Articles: respiratory-distress-syndrome.
-
Bronchoalveolar lavage (BAL) fluid was obtained from 24 sequentially studied patients with adult respiratory distress syndrome (ARDS) for assessment of potential activating and mediating factors. Proteolytic activity of the fluids was observed by measuring cleavage of radiolabeled proteins of the contact (Hageman factor) and complement systems. Proteolytic activity was observed in 17 of 24 (71%) patients with ARDS, and BAL fluid of the 7 ARDS patients without demonstrable, active, enzyme exhibited inhibitory activity for the proteolytic activity. ⋯ Free, inactive alpha1-PI was also observed in these fluids. The data reveal that in BAL fluids from all 24 patients with ARDS, leukocytic elastase and/or alpha1-PI exist. A complex of elastase and alpha1-PI was observed in BAL fluids, and in some cases where active enzyme and alpha1-PI coexisted, free, but inactive alpha1-PI was present.
-
The efficacy of administering continuous positive airway pressure (CPAP) by face mask was evaluated in 40 consecutive patients treated with 10 cm of water pressure or greater. Thirty-five patients were treated for progressive hypoxemia with all patients improving their PaO2/FIO2 ratio within the first hour of therapy. ⋯ Five other patients were treated for atelectasis unresponsive to the usual therapeutic measures, with three patients demonstrating roentgenographic improvement. Face mask CPAP proved to be a safe and effective method for treating hypoxemia associated with early progressive respiratory distress in alert, spontaneously breathing patients.
-
Acta Anaesthesiol Belg · Jan 1982
Techniques of ventilatory therapy in the adult respiratory distress syndrome (ARDS).
Techniques of respiratory support in ARDS are becoming more and more complex. New modes of ventilatory therapy like continuous positive airway pressure (CPAP), appeared during the last years and became popular; other ones are now under investigation, high frequency ventilation and extracorporeal CO2 removal, for instance. A lot of abbreviations are actually commonly used by physicians involved in intensive care as well as by ventilator industries. ⋯ The respective use of these different modes in our Center of Intensive Care at the University of Liège during recent years is analysed. It appears that mechanical ventilation, especially with positive end expiratory pressure (PEEP) keeps a place of choice and that spontaneous breathing with positive pressure (CPAP) represents one of the best improvements of the late years in respiratory intensive care. Last but not least is the absolute necessity to start respiratory assistance with positive pressure as soon as possible, once the diagnosis of ARDS is suspected.