Lung embolism

Stability in plasma is an important requirement for IV emulsions as flocculated droplets may result in lung embolism. It was found that tocol-based emulsions stabilized by sodium deoxycholate/lecithins flocculated strongly when mixed with mouse, rat, and sheep plasma and serum, whereas soya oil-based emulsions with the same emulsifiers did not [123], It was hypothesized that this effect was caused by the adsorption of plasma proteins onto the tocol droplets (opsonization). Indeed, the steric stabilization of emulsions by incorporation of emulsifiers like poloxamer 188 or PEGylated phospholipids such as PEG5000PE proved to be effective in the stabilization of tocol-based emulsions in plasma. Conversely, in vitro studies were... 

Damaged skeletal or heart muscle releases Ck. into the serum. Increases in serum Ck. are therefore used in the early diagnosis of heart infarction, the detection of muscle wastage, and to distinguish heart infarction from lung embolism, in which there is no increase in serum C. k. 

Pulmonary embolism. A blood clot trapped in the blood vessels of the lungs. 

Many serious health problems result from abnormally located blood clots heart attacks (clots in coronary arteries), pulmonary embolism (clots in the lungs), and peripheral arterial occlusion and deep vein thrombosis (clots in the limbs). Each year heart attacks alone afflict over a million people in the United States, and almost half of them die as a result. 

Early restrictive lung disease Infection Pneumothorax Pulmonary edema Pulmonary embolism Tissue hypoxia Burn injury Excessive mechanical ventilation Fever... 

Outcome parameters for VAP, HAP, and HCAP are similar to those with CAP. Clinical improvement should occur within 48 to 72 hours of the start of therapy. If a patient is not responding to therapy, then, again, consider infectious and noninfectious reasons. Infectious explanations are the same as for CAP, but noninfectious reasons are not. They include atelectasis, acute respiratory distress syndrome (ARDS), pulmonary embolism or hemorrhage, cancer, empyema, or lung abscess. 

Embolic phenomena (emboli affect the heart, lungs, abdomen, or extremities)... 

The most prescribed drugs for blood-related disorders are also summarized in Table 1.17. Blood clots can occur in the veins at extremities (especially after a long period of immobility). Those clots can subsequently become lodged in the blood vessels, the atria, the heart valves, and within the lungs, causing embolism and shortness of breath. Under severe conditions, the clots can also obstruct the flow of blood to the brain, leading to a stroke and paralysis. Coumadin (warfarin see chemical structure below) is one of the main hematological compounds that has been widely prescribed to counter these conditions... 

Intravenously administered particles with dimensions exceeding 7 /mi (the diameter of the smallest capillaries) will be filtered by the first capillary bed they encounter, usually the lungs, leading to embolism. Intra-arterially administered particles with dimensions exceeding 7 m will be trapped in the closest organ located upstream for example, administration into the mesenteric artery leads to entrapment in the gut, into the renal artery leads to entrapment in the kidney etc. This approach is under investigation to improve the treatment of diseases in the liver. 

Thrombosis (blood clot) - may occur up to six weeks after surgery. Rarely, a blood clot can pass to the lungs causing a pulmonary embolism and a medical emergency. Treatment may necessitate anticoagulants. 

If the clot forms on an atheromatous plaque in a coronary artery, myocardial infarction is imminent a thrombus in a deep leg vein can be dislodged and carried into a lung artery and can cause pulmonary embolism. 

Embolism associated with long flights is generally due to thrombus formation in deep leg veins (deep-vein thrombosis, or DVT). The thrombus may move to the pulmonary circulation, where effects on lung function depend on the extent of the blockage produced. A massive embolus may occlude the main pulmonary artery, resulting in hypotension, shock and possibly death multiple small emboli cause little problem and are lysed by the fibrinolytic system. Sometimes surgical removal of the embolus is necessary, but in Pats/s case clot lysis was successful and she made an uneventful recovery. 

As the talc, cornstarch, and other insoluble tablet fillers embolize to the lungs, they become trapped within the pulmonary tissues and eventually cause pulmonary hypertension. This leads to the development of collateral vessels that allow part of the venous retmn to bypass the lungs and enter the left side of the heart, where the particles are further embolized to the eye and other organs of the body. The presence of talc particles in the eye indicates that substantial foreign body damage has occurred in the lungs. 

In cases of severe fatty liver, there is indeed a risk of fat embolism occurring in the lungs, brain and kidneys. In view of the considerable fat masses stored in the hepatic parenchyma due to this condition, R. Virchow suspected the manifestation of fat embolism as early as 1886. (s. tab. 31.9) Blunt traumatism of the (enlarged) liver with subsequent mobilization of fat is thought to be the cause of this condition. It is not clear at present whether this so-called inundation theory offers sufficient explanation or whether it needs to be amended or even replaced by the so-called segregation theory (high lipaemia, deemulsification of blood fats, etc.). While hepatic fat embolism may be rare, it is nevertheless clinically relevant. 

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