Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0020440 (hypercapnia)
 7,939 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty-four newborns with severe respiratory distress, treated by mechanical ventilation, are investigated by inspiratory pressure-volume curve. The curves are obtained by slow continuous inflation technique. Two shapes are described: concave curve, ten newborns (group I), linear curve, fourteen newborns (group II). The gestational age is over 36 weeks in both groups. Determination of respiratory mechanics is indicated when mean AaDO2 is higher than 500 torr in both groups, and when there is a hypercapnia (PaCO2 = 53 +/- 11 torr, with p less than 0.05) in group II. Mechanical ventilation is conducted with individually adjusted PEEP in group I, and without PEEP in group II. Twelve hours after; mean AaDO2 in group I (260 +/- 101 torr) and in group II (420 +/- 188 torr) are significantly different (p less than 0.05). The variance analysis in group II shows that PaCO2 and pH are normalized (p less than 0.001). All the newborns in group I recovered. Three newborns in group II died. Group I can be assimilated to hyaline membrane disease in full-term neonates. Practically, the cases of neonatal respiratory distress in which PEEP is not indicated can be identified by the functional characteristics of group II.
 ...
PMID:[Severe neonatal respiratory distress with linear inspiratory pressure-volume curve]. 240 67

A 2,980-gram female infant was born to a 25-year-old mother at the gestational age of 34 weeks with the chief problems of asphyxia and respiratory distress. Prenatal sonogram at 34th week of gestation showed significant pleural effusion, mediastinal shift, polyhydramnios and large for date. Soon after birth, she was put on intubation and ventilator therapy. Physical examination revealed poor chest wall excursion. Breathing sound was markedly decreased over the right lung field. Abdomen was soft and slightly distended with the liver palpable 0.5 cm below the right costal margin and 2 cm below the xyphoid process. Arterial blood gas with patient breathing 100% oxygen revealed severe acidosis and carbon dioxide retention. The first chest film showed right pleural effusion. Chest tap was performed, and 90 cc serosanguineous fluid was aspirated. The white cells of the effusion were 1,971 with lymphocyte predominant. No microorganism or malignant cell was found. Severe respiratory distress and cyanosis persisted inspite of these managements. Follow up chest film at the age of 11 hours revealed the right chest was occupied by intestinal loops. A thoracotomy was performed with the impression of right diaphragmatic hernia. The operation findings included a very redundant membranous portion of diaphragm formed a large sac containing the liver and some bowel loops, the lower lobe of the right lung collapsed and was located high in the posterior chest cavity. Diaphragmatic plication and excision were done with transient improvement of the skin color. The baby's condition deteriorated and expired at the age of 25 hours despite of postoperative vasodilator and ventilator therapies.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Congenital right diaphragmatic eventration manifested with pleural effusion. Report of one case]. 263 24

After a brief historical recall, this review states the needs for an accurate diagnosis of the neonatal respiratory distress syndrome (RDS). The clinical features consist of disturbances of respiratory rate, grunting, intercostal retractions, and cyanosis, but early mechanical ventilation tends to suppress most of them. Laboratory findings include hypoxemia, hypercapnia, and mixed acidosis. Positive radiological diagnosis remains an important criterion but early ventilation with positive end-expiratory pressure has made grading obsolete. The biochemical diagnosis addresses the basic lung surfactant deficiency, by determination of the lecithin/sphingomyelin ratio and phosphatidylglycerol ("modified lung profile") in lung effluents at birth. If clinical and radiological diagnosis remains adequate for daily practice and epidemiological studies, biochemical diagnosis should be mandatory for therapeutic trials. However, the problem of atypical RDS in very low birth weight infants has not been totally solved. RDS has now been known for more than 80 years; yet its diagnosis is still a matter of controversy.
 ...
PMID:Neonatal diagnosis of respiratory distress syndrome. 266 94

Three children developed severe respiratory distress at days +12, +11, and +11 following allogeneic bone marrow transplantation from donors. The first child was a 13-year-old Hispanic boy transplanted in relapse of Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL). At day -14, a bronchial washing done for a streaky pulmonary infiltrate was negative for acid-fast bacilli. Miliary tuberculosis was discovered at postmortem examination. A second child, transplanted in remission of null-cell ALL, developed severe hypoxia and hypercarbia on day +11 but recovered fully following prolonged mechanical ventilation. An open-lung biopsy showed a pattern of nonspecific, diffuse alveolar damage compatible with respiratory distress syndrome. The third child was transplanted in remission of B-cell ALL and developed fatal fungal and cytomegalovirus pneumonia on day +12. In these latter two cases, it is likely that open-lung biopsy would have missed the diagnosis because of the uneven pulmonary involvement and multiple etiologies observed. All three children received cyclosporine, granulocyte transfusions, and multiple antimicrobials, including amphotericin B. Hyperfractioned total-body irradiation with lung shielding was used in the latter two patients.
 ...
PMID:Difficulty in establishing diagnosis from lung biopsies and bronchial washing analysis in children with leukemia following bone marrow transplantation. 331 45

