Articles: respiratory-distress-syndrome.
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The mortality of patients with acute respiratory distress syndrome (ARDS) is still above 50% despite continuous progress in intensive care medicine. Recent therapy regimens such as the extra corporeal life support (ECLS), permissive hypercarbia, high-frequency ventilation techniques and inhaled nitric oxide (NO) are being applied. All of the above techniques are aimed at different parts of the problems caused by ARDS. ⋯ Although the pulmonary status of the patient improved, the patient died due to therapy-resistant hemodynamic failure. CONCLUSION. It will take further studies to judge whether the success of this new ventilation strategy is reproducible and if the improvement of the oxygenation is more pronounced when adding inhaled NO to SHFJV than when each technique is applied separately.
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Adult respiratory distress syndrome (ARDS) has been a well recognized severe form of acute respiratory failure of multiple causes, which is characterized by intractable hypoxemia and an extremely high mortality rate. Forty-six cases of ARDS admitted to the Department of Medicine, Ramathibodi Hospital during a 39 months period were studied prospectively to explore the etiologic risk, positive end-expiratory pressure (PEEP) profiles, complications and outcome of treatment. There were 19 females and 27 males with the mean age of 40 years. ⋯ There were 28 deaths of patients in this study, giving an overall 60.8% group mortality rate. Despite the similarities in most clinical profiles, the survivors, when compared to the non-survivors, showed a greater extent of improved oxygenation in response to the application of PEEP, with fewer PEEP complications. The present study would, hopefully, provide the Thai clinicians with valuable informations in the management of ARDS.