Document Detail


Pathogenesis and treatment of the adult respiratory distress syndrome.
MedLine Citation:
PMID:  8526694     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The adult respiratory distress syndrome is an acute clinical illness characterized by noncardiogenic pulmonary edema and refractory hypoxemia. Injury to the alveolar-capillary barrier and lung inflammation lead to intrapulmonary shunting of blood, surfactant depletion, and pulmonary vascular obstruction. Numerous mediators contribute to the pathologic response. Conventional therapy includes treating underlying causes and positive pressure mechanical ventilation. Concern about pressure-induced lung injury had led to new strategies to accomplish adequate gas exchange. Novel therapeutic interventions have included extracorporeal support techniques, use of compounds designed to neutralize proinflammatory cytokines, and administration of surfactants, but these efforts have not definitely affected mortality in randomized trials. Potent antioxidant agents have shown promise in animal models of acute lung injury, but human studies are lacking. Inhaled nitric oxide appears to have temporary effects on pulmonary artery pressure and on ventilation or perfusion relationships, but longer-term efficacy and safety in patients suffering from adult respiratory distress syndrome is unknown and awaits results of ongoing clinical trials.
Authors:
W J Fulkerson; N MacIntyre; J Stamler; J D Crapo
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of internal medicine     Volume:  156     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1996 Jan 
Date Detail:
Created Date:  1996-01-25     Completed Date:  1996-01-25     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  29-38     Citation Subset:  AIM; IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, NC., USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Humans
Respiratory Distress Syndrome, Adult / physiopathology*,  therapy*

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