Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0476273 (respiratory distress)
 19,632 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Report about the management of cases of severe Rhesus erythroblastosis. One case is specially discussed because of it's actuality. This was a patient with severe Rh-sensitization (OOD at 450 mm from the beginning of the 30th week of gestation in zone III according to Liley). Because of the haemolytic disease and the chronic fetal distress the Caesarean section was already performed in the 32nd week of gestation after Betamethason treatment of the mother. The Lecithin-Sphingomyelin (L/S) ratio in the amniotic fluid as a criterium of fetal lung maturity raised almost twicefold (from 0.9 to 1.6) after Cortison treatment. The intensive care (assisted ventilation with PEEP, correction of the acidosis and transfusion of packed red cells) of the severely anaemic (Hb 3.5 g%, Hk 15 vol.%) and hydropic newborn was already started in the delivery room. The newborn developed no RDS and was discharged healthy. With reference to this and other cases the management of severe Rh-sensitization before the 34th week of gestation is discussed. Premature infants are mainly susceptable to the development of a Respiratory Distress syndrome (RDS). After antepartum Cortison treatment for prevention of an RDS the date of confinement should be arranged earlier. The value of an early Caesarian section after antepartum Glucocorticoid treatment as compared to the application of intrauterine transfusions in cases of severe erythroblastosis is discussed. It is also reported about recent methods of treatment of severe conditions of hydrops fetalis.
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PMID:[Treatment of severe Rhesus erythroblastosis]. 40 79

In order to evaluate the role of surfactant lecithin composition in the development of the infantile respiratory distress syndrome (IRDS) we have examined lecithin fatty acid composition from gastric aspirates obtained at the time of delivery from 14 full term healthy infants, 9 control premature infants without respiratory distress, and 16 premature infants who developed IRDS. The latter had significantly reduced concentrations of palmitic acid (48.4 +/- 1.8% vs. 65.3 +/- 1.5% in fullterm and 59.5 +/- 0.8% in control premature infants, P less than 0.001). None of the infants in whom palmitic acid was more than 60% of total lecithin fatty acids developed IRDS, whereas 10 of 11 infants with values below 50% did develop this complication. Lecithin from gastric aspirate was shown to be similar in fatty acid composition to lecithins from tracheal washings and amniotic fluid. Palmitic acid concentrations in lecithins of serial tracheal washings paralleled the clinical course of eight infants with IRDS.
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PMID:Surfactant lecithin fatty acid composition and its relationship to the infantile respiratory distress syndrome. 58 Sep 59

A total of 2702 transabdominal amniocenteses performed at the Los Angeles County--University of Southern California Medical Center were reviewed, with particular emphasis on 392 samples performed beyong 41 weeks' gestation. A significant rise in the percent of amniocenteses with meconium staining was found to occur at an beyond 39 weeks. Meconium-stained fluid at amniocentesis was found to be associated with an increased incidence of babies weighing greater than 4000 g, maternal diabetes mellitus, and cesarean deliveries, in comparison to samples with clear amniotic fluid. Infants with meconium-stained fluid had an increased incidence of low 1-minute Apgar scores, but all 5-minute Apgar scores were 7 or greater. Ten perinatal deaths occurred after an amniocentesis with clear fluid in prolonged pregnancy, with four of these occurring within 7 days of amniocentesis. Lecithin/sphingomyelin (L/S) ratios less than 2.0 were found in 6% of amniocenteses performed beyond 41 weeks. However, none of the newborns with low L/S ratios develop subsequent neonatal respiratory distress syndrome. Amniotic fluid creatine values or blood-contaminated fluid were not found to be correlated with fetal outcome. No fetal mortality was attributable to amniocentesis. In view of the significant amount of false-positive and false-negative results, and the rare inherent danger associated with amniocentesis, its use solely to demonstrate the presence or absence of meconium staining appears to be of questionable value in the management of prolonged pregnancy.
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PMID:The value of amniocentesis in prolonged pregnancy. 62 31

