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

1. Sheep rumens were insufflated with nitrogen to 5, 10, 15, and 20 cm water pressure and sustained at each pressure for 10 min. 2. Measurements included rumen motility, reticulorumen myoelectric activity, eructation frequency and volume, changes in tracheal pressure and rumen contraction amplitude. 3. As intra-rumen pressure increased, contractions designated as special secondary contractions appeared. 4. At a pressure of approximately 15 cm water, most of the special secondary contractions became regular secondaries; therefore, the special secondaries were called pro-secondary contractions. 5. Increased intra-rumen pressure was associated with respiratory distress. The recovery phase following, rumen insufflation was accompanied by hyperpnea.
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PMID:Elevated intra-rumen pressure and secondary rumen contractions in sheep (Ovis aries). 290 20

Atrial natriuretic factor (ANF) plasma concentrations were measured in 16 healthy term newborn infants and in 18 preterm infants with respiratory distress syndrome during the first 4 postnatal days. Changes in the plasma concentration of ANF were then correlated with postnatal age, severity of respiratory distress, and water and sodium balance. The plasma ANF concentration in healthy term infants increased during the first 2 days of life. Similar values were observed among preterm infants requiring hood oxygen. The plasma ANF concentrations were substantially higher in preterm infants receiving positive pressure ventilation. All infants had negative water and sodium balance during the period of study. No correlation was found, however, between absolute plasma ANF concentrations and urinary flow rate, sodium excretion, or fractional sodium excretion, suggesting that ANF did not exert a dominant role in the excretion of sodium in these infants.
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PMID:Elevated atrial natriuretic factor in neonates with respiratory distress syndrome. 294 39

Respiratory distress, from severe gastric aspiration pneumonitis and abdominal distention in the patient with tracheoesophageal fistula frequently requires mechanical ventilatory support. Bulk flow ventilation can lead to enlargement of the fistulous tract, elevation of gastric intraluminal pressures, raised airway pressures with hemodynamic instability, and retained secretions. We report a case of tracheoesophageal fistula, secondary to perforation of a squamous cell carcinoma of the esophagus, with temporary improvement in gas exchange on high frequency ventilation after failing on a conventional ventilator. The patient initially failed to improve on an Engstrom ventilator (Engstrom-Gambro, Inc., Barrington, IL) at 13 l/minute ventilation. Instituting high frequency jet ventilation with a VS 600 Jet Ventilator (Instrument Development Corporation, Pittsburgh, PA) at initial settings of 35 psi, rate 150, inspiratory time 40%, FiO2 0.8 and 12 cm H2O positive end expiratory pressure (PEEP), provided incremental improvement in gas exchange and oxygenation up to 26 cm H2O PEEP. However, in view of progressive multi-organ failure we terminated the jet ventilation after 48 h and returned the patient to conventional ventilation. We were unable to provide life-sustaining ventilation and oxygenation with either an Engstrom ventilator at 13 l/-minute ventilation or an MA-1 ventilator (Puritan-Bennett, Kansas City, MO) at a tidal volume of 800 cc and a ventilator rate of 30. Terminal respiratory failure occurred. Based on the period of improvement using high frequency jet ventilation, we believe this mode of ventilatory support is beneficial in the management of tracheoesophageal fistula.
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PMID:A double-crossover study comparing conventional ventilation with high frequency ventilation in a patient with tracheoesophageal fistula. 298 90

