1999
DOI: 10.1097/00132586-199912000-00040
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Intraoperative Respiratory Failure in a Patient After Treatment with Bleomycin: Previous and Current Intraoperative Exposure to 50% Oxygen

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Cited by 5 publications
(7 citation statements)
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“…Therefore, the reason why ARDS progressed so rapidly during the patient's elective surgery remains a mystery. It is considered that the "two-hit" hypothesis can explain at least some categories of ARDS and acute lung injury, induced both experimentally [12,13] and clinically [7,14]. One possible explanation for the ARDS in our patient could be that sepsis from the urinary tract infection before the operation had fi rst triggered systemic infl ammation and primed neutrophils that accumulated in the lung.…”
Section: Discussionmentioning
confidence: 80%
See 1 more Smart Citation
“…Therefore, the reason why ARDS progressed so rapidly during the patient's elective surgery remains a mystery. It is considered that the "two-hit" hypothesis can explain at least some categories of ARDS and acute lung injury, induced both experimentally [12,13] and clinically [7,14]. One possible explanation for the ARDS in our patient could be that sepsis from the urinary tract infection before the operation had fi rst triggered systemic infl ammation and primed neutrophils that accumulated in the lung.…”
Section: Discussionmentioning
confidence: 80%
“…Several drugs have been demonstrated to cause acute permeability lung edema. Luis et al [7] reported the development of ARDS during an operation in a patient previously exposed to bleomycin, and they suggested that oxygen toxicity and bleomycin exposure were the possible cause of the ARDS. Although other drugs, such as intrathecal methotrexate [8] and intravenous aprotinin [9], have been reported to be possible causes of ARDS, no reports, as far as we investigated, have described the development of ARDS induced by the drugs that we used during the anesthesia.…”
Section: Discussionmentioning
confidence: 99%
“…This is in line with precedent publications [7,18], recommending a low FiO2 during surgery and administration of 100% oxygen during induction of anaesthesia. Indeed despite reports indicating that in animal models the risk of BIP is lowered when hyperoxymia after bleomycin exposition is delayed, many cases of respiratory failure after hyperoxia in patients with an interval to 6 months or more after bleomycin exposition have been reported with mostly catastrophic consequences for the patients and associated with high lethality [12,14,15,19].…”
Section: Discussionmentioning
confidence: 99%
“…Using a high level of inspired oxygen (FiO2 > 50%) has been shown to reduce the incidence of perioperative infections [9,10]; however this approach has certain limitation and is disputable. There are numerous case reports and series on BIP showing a high lethality after hyperoxia [11][12][13][14][15]. The aim of this study was to retrospectively assess perioperative pulmonary complications after general anesthesia with a controlled FiO2 for retroperitoneal lymphadenectomy (RPLND) in patients who had undergone bleomycin treatment <6 months before surgery, therefore considered to be at risk for BIP.…”
Section: Introductionmentioning
confidence: 99%
“…Concerns have been raised regarding the risk for progressive pulmonary toxicity in patients who receive high concentrations of oxygen after prior therapy with bleomycin therapy. 68,69 This has led to a recommendation that supplemental oxygen (e.g., during anesthesia) should be limited to the lowest concentration possible to minimize the risk. However, some studies have failed to demonstrate a relationship between fractional inspired oxygen and risk for pulmonary toxicity.…”
Section: Pulmonary Late Effectsmentioning
confidence: 99%