Articles: respiratory-distress-syndrome.
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Editorial Comment Review
Ventilation of the acute respiratory distress syndrome. Looking for Mr. Goodmode.
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Comparative Study Clinical Trial
Prolonged inhalation of low concentrations of nitric oxide in patients with severe adult respiratory distress syndrome. Effects on pulmonary hemodynamics and oxygenation.
Nitric oxide (NO) inhalation selectively decreases pulmonary artery hypertension and improves arterial oxygenation in patients with the adult respiratory distress syndrome (ARDS). In this study of patients with severe ARDS, we sought to determine the effect of inhaled NO dose and time on pulmonary artery pressure and oxygen exchange and to determine which patients with ARDS are most likely to show this response. ⋯ Long-term NO inhalation at low concentrations selectively decreases mean pulmonary artery pressure and improves arterial oxygen tension in patients with ARDS. The selective pulmonary vasodilation effect is most pronounced in ARDS patients with the greatest degree of pulmonary vasoconstriction.
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Critical care medicine · Apr 1994
Comparative StudyAlveolar-arterial oxygen gradients before extracorporeal life support for severe pediatric respiratory failure: improved outcome for extracorporeal life support-managed patients?
Recent reports have described the usefulness of the alveolar-arterial oxygen tension difference (P[A-a]O2) in predicting mortality in children with acute respiratory failure managed with mechanical ventilation. We reviewed our experience with extracorporeal life support for acute pediatric respiratory failure and specifically examined P(A-a)O2 measurements during the 24 hrs before extracorporeal life support to determine if defined cutoffs established with conventional mechanical ventilation were applicable to extracorporeal life-support survival. ⋯ Based on previous reports of the utility of P(A-a)O2 measurements to predict mortality, our preliminary evidence suggests that extracorporeal life support results in 62% survival for pediatric respiratory failure patients predicted to have no chance of survival using conventional mechanical ventilation. Prospective, randomized trials of children with severe acute respiratory failure managed with mechanical ventilation vs. extracorporeal life support may be indicated.
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Critical care medicine · Apr 1994
Comparative StudyContinuous intra-arterial blood gas and pH monitoring in critically ill patients with severe respiratory failure: a prospective, criterion standard study.
To evaluate the routine clinical performance of a new intra-arterial fiberoptic blood gas sensor that provides continuous PO2, PCO2, and pH monitoring. ⋯ The degree of agreement of intra-arterial blood gas sensor values with conventional blood gas analysis is within an acceptable range for routine clinical purposes. Acute changes in measured values are detected reliably. Continuous intra-arterial blood gas analysis can add substantially to the safety of patients with acute respiratory failure and can reduce blood sampling requirements for blood gas analysis.