7 Rochester DF, Braun NMT, Laine S. Diaphra~atic ener~ expenditure in chronic respiratory. failure: the effect of assisted ventilation with body ventilators. Am J Med 1977; 63:223-32 8 Delaubier A. Traitement de l'insuffisance respiratoire chronique dans les dystrophies musculaires. In: Memoires de certficat d'etudes superieures de reeducation et readaptation fonctionelles. Paris: Universite R. Descartes, 1984:1-124 9 Kerby GR, Mayer LS, Pingleton SK. Nocturnal positive pressure ventilation via nasal mask. Am Rev Respir Dis 1987; 135:738-40 10 Bach JR, Alba A, Mosher R, Delaubier A. Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency. Chest 1987; 92:168-70 II Carrey Z, Gottfried SB, Levy RD. Ventilatory muscle support in respiratory failure with nasal positive pressure ventilation. Chest 1990; 97:150-58 12 Gay P, Viggiano R, Edell E, Staats B. Treatment ofcomplications from intermittent nasal ventilation for neuromuscular disease and hypercarbic respiratory failure. Chest 1989; 96: 173S 13 Bach JR, Alba AS. Management of chronic alveolar hypoventilation by nasal ventilation. Chest 1990; 97:52-7 14 Bach JR, Alba AS, Shin D. Management alternatives for postpolio respiratory insufficiency: assisted ventilation by nasal or oral-nasal interface. Am J Phys Med Rehab 1989; 68:264-71 15 Bach JR, Alba AS. Noninvasive options for ventilatory support of the traumatic high level quadriplewc patient. Chest 1990; 98:613-19
Unilateral Pulmonary Edema* An Unusual Cause Steven E Kagele, M.D.; and Nirmal B. Charan, M.D., EC.C.P.
A patient presented with shortness of breath without fever, cough or sputum production. The patient was hypoxic without leukocytosis and a chest x-ray 6lm demonstrated a right unilateral pulmonary in6ltrate. A chest CT showed a large ascending thoracic aortic aneurysm with dissection. During surgical repair, the aneurysm was noted to be compressing the single right pulmonary vein. The in6ltrate resolved postoperatively, and the patient has remained symptom-free for one year. (Chellt 1992; 102:1279-80)
I
DFA
FICURE 1. Cbest x-ray film demonstmting sternal wires fnlm previous (.'()ronary surgery and a diffuse right-sided interstitial infiltrate. cough. He denied orthopnea, paroxysmal nocturnal dyspnea, chest pain, leg swelling, fever, chills, hemoptysis, rash and night sweats. He was retired and traveled extensively in his motor home throughout the Southwest, Northwest and Central United States. Symptoms were more pnmounced the weekend before admission while tbe patient was camping at 8,000 feet elevation. He had a history of myocardial infarction with congestive heart failure and had a threevessel coronary artery bypass in 1971. Initial vital signs showed temperature of 37°C, respiratory rate of 35 breaths per minute, blood pressure of 120160 mm Hg and a regular heart rate of 65 beats per minute. Oral mucosa was moist and there was no jugular venous distention. Lung fields were clear. Heart examination revealed a grade 216 systolic ejection murmur at the upper left sternal border without any gallop. A chest x-ray film showed a diffuse right-sided pulmonary infiltrate without cardiomegaly, masses or pleural effusions (Fig I). Laboratory examination showed a white blood cell count of 9,500 cells/dl, with a normal differential
Unilateral Pulmonary Edema* An Unusual Cause Steven E Kagele, M.D.; and Nirmal B. Charan, M.D., EC.C.P.
A patient presented with shortness of breath without fever, cough or sputum production. The patient was hypoxic without leukocytosis and a chest x-ray 6lm demonstrated a right unilateral pulmonary in6ltrate. A chest CT showed a large ascending thoracic aortic aneurysm with dissection. During surgical repair, the aneurysm was noted to be compressing the single right pulmonary vein. The in6ltrate resolved postoperatively, and the patient has remained symptom-free for one year. (Chellt 1992; 102:1279-80)
I
DFA
FICURE 1. Cbest x-ray film demonstmting sternal wires fnlm previous (.'()ronary surgery and a diffuse right-sided interstitial infiltrate. cough. He denied orthopnea, paroxysmal nocturnal dyspnea, chest pain, leg swelling, fever, chills, hemoptysis, rash and night sweats. He was retired and traveled extensively in his motor home throughout the Southwest, Northwest and Central United States. Symptoms were more pnmounced the weekend before admission while tbe patient was camping at 8,000 feet elevation. He had a history of myocardial infarction with congestive heart failure and had a threevessel coronary artery bypass in 1971. Initial vital signs showed temperature of 37°C, respiratory rate of 35 breaths per minute, blood pressure of 120160 mm Hg and a regular heart rate of 65 beats per minute. Oral mucosa was moist and there was no jugular venous distention. Lung fields were clear. Heart examination revealed a grade 216 systolic ejection murmur at the upper left sternal border without any gallop. A chest x-ray film showed a diffuse right-sided pulmonary infiltrate without cardiomegaly, masses or pleural effusions (Fig I). Laboratory examination showed a white blood cell count of 9,500 cells/dl, with a normal differential
