Enlarged Pulmonary Arteriovenous Vessels in COPD

Miller, Warner A.; Heard, John G.; Unger, Kenneth M.

doi:10.1378/chest.86.5.704

Cited by 26 publications

(15 citation statements)

References 10 publications

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“…It is widely known that COPD is one of the main causes of acute respiratory failure. Resting hypoxia, usually due to V A / Q mismatching, and exercise aggravation of hypoxia due to increased flow and oxygen disequilibrium are often seen in COPD patients [6, 7]. Acute hypercapnic respiratory failure as a result of an acute exacerbation of COPD is a common reason for emergency hospital admission [8].…”

Section: Introductionmentioning

confidence: 99%

Plasma Orexin-A Levels in COPD Patients with Hypercapnic Respiratory Failure

Zhu

Summah

Jiang

et al. 2011

Mediators of Inflammation

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Orexins have previously been shown to promote wakefulness, regulate lipid metabolism and participate in energy homeostasis. The aim of the study was to determine the relationship between plasma orexin-A and body composition in COPD in-patients with hypercapnic respiratory failure. 40 patients with hypercapnic respiratory failure and 22 healthy individuals were enrolled prospectively in this study. Plasma orexin-A levels, BMI, SaO2, PaCO2 and PaO2 were noted for all the patients. Plasma orexin-A levels were higher in the underweight (UW) group, normal weight (NW) group and overweight (OW) group of COPD patients as compared with UW, NW and OW group of the control group (P < .05). Plasma orexin-A in COPD patients were higher in the OW group than in the NW group and the UW group. Plasma orexin-A levels showed significant correlation with body mass index (BMI), independent of PaO2 (r = 0.576; P < .05) and %fat (r = 0.367; P < .05); a negative correlation was noted between plasma orexin-A levels and PaO2 (r = −0.738; P < .05) and SaO2 (r = −0.616; P < .05). Our results suggest that orexin-A levels are high in COPD patients with hypercapnic respiratory failure, and vary according to BMI and body composition. Orexin-A may be associated with the severity of hypoxemia in COPD patients with hypercapnic respiratory failure.

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Section: Introductionmentioning

confidence: 99%

Plasma Orexin-A Levels in COPD Patients with Hypercapnic Respiratory Failure

Zhu

Summah

Jiang

et al. 2011

Mediators of Inflammation

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“…The possible mechanism of paradoxical cerebral air embolism in our patient is as follows. First, patients with chronic obstructive pulmonary disease had greater anatomical intrapulmonary shunting than normal subjects (14). Our patient had right fibrothorax associated with tuberculosis sequelae and poor lung function.…”

Section: Discussionmentioning

confidence: 99%

Massive Paradoxical Air Embolism in Brain Occurring after Central Venous Catheterization: A Case Report

et al. 2010

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Cerebral air embolism is a rare but fatal complication of central venous catheterization. Here, we report a case of paradoxical cerebral air embolism associated with central venous catheterization. An 85-yr-old man underwent right internal jugular vein catheterization, and became obtunded. Brain MR imaging and CT revealed acute infarction with multiple air bubbles on the side of catheter insertion. The possibility of cerebral air embolism should be considered in patients developing neurological impairment after central venous catheterization, and efforts should be made to limit cerebral damage.

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“…For example, patients with chronic obstructive pulmonary disease (COPD) who also have arterial hypoxemia are likely to have patent intrapulmonary right-to-left shunts at rest (Miller et al, 1984;Dansky et al, 1992). Preliminary work in our lab using saline contrast echocardiography has detected these pathways in subjects with COPD who do not have a PFO (Figure 5).…”

Section: Research Using Echocardiography In Patients With Lung Diseasmentioning

confidence: 99%

“…Thus, the opening of either intrapulmonary or intracardiac shunts at rest and/or during exercise may play a role in determining pulmonary gas exchange efficiency (Sun et al, 2002;Stickland & Lovering, 2006;Lovering et al, 2011). The opening of these shunts may also explain why some people with pulmonary diseases such as chronic obstructive pulmonary disease (COPD) desaturate so profoundly during even mild exercise (Miller et al, 1984;Dansky et al, 1992). The second reason that these pathways are clinically relevant is that anatomic right-to-left shunts may allow for thrombi to bypass the pulmonary capillary filter.…”

Section: Introductionmentioning

confidence: 99%