Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RESPIRATORY DISTRESS SYNDROME”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 361 records · Page 20Linked to original sources
PubMed1977

Long-term physiologic consequences of the adult respiratory distress syndrome.

Six survivors of the adult respiratory distress syndrome were studied. Measurements were made of lung volumes, flow rates, single-breath diffusing capacity for carbon dioxide (Dsb), arterial blood gas levels at rest and during exercise, the ratio of physiologic dead space to tidal volume (VD/VT), alveolar-arterial oxygen pressure difference (P[A-a]O2) and percent shunt (using an assumed arteriovenous oxygen content difference). At the time of study, which varied from 3 to 16 months after recovery, we found minor and inconsistent abnormalities in the lung volumes (reduced vital capacity in one patient, elevated residual volume [RV] in two, and reduced RV in three) and in the flow rates (reduced instantaneous forced expiratory flow after 50 percent of the forced vital capacity had been exhaled in two patients). In those tests having to do with transfer of gas, there were more abnormalities, consisting of a decreased Dsb in three patients, an elevated P(A-a)O2 in four, a low resting arterial oxygen pressure (PaO2) in two, a decrease in exercise PaO2 in three, an elevated shunt fraction (Qsan/Qt) in three, and an elevated VD/VT in one patient. Clinically, at the time of study, the patients all had returned to their status before illness.

Adult↗
PubMed1983

Early closure of patent ductus arteriosus with indomethacin in preterm infants with idiopathic respiratory distress syndrome.

Thirty-seven preterm infants with idiopathic respiratory distress syndrome were prospectively studied for the effect of the early closure of patent ductus arteriosus with indomethacin on the course of idiopathic respiratory distress syndrome. Serial retrograde aortograms were performed in all infants in order to visualize the ductus arteriosus, apart from three patients, who died early and were evaluated aortographically only once. The ductus was initially open in 27 infants and closed in 10 infants. The infants with open ductus arteriosus were randomly divided into two groups. The first group consisted of 13 infants, in whom the ductus was closed with indomethacin at a median age of 18 hours. The other 14 infants served as controls. Total time on assisted ventilation and duration of exposure to additional oxygen were significantly shorter in medicated infants than in controls. Oxygenation of infants with an initially closed ductus was better from birth and duration of their ventilatory assistance and oxygen exposure were shorter than in infants with initial ductal shunting. The data suggest that the early closure of the patent ductus arteriosus with indomethacin in distressed preterm infants has a favourable effect on the course of idiopathic respiratory distress syndrome.

Clinical Trials as Topic↗
PubMedDate not supplied

[Acute respiratory distress syndrome: definitions, mechanisms and treatment].

Acute respiratory distress syndrome is a secondary acute respiratory insufficiency caused by an inflammatory syndrome which is characterized by an increased of permeability pulmonary edema, associated with many other clinic anomalies, radiological and pathophysiological not directly caused by, but with which it could coexist, a left atrial hypertension. The illness, characterized by refractory hypoxemia, recognizes several causes, which have direct or indirect harm on the cells of the membrane alveolus-capillary. In spite of the improvements in the therapeutic approach, during these last 40 years, represented by the aid of the mechanical ventilation and the use of selective pulmonary vasodilators, this condition is life threatening and often lethal: 90% of mortality rate amongst those older than 65 years.

Humans↗
PubMed1993

Adult respiratory distress syndrome in children: associated disease, clinical course, and predictors of death.

The adult respiratory distress syndrome is a common cause of respiratory failure; however, its incidence, risk factors, course, and mortality rate for children remain incompletely understood. A 24-month surveillance of pediatric intensive care admissions identified 60 children with adult respiratory distress syndrome constituting 2.7% of such admissions, 8% of total days spent in a pediatric intensive care unit, and 33% of deaths. The mortality rate was 62% (confidence interval, 48.2% to 73.9%). Adult respiratory distress syndrome occurred in approximately 12% of children admitted for sepsis, viral pneumonia, smoke inhalation, or drowning. A low incidence (< 3%) was observed in children admitted with pulmonary contusion or multiple trauma. Ongoing changes in measures of pulmonary gas exchange varied with the magnitude of alveolar injury; no differences were associated with the underlying acute disease or lung injury mechanism. Efficiency of oxygenation differed among outcome groups by the second day after onset of adult respiratory distress syndrome. An alveolar-arterial oxygen tension difference > 420 was the best early predictor of death (sensitivity 80%, specificity 87%, positive predictive value 87%, negative predictive value 80%, and odds ratio 26.7). We conclude that adult respiratory distress syndrome behaves clinically as a single disease regardless of the underlying cause; its course and outcome are dependent on the magnitude of alveolar injury. We speculate that strategies for minimizing secondary lung injury may benefit all patients with adult respiratory distress syndrome.

