Articles: respiratory-distress-syndrome.
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Intensive care medicine · Jan 1991
Effect of a single inflation of the lungs on oxygenation during total extracorporeal carbon dioxide removal in experimental respiratory distress syndrome.
Respiratory distress syndrome (RDS) was modelled in rabbits using pulmonary lavage to remove surfactant. The stability of the resulting pressure-volume hysteresis of the lungs in vivo was studied with the aid of whole-body plethysmography during apnoeic oxygenation made possible by total extracorporeal carbon dioxide removal. Systemic oxygen delivery was measured as a function of the constant airway pressure during apnoea. ⋯ These rises were well maintained for 40 min following the inflation. In a further 6 subjects with RDS single inflations permitted optimum systemic oxygen transport to occur at the low airway pressure of 0.3 kPa, similar to the optimum airway pressure in 6 healthy control subjects. Where pressure-volume hysteresis is present in RDS it can be exploited during apnoeic oxygenation, and probably during high frequency ventilation, to improve oxygenation by the use of infrequent single inflations of the lungs.
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Pediatric pulmonology · Jan 1991
Birthweight, early passive respiratory system mechanics, and ventilator requirements as predictors of outcome in premature infants with respiratory failure.
Early respiratory mechanics have been reported to predict outcome in newborns with respiratory failure. However, it remains unknown whether measurements of pulmonary function add significantly to the predictive value of more readily available variables The present study was designed to answer this question. Passive respiratory system mechanics were measured by an airway occlusion technique in 104 ventilator-dependent premature infants between 6 and 48 hours of life and corrected for infant size. ⋯ Respiratory system conductance (P = 0.15) and compliance (P = 0.93) entered on the third and last step, respectively. We conclude that in premature infants with respiratory failure, birthweight is a strong predictor of outcome. Early ventilator requirements but not respiratory system mechanics, add significantly to this predictive model.
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Pediatric pulmonology · Jan 1991
Relationship of symptoms to lung function abnormalities in preterm infants at follow-up.
Recurrent respiratory symptoms are common in preterm infants in the first 2 years of life. The aim of this study was to determine the lung function abnormalities associated with such symptoms. Forty preterm infants, with a median gestational age of 29 weeks were studied at a median postnatal age of 12 months. ⋯ Lung function was assessed by measurement of functional residual capacity (FRC), using a helium gas dilution technique, and airway resistance (Raw) and thoracic gas volume (TGV) plethysmographically. No significant difference was found in TGV between symptomatic and asymptomatic infants, but the median FRC was lower (P less than 0.01), Raw higher (P less than 0.01), and FRC:TGV ratio lower (P less than 0.001) in the symptomatic infants. These lung function abnormalities in the symptomatic infants are suggestive of gas trapping.
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Diffuse atelectasis often occurs in the dorsal region of the lung of critically ill patients under long term mechanical ventilation. Conventional physical therapies (ex. PEEP, Sigh) have little effect on diffuse dorsal atelectasis. ⋯ It was assumed that the prone position was the factor responsible for the improvement of pulmonary V/Q ratio, the change of movement pattern of the diaphragm, and the ease of postural drainage of sputum. There were no complications. We conclude that prone position respiratory care has high utility for critically ill patients with diffuse dorsal atelectasis.