Articles: respiratory-distress-syndrome.
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The outcome of adult respiratory distress syndrome complicating cardiopulmonary bypass has changed little in recent years. A retrospective, case-controlled study was designed to assess the incidence of the adult respiratory distress syndrome in these circumstances and the extent to which it could be linked with pre and peri-operative predictive factors. ⋯ Significant predictors were a high intra and postoperative intervention score, the total volume of blood pumped during bypass (greater than 300 l) and age (greater than 60 years). These risk factors should alert the clinician to the possibility of severe postoperative pulmonary complications.
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Klinicheskaia meditsina · Mar 1992
[Adult respiratory distress syndrome in patients with infection].
A grave complication of sepsis is a respiratory distress in adult persons observed by the authors in 11.3% of the examinees. The syndrome of respiratory distress could develop in the presence of toxico-infectious (septic) shock or severe allergic immediate responses to the administration of certain drugs. The main approaches to the treatment of respiratory distress in adult septic patients turned to be glucocorticoids, heparin and recurrent sessions of hemosorption.
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Comparative Study
[Hemodynamic differences do not exist in patients with adult respiratory syndrome with or without infection].
To verify whether patients with adult respiratory distress syndrome (ARDS), associated to sepsis or not, may be differentiated according to the values of the hemodynamic variables. ⋯ This study demonstrated that patients with the septic adult respiratory distress syndrome (ARDS) have the same hemodynamic changes as those observed in patients with ARDS without sepsis. This absence of differences may be explained by the presence of mechanisms common in sepsis and ARDS.
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Randomized Controlled Trial Clinical Trial
Selective gut decontamination reduces nosocomial infections and length of stay but not mortality or organ failure in surgical intensive care unit patients.
Suppression of the gut luminal aerobic flora to reduce nosocomial infections was tested in a prospective, randomized, double-blind, placebo-controlled clinical trial in patients in a surgical intensive care unit who had persistent hypermetabolism. Forty-six patients were randomized to receive either norfloxacin, 500-mg suspension every 8 hours, together with nystatin, 1 million units every 6 hours, or matching placebo solutions administered through a nasogastric tube within 48 hours of surgical intensive care unit admission. Selective gut decontamination with the experimental therapy or placebo solutions continued for at least 5 days or until the time of surgical intensive care unit discharge. ⋯ All other therapy was given as clinically indicated, including systemic antibiotics. The selective gut decontamination group experienced a significant reduction in the incidence of nosocomial infections and a reduced length of stay. However, these results were not associated with a concomitant decrease in progressive multiple organ failure syndrome, adult respiratory distress syndrome, or mortality.
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Randomized Controlled Trial Clinical Trial
Progress in veno-venous long-term bypass techniques for the treatment of ARDS. Controlled clinical trial with the heparin-coated bypass circuit.
Extracorporeal CO2 removal combined with low-frequency positive pressure ventilation (ECCO2-R LFPPV) is a new therapeutic approach in treatment of ARDS. The main problem during long-term extracorporeal support is anticoagulation and related bleeding problems. ⋯ Bleeding complications were less and more patients survived in group 2. The disadvantage of the hollow fiber oxygenators in the heparin-coated system was plasma leakage, which was more frequent in patients with pancreatitis and hyperbilirubinemia.