Articles: respiratory-distress-syndrome.
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Anaesth Intensive Care · Oct 1996
Comparative StudyInhaled aerosolized prostacyclin and nitric oxide as selective pulmonary vasodilators in ARDS--a pilot study.
Nitric oxide 10 ppm and inhaled aerosolized prostacyclin 50 ng/kg/min were compared as selective pulmonary vasodilators in five patients with hypoxaemia secondary to acute respiratory distress syndrome. Neither agent resulted in systemic haemodynamic changes, indicating true pulmonary selectivity. Inhaled aerolized prostacyclin improved oxygenation to a degree comparable to nitric oxide, as measured by the arterial alveolar oxygen partial pressure gradient and shunt fraction.
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Anaesth Intensive Care · Oct 1996
Alveolar overdistension is an important mechanism of persistent lung damage following severe protracted ARDS.
It is now widely accepted that mechanical ventilation may damage the lung, but the mechanism of lung damage is not clear. Possible causes include overdistension of aerated alveoli by inappropriately large tidal volumes (volutrauma), shear stresses generated during the recruitment and de-recruitment of lung units at the junction of aerated and collapsed lung, and infective or ischaemic necrosis of persistently collapsed lung. ⋯ All three patients had persistent abnormalities of lung structure which were most marked in the anterior regions of the lung. These findings suggest that overdistension of non-dependent lung regions in the main mechanism of lung damage persisting after recovery from severe protracted ARDS.
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Arch. Dis. Child. Fetal Neonatal Ed. · Sep 1996
Comparative Study Clinical Trial Controlled Clinical TrialComparison of effects of 95% and 90% oxygen saturations in respiratory distress syndrome.
To determine if decreasing arterial blood saturation from 95% to 90% could cause vasoconstriction of the pulmonary vasculature and dilatation of a patent ductus arteriosus in preterm newborn infants with respiratory distress syndrome (RDS). ⋯ A decrease from 95% to 90% SpO2 did not have any effect on the pulmonary circulatory haemodynamics nor the ductus arteriosus.
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Clinics in chest medicine · Sep 1996
ReviewEvolving concepts in the ventilatory management of acute respiratory distress syndrome.
With few modifications, a high tidal volume, normoxic, normocapnic ventilation paradigm developed as the standard approach to supporting most critically ill patients. Large tidal volumes, high end-tidal (plateau) alveolar pressures, and low levels of positive end-expiratory pressure are still common in many ICUs during ventilation of acute respiratory distress syndrome (ARDS). ⋯ A relatively small but growing number of practitioners are shifting their first priority from optimizing oxygen exchange, oxygen delivery, or respiratory system compliance to ensuring adequate lung protection. This article reviews the basis for concern about traditional ventilatory support in ARDS and develops an approach based on current evidence and newer options for management.
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Critical care medicine · Sep 1996
The 67gallium pulmonary leak index in assessing the severity and course of the adult respiratory distress syndrome.
To establish the value of the 67Gallium (Ga) pulmonary leak index, a marker of increased permeability edema of the lungs, in assessing the severity and course of the adult respiratory distress syndrome (ARDS). ⋯ The 67Ga pulmonary leak index may be a clinically useful tool to quantify the severity and course of ARDS, since clinical recovery from the syndrome may be characterized by amelioration of increased microvascular permeability.