Articles: respiratory-distress-syndrome.
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Diseases which manifest with the respiratory distress in the newborn include 1) respiratory diseases-IRDS, type II RDS, neonatal asphyxia, and MAS etc. 2) anemia, CHD 3) CNS and 4) metabolic diseases. Among these, IRDS has high mortality rate because of the lack of the pulmonary surfactant and immaturity of respiratory center, and has many difficult problems in terms of its prevention and respiratory management. The points of its respiratory management are as follows: 1) Estimation of the level of arterial oxygen ation-this is the most important point. ⋯ In MAS, pneumothorax, pneumomediastinum and severe asphyxia, the proper resuscitation, oxygen administration should be given according to several conditions, especially the degree of hypoxia. The peritoneal dialysis can be lifesaving in case of severe renal impairment with RD. As the respiratory distress in the newborn is very frequent in its occurrence and death rate, its proper management is expected to result in the decrease in the newborn death rate in Hokkaido (8.1--6.6 per 1,000 live births) and the increase in the survival rate without any handicap, particularly if hospitals in each Hokkaido district give the newborn medical care more intensively than at present.
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Randomized Controlled Trial Comparative Study Clinical Trial
Early positive end-expiratory pressure in the adult respiratory distress syndrome.
This prospective study was designed to determine the effect of positive end-expiratory pressure (PEEP) instituted early in the course of adult respiratory distress syndrome (ARDS). Seventy-nine (7%) of 1,200 patients admitted to the surgical intensive care unit were selected because of a high probability that ARDS would develop, and were randomized into two treatment groups. ⋯ Fewer pulmonary deaths occurred in this group (11% vs 29%; P = .02), and there was less pulmonary morbidity. This study supports the efficacy of early low-level PEEP in the treatment of patients for whom there is a high probability that ARDS will develop.