Articles: respiratory-distress-syndrome.
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Case Reports
Experience with renal failure during extracorporeal membrane oxygenation: treatment with continuous hemofiltration.
We use extracorporeal membrane oxygenation (ECMO) to treat respiratory and cardiac failure in children who are unresponsive to standard ventilator and pharmacologic management. All patients have cardiac and abdominal ultrasonography prior to ECMO to identify major structural anomalies and anatomically normal kidneys. Despite this, oliguric renal failure is seen in a number of patients. ⋯ Four of the patients on CH died of their primary pulmonary or cardiac disease without specific problems related to ARF. The other two patients were successfully weaned from ECMO, extubated, and have not needed further therapy for renal failure. We conclude that CH is useful in managing the complications of oliguric renal failure during ECMO.
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Early human development · Jul 1987
Failure of observation and impedance respirography to detect active expiration in ventilated preterm infants.
Twenty preterm infants ventilated for the respiratory distress syndrome were studied on 44 occasions to identify the pattern of interaction between their spontaneous respiratory efforts and the ventilator, using three techniques: (1) an oesophageal balloon and pneumotachograph, (2) impedance respirography and (3) clinical scoring. The information was in agreement on 23 of the occasions. ⋯ This study shows that only a system incorporating an accurate assessment of the baby's own respiratory pattern is able to detect different patterns of interaction. Impedance respirography and clinical observation appear to be unsatisfactory in this context.
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J. Thorac. Cardiovasc. Surg. · Jun 1987
Case ReportsLife-threatening postoperative pulmonary complications in patients with previous amiodarone pulmonary toxicity undergoing cardiothoracic operations.
Amiodarone therapy for cardiac arrhythmias is increasingly being recognized to be associated with pulmonary toxicity. In this report, we describe the case histories of four patients with previously diagnosed amiodarone pulmonary toxicity in whom the adult respiratory distress syndrome developed after cardiothoracic operations for malignant ventricular arrhythmias. Three patients underwent endocardial resection (two died), and a fourth patient had implantation of an automatic defibrillator unit. ⋯ In the two patients who died, desethylamiodarone levels were 510 and 4,400 micrograms/gm in pulmonary tissue. Histologic examination showed "honeycomb" appearance of the lung with prominent septae, alveolar foamy macrophages, and hyperplasia of alveolar lining cells, consistent with amiodarone pulmonary toxicity. Causes including pump-oxygenator time, oxygen toxicity, anesthetic agents, congestive heart failure, and pulmonary infection superimposed on amiodarone pulmonary toxicity are discussed with a review of the literature.