surfactant therapy in neonatal respiratory distress syndrome

... đóng ống động mạch thuốc Dịch từ “European Consensus Guidelines on the Management of Neonatal Respiratory Distress Syndrome in Preterm Infants – 2010 Update” Neonatology 2010;97:402–417 Người dịch: ... sóc trước sinh, ổn định phòng sinh, hỗ trợ hô hấp surfactant, chăm sóc hỗ trợ tóm tắt bảng Bảng Tóm tắt lời khuyên Chăm sóc trước sinh - Những trẻ sinh thiếu tháng có nguy bị RDS phải sinh trung ... Đối với trẻ sinh non, cân nhắc đặt ống nội khí quản phòng sinh để dùng surfactant dự phòng Đối với trẻ sinh non hơn, phải bắt đầu dùng CPAP sớm Hỗ trợ hô hấp surfactant - Phải dùng surfactants...

Ngày tải lên: 08/06/2014, 06:58

... pertaining to the surfactant system (i.e infiltrating inflammatory cells), or to a combination of these ARDS = acute respiratory distress syndrome k21 and k12 = disaturated-phosphatidylcholine inter-conversion ... written, informed consent was obtained After intubation with a cuffed tube, all patients received into the trachea 20 ml of normal saline containing 7.5 mg of 13C-dipalmitoylphosphatidylcholine and ... head injury Clinical characteristics of the 12 ARDS and controls are reported in Table ARDS was induced by an indirect insult in all but one patient (patient 5, Table 2) Mean age was comparable in...

Ngày tải lên: 12/08/2014, 15:20

... calculated in 10 out of 15 patients Surfactant proteins were analyzed in large surfactant aggregates (SP-A, SP-B, SP-C) or in BALF (SP-D): Surfactant protein A (SP-A) was measured using an ELISA ... although there is only limited information available with regard to surfactant properties in response to surfactant treatment As outlined in one recent investigation in surfactant treated ARDS patients, ... regimen, may indeed promote better outcome in ARDS In this line of reasoning, multiple surfactant dosing with persistent improvement in gas exchange may ultimately improve outcome in ARDS Conclusion...

Ngày tải lên: 12/08/2014, 15:21

... dopamine, epinephrine or norepinephrine tend to reinforce hypoxic pulmonary vasoconstriction In the present study, patients with circulatory shock receiving vasodilating inotrops were excluded in ... http://ccforum.com/content/1/1/25 Figure Individual changes in MPAP and PaO2/FiO2 induced by increasing inspiratory intratracheal concentrations of inhaled NO (Insp IT NO) in eight patients with ARDS and ... et al Figure Individual changes in mean pulmonary artery pressure (MPAP) and PaO2/FiO2 induced by increasing inspiratory intratracheal concentrations of inhaled NO (Insp IT NO) in eight patients...

Ngày tải lên: 12/08/2014, 18:20

... and recruitment during prolonged breathing in porcine lung injury J Appl Physiol 1998, 85:1533-1543 Stenqvist O, Lindgren S, Karason S, Sondergaard S, Lundin S: Warning! Suctioning A lung model ... routines in our intensive care unit, the Figure Timeline of the study in minutes The order of the two suctioning procedures α and β was randomized The vertical lines above the timeline indicate blood ... pressure in a patient with acute respiratory distress syndrome Crit Care Med 2000, 28:1210-1216 26 Pelosi P, Cadringher P, Bottino N, Panigada M, Carrieri F, Riva E, Lissoni A, Gattinoni L: Sigh in...

Ngày tải lên: 12/08/2014, 19:21

... PEEPbaseline The pHi at PEEPmax was lower in 12 (70.6%) and higher in five (29.4%) patients as compared with baseline values The P(t–a)CO2 values increased in nine (52.3%) patients at PEEPopt and in ... changes in pHi and P(t–a)CO2 during PEEP titration differed between individual patients (Table 3) The pHi decreased in eight patients (47%), it increased in five (29.4%) and it was unchanged in four ... present study indicate that incremental increases in PEEP not impact on splanchnic perfusion, as assessed by gastric tonometry, when cardiac output (and consequently DO2) is maintained R20 In animals,...

