Articles: respiratory-distress-syndrome.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 1991
Case Reports[Artificial respiration in the prone position in a case of acute respiratory distress syndrome].
A patient is presented in whom an acute respiratory distress syndrome (ARDS) developed after severe lung contusion. Exchange of gas was markedly restricted under aggressive respiration (FiO2 = 1.0, PEEP = 10 mmHg, breathing time quotient = 0.5, respiratory minute volume = 16 litres; gas exchange values: PaO2 = 67 mmHg, PaCO2 = 45 mmHg, PA-aO2 = 461 mmHg). After control of the computed tomogram of the lungs showed marked densifications in those parts of the lung that are lower most by gravitation according to the positioning of the patient at a particular time the patient was ventilated in ventricumbent (prone) position for 60 hours. ⋯ Five days later the patient could be extubated. Respiration in ventricumbent (prone) position may considerably improve oxygenation by perfusion of well-ventilated regions of the lung that are lower-most by gravitation according to the relative positioning of the patient. Besides regions not well ventilated or not ventilated at all (according to the patient's position) may be better ventilated or re-opened and made accessible to ventilation by this method.
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Obstet. Gynecol. Clin. North Am. · Jun 1991
ReviewAdult respiratory distress syndrome in obstetrics.
Despite the advances in medical technologies, ARDS is highly lethal. In the management of patients with ARDS, certain clinical conditions are common predisposing factors to the development of the syndrome. Infection, sepsis syndrome, and conditions requiring massive transfusion are the most common causes in patients initially managed by obstetricians and gynecologist. ⋯ Due to the overall relative youth of our obstetric and gynecologic patients and their lack of other underlying diseases, they should do better than most patients with ARDS. However, at least 50% of all patients succumb to the disease itself or to complications inherent in the care needed. Families and treating physicians should be apprised of this early in the course.