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

The modification of a simple nasal CPAP-system is described. Results in therapy of respiratory distress syndrom with this method are discussed.
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PMID:[Treatment of impending and manifested respiratory distress syndrome in newborn infants using a simple nasal CPAP-system]. 10 8

CPAP is a technique of respiratory care which was originally described in the management of the respiratory distress syndrome of the newborn and later in the post operative management of the cardiac infant following surgery. It has potential value in the respiratory management of older children and adults. Apparatus is described suitable for the application of continuous airway pressure during spontaneous ventilation via endotracheal tube in either neonates or adults. The inspired oxygen content is adjustable and the fresh gas warmed and humidified. High and low pressure alarms are not considered necessary. A head-harness is described for the application of CPAP in neonates via twin nasal or nasopharyngeal tubes. This equipment may be obtained from Messrs. Lusterlite Products Limited, 56 Devon Road, Leeds 2.
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PMID:Continuous positive airway pressure breathing (CPAP). Apparatus for use in neonates or adults. 12 28

A review of infants with idiopathic respiratory distress syndrome developing pneumomediastinum and pneumothorax reveals (1) an incidence of 20% in patients receiving CPAP with an 11% incidence in comparable infants not receiving this mode of therapy; (2) in the CPAP-treated group the occurrence was at a stage in the illness when the inspired oxygen concentration was being lowered and when ventilation was stable; (3) the inspired oxygen concentration in the CPAP group at the time of the PM and/or PT was 52% (plus or minus S.D. 15%) at a mean age of 33 hours (plus or minus S.D. 23 hr). These observations suggest that distending airway pressure creates excessive alveolar distention as an underlying mechanism of the air leak. It is recommended that distending airway pressure be lowered prior to achieving an inspried oxygen concentration of 60%. A controlled study is in progress to delineate the optimum distending airway pressures at specific inspired oxygen concentrations in order to reduce the incidence of alveolar rupture to a minimum.
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PMID:Pneumothorax and pneumomediastinum in infants with idiopathic respiratory distress syndrome receiving continuous positive airway pressure. 23 34

We describe a simple and reliable method to determine optimal airway pressure in infants with idiopathic respiratory distress syndrome who require continuous positive airway pressure treatment. Esophageal pressure was monitored in ten infants with IRDS during initial application of CPAP. As the level of CPAP was increased in 2 cm H2O increments, changes in Pes were compared with changes in PaO2. Below optimal airway pressure, Pes as well as PaO2 increased insignificantly. When optimal airway pressure (8.1 +/- 0.8 cm H2O) was applied, there was a marked increase in Pes (3.6 +/- 0.8 cm H2O. p less than 0.001) and PaO2 (39.0 +/- 10.0 mm Hg, p less than 0.01). Further increase in CPAP did not result in any subsequent appreciable increase in Pes while PaO2 decreased slightly and PaCO2 increased. Less than optimal CPAP increases F102 requirements and may increase the associated risk of bronchopulmonary dysplasia, while excessive levels of CPAP may increase the risk of pneumothorax. We suggest that esophageal pressure be monitored routinely to determine the optimal level of CPAP for each infant during the initial application of therapy.
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PMID:Determination of optimal continuous positive airway pressure for the treatment of IRDS by measurement of esophageal pressure. 33 Aug 31

The nasal CPAP modification of spontaneous positive pressure breathing is technically simple, non-invasive for the patient, and does not interfere with routine infant care, yet provides most of the advantages of other CPAP modifications. Endotracheal intubation is eliminated since airway pressure is delivered by two short canules attached by means of adhesive tape to the patient's nose. The CPAP system was used in the care of 35 newborns and premature infants admitted to the University Children's Clinic Graz, with the diagnosis of respiratory distress (31 cases) or apnea-syndrome (4 cases) between Sept. 1973 and July 1975. The indications for the use of this system was based on the arterial oxygen tension values while breathing 100% O2 for 15 min. 22 of the 28 patients surviving were treated with N-CPAP alone, whereas 13 patients were CPAP-failures and required further ventilation (IPPV,PEEP). In the latter group apnea and 2 cases of pneumothorax necessitated intubation and ventilation, rather than the respiratory distress for which they had been initially treated. All 7 patients who died during this study were from this group of N-CPAP-failures (20% of the total, 54% of all N-CPAP-failures). Keeping ambient oxygen concentrations constant, an increase in arterial oxygen tension was measured in almost all patients surviving on N-CPAP and was initially even seen in those who later died, so that the ambient oxygen concentration could eventually be decreased.
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PMID:[Clinical experience with the use of continuous positive airway pressure delivered by the nasal route (N-CPAP) (author's transl)]. 34 22

Ten newborn infants with the idiopathic respiratory distress syndrome (IRDS) or foetal aspiration (FA) were treated with a simplified nasal CPAP system (continuous positive airway pressure). The system consists of a Hudson binasal cannula and a Benveniste pediatric jet device (weight 5 g). The desired airway pressures are obtained by adjustment of the jet flow in accordance with the naso-pharyngeal flow/pressure relationship. The system was found to be effective in the treatment of 9 of the 10 children, as demonstrated by improved blood gas values, and improved respiration; the latter was also evident in infants with pronounced apnea. In one child pneumothorax, occuring after about 24 hours of successful CPAP treatment, necessitated respirator treatment. The system is quick and simple to use, and permits feeding, lung physiotherapy and routine nursing of the child during treatment.
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PMID:Nasal CPAP treatment of the respiratory distress syndrome: a prospective investigation of 10 new born infants. 35 65