Acute Disease↗
PubMed2000

Very low surfactant protein C contents in newborn Belgian White and Blue calves with respiratory distress syndrome.

We have studied a respiratory distress syndrome (RDS) occurring in newborn calves of the Belgian White and Blue (BWB) breed that represents the large majority of beef cattle in Belgium. Pulmonary surfactant isolated from 14 BWB newborn calves that died from RDS and from 7 healthy controls was analysed for composition and surface activity. An extremely low content or, in some instances, an absence of surfactant protein C (SP-C) was detected in the RDS samples by Western blotting and differential amino acid analysis [0.03+/-0.01% (w/w) relative to total phospholipids, compared with 0.39+/-0.06% for healthy controls (means+/-S.E.M., P < 0.001)]. The contents of surfactant protein B (SP-B) were similar in RDS and control samples. The crude surfactant samples isolated from RDS calves had higher ratios of total protein to total phospholipid, altered phospholipid profiles and lower SP-A contents. Both crude and organic extracts of RDS surfactant samples showed increased dynamic surface tension compared with healthy controls when evaluated with a pulsating-bubble surfactometer. The addition of purified SP-C to organic extracts of RDS surfactant samples lowered surface tension. Strongly decreased levels of mature SP-C associated with fatal RDS and altered surface activity in vitro have, to the best of our knowledge, not been previously reported. The mechanisms underlying RDS and the decrease in SP-C in BWB calves remain to be established.

Animals↗
PubMed2002

Pulmonary versus extrapulmonary acute respiratory distress syndrome: different diseases or just a useful concept?

The acute respiratory distress syndrome may complicate both pulmonary and extrapulmonary conditions. There is a growing belief that the predisposition to, and clinical course of, the syndrome may be influenced by the extent to which the lung is directly involved in the precipitating pathologic changes. Several studies have highlighted differences in morphology and respiratory physiology between the two subgroups in the early stages of acute respiratory distress syndrome. Further, preliminary reports have suggested that the effects of therapeutic interventions such as alterations in positive end-expiratory pressure, prone ventilation, and the use of inhaled vasoactive agents may differ between pulmonary and extrapulmonary acute respiratory distress syndrome. There are, however, inconsistencies between various studies addressing these issues, which may relate in part to differences in etiologic case mix. There are also practical difficulties in assigning certain cases to one of these two groups. Finally, there are as yet no outcome data to support any modification of clinical management on the basis of this distinction.

Acute Disease↗
PubMed2004

Comparison of 3 methods of detecting acute respiratory distress syndrome: clinical screening, chart review, and diagnostic coding.

BACKGROUND: Although the incidence of acute respiratory distress syndrome has been studied, few researchers have prospectively assessed the search tool used to identify cases. METHODS: For 5 months, all patients admitted to a medical intensive care unit in a teaching hospital were evaluated daily to determine whether criteria for acute respiratory distress syndrome were met, and physicians' progress notes and discharge summaries for these prospectively identified patients were reviewed for mention of the syndrome. Discharge forms were reviewed for the codes (International Classification of Diseases, Ninth Revision) specific to acute respiratory distress syndrome (518.82 or 518.85). RESULTS: Of 314 patients admitted, 65 prospectively met the criteria for acute respiratory distress syndrome. Of these 65 patients, 31 had acute respiratory distress syndrome mentioned in their progress notes, and 4 of the 31 were subsequently assigned a code of 518.82 or 518.85. Patients with a physician's notation for acute respiratory distress syndrome in their charts had a higher mortality (22/31 [71%]) than did the patients with no such notation (10/34 [29%]). This difference could not be accounted for by differences in length of stay, mean age, score on Acute Physiology and Chronic Health Evaluation III, or number of days in the unit before meeting the criteria. CONCLUSIONS: The incidence of acute respiratory distress syndrome is underestimated when based on either diagnostic coding or physicians' notes without testing of the accuracy of coding. Both physicians and medical record coding specialists may require training in use of terms related to acute respiratory distress syndrome.

APACHE↗
PubMed1986

Adult respiratory distress syndrome in neutropenic patients.

