Articles: respiratory-distress-syndrome.
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Critical care medicine · Nov 1984
Sequential hemofiltration in nonoliguric high capillary permeability pulmonary edema of severe sepsis: preliminary report.
Five patients with nonoliguric adult respiratory distress syndrome (ARDS) secondary to severe sepsis showed improved blood oxygenation after up to 36 h of conventional therapy and mechanical ventilation with optimal positive end-expiratory pressure. However, metabolic acidosis was unchanged, and blood urea had increased. Some patients showed hemodynamic signs of incipient heart failure. ⋯ Patients recovered from ARDS in spite of fluid accumulation. Mechanical ventilation was stopped up to 8.5 h after the last hemofiltration. We postulate that convective ultrafiltration clears the blood of circulating low- and middle-weight vasoactive molecules implicated in the development of high microvascular permeability acute pulmonary edema secondary to sepsis.
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The adult respiratory distress syndrome (ARDS) is a common form of acute respiratory failure that has been increasingly reported as associated with a wide variety of medical conditions. Unlike other identifiable pathological events causing severe lung injury, it is now recognized that ARDS is not a single disease, but a complex interaction of pathophysiological events that result in diffuse injury to lung parenchyma. ⋯ This review article is intended to provide an overview of the suspected precipitating causes, discrete pathophysiologic changes, and monitorable clinical events associated with ARDS. With mortality from ARDS high, significant attention is being given to improving therapeutic intervention with such conventional measures as mechanical ventilation, positive end-expiratory pressure, and fluid management, along with corticosteroids and several new experimental pharmacologic approaches.
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Klinische Pädiatrie · Nov 1984
Case Reports[Central venous air embolism in an artificially respirated premature infant with respiratory distress syndrome].
We report a 935 g 27 weeks gestational age male infant born to a 30 year old mother on chronic intermittent hemodialysis for three years prior to the pregnancy. Immediately after birth the infant presented with severe respiratory distress requiring mechanical ventilation. Chest x-ray showed severe hyaline membrane disease with interstitial emphysema. The infant developed a left tension pneumothorax and systemic air embolism of the right heart, the inferior and superior vena cava and the hepatic vein, from which it subsequently died about 12 h later.