Articles: respiratory-distress-syndrome.
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Critical care medicine · Jun 1996
Gabexate mesilate, a synthetic protease inhibitor, attenuates endotoxin-induced pulmonary vascular injury by inhibiting tumor necrosis factor production by monocytes.
In order to determine whether gabexate mesilate, a synthetic protease inhibitor with anticoagulant properties, is useful for the treatment of adult respiratory distress syndrome, we examined its effect on endotoxin-induced pulmonary vascular injury in rats. ⋯ Our findings suggest that gabexate mesilate attenuated endotoxin-induced pulmonary vascular injury mainly by inhibiting TNF-alpha production by monocytes, which may play a central role in sepsis-related lung injury.
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The severity of acute pulmonary hypertension (APHT) in acute respiratory distress syndrome was examined in 20 patients. All patients had significant APHT (mean pressure 40.6 +/- 6.3 mmHg) on admission to the intensive care unit. ⋯ The RV afterload, i.e. pulmonary artery elastance (Ea = stroke volume/peak pulmonary artery pressure), was raised. Stroke volume could not be predicted from Ea or RVSWI alone, but regression analysis indicated that the ratio of RVSWI/Ea (i.e. ventriculo-arterial coupling) could account for 88% of the stroke volume.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Aerosolized surfactant in adults with sepsis-induced acute respiratory distress syndrome. Exosurf Acute Respiratory Distress Syndrome Sepsis Study Group.
Patients with acute respiratory distress syndrome (ARDS) have a deficiency of surfactant. Surfactant replacement improves physiologic function in such patients, and preliminary data suggest that it may improve survival. ⋯ The continuous administration of aerosolized synthetic surfactant to patients with sepsis-induced ARDS had no significant effect on 30-day survival, length of stay in the intensive care unit, duration of mechanical ventilation, or physiologic function.
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Swiss medical weekly · May 1996
Review[Ventilation in the prone position in acute respiratory distress syndrome (ARDS)].
Prone position mechanical ventilation (PPV) secures an improvement in gas exchange in approximately two-thirds of ARDS patients. Recent experimental and clinical data suggest that PPV acts mainly by recruiting alveoli situated in the dorsal dependent regions which are collapsed under the superimposed weight of the overlying edema-laden lungs. The purpose of this article is to provide an overview of the basic pathophysiological mechanisms underlying PPV as well as to underscore the promising clinical results so far obtained with this technique. In spite of these results the place of PPV among the other ventilatory and pharmacological approaches in the supportive treatment of ARDS, and the possible beneficial or deleterious consequences of associating PPV with one or more of these therapeutic modalities, remains to be determined.
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Intensive care medicine · May 1996
The role of gallium-67 scintigraphy in diagnosing sources of fever in ventilated patients.
To evaluate the diagnostic value of gallium-67 scintigraphy in febrile ventilated patients by correlating the findings of 67Ga scintigraphy to sources of fever and pulmonary density, as determined by a comprehensive protocolized diagnostic evaluation. ⋯ 67Ga scintigraphy should be considered only as an adjunct diagnostic test in the febrile, ventilated patient who has no obvious source of fever, despite a negative evaluation that includes testing for pneumonia, sinusitis, and urinary tract infection, conditions that are rarely detected by 67Ga scintigraphy.