The precise pathophysiologic mechanisms that cause the adult respiratory distress syndrome are unknown. Indirect evidence from human studies and extrapolations from animal models have suggested that phagocytic neutrophils are important in the pathogenesis of this disease. To further evaluate the role of neutrophils, the frequency of neutropenia in 18 bacteremic patients who had the adult respiratory distress syndrome was compared with that in a control group who had bacteremia alone. Three of 18 patients in the group with the adult respiratory distress syndrome were neutropenic as opposed to one of 18 in the control group (p greater than 0.6). Histologic examination of the lungs from two patients with the adult respiratory distress syndrome and neutropenia demonstrated the absence of neutrophils. It is likely that there are many pathways that lead to the adult respiratory distress syndrome. Although neutrophils may be involved in some of these processes, this study demonstrates that neutrophils are not required for the development of the syndrome. In the appropriate clinical setting, the diagnosis of the adult respiratory distress syndrome should not be excluded solely because of neutropenia.

Adult↗
PubMed1989

[Changes in the blood coagulation potential of premature calves with and without respiratory distress syndrome].

In 46 newborn calves with and without respiratory distress syndrome which had been delivered prematurely by caesarean section a blood coagulation profile was established. These animals were compared with 26 healthy, 5- to 8-day-old calves. Prematurely delivered calves showed a lower average plasma fibrinogen concentration than animals delivered in due time. Calves which developed a respiratory distress syndrome had a slightly prolonged prothrombin time and partial thromboplastin time as well as a lower antithrombin III activity already immediately postnatum compared with healthy prematures and some-day-old calves. It has to be assumed that in calves with respiratory distress syndrome--in analogy to pulmonary immaturity--the blood clotting mechanism is not yet fully developed. In healthy prematures and surviving asphyctic calves hemostasis remains largely stable during the first day of life, whereas plasma fibrinogen concentration increases. In the calves not surviving the examination period prothrombin time and partial thromboplastin time postnatum became significantly longer. Only in these severely asphyctic calves the presence of a consumption coagulopathy seems likely. A secondary reactive fibrinolysis was not observed.

Animals↗
PubMedDate not supplied

[Mortality risk factors in premature infants with respiratory distress syndrome treated by mechanical ventilation].

INTRODUCTION: Respiratory distress syndrome (RDS) is the most common cause of respiratory failure and requirement for mechanical ventilation (MV) of newborns. RDS is also common cause of mortality and severe morbidity in premature infants. In developing countries, despite facilities for respiratory care of newborn infants, RDS mortality rate and percentage of complications still remain high in comparison to the developed countries. Survival rates of RDS infants requiring MV ranged from 25% in those newborns with birth weight <1000 grams up to 53% in those with birth weight >2500 grams. There have been limited data about causes of high mortality rate in infants with RDS from developing countries. AIM: The objectives of the study were to determine (I) the incidence of severe RDS at Pediatric Intensive Care Unit (PICU), University Children's Hospital Skopje (UCHS) and main characteristics of infants with RDS, as well as (II) the survival rate and mortality risk factors of these infants. MATERIAL AND METHODS: The study included 126 premature infants with clinical and radiological signs of RDS requiring mechanical ventilation who were admitted to PICU, UCHS between January 1996 and December 2003. The mean gestational age (GA) of the infants was 31.5+/-2.5 weeks, and the mean birth weight (BW) was 1663+/-489 grams. The management of newborns with RDS at PICU, UCHS, follows the standard protocol, with emphasis on minimal manipulation, maintenance of thermoneutral environment, administration of humidified oxygen and noninvasive cardiorespiratory monitoring. Pressure-limited time-cycled mechanical ventilation with pediatric/neonatal ventilators was performed in all infants. In those newborn infants with clinical and radiological signs of RDS and need for MV with FiO2>0.4, synthetic (Exosurf) or natural (Survanta) surfactants were administered. Out of all newborns, 43 infants (34%) were not treated with surfactant, because it was not available at that time. RESULTS: In the period 1996-2003, out of 1722 consecutive admissions to PICU, 693 hospitalized infants had neonatal RDS (40.2%). A total of 210 (30.3%) infants with RDS required intubation and PPV, and 126 met the inclusion criteria for this study. Surfactant replacement therapy (up to two doses) was given to 83 (65.8%) infants. Most of neonates (80 or 63.4%) were born at two maternity hospitals in Skopje, and others were transferred from regional maternity hospitals in Macedonia. The relation between perinatal characteristics, disease severity and outcome was illustrated in Table 2. There was higher risk of mortality in infants with lower birth weight, lower Apgar score (minutes 1 and 5), and shorter gestational age. Expected admission values of VI as well as other parameters of illness severity were not significantly associated with higher risk of mortality. The newborns with air-leak sy (any form) and pulmonary hemorrhage had significantly higher risk of dying, while the risk of mortality was significantly lower in infants with sepsis and BPD as complications in studied cohort. The findings of logistic regression analysis for mortality risk factors were presented in Table 3. The minimal model identified a number of factors as independently associated with significantly higher risk of mortality. Infant birth weight < or =1500 grams, admission VI > or =0.2 mmHg and air leak sy (any form) as complication significantly increased the risk of dying in infants with RDS. BPD was significantly associated with survival in studied cohort. CONCLUSION: In spite of the implementation of high technology in Neonatal Intensive Care in our country, the mortality rate of the infants with RDS is high, but is not different from that in developing countries. The improvement of perinatal care and diminution of risk factors, common use of surfactant as well as antenatal steroids could most probably result in better outcome of neonatal RDS.

