Transfusion-related acute lung injury (TRALI) is characterized by acute severe hypoxemia with bilateral noncardiogenic pulmonary edema after transfusion of a plasma-containing blood component. In patients undergoing c...Transfusion-related acute lung injury (TRALI) is characterized by acute severe hypoxemia with bilateral noncardiogenic pulmonary edema after transfusion of a plasma-containing blood component. In patients undergoing cardiac surgery, the incidence of TRALI is high;however, the detailed clinical course is unknown. Here, we report a case of life-threatening TRALI following pulmonary thrombectomy, which was successfully treated with extracorporeal membranous oxygenation (ECMO).展开更多
Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old ma...Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis.展开更多
Objective:To study the therapy effect of ultraviolet blood irradiation and oxygenation (UBIO) on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods:Forty rabbits were randomly di...Objective:To study the therapy effect of ultraviolet blood irradiation and oxygenation (UBIO) on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods:Forty rabbits were randomly divided into 4 groups: normal control group, intoxication group, routine therapy group and UBIO therapy group. Blood AChe activity and artery blood gas were analyzed 2 h after intoxication. ACP and AKP activities in BALF were determined respectively. Results:Blood AChe activity in intoxication group was lower than that in normal control group (P<0.05). BALF ACP and AKP activities in intoxication group were higher than that in normal control group. Blood AChe activities in UBIO therapy group increased and were higher than that in intoxication and routine therapy groups. Compared with intoxication group, BALF ACP and AKP activities were decreased (P<0.05) in UBIO therapy group, while artery blood pH, PaO2 and SaO2 increased (P<0.05). Conclusion: UBIO therapy can elevate blood AChe activity and alleviate lung injury induced by soman intoxication. So it may be a new way to treat acute soman intoxication.展开更多
Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lu...Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lung injury after abdominal operation were analyze with multiple clinical and laboratory parameters and were treated early with herbs activating blood circulation and dispersing stasis. Results: After 2 days of medication,arterial oxygen saturation (SaO2 ) and partial pressure of oxygen in artery (PaO2 ) markedly improved, with significant difference as compared with those before medication (P < 0. 01 ). After continous medication for 4 days, SaO2, PaO2 and chest X-ray as well as synthetic physiologic parameters obviously improved, prostaglandin F1a,thromboxane B2 (TXB2 ), C-reactive protein (CRP), erythrocyte C3b were very significantly different from those medication (P < 0. 01 ), the synthetic physiological parameters returned generally to normal. After 5 days of herbal medication, all parameters resumed normal with satisfactory physiologic criteria. Conclusions: Early application of herbs activating blood circulation and dispersing stasis could obviously improve hypoxemia and the lung lesions, and consequently the general condition of the patient.展开更多
目的:观察益气活血中药对急性肺损伤(ALI)机械通气后的肺保护作用。方法:对符合纳入标准67例ALI患者按纳入的时间顺序随机分为2组,对照组32例给予常规综合治疗,观察组35例辅以益气活血中药治疗,60 m L/次,3次/天,连用14天。在服药后第3...目的:观察益气活血中药对急性肺损伤(ALI)机械通气后的肺保护作用。方法:对符合纳入标准67例ALI患者按纳入的时间顺序随机分为2组,对照组32例给予常规综合治疗,观察组35例辅以益气活血中药治疗,60 m L/次,3次/天,连用14天。在服药后第3、7、14天比较患者血气分析、血流动力学、外周血中性粒细胞(PMN)计数指标及支气管镜显像等变化。结果:观察组在PMN、体循环血管阻力(SVR)、心率(HR)、血氧分压(Pa O2)、氧合指数(PO2/Fi O2)及p H值较对照组显著改善(P<0.05)。观察组气管镜下显像提示充血、水肿及炎症反应有显著好转。结论:益气活血中药辅助治疗能改善ALI患者的血流动力学、动脉血气及炎性指标,对肺有较好的保护作用,疗效确切。展开更多
文摘Transfusion-related acute lung injury (TRALI) is characterized by acute severe hypoxemia with bilateral noncardiogenic pulmonary edema after transfusion of a plasma-containing blood component. In patients undergoing cardiac surgery, the incidence of TRALI is high;however, the detailed clinical course is unknown. Here, we report a case of life-threatening TRALI following pulmonary thrombectomy, which was successfully treated with extracorporeal membranous oxygenation (ECMO).
