Articles: respiratory-distress-syndrome.
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Indian J Chest Dis Allied Sci · Jul 1996
ReviewAcute respiratory distress syndrome (ARDS) in miliary tuberculosis: a twelve year experience.
Miliary tuberculosis [MTB] is an uncommon but important treatable cause of acute respiratory distress syndrome [ARDS]. In this communication, six patients with MTB who developed ARDS in the course of their illness are described. The difficulties encountered in diagnosing MTB as a primary cause of ARDS are highlighted. The pathogenetic mechanisms of ARDS in MTB are briefly reviewed.
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Intensive care medicine · Jul 1996
Combined effects of NO inhalation and intravenous PGF2 alpha on pulmonary circulation and gas exchange in an ovine ARDS model.
Inhalation of nitric oxide (NO) selectively dilates pulmonary vessels in well-ventilated regions. Prostaglandin F2 alpha (PGF2 alpha) is a vasoconstrictor and is reported to enhance hypoxic pulmonary vasoconstriction. The objective of this study was to examine whether the combination of intravenous PGF2 alpha and inhaled NO in ARDS lungs has a beneficial effect on oxygenation. ⋯ It is suggested that inhalation of NO reduced the critical vascular pressure near alveoli without affecting upstream vessels, while infused PGF2 alpha constricted the larger upstream pulmonary artery vessels without appreciably affecting the critical pressure. Inhalation of NO into well-ventilated lung areas shifted perfusion to well-oxygenated areas, and there was no supplemental shift in blood flow by adding an infusion of PGF2 alpha.
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Critical care medicine · Jul 1996
Randomized Controlled Trial Clinical TrialAn increase in serum C18 unsaturated free fatty acids as a predictor of the development of acute respiratory distress syndrome.
No means exist for predicting the acute respiratory distress syndrome (ARDS), which complicates sepsis, trauma, and a variety of clinical disorders. Because activation of phospholipid-signaling pathways involving the acyl chains oleate and linoleate may initiate and amplify the inflammatory response, and thereby lead to the development of ARDS, we examined whether serum concentrations of these bioactive lipids increase and are predictive of ARDS in at-risk patients. ⋯ Increases in unsaturated serum acyl chain ratios differentiate between healthy and seriously iII patients, and identify those patients likely to develop ARDS. Thus, the serum acyl ratio may not only prospectively identify and facilitate the assessment of new treatments in patients at highest risk for developing ARDS, but may also lead to new insights about the pathogenesis of ARDS.
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The Journal of pediatrics · Jul 1996
Randomized Controlled Trial Clinical TrialRoutine use of fentanyl infusions for pain and stress reduction in infants with respiratory distress syndrome.
To determine whether fentanyl infusions given to premature infants with respiratory distress syndrome reduce stress and improve long- and short-term outcome. ⋯ Although there was a reduction in stress markers in the infants receiving fentanyl, we were unable to demonstrate an improvement in catabolic state or long-term outcome. In addition, the infants receiving fentanyl required higher ventilatory support in the early phase of respiratory distress syndrome than did those receiving placebo.
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Am. J. Respir. Crit. Care Med. · Jul 1996
Changes in the inflammatory response of the lung during acute respiratory distress syndrome: prognostic indicators.
We studied paired bronchoalveolar lavage (BAL) in patients with sepsis-associated acute respiratory distress syndrome (ARDS). Patients were evaluated at one institution and underwent bronchoscopy with BAL within 48 h of the onset of ARDS. Patients were restudied with bronchoscopy and BAL after 4 d of treatment. ⋯ In the follow-up lavage, there was a significant fall for the IL-8 concentrations for the survivors but not the nonsurvivors. We conclude that neutrophil influx in ARDS may rapidly resolve within a week of the onset of ARDS. The resolution of neutrophils was associated with a good prognosis.