Articles: respiratory-distress-syndrome.
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Southern medical journal · Jun 1986
Case ReportsChronic eosinophilic pneumonia: a cause of adult respiratory distress syndrome.
It is important that physicians not overlook the diagnosis of chronic eosinophilic pneumonia (CEP), since this disorder is readily reversible with corticosteroid therapy. Six patients with CEP were seen at our institution between 1979 and 1983. We present their clinical features, chest films, and pathologic findings, and review the literature on CEP. ⋯ In fact, the two patients who had adult respiratory distress syndrome (ARDS), presented diagnostic difficulty and required admission to the intensive care unit. In contradistinction to the four patients with classic CEP, the two with ARDS had a delayed response to corticosteroids. Therefore, we conclude that chronic eosinophilic pneumonia is an important entity to recognize as a potentially fatal cause of the adult respiratory distress syndrome.
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Comparative Study
Preservation of normal lung regions in the adult respiratory distress syndrome. Analysis by computed tomography.
In this report, we challenge the commonly held assumption that the adult respiratory distress syndrome (ARDS) is a homogeneous process associated with generalized and relatively uniform damage to the alveolar capillary membrane. We studied 13 patients with ARDS, comparing the pulmonary parenchymal changes seen by standard bedside chest roentgenograms with those seen by computed tomography of the chest. Three patients demonstrated generalized lung involvement by both radiologic techniques. ⋯ Two patients showed patchy involvement by both techniques. The fact that ARDS spares some regions of lung parenchyma is useful knowledge in understanding the gas-exchange abnormalities of ARDS, the variable responsiveness to positive end-expiratory pressure, and the occurrence of oxygen toxicity. The problem of regional inhomogeneity should also be kept in mind when interpreting lung biopsy specimens or bronchoalveolar lavage fluid in patients with ARDS.
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Critical care medicine · May 1986
Randomized Controlled Trial Comparative Study Clinical TrialEffectiveness of dextran 70 versus Ringer's acetate in traumatic shock and adult respiratory distress syndrome.
During a 3-yr period, 31 adult victims of severe traumatic shock were enrolled in a prospective randomized investigation of the relative effectiveness of dextran 70 vs. Ringer's acetate to treat shock and protect against trauma-induced adult respiratory distress syndrome (ARDS). Fourteen patients were given dextran 70 and Ringer's acetate to compensate for interstitial fluid loss, and whole blood as required; the remaining 17 patients received three to four times the total fluid volume of Ringer's acetate given in the former group, and whole blood as required. ⋯ It is concluded that in the severely traumatized patient, a fluid program based on dextran 70 is superior to Ringer's acetate alone. Furthermore, patients should continue on a fluid program containing dextran 70 to counteract unrecognized hypovolemia. Our results support the assumption that early aggressive shock treatment with dextran 70, followed by continued dextran administration in the post-trauma period might prevent complications such as ARDS.