4.Pathogenicity and treatment of acute respiratory distress syndrome after thoracotomy.
Xiao-feng CHEN ; Jia-an DING ; Wen GAO ; Lei JIANG ; Guang-ya SUN ; Zheng-he HU
Chinese Journal of Surgery 2003;41(12):906-908
OBJECTIVETo investigate the causes of acute respiratory distress (ARDS) after thoracotomy and to find out the measures to prevent ARDS.
METHODSThe characteristics of incidence, pathogenicity and treatment of ARDS after thoracotomy in 31 patients were analysed.
RESULTSThe patients who had chronic obstructive pulmonary disease, long history of smoking, hypertension were prone to ARDS. Injury to lung in operation, shock and pulmonary infection probably caused ARDS. Clearing away respiratory tract secretion, preserving of a clear airway, controlling pulmonary infection, alleviating pneumonedema by diuresis, early executing tracheotomy or mechanic assistant ventilation by tracheointubation were keys to rescuing patients successfully.
CONCLUSIONSIt is suggested that multi factors were related to ARDS after thoracotomy. Shock, injury to lung in operation, pulmonary infection, are important factors that lead to post-operative ARDS after thoracotomy. Early treatment can reduce mortality of ARDS.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Respiratory Distress Syndrome, Adult ; etiology ; prevention & control ; therapy ; Thoracotomy ; adverse effects
5.Comparison between tow methods of acute physiology and chronic health evaluation III and acute lung injury scale to evaluate the severity and prognosis of severe acute respiratory syndrome.
Guo-qiang ZHANG ; Cheng-dong GU ; Yu-qing ZHU ; Li-ye WANG ; Peng LIU
Chinese Journal of Epidemiology 2004;25(9):802-804
OBJECTIVETo evaluate the acute physiology and chronic health evaluation III (APACHE III) and acute lung injury (ALI) scale in the severity and prognosis of severe acute respiratory syndrome (SARS).
METHODSThe clinical data of 38 SARS patients, including survivors (24 cases) and no survivors (14 cases) were collected and evaluated with APACHE III and ALI scoring systems. The correlation of scores and prognosis was evaluated.
RESULTSThe scores of APACHE III in the non survivors were higher remarkably than those in the survivor group (P < 0.001). The scores of APACHE III had positive correlation with the overall fatality rate. When the scores of APACHE III was higher than 60, the mortality increased obviously (chi(2) = 3.886, P < 0.05). Elderly patients with SARS who were over 60 years old had a high mortality (chi(2) = 8.660, P < 0.05). The scores of ALI in the non survivors had not statistical significance than those in the survivor group (P = 0.127).
CONCLUSIONSThe score of APACHE III in the SARS are correlated with the patient's condition and prognosis. Elderly patients with SARS have a high mortality.
APACHE ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Respiratory Distress Syndrome, Adult ; etiology ; physiopathology ; Severe Acute Respiratory Syndrome ; physiopathology
6.The investigation of pathologic oxygen supply dependency.
Chinese Journal of Pediatrics 2003;41(2):152-154
10.Mechanical ventilation treatment on acute respiratory distress syndrome in operations by cardiopulmonary bypass.
Liang CAO ; Yi-feng YANG ; Jin-fu YANG
Journal of Central South University(Medical Sciences) 2007;32(6):1080-1084
OBJECTIVE:
To explore the early diagnosis of acute respiratory distress syndrome (ARDS) and the mechanical ventilation treatment in operations of cardiopulmonary bypass.
METHODS:
Thirty-four patients with acute respiratory distress syndrome were divided into the traditional ventilation strategy plus positive end expiratory pressure (PEEP) group (n=13) and the protective ventilation strategy group (n=21), and their diagnosis and treatment were reviewed.
RESULTS:
The average ventilator-carrying time in the protective ventilation strategy group and the traditional ventilation strategy plus PEEP group was (4.8+/-2.1) and (7.2+/-3.6) days,and the mortality was 23.8% and 61.5% respectively. There was statistical significance in the 2 groups (P<0.05).
CONCLUSION
The key to ARDS is the early diagnosis and ventilation strategy. Protective ventilation strategy in treating ARDS is more effective than the traditional ventilation strategy plus PEEP, and it can obviously shorten the ventilator-carrying time and reduce the mortality of ARDS.
Adolescent
;
Adult
;
Cardiopulmonary Bypass
;
adverse effects
;
Female
;
Humans
;
Male
;
Respiration, Artificial
;
methods
;
Respiratory Distress Syndrome, Adult
;
etiology
;
therapy
;
Retrospective Studies
;
Young Adult
Result Analysis
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