Lecithin-sphingomyelin (L/S) ratios were measured in both amniotic and in lung fluids of fetal lambs. Around Day 130 of fetal age sudden increase of L/S ratio appeared in lung fluid. The amniotic L/S ratio increased only slowly as a consequence of which false negative values were obtained. A respiratory distress syndrome is to be expected when the lung fluid shows a L/S ratio less than 2. The L/S ratio of lung fluid is preferable to amniotic L/S ratio. In comparison with those of amniotic fluid the L/S ratios of lung fluid were significantly higher. Lung fluid secretion was measured daily. Large differences were seen among the lambs. Two days before delivery a striking decrease in the quantity of lung fluid production was noticed in all aminals.
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PMID:Transversal and longitudinal lecithin-sphingomyelin ratios in amniotic and lung fluids of fetal lambs. 104 Nov 94

In 55 infants with respiratory distress syndrome the dynamic compliance of the respiratory system (CRS) was measured by pneumotachography during the course of the disease. Lecithin/sphingomyelin ratio (L/S) was evaluated at birth and every 10th day. Thirteen infants who developed bronchopulmonary dysplasia (BPD) had lower L/S ratios at birth than those infants without BPD (mean = 1.0 versus 3.5, p less than 0.01). During the course of disease, L/S ratios were variable and increased in all infants independently of outcome. In the first days of life CRS was low (0.30 ml/cm H2O/kg) in all infants independently of outcome. In infants with BPD who survived, CRS was significantly higher from the 30th day on than in infants who died from the disease (0.35 versus 0.23 ml/cm H2O/kg). Together with an decrease in oxygen supply at this time (less than 70%) the CRS is a reliable predictor of survival in cases of BPD.
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PMID:Lecithin/sphingomyelin ratio from tracheal aspirates and compliance of the respiratory system in infants with bronchopulmonary dysplasia. 211 8

Lecithin phosphorus concentration, the standard fetal lung maturity test in our institution, and phosphatidylglyercol were assayed in 69, 29, and 45 amniotic fluid samples from normal (GI), gestational (GII), and insulin-dependent diabetic (GIII) women by means of thin layer chromatography and Amniostat-FLM, respectively. Lecithin phosphorus concentration greater than or equal to 0.1 mg/dl and positive or strong positive Amniostat-FLM results were considered mature. The results of both assays were concordant in 79% of the samples. The discordance rate was highest in GIII patients. In our experience, respiratory distress syndrome did not develop in neonate infants of diabetic women delivered after a mature lecithin result. With lecithin phosphorus concentration as the reference standard, the predictive value of a mature Amniostat-FLM result was 96.2%, whereas that of an immature result was 58.5%. Respiratory distress syndrome occurred in only two GIII neonates who were delivered within 72 hours of both immature lecithin and Amniostat-FLM results. These findings support the use of Aminostat-FLM as a screening test for fetal lung maturity in both normal and diabetic pregnancies. Additional tests will be necessary to evaluate further fetal lung maturity only if the results are negative.
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PMID:The reliability and clinical use of a rapid phosphatidylglycerol assay in normal and diabetic pregnancies. 342 55

Various anomalies of pulmonary surfactant have been described in relation to acute respiratory distress syndromes, hypersensitivity lung disease and pulmonary sarcoidosis. Phosphatidylcholine (PC) is the essential phospholipid component of pulmonary surfactant. Cytidine diphosphocholine (CDP-choline) is an essential intermediary in the biosynthesis of PC. The authors studied two groups of patients: one group consisted of diffuse interstitial pulmonary fibrosis and the other consisted of pulmonary sarcoidosis with parenchymal involvement. They observed quantitative and qualitative abnormalities of the phospholipid fractions of surfactant and more particularly of PC. The finding of a marked decrease in this phospholipid, especially in the cases of pulmonary fibrosis, justified the study of the therapeutic effects of CDP-choline. After one month of treatment with this substance, at a dose of 1 g I.M. per day, the PC fraction had returned to normal and, at the same time, there was an improvement in the PaO2 at rest and after exercise. Long term administration of CDP-choline appears to be valuable in the maintenance of the phospholipid equilibrium of pulmonary surfactant and in the improvement of the quality of alveolar gas exchange.
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PMID:[Respiratory function and alveolar biological changes under the effect of CDP-choline in pulmonary interstitial pathology: pulmonary fibrosis and sarcoidosis]. 383 93

