Articles: respiratory-distress-syndrome.
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Wien. Klin. Wochenschr. · Jan 1995
Case Reports[Acute respiratory failure (ARDS) in a young child after drowning accident: therapy with exogenous surfactant and high frequency oscillatory ventilation].
The adult respiratory distress syndrome (ARDS) in children has a very poor prognosis with a mortality risk of between 55 and 85%, in spite of improvements due to the introduction of positive endexpiratory pressure ventilation. We describe the clinical course of a not yet 3 year-old boy with severe ARDS following near-drowing. Treatment with exogenous surfactant and high frequency oscillatory ventilation, a well-established procedure in neonatology, was responsible for the favorable outcome. The high cost of surfactant therapy, however, is the main limiting factor for this kind of treatment in children beyond the neonatal period, but it may be the last therapeutic resort in the management of severe ARDS.
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Wien. Klin. Wochenschr. · Jan 1995
[Extracorporeal membrane oxygenation in newborn infants and children].
The purpose of this report is to describe our experience with veno-arterial (VA) and veno-venous extracorporeal membrane oxygenation (VV-ECMO) for neonates and children with severe acute respiratory or cardiocirculatory failure. From 1990 to 1994 20 neonates and 12 children were treated at the ECMO center in Graz. Indications for ECMO were acute respiratory failure in 27 patients and cardiocirculatory failure in 5 patients. ⋯ Major complications on ECMO were local and intracerebral bleeding. ECMO is an effective therapy for neonates and children with acute respiratory failure. It is less effective for cardiac support in children after open heart surgery, but the use of heparin-layered ECMO systems might increase the safety of the procedure.
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Acta Anaesthesiol Scand Suppl · Jan 1995
Case ReportsHow far can we go with permissive hypercapnia? A case presentation and some biased comments with emphasis on maintaining normal haemoglobin level.
The respiratory management strategy of small tidal volume with permissive hypercapnia has been adopted to avoid further aggravation of lung injury due to high airway pressure with some impressive success (1). No consensus, however, has been established in terms of the rate of increase in PaCO2 and its upper limit. ⋯ The fact that PaCO2 may reach a very high level in the clinical setting and the well-known role of haemoglobin (Hb) in buffering CO2 led us to study effects of different Hb levels on pH and haemodynamic changes in response to acute CO2 loading in the blood. We will summarize the case report first with permission of authors (the case report was published in Japanese) (2) and then discuss the studies conducted in our animal laboratory.