Acute respiratory distress syndrome in children
1
Citation
10
Reference
10
Related Paper
Citation Trend
Abstract:
Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India Pediatric Intensive Care Unit, Royal Children’s Hospital, Parkville, Victoria, Australia *See also p. 3238. The authors have not disclosed any potential conflicts of interest.Respiratory distress syndrome is pulmoner insufficiency caused by the lack of surfactant and the main reason of morbidity and mortality in preterm infants. Mothers at high risk of preterm birth should be transferred to perinatal centers with experience for respiratory distress syndrome and ante-natal steroids should be given before 35 weeks' of gestational age. Surfactant treatment should be applied to babies with or at high risk for respiratory distress syndrome. Prophylaxis should be given to infants of <26 weeks of gestational age and to infants requiring entubation in the delivery room. Nasal continuous positive airway pressure should be considered in infants with complete steroid treatment and without entubation need. Early surfactant may be given if entubation is performed during follow-up. Natural forms of surfactant should be preferred when needed. If the infant is stable, early extubation and non-invasive respiratory support should be considered. In this review, the recent studies' current data about surfactant treatment will be discussed.
Surfactant therapy
Cite
Citations (2)
Cite
Citations (19)
Cite
Citations (94)
Background: As Transient tachypnea of newborn is the most common cause of Respiratory distress and significant number of newborns with respiratory distress develops severe respiratory insufficiency requiring intensive monitoring. With these points, we undertake to identify risk factors associated with development of severe respiratory distress in the new born.Methods: Hundred newborns that were having respiratory distress within 72 hours of birth admitted to NICU were included in the present study. The severity of respiratory distress was noted according to risk factors and clinical assessment. The details were noted in all the newborns- General information, history, risk factors and clinical examination findings of mother and newborn were documented.Results: In the present study, 62.5% of the newborns born to Primigravida mothers developed severe respiratory distress. In the present study it was seen that 83.6% of newborns with SGA developed severe respiratory distress compared to 60% and 33.3% newborns with LGA and AGA respectively. It was seen that the risk of neonatal respiratory distress markedly increased with decreasing birth weight (p<0.001).Conclusions: Immediate clinical outcome of newborn respiratory distress in term of mortality rate is variable and depends on the cause of newborn distress.
Tachypnea
Cite
Citations (0)
Fluid Management With a Simplified Conservative Protocol for the Acute Respiratory Distress Syndrome
Grissom, Colin K.*†; Hirshberg, Eliotte L.*†‡; Dickerson, Justin B.*§; Brown, Samuel M.*†; Lanspa, Michael J.*†; Liu, Kathleen D.∥¶; Schoenfeld, David#; Tidswell, Mark**; Hite, Duncan††; Rock, Peter‡‡; Miller, Russell R. III*†; Morris, Alan H.*† for the National Institutes of HealthNational Heart Lung and Blood Institute Acute Respiratory Distress Syndrome Network Author Information
Miller
Cite
Citations (0)
Multiple mutations of surfactant genes causing surfactant dysfunction have been described. Surfactant protein C (SP-C) deficiency is associated with variable clinical manifestations ranging from neonatal respiratory distress syndrome to lethal lung disease. We present an extremely low birth weight male infant with an unusual course of respiratory distress syndrome associated with two mutations in the SFTPC gene: C43-7G>A and 12T>A. He required mechanical ventilation for 26 days and was treated with 5 subsequent doses of surfactant with temporary and short-term efficacy. He was discharged at 37 weeks of postconceptional age without any respiratory support. During the first 16 months of life he developed five respiratory infections that did not require hospitalization. Conclusion. This mild course in our patient with two mutations is peculiar because the outcome in patients with a single SFTPC mutation is usually poor.
Surfactant protein C
Cite
Citations (6)
the infant had been breathing 100°/o 02 by mask at 10 I./min.for 15 minutes, the initial arterial sample was obtained.Subsequently, if the infant's condition permitted, arterial Po2 was measured, with the infant breathing room air for 15 minutes.Blood was analysed for pH and carbon dioxide tension (Paco.,)by the interpolation method (Astrup, J0rgensen, Siggaard Andersen, and Engel, 1960) and the base deficit (negative base excess) calculated from a nomogram (Siggaard Andersen, 1962).The base deficit values were corrected for oxygen saturation and the effect of increases in PaCo2 (Dell, Engel, and Winters, 1966).The arterial oxygen tension (Pao2) was determined with a modified Clark electrode (Radiometer-Beckman) calibrated with tonometred water and maintained at 38°C.All readings were corrected for temperature differences and
Cite
Citations (10)
Demographics
Cite
Citations (6)
Cite
Citations (1)
Background: Delayed transfer of patients from the emergency department to the intensive care unit is associated with adverse clinical outcomes. Critically ill patients with delayed admission to the intensive care unit had higher in-hospital mortality and increased hospital length of stay. Objectives: We investigated the effects of an intensive care unit admission protocol controlled by intensivists on the emergency department length of stay among critically ill patients. Methods: We designed the intensive care unit admission protocol to reduce the emergency department length of stay in critically ill patients. Full-time intensivists determined intensive care unit admission priorities based on the severity of illness. Data were gathered from patients who were admitted from the emergency department to the intensive care unit between 1 April 2016 and 30 November 2016. We retrospectively analyzed the clinical data and compared the emergency department length of stay between patients admitted from the emergency department to the intensive care unit before and after intervention. Results: We included 292 patients, 120 and 172 were admitted before and after application of the intensive care unit admission protocol, respectively. The demographic characteristics did not differ significantly between the groups. After intervention, the overall emergency department length of stay decreased significantly from 1045.5 (425.3–1665.3) min to 392.0 (279.3–686.8) min (p < 0.001). Intensive care unit length of stay also significantly decreased from 6.0 (4.0–11.8) days to 5.0 (3.0–10.0) days (p = 0.015). Conclusion: Our findings suggest that introduction of the intensive care unit admission protocol controlled by intensivists successfully decreased the emergency department length of stay and intensive care unit length of stay among critically ill patients at our institution.
Cite
Citations (5)