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Biomedical subjects

A J Roncoroni

Publications and source records attributed to A J Roncoroni.

At least 109 records · Page 6Linked to original sources

Correction of severe metabolic acidosis: a physiological approach.

1 - Five patients with severe metabolic acidosis secondary to methanol poisoning were studied before and after receiving 6.7 to 10 mEq NaHCO3/kg body weight. 2 - Two thirds of the infused HCO3- left the extracellular space and, since its apparent volume of distribution was much larger than under normal conditions, it largely overestimated HCO3- needs. On the contrary, the volume of distribution of the buffer base excess was found to be more stable and little affected by the acid-base status. 3 - Based on these observations, a simple method for estimating HCO3- needs in severe metabolic acidosis is proposed, requiring only the initial excess buffer base space which is calculated from body weight and blood buffer base excess values obtained before and after a first dose of bicarbonate.

Acidosis↗

Successful treatment of acute respiratory distress syndrome with prolonged continuous positive-pressure ventilation.

A 37 year-old man was admitted in severe acute respiratory failure after a surgical procedure. He was ventilated mechanically (FIO2 - 0.60), and had a Pa,O2 of 34 mmHg. Continuous positive-pressure ventilation was started and the Pa,O2 rose to 74 mmHg. This procedure was required for 18 days. During the period of the greater derangement of gas exchange, the venous admixture on inhalation of 40% oxygen was 80% and later 43%, whereas on inhalation of 100% oxygen it was 52% and later 35%. He was weaned from the respirator on the nineteenth day. If unevennes of ventilation--perfusion due to regional hypoventilation disappear on inhalation of 40% oxygen, a decrease of shunt on inhalation of 100% oxygen suggests impairment of diffusion.

Acute Disease↗

Bronchoconstriction induced by repeated forced vital capacity manoeuvres.

An asthmatic atopic patient who developed bronchoconstriction during repeated forced vital capacity manoeuvres and after exercise is reported. Since increases in total airway and upper segment resistances and drop in FEV1 and Vmax 50 were induced, it is considered that bronchoconstriction involved most of the airways. Partial prevention of this effect could be demonstrated after inhalation of an adrenergic bronchidilator or disodium cromoglycate. Atropine completely prevented the flow response but did not alter the total airway resistance increase. Bronchoconstriction is interpreted as partially related to mast cell disruption and cholinergically mediated stimuli.

Adolescent↗

Idiopathic interstitial pulmonary fibrosis with hypercapnia.

A 38-year-old patient with effort dyspnea, somnolence, cianosis and cor pulmonale is presented. Chest roentgenograms and lung function studies suggested the diagnosis of pulmonary fibrosis. The patient showed also severe hypercapnia with normal resting ventilation and ventilatory response to exercise lower than usual for this condition. Autopsy confirmed the clinical diagnosis. This subject may belong to the growing group of patients where CO2 retention is not explained by their pulmonary pathology.

Adult↗