Articles: respiratory-distress-syndrome.
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J. Heart Lung Transplant. · Sep 1992
Case ReportsSuccessful lung transplantation for posttraumatic adult respiratory distress syndrome after extracorporeal membrane oxygenation support.
A severe adult respiratory distress syndrome after bilateral lung contusion was successfully treated by extracorporeal membrane oxygenation and subsequent double-lung transplantation in a 19-year-old man. The patient is fully rehabilitated 1 year after transplantation.
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Comparative Study
Relationship of oxygen consumption and oxygen delivery in surgical patients with ARDS.
Previous studies have described oxygen delivery (DO2) and oxygen consumption (VO2) relationships in patients with ARDS and other acute diseases that suggest occasions when VO2 may be dependent on the supply of oxygen, ie, DO2. We studied 127 postoperative patients who developed ARDS to evaluate the relationship of DO2 to VO2. We found a weak correlation between DO2 and VO2 in the total series (r = 0.49) as well as in several clinical subgroups of patients with ARDS. ⋯ We also examined the DO2/VO2 data of individual patients with ARDS to identify instances where flow-dependent VO2 patterns developed into flow-independent VO2 patterns. We were able to identify an apparent plateau in the DO2/VO2 relationships in 29/50 (58 percent) patients where multiple measurements were obtained over a short period of time. Our data are consistent with the concept that the DO2/VO2 relationship in acutely ill early postoperative patients with and without ARDS is affected by antecedent circulatory problems that may lead to tissue hypoxia and tissue oxygen deficiencies that are manifest by flow dependency.
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Severely ill ARDS patients present major supportive challenges when conventional ventilatory support is failing. A patient is described who was treated with venovenous extracorporeal lung support for 28 days, using surface-heparinized circuitry. Her recovery illustrates the potential for salvage of near-terminal ARDS patients when complications of support can be minimized.