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

Therapeutic use of helium-oxygen mixture in continuous positive airway pressure (He-CPAP) was employed for early weaning from mechanical ventilation of 11 infants who underwent cardiac surgery from August, 1974, to April, 1975. With the use of He-CPAP, a 20 to 30 mm. Hg elevation of PaO2 was usually observed and respiratory distress was reduced, as compared to results obtained with nitrogen-oxygen CPAP. In all cases, He-CPAP resulted in the possibility of relatively early removal of the endotracheal tube. Therefore, He-CPAP is recommendable for intermediate respiratory support between mechanical ventilation and nitrogen-oxygen CPAP.
 ...
PMID:Therapeutic use of helium-oxygen mixture in continuous positive airway pressure for early weaning from mechanical ventilation after cardiovascular surgery in infants. 77 98

CPPV (continuous positive pressure ventilation) is obviously superior to IPPV (intermittent positive pressure ventilation) for the treatment of patients with acute respiratory insufficiency (ARI) and results within a few minutes in a considerable increase in the oxygen transport. The principle is to add a positive end-expiratory plateau (PEEP) to IPPV, with a subsequent increase in FRC (functional residual capacity) resulting in re-opening in first and foremost the declive alveolae, which can then once again take part in the gas exchange and possibly re-commence the disrupted surfactant production. In this manner the ventilation/perfusion ratio in the diseases lungs is normalized and the intrapulmonary shunting of venous blood (Qs/Qt) will decrease. At the same time the dead space ventilation fraction (VD/VT) normalizes and the compliance of the lungs (CL) increases. The PEEP value, which results in a maximum oxygen transport, and the lowest dead space fraction, also appears to result in the greatest total static compliance (CT) and the greatest increase in mixed venous oxygen tension (PVO2); this value can be termed "optimal PEEP". The greater the FRC is, with an airway pressure = atmospheric pressure, the lower the PEEP value required in order to obtain maximum oxygen transport. If the optimal PEEP value is exceeded the oxygen transport will fall because of a falling Qt (cardiac output) due to a reduction in venous return. CT and PVO2 will fall and VD/VT will increase. Increasing hyperinflation of the alveolae will result in a rising danger of alveolar rupture. The critical use of CPPV treatment means that the lungs may be safeguarded against high oxygen percents. The mortality of newborn infants with RDS (respiratory distress syndrome) has fallen considerably after the general introduction of CPPV and CPAP (continuous positive airway pressures). The same appears to be the case with adults suffering from ARI (acute respiratory insufficiency).
 ...
PMID:Review: artifical ventilation with positive end-expiratory pressure (PEEP). Historical background, terminology and patho-physiology. 78 40

The transport incubator used since 1972 was modified for the CPAP method (continuous positive airway pressure). A very generous indication for the use of this ventilatory assistance in the presence of very early clinical signs of respiratory distress syndrome before or during the transport into the Children's Hospital has contributed towards improving the survival rate of infants with a birth weight of 1001-1500 grams to 84,8% and for those below 1000 grams to 39,4%.
 ...
PMID:Further improvements in the transport of high-risk neonates. 78 85

In this pilot study, Curosurf (200 mg/kg) was administrated to 34 patients with the respiratory distress syndrome in nasal-CPAP therapy with FiO2 requirements greater than 0.60 and/or TcPCO2 greater than 8 kPa. The surfactant was instilled during a short period of intubation or in a few cases via an intratracheal catheter (Ch. 6). The age of the patients on surfactant treatment ranged from two to 72 hours. Eighteen patients could be maintained on nasal-CPAP after treatment with Curosurf and only a few complications were seen in these infants. The other 16 patients subsequently required artificial ventilation and had a higher incidence of pulmonary and extrapulmonary complications. On the basis of these observations, we plan a randomized trial to investigate whether, administration of surfactant reduces the need for ventilator treatment and improves the odds for uneventful recovery in this category of patients.
 ...
PMID:[Surfactant treatment of newborn infants with respiratory distress syndrome primarily treated with nasal continuous positive air pressure. A pilot study]. 150 93

Human Immunodeficiency Virus (HIV) related Pneumocystis carinii pneumonia (PCP) associated with severe respiratory failure is an increasingly common problem in major centres and is associated with a high mortality in previous and recent studies. Early in the epidemic, alternatives to invasive intensive care treatment were utilized in our institution and found to be successful. When respiratory failure developed, mask CPAP was used instead of intubation and ventilation. A retrospective review of 175 cases of HIV infected patients with confirmed first presentation PCP was undertaken. Treatment with our protocol resulted in an overall hospital mortality of 9%. Those patients who did not require supplemental oxygen or respiratory support had no in-hospital mortality. The group who required supplemental oxygen had a mortality of 10%. If respiratory failure supervened (severe respiratory distress, PaO2 less than 50 mmHg, SaO2 less than 90% on mask oxygen), CPAP was introduced. The mortality in this group was 22%. Only two patients were admitted to the intensive care unit for respiratory support after failure of CPAP. Both patients were intubated and received intermittent positive pressure ventilation (IPPV). Both patients died.
 ...
PMID:CPAP, effective respiratory support in patients with AIDS-related Pneumocystis carinii pneumonia. 175 Jun 39

