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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A randomized controlled study was carried out at three medical centers to compare the efficacy and side effects of ethanol and ritodrine in the treatment of threatened premature labor. One hundred and thirty-five patients judged to be between the twentieth and thirty-sixth week of gestation and presenting with clinical symptoms of premature labor were included. Sixty-seven patients were treated with intravenous infusion of 10 per cent ethanol. Sixty-eight patients were treated with intravenous infusion of ritodrine for 12 hours followed by oral ritodrine. If labor recurred prematurely, up to two additional courses of ethanol or ritodrine were given. Delivery was postponed for more than 72 hours in 49 of 67 patients (73 per cent) with ethanol and in 61 of 68 patients (90 per cent) with ritodrine; this difference was significant. Patients in the ethanol group gained a mean of 27.6 days while patients in the ritodrine group gained a mean of 44.0 days. Fifty-four per cent of the ethanol group and 72 per cent of the ritodrine group carried their infants to 36 weeks of gestation. Five infants in the ethanol group and one infant in the ritodrine group died from respiratory distress syndrome. The most frequent side effect of ethanol were nausea and vomiting. The most frequent side effects of ritodrine were tachycardia and blood pressure changes which were easily controlled by lowering the infusion rate. Ethanol and ritodrine were both found to be effective inhibitors of premature labor with ritodrine giving the most favorable results.
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PMID:Inhibition of premature labor: a multicenter comparison of ritodrine and ethanol. 85 Nov 40

The validity of the assessment of the fetal age and pulmonary maturity was evaluated on 369 patients at various stages of normal pregnancy and complicated by diabetes, toxemia and fetal anencephaly. Gestational maturity was assessed by ultrasonic measurement of the fetal biparietal diameter and by analysing constituents of amniotic fluid (creatinine, bilirubin, fat cells) while pulmonary maturity was assessed from the L/S ratio in the amniotic fluid. Each individual method has a wide margin of error, however, ultrasound cephalometry gave the best prediction for determination of fetal age. In 135 selected cases lung maturity was assessed by using two techniques, a thin layer chromatographic determination of the lecithin/sphingomyelin ratio in the amniotic fluid and a rapid semiquantitative test to determine the titre of surfactant which generates stable foam in presence of ethanol. The results obtained by the two methods correlated well and were reliable in predicting the respiratory distress syndrome. It appears that these methods make it possible to obtain greater margins of reliability. The role of fetal and maternal factors in the maturation of fetal lungs was also studied in several pathological conditions and it was noted that in many cases of maternal diabetes mellitus lung maturity was reached at a later age than in normal pregnancies. It is condluded that if termination of pregnancy is indicated, the physician should rely more on the assessment of lung maturity than on indicators of gestational age.
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PMID:Determination of fetal maturity and of development of the fetal lungs by means of combined methods. 118 80

In hyaline membrane disease of premature infants, lack of surfactant leads to pulmonary atelectasis and respiratory distress. Hydrophobic surfactant proteins of Mr = 5,000-14,000 have been isolated from mammalian surfactants which enhance the rate of spreading and the surface tension lowering properties of phospholipids during dynamic compression. We have characterized the amino-terminal amino acid sequence of pulmonary proteolipids from ether/ethanol extracts of bovine, canine, and human surfactant. Two distinct peptides were identified and termed SPL(pVal) and SPL(Phe). An oligonucleotide probe based on the valine-rich amino-terminal amino acid sequence of SPL(pVal) was utilized to isolate cDNA and genomic DNA encoding the human protein, termed surfactant proteolipid SPL(pVal) on the basis of its unique polyvaline domain. The primary structure of a precursor protein of 20,870 daltons, containing the SPL(pVal) peptide, was deduced from the nucleotide sequence of the cDNAs. Hybrid-arrested translation and immunoprecipitation of labeled translation products of human mRNA demonstrated an Mr = 22,000 precursor protein, the active hydrophobic peptide being produced by proteolytic processing to Mr = 5,000-6,000. Two classes of cDNAs encoding SPL(pVal) were identified. mRNA of approximately 900 bases was identified on Northern analysis of fetal and adult RNA. Human SPL(pVal) mRNA was more abundant in the adult than in fetal lung. The SPL(pVal) gene locus was assigned to chromosome 8.
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PMID:cDNA, deduced polypeptide structure and chromosomal assignment of human pulmonary surfactant proteolipid, SPL(pVal). 333 10

A case report of a quadruplet pregnancy that followed the induction of ovulation by human chorionic gonadotropin and human menopausal gonadotropin is presented. Examination revealed 4 separate placentas, indicating development from 4 different ova. The infants all did well at term, with no signs of respiratory distress syndrome, and have developed normally. Early diagnosis by ultrasonography and complete early bedrest are important for fetal survival. Hospitalization at Week 27-28 of pregnancy is essential, and a complete, competent staff able to handle high-risk patients should be available. Intravenous ethanol infusion is useful during early labor. The patient must be carefully observed for postpartum hemorrhage and should be followed in the recovery room for 24 hours.
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PMID:Successful quadruplet pregnancy following ovulation induced with human menopausal gonadotropin and human chorionic gonadotropin. 444 Apr 70

