Abstract
Despite great advances in the treatment of acute respiratory failure, many patients do not respond to accepted methods of resuscitation. The great majority of these critically ill patients fall into the category of adult respiratory distress syndrome (ARDS). The name of this syndrome was given by Ashbaugh et al. [1], who based it upon the severe respiratory distress in illness closely resembling the infant RDS (IRDS). Although the pathogenesis varies highly, it is useful to group various categories of patients together if they meet the clinical, physiological and pathological conditions of the RDS, and respond in a similar manner to a given type of treatment [2]. Infant respiratory distress syndrome is closely related to immaturity [73], whereas ARDS develops in conjunction with severe diseases such as trauma, fat embolism, aspiration pneumonitis or virus pneumonitis, acute renal failure or gas intoxication [79].
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Ashbaugh DG, Bigelow DB, Petty TL, Levine BE: Acute respiratory distress in adults. Lancet 2: 319–323, 1967.
Ashbaugh DG, Petty TL, Bigelow DB, Harris TM: Continuous positive-pressure breathing (CPPB) in adult respiratory distress syndrome. J Thorac Cardiovasc Surg 57: 3120 1341, 1969.
Ashbaugh DG: Acute respiratory failure after surgery or trauma. In: Petty TL (ed) Respiratory care, 2nd edn. Philadelphia: Lea and Febiger, 1974, pp 190–204.
Baum M, Benzer H, Mutz N, Pauser G, Tonczar L: Inversed ratio ventilation (IRV). Die Rolle des Atemzeitverhaltnisses in der Beatmung beim ARDS. Anaesthetist 29: 592–596, 1980.
Benzer H, Coraim F, Mutz N, Geyer A, Pauser G: Probleme der “Respiratorischen” Beatmung bei der Schocklunge. In: Mayrhofer-Krammel O, Schlag G, Stoeckel H (eds) Acute respiratory failure Stuttgart: Georg-Thieme-Verlag, 1979, pp 263–270.
Blaisdell FW, Lewis FR Jr: Respiratory distress syndrome of shock and trauma: post-traumatic respiratory failure. In: Ebert PA (ed) Major problems in clinical surgery. Philadelphia: WB Saunders, 1977, pp 28–132.
Bleyl U: Die Histophysiologie und Histopathologic der terminalen Lungenstrombahn bei akutem Lungenversagen. In: Ahnefeld FW, Bergmann H, Burri C, Dick W, Halmagyi M, Hossli G, Rugheimer E (eds) Akutes Lungenversagen. Berlin: Springer-Verlag, 1979, pp 1–13.
Bohn DJ, Miyasaka K, Marchak BE, Thompson WK, Froese AB, Bryan AC: Ventilation by high-frequency oscillation. J Appl Physiol (Respir Environ Exerc Physiol) 48: 710–716, 1980.
Boros SJ, Matalon SV, Ewald R, Leonard AS, Hunt CE: The effect of independent variations in inspiratory-expiratory ratio and end-expiratory pressure during mechanical ventilation in hyaline membrane disease: the significance of mean airway pressure. J Pediatr 91: 794–798, 1977.
Boros SJ: Variations in inspiratory: expiratory ratio and airway pressure wave form during mechanical ventilation: the significance of mean airway pressure. J Pediatr 94: 114–117, 1979.
Burchardi H: Verteilungsstorungen bei Langzeitbeatmung. In: Wiemers K, Scholler KL (eds) Lungenveranderungen bei Langzeitbeatmung. International symposium, Freiburg, 1971. Stuttgart: Georg-Thieme-Verlag, 1973, pp 100–105.
Busing CM, Bleyl U, Rtifer R: Correlation between plasma proteins and surfactants. In: Wichert PV (ed) Progress in respiration research. Clinical importance of surfactant defects. Basel: S Karger, 1981, pp 224–233.
Douglas MME, Downs JB: Pulmonary function following severe acute respiratory failure and high levels of positive end-expiratory pressure. Chest 71: 18–23, 1977.
Downs JB, Klein EF Jr, Desautels D, Modell JH, Kirby RR: Intermittent mandatory ventilation: a new approach to weaning patients from mechanical ventilators. Chest 64:331–335, 1973.
