Articles: respiratory-distress-syndrome.
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Considerable attention has been directed toward the study of oxygen transport principles in the adult respiratory distress syndrome (ARDS). In particular, concerns have been voiced regarding disturbed tissue oxygen extraction creating a pathologic dependency of oxygen consumption on oxygen delivery. This article discusses oxygen transport principles, data relevant to the oxygen extraction controversy, and implications regarding the pathogenesis and potential therapies for ARDS.
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This study was done to evaluate the diagnostic accuracy of bedside chest radiography for pneumonia, adult respiratory distress syndrome (ARDS), or both in patients receiving mechanical ventilation. The series consisted of 40 patients; diagnostic accuracy was defined as the area under the receiver operating characteristic curve. Overall diagnostic accuracy for ARDS was 0.84. ⋯ The authors conclude that chest radiography is of limited value for the diagnosis of pneumonia in patients receiving mechanical ventilation. The high false-negative and false-positive ratings for pneumonia resulted in a low diagnostic accuracy. The high diagnostic accuracy for ARDS was primarily due to the well-defined radiographic appearance of ARDS and few false-positive ratings.
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Dtsch. Med. Wochenschr. · Jul 1993
Case Reports[Acute respiratory failure in tropical malaria during pregnancy. Successful treatment using extracorporeal CO2 elimination].
A 32-year-old woman in the 26th week of pregnancy became ill, 6 days after returning from a trip to Indonesia, with a fever up to 42 degrees C, haemolytic anaemia (haemoglobin 7.6 g/dl) and thrombocytopenia (7,000/microliters). She had not been on any malaria prophylaxis. Chloroquine, quinine and pyrimethamine, administered after macrogametocytes of Plasmodium falciparum had been found in the blood smear, eliminated the parasites from the peripheral blood, but respiratory failure and treatment-resistant pneumonia occurred, leading to the adult respiratory distress syndrome (Morel stage 4). ⋯ The extracorporeal CO2 elimination was discontinued after twelve days, because artificial ventilation could now be adequately controlled. The woman was gradually weaned from the ventilator and discharged home without symptoms after a total of 11 weeks in hospital. Her child has not shown any neurological symptoms.