A simple test for surfactant, utilizing bubble stability in ethanol, was performed in 106 samples of amniotic fluid obtained from 94 patients. Of these patients 80 delivered within 48 hours of the collection of the sample. The results were compared with the lecithin concentration in the same amniotic fluid samples and with the quality of respiration in the neonate. The test was "positive," indicating fetal pulmonary maturity, in 37 cases and none of these infants developed respiratory distress syndrome (R.D.S.). In only one of these cases, however, was gestation less than 37 weeks. The test was "intermediate" or "negative" in 43 cases but in 35 of these infants respiration at birth was perfectly normal.Performed by the method described by its originators, this simple test gives too many false negative results to be of value in routine clinical practice, although a positive result is helpful. The concept of the test is ingenious, however, and further developments may be expected.
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PMID:Bubble stability test compared with lecithin assay in prediction of respiratory distress syndrome. 473 29

Dopamine, ethanol, and mannitol were investigated to determine if they could increase pulmonary blood flow and oxygen delivery without significantly increasing intrapulmonary shunt. These drugs were studied in adult patients with respiratory distress following trauma, operation, or sepsis. Intravascular pressure, cardiac output, oxygen consumption and delivery, and limb blood flow and peripheral oxygen delivery were measured in all patients. Hypotensive patients received dopamine in incremental doses of 2 mu g/kg/min until either mean arterial pressure increased 15 mm Hg or heart rate increased by more than 15 beats/min. Ethanol was given as 10% ethanol in 5% dextrose at 2 ml/kg/hr. Mannitol was given as 25 gm of a 25% solution in a single bolus followed by infusion of 8 to 25 gm of 20% solution (mean 10 +/- 2 gm) as a continuous intravenous drip over 1 hour. No drug produced a significant change in intrapulmonary shunt. Ethanol produced significant (p less than 0.05) increases in cardiac index, heart rate, oxygen consumption, and oxygen delivery. Dopamine significantly decreased pulmonary vascular resistance while increasing systemic blood pressure. Visceral blood flow apparently increased while the peripheral vascular response to ischemia remained intact. Mannitol increased oxygen delivery and consumption in both the total body and limb. Thus in patients with adult respiratory distress syndrome (ARDS), increases in pulmonary blood flow can be achieved with several distinct pharmacologic agents without significant increases in intrapulmonary shunt. These increases in flow are generally accompanied by increases in oxygen delivery without increased pulmonary vascular resistance.
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PMID:Effects of dopamine, ethanol, and mannitol on cardiopulmonary function in patients with adult respiratory distress syndrome. 678 9

In a multicenter series of randomized prospective double-blind controlled studies, ritodrine hydrochloride was compared with either ethanol or placebo in treatment of idiopathic preterm labor. When compared with controls, there was, among offspring of ritodrine-treated mothers, a significantly reduced incidence of neonatal death and respiratory distress syndrome (P less than .05 in both comparisons) and a significantly higher proportion of infants achieving 36 weeks' gestation (P less than .05) or birth weight greater than 2500 g (P less than .05). There was also a significant improvement in gestational age at delivery (P less than .05) and in the number of days gained in utero (P less than .001) among ritodrine-treated patients as compared with controls. These results, coupled with a finding of generally acceptable side effects, have contributed to ritodrine's becoming the first drug approved for the treatment of preterm labor in the United States.
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PMID:Ritodrine hydrochloride: a betamimetic agent for use in preterm labor. II. Evidence of efficacy. 699 3

Forty-six patients in premature labor were initially successfully treated with ethanol infusion. Twenty-three of these patients were then given prolonged oral terbutaline sulfate therapy until 38 weeks' gestation, and the remaining 23 patients were given placebo. The treated group gained significantly more time in gestation than the placebo group (P < .05), although the placebo group started with a higher Bishop score. In addition, idiopathic respiratory distress syndrome was seen significantly less often in the treated group. There was no perinatal mortality in either group.
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PMID:Terbutaline sulfate in the prevention of recurrence of premature labor. 700 77

Presented is a retrospective study of the newborn infants of mothers who were treated with ethanol in order to arrest premature labor, in comparison with matched control infants. In regard to neonatal mortality, there was no statistical difference between the study and the control infants. However, infants born within 12 hours after administration of ethanol had a significantly lower 1-minute Apgar score and a higher incidence of respiratory distress syndrome. This indicates that treatment with ethanol should be discontinued as soon as it becomes evident that labor cannot be arrested.
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PMID:Infants of mothers treated with ethanol for premature labor. 739 35

Appropriate and early treatment with exogenous surfactant has clinical and economic benefits for neonates with pulmonary surfactant deficiency. In order to rapidly and reliably identify such neonates, we have evaluated the shake and click tests, biophysical tests of surfactant function, using 0.2 mL samples of tracheal (TA) and gastric aspirates (GA). Samples from 181 neonates with a gestational age range of 24-40 weeks were shaken with 95% ethanol. If bubbles formed (positive shake test) they were examined in air-free water under a microscope. In a positive shake or click test, the bubbles rhythmically increase and then decrease in size, denoting the presence of active surfactant. The probability of the tests to predict clinical surfactant deficiency was analyzed. The latter was defined as respiratory distress syndrome or transient tachypnea of the newborn diagnosed by chest radiography and clinical criteria. The click test on TA from preterm infants was most accurate, with a 100% positive predictive value and specificity, and a 93% and 94% negative predictive value and sensitivity respectively. These values for GA were 73%, 84%, 97%, and 95%, respectively. The test is quick, simple, inexpensive, reproducible, and unaffected by contamination with blood. The accuracy of this test on TA in diagnosing surfactant deficiency in neonates would permit early and optimal treatment with exogenous surfactant. When performed on GA, the test could aid decisions regarding transfer of neonates to tertiary level care.
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PMID:"Click test": rapid diagnosis of the respiratory distress syndrome. 809 Jun 9


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