Articles: respiratory-distress-syndrome.
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Auscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bedside auscultation in that clinicians are not present to optimize the quality of auscultation. No prior studies have compared these two auscultation methods. ⋯ Extending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Randomized Controlled TrialEffect of High-Frequency Oscillatory Ventilation, Combined With Prone Positioning, in Infants With Acute Respiratory Distress Syndrome After Congenital Heart Surgery: A Prospective Randomized Controlled Trial.
This study aimed to evaluate the effect of high-frequency oscillatory ventilation, (HFOV) combined with prone positioning, on oxygenation and pulmonary ventilation in infants with acute respiratory distress syndrome (ARDS) after congenital heart surgery. ⋯ HFOV-PP significantly improved oxygenation in infants with ARDS after cardiac surgery and had no serious complications.
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Am. J. Respir. Crit. Care Med. · Oct 2022
Vasculopathy and Increased Vascular Congestion in Fatal COVID-19 and ARDS.
Rationale: The leading cause of death in coronavirus disease 2019 (COVID-19) is severe pneumonia, with many patients developing acute respiratory distress syndrome (ARDS) and diffuse alveolar damage (DAD). Whether DAD in fatal COVID-19 is distinct from other causes of DAD remains unknown. Objective: To compare lung parenchymal and vascular alterations between patients with fatal COVID-19 pneumonia and other DAD-causing etiologies using a multidimensional approach. ⋯ Alveolar-septal congestion was associated with a significantly shorter time to death from symptom onset (P = 0.03), length of hospital stay (P = 0.02), and increased ventilatory ratio [an estimate for pulmonary dead space fraction (Vd); p = 0.043] in all cases of ARDS. Conclusions: Severe COVID-19 pneumonia is characterized by significant vasculopathy and aberrant alveolar-septal congestion. Our findings also highlight the role that vascular alterations may play in Vd and clinical outcomes in ARDS in general.
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Journal of critical care · Oct 2022
Increased respiratory dead space could associate with coagulation activation and poor outcomes in COVID-19 ARDS.
To determine whether VDPhys/VT is associated with coagulation activation and outcomes. ⋯ In critically ill COVID-19 patients, increased VDPhys/VT was associated with high D-dimer levels and a lower likelihood of being discharged alive. Dichotomic VDPhys/VT could help identify a high-risk subgroup of patients neglected by the P/F ratio.