Articles: respiratory-distress-syndrome.
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Critical care medicine · Nov 1985
Case ReportsAdult respiratory distress syndrome: successful support with continuous negative extrathoracic pressure.
We describe the use of continuous negative extrathoracic pressure to treat successfully the adult respiratory distress syndrome in a 19-yr-old woman who resisted the application of positive airway pressure. Arterial hypoxemia was reversed with -26 cm H2O of extrathoracic pressure, produced by a modified Emerson iron lung. ⋯ The patient required continuous negative extrathoracic pressure for 9 days; 12 days after admission, she was discharged. This case indicates that negative extrathoracic pressure therapy can be an effective and safe alternative to positive airway pressure for the management of selected patients with adult respiratory distress syndrome.
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The Adult Respiratory Distress Syndrome remains one of the most lethal complications in both surgical and medical intensive care units. Mortalities of 50 to 80 per cent are still reported in recent reviews. ⋯ Studies of physiopathologic factors of ARDS implicate granulocyte aggregation with the formation of oxygen free radicals and other cellular and chemical mediators. Pharmacologic agents and high frequency positive pressure ventilation are presently being investigated, but the accepted form of therapy combines increased inspired oxygen tensions, positive end expiratory pressure and some form of mechanical ventilation, if necessary.