Articles: respiratory-distress-syndrome.
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Pulmonary effluent samples were obtained from 26 preterm or term infants throughout the period of endotracheal intubation. Infants with respiratory distress syndrome, infants with this disorder developing bronchopulmonary dysplasia, and intubated infants without lung disease were compared daily in terms of lung effluent cellularity, albumin, elastase activity, alpha 1-proteinase content and activity, and elastase inhibitory capacity. The elastase activity was determined to be neutrophilic in origin. ⋯ Pulmonary effluent neutrophils, macrophages, and elastase activity were increased by day 3 of life in infants with respiratory distress syndrome eventually developing bronchopulmonary dysplasia. Elastase inhibitory capacity and alpha 1-proteinase inhibitor activity were reduced in infants developing chronic lung disease. Bronchopulmonary dysplasia developed in infants with enhanced inflammatory response, but with less or inhibited antiprotease activity.
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The adult respiratory distress syndrome (ARDS) is an extreme form of noncardiogenic pulmonary edema associated with alveolar-capillary damage. Clinical features include acute respiratory distress, dyspnea and tachypnea, severe hypoxemia refractory to oxygen therapy, and diffuse bilateral pulmonary infiltrates. ⋯ Treatment includes positive end-expiratory pressure, careful fluid management, steroid therapy, and adequate nutrition. Unfortunately, even with the most sophisticated intensive care, the mortality of ARDS is still greater than 50%.
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Comparative Study
[Comparison of high-frequency jet ventilation and conventional ventilation in the adult respiratory distress syndrome].
Sixteen adult patients with respiratory distress syndrome requiring mechanical respiratory assistance entered this study, the purpose of which was to obtain the same blood gas values under high frequency jet ventilation as under conventional ventilation. When high frequency jet ventilation without spontaneous breathing was compared to continuous positive pressure ventilation, peak airway pressure was the same, but mean airway pressure, positive end-expiratory pressure and pleural pressure were higher and cardiac index lower. When high frequency jet ventilation with spontaneous breathing was compared to intermittent mandatory ventilation, peak airway pressure was lower, mean airway pressure and positive end-expiratory pressure were higher, and pleural pressure and cardiac index were not different.