In recent years, the survival rate of high risk infants has markedly increased. The role of such medical management as fluid, electrolyte and nutritional therapy have assumed a greater importance in assuring optimal quality of the survivors. The very low birth weight infants, particularly those with respiratory distress syndrome and perinatal asphyxia, are at highest risk. The inefficient renal function, unique characteristic of body fluid composition and/or presence of severe clinical illness often make the management of fluid and electrolytes in this group of infants difficult. The numerous factors that influence insensible water loss make calculation of fluid management in the high risk infant even more challenging. Systematic collection of data such as daily body weight, intake, output, urine specific gravity and serum electrolyte is essential to appropriately maintain fluid and electrolytes balance in these infants. Respiratory distress syndrome is a common problem in premature infants and the fluid and electrolyte management in these infants will require similar attention to details as described for the fluid and electrolytes of very low birth infants. Perinatal asphyxia often results in oliguria or anuria because of possible development of inappropriate ADH secretion or acute tubular necrosis. It is essential that fluid restriction be done on the first day or two of life to avoid fluid overload.
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PMID:Renal function and fluid therapy in high risk infants. 304 69

In respiratory distress syndrome (RDS), PEEP improves arterial oxygenation but may impair cardiac output. The effects of PEEP on gas exchange and hemodynamics were studied in 12 mechanically ventilated newborns in the acute phase of RDS. Stepwise increase in PEEP resulted in both a) a progressive increase in PaO2 and transcutaneous oxyhemoglobin saturation, and b) a depression of pulsed Doppler-measured cardiac output that was statistically significant at 9 cm H2O PEEP. Thus, averaged systemic oxygen delivery (DO2) was maintained with improved arterial oxygenation up to 6 cm H2O PEEP. Further increase in PEEP induced a significant fall in DO2. No variation was observed in heart rate and mean arterial pressure. The combined use of oximetry and pulsed Doppler echocardiography enables noninvasive optimization of mechanical ventilation and PEEP during the clinical course.
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PMID:Optimization of oxygen transport in mechanically ventilated newborns using oximetry and pulsed Doppler-derived cardiac output. 304 99

Application of continuous distending pressure at birth (very early CDP) should stabilize the immature airways and reduce the severity of respiratory distress syndrome (RDS) in preterm infants. Eighty-two preterm infants of less than 32 weeks gestation were randomly assigned at birth to early treatment group (TG), in which CDP of 6 cm water pressure was applied at birth by the nasopharyngeal route (NP-CDP), or to control group (CG), in which CDP was applied when indicated for established criteria (pO2 less than 50 mmHg in FiO2 greater than 0.5). Characteristics of the infants in the two groups were comparable. No statistically significant difference between the two groups was found in the incidence of RDS. The course of RDS, and oxygen and ventilatory requirements also did not appear to be changed. In blood gas parameters of most of the time frames, no significant difference was found between the two groups when the results were analyzed according to the assigned group. When the results were analyzed separately for the infants who developed RDS, infants in TG appear to have fared worse from the therapy in terms of oxygenation, as indicated by significantly higher FiO2 (P less than 0.01) and lower a/A (P less than 0.01) values on the third day of the course of RDS, as compared to infants in CG. The incidence of complications was comparable in the two groups. Four infants from TG (9.3%) and one from CG (2.6%) died (P = NS). We conclude that VECDP by nasopharyngeal route does not reduce the incidence of RDS and does not appear to improve the outcome and may worsen the severity of RDS when compared to application of CDP for established criteria.
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PMID:Randomized controlled trial of very early continuous distending pressure in the management of preterm infants. 310 11

Little is known of the endorphins' role in sepsis-induced respiratory distress and naloxone's effect as a treatment of it. Thirteen piglets were infused with live Escherichia coli at a rate of 2 to 10 X 10(8) colony-forming units per hour for six hours or until death and were divided into two groups: the septic control group (n = 8), and the naloxone-treated group (n = 5), which received 8 mg/kg/h of naloxone by continuous infusion. Hemodynamic parameters, the intrapulmonary shunt fraction (QS/QT), physiologic dead space (VD/VT), minute ventilation, and blood gas levels were measured. Lung lymph flow was obtained by cannulating the right lymphatic duct. The extravascular lung water weight was also measured. The results showed a significant reduction of QS/QT, VD/VT, and arterial carbon dioxide pressure at one hour and a significant increase of arterial carbon dioxide pressure and minute ventilation at 1, 3, and 4 hours in the naloxone-treated group, compared with the untreated septic group. None of the piglets in the naloxone-treated group developed ventilatory depression, while 75% of those in the untreated septic group did. Among the latter piglets, three died of apnea within one hour. These beneficial effects of naloxone are likely related to its action on the central and peripheral respiratory regulatory mechanisms. A transient protection of the cardiac output and relatively decreased extravascular lung water with naloxone treatment may also, in part, improve the ventilation-perfusion maldistribution and secondarily reduce QS/QT and VD/VT. We conclude that endorphins play a role in septic ventilatory depression and that naloxone is effective in ameliorating it.
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PMID:Prevention of septic ventilatory depression with naloxone. 311 29

