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Query: UMLS:C0476273 (
respiratory distress
)
19,632
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
The study of 16 newborn of birthweight less than or equal to 2,200 g characterized by a common point: the presence of PLACENTA PRAEVIA IN THE MOTHER, enabled us to come to grips with the severe
respiratory distress
that these newborn can have. From the clinical standpoint: there is always early
respiratory distress
. From the radiological standpoint: by far the most dominant pathology was interstitial edema, giving rise to a WET
LUNG
. From the biochemical standpoint: the blood gases were characterized in a certain number of cases by hypoxemia which was refractory to the usual forms of treatment. From the mechanical standpoint: measurements carried out in 4 patients confirmed the extraordinary fall in these patients' compliance. The clinical, radiological, blood gas and mechanical analysis enabled one to differenciate 2 main types of indications for artificial ventilation: -- acute hypoxemia, -- the idea of an increased need for oxygen. In these 2 types of indications for artificial ventilation, it was apparent that the treatment of choice is constant positive pressure which may or may not be combined with intermittent positive pressure. With this treatment technique, none of the patients progressed to massive atelectasis. It can be said that with the advent of techniques of ventilation by high pressure combining IPP with CPP, one has definitively eliminated from this pathological picture, the principal cause of death: --anoxia due to massive alveolar collapse.
...
PMID:[Severe respiratory distress with stubborn hypoxemia in newborn infants whose mothers had had placenta previa]. 0 84
Arterial blood gases and regional lung function, measured with a 133xenon technique, were used to evalute the physiological defects and follow the natural history of 16 infants with lobar hyperinflation ("emphysema"). Hypoxemia was due to V/Q inequality at rest. Worsening of hypoxemia (mean Pao2 delta--26 mm Hg) with crying was due to shunting as a consequence of cessation of ventilation in the involved lobe. Surgery was necessary in three patients. Two deaths were caused by bronchopulmonary dysplasia after
respiratory distress
syndrome (RDS). In 12 of 14 infants, lung function was normal between the ages of 5 days and 1 year. Pediatrics, 59:1012-1018, 1977, LOBAR EMPHYSEMA, BLOOD GASES, REGIONAL
LUNG
FUNCTION.
...
PMID:Infantile lobar hyperinflation: expectant treatment. 32 90
The recent Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (
LUNG
SAFE) challenges current data on the prevalence of acute
respiratory distress
syndrome (ARDS). The
LUNG
SAFE investigators claimed that their data demonstrated the predictive validity of the Berlin criteria. Also, the
LUNG
SAFE showed a disturbingly large gap between scientific evidence and medical practice. All of these statements demand that we question the interpretations of the study's findings.
...
PMID:The LUNG SAFE: a biased presentation of the prevalence of ARDS! 2760 29
There have been many advances in the management of acute
respiratory distress
syndrome, a condition which Bellani et al, in the
LUNG
SAFE trial (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure), found represents up to 10.4% of intensive care unit admissions and 23.4% of patients requiring mechanical ventilation, with an unadjusted intensive care unit and hospital mortality of 35.3% and 40%, respectively. Studies have shown that prone positioning can improve oxygenation in patients who are mechanically ventilated for acute
respiratory distress
syndrome. This case report describes an example in which intraoperative prone positioning improved oxygenation in a patient after aspiration of gastric contents on induction of general anesthesia.
...
PMID:Acute Respiratory Distress in the Operating Room and Prone Ventilation: A Case Report. 3000 10
Extracorporeal carbon dioxide (CO
2
) removal (ECCO
2
R) facilitates the use of low tidal volumes during protective or ultraprotective mechanical ventilation when managing patients with acute
respiratory distress
syndrome (ARDS); however, the rate of ECCO
2
R required to avoid hypercapnia remains unclear. We calculated ECCO
2
R rate requirements to maintain arterial partial pressure of CO
2
(PaCO
2
) at clinically desirable levels in mechanically ventilated ARDS patients using a six-compartment mathematical model of CO
2
and oxygen (O
2
) biochemistry and whole-body transport with the inclusion of an ECCO
2
R device for extracorporeal veno-venous removal of CO
2
. The model assumes steady state conditions. Model compartments were lung capillary blood, arterial blood, venous blood, post-ECCO
2
R venous blood, interstitial fluid and tissue cells, with CO
2
and O
2
distribution within each compartment; biochemistry included equilibrium among bicarbonate and non-bicarbonate buffers and CO
2
and O
2
binding to hemoglobin to elucidate Bohr and Haldane effects. O
2
consumption and CO
2
production rates were assumed proportional to predicted body weight (PBW) and adjusted to achieve reported arterial partial pressure of O
2
and a PaCO
2
level of 46 mmHg at a tidal volume of 7.6 mL/kg PBW in the absence of an ECCO
2
R device based on average data from
LUNG
SAFE. Model calculations showed that ECCO
2
R rates required to achieve mild permissive hypercapnia (PaCO
2
of 46 mmHg) at a ventilation frequency or respiratory rate of 20.8/min during mechanical ventilation increased when tidal volumes decreased from 7.6 to 3 mL/kg PBW. Higher ECCO2R rates were required to achieve normocapnia (PaCO2 of 40 mmHg). Model calculations also showed that required ECCO2R rates were lower when ventilation frequencies were increased from 20.8/min to 26/min. The current mathematical model predicts that ECCO2R rates resulting in clinically desirable PaCO2 levels at tidal volumes of 5-6 mL/kg PBW can likely be achieved in mechanically ventilated ARDS patients with current technologies; use of ultraprotective tidal volumes (3-4 mL/kg PBW) may be challenging unless high mechanical ventilation frequencies are used.
...
PMID:Extracorporeal carbon dioxide removal requirements for ultraprotective mechanical ventilation: Mathematical model predictions. 3176 43
Clinical recognition of acute
respiratory distress
syndrome (ARDS) is delayed or missed entirely in a substantial proportion of patients. In the
LUNG
SAFE study, the largest international cohort of patients with ARDS, investigators were able to determine if ARDS was present, and at what stage the clinician made the diagnosis of ARDS. The diagnosis of ARDS was delayed or missed in two-thirds of patients, with the diagnosis missed entirely in 40% of patients, while ARDS recognition ranged from 51% in mild ARDS to 79% in severe cases. Failure to recognize ARDS in a timely fashion leads to failure to use strategies that improve survival in ARDS. Early diagnosis of ARDS may facilitate measures to abrogate progression of the lung injury, including protective mechanical ventilation, fluid restriction, and adjunctive measures proven to improve survival such as prone positioning. Information overload and a complex 'syndrome' diagnosis likely play key roles in ARDS under-recognition. Clinical under-recognition has important consequences particularly in terms of therapeutic options not considered. The development of approaches to enable more timely recognition has the potential to save lives.
...
PMID:Missed or delayed diagnosis of ARDS: a common and serious problem. 3232 23
