patients with background retinopathy