Articles: respiratory-distress-syndrome.
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Damage to the respiratory system caused by inhalation of toxic products of combustion and the subsequent development of adult respiratory distress syndrome (ARDS) are the main lethal factors in burns patients. Treatment with exogenous surfactant is one of the therapeutic options. However, no clinical reports have yet been published about this therapy. ⋯ Intrabronchial application of surfactant by bronchoscopy during exhaustive conventional mechanical ventilation resulted in improved gas exchange with an increase in arterial O2 pressure (paO2); inspired O2 concentration (FiO2) was lowered and there was an improvement in lung compliance. Both patients survived this critical situation. We conclude that treatment with exogenous surfactant in postburn victims with ARDS is a promising therapeutic approach to improve the survival rate of these high-risk patients.
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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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J. Heart Lung Transplant. · Apr 1997
Case ReportsExtracorporeal membrane oxygenation for early graft dysfunction in lung transplantation: a case report.
Although extracorporeal membrane oxygenation (ECMO) has become standard treatment for neonatal respiratory failure, the results of ECMO in adults have been less encouraging. With technical improvements in membrane oxygenators and revised ECMO protocols, there has been renewed interest in ECMO for adults with severe acute respiratory failure. ⋯ We present the case of a 20-year-old woman with cystic fibrosis who underwent bilateral single lung transplantation. She had development of severe graft dysfunction in the immediate postoperative period requiring support with ECMO for stabilization.