Articles: respiratory-distress-syndrome.
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Investigative radiology · Jan 1993
Computed tomography and histologic results in the early stages of endotoxin-injured pig lungs as a model for adult respiratory distress syndrome.
To determine early radiographic changes in diffuse alveolar injury, the authors correlated computed tomography (CT) and histopathology in pigs with recurrent endotoxinemia. ⋯ CT clearly depicts changes in endotoxin-injured pig lungs in an early clinical state, which are similar to changes associated with ARDS on histologic examination.
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Ann. Clin. Lab. Sci. · Jan 1993
Alterations in von Willebrand factor antigen in premature infants with respiratory distress syndrome and chronic lung disease.
Elevated levels of von Willebrand Factor Antigen (vWF:Ag) may occur in the presence of endothelial injury, a component in the pathology of acute pulmonary insufficiency. The vWF:Ag levels were examined in 13 well infants (controls) and 20 infants with respiratory distress syndrome (RDS), nine of whom developed bronchopulmonary dysplasia (BPD). All infants were very low birth weight (730 to 1500 g) and premature (25 to 34 weeks estimated gestational age). ⋯ Visual examination of vWF multimer patterns revealed absence of unusually large vWF multimers and triplet patterns suggestive of increased proteolytic degradation of von Willebrand factor. However, densitometer scanning revealed that samples with higher vWF:Ag levels (> 200 percent) had increased amounts of moderate to smaller sized multimers, regardless of presence or absence of BPD. It is our conclusion that von Willebrand factor antigen levels are nonspecifically elevated in premature infants and that chronic lung disease is associated with even higher plasma values, possibly owing to pulmonary endothelial injury.
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Cardiac catheterization studies have demonstrated that Doppler-derived flow velocities in the ductal flow jet and the left pulmonary artery accurately predict the aortopulmonary pressure difference and left-to-right shunt size in newborns. To assess the presence of persistent pulmonary hypertension in premature newborns with various degrees of respiratory distress syndrome (RDS) severity, we estimated pulmonary artery pressure from the aortopulmonary pressure difference and pulmonary blood flow from the left pulmonary artery flow velocity with color-flow-directed, pulsed Doppler echocardiography. ⋯ The mean aortopulmonary pressure difference was 0.9 +/- 0.3 mm Hg during the first 72 hours in neonates with fatal RDS, but increased from 1.5 +/- 0.3 mm Hg at 4 hours to 7.4 +/- 0.6 at 24 hours and 21.5 +/- 0.7 mm Hg at 72 hours of age in neonates with severe RDS. Left pulmonary artery velocity time integrals were 18.3 +/- 0.5 cm in premature and 18.8 +/- 0.5 cm in term neonates with no/mild RDS at 12 hours vs 11.2 +/- 0.4 cm in neonates with severe and 9.9 +/- 0.5 cm in neonates with fatal RDS (P < .001).(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
General anaesthesia and the hypereosinophilic syndrome: severe postoperative complications in two patients.
Two patients with markedly increased eosinophil counts developed severe postoperative complications after general anaesthesia. One patient suffered life-threatening Adult Respiratory Distress Syndrome (ARDS), while the other presented with a coagulopathy and less severe respiratory problems. ⋯ These cases suggest that, in patients with marked eosinophilia requiring general anaesthesia, perioperative steroid cover is advisable. This may reduce or prevent serious lung damage and other complications.