دورية أكاديمية
Case Studies in Physiology: Untangling the cause of hypoxemia in a patient with obesity with acute leukemia.
| العنوان: | Case Studies in Physiology: Untangling the cause of hypoxemia in a patient with obesity with acute leukemia. |
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| المؤلفون: | Amaza I; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, Iowa., Kalra H; Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.; Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa., Eberlein M; Department of Internal Medicine, Division of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, Iowa., Jethava Y; Department of Internal Medicine, Division of Hematology, Oncology, and Bone Marrow Transplant, University of Iowa, Iowa City, Iowa.; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa., McDonell J; Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.; Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa., Wolfe B; Department of Surgery, University of Iowa, Iowa City, Iowa., Tomasson MH; Department of Internal Medicine, Division of Hematology, Oncology, and Bone Marrow Transplant, University of Iowa, Iowa City, Iowa.; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa., Bates ML; Department of Internal Medicine, Division of Hematology, Oncology, and Bone Marrow Transplant, University of Iowa, Iowa City, Iowa.; Department of Health and Human Physiology, University of Iowa, Iowa City, Iowa.; Stead Family Department of Pediatrics, University of Iowa, Iowa City, Iowa.; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa. |
| المصدر: | Journal of applied physiology (Bethesda, Md. : 1985) [J Appl Physiol (1985)] 2021 Aug 01; Vol. 131 (2), pp. 788-793. Date of Electronic Publication: 2021 May 06. |
| نوع المنشور: | Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Physiological Society Country of Publication: United States NLM ID: 8502536 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1522-1601 (Electronic) Linking ISSN: 01617567 NLM ISO Abbreviation: J Appl Physiol (1985) Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Bethesda, MD : American Physiological Society, c1985- |
| مواضيع طبية MeSH: | Hypoxia* , Leukemia*, Humans ; Male ; Obesity/complications ; Oxygen ; Partial Pressure |
| مستخلص: | Diagnosing the cause of hypoxemia and dyspnea can be complicated in complex patients with multiple comorbidities. This "Case Study in Physiology" describes an man with obesity admitted to the hospital for relapse of acute lymphoblastic leukemia, who experienced progressive hypoxemia, shortness of breath, and dyspnea on exertion during his hospitalization. After initial empirical treatment with diuresis and antibiotics failed to improve his symptoms and because an arterial blood gas measurement was not readily available, we applied a novel, recently described physiological method to estimate the arterial partial pressure of oxygen from the peripheral saturation measurement and calculate the alveolar-arterial oxygen difference to discern the source of his hypoxemia and dyspnea. Using basic physiological principles, we describe how hypoventilation, anemia, and the use of a β blocker and furosemide, collaborated to create a "perfect storm" in this patient that impaired oxygen delivery and limited utilization. This case illustrates the application of innovative physiology methodology in medicine and provides a strong rationale for continuing to integrate physiology education in medical education. NEW & NOTEWORTHY Discerning the cause of dyspnea and hypoxemia in complex patients can be difficult. We describe the "real world" application of an innovative methodology to untangle the underlying physiology in a patient with multiple comorbidities. This case further demonstrates the importance of applying physiology to interrogate the underlying cause of a patient's symptoms when treatment based on probability fails. |
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| معلومات مُعتمدة: | P30 CA086862 United States CA NCI NIH HHS; UL1 TR002537 United States TR NCATS NIH HHS; P30CA086862 United States NH NIH HHS |
| فهرسة مساهمة: | Keywords: A-aDO2; Hill equation; blood cancer; obesity hypoventilation syndrome; physiology education |
| المشرفين على المادة: | S88TT14065 (Oxygen) |
| تواريخ الأحداث: | Date Created: 20210506 Date Completed: 20211028 Latest Revision: 20230714 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8409924 |
| DOI: | 10.1152/japplphysiol.00867.2020 |
| PMID: | 33955261 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1522-1601 |
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| DOI: | 10.1152/japplphysiol.00867.2020 |