Filter by keywords:



Filtering documents. Please wait...

1/42. Successful treatment of a patient with ARDS after pneumonectomy using high-frequency oscillatory ventilation.

    High frequency oscillatory ventilation (HFOV) was used in a patient who developed the acute respiratory distress syndrome 5 days following a right pneumonectomy for bronchogenic carcinoma. When conventional pressure-controlled ventilation failed to maintain adequate oxygenation, HFOV dramatically improved oxygenation within the first few hours of therapy. Pulmonary function and gas exchange recovered during a 10-day period of HFOV. No negative side effects were observed. Early use of HFOV may be a beneficial ventilation strategy for adults with acute pulmonary failure, even in the postoperative period after lung resection.
- - - - - - - - - -
ranking = 1
keywords = frequency
(Clic here for more details about this article)

2/42. nitric oxide and high frequency jet ventilation in a patient with bilateral bronchopleural fistulae and ARDS.

    PURPOSE: To describe a method of delivering nitric oxide during high frequency jet ventilation. CLINICAL FEATURES: A 63-yr-old man underwent reduction pneumoplasty for bullous emphysema. Postoperatively, ventilation was inadequate, secondary to bilateral high output bronchopleural fistulae. High frequency jet ventilation was initiated and achieved adequate ventilation (pH>7.2). Over the following 24 hr, progressive hypoxemia (SaO2 <86%) developed along with the acute respiratory distress syndrome. nitric oxide was delivered by continuous flow at the patient Y-connector during combined high frequency jet and conventional ventilation (two conventional low volume breaths/minute). Substantial improvement in oxygenation (FiO2 0.8 0.5, SaO2 >92%) was noted initially and was sustained over 72 hr. Subsequently, the patient was weaned to conventional ventilation without difficulty. Mechanical ventilation was discontinued on postoperative day sixteen. CONCLUSION: The simultaneous use of nitric oxide and high-frequency jet ventilation was used safely and effectively in this patient as a method of support for acute respiratory distress syndrome with co-existing large bilateral bronchopleural fistulae.
- - - - - - - - - -
ranking = 369.25936686716
keywords = high frequency, frequency
(Clic here for more details about this article)

3/42. Use of extracorporeal membrane oxygenation to rescue a child with acute respiratory distress syndrome.

    Acute respiratory distress syndrome (ARDS) carries a high mortality of about 60%. The results of conventional treatments for ARDS are poor. We report the use of extracorporeal membrane oxygenation (ECMO) to rescue a child with ARDS. The patient, a 7-year-old boy, underwent a Ross procedure and mitral valvuloplasty because of severe aortic and mild mitral regurgitation. ARDS due to massive transfusion and prolonged cardiopulmonary bypass developed in the early postoperative period. Hypoxemia persisted despite conventional treatments, including pressure-controlled ventilation and high-frequency ventilation. Finally, venovenous ECMO was used to rescue the patient. With ECMO support, gas exchange was well maintained with a lower ventilator setting, and ventilator-induced lung injuries were avoided. ECMO was used for 183 hours, at which point the boy was weaned without complications. His recovery was uneventful. At the latest follow-up, 6 months after the operation, he was in New York heart association function class I and had no complaints of lung disease. This case suggests that venovenous ECMO can be a rescue method for patients with ARDS that is refractory to conventional treatments.
- - - - - - - - - -
ranking = 0.2
keywords = frequency
(Clic here for more details about this article)

4/42. The use of high-frequency oscillatory ventilation in adult ARDS patients.

    Current ventilatory objectives for adults with ARDS include maximizing gas exchange while minimizing lung injury. To this end, high-frequency oscillatory ventilation (HFOV), a mechanical ventilation strategy that simultaneously avoids end-inspiratory alveolar overdistension and end-expiratory alveolar collapse, has been recommended. HFOV meets these criteria from a theoretical perspective, however, is without the benefit of a prospective randomized clinical trial of CMV versus HFOV to demonstrate that effect. This article provides an overview of high-frequency oscillation, followed by an illustration of how it was applied in the case of a 43-year-old patient who developed respiratory failure 24 hours post-Caesarean section.
- - - - - - - - - -
ranking = 1.2
keywords = frequency
(Clic here for more details about this article)

5/42. Hypercapnic respiratory failure and partial upper airway obstruction during high frequency oscillatory ventilation in an adult burn patient.

    PURPOSE: To present a case of severe hypercapnic respiratory failure in an adult burn patient and to describe our clinical problem solving approach during support with an unconventional mode of mechanical ventilation. CLINICAL FEATURES: A 19-yr-old male with smoke inhalation and flame burns to 50% total body surface area was admitted to the Ross Tilley Burn Centre. High frequency oscillatory ventilation (HFOV) was initiated on day three for treatment of severe hypoxemia. By day four, the patient met consensus criteria for acute respiratory distress syndrome. On day nine, alveolar ventilation was severely compromised and was characterized by hypercapnea (PaCO(2) 136 mmHg) and acidosis (pH 7.10). Attempts to improve CO(2) elimination by a decrease in the HFOV oscillatory frequency and an increase in the amplitude pressure failed. An intentional orotracheal tube cuff leak was also ineffective. A 6.0-mm nasotracheal tube was inserted into the supraglottic hypopharynx to palliate presumed expiratory upper airway obstruction. After nasotracheal tube placement, an intentional cuff leak of the orotracheal tube improved ventilation (PaCO(2) 81 mmHg) and relieved the acidosis (pH 7.30). The improvement in ventilation (with normal oxygen saturation) was sustained until the patient's death from multiple organ dysfunction four days later. CONCLUSION: During HFOV in burn patients, postresuscitation edema of the supraglottic upper airway may cause expiratory upper airway obstruction. The insertion of a nasotracheal tube, combined with an intentional orotracheal cuff leak may improve alveolar ventilation during HFOV in such patients.
- - - - - - - - - -
ranking = 1.2
keywords = frequency
(Clic here for more details about this article)

6/42. Colobronchial fistula in a pediatric patient: diagnostic value of isolated single-lung ventilation and intraoperative use of high frequency oscillatory ventilation.

