Association of Chronic Thromboembolic Pulmonary Hypertension with Hereditary and Acquired Risk Factors for Thromboembolism

Thrombophilia increases the incidence of pulmonary thrombosis significantly. Various hereditary and acquired factors are known for thromboembolism. The hereditary factors are two common genetic autosomal mutations including factor V leidan mutation and prothrombin gene mutation. A descriptive- analytical design was conducted on 60 patients with thromboembolism who met the inclusion criteria. Two groups with hereditary and acquired risk factors for thromboembolism (group A, B, each 30 people) were evaluated. All the patients of two groups were evaluated in terms of emboli associated with hereditary and acquired risk factors. Association of thromboembolism risk factors' with pulmonary hypertension were studied at the beginning of the study and six months after the treatment then the results of two groups were compared. Among participants, 31 (56.4%) were men.  The mean age of the patients was 44.4±14 years, ranging between 23-75 years. Significant association was observed between the stability of the blood clot in pulmonary vessel, six months after the treatment with genetic risk factors (P=0.03). However, no significant association was between pulmonary hypertension and hereditary and acquired risk factors (P=0.24). Based on the significant association between the hereditary risk factors and pulmonary emboli, by taking special prevention and therapy measurements (e.g. genetic engineering), some pulmonary and mortality complications can be prevented and the patient himself and health care system would benefit from this issue

Ultrasound assessment of diaphragm thickness in mechanically ventilated patients suffering from obstructive pulmonary disease and its relationship with outcomes of mechanical ventilation and mechanical parameters of lungs

Introduction: Successful weaning from the ventilator depends on several factors including muscular, cardiac, respiratory, and metabolic strength. Acquired weakness of diaphragm muscle caused by mechanical ventilation is one of the reasons for failure to wean patients from ventilators. Meanwhile, it has been shown that the thickening fraction (TF) and ultrasound of the diaphragm are proper non-invasive indicators for making decisions on weaning patients from the ventilator. Methodology: Mechanically ventilated patients with chronic obstructive pulmonary disease who had been admitted to pulmonary intensive care units during a period of one year were selected for this study. Through statistical consultation, sixty patients were examined for the study. There was no gender difference in the number of patients. After selecting the patients, all of them underwent a B-mode ultrasound with a linear probe of 9 to 12 megahertz on the second day after intubation in the supine position. The thickness of the diaphragm in all patients was measured at the end of exhalation and in the space between the 9th and 10th ribs, between the anterior and middle axillary lines, and the results were compared between the individuals in two ways: successful and unsuccessful weaning