During a 3-year period (1979-81) 85 premature infants with idiopathic respiratory distress (IRDS) were treated early with an easily applicable light-weight CPAP-system with a binasal tube and a gas jet. We used conservative criteria for ventilator treatment. The treatment proved sufficient in 18 out of 25 infants with a birth weight less than or equal to 1500 g and in 53 out of 60 infants with a birth weight greater than 1500 g. Seven infants developed pneumothorax during CPAP treatment. Seventy-four infants survived, all without bronchopulmonary dysplasia. At the age of 1.5-4.5 years the incidence of respiratory tract infections did not differ from that in a group of siblings; and the incidence of lower respiratory tract infections was low compared to previous studies. With the criteria used, early CPAP proved effective in the majority of infants with IRDS.
 ...
PMID:Early treatment of idiopathic respiratory distress syndrome using binasal continuous positive airway pressure. 220 Nov 66

The authors report their 6 years experience in the use of a CPAP nasal cannula in 91 children. Their indications are idiopathic respiratory distress (hyaline membrane disease) stage I, II, III in children more than 1500 g, stage I and II for those less than 1500 g; transitory respiratory distress; cesarean lung; amniotic inhalation after aspiration and physiotherapy. In 75 newborns this method rendered tracheal intubation unnecessary. There were few side effects and very few serious accidents. The authors propose this method to be a substitute to tracheal intubation and mechanical ventilation, for the units of neonatal intensive care, or nurseries, specially in tropical countries, without important medical supplies. They give modalities, indications and applications of this innocuousness, easy and non-expensive method.
 ...
PMID:[Nasal cannula, a simple, not very cumbersome, and efficacious means to induce a positive expiratory pressure in neonatology]. 388 91

Three infants presenting with respiratory distress required early ventilator support. With attempts at extubation recurrent airway obstruction occurred. The clinical course was marked by recurrent episodes of hyperinflation, atelectasis, and pneumonia. Bronchoscopy, bronchography, and chest fluoroscopy revealed extensive collapse of the trachea and main stem bronchi. Two of the infants had gastroesophageal reflux and recurrent aspiration. Treatment of tracheobronchomalacia (TBM) was carried out with a tracheostomy tube attached to a portable CPAP apparatus. Initially CPAP was maintained at 10 cm of water and subsequently weaning was achieved by gradual decreasing of both positive pressure and hours of treatment per day. Total treatment time ranged from 13 to 25 months. Feedings were carried out via gastrostomy. Two infants with severe gastroesophageal reflux underwent fundoplication. Each infant was successfully weaned from distending pressure and decanulated. The treatment of severe TBM with long-term CPAP appears to be a reasonable alternative or adjunct to surgical procedures such as tracheopexy, resection, external splinting and tracheobronchoplasty.
 ...
PMID:Management of tracheobronchomalacia with continuous positive airway pressure. 390 98

1. With improvements in treatment of burn shock and wound sepsis, inhalation injury has emerged as the number one cause of fatality in the burn patient; it accounts for 20 to 84 per cent of burn mortality. 2. Only steam is capable of inflicting direct thermal damage; most injury is caused by incomplete products of combustion, the most important being aldehydes. 3. More accurate diagnostic techniques, including fiberoptic bronchoscopy and 133Xe scanning, have been added to the traditional clinical signs of inhalation injury, such as facial burns, singed nasal vibrissae, and closed space injury, and have led to a new estimation of a 30 per cent incidence among patients with major burns. 4. Patients with inhalation injury typically pass through three stages, those of acute pulmonary insufficiency, pulmonary edema, and bronchopneumonia. 5. The major early pathophysiologic changes seen in the lungs of burned patients related to edema. With inhalation injury this is probably mediated by the products of activated neutrophils. Later changes are the result of the reduction of surfactant and thus lung compliance. 6. Treatment consists of intubation at the first hint of respiratory distress; the issue of tracheostomy versus endotracheal intubation has not been scientifically resolved, but most centers employ prolonged nasotracheal intubation. Prophylactic antibiotics or steroids are not of benefit. Further care is only supportive and includes CPAP, PEEP, vigorous pulmonary toilet, humidification of inspired air, and antibiotics for documented infection. 7. Further advances await the development of pharmacologic methods of affecting the lung's response to injury, which includes altered capillary permeability and decreased immune function.
 ...
PMID:Pulmonary injury in burned patients. 391 76

The process of adaptation for extrauterine life can be easily disturbed by respiratory insufficiency. The surfactant deficiency as well as anatomical and physiological immaturity of a newborn can be considered as etiological factors in some diseases, such as respiratory distress syndrome (RDS), transient tachypnoea (TT) syndrome, segmental atelectasis or pneumonia complicated by atelectasis. The widespread used method of treatment is based on mechanical increase of difference between alveolar and atmospheric pressure. So-called constant distending pressure (CDP) increases functional residual capacity (FRC), keeps alveoli open and finally increases oxygenation of arterial blood. During 3 years period continuous positive airway pressure by nasal route (n-CPAP) was used as only one method in 26 newborns. The newborns were treated because of RDS (15 cases) and pneumonia with atelectasis (11 cases). n-CPAP was starting with pressure 8 cm H2O (0.8 kPa) and FIO2 0.5, if atelectasis with severe dyspnea, hypoxia and forced hyperventilation were found. This method was very well tolerated. 22 newborns treated for 2-7 days--survived, 4 small-for-date babies--died. The most common cause of death was septicaemia complicated by disseminated intravascular coagulation. The moderate hyperbilirubinemia, oliguria with tissue oedema was observed in many cases. The light nostril decubitus were only complications. No pneumothorax was detected. We found n-CPAP as a simple, safe method in treatment of atelectasis in newborns.
 ...
PMID:[Continuous positive pressure respiration by nasal route (n-CPAP) as a preferred treatment method in various types of acute respiratory insufficiency in newborn infants]. 637 92


<< Previous 1 2 3 4 5 6 7 Next >>