Female↗
PubMed2004

Recruitment maneuvers after a positive end-expiratory pressure trial do not induce sustained effects in early adult respiratory distress syndrome.

BACKGROUND: Recruitment maneuvers performed in early adult respiratory distress syndrome remain a matter of dispute in patients ventilated with low tidal volumes and high levels of positive end-expiratory pressure (PEEP). In this prospective, randomized controlled study the authors evaluated the impact of recruitment maneuvers after a PEEP trial on oxygenation and venous admixture (Qs/Qt) in patients with early extrapulmonary adult respiratory distress syndrome. METHODS: After a PEEP trial 30 consecutive patients ventilated with low tidal volumes and high levels of PEEP were randomly assigned to either undergo a recruitment maneuver or not. Data were recorded at baseline, 3 min after the recruitment maneuver, and 30 min after baseline. Recruitment maneuvers were performed with a sustained inflation of 50 cm H2O maintained for 30 s. RESULTS: Compared with baseline the ratio of the arterial oxygen partial pressure to the fraction of inspired oxygen (Pao2/Fio2) and Qs/Qt improved significantly at 3 min after the recruitment maneuver (Pao2/Fio2, 139 +/- 46 mm Hg versus 246 +/- 111 mm Hg, P < 0.001; Qs/Qt, 30.8 +/- 5.8% versus 21.5 +/- 9.7%, P < 0.005), but baseline values were reached again within 30 min. No significant differences in Pao2/Fio2 and Qs/Qt were detected between the recruitment maneuver group and the control group at baseline and after 30 min (recruitment maneuver group [n = 15]: Pao2/Fio2, 139 +/- 46 mm Hg versus 138 +/- 39 mm Hg; Qs/Qt, 30.8 +/- 5.8% versus 29.2 +/- 7.4%; control group: [n = 15]: Pao2/Fio2, 145 +/- 33 mm Hg versus 155 +/- 52 mm Hg; Qs/Qt, 30.2 +/- 8.5% versus 28.1 +/- 5.4%). CONCLUSION: In patients with early extrapulmonary adult respiratory distress syndrome who underwent a PEEP trial, recruitment maneuvers failed to induce a sustained improvement of oxygenation and venous admixture.

Aged↗
PubMed2003

Incidence of respiratory distress syndrome.

OBJECTIVE: To determine the incidence of respiratory distress syndrome (RDS) in hospital born babies. DESIGN: A prospective study. PLACE AND DURATION OF STUDY: The study was conducted in the neonatal intensive care unit (NICU) at the Pediatric department, in collaboration with the Obstetrics and Gynecology Department, Military Hospital, Rawalpindi, over a period of one year from January to December 2000. SUBJECTS AND METHODS: All live born infants delivered at the hospital and who fulfilled the diagnostic criteria of respiratory distress syndrome (RDS) were included in the study. RESULTS: Ninety-four neonates developed RDS. Out of these, 88 (93.61%) were preterm and 06 (6.38%) were term infants. There was a male preponderance (65.95%). RDS was documented in 1.72% of total live births, 37.28% of preterm and 0.11% of term neonates born at the hospital. The incidence of RDS was 100% at 26 or less weeks of gestation, 57.14% at 32 weeks, and 3.70% at 36 weeks. The mortality with RDS was 41 (43.61%). CONCLUSION: RDS is the commonest cause of respiratory distress in the newborn, particularly, in preterm infants. It carries a high mortality rate and the incidence is more than that documented in the Western world.

Female↗
PubMed2006

Conventional mechanical ventilation in acute lung injury and acute respiratory distress syndrome.

Acute lung injury and acute respiratory distress syndrome are inflammatory conditions involving a broad spectrum of lung injury from mild respiratory abnormality to severe respiratory derangement. Regardless of cause (direct or indirect lung injury), pulmonary physiology and mechanics are altered, leading to hypoxemic respiratory failure. the use of positive pressure ventilation itself may cause lung injury (ventilator-induced lung injury, or VILI). VILI may amplify preexisting injury, delay lung recovery, and result in adverse outcomes. This article examines the evidence supporting lung-protective ventilation strategies and addresses the methods, outcomes, and potential obstacles to implementation of such approaches.

