Articles: respiratory-distress-syndrome.
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J. Thorac. Cardiovasc. Surg. · Aug 1981
Comparative StudyEffects of dopamine, ethanol, and mannitol on cardiopulmonary function in patients with adult respiratory distress syndrome.
Dopamine, ethanol, and mannitol were investigated to determine if they could increase pulmonary blood flow and oxygen delivery without significantly increasing intrapulmonary shunt. These drugs were studied in adult patients with respiratory distress following trauma, operation, or sepsis. Intravascular pressure, cardiac output, oxygen consumption and delivery, and limb blood flow and peripheral oxygen delivery were measured in all patients. ⋯ Mannitol increased oxygen delivery and consumption in both the total body and limb. Thus in patients with adult respiratory distress syndrome (ARDS), increases in pulmonary blood flow can be achieved with several distinct pharmacologic agents without significant increases in intrapulmonary shunt. These increases in flow are generally accompanied by increases in oxygen delivery without increased pulmonary vascular resistance.
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Adult respiratory distress syndrome, commonly seen in adults, is not well recognized in children. A retrospective chart review was carried out to determine the relative incidence, predisposing conditions, clinical course, and outcome of children with adult respiratory distress syndrome. fifteen patients were identified. The most common predisposing conditions were near-drowning and near-strangulation with a noticeable absence of major trauma. ⋯ Air leak was the most common complication of treatment. Two of six survivors suffered major neurologic handicaps. Long-term pulmonary sequelae were minimal.
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Case Reports
Adult respiratory distress syndrome treated with high-frequency positive pressure ventilation.
Adult respiratory distress syndrome (ARDS) is a severe disease that carries a poor prognosis (50 to 60% mortality). Although modern ventilatory techniques, especially positive end-expiratory pressure ventilation, have reduced the mortality rate somewhat, they are still far from serving as the ideal solution to this grave condition. ⋯ A dramatic improvement was achieved within 60 min of increasing the ventilatory rate from 12 to 80/min, with a concomitant decrease of tidal volume from 12 to between 2 and 23 ml/kg. HFPPV may be a useful alternative method in the treatment of patients with ARDS.