Document Detail


Pathogenesis of respiratory failure (ARDS) after hemorrhage and trauma: II. Cardiorespiratory patterns after development of ARDS.
MedLine Citation:
PMID:  7418427     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Hemodynamic and oxygen transport variables were studied in a series of 60 patients who sustained adult respiratory distress syndrome (ARDS) from hemorrhage and trauma; measurements were made during the period of their ARDS and in survivors after their recovery from ARDS. In general, cardiac index (CI) and myocardial performance were increased over normal values; they were greater in trauma patients than in hemorrhage patients and greater in the survivors than in nonsurvivors. The mean pulmonary artery pressure (MPAP) and pulmonary vascular resistance index (PVRI) were high in all groups. Blood volume and hemoglobin (Hgb) concentrations were reduced especially in the nonsurviving hemorrhage patients; hemoglobin saturation (SaO2) and oxygen tension (PaO2) were low initially, but usually responded to therapy; oxygen consumption (VO2) was normal or high in all groups, and was greater in survivors than in nonsurvivors, and greater in trauma than in hemorrhage. Thus, the patient with post-traumatic ARDS has circulatory and metabolic needs which are greater than normal values defined by values from healthy unstressed volunteers and also somewhat greater than hemorrhage and trauma patients without ARDS. Optimal blood volume, hemodynamic and oxygen transport values defined by the survivor's values as well as the standard respiratory care are recommended as goals for preventive or ealy therapy of these patients. Volume therapy should be given provided it does not elevate the pulmonary arterial wedge pressure (WP) above 18 mm Hg to avoid overloading the pulmonary vascular bed and causing pulmonary edema.
Authors:
L S Czer; P Appel; W C Shoemaker
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Critical care medicine     Volume:  8     ISSN:  0090-3493     ISO Abbreviation:  Crit. Care Med.     Publication Date:  1980 Sep 
Date Detail:
Created Date:  1980-12-16     Completed Date:  1980-12-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  513-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Female
Hemodynamics*
Humans
Male
Middle Aged
Oxygen / blood*
Prognosis
Respiratory Distress Syndrome, Adult / etiology*,  physiopathology
Shock, Hemorrhagic / complications*,  physiopathology
Shock, Traumatic / complications*,  physiopathology
Ventilation-Perfusion Ratio
Grant Support
ID/Acronym/Agency:
HS 01833/HS/AHRQ HHS
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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