Articles: respiratory-distress-syndrome.
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A review of 9401 consecutive live births at the Mercy Maternity Hospital, Melbourne, was performed to determine the incidence of air leak in those with respiratory distress syndrome. Respiratory distress was detected in 552 (5.9%) infants and hyaline membrane disease was the most common cause occurring in 238 (2.5%) infants. ⋯ Ninety-five per cent of air leak developed in infants with hyaline membrane, and these were smaller, less mature and sicker than those without air leak. Eighty-seven per cent of air leak developed in infants treated with assisted ventilation and was commoner with mechanical ventilators with a more rapid rise in inspiratory pressure.
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Proper pulmonary function is a vital part of the physiological adjustment of the patient subjected to radical surgical procedures. The pathophysiology, diagnosis, and treatment of acute respiratory failure are discussed as well as the use of mechanical ventilation, PEEP, CPAP, and IMV and the indications for intubation and extubation.
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A 6 years experience of the use of a CPAP nasal cannula is reported. In children over 1,500 g and Silverman's index less than or equal to 6, the indications for this technique were neonatal idiopathic respiratory distress (excluding stage 4), transitory respiratory distress, cesarean lungs and amniotic inhalation of clear fluid after aspiration and physiotherapy. ⋯ The innocuousness of the method makes it a routine technique in all cases at the onset of respiratory distress, reducing the need for intubations. It was found to be an efficient complement for the relay after mechanical ventilation.
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Case Reports
Adult respiratory distress syndrome associated with miliary tuberculosis. A case report.
In this report we describe a patient with miliary tuberculosis who presented with the adult respiratory distress syndrome. The diagnostic problems are discussed and the value of transbronchial lung biopsy is emphasized. Our experience with this patient stresses the need for maintaining a high index of suspicion for treatable causes of adult respiratory distress syndrome.