Downs JB. Douglas ME, Sanfelippo PM, Stanford W, Hodges MR: Ventilatory pattern, intrapleural pressure and cardiac output. Anesth Analg 56: 88–94, 1977.
Fairley HB, Blenkarn GD: Effect of pulmonary gas exchange of variations in inspiratory flow rate during intermittent positive pressure ventilation. Br J Anaesth 38: 320–328, 1966.
Fujiwara T, Chida S, Watabe Y, Maeta H, Morita T, Abe T: Artificial surfactant therapy in hyaline membrane disease. Lancet 1: 55–59, 1980.
Fuleihan SF, Wilson RS, Pontoppidan H: Effect of mechanical ventilation with end-inspiratory pause on blood-gas exchange. Anesth Analg 55: 122–130, 1976.
Gattinoui L, Pesenti A, Rossi GP, Vesconi S, Fox U, Kolobow T, Agostini A, Pelizzola A, Langer M, Uziel L, Longoni F, Damia G: Treatment of acute respiratory failure with low- frequency positive-pressure ventilation and extracorporeal removal of C02. Lancet 2:292– 294, 1980.
Gilston A: The effects of PEEP on arterial oxygenation: an examination of some possible mechanisms. Intensive Care Med 3: 267–271, 1977.
Gregory GA, Kitterman JA, Phibbs RH, Tooley WH, Hamilton WK: Treatment of the idiopathic respiratory distress syndrome with continuous positive airway pressure. N Engl J Med 284: 1333–1340, 1971.
Herman S, Reynolds EOR: Methods for improving oxygenation in infants mechanically ventilated for severe hyaline membrane disease. Arch Dis Child 48: 612–617, 1973.
Hughes JMB, Hoppin FG, Mead J: Effect of lung inflation on bronchial length and diameter in excised lungs. J Appl Physiol 32: 25–35, 1972.
Jonson B: Positive airway pressure - some physical and biological effects. This book, ch 8.
Jonson B, Ahlstrom H, Lindroth M, Svenningsen NW: Continuous positive airway pressure: modes of action in relation to clinical applications. Pediatr Clin North Am 27: 687–699, 1980.
Kirby RR, Downs JB, Civetta JM, Modell JH, Dannemiller FJ, Klein EF, Hodges M: High level positive end-expiratory pressure (PEEP) in acute respiratory insufficiency. Chest 67: 156–163, 1975.
Klain M, Smith RB: High frequency percutaneous transtracheal jet ventilation. Crit Care Med 5: 280–287, 1977.
Knelson JH, Howatt WF, DeMuth GR: Effect of respiratory pattern on alveolar gas exchange. J Appl Physiol 29: 328–331, 1970.
Kolobow T, Solca M, Gattioni L, Pesenti A: Adult respiratory distress syndrome (ARDS): why did ECMO fail? Int J Artificial Organs 4: 58–59, 1981.
Kumar A, Falke KJ, Geffin B, Aldredge CF, Laver MB, Lowenstein E, Pontoppidan H: Continuous positive-pressure ventilation in acute respiratory failure. Effects on hemodynamics and lung function. N Engl J Med 283: 1430–1436, 1970.
Lachmann B, Robertson B, Vogel J: In vivo lung lavage as an experimental model of the respiratory distress syndrome. Acta Anaesthesiol Scand 24: 231–236, 1980.
Lachmann B, Fujiwara T, Chida S, Morita T, Konishi M, Nakamura K, Maeta H: Improved gas exchange after tracheal instillation of surfactant in the experimental adult respiratory distress syndrome [abstr]. Crit Care Med 9: 158, 1981.
Lachmann B: The role of lung surfactant in etiology, pathogenesis and therapy of acute respiratory distress syndrome in newborn infants and adults. Eur J Respir Dis [Suppl 113] 62: 123–125, 1981.
Lachmann B, Grossmann G, Freyse J, Robertson B: Lung-thorax compliance in the artificially ventilated premature rabbit neonate in relation to variations in inspiration/expiration ratio. Pediatr Res 15: 833–838, 1981.
Lachmann B, Jonson B, Lindroth M, Robertson B: Modes of artificial ventilation in severe respiratory distress syndrome. Lung function and morphology studied in rabbits after washout of alveolar surfactant. Crit Care Med (in press).
