Articles: respiratory-distress-syndrome.
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PSV has been increasingly used as a partial ventilatory support for various types of respiratory failure. We experienced premature breath termination and double triggering in a patient with ARDS during PSV, and investigated the cause of this phenomenon using respiratory muscle pressure (Pmus). ⋯ The limitation of synchronization was attributable to fixed flow termination criteria in the present PSV algorithm. When dissynchronization is not manageable, other ventilatory modes (eg, APRV, PCV) allowing spontaneous ventilation should be considered as an alternative.
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Am. J. Respir. Crit. Care Med. · Sep 1995
Incidence of the adult respiratory distress syndrome in the state of Utah.
To determine the incidence of the adult respiratory distress syndrome (ARDS) in Utah, we prospectively screened intensive-care-unit (ICU) patients for ARDS in six of the 40 general acute-care hospitals in Utah. Over a 1-yr period, we diagnosed severe ARDS (oxygenation criterion: PaO2/PAO2 < or = 0.2) in 110 patients. Of these patients, 27 were not residents of Utah. ⋯ Incorporating these two estimates, we calculated an estimated upper limit for ARDS incidence in Utah of 8.3 ARDS patients per 100,000 total Utah population per year. Using only directly identified Utah residents with ARDS, we calculated the absolute lower limit for ARDS incidence in Utah to be 4.8 ARDS patients per 100,000 Utah population per year. The incidence of ARDS in Utah is about an order of magnitude less than the 1972 National Heart and Lung Institute Task Force estimate of ARDS incidence in the United States, but agrees with more recently published ARDS incidence figures.
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Semin Respir Infect · Sep 1995
ReviewThe fibroproliferative phase of late adult respiratory distress syndrome.
Tissue response to insults is similar regardless of the tissue involved, and occurs in two sequential and interconnected steps, inflammation and fibroproliferation. Adult respiratory distress syndrome (ARDS) is a disease characterized by acute onset of diffuse and severe inflammatory reaction of the lung parenchyma with loss of compartmentalization, resulting in protein rich exudative edema. ⋯ We will review recent observations indicating that an exaggerated pulmonary inflammatory response plays a key role in the progression of ARDS. We will provide a unifying pathogenetic model of ARDS, showing how the evolution from acute to chronic inflammation explains the progression of histological, laboratory, clinical, and physiological findings seen during the course of unresolving ARDS.
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Comparative Study
Volume-controlled inverse ratio ventilation in oleic acid induced lung injury. Effects on gas exchange, hemodynamics, and computed tomographic lung density.
To compare volume-controlled inverse ratio ventilation (VCIRV) with volume-controlled ventilation with conventional inspiratory to expiratory (I:E) ratio (VCV PEEP) at equal levels of end-expiratory pressure. ⋯ VCIRV was comparable to VCV PEEP at similar PEEP levels in alveolar recruitment, aeration of the lung tissues, and in oxygenating the blood. Since cardiac output also remained unchanged, oxygen delivery to peripheral tissues did not differ significantly between the two modes. Neither method has thus proved superior to the other one.