Humans↗
PubMed1995

Adult respiratory distress syndrome in Thai medical patients.

Adult respiratory distress syndrome (ARDS) has been a well recognized severe form of acute respiratory failure of multiple causes, which is characterized by intractable hypoxemia and an extremely high mortality rate. Forty-six cases of ARDS admitted to the Department of Medicine, Ramathibodi Hospital during a 39 months period were studied prospectively to explore the etiologic risk, positive end-expiratory pressure (PEEP) profiles, complications and outcome of treatment. There were 19 females and 27 males with the mean age of 40 years. Risks of ARDS included intra- and extra-pulmonary disease conditions and also tropical diseases such as malaria and leptospirosis. At the time of diagnosis, patients in this group were extremely hypoxic with a mean arterial/alveolar oxygen tension (PaO2/PAO2) of 0.125 +/- 0.04. After the application of appropriate PEEP, the mean PaO2/PAO2 ratios increased significantly in both survivor and non-survivor groups (0.277 and 0.199). The levels of PEEP used were below 16 and 11 cmH2O in 93.46% and 67.38% of cases, respectively. Complications of PEEP which included barotrauma and hypotension were found in 11 cases (23.9%) with a very high mortality rate (81.8%). There were 28 deaths of patients in this study, giving an overall 60.8% group mortality rate. Despite the similarities in most clinical profiles, the survivors, when compared to the non-survivors, showed a greater extent of improved oxygenation in response to the application of PEEP, with fewer PEEP complications. The present study would, hopefully, provide the Thai clinicians with valuable informations in the management of ARDS.

Adult↗
PubMed1988

Passive compliance of total respiratory system in preterm newborn infants with respiratory distress syndrome.

The passive compliance of the total respiratory system (CRS) was measured by the occlusion technique in 34 preterm newborn infants with respiratory distress syndrome. Gestational age ranged from 27 to 33 weeks. Preterm newborn infants were divided into four groups on the basis of clinical criteria. Group 1 consisted of 10 infants tested during the first postnatal days (1 to 3 days) while acutely ill and requiring ventilation and oxygen therapy. After the acute phase of respiratory distress syndrome, two groups were tested: group 2 consisted of nine infants (5 to 22 days of age) who no longer required ventilation, and group 3 consisted of six infants (7 to 28 days of age) who subsequently had bronchopulmonary dysplasia. Group 4 consisted of nine infants older than 1 month of age with confirmed bronchopulmonary dysplasia. Group 1 had significantly lower CRS and CRS normalized for body weight (CRS/BW) than group 2 had (P less than 0.001). In groups 3 and 4 CRS was significantly lower than in group 2 (P less than 0.001), as was CRS/BW (P less than 0.001). There was no significant difference in CRS and CRS/BW values between groups 3 and 4. This cross-sectional study in preterm infants with respiratory distress syndrome suggests that CRS may have predictive value in regard to development of bronchopulmonary dysplasia after the acute phase of respiratory distress syndrome.

Bronchopulmonary Dysplasia↗
PubMed1996

Surfactant treatment in the neonate with severe respiratory distress syndrome.

Eighteen preterm infants severely ill with respiratory distress syndrome who required assisted ventilaton were given modified natural surfactant (Survanta) endotracheally. They had a mean +/- SEM gestational age of 31.2 +/- 0.4 weeks (range 28-34) and a mean +/- SEM birthweight of 1562 +/- 71 g (range 1160-2010). Average time of initial surfactant administration was 15 +/- 1.7 hour (range 5-24). No significant side effects were found during surfactant instillation. Post surfactant, the air entry was improved, oxygenation and arterial/alveolar gradients increased, and the levels of inspired oxygen could be reduced. Some of the radiological abnormalities were resolved. In 13 infants, patent ductus arteriosus became clinically evident, seven of whom received Indomethacin. There were 4 cases of pulmonary air leak, 5 cases of pulmonary hemorrhage and 8 cases of bronchopulmonary dysplasia. Four infants expired, two were due to severe asphyxia/shock and two died of unrelated causes. Among the 14 survivors who came for follow-up, two cases of retinopathy of prematurity had gradually regressed, one had cerebral palsy and delayed development. Surfactant rescue therapy is a supplemental beneficial treatment for severe respiratory distress syndrome while newborn intensive care concept is necessary for efficient diagnosis and treatment of RDS.

Biological Products↗