Lamy M: Management of ventilatory supports in adult respiratory distress syndrome (ARDS). In: Mayrhofer-Krammel O, Schlag G, Stoeckel H (eds) Acute respiratory failure. Stuttgart: Georg-Thieme-Verlag, 1979, pp 245–255.
Lawin P, Scherer R: Beatmung. In: La win P (ed) Praxis der Intensivbehandlung, 4. Aufl. Stuttgart: Georg-Thieme-Verlag, 1981, pp 16. 1–16. 39.
Luce JM, Pierson DJ, Hudson LD: Intermittent mandatory ventilation. Chest 79: 678–685, 1981.
Manginello FP, Grassi AE, Schechner S, Krauss AN, Auld PAM: Evaluation of methods of assisted ventilation in hyaline membrane disease. Arch Dis Child 53: 878–881, 1978.
Mittermayer Ch, Riede UN, McEwan JR: Pathologisch-anatomische Untersuchungen der Schocklunge. II. Spatschaden und Irreversibility. In: Mayrhofer-Krammel O, Schlag G, Stoeckel H (eds) Acute respiratory failure. Stuttgart: Georg-Thieme-Verlag, 1979, pp 163–170.
Modell HI, Cheney FW: Effects of inspiratory flow pattern on gas exchange in normal and abnormal lungs. J Appl Physiol (Respir Environ Exerc Physiol) 46: 1103–1107, 1979.
Murray JF: Mechanism of acute respiratory failure, conference report. Am Rev Respir Dis 115: 1071–1078, 1977.
Nash G, Blennerhassett JB, Pontoppidan H: Pulmonary lesions associated with oxygen therapy and artificial ventilation. N Engl J Med 276: 368–374, 1967.
Nilsson R, Grossmann G, Robertson B: Bronchiolar epithelial lesions induced in the premature rabbit neonate by short periods of artificial ventilation. Acta Pathol Microbiol Scand [A] 88: 359–367, 1980.
Nilsson R: Artificial ventilation in the newborn rabbit. MD thesis, Karolinska Institute, Stockholm, Sweden, 1980.
Nilsson R, Grossmann G, Robertson B: Pathogenesis of neonatal lung lesions induced by artificial ventilation: evidence against the role of barotrauma. Respiration 40: 218–225, 1980.
Northway WH, Rosan RC, Porter DY: Pulmonary disease following respirator therapy of hyaline-membrane disease. N Engl J Med 276: 357–367, 1967.
Osswald PM, Hartung HJ, Klose R, Spier R: Die Wirkung von verlangerter Inspirationszeit und PEEP auf die Compliance und den Gasaustausch bei der mechanischen Ventilation. Anaesthetist 30: 71–76, 1981.
Petty TL, Ashbaugh DG: The adult respiratory distress syndrome clinical features, factors influencing prognosis and principles of management. Chest 60: 233–239, 1971.
Petty TL, Ashbaugh DG: The adult respiratory distress syndrome. In: Petty TL (ed) Respiratory care, 2nd edn. Philadelphia: Lea and Febiger, 1974, pp 205–222.
Petty TL, Reiss OK, Paul GW, Silvers GW, Elkins ND: Characteristics of pulmonary surfactant in adult respiratory distress syndrome associated with trauma and shock. Am Rev Respir Dis 115: 531–536, 1977.
Petty TL, Newman JH: Adult respiratory distress syndrome. West J Med 128: 399–407, 1978.
Petty TL, Silvers GW, Paul GW, Stanford RE: Abnormalities in lung elastic properties and surfactant function in adult respiratory distress syndrome. Chest 75:571–-574, 1979.
Petty TL: Why (not) try PEEP? Crit Care Med 9: 67–68, 1981.
Pontoppidan H, Geffin B, Lowenstein E: Acute respiratory failure. Part I. N Engl J Med 287: 690–698, 1972.
Pontoppidan H, Geffin B, Lowenstein E: Acute respiratory failure. Part II. N Engl J Med 287: 743–752, 1972.
Pontoppidan H, Geffin B, Lowenstein E: Acute respiratory failure in the adult. Part III. N Engl J Med 287: 799–806, 1972.
Pontoppidan H, Geffin B, Lowenstein E: Acute respiratory failure in the adult. Boston: Little Brown and Co, 1973, pp 1–89.
