Articles: respiratory-distress-syndrome.
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Critical care medicine · Apr 1997
Significant reduction in minute ventilation and peak inspiratory pressures with arteriovenous CO2 removal during severe respiratory failure.
To quantify CO2 removal using an extracorporeal low-resistance membrane gas exchanger placed in an arteriovenous shunt and evaluate its effects on the reduction of ventilatory volumes and airway pressures during severe respiratory failure induced by smoke inhalation injury. ⋯ Extracorporeal CO2 removal using a low-resistance gas exchanger in a simple arteriovenous shunt allows significant reduction in minute ventilation and peak inspiratory pressure without hypercapnia or the complex circuitry and monitoring required for conventional extracorporeal membrane oxygenation. Arteriovenous CO2 removal can be applied as an easy and cost-effective treatment to minimize ventilator-induced barotrauma and volutrauma during severe respiratory failure.
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Pathologie-biologie · Apr 1997
Right shift of the oxyhemoglobin dissociation curve in acute respiratory distress syndrome.
Deep hypoxia is known to increase the intraerythrocytic 2,3 diphosphoglycerate (DPG) level and therefore to induce a right shift of the oxyhemoglobin dissociation curve (ODC), which is considered to be a protective mechanism against tissular hypoxia. Our purpose was to assess whether the ODC is shifted to the right in patients with acute respiratory distress syndrome (ARDS) and whether this shift had a beneficial effect on tissue oxygenation. We have determined the whole ODC and related indices in 29 control subjects and 29 patients suffering from ARDS for at least 5 days. ⋯ A right shift decreases therefore the captation of oxygen from the lung. On the other hand theoretical studies have shown that at low arterial PO2 values a right shift of the ODC has a detrimental effect on release of oxygen from hemoglobin if the mixed venous PO2 is decreased. In order to quantify the amount of oxygen actually transmitted to the tissues, others factors are to be investigate as the PCO2 or the temperature.
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Review Case Reports
Pseudopulmonary embolism: acute respiratory distress in the syndrome of heparin-induced thrombocytopenia.
A 73-year-old man with myasthenia gravis was treated with daily plasmapheresis. During the course of treatment, the patient developed progressive thrombocytopenia and an episode of severe acute respiratory distress suggesting pulmonary embolism. ⋯ The time frame of clinical events suggests a heparin-mediated mechanism for both the thrombocytopenia and respiratory compromise. We conclude that acute respiratory distress may be the presenting manifestation of the syndrome of heparin-associated thrombocytopenia in patients treated with dialysis or apheresis.