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  • Adult respiratory distress syndrome  (3)
  • Electron spin resonance  (1)
  • 1
    ISSN: 0891-5849
    Keywords: Electron spin resonance ; Free radicals ; Kidney transplantation
    Source: Elsevier Journal Backfiles on ScienceDirect 1907 - 2002
    Topics: Biology , Chemistry and Pharmacology , Medicine
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Adult respiratory distress syndrome ; Trypsin ; Sepsis ; Amylase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract With the purpose of studying the role of proteinases in the development of ARDS, plasma levels of immunoreactive trypsin (IRT) and amylase were measured in 43 intensive care patients at risk of developing ARDS (22 polytrauma, seven abdominal surgery, four burns, two DIC and eight pancreatitis). Twenty four of these 43 patients developed ARDS and 31 presented abnormal IRT values (above 70 μg/L). Twenty-one of these 31 patients had ARDS; a significant correlation thus appeared between ARDS and abnormal IRT values. In nine patients, IRT values were higher than 800 μg/L and remained high for 3 to 4 days. A statistically significant correlation also appeared between abnormal IRT and septic phenomena: 20 patients with high IRT values presented septic problems. When IRT values were high, amylase values were often also abnormal: 12 of 23 patients with high IRT had abnormal amylase levels (the eight patients with documented pancreatitis were excluded); no other clinical signs or symptoms of pancreatitis were present in these patients. IRT could be one of the mediators of ARDS in septic patients. It is not clear that the pancreas is the origin of IRT in all cases.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-1238
    Keywords: Severe acute pancreatitis ; Thoracic duct ; Adult respiratory distress syndrome ; Respiratory failure ; Trypsin ; Myeloperoxidase
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Thoracic duct drainage (TDD) may be of value for removing toxic substances released by the inflamed pancreas and which are responsible for lung damage. We have prospectively assessed the efficacy of TDD in improving pulmonary gas exchange in 12 patients with severe acute pancreatitis (SAP) complicated by persistent respiratory failure despite standard conservative treatment including peritoneal dialysis in 8 patients. In group A were 6 patients (mean Ranson score=7.3) with adult respiratory distress syndrome (ARDS) and in group B were 6 hypoxemic patients (mean Ranson score=6.6) judged to be at risk of developing ARDS. The duration of TDD ranged from 3 to 10 days and the total amount of drained lymph (L) varied from 770 to 15 600 ml. Immunoreactive trypsin levels were significantly higher in L when compared to blood in both groups. Leukocyte myeloperoxidases in L (normal value 〈 than 332±82 ng/ml in plasma) were increased in 5 of 5 group A patients (830±317 ng/ml) and in 3 of 6 patients in group B (671±467 ng/ml). After TDD pulmonary gas exchange as measured by median PaO2/FiO2 (mmHg) improved from 148±60 to 285±42 in group A and from 192±37 to 330±42 in group B (p〈0.05). All patients were weaned after ventilation for a mean of 8 days in group A and 4 days in group B. All patients survived apart from 1 group B patient who died of sepsis on day 34. These data suggest that TDD, by allowing removal of potential mediators of lung injury is of major therapeutic value in ARDS complicating SAP. This approach may also prevent further respiratory impairment in susceptible patients.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1238
    Keywords: Adult respiratory distress syndrome ; Thromboxane B2 ; 6-keto-PGF1α ; Sepsis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Plasma thromboxane B2 (TXB2) and 6-ketoprostaglandin F1α (6-keto-PGF1α) were measured in 84 patients at risk of developing adult respiratory distress syndrome (ARDS) (44 patients following multiple trauma, 29 patients following abdominal surgery and 11 patients with acute pancreatitis). Forty-nine of these 84 patients developed an ARDS. High (〉140 pg/ml plasma) TXB2 values were found in 52/84 patients. The median values of TXB2 were: 360 pg/ml in multiple injured, 250 pg/ml in abdominal surgery and 410 pg/ml in acute pancreatitis patients. The median TXB2 value was 575 pg/ml in patients developing ARDS and 140 pg/ml in those without this complication: this difference was statistically significant (p〈0.05). The median values of 6-keto-PGF1α were 55pg/ml in multiple injured, 25 pg/ml in abdominal surgery and 120 pg/ml in acute pancreatitis patients. The median 6-keto-PGF1α value was 122 pg/ml in ARDS patients and 25 pg/ml in non-ARDS patients (statistically significant: p〈0.05). High TXB2 and 6-keto-PGF1α values were particularly related to sepsis in abdominal surgery patients (p〈0.05) and in multiple injured patients (p〈0.01). No relation could be established between abnormal TXB2 or 6-keto-PGF1α values and death. High TXB2 values often persisted for several days and were observed particularly at the time ARDS diagnostic criteria were fulfilled. An imbalance between TXB2 and 6-keto-PGF1α was observed: 6-keto-PGF1α values were always lower than TXB2 values and did not persist for more than 24 h except in four cases. Our data demonstrate a significant production of prostanoids in ARDS patients particularly in sepsis and indicate a disturbance in balance of the prostacyclin/thromboxane axis.
    Type of Medium: Electronic Resource
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