Articles: respiratory-distress-syndrome.
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Assess expression and management of HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count) occurring before 32 weeks gestation. ⋯ Based on the physiological mechanisms involved in HELLP syndrome, criteria for obstetrical extraction and the possibilities for conservative management in very premature pregnancies, we propose a management protocol for HELLP syndrome developing before 32 weeks gestation. Corticosteroid therapy may be given for 48 hours in cases without maternal or fetal complications in order to accelerate fetal maturation before extraction.
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Editorial Comment
Innovative life support in the acute respiratory distress syndrome.
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Case Reports Clinical Trial
Initial experience with partial liquid ventilation in adult patients with the acute respiratory distress syndrome.
To evaluate the safety and efficacy of partial liquid ventilation (PLV). ⋯ Perflubron may be safely administered into the lungs of patients with severe respiratory failure receiving extracorporeal life support and may be associated with improvement in gas exchange and pulmonary compliance.
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Am. J. Respir. Crit. Care Med. · Feb 1996
Comparative StudyExogenous surfactants in a piglet model of acute respiratory distress syndrome.
Evidence for surfactant dysfunction in acute respiratory distress syndrome (ARDS) suggests a role for exogenous surfactant which contains apoprotein for resistance to protein inhibition. We compared the effects of KL-4-Surfactant, an artificial preparation containing a synthetic 21 amino acid peptide with SP-B-like activity, with Exosurf, an artificial protein-free surfactant, and Survanta, a bovine protein-containing surfactant, in a saline lung lavage model of ARDS in neonatal piglets. Two sequential series of lung lavages were performed to lower PaO2 < 100 mm Hg, each followed by administration of surfactant or air and a 90-min observation period. ⋯ Only KL-4-Surfactant demonstrated greater pressure-volume characteristics and lower bronchoalveolar protein than those of Controls. We conclude that the physiologic effects of KL-4-Surfactant are more like Survanta in this model. We speculate that KL-4-Surfactant may improve pulmonary function, reduce alveolar protein leak, and thus be efficacious in the treatment of ARDS.
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Clinical Trial
Feasibility study of the use of bilevel positive airway pressure for respiratory support in the emergency department.
To determine the feasibility of bilevel positive airway pressure (BiPAP) support for acute respiratory distress (ARD) in the emergency department. ⋯ As has been reported from other critical care settings, use of BiPAP is feasible and has potential utility in the management of ARD in the ED.