Articles: respiratory-distress-syndrome.
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J. Physiol. Pharmacol. · Dec 1997
ReviewMechanisms of acute respiratory distress syndrome: role of surfactant changes and mechanical ventilation.
Acute respiratory distress syndrome (ARDS) is a condition characterized by a high permeability oedema due to loss of the integrity of the alveolo-capillary barrier with impairment of normal surfactant function, resulting in an increased collapse tendency of the alveoli. Mechanical ventilation on such alveoli with repeated alveolar collapse and subsequent reexpansion results in severe lung parenchymal injury and may induce further surfactant impairment. ⋯ Recent evidence from experimental studies has shown that ventilator modes which allow end-expiratory collapse can induce bacterial translocation from the lung into the bloodstream and trigger the release of inflammatory mediators, which can also be presented by maintaining end-expiratory alveolar volume. These data suggest that the interaction between surfactant changes and mechanical ventilation may play a role in the transition of ARDS into the systematic inflammatory disease process of multiple system organ failure (MSOF).
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J. Physiol. Pharmacol. · Dec 1997
ReviewPhysiologic, metabolic and mediator responses in posttrauma ARDS and sepsis: is oxygen debt a critical initiating factor?
Posttrauma adult respiratory distress syndrome (ARDS) and sepsis initiate complex humoral and cellular inflammatory responses that initially effect the microvascular system, but rapidly extend to involve and modulate the solid organ metabolic response. It is discussed whether the interaction between these cellular processes and the organs which they involve appear to be initiated by the trauma induced oxygen debt.
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Journal of critical care · Dec 1997
Pressure support ventilation in adult respiratory distress syndrome: short-term effects of a servocontrolled mode.
To assess the short-term effects of pressure support ventilation in adult respiratory distress syndrome (ARDS), we studied 17 patients with moderate to severe ARDS using mandatory rate ventilation (MRV), a servocontrolled mode of PSV having respiratory rate as the targeted parameter. ⋯ We conclude that (1) PSV delivered by MRV may adequately ventilate patients with moderate to severe ARDS, preserving gas exchange and hemodynamics, at least for the short period tested; (2) early and intermediate ARDS respond in a different manner to MRV in terms of breathing pattern, gas exchange, and level of pressure assistance; and (3) patients with early ARDS are those who have an improvement in intrapulmonary oxygenation probably due, at least in part, to alveolar recruitment augmented by active diaphragmatic contraction.
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To examine the effects of an increase in ambient oxygen (O2) concentrations on the extent of inflammatory pulmonary damage following acid aspiration. ⋯ Hyperoxia increases acid aspiration-induced inflammatory microvascular lung injury. This appears to be mediated by production of reactive species of O2.