Articles: respiratory-distress-syndrome.
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Acute respiratory distress syndrome (ARDS) is rare but beset with a high mortality rate. In recent years, however, a trend towards higher survival rates has been observed. High inspiratory oxygen concentrations, large tidal volumes, and high peak inspiratory airway pressures applied during mechanical ventilation have been identified as harmful to the lung and can contribute to the progression of ARDS. ⋯ Should these procedures fail to improve impaired gas exchange, extracorporeal membrane oxygenation is an additional therapeutic option. None of these therapeutic procedures, however, has been tested against traditional standard treatment in a classical randomised controlled trial. The following review focuses on the latest insights into the pathophysiology, diagnosis, and treatment of ARDS.
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Amiodarone, a widely used antiarrhythmic drug, is associated with pulmonary toxicity, with an estimated mortality of 1% to 33%. Standard treatment for amiodarone pulmonary toxicity (APT) has been discontinuance of the drug and steroid therapy. We report a case of APT that recurred after withdrawal of steroids and failed to respond to reinstatement of steroid therapy. Recurrent APT is a rare clinical entity that has been reported only twice in recent literature.
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Case Reports
Severe rhinorrhea and respiratory distress in a neonate exposed to fluphenazine hydrochloride prenatally.
To report a case of respiratory distress with severe rhinorrhea in a newborn exposed prenatally to fluphenazine hydrochloride. ⋯ Severe rhinorrhea, vomiting, and respiratory distress that occurred in this infant have not been reported previously following prenatal fluphenazine hydrochloride exposure. Awareness of this problem would be helpful to clinicians and should be considered in the differential diagnosis of rhinorrhea in newborns.
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Revista médica de Chile · Jan 1996
[Extracorporeal respiratory assistance. Experience in the treatment of severe acute respiratory failure].
Acute respiratory distress syndrome (ARDS) secondary to systemic injury has a high mortality. Symptomatic treatment with mechanical ventilation, PEEP and high levels of inspired oxygen is effective for most of the patients. When ventilatory support fails in reversing hypoxemia, extracorporeal respiratory assistance has been advocated as a temporary treatment until lung repair occurs. ⋯ Extracorporeal assistance was maintained for 52 +/- 34 h (19-134). Five (45%) patients were weaned off the pump and two (18%) survived and were discharged. Despite the high cost, extracorporeal respiratory assistance, when applied to selected patients, can reverse hypoxia and may save some previously unsalvagable patients, allowing them to return to a normal life.