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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Near-hanging and strangulation injuries can result in multiorgan failure. A 13-year-old male sustained an ischemic anoxic cerebral injury that was followed by an encephalopathy lasting approximately 30 hours and pulmonary edema lasting more than 48 hours. The patient was treated with continuous positive pressure ventilation followed by spontaneous breathing with continuous positive airway pressure by a mask; shock was reversed. The loss of cardiovascular competency and pulmonary insufficiency are problems frequently encountered in the patient who has sustained an hypoxic insult. Cerebral injury can result from hypoxemia related to tracheal compression, aspiration, and pulmonary edema; cerebral vascular engorgement secondary to venous compression; and ischemic anoxia related to arterial compression. Cerebral changes continue after circulatory and pulmonary competence has been restored. Multiorgan monitoring and control including intracranial pressure monitoring may be required to guide therapy. Respiratory distress syndrome may develop secondary to multiple factors including autonomic reflexes triggered by cerebral hypoxia and edema.
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PMID:Multiple organ failure after near-hanging. A case report. 72 97

We administered teicoplanin as specific antibiotic therapy for nosocomial "ICU specific" infections with methicillin-resistant Staphylococcus aureus and epidermidis (MRSA-MRSE). The above mentioned drug has been given to 20 patients (15 newborns and 5 not-newborns) admitted into intensive care unit during the years 1988, 1989, 1990 with MRSA-MRSE localized and/or systemic infection, affected by severe disease (RDS, pulmonary edema, congenital cardiac disease, cystic fibrosis) undergoing invasive procedures which presented high nosocomial infective risk (tracheal intubation, mechanical ventilation, venous and arterial cannulation, total parenteral nutrition, etc.). Complete recovery from systemic or localized infection (sepsis, low respiratory tract infection, high respiratory tract infection) occurred in 19 out of 20 patients, with a rate of success of 95%. Teicoplanin treatment lasted from a minimum of nine days to a maximum of thirty days. The dose was 5-6 mg/kg/die in one administration for the first three days, then 4 mg/kg/die. The tolerability of teicoplanin has proven satisfactory, since we had no major side effects during treatment and follow up.
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PMID:[Teicoplanin therapy in neonatal and pediatric intensive therapy]. 138 7

Surfactant is now available for general clinical use in infants with RDS. While surfactant is effective, it does not prevent lung disease in many preterm infants because of other aspects of lung immaturity. In experimental models, corticosteroids alter the fetal lung by improving compliances, increasing lung volumes, decreasing pulmonary edema, and altering surfactant-compliance dose response curves. These effects are independent of changes in surfactant pools but augment the responses of the lungs to surfactant treatment. Optimal outcomes for the preterm require the combined use of fetal maturation strategies and postnatal surfactant.
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PMID:Surfactant in the perinatal period. 139 80

From January 1987 to December 1989, prematures with RDS weighing 1750 g or less admitted to the Neonatal Intensive Care Unite (NICU) were submitted from the third postnatal day to serial two-dimensional and pulsed Doppler (ATL MK 600) echocardiographic evaluation for "silent" patent ductus arteriosus (PDA). PDA was diagnosed in 36/175 prematures with RDS (20.5%). Thirty patients had indomethacin treatment and the PDA closed completely in 27 (90%); five needed a second course of indomethacin, that was effective in two (40%). Four RDS patients (4/36-11%) already weaned from the respirator, needed supplemental oxygen. The three non-responders and six other prematures with counterindications to the drug underwent surgical ligation (25%). As historical control, we retrospectively evaluated the population of preterm infants with RDS weighing less than or equal to 1750 g treated for hemodynamically significant PDA during three previous years before the screening protocol; in this group the echocardiographic and Doppler evaluations were done when congestive heart failure and pulmonary edema were clinically evident. In comparison, we found a reduced incidence of prematures with RDS treated for PDA, 7/120 (5.8%) a higher age at medical treatment (9 +/- 1.4 vs 4.4 - 2.3 days) and a larger prevalence of patients underwent ductal ligation (71.4%). These data show that early screening and treatment of "silent" PDA may result advantageous to improve the efficacy (90%) of indomethacin, in a critical time for the recovery of RDS, and furthermore decreasing the need of surgical ligation.
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PMID:Early screening and treatment of "silent" patent ductus arteriosus in prematures with RDS. 196 Jun 32

