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Biomedical subjects

A A Garzon

Publications and source records attributed to A A Garzon.

At least 19 recordsLinked to original sources
PubMed1982

Exsanguinating hemoptysis.

Massive hemoptysis (600 ml in 24 hours) results in a mortality of more than 50%. We have performed 74 pulmonary resections in patients with massive hemoptysis in the last 15 years, with a mortality of 13%. The mortality correlated with the rate and the amount of recorded blood loss before the operation. From this experience, we have identified a subgroup of patients with such massive hemoptysis that life was threatened by exsanguination. Twenty-four of our patients lost more than 1,000 ml of blood, at a rate of at least 150 ml an hour, before the pulmonary resection was performed. The bleeding site was always identified by bronchoscopy. All patients were treated by resection of the bleeding lung parenchyma. Several methods were used to avoid the patient's drowning in his own blood during the operation. In five patients, a double-lumen endotracheal tube was used: Two died of suffocation during the procedure and another died of respiratory and liver failure. In four patients, single-lung ventilation with an endotracheal tube in the left main bronchus was used: All four survived. In another 10 patients a bronchial blocker (No. 9 Fogarty balloon venous catheter) was used to stop bleeding. Two patients died of renal failure and gastrointestinal bleeding, respectively, but none had aspiration problems. In five additional patients, a regular endotracheal tube was used: One patient died of massive aspiration. Our experience indicates that bleeding from the left lung and right lower lobe should be controlled by intubation of the left bronchus. Patients with exsanguinating hemoptysis should be treated, when possible, by pulmonary resection. A survival rate of 75% was obtained in our patients.

Adolescent↗
PubMed1978

Surgical management of massive hemoptysis. A ten-year experience.

Pulmonary bleeding was defined as massive when the collected blood was 600 ml or more in 24 hours. Hemoptysis of this magnitude carries more than 50% mortality when managed without surgical intervention, For this reason all patients admitted, bleeding massively, in the past ten years were considered candidates for surgical therapy. Localization of the bleeding was done by bronchoscopy. Pulmonary reserve was evaluated by clinical and radiological observation and, when feasible, by spirometry. Of the 75 patients seen with massive hemoptysis, 68 were operated. Seven patients were excluded for various reasons. Five of these patients died during the acute bleeding episode. Sixt-five resections were performed with 11 deaths (17%) and three cavernostomies with one death. Of 51 lobectomies, seven expired (14%). One segmentectomy survived. Other than the magnitude of the surgical resection, the mortality was related to the amount of bleeding in the 24 hours preceding the surgical procedure. Severe bleeding at the time of resection requiring one-lung ventilation also significantly influenced the mortality (33% against 7%). This experience shows that pulmonary resection is the treatment of choice in patients with massive hemoptysis.

Adolescent↗
PubMed1977

Hypothermic lung preservation functions, six or more years later.

The functions of each lung were measured 41 and 79 months following hypothermic twenty-four four lung preservation and autotransplantation in six and four dogs respectively. Functional results were compared with long-term autotransplanted canine lungs. Compliance, total lung capacity, functional reserve capacity and ventilation of preserved lungs were similar to autotransplanted lungs, and only slightly decreased as compared with normal animals. There was no statistically significant difference between the pulmonary diffusion capacity and oxygen uptake of the preserved and autotransplanted lungs group and autotransplants alone. However, in both groups, diffusion capacity and oxygen uptake were decreased as compared with intact animals. Pulmonary hypertension was found on occlusion of the contralateral lung's artery: it was due to increased pulmonary vascular resistance. No gross narrowing of the pulmonary artery or venous anastomosis was found that could explain the increased resistance. Diffuse emphysema of various degrees was observed in all animals. This study seems to indicate that hypothermic preservation of the lung does not affect significantly the long-term functional ability of the organ, and probably will have practical value in future clinical lung transplantation.

Animals↗