Articles: respiratory-distress-syndrome.
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Southern medical journal · Apr 1988
Case ReportsNeuroleptic malignant syndrome presenting as adult respiratory distress syndrome and disseminated intravascular coagulation.
We have reported a case of neuroleptic malignant syndrome (NMS) in a patient with historical and clinical features suggestive of heat stroke or sepsis and adult respiratory distress syndrome (ARDS). ARDS and disseminated intravascular coagulation may be important, atypical signs encountered early in NMS and complicating its recognition.
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The Journal of pediatrics · Mar 1988
ReviewAdult respiratory distress syndrome in pediatric patients. II. Management.
Adult respiratory distress syndrome, a clinical syndrome of respiratory failure that follows many kinds of insults, often in patients with no previous pulmonary disease, occurs in pediatric patients. This group of disorders has a typical clinical, pathologic, and pathophysiologic course, the hallmark of which is injury to the alveolar-capillary membrane with increased permeability of the pulmonary vasculature and pulmonary edema. Resolution may occur at any stage, but most patients die and many develop chronic lung disease requiring respiratory support for weeks or months. ⋯ Efforts to treat ARDS after it is clinically apparent have been disappointing. The pathogenic mechanisms that lead to ARDS are probably well advanced by the time the syndrome is diagnosed on the basis of the usual clinical signs. Therefore an emphasis on understanding the mechanisms of lung injury so that specific markers can be used to predict which patients will develop ARDS, allowing intervention in the early stages of the process, may prove rewarding.
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To compare the accuracy of clinical observation and detailed respiratory recordings in identifying infants at high risk of developing pneumothoraces 10 infants, with idiopathic respiratory distress syndrome, were studied at three different ventilator rates. All infants with synchronous respiration at fast rates were correctly identified by clinical observation. ⋯ These criteria enabled correct identification of 'high risk' respiratory patterns on 15 (88%) of the 17 study occasions. These clinical criteria were then used as criteria for selective paralysis; no infant developed a pneumothorax during ventilation.