Articles: respiratory-distress-syndrome.
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In nine subjects undergoing oesophagectomy a transient but significant increase in pulmonary vascular permeability to transferrin was detected in both lungs 8 h after surgery. It coincided with a significant increase in plasma lactoferrin, evidence of intravascular and intra-alveolar neutrophil elastase release and with arterial hypoxaemia. The postoperative state in these patients had intravascular and pulmonary features often associated with the adult respiratory distress syndrome, and might be a useful model for the study of the early inflammatory events underlying lung injury in man.
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Upper airway obstruction following adult respiratory distress syndrome. An analysis of 30 survivors.
To evaluate the effects of current supportive care measures for the adult respiratory distress syndrome (ARDS) upon the upper airway, we studied 30 survivors of ARDS. All patients were interviewed and examined and performed inspiratory and expiratory maximal flow-volume curves more than six months after the onset of ARDS. Three women had developed symptomatic upper airway obstruction due to laryngotracheal stenosis 4 to 12 months after discharge from the hospital. ⋯ Although corrective surgery improved airflow, two survivors of ARDS had upper airway obstruction and exertional dyspnea more than five years after the ARDS. We conclude that upper airway obstruction is an important cause of dyspnea and impairment following ARDS. Exertional dyspnea weeks to months following treatment for ARDS suggests the possibility of laryngotracheal stenosis.