文摘Objective:To establish a rat model of transfusion-related acute lung injury(TRALI)with coronary heart disease(CHD),and to analyze the safety of blood transfusion through oxygen balance.Methods:Forty-five 10-day-old male Wistar rats were purchased,and 35 of them were fed with high-fat diet to establish coronary heart disease rat models,and then 20 of them were selected to establish rat models of transfusion-related acute lung injury with coronary heart disease(model group,10 rats),positive acute lung injury group(positive group,5 rats)and negative acute lung injury group(negative group,5 rats),and the lung histomorphology,pathological score and wet/dry weight ratio were compared.Then,another 15 rats with coronary heart disease were selected and infused with mutant Hb,rHb1.1 and rHb2.0 with the same osmotic pressure through femoral vein catheterization,respectively,and were divided into mutant Hb group,rHb1.1 group and rHb2.0 group,with 5 rats in each group,and 5 healthy rats were combined as control group.The MAP,HR and blood gas values of mesenteric artery of rats were compared at 0,30,60 and 90 min after infusion.Results:(1)Rats in the model group and the positive group showed symptoms such as irregular and shallow breathing,increased oral and nasal secretions,and audible wheezing,which were consistent with the symptoms of acute lung injury.Comparison of lung histological score and lung tissue wet/dry ratio in three groups:There was no significant difference in lung histological score and lung tissue wet/dry ratio(P>0.05),but they were higher than those in the negative group(P<0.05).(2)During hemoglobin infusion,the MAP of mutant Hb group,rHb1.1 group and rHb2.0 group was higher than that of the control group,while the pH and PaCO2were lower than those of the control group(P<0.05),and there was no significant difference in QSMA(P>0.05).In the mutant Hb group,MAP returned to normal at 30-60 min after infusion(P>0.05),but MAP increased again at 90 min after infusion(P<0.05),and QSMA increased significantly at 60 min after transfusion(P<0.05).The pH value was lower than the normal value and the PaCO2was higher than the normal value within 90 min of infusion(P<0.05),and the HCO3-level returned to normal after 30 min of infusion(P>0.05).In rHb 1.1 group,MAP returned to normal,QSMA remained at normal level(P>0.05),and pH,PaCO2and HCO3-returned to normal after 60 min of infusion(P>0.05);In rHb 2.0 group,the levels of MAP,pH,PaCO2and HCO3-returned to normal after 30 min of infusion(P>0.05),and QSMA remained normal during infusion(P>0.05).Conclusion:The rat model of transfusion-relatted acute lung injury with coronary heart disease can be successfully established by injecting LPS into the rat model of coronary heart disease,and the infusion of recombinant hemoglobin can improve the balance of blood supply in rats,in which the infusion of rHb2.0 can better correct the metabolic acidosis.
文摘Objective:To study the therapy effect of ultraviolet blood irradiation and oxygenation (UBIO) on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods:Forty rabbits were randomly divided into 4 groups: normal control group, intoxication group, routine therapy group and UBIO therapy group. Blood AChe activity and artery blood gas were analyzed 2 h after intoxication. ACP and AKP activities in BALF were determined respectively. Results:Blood AChe activity in intoxication group was lower than that in normal control group (P<0.05). BALF ACP and AKP activities in intoxication group were higher than that in normal control group. Blood AChe activities in UBIO therapy group increased and were higher than that in intoxication and routine therapy groups. Compared with intoxication group, BALF ACP and AKP activities were decreased (P<0.05) in UBIO therapy group, while artery blood pH, PaO2 and SaO2 increased (P<0.05). Conclusion: UBIO therapy can elevate blood AChe activity and alleviate lung injury induced by soman intoxication. So it may be a new way to treat acute soman intoxication.
文摘Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lung injury after abdominal operation were analyze with multiple clinical and laboratory parameters and were treated early with herbs activating blood circulation and dispersing stasis. Results: After 2 days of medication,arterial oxygen saturation (SaO2 ) and partial pressure of oxygen in artery (PaO2 ) markedly improved, with significant difference as compared with those before medication (P < 0. 01 ). After continous medication for 4 days, SaO2, PaO2 and chest X-ray as well as synthetic physiologic parameters obviously improved, prostaglandin F1a,thromboxane B2 (TXB2 ), C-reactive protein (CRP), erythrocyte C3b were very significantly different from those medication (P < 0. 01 ), the synthetic physiological parameters returned generally to normal. After 5 days of herbal medication, all parameters resumed normal with satisfactory physiologic criteria. Conclusions: Early application of herbs activating blood circulation and dispersing stasis could obviously improve hypoxemia and the lung lesions, and consequently the general condition of the patient.