Articles: respiratory-distress-syndrome.
-
Gaoxiong Yi Xue Ke Xue Za Zhi · Feb 1993
Evaluation of prognostic indices based on pulmonary and hemodynamic variables in patients with adult respiratory distress syndrome (ARDS).
Patients with established ARDS have a high mortality rate. We continuously monitored hemodynamic and respiratory parameters of 30 patients in our ICU, all had acute respiratory failure during admission then progressively developed ARDS. We compared demographic characteristics, APACHE II (acute physiology and chronic health evaluation) score, ALI (acute lung injury) score, associated MSOF (multiple systems organ failure) in the disease process, pulmonary variables, and hemodynamic variables between survivors and nonsurvivors. ⋯ But those who had PEEP of 6 cm H2O or higher applied at the beginning of respiratory failure and those had PEEP of less than 10 cm H2O after development of ARDS had a better outcome (P < 0.04 vs. P < 0.05). Nevertheless, more controlled trials are needed before we make any conclusion about PEEP therapy.
-
Early human development · Feb 1993
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter randomized trial of high frequency oscillatory ventilation as compared with conventional mechanical ventilation in preterm infants with respiratory failure.
A multicenter randomised trial was conducted in nine neonatal centers in Japan to re-evaluate the safety and the efficacy of high frequency oscillatory ventilation using the piston type oscillator (Hummingbird) in the treatment of respiratory failure in preterm infants weighing between 750 and 2000 g at birth. A total of 92 infants were enrolled in the study. Forty-six infants were allocated to high frequency oscillatory ventilation and 46 infants to conventional mechanical ventilation. ⋯ Mean airway pressure was significantly higher in the high frequency oscillatory ventilation group and the infants on high frequency oscillation showed a significantly higher arterial to alveolar oxygen tension ratio after 6 h of treatment. These results suggest that high frequency oscillatory ventilation does not increase the risk of severe complications such as air leaks, intraventricular hemorrhage or periventricular leukomalacia when it is used by experienced neonatologists. Indeed high frequency oscillatory ventilation helps provide better oxygenation with higher mean airway pressure without increasing the risk of bronchopulmonary dysplasia and severe complications such as air leaks and intraventricular hemorrhage.
-
American family physician · Feb 1993
ReviewRespiratory distress syndrome in the newborn: innovative therapies.
Neonatal respiratory distress syndrome affects 60,000 to 70,000 infants each year in the United States. Although the mortality rate has decreased dramatically over the past 30 years, many infants die or have sequelae from the syndrome. ⋯ Surfactant therapy should be considered the standard of care for infants with respiratory distress syndrome who require mechanical ventilation. Further investigation is needed to define the precise roles of high-frequency ventilation and extracorporeal membrane oxygenation in the management of neonates with respiratory distress syndrome.
-
Critical care medicine · Feb 1993
High-frequency oscillatory ventilation in pediatric respiratory failure.
To evaluate the safety and effectiveness of high-frequency oscillatory ventilation using a protocol designed to achieve and maintain optimal lung volume in pediatric patients with respiratory failure. ⋯ High-frequency oscillatory ventilation, using a high-volume strategy, may be used safely and effectively in pediatric patients with respiratory failure and with high predicted mortality rates. High mean airway pressure during oscillatory ventilation does not appear to compromise DO2. Whether this technique can alter morbidity or mortality rates in this population awaits prospective randomized study.