Articles: respiratory-distress-syndrome.
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Tokai J. Exp. Clin. Med. · Sep 1982
Measurement of functional residual capacity and pulmonary carbon monoxide diffusing capacity during mechanical ventilation with PEEP.
First, our new simplified method to measure FRC and DLCO simultaneously during mechanical ventilation was described in detail. Secondly, we applied the method to ARDS patients and observed the effects of PEEP on arterial blood gases (ABGs), FRC and DLCO of these patients. ⋯ DLCO/FRC remained unchanged, although DLCO increased with PEEP. We concluded that the dissociation of FRC and ABG data in a group of patients could be caused by wasted ventilation which might be attributed to VA/Q unevenness.
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Adult respiratory distress syndrome is becoming more frequent in pediatric age. There are several factors involved in its' etiology. Sepsis is almost invariably present in all patients. ⋯ The extracorporeal oxygenation guarantees the oxygen exchange but it does not affect survival. Mortality is 95%. Patients who survive have minimal pulmonary sequelae.
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Case Reports
Respiratory distress syndrome and its treatment with high positive end-expiratory pressure ventilation.
In a 25-month period, nine patients developed a severe, rapidly progressive respiratory distress syndrome (RDS) and did not respond adequately to conventional respiratory therapy despite the application of positive end-expiratory pressure ventilation (PEEP) up to an upper limit of 15 cm H2O. Treatment with high PEEP was instituted up to 35 cm H2O, in order to achieve a PaO2 higher than 70 mmHg. Massive infusion of electrolyte solutions, colloids and red blood cells were necessary to maintain an adequate circulation that could be monitored by simple parameters such as arterial blood pressure, peripheral skin temperature and urine production. ⋯ There were no pulmonary functional or radiological abnormalities, one to 14 months after discharge from the hospital. The upper limit for PEEP should be abandoned and PEEP should be administered according to the needs of each individual patient. As an adequate oxygenation can always be achieved with high-PEEP ventilation, in surgical patients there is hardly, if ever, an indication for ECMO.