Adult respiratory distress syndrome in newborns: 5 cases.

Revista paulista de medicina Pub Date : 1993-11-01
W B de Carvalho, E J Souto, L P Fascina, G A Moreira, H M Lederman, G A Madeira
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Abstract

Aiming to set out the occurrence of the Adult Respiratory Distress Syndrome (ARDS) in the neonatal period, and according to recent descriptions in literature, we prospectively analyzed 5 cases. The criterion adopted to characterize ARDS was the expanded definition of the syndrome suggested by Murray & Matthay, (10), conjointly with non-invasive cardiac monitoring, to exclude pulmonary edema resulting from myocardial dysfunction. For each case, evolution was briefly described, as well as the predisposing conditions associated to the clinical score punctuation for diagnosis, stressing the importance of adequate identification and fastest possible management of such source of systemic effects. Upon admission at the intensive care unit (Ped. ICU), the five cases were either related to sepsis or to the syndrome of multiple organ failure, or to both. Both syndromes were essentially triggered by severe anoxia neonatorum, respiratory distress of the newborn and/or previous hospitalization with hypoxemia and use of a higher inspired fraction of oxygen. The primary causes of death were related to uncontrolled infection or shock, and not directly related to pulmonary failure.

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新生儿成人呼吸窘迫综合征5例。
为了了解成人呼吸窘迫综合征(ARDS)在新生儿期的发生情况,并根据近期文献的描述,对5例进行前瞻性分析。采用Murray和Matthay(10)提出的扩展综合征定义作为ARDS的诊断标准,并结合无创心脏监测,排除心肌功能障碍引起的肺水肿。对于每个病例,简要描述了进化,以及与临床评分标点符号诊断相关的易感条件,强调了充分识别和尽可能快地管理这种系统性影响来源的重要性。在重症监护室(Ped。5例患者或与脓毒症有关,或与多器官功能衰竭综合征有关,或两者兼有。这两种综合征基本上都是由新生儿严重缺氧、新生儿呼吸窘迫和/或以前因低氧血症住院和使用较高吸氧率引起的。主要死亡原因与未受控制的感染或休克有关,与肺功能衰竭无直接关系。
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