Factors affecting the survival of 175 preterm infants born with body weight less than 1500 g were examined. The still-birth and perinatal mortality rates were 143 and 446 per 1000 births respectively; neonatal death rate was 447 per 1000 live births. Survival improved progressively with increasing gestational age, and survival was better for infants born after 27 weeks of gestation. Neither maternal nor labour and delivery variables significantly affected survival. Male infants had half the survival rate of females. Birth asphyxia, hypercapnia and respiratory distress syndrome were the most common forms of morbidity, occurring in greater than 20% of the population. Infants with such pathology had significantly lower survival rates.
 ...
PMID:Prenatal and postnatal factors affecting short-term survival of very low birth weight infants. Italian Collaborative Group on Preterm Delivery. 340 21

We studied the value of transcutaneous carbon dioxide (PtcCO2) monitoring during neonatal transport. Thirty-two neonates with respiratory distress were alternately enrolled in an experimental group (results of PtcO2 and PtcCO2 available for clinical management) and a control group (results of only PtcO2 available). Although differences were not significant, infants in the experimental group had more changes in the intermittent mandatory ventilation (IMV) settings during transport, and more such infants arrived at the receiving hospital with acceptable pH and PCO2 values. On arrival at the receiving hospital, two patients in the control group had acidosis and hypercarbia and were placed on IMV immediately on arrival. No such patients were encountered in the experimental group. For patients needing IMV during transport, the percentage of study time spent with PtcCO2 measurements in the normal range (35 to 45 torr) was greater for the experimental group (p less than .02). Continuous PtcCO2 monitoring during transport offers the opportunity to further decrease the risks of transporting a critically ill neonate.
 ...
PMID:Transcutaneous carbon dioxide monitoring during neonatal transport. 378 Feb 48

A radiographic pattern associated with respiratory distress, distinct from hyaline membrane disease and transient tachypnea of the newborn, is described in eight infants of diabetic mothers. The radiographic findings demonstrate a regional distribution of reticulogranular densities accompanied by increased lung volumes. Clinical features were gestationally mature infants in moderate respiratory distress with tachypnea, hypercapnia, and hypoxemia requiring supplemental oxygen, with steady improvement and uneventful recovery within 2 weeks. There was no bacteriologic evidence of infection or radiographic evidence of delayed lung fluid absorption. The mothers had mild diabetes. These features characterize a newly recognized entity in diabetes-related idiopathic lung disease of the newborn. Possible causative factors are discussed.
 ...
PMID:A newly recognized profile in neonatal lung disease with maternal diabetes. 387 61

Severe head trauma patients frequently develop pulmonary failure. The aetiology of this respiratory distress may be central (neurogenic pulmonary oedema, delayed neurogenic pulmonary dysfunction, abnormal respiratory patterns) or peripheral, due to chest trauma, multiple trauma or lung infection. Hypoxia and hypercarbia alter cerebral haemodynamics, increase intracranial pressure and cause secondary deterioration of neurological function. Ventilatory support is of utmost importance in supportive care of head trauma patients. Continuous mechanical ventilation and intermittent mandatory ventilation are most frequently employed. Hyperventilation is used to lower intracranial pressure and positive end-expiratory pressure (PEEP) is applied in lung disorders characterized by interstitial oedema and alveolar collapse. The effects of PEEP on cerebral perfusion pressure and on intracranial pressure depend on the interaction of pulmonary compliance, cerebral pressure/volume relationship and cerebral vascular autoregulation. High levels of PEEP may be deleterious in patients with altered cerebral autoregulation. High frequency ventilation theoretically has less influence on intrathoracic pressures and on cerebral haemodynamics but has not been shown superior in the respiratory support of severe head trauma patients.
 ...
PMID:Ventilatory support for pulmonary failure of the head trauma patient. 389 Sep 90

The present experimental work focuses on the mechanisms involved in respiratory distress observed in the course of subarachnoid haemorrhage. For this purpose, respiratory disturbances were induced in rabbits by injecting fresh autologous blood into the subarachnoid space. For six hours after this artificially induced SAH, blood PO2 and PCO2 as well as expiratory air CO2 were regularly determined, while during the same period cerebral blood flow and cerebrospinal fluid pressure measurements were recorded. The results of this study suggest that pressure effects acting the brain structures that support respiration are principally involved in the pathogenesis of respiratory disturbances following SAH. A decrease in CBF and hypoxia with hypercapnia play a contributing secondary role adding to a vicious cycle phenomenon.
 ...
PMID:A contribution to the pathogenesis of respiratory disturbances associated with subarachnoid haemorrhage; an experimental approach using an animal model. 393 45

The clinical and physiologic features of 28 infants with Pierre Robin syndrome and those of 20 infants with various types of nasal obstruction were reviewed to determine whether different causes of upper airway obstructure may lead to a common syndrome. The patients had no significant differences in distribution of main clinical manifestations. Their features included cyanosis with respiratory distress, apneic spells, oropharyngeal dysphagia, vomiting, failure to thrive, cor pulmonale, brain damage, and sudden death during sleep. The common physiologic manifestation appeared to be an oropharyngeal obstruction caused by glossoptosis, which occurred mainly during wakefulness. Upper airway obstruction led to hypoxemia, which, in many instances, was not associated with hypercapnia and was not relieved by oxygen administration. It is concluded that regardless of a specific cause, any airway obstruction that results in a decreased inspiratory pressure overcoming the airway maintaining genioglossus action causes a glossoptosis-apnea syndrome.
 ...
PMID:Glossoptosis-apnea syndrome in infancy. 399 Dec 69


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>