Ngày tải lên: 12/08/2014, 19:22

... mortality in the acute respiratory distress syndrome N Engl J Med 1998, 338:347-354 Gutierrez G, Palizas F, Doglio G, Wainsztein N, Gallesio A, Pacin J, Dubin A, Schiavi E, Jorge M, Pusajo J, Klein ... high PEEP levels induced a decrease in cardiac output [20] In contrast, we found no decrease in cardiac output in our patients tested with increasing PEEP levels when fluid administration was ... and Chronic Health Evaluation; Crs, Respiratory system compliance; Dbt, dobutamine; Dp, dopamine; LIP, lower inflection point; NE, norepinephrine (noradrenaline); NL, no LIP found; NS, not significant;...

Ngày tải lên: 12/08/2014, 20:20

... disorders [13] In the case of abdominal diseases leading to ARDS (which was the case in three out of eight patients), intra-abdominal pressure may be increased, thus compromising both systemic ... perfusion, thus potentially influencing the findings of the study [14] References 10 11 12 13 14 Ashbaugh DG, Bigelow DB, Petty TL, Levine BE: Acute respiratory distress in adults Lancet 1967, 2:319-323 ... additional limitations were addressed in part by the authors themselves, and should be kept in mind when considering the findings of the study First, the patients included fulfilled the criteria for...

Ngày tải lên: 12/08/2014, 20:20

... but was present only in one patient (no 13) Clinical data are given in Table Twenty healthy nonsmoking students independent of the investigating institutions were enrolled and interviewed to rule ... or CT scanned in maintained apnoea The rebreathing procedure was performed in duplicate before and after a single CT exposure Before the supine measurements, the nose-clipped, supine and relaxed ... ventilation by a moderate increase in PEEP Accordingly, increasing PEEP from to 15 cmH2O has been shown in a study of pulmonary mechanics to increase pulmonary compliance in some patients, which...

Ngày tải lên: 12/08/2014, 22:21

... study investigators have a financial interest in SensorMedics Corporation The authors declare that they have no competing interests Authors' contributions AJvV initiated the study, participated in ... (PEEP) resulted in additional overinflation contributing to ventilator-induced lung injury [17] The combination of high levels of PEEP and over-distension are directly reflected in the OI HFOV ... only in patients with a higher initial OI This is in Available online http://ccforum.com/content/9/4/R430 Figure Conclusion In this study, we were not able to find significant differences in efficacy...

Ngày tải lên: 12/08/2014, 22:22

... 22 23 24 respiratory distress syndrome – a pilot study Crit Care Med 1997, 25:937-947 Ware LB: Prognostic determinants of acute respiratory distress syndrome in adults: impact on clinical trial ... factors and outcome could be explained by possibly intermediate factors To that end we investigated whether inclusion in the model of such intermediate factors would indeed attenuate the association ... unidentified intermediate determinants of lung damage remained Moreover, the association of prolonged time on CV before initiating HFOV treatment and increased risk of death disappeared by adjusting for...

Ngày tải lên: 12/08/2014, 23:21

... parenchyma in the adult respiratory distress syndrome Clin Chest Med 1982, 3:35-56 Haitsma JJ, Papadakos PJ, Lachmann B: Surfactant therapy for acute lung injury/acute respiratory distress syndrome ... not observe inflammatory cell infiltration into the airways or increased proinflammatory cytokines in alveolar fluid They interpreted this to indicate the earliest distal airway injury results ... reflecting the average intrinsic PEEP It is important to remember that intrinsic PEEP may not be accurately detected if the exogenous PEEP is greater than the intrinsic PEEP Consequently, if intrinsic...

Ngày tải lên: 13/08/2014, 03:20

... low flow in a porcine acute respiratory distress syndrome model Clin Physiol Funct Imaging 2006, 26:113-119 Woolcock AJ, Macklem PT: Mechanical factors influencing collateral ventilation in human, ... seeks the ventilator setting that is optimal for reaching these goals In the present context, the simulation goals were defined with the intention being to minimize VT, maintain normocapnia (Paco2 ... ventilator setting providing normocapnia at a PPLAT of 30 cmH2O at 40 breaths/min In spite of the high starting frequency, further gains in terms of a modest but significant reduction in VT could...