    IMPLICATIONS: We describe the anesthetic management of a pediatric patient who underwent thoracotomy repair of a colobronchial fistula. Single-lung ventilation confirmed the diagnosis and the position of the fistula. In addition, the intraoperative use of high frequency oscillatory ventilation in combination with conventional ventilation of the nonoperative side is described.
- - - - - - - - - -
ranking = 307.38280572264
keywords = high frequency, frequency
(Clic here for more details about this article)

7/42. Simultaneous fracture of every cervical vertebra: a case study.

    STUDY DESIGN: The case of a 14-year-old boy who sustained simultaneous fractures of every cervical vertebra in a high-energy snowmobile accident is reported. OBJECTIVE: To describe a case of multiple cervical spine fractures and their management. SUMMARY OF BACKGROUND DATA: Injuries from all-terrain vehicles and off-road vehicles, including snowmobiles, are increasing in severity and frequency. The reported case illustrates a result of high-impact loading in which the driver struck his head after being thrown from a snowmobile at high speed. methods: The 14-year-old boy in the reported case fractured C1-C7, but had no neurologic sequelae. RESULTS: The fractures were treated with a halo vest after traction and reduction of the displaced odontoid fracture. All the fractures healed with no residual cervical instability. CONCLUSIONS: This case report is the first to describe a patient of any age who sustained simultaneous fractures of every cervical vertebra. Treatment with a halo vest was successful in protecting the cervical spine until healing was complete.
- - - - - - - - - -
ranking = 0.2
keywords = frequency
(Clic here for more details about this article)

8/42. Transfusion-related acute lung injury (TRALI) following allogeneic stem cell transplant for acute myeloid leukemia.

    Transfusion-related acute lung injury (TRALI) is a serious complication of transfusion characterized by dyspnea, hypoxemia, hypotension, fever, and bilateral pulmonary infiltrates. Although the frequency is estimated at 1/1,120 to 1/5,000 transfusions, few cases have been reported after hematopoietic stem cell transplant. We report a case occurring in an allogeneic transplant recipient who developed acute respiratory distress and bilateral pulmonary infiltrates 2 hr after a platelet transfusion due to the presence of anti granulocyte antibody HNA-3a in the product. As there is a wide differential diagnosis for pulmonary infiltrates developing post transplant, TRALI may be under-recognized and should be considered in this setting.
- - - - - - - - - -
ranking = 0.2
keywords = frequency
(Clic here for more details about this article)

9/42. High frequency oscillatory ventilation in the management of a high output bronchopleural fistula: a case report.

    PURPOSE: To describe the use of high frequency oscillatory ventilation (HFOV) in the management of a high output bronchopleural fistula (BPF). CLINICAL FEATURES: A 55-yr-old female developed a BPF after thoracotomy and decortication of an empyema. The patient deteriorated on the second postoperative day (pH 7.10 PCO2 89) requiring 100% oxygen and mechanical ventilation. After initial improvement, deterioration occurred by 24 hr with conventional positive pressure ventilation (volume or pressure limited) because of decreased pulmonary compliance and bilateral diffuse airspace disease (acute respiratory distress syndrome), persistent increased peak and plateau airway pressures, a prolonged inspired oxygen concentration greater than 0.6, and inability to apply positive end expiratory pressures because of an increased BPF leak (530 mL.breaths(-1)). HFOV was initiated and maintained for 28 days until resolution of the airspace disease and decreased leak through the BPF to 100 mL.breaths(-1). CONCLUSION: We report the successful use of HFOV in a patient with high output BPF. We suggest that HFOV is a useful technique in patients with a BPF when conventional positive pressure ventilation fails.
- - - - - - - - - -
ranking = 62.276561144527
keywords = high frequency, frequency
(Clic here for more details about this article)

10/42. Fatal bile pulmonary embolism after radiofrequency treatment of a hepatocellular carcinoma.

    Radiofrequency is increasingly used to manage liver tumors. This report describes the case of a 74-year-old man who received two courses of percutaneous radiofrequency thermal ablation for a hepatocellular carcinoma over a 4-month period. He subsequently required computed tomography-guided drainage for an area of intrahepatic necrosis. During the procedure, hemobilia developed, followed by respiratory distress and collapse. The diagnosis of bile pulmonary embolism was established on the basis of high biliary acid concentrations in pulmonary fluid aspiration and blood plasma. Radiofrequency thermoablation provides local control of advanced liver tumors with low recurrence and morbidity. However, this interventional procedure risks damage to liver parenchyma involving vascular and biliary structures, which may lead to biliary-venous fistula and possible bile emboli.
- - - - - - - - - -
ranking = 1.4
keywords = frequency
(Clic here for more details about this article)
| Next ->


Leave a message about 'Respiratory Distress Syndrome, Adult'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.