Articles: respiratory-distress-syndrome.
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Severe respiratory failure may develop in patients following or during various types of shock. A number of mechanisms for the genesis of this syndrome have been proposed. The exact role of each of these etiologies is unknown, but a combination of these and others may be the actual causative factors. ⋯ At the present the principal feature in treatment consists of IPPV with adequate inspired oxygen concentration. If progressive pulmonary deterioration occurs in patients on IPPV, the CPPV may be indicated. Judicious use of CPPV may result in an apparent improvement of shock lung in some instances.
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Am. Rev. Respir. Dis. · Mar 1977
Case ReportsCharacteristics of pulmonary surfactant in adult respiratory distress syndrome associated with trauma and shock.
Broncho-alveolar lavage fluid was obtained from a 24-year-old man who developed the adult respiratory distress syndrome one day after massive trauma and hemorrhagic shock. The lungs were available 3 days later when organ transplantation was performed. ⋯ This suggests that surfactant films in the adult respiratory distress syndrome are less responsive to stress, and that as a result, a loss of film elasticity may contribute to the abnormal pressure-volume relationships observed with the intact lung. Changes in the lipid-to-protein ratios of the purified lipid-protein aggregates were also found, as indicated by the recovery of 3 lipid-protein aggregates with different isopycnic densities from the lung with adult respiratory distress syndrome; only one major aggregate could be recovered from the lavages of normal lungs.
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Journal of neurosurgery · Feb 1977
Effect of positive end expiratory pressure ventilation on intracranial pressure in man.
THsi study was designed to define the effect of positive end expiratory pressure (PEEP) ventilation on intracranial pressure (ICP). In 25 patients with severe head trauma with and without associated pulmonary injury the following parameters were simultaneously monitored under mechanical ventilation with and without PEEP:ICP, arterial blood pressure, central venous pressure, arterial blood gases, and cardiac rate. In addition, the volume-pressure response (VPR) was evaluted in each patient to assess cerebral elastance. ⋯ Half of this latter group manifested impairment of cerebral perfusion pressure to levels less than 60 mm Hg. Return to baseline CIP levels was observed with termination of PEEP. No significantly consistent changes in other parameters were noted.