Ngày tải lên: 13/08/2014, 03:20

... Menaldo E, Davini O, Gandini G, Herrmann P, Mascia L, Quintel M, Slutsky AS, Gattinoni L, Ranieri VM: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome ... ‘protective’ against VILI In oleic-acid-induced and endotoxin-induced lung injuries, distal lung units are expanded, are filled with haemorrhagic or proteinaceous oedema, and are infiltrated by inflammatory ... and tissue in acute respiratory distress syndrome III Consequences for the effects of positive end-expiratory pressure CT Scan ARDS Study Group Adult Respiratory Distress Syndrome Intensive Care...

Ngày tải lên: 13/08/2014, 10:20

... respiratory distress syndrome and inclusion in the study; LIP, lower inflection point on the pressure-volume curve; PBW, predicted body weight; rpm, respirations per minute; RR, respiratory rate; ... Constantin et al Table Respiratory and hemodynamic parameters before and after recruitment maneuver Extended sigh Continuous positive airway pressure Baseline minutes 60 minutes Baseline minutes ... Gandini G, Herrmann P, Mascia L, Quintel M, Slutsky AS, Gattinoni L, Ranieri VM: Tidal hyperinflation during low tidal volume ventilation in acute respiratory distress syndrome Am J Respir Crit Care...

Ngày tải lên: 13/08/2014, 10:20

... would result in increases in V'A (or in PaCO2) of 18%, 29% and 39%, respectively (Figure 6) Regarding dead space of a non-VdAS origin, the increase in total ventilation needed to maintain PaCO2 would ... haemoglobin levels and metabolic acidosis • Maintained homeostasis mitigates these effects of shunt Competing interests Clinically relevant effects of increasing VdAS/VtA are permissively increased ... is present in the respiratory zone [3,14] The essence of intensive care is to support the patient by maintaining homeostasis In ARDS, adequate oxygenation may be achieved by reducing intrapulmonary...

Ngày tải lên: 13/08/2014, 10:20

... patients learning to re-integrate into independent community living Dominant themes included the need for psychological counseling and rehabilitation services to improve recovery Information needs ... identified during and persisting following critical illness Intensive Care Med 2006, 32:923-926 Larson MJ, Weaver LK, Hopkins RO: Cognitive sequelae in acute respiratory distress syndrome patients ... support, and/or training? ARDS = acute respiratory distress syndrome; All interviews were conducted either in- person or by telephone because the quantity and quality of data colected in these two ways...

Ngày tải lên: 13/08/2014, 19:20

... conventional twopoint analysis [37-39] Therefore, we excluded data corresponding to that time interval from the fitting and included, instead, the loading interval during volume inflation for the ... Guttmann J, Kersting K, Kuhlen R, Putensen C, Sydow M, Kramer S: Analysis of respiratory pressure-volume curves in intensive care medicine using inductive machine learning Artif Intell Med 2002, ... 342:1301-1308 Stenqvist O, Odenstedt H, Lundin S: Dynamic respiratory mechanics in acute lung injury/acute respiratory distress syndrome: research or clinical tool? Curr Opin Crit Care 2008, 14:87-93 Hotchkiss...

Ngày tải lên: 13/08/2014, 20:21

... maneuver, the following seem particularly interesting: 1) incremental increase in PEEP limiting the maximum inspiratory pressure; 2) pressure-controlled ventilation applied with escalating PEEP and ... abdominal contents and heart [22], yielding a redistribution of ventilation; (b) increased endexpiratory lung volume resulting in a reduction in stress and strain [25]; and (c) changes in regional ... the sustained in ation technique, in which a continuous pressure of 40 cmH2O is applied to the airways for up to 60  sec [8] Sustained in ation has been shown to be effective in reducing lung...

Ngày tải lên: 13/08/2014, 20:21

... proteins and MMPs was determined in IHC-stained slides The area of ECM proteins positive staining was determined in three airway regions: inner, SM and outer layers The area of MMP-positive staining ... in 10% buffered formalin for 24 hours, routinely processed and paraffin embedded Five μmthick sections were stained with hematoxylin and eosin (H&E) and with Weigert’s Resorcin-Fuchsin staining ... mast cells in the acute respiratory distress syndrome Thorax 1998, 53:823-829 Krein PM, Sabatini PJB, Tinmouth W, Green FHY, Winston BW: Localization of insulin-like growth factor-i in lung tissues...

Ngày tải lên: 14/08/2014, 07:21