Unexpected stability of arterial oxygen and carbon dioxide tensions occurred in infants recovering from respiratory distress syndrome (RDS) on the abrupt withdrawal of CPAP at 6 cmH2O pressure. 30 preterm infants (birthweights 880--3200 g gestational ages 29--38 weeks) were treated at a mean age of 10 hours and for a mean duration of 62 hours. CPAP was stopped when F1O2 requirement fell below 0.3, and stable PO2 was maintained for 4 hours. Discontinuation of CPAP at 6 cmH2O resulted in a mean change in PO2 from 66 to 64 mmHg (8.8 to 8.5 kPa) and a mean change in PCO2 from 41 to 40 mmHg (5.4 to 5.3 kPa). We conclude that this population of infants suffering from moderate RDS tolerated the abrupt withdrawal of CPAP, and that gradual reduction of pressure was unnecessary.
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PMID:Discontinuation of continuous positive airways pressure in infants with respiratory distress syndrome. 39 Nov 60

Diseases which manifest with the respiratory distress in the newborn include 1) respiratory diseases-IRDS, type II RDS, neonatal asphyxia, and MAS etc. 2) anemia, CHD 3) CNS and 4) metabolic diseases. Among these, IRDS has high mortality rate because of the lack of the pulmonary surfactant and immaturity of respiratory center, and has many difficult problems in terms of its prevention and respiratory management. The points of its respiratory management are as follows: 1) Estimation of the level of arterial oxygen ation-this is the most important point. It has become possible, these days, to monitor continuous oxygenation using a transcutaneous oxygen electrode. 2) Knowledge of the physiology & management of apnea, and monitoring of heart rate and respiration. 3) Correction of acidosis & anemia and the nutritional supply by the intraveonous fluid administration. 4) Airway maintenance. 5) Oxygen administration to main PaO2 or tc PO2 of 60--80 mmHg. 6) Artificial ventilation by CPAP or IMV and 7) The specific drug therapy includes indomethacin for PDA associated with IRDS, Tolazoline for the fetal circulation syndrome, and Xanthine derivatives for primary apnea. 8) However, improvement by exchange transfusion has been contro-versial. On the other hand, in the type II RDS which has a relatively good prognosis, the intact survival can be expected by means of the proper management of general condition and respiration. In MAS, pneumothorax, pneumomediastinum and severe asphyxia, the proper resuscitation, oxygen administration should be given according to several conditions, especially the degree of hypoxia. The peritoneal dialysis can be lifesaving in case of severe renal impairment with RD. As the respiratory distress in the newborn is very frequent in its occurrence and death rate, its proper management is expected to result in the decrease in the newborn death rate in Hokkaido (8.1--6.6 per 1,000 live births) and the increase in the survival rate without any handicap, particularly if hospitals in each Hokkaido district give the newborn medical care more intensively than at present.
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PMID:[Respiratory distress in the newborn (author's transl)]. 39 87

In order to prove the progress in diagnosis and treatment of pregnancies with low birthweight we performed a retrospective computer-analysis of three groups of patients including newborns below 2750 g delivered dumping the last 10 years. The first group contains the years 1967/68; the deliveries of low birthweight infants were monitored without cardiotocogram. The second group of patients from the years 1971/72 was monitored continuously during delivery by cardiotocogram. The endocrinologic diagnostic methods for detection of a possible placental insufficiency in low weight fetus were applied regularly (DHEA-S-loading test, oestriol, HPL). The treatment of premature newborns with respiratory distress syndrome was facilitated by CPAP. A thorough ultrasound diagnosis was available additionally for the third group of patients. Long term treatment with Partusisten was applied in cases of premature labour in this group and betamethasone-therapy was used for accelleration of fetal lung maturation. With a nearly constant number of preterm eutrophic newborns, preterm infants with retarded growth and mature infants with retarded growth over a period of ten years the unpurified mortality rate decreased from 14.3% to 6.7% when the pregnancies and deliveries had intensive (obstetrical medical) care. With the help of Shirodkar procedure and tocolytic treatment the birthweight could be shifted significantly into the favourable group over 2000 g. The prenatal prophylactical treatment of the respiratory distress syndrome with beta-methasone and the postnatal CPAP-therapy decrease the mortality rate caused by respiratory deficiency from 13.7% to 6.4%. The preventive caesarean section in cases of low birthweight infants with abnormal positions in utero helped to reduce the mortality rate from 21% to 10.6% in these cases. The accuracy of prenatal diagnosis of intrauterine retarded fetal growth by hormone analysis and ultrasonic measurement of the fetus was improved from 24% to 66%.
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PMID:[Progress in diagnosis and treatment of pregnancies with low birthweight infants (author's transl)]. 68 May 42

Four prematurely born neonates who where mechanically ventilated with CPAP for respiratory distress have developed severe unilateral pulmonary interstitial emphysema. Some particular circumstances can be pointed out in these cases. Spontaneous worsening is usual. Selective bronchial intubation protects the overinflated lung. It allowed total improvement of the lung function for the 3 cases who underwent this treatment. Although no major complications have been noticed, it is mandatory to suck out regularly bronchial secretions accumulated in the excluded lung.
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PMID:[Unilateral interstitial emphysema in the newborn (apropos of 4 case reports)]. 73 27


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