Articles: respiratory-distress-syndrome.
-
Wien Klin Wochenschr Suppl · Jan 1989
[Incidence and prognostic significance of pulmonary artery thromboses in patients with acute respiratory failure: a study of 106 patients using bilateral pulmonary balloon occlusion angiography].
In 106 patients suffering from acute respiratory failure of different severity 157 bedside balloon occlusion pulmonary angiographic studies have been performed through a pulmonary artery catheter to assess the frequency and extent of intravascular occlusive disease. The vascular alterations in acute respiratory failure impair the prognosis essentially. The decreasing pulmonary vascular cross-section causes a greater pulmonary vascular resistance and consecutive pulmonary artery hypertension and finally right heart failure. ⋯ Only in 30.2% the angiography was interpreted as normal. The mortality rate was significant higher in patients with multiple macro- and microthrombosis (82.9% respectively 52.2%) compared to patients with singular pulmonary artery filling defects and normal angiography (37.5% respectively 28.1%). The angiographic result was further correlated with the severity of the acute respiratory failure, the haemodynamic and haemostasiologic data, the degree of consolidation in the chest-X-ray and the post mortem angiographic studies.
-
Langenbecks Arch Chir Suppl II Verh Dtsch Ges Chir · Jan 1989
Review[Pulmonary complications within the scope of multiple organ failure].
The adult respiratory distress syndrome (ARDS) is the pulmonary manifestation of multiple organ failure. Respiratory distress, alveolar consolidation and hypoxemia refractory to oxygen are the result of uniform and unspecific morphological reactions of the alveolo capillary membrane. ⋯ A causal therapy for ARDS is not known. Treatment of the underlying disease, maintenance of arterial oxygenation and prevention of secondary complications are the most important therapeutic measures.
-
Over the past 20 years, substantial information has been gained concerning sepsis-associated ALI. Although the mortality from ARDS remains unchanged, the spectrum of disease has altered. Patients rarely die acutely from the direct sequelae of ALI, including hypoxemia, but most commonly demonstrate a protracted clinical course that eventuates in MSOF. ⋯ Without an effective and singular "golden bullet" for the treatment of the varied presentation of ARDS, it remains our contention that basic management principles of ARDS must continue to emphasize an aggressive approach to the identification and treatment of the septic focus while all efforts are concurrently exploited to reduce the potentially aggravating effects of secondary injury on microvascular function. Currently research into the diagnosis, prevention, and treatment of nosocomial pneumonia is an example of how secondary injury may be minimized in ALI. Further, it is important to recognize the potentially detrimental effects of various therapies on the microvascular membrane in ARDS.
-
Prog. Clin. Biol. Res. · Jan 1989
Review Clinical TrialCorticosteroids for septic shock and adult respiratory distress syndrome.