The study was performed on 80 chronic renal failure(CRF) subjects. Initial results: Clinical respiratory manifestation: The main respiratory symptom in CRF: chest pain 60,49%, cough 46,25%. There is not significant difference in respiratory symptoms between CRF with intermittent dialysis (P>0.05). Physical symptoms: Crepitating 48,75%, rough vesicular breathing 37,5%. Vesicular breathing and crackle in CRF with intermittent dialysis were significantly higher (P<0,01). Lung radiographic features: There are 8 lesions on lung X-ray, main lesions: lung calcification 80%, large-lung hilar syndrome 71%, lung manifestation in hyperuremia 32,5%, pleural effusion 26,25%. Lung calcification and large lung hilar-syndrom in CRF with ID were higher (P<0,01). There is a relationship between the lesions on chest X-ray and hyperuremia level.
Kidney Failure ; Lung ; Signs and Symptoms, Respiratory

The diagnosis of severity of the acute respiratory failure plays an important role for properly managing. The causes of the acute respiratory failure due to the chronic obstructive pulmonary disease included infection (first leading cause), cardiac functional disorder, emphysema and irrational drugs. The treatment of acute respiratory failure involved to the management of reduction of blood oxygen respiratory acidosis, bronchospasm, removal of sputum, prevention and control of complications, and use of antibiotics and corticoids.
Pulmonary Disease, Chronic Obstructive ; respiratory failure ; therapeutics

A mechanical circulatory support system is a life-saving option for treating acute severe respiratory failure or cardiac failure. There are currently a few types of assist devices and the Twin-Pulse Life Support (T-PLS) system is a kind of pulsatile pump. We report here on three patients with severe life threatening cardiopulmonary dysfunction who had the T-PLS system used as an assist device. The indications for applying the T-PLS system were continuing respiratory or cardiac failure in spite of maximal ventilatory and inotropic support. There were two patients with acute respiratory failure due to infection and one patient with cardiac failure due to acute myocarditis. One respiratory failure patient and one cardiac failure patient survived after applying the T-PLS system for 3 days and 5 days, respectively. The T-PLS system is useful as an assist device and it should be considered before multi-organ failure occurs.
Extracorporeal Circulation ; Heart Failure ; Humans ; Myocarditis ; Respiratory Insufficiency

To suggest the guide for indication of IV and NPPV for ARF of COPD, from January 1996 to May 1998, a prospective clinical trial was carried out in 57 COPD patients with ARF at the ICU of Bach Mai hospital. NPPV was indicated without severe complications. IV was indicated for 42 patients, the mortality rate decreased from 73% (1991-1994) to 28.5% (1996 - 1998). 2 patients in the IV group were extubated and successfully followed by NPPV. We conclude that, NPPV should be attempted before the decision of intubation or tracheotomy is made. IV with the moderate minute volume had very good effectiveness in severe ARFCOPD. We also suggest a guide for indications of NPPV and IV for ARFCOPD.
Intermittent Positive-Pressure Ventilation ; respiratory failure ; Pulmonary Disease, Chronic Obstructive

The study was carried out on 42 patients with acute respiratory failure due to COPD at A9 Department of Bach Mai Hospital from January 1996 to May 1998, in which 54.4% of patients with serious acute respiratory failure. Results showed that 7.14% of patients survived, 21.23% of patients died and 7.14% of patients dropped out of study. Mortality rate in the life-threatening group was 39.13% (9/23 patients): 0% in the severe group. Conclusion: the moderate minute volume - ventilation had very good effectiveness in Acute Respiratory Failure on COPD patients (especially in the severe group).
Respiration, Artificial ; respiratory failure ; Pulmonary Disease, Chronic Obstructive