Acute interstitial pulmonary edema in Respiratory distress syndrome with serious functional insufficiency is frequently accidental, and presents a process which develops rapidly in the alveolar-capillary structure, especially within the surfactant system. Its biogenic anti-atelectatic activity is initially diminished, and becomes excluded in the end. Mechanical ventilation with positive end-expiratory pressure is the logical way of treatment, based on the pathophysiological principle. Our clinical experience is accordant regarding the good effects of mechanical ventilation with positive end-expiratory pressure (PEEP).
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PMID:[Development of acute interstitial pulmonary edema in the respiratory distress syndrome]. 209 77

An animal model of API similar to RDS was established by feeding the rabbits with live E. Coli (10(11)/kg B.W.) and bleeding them till a mean arterial pressure of 6.0 kPa was maintained for 90 minutes. After resuscitation, there were decrease of PaO2, increase of respiratory rate as well as lung edema. Histological and electron microscopic examination showed interstitial and alveolar edema. The tight junctions both in alveolar epithelium and capillary endothelium showed alterations including discontinuity, irregularity, and free-ended strands being present as early as the 4th hour by freeze-fracture technique. Impairment of the tight junctions is considered to be the main route of fluid leakage from pulmonary capillaries inducing pulmonary edema.
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PMID:[Pathological changes in an animal model of acute pulmonary injury induced by hemorrhagic shock and E. coli infection]. 227 12

This article reviews the phenomenon of surfactant inactivation by soluble proteins. Following surfactant treatment of preterm lambs, the initial clinical response was not maintained. The surface tensions that were low in the lungs following surfactant treatment increased to high values concurrently with the return of severe respiratory failure. The surface properties of the surfactant that remained in the airways and alveoli could be restored if the soluble proteins were removed. These soluble proteins inactivated different surfactants to different degrees and the interaction was very concentration dependent. The proteins entered the lungs of the preterm lamb because of the tendency of these lungs to form pulmonary oedema. Similar surfactant inactivation occurred in the lungs of infants with respiratory distress syndrome. A variety of manipulations influenced the formation of proteinaceous pulmonary oedema, suggesting that new therapeutic strategies could be developed to treat infants with RDS.
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PMID:Protein leaks and surfactant dysfunction in the pathogenesis of respiratory distress syndrome. 274 83

The outstanding scientific and surgical accomplishments of the Second Auxiliary Surgical Group in the Mediterranean Theater of Operations and the 7th Army in World War II were not exceeded by any other group in the United States Army Medical Corps. In the final 921-page report to the Surgeon General with 550 tables, 8801 severely wounded casualties out of a total of 22,000 treated were reviewed. In addition, the major portion of three books on war surgery and over 60 scientific articles were written by this group. The contributions in thoracic surgery that focused attention on physiologic principles and limited the indications for thoracotomy have stood the test of time. The author made the original description of the reaction of the lung to severe trauma of the brain, abdomen, and extremities by the development of "the wet lung of trauma" (RDS), while his introduction of a hand-operated, intermittent positive pressure oxygen respirator to treat the advanced form of this syndrome (pulmonary edema) ushered in a new form of treatment. Long-term, follow-up studies by the author confirm the validity of the physiologic approach to the treatment of thoracic trauma.
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PMID:The contributions of the Second Auxiliary Surgical Group to military surgery during World War II with special reference to thoracic surgery. 633 43

To determine the relationship between improvement in pulmonary function and diuresis in respiratory distress syndrome, ten consecutive premature infants requiring mechanical ventilation for severe RDS were studied. Every infant had a diuresis (output/intake greater than 80%), which began at 26 to 34 hours of life and which lasted for an additional 64-72 hours. The diuresis preceded significant improvement in AaDo2 and ventilator settings (IMV, PIP, PEEP) by 52 hours. There was a significant decrease in body weight among all study infants during the first four days of life despite an increase in fluid intake. This study suggests a relationship in RDS between improvement in oxygenation and removal of interstitial lung edema.
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PMID:The diuretic phase of respiratory distress syndrome and its relationship to oxygenation. 720 62

The effect of putrescine on oleic acid-induced RDS were studied in rat, it was found that preadministration of putrescine to rat with RDS significantly improved its hypoxemia, pulmonary edema and histologic injury; inhibited the leakage of protein from plasma; lowered increase of pulmonary lipid peroxidation products (malondialdehde, MDA). The result suggests that putrescine could have significant potential for clinical treatment of acute pulmonary injury.
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PMID:[Protective effect of putrescine on oleic acid-induced respiratory distress syndrome (RDS)]. 783 71


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