Diabetic pregnancy is said to be associated with a delay in pulmonary maturity and significant false-positive rates for the lecithin/sphingomyelin (L:S) ratio. Lecithin/sphingomyelin ratios without routine estimation of phosphatidylglycerol in the management of 102 insulin-dependent diabetics were analyzed to assess whether or not these ratios were mature at 37 weeks and whether or not the method used was reliable. Only two of 102 (1.9%) values were reported at less than 2 to 1 from amniocentesis at 37 weeks' gestation. The incidence of respiratory distress syndrome was zero. The authors concluded that the L:S ratio measured by the method used, is a reliable predictor of lung maturity in diabetic pregnancy and that with strict glucose homeostasis, normal pulmonary maturation occurs by 37 weeks' gestation in diabetic pregnancy.
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PMID:Reliability of lecithin/sphingomyelin ratios in diabetic pregnancy. 404 42

The best management of respiratory distress syndrome (RDS) is prevention. Prenatal administration of Cortico-steroids has been proved to be a valuable way for accelerating fetal lung maturation. In case of high risk pregnancy, however, where acceleration of lung maturation is most needed, there may be a relative contraindication for using steroids. According to the theory that the increase in the phospholipid component of surfactant may be mediated by intra-amniotic thyroxin administration, its use for accelerating human fetal lung maturation has been tested. Seven samples of amniotic fluid were obtained in order to determine the lung maturity in seven pathological pregnancies (pre-eclamptic toxemia, diabetes, infection, hypertension, placental insufficiency) prior to elective caesarean section. Since thyroxin does not cross the placenta, it has to be injected directly into the amniotic sac. 20 ml of clear fluid were obtained by amniocentesis prior to each injection of 250 micrograms of Levothyroxin through the same needle. Each of the infants was delivered before 34 weeks. Birth weights of the premature infants were between 1220-1870 grams. In all cases the Lecithin/Sphingomyelin Ratio (L/S) in amniotic fluid analysis was immature. After thyroxin administration L/S Ratio was mature in pharyngeal aspirate examination after delivery in 6 cases. RDS was seen in only one infant. The interval between intraamniotic administration of T4 and delivery ranged from 72 hours to 2 weeks in 6 cases. In one case with clinical and radiological signs of RDS the injection-delivery interval was less than 48 hours: the L/S Ratio in pharyngeal aspirate was immature 2,8 (normal greater than 3).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Prevention of hyaline membrane disease by intraamniotic administration of thyroxine]. 653 84

We investigated the extent of the influence of maternal diabetes on the phospholipid composition and exchange activity of the neonatal lung alveolar surfactant. The results show that each phospholipid fraction (as well as the total phospholipid content) of the surfactant of neonates with diabetic mothers are decreased to about 30% of the control values. Phosphatidylcholine and phosphatidylglycerol, which are the most important surface active phospholipid fractions, were decreased to 27% and 34% respectively. In lung tissue of the neonates with diabetic mothers, all phospholipid fractions were increased. We found that the phosphatidylcholine-exchange activity in the alveolar surfactant does not exist in neonates with diabetic mothers. This inhibited phospholipid-exchange activity may be the reason for the decrease in the surfactant phospholipids and their increase in the lungs of neonates with diabetic mothers. The cholesterol content in the surfactant of such neonates decreased by almost half in comparison with the controls, while in lung tissue it remained unchanged. Producing an experimental respiratory distress syndrome could permit to study more deeply the causes which provoke it and the accompanying metabolic changes.
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PMID:Maternal diabetes mellitus and changes in neonatal rat lung and alveolar surfactant phospholipids. 668 58


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