No abstract available.
Drug Therapy* ; Respiratory Distress Syndrome, Adult*

Background:Pulmonary disease is still the main reason cause diseases and mortality for preterm babies. Objectives:This study aims to evaluate of the clinical efficacy of high-frequency oscillatory ventilation in the treatment of preterm infants who have seriously respiratory distress syndrome required mechanical ventilation. Subjects and method:A prospective clinical trail was conducted at Neonatal Unit of Tu Du Hospital from 1st December 2005 to 30th November 2006. Intervention: Patients were randomized to high-frequency oscillatory ventilation (20 patients) or conventional mechanical ventilation-CMV (59 patients). High-frequency oscillatory ventilation(HFOV) was used in high lung volume strategy. Results:The two groups of patients were similar in demographic distribution of birth weight, gestational age, gender, surfactant after birth. Patients on HFOV were ventilator \ufffd?dependent (2.14 \xb1 1.76 vs 3.48 \xb1 2.70 day. p=0.004) and respiratory pressure support (4.01 \xb1 2.23 vs 6.55 \xb1 day. p =0.02) for a shorter time than patients on CMV. Conclusion: First intention HFOV with high volume strategy shortened the time of ventilation and pressure support in preterm infants with seriously respiratory distress syndrome. In the future, it will be necessary to have the tremendous research for the efficacy of HFOV in order to decrease the ratio of bronchopulmonary dysplasia of infants who have seriously respiratory distress syndrome required mechanical ventilation.
Respiratory Distress Syndrome ; Newborn/ therapy ; Infant ; Premature

Acute Lung Injury ; therapy ; Humans ; Respiratory Distress Syndrome, Adult ; therapy

OBJECTIVETo discuss the rationale, hypothesis, modality of extracorporeal blood purification (EBP) techniques for the critically ill animal models or patients, and to summarize the experimental and clinical studies with inconsistent data which explored the EBP's efficacy in the areas of critical care medicine.

DATA SOURCESArticles referred in this review were collected from the database of PubMed published in English up to June 2014.

STUDY SELECTIONWe had done a literature search by using the term "(sepsis OR acute lung injury OR acute respiratory distress syndrome) AND (extracorporeal blood purification OR hemofiltration OR hemoperfusion OR plasma exchange OR plasmapheresis OR adsorpiton)". Related original or review articles were included and carefully analyzed.

RESULTSAcute cellular and humoral immune disturbances occur in both sepsis and acute respiratory distress syndrome (ARDS). Treatments aimed at targeting one single pro-/anti-inflammatory mediator have largely failed with no proven clinical benefits. Such failure shifts the therapeutic rationale to the nonspecific, broad-spectrum methods for modulating the over-activated inflammatory and anti-inflammatory response. Therefore, EBP techniques have become the potential weapons with high promise for removing the circulating pro-/anti-inflammatory mediators and promoting immune reconstitution. Over the years, multiple extracorporeal techniques for the critically ill animal models or patients have been developed, including hemofiltration (HF), high-volume hemofiltration (HVHF), high-cutoff hemofiltration (HCO-HF), hemo-perfusion or -adsorption (HP/HA), coupled plasma filtration adsorption (CPFA), and plasma exchange (PE). These previous studies showed that EBP therapy was feasible and safe for the critically ill animal models or patients. However, data on their efficacy (especially on the clinical benefits, such as mortality) were inconsistent.

CONCLUSIONSIt is not now to conclude that EBP intervention can purify septic or ARDS patients with high clinical efficacy from current experimental and clinical practice. Prospective, randomized controlled, and well-designed clinical or experimental studies and most suitable EBP modalities should be further developed.

Animals ; Humans ; Rats ; Respiratory Distress Syndrome, Adult ; etiology ; therapy

Humans ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult ; therapy

Adult ; Humans ; Respiratory Distress Syndrome, Adult ; drug therapy

The objective of this study was to determine how the neonatal mortality rate has changed since surfactant (S) therapy was introduced in our Neonatal Intensive Care Unit (NICU), and to evaluate the efficacy of surfactant therapy in respiratory distress syndrome (RDS) patients. Incidences of risk babies such as outborns, prematurity, low birth weight infants and RDS, and neonatal mortality rates were compared between 'pre' (control, 1988 to 1991, n=4,861) and 'post' S period (study, 1993 to 1996, n=5,430). In RDS patients of 'post' S period, neonatal mortality rate was compared between S-treated and non-treated patients, and chest X-ray and ventilatory parameters were compared between pre- and post-72 hr of surfactant treatment. Surfactant therapy showed short term effects, judging by the decrease of early neonatal deaths and improvement of chest X-ray and ventilatory parameters in RDS patients. The overall neonatal mortality rate had a tendency to decrease in spite of increased incidences of risk babies in 'post' S period but it was less than expected. The reasons were thought to be that we had a high proportion of risk babies, and there was some bias in patient selection for surfactant therapy and its use. In conclusion, with the active prevention of risk baby delivery and appropriate use of surfactant, better results could be expected.
Female ; Human ; Incidence ; Infant Mortality ; Infant, Newborn ; Male ; Pulmonary Surfactants/therapeutic use* ; Respiratory Distress Syndrome/mortality* ; Respiratory Distress Syndrome/epidemiology ; Respiratory Distress Syndrome/drug therapy* ; Risk Factors

Child ; Humans ; Infant, Newborn ; Consensus ; Respiratory Distress Syndrome/therapy* ; Respiratory Distress Syndrome, Newborn ; Respiration, Artificial ; Intensive Care Units, Pediatric

Acute severe ammonia inhalation can seriously affect oxygenation and ventilation function of patients, and even cause acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) technology is increasingly used in treating patients with ARDS caused by infection, cardiogenic shock, trauma, and drowning with achieved certain effects, but its usage for ARDS caused by ammonia is rarely reported. On July 7, 2018, a case of ARDS caused by ammonia inhalation was admitted to the emergency ICU of the First Affiliated Hospital of Zhengzhou University. After admission, the patient was treated with ECMO immediately on the basis of anti-infection, anti-oxidation, suctioning and nebulization treatments. After 8 days, he was weaned from ECMO and transferred to a general ward for continued rehabilitation. After 23 days, his condition improved and was discharged without complaining of any discomfort during the follow-up till March 2019. The successful experience was summarized in order to provide reference for the treatment of such patients in the future.
Ammonia/poisoning* ; Extracorporeal Membrane Oxygenation/methods* ; Humans ; Male ; Respiratory Distress Syndrome/therapy* ; Respiratory Insufficiency ; Shock, Cardiogenic