Articles: respiratory-distress-syndrome.
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Pediatric pulmonology · Apr 1996
Lung volume measurements immediately after extubation by prediction of "extubation failure" in premature infants.
To test the hypothesis that premature infants in whom extubation fails in the first 10 days of life have low volume lungs, functional residual capacity (FRC) was measured in the first hour after extubation. Once extubated, infants received the appropriate level of inspired oxygen necessary to maintain acceptable arterial oxygen saturation. After humidification, oxygen was bled into a headbox, and FRC was assessed using a helium gas dilution technique and a specially designed infant circuit. ⋯ In the infants who failed extubation, the median FRC was 19 ml/kg (range, 12-27 ml/kg), which was lower than that of the infants in whom extubation was successfully accomplished (median, 28 ml/kg; range, 19-37 ml/kg; P < 0.01). An FRC of less than 26 ml/kg had a sensitivity of 71% and specificity of 77% in predicting extubation failure. These results support the hypothesis that a very low lung volume relates to extubation failure in the first 10 days of life.
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Southern medical journal · Apr 1996
Established adult respiratory distress syndrome successfully treated with corticosteroids.
In 1990, we described the treatment of established adult respiratory distress syndrome (ARDS) with a sustained course of adrenocortical steroids (ACS). This report updates our experience with an uncontrolled prospective series. Patients with ARDS of more than 3 days' duration were initially given ACS in intravenous dosages of 125 to 250 mg every 6 hours, with tapering every 3 to 4 days. ⋯ We have treated 26 patients, and overall survival was 81% (21/26). When complicating features were present, survival was 64% (9/14). Our uncontrolled, observational experience in treating established ARDS suggests that a sustained course of ACS may improve survival in these severely ill patients.
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Thrombosis research · Apr 1996
Pulmonary vascular injury induced by hemorrhagic shock is mediated by P-selectin in rats.
To investigate whether the P-selectin-mediated leukocyte adhesion to the endothelial cells is involved in pulmonary vascular injury after hemorrhagic shock, we examined the effect of an anti-P-selectin monoclonal antibody (MAb PB1.3) on the pulmonary accumulation of leukocytes and the subsequent pulmonary vascular injury observed after hemorrhagic shock in rats. Two hours after hemorrhagic shock, pulmonary accumulation of leukocytes, as evaluated by measuring myeloperoxidase activity, began to increase and peaked after 6 hours. ⋯ MAb PNB1.6, an anti-P-selectin monoclonal antibody incapable of inhibiting P-selectin-mediated leukocyte adhesion, did not prevent either of these effects. These observations strongly suggest that the pulmonary sequestration of leukocytes and the subsequent pulmonary vascular injury after hemorrhagic shock are mediated by P-selectin.
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Critical care medicine · Apr 1996
Meta AnalysisAdult respiratory distress syndrome: a systemic overview of incidence and risk factors.
To determine the published incidence of adult respiratory distress syndrome (ARDS) as well as the clinical evidence supporting a casual association between ARDS and its major risk factors. ⋯ The significant variation in the incidence of ARDS is attributed to differences in the type and strength of study designs, as well as definitions or ARDS. While a substantial body of evidence exists concerning a casual role of ARDS risk factors, such as sepsis, aspiration, and trauma, > 60% of clinical studies employed weak designs. The lack of reproducible definitions for ARDS or its potential risk factors in 49% of studies raises concerns about the validity of the conclusions of these studies regarding the association between ARDS and the supposed risk factors.