A 55-year-old man visited his neighborhood general practitioner complaining of headache, fever and wet cough on July 7, 2003, but there were no sigins that his symptoms would subside. Since an abnormal shadow was found on chest X-ray on July 11, he was referred to our department and hospitalized on the same day. We started to treat him on the assumption that he had community-acquired pneumonia due-to common pathogens. However, he developed severe hypoxemia, and abnormal shadows rapidly progressed to affect both lungs, which led us to suspect that he had acute respiratory distress syndrome (ARDS). We identified the pathogen by examining urinary antigens and serum antibodies and diagnosed of his case as Legionella pneumonia. Although he suffered complications of acute renal failure and shock, the respirator was withdrawn after 11 days of controlled mechanical ventilation, as he was steadily recovering from his illness. The patient was discharged from the hospital on September 9. Although the mortality of legionella pneumonia, when complicated by ARDS, acute renal failure and shock as in the present case, has been reported to be as high as 50 to 80%, we consider that the administration of neutrophil elastase inhibitors and steroids was effective against this disorder.
Shock ; Respiratory Distress Syndrome, Adult ; Pneumonia ; Kidney Failure, Acute ; Complicated

Respiratory syncytial virus (RSV) typically causes lower respiratory tract infections in children, and most patients recover successfully. However, some infants and young children can have a severe course of disease with respiratory failure, and extrapulmonary manifestations can occur in severe RSV disease. We report one case of severe RSV bronchiolitis complicated with acute myocarditis, fulminant hepatic failure, and disseminated intravascular coagulation.
Bronchiolitis ; Child ; Disseminated Intravascular Coagulation ; Humans ; Infant ; Liver Failure ; Liver Failure, Acute ; Myocarditis ; Respiratory Insufficiency ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

Respiratory syncytial virus (RSV) typically causes lower respiratory tract infections in children, and most patients recover successfully. However, some infants and young children can have a severe course of disease with respiratory failure, and extrapulmonary manifestations can occur in severe RSV disease. We report one case of severe RSV bronchiolitis complicated with acute myocarditis, fulminant hepatic failure, and disseminated intravascular coagulation.
Bronchiolitis ; Child ; Disseminated Intravascular Coagulation ; Humans ; Infant ; Liver Failure ; Liver Failure, Acute ; Myocarditis ; Respiratory Insufficiency ; Respiratory Syncytial Viruses* ; Respiratory Tract Infections

H-type tracheoesophageal fistula (TEF) is extremely rare in infants and children, and clinical manifestations of this condition are diverse based on its severity. Some cases of congenital TEF diagnosed in adulthood have been reported, which indicate the difficulty of early diagnosis of this disease. Gastroesophageal reflux (GER) may induce chronic aspiration, pulmonary aspiration, apparent life-threatening events, and failure to thrive. We report a 5-month- old boy whose recurrent pneumonia and wheezing did not improve under usual treatment and led to acute respiratory distress syndrome. He was found to have severe GER on the second-trial of the esophagogram and was eventually revealed to have congenital H-type TEF upon repeated evaluation.
Child ; Early Diagnosis ; Failure to Thrive ; Gastroesophageal Reflux ; Humans ; Infant ; Pneumonia ; Respiratory Distress Syndrome, Adult ; Respiratory Sounds ; Tracheoesophageal Fistula

PURPOSE: In pediatric acute respiratory failure patients requiring mechanical ventilator support, mortality is seldom related to respiratory disease alone, but more generally to multiple organ dysfunction syndrome. The purpose of this study is to evaluate whether early changes in the SOFA score (Delta-SOFA) are more effective for predicting the outcome than a single assessment upon admission for pediatric acute respiratory failure patients requiring mechanical ventilator support. METHODS: The medical records of pediatric patients with acute respiratory failure requiring mechanical ventilator support for more than 72 hours in the PICU of the Asan Medical Center Children's Hospital, Seoul, Korea, between January 2008 and May 2009 were retrospectively reviewed. RESULTS: Early Delta-SOFA showed a significantly stronger correlation with patient mortality compared with the initial SOFA score, PRISM III score and PELOD score (P<0.05). When analyzing the trends in the SOFA score during the first 72 hours, the mortality rate was significantly higher in children with increased and unchanged SOFA scores 72 hours after admission than in children with a decreased SOFA score. (14.5% vs. 42.9%, P<0.05) CONCLUSION: Regardless of the initial SOFA score, early serial evaluation of the SOFA scores during the first 3 days of PICU admission is a better indicator of the prognosis than a single assessment obtained at admission in acute respiratory failure patients mechanically ventilated for more than 3 days.
Child ; Humans ; Korea ; Medical Records ; Multiple Organ Failure ; Prognosis ; Respiratory Insufficiency ; Retrospective Studies ; Ventilators, Mechanical