Articles: respiratory-distress-syndrome.
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Critical care medicine · Mar 1997
Effects of eicosapentaenoic and gamma-linolenic acid on lung permeability and alveolar macrophage eicosanoid synthesis in endotoxic rats.
Proinflammatory eicosanoids (cyclooxgenase and lipoxygenase metabolites of arachidonic acid) released by alveolar macrophages play an important role in endotoxin-induced acute lung injury. We investigated the effect of prefeeding rats for 21 days with enteral diets that provided the anti-inflammatory fatty acids, eicosapentaenoic acid and gamma-linolenic acid (derived from fish oil and borage oil, respectively), as compared with an n-6 fatty acid-enriched diet (corn oil) on the following: a) lung microvascular protein permeability, arterial blood pressure, and platelet and white blood cells in a model of endotoxin-induced acute lung injury; b) alveolar macrophage prostaglandin and leukotriene synthesis; and c) liver and alveolar macrophage phospholipid fatty acid composition. ⋯ The severity of pulmonary microvascular protein permeability and the degree of hypotension were reduced with fish or fish and borage oil diets, as compared with corn oil, in endotoxic rats. The reduced synthesis of the proinflammatory arachidonic acid-derived mediators, leukotriene B4, thromboxane B2, and prostaglandin E2 from stimulated alveolar macrophages was indicative of a decrease in arachidonic acid and an increase in eicosapentaenoic acid and docosahexaenoic acid in cell membrane phospholipids.
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Intensive care medicine · Mar 1997
Case ReportsARDS caused by herpes simplex virus pneumonia in a patient with Crohn's disease: a case report.
Pneumonia caused by herpes simplex virus type 1 (HSV1) is rare and occurs in severely immunosuppressed patients. HSV1 can be detected in bronchoalveolar lavage (BAL) from patients presenting with respiratory failure, but its direct effect on disease is difficult to prove. We demonstrate the causative role of HSV1 in the case of a 44-year-old male with Crohn's disease who presented to the intensive care unit with the acute respiratory distress syndrome after surgery. ⋯ A lung biposy specimen showed fibroproliferation without pathogens. Immunosuppressive therapy had been stopped and acyclovir was introduced at this time. The diagnostic difficulties in this patient underline the importance of early recognition of viral infection as a potential cause of severe pneumonia in severely ill, immunocompromised patients.
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Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi · Mar 1997
Clinical TrialHigh-frequency oscillatory ventilation for infants and children with adult respiratory distress syndrome.
Two infants and two children suffered from severe hypoxemia, presenting as a ratio of arterial to alveolar PaO2 < 0.1, persisting for more than 3 hours in spite of high settings on conventional mechanical ventilator. Adult respiratory distress syndrome was diagnosed with the support of bilateral diffuse haziness on chest radiographs. High-frequency oscillatory ventilation with high-lung-volume strategy resulted in prompt decrease in oxygenation index and increase in ratio of arterial to alveolar P O2 in three (75%) of the 4 patients within 6 hours. ⋯ There were 2 episodes of pneumothorax developing during high-frequency oscillatory ventilation. After decreasing mean airway pressure and amplitude, the airleak resolved with chest tube insertion. We conclude that high-frequency oscillatory ventilation with high-lung-volume strategy may be an effective rescue therapy to relieve profound hypoxemia in infants and children with adult respiratory distress syndrome.
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Critical care medicine · Mar 1997
Experimental study of double-lumen, two-stage endotracheal tube during conventional mechanical ventilation in rabbits.
To evaluate the effects of a double-lumen, two-stage endotracheal tube on gas exchanges (ventilatory efficiency) during conventional mechanical ventilation, using a ventilator in rabbits. ⋯ Compared with the conventional endotracheal tube, the new double-lumen, two-stage endotracheal tube reduced Paco2 by decreasing anatomical deadspace in rabbits with normal and injured lungs under pressure control ventilation, thus enhancing ventilatory efficiency and reducing ventilator-induced injury.
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Klinische Pädiatrie · Mar 1997
[Simultaneous measurements of end-expiratory and transcutaneous carbon dioxide partial pressure in ventilated premature and newborn infants].
The aim of the present trial was to study the relationship between end-tidal pCO2 (p(et)CO2) and transcutaneous pCO2 (ptcCO2) after in-vivo calibration in ventilated newborns. ⋯ Capnographic determination of P(et)CO2 provides informations about alveolar ventilation-perfusion-disturbances. Capnography enables the on-line control of end-tidal pCO2 in neonates with respiratory failure. It cannot replace transcutaneous pCO2 measurements or blood gas analysis but it can reduce its frequency in clinically stable patients. The analysis of the capnogram can be used to optimise artificial ventilation. A quantitative evaluation of the capnogram by calculation of Murányi's-CO2-Index was possible only in 28% of the ventilated newborns which limits its value in such patients.