Sequential lung function was measured in 12 very low-birth weight infants (less than or equal to 1,250 g) within 14 hours of birth, and at daily intervals thereafter for the first week of life, using an esophageal balloon and pneumotachograph system. All infants were clinically free of respiratory distress syndrome and radiographically showed no evidence of atelectasis or pulmonary edema. The alveolar-arterial oxygen tension gradient was high at birth and remained elevated over the period during which arterial blood gases were monitored. Increases of lung compliance and tidal volume between the first day and the end of the first week of life were not significant. Day-to-day determinations of lung compliance revealed an individual and group variability without a definite pattern. Lung resistance measurements indicated no clear trend for the group as a whole, but inspiratory resistance was generally lower than expiratory resistance. Possible causes, in addition to technical factors, that may account for the variability in the pulmonary mechanics of these small infants include an instability of lung volume and uneven distribution of pleural pressure due to chest wall distortion, differences in sleep-state, and alteration in the distribution of body fluids, resulting in a change in lung water. Any or all of these mechanisms may result in an unstable lung, even in an apparently clinically stable very low-birth weight infant.
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PMID:Sequential pulmonary function measurements in very low-birth weight infants during the first week of life. 312 53

The performance of a high frequency flow-interrupter (HFFI) type neonatal ventilator was evaluated on nine adult rabbits (control) and on five adult rabbits after bronchoalveolar lavage (BAL). Tidal volumes and airway pressures were measured during conventional ventilation and during HFFI at rates of 4, 6, 8, 10, and 12 cycles/s. Tidal volumes were adjusted to maintain PaCO2 between 35 and 42 mm Hg in control rabbits and 35-55 mm Hg in BAL rabbits; a positive end-expiratory pressure of 4 cm H2O was applied to BAL rabbits to reduce atelectasis and improve gas exchange. The normalized tidal volume required to maintain PaCO2 within the specified range during HFFI varied between 2.02 ml/kg (0.30 SD) and 2.55 (0.41) in control rabbits and between 2.65 (0.57) and 2.97 (0.51) in BAL rabbits. In neither group did the normalized tidal volume vary systematically with the rate of ventilation (p less than 0.05). Mean airway pressures were lower during HFFI than during conventional ventilation in control rabbits but comparable in the BAL group. Peak inflation pressures were greater during HFFI than conventional ventilation in control rabbits but similar in the BAL group. End-expiratory lung volume was not affected by ventilation rate during HFFI in control rabbits. We conclude 1) that HFFI can maintain gas exchange in rabbits suffering from acute respiratory distress with airway pressures that are comparable to those measured during conventional ventilation and 2) the capacity of HFFI to ventilate the lungs with significantly lower airway pressures than conventional ventilation depends, in part, on the condition of the lungs.
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PMID:Gas exchange during high frequency flow-interruption in rabbits before and after bronchoalveolar lavage. 314 93

In feeding the newborn with respiratory distress it must be considered the increased metabolic and water requirements. To feed this newborn we can choose among total parenteral nutrition, total enteral nutrition and a combination of the two methods. Data concerning 98 newborns with respiratory distress, admitted into Neonatal Intensive Care Unit of the Provincial Maternity Hospital of Milan, are described.
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PMID:[Feeding the newborn infant with respiratory insufficiency]. 315 Feb 63


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