Articles: respiratory-distress-syndrome.
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Intensive care world · Dec 1991
Review Historical ArticleThe current role of ECMO in paediatric practice.
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Eur J Clin Chem Clin Biochem · Dec 1991
The prognostic value of extracellular matrix component concentrations in serum during treatment of adult respiratory distress syndrome with extracorporeal CO2 removal.
The time-dependent concentrations of hyaluronan, aminoterminal propeptide of type III procollagen, and laminin were determined in sera of 16 patients with severe adult respiratory distress syndrome during treatment with an extracorporeal CO2 removal device. Patients were classified according to lung parameters as responders (n = 10) and non-responders (n = 6) to extracorporeal CO2 removal. At the beginning of treatment strongly elevated serum concentrations of all studied extracellular matrix components were found. ⋯ By non-parametric analysis of variance, significant differences between responders and non-responders according to treatment time could be established. By analysing the time course of the serum concentrations of hyaluronan and aminoterminal propeptide of type III procollagen, a total differentiation between responders and nonresponders was made possible by the trends of these analytes as early as three days after the start of treatment. The determination of aminoterminal propeptide of type III procollagen and hyaluronan in serum of patients with adult respiratory distress syndrome might therefore have prognostic significance in extracorporeal CO2 removal.
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Randomized Controlled Trial Comparative Study Clinical Trial
Nasal continuous positive airway pressure facilitates extubation of very low birth weight neonates.
A prospective randomized trial was performed in 58 neonates comparing nasal continuous positive airway pressure (NCPAP) vs oxyhood following extubation of neonates weighing less than 1 kg. All neonates had been ventilated for the treatment of respiratory distress syndrome for at least 24 hours and weighed less than 1 kg at the time of extubation. Clinical criteria for elective extubation included improving pulmonary status, fraction of inspired oxygen (FIO2) less than or equal to 0.35, mean airway pressure less than or equal to 7 cm H2O, ventilator rate less than or equal to 20 breaths per minute, and weight at least 80% of birth weight. ⋯ There were no differences in baseline characteristics between the two groups. Of the 23 neonates who failed oxyhood, 21 were then given a trial of NCPAP and 58% (12/21) remained extubated. Data indicate that using selected clinical criteria for elective extubation of neonates weighing less than 1 kg, NCPAP facilitates successful extubation.
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We assessed pulmonary function in 14 mechanically ventilated newborn very low birth weight infants with idiopathic respiratory distress syndrome by means of a face-out, volume displacement body plethysmograph and nitrogen washout analyses. Specially designed computer programs were used for calculations of lung volumes, ventilation, gas mixing efficiency, and mechanical parameters. ⋯ No correlations between positive end-expiratory pressure and mean airway pressure versus compliance, resistance, or FRC could be found. Neither could correlations be found between FRC and compliance or FRC and the calculated right to left shunt.