Articles: respiratory-distress-syndrome.
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Pediatr. Infect. Dis. J. · Mar 1987
Evaluation of routine lumbar punctures in newborn infants with respiratory distress syndrome.
Infants with respiratory distress syndrome are routinely evaluated for infection which commonly includes a lumbar puncture. In this study cerebrospinal fluid (CSF) examination failed to elicit evidence for meningitis in 238 consecutively admitted infants with respiratory distress syndrome evaluated during the first 24 hours of life. Blood cultures were obtained in all; suprapubic or catheterized urine was obtained in 163 infants; CSF was collected successfully in 203 infants. ⋯ CSF obtained from 14 of those infants had normal examinations and sterile cultures. Factors associated with bacteremia were birth weight (P less than 0.01), gestational age (P less than 0.01), prolonged rupture of membranes (P less than 0.05) and leukopenia below 10 000/mm3 (P less than 0.05). In view of the negative CSF examinations in infants with positive blood cultures and the potential complications of lumbar puncture (hypoxia, trauma, infection, epidermoid tumor), the potential risks of CSF evaluation may exceed the assessed benefit for the infant with respiratory distress syndrome.
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Measurement of the effect of therapy is a principle in the provision of all care, including respiratory therapy of newborns. Crucial to such measurement are guidelines of respiratory therapy services. The author offers a method for establishment of these guidelines, as well as a literature review of the outcomes of infants who required respiratory care.
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Post-traumatic pulmonary insufficiency or the adult respiratory distress syndrome is not infrequently associated with multiple organ-system injury. Mortality presently approaches 50%. Mechanical ventilation (CMV) with continuous positive airway pressure (CPAP) remains the mainstay of therapy. ⋯ All patients on HFJV demonstrated improved CO2 elimination with the same hemodynamic profiles. Those on HFPG demonstrated comparable gas exchange and hemodynamic profiles with lower CPAP/PIP. Where measured, PAW was significantly lower with HFPG when compared with CMV.
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J. Thorac. Cardiovasc. Surg. · Feb 1987
Extracorporeal membrane oxygenation for respiratory and cardiac failure in infants and children.
Fifty-three neonates and seven pediatric patients were treated with extracorporeal membrane oxygenation from September 1983 until April 1986. Venoarterial bypass was achieved by cannulating the right atrium via the right internal jugular vein and the aortic arch via the right common carotid artery. In the neonatal group, 40 infants with acute respiratory failure were treated, and 36 (90%) survived. ⋯ It has also been useful in the support of infants with congenital heart disease and congenital diaphragmatic hernia. In pediatric patients one cannot expect to get results that are comparable to those found in neonates. Still, this modality can be useful in salvaging some moribund patients with pulmonary or cardiac failure, or both.