South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Comparative Study
Adult respiratory distress syndrome in cases of severe trauma--the prophylactic value of methylprednisolone sodium succinate.
The more important known pathogenetic mechanisms apparently responsible for the development of adult respiratory distress syndrome (ARDS) are briefly discussed. Reactions in the development of ARDS for which corticosteroids are possibly beneficial are pointed out. ⋯ MPSS was administered to 47 seriously injured patients and omitted from the management regimen of 45 patients comparable as regards age and severity of injury. The percentage of patients who developed ARDS was significantly lower in the group that received MPSS than in the control group.
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Between January 1981 and December 1983, 53 systemic-to-pulmonary artery shunts, Blalock-Taussig shunts (BTSs) and modified Blalock-Taussig shunts (MBTSs) were carried out either as a preliminary procedure before complete correction of heart defects or as a means of permanent palliation. Central shunts continue to pose early and late problems and we seldom use them. Fifteen patients underwent a BTS and 38 an MBTS with a 5 mm polytetrafluoro-ethylene (PTFE) graft. ⋯ Long-term results are difficult to assess accurately because of problems with follow-up. Eight of the 53 patients had mild congestive heart failure which responded to digitalis. Because of the reliability and excellent late patency of the PTFE prosthesis, we consider it to be superior to the Waterston shunt for relief of cyanosis in the neonate and infant and as reliable as the BTS.