Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

13 unselected premature infants with idiopathic respiratory distress syndrome (IRDS) have been treated with continuous negative pressure (CNP). A chamber was applied to the infants' body, so that the head remained outside in normal atmospheric pressure. 4 infants died during the period of treatment. 6 out of 13 differently treated IRDS-infants died over the same 6 months period. In comparison 18 out of 27 infants with IRDS died the previous year, during the same period. The frequency of IRDS in both observation periods was the same, as was the therapy of acidosis and hypoxia. The infants responded to CNP with decreased respiratory frequency, lessening of "grunting" and return of a pink skin color. Pathological examination of 3 out of 4 deceased infants in the study group revealed both atelectases and some degree of interstitial emphysema and widened capillaries. No intravascular hyaline thrombi were seen. The remaining infant died with clinical signs of coagulopathy (no autopsy). Of the 9 surviving infants in the study group one developed a hydrocephalus and subsequent mild psychomotor developmental retardation. We conclude that the CNP therapy in the chamber is an asset to the treatment of early and medium-severe cases of IRDS. We believe, that early application might prevent development of severe IRDS. The method is not recommended for severe cases.
 ...
PMID:[Continuous negative pressure (cnp) in infants with idiopathic respiratory distress syndrome (irds) (author's transl)]. 117 50

The follow-up results of intensive care for 68 infants with birth weights less than 801 g treated at Stanford University Hospital were reviewed. The overall survival rate for these infants was 35%, but was 50% for those infants who had been successfully resuscitated in the delivery room and were admitted to the Intensive Care Nursery. Infants under 601 g in weight or less than 25 weeks gestation were more likely to die in the delivery room, but survival among those admitted to the Intensive Care Nursery did not depend on birth weight or gestational age. One-minute and 5-minute Apgar scores less than 5 and interstitial emphysema were associated with increased risk of neonatal death. Only two of 22 survivors (9%) were severely handicapped and another eight (36%) had remediable disabilities at 2 years of age. No infant developed hydrocephalus and only one infant had spasticity. We suggest that the low incidence of major handicaps among survivors encourages the vigorous resuscitation of infants weighing less than 801 g at birth, yet strategies must be developed that will minimize both prolonged dying and the cost of intensive care for nonviable infants.
 ...
PMID:Outcome of neonates with birth weights of less than 801 grams. 246 42

Intraventricular tension pneumocephalus is an unusual complication of surgically treated hydrocephalus. This is a life-threatening complication requiring prompt diagnosis and treatment. A case is presented wherein tension pneumocephalus developed as a result of cervicocranial subcutaneous emphysema in the presence of a ventriculoperitoneal shunt.
 ...
PMID:Intraventricular pneumocephalus secondary to subcutaneous emphysema: a case report. 633 50

An open prospective descriptive pilot study was undertaken to assess the effectiveness and experience in the use of ExosurfNeonatal, a synthetic surfactant, on preterm infants with respiratory distress syndrome in the neonatal intensive care unit of the Paediatric Institute. Of 10 infants treated, seven (70%) survived with no major handicap on discharge. The mean duration of ventilation for these survivors was 6.4 days, mean duration of oxygen therapy 9.1 days and mean length of hospital stay 38.3 days. A comparison was made with a retrospective analysis of 15 neonates who were admitted during an eight month period prior to the pilot study. These infants were mechanically ventilated for respiratory distress syndrome but not given surfactant therapy. Of these, nine (60%) survived (P > 0.1 compared to Exosurf treated infants), but two developed post haemorrhagic hydrocephalus requiring shunting. For these nine survivors, the mean duration of ventilator therapy was 12.6 days, the mean duration of oxygen therapy 20.7 days and the mean length of hospital stay 70.8 days. This difference was statistically significant (P < 0.05). Of the three ExosurfNeonatal treated infants who died, two were extremely premature. Both developed grade IV periventricular haemorrhage while the third infant was admitted in shock and hypothermia and died from intraventricular haemorrhage and pulmonary interstitial emphysema. Except for the very sick and extremely premature infants, surfactant therapy is useful in reducing the mortality and morbidity of premature infants with respiratory distress syndrome in our neonatal intensive unit.
 ...
PMID:Surfactant therapy in respiratory distress syndrome--the first local experience. 805 89

The authors report the case of 14-year-old girl with a history of myelomeningocele and previously shunt-treated hydrocephalus who presented with right-sided abdominal pain and subcutaneous emphysema that developed over a 1-week period. A CT scan of the patient's abdomen revealed a retained distal ventriculoperitoneal (VP) catheter with air tracking from the catheter to the upper chest wall. Given the high suspicion of the catheter being intraluminal, an exploratory laparotomy was performed and revealed multiple jejunal perforations. The patient required a partial small-bowel resection and reanastomosis for complete removal of the retained catheter. Six other similar cases of bowel perforation occurring in patients with abandoned VP and subdural-peritoneal shunts have been reported. The authors analyzed these cases with regard to age of presentation, symptomatic presentation, management, morbidity, and mortality. While there was 0% mortality associated with bowel perforation secondary to a retained distal VP catheter, the morbidity was significantly high and included peritonitis and small bowel resection.
...
PMID:Bowel perforation presenting with acute abdominal pain and subcutaneous emphysema in a 14-year-old girl with an abandoned distal peritoneal shunt catheter: case report. 2715 75

An 82-year-old woman underwent a ventriculoperitoneal (VP) shunt placement to treat hydrocephalus secondary to a right thalamic intracerebral hemorrhage. Pneumothorax and subcutaneous emphysema was noted 2 hours later. No respiratory distress was noted. A chest computed tomography scan revealed that the shunt tube had penetrated the diaphragm and entered the pleural space. The shunt tube penetrated the lung parenchyma and exited the pleural space via the third intercostal space. She underwent chest drainage and VP shunt re-position. The VP shunt functioned properly and no infection was noted. Bending the shunt passer slightly and keeping the passer tip pointed upward and palpable during its advancement may prevent this complication. It may be acceptable to leave the shunt tube in place after chest drainage for pneumothorax.
 ...
PMID:Pneumothorax After a Ventriculoperitoneal Shunt Placement: Case Report and Review of the Literature. 2956 95