Amniotic fluid embolism.
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Biomedical subjects
Publications and source records attributed to G J Heymach.
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Cryoprecipitate was administered to a patient with severe adult respiratory distress syndrome secondary to an amniotic fluid embolus, diagnosed cytologically. Following the administration of cryoprecipitate, cardiopulmonary and hematologic status markedly improved, and the patient recovered without apparent sequela. She is the sixth surviving patient reported to have an amniotic fluid embolus confirmed cytologically. On the basis of accumulating data on the relationship between fibronectin levels and the integrity of the reticuloendothelial system, it is quite possible that fibronectin (cold-insoluble globulin), and not fibrinogen, played the key role in her dramatic improvement and may well have been responsible for the clinical improvement in earlier patients treated with blood products containing fibronectin.
Bronchopulmonary lavage with a fiberoptic bronchoscope was performed on a patient with alveolar proteinosis and only one lung. Lavage was performed under general anesthesia with continuous monitoring of oxygen saturation. Sequential washing of subsegments of his right upper and middle lobes did not compromise gas exchange to the remaining lower lobe. The patient tolerated the procedure without difficulty and had rapid improvement in pulmonary function and exercise capability, persisting during two months of follow-up. The necessity for cardiopulmonary bypass to provide oxygenation was anticipated and new equipment was designed should it have been required.
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