Pontoppidan H, Wilson RS, Rie MA, Schneider RC: Respiratory intensive care. Anesthesiology 47: 96–116, 1977.
Qvist J, Pontoppidan H, Wilson RS, Lowenstein E, Laver MB: Hemodynamic responses to mechanical ventilation with PEEP; the effect of hypervolemia. Anesthesiology 42: 45–55, 1975.
Reynolds EOR: Effect of alterations in mechanical ventilator settings on pulmonary gas exchange in hyaline membrane disease. Arch Dis Child 46: 152–159, 1971.
Reynolds EOR: Pressure waveform and ventilator settings for mechanical ventilation in severe hyaline membrane disease. Int Anesthesiol Clin 12: 259–280, 1974.
Reynolds EOR, Taghizadeh A: Improved prognosis of infants mechanically ventilated for hyaline membrane disease. Arch Dis Child 49: 505–515, 1974.
Robertson B: Surfactant substitution: experimental models and clinical applications. Lung 158: 57–68, 1980.
Robertson B: Review of experimental hyaline membrane disease. Diagn Histopathol 4:49– 60, 1981.
Safar P, Grenvik A, Smith J: Progressive pulmonary consolidation: review of cases and pathogenesis. J Trauma 12: 955–967, 1972.
Schlimgen R: Die Bedeutung des endinspiratorischen Beatmungsplateaus von Respiratoren. Prakt Anaesth 12:505–-510, 1977.
Shah DM, Newell JC, Dutton RE, Powers SR: Continuous positive airway pressure versus positive end-expiratory pressure in respiratory distress syndrome. J Thorac Cardiovasc Surg 74: 557–562, 1977.
Shapiro BA: Airway pressure therapy for acute restrictive pulmonary pathology. In: Critical care, vol 2. State of the art. The Society of Critical Care Medicine, 1981, pp II C 1–53.
Sjostrand U: High-frequency positive-pressure ventilation (HVPPV): a review. Crit Care Med 8: 345–364, 1980.
Skoskiewicz MJ: Role of pulmonary transplantation in patients with acute respiratory failure. In: Zapol WM, Quist J (eds) Artificial lungs for acute respiratory failure. Washington: Hemisphere Publishing Corporation: distributed by Academic Press, 1976, pp 483–488.
Smith PC, Daily WJR: Mechanical ventilation of newborn infants, II. Effects of independent variation of rate and pressure on arterial oxygenation of infants with RDS. Anesthesiology 37: 498–502, 1972.
Strang LB: Neonatal respiration - physiological and clinical studies. Oxford: Blackwell Scientific, 1977, pp 181–249.
Suter PM, Fairley HB, Isenberg MD: Optimum end-expiratory airway pressure in patients with acute pulmonary failure. N Engl J Med 292: 284–289, 1975.
Suter P: Individuell adaptierter Einsatz verschiedener Beatmungsmethoden zur Therapie des akuten Lungenversagens. In: Ahnefeld FW, Bergmann H, Burri C, Dick W, Halmagyi M, Hossli G, Riigheimer E (eds) Akutes Lungenversagen. Berlin: Springer-Verlag, 1979, pp 113–119.
Suter PM: “Optimal” regulation of mechanical ventilation. Anaesthetist 29:163–164, 1980.
Suter PM: Respirator-Therapie. In: Peter K (ed) Akute respiratorische Insuffizienz. Berlin: Springer-Verlag, 1980, pp 94–97.
Taghizadeh A, Reynolds EOR: Pathogenesis of bronchopulmonary dysplasia following hyaline membrane disease. Am J Pathol 82: 241–264, 1976.
Task Force Report on Problems Research Approaches Needs: The lung program. National Heart and Lung Institute, October 1972. Panel X: Respiratory distress syndrome. Washington: DHEW Publication no. (NIH) 73-432, pp 165–180.
Tyler DC, Cheyney FW: Comparison of positive end-expiratory pressure and inspiratory positive pressure plateau in ventilation of rabbits with experimental pulmonary edema. Anesth Analg 58: 288–292, 1979.
Weinstein ME, Rice CL, Peters RM, Virgilio RW: Hemodynamic and respiratory response to varying gradients between end-expiratory pressure and end-inspiratory pressure in patients breathing on continuous positive airway pressure. J Trauma 18: 231–235, 1978.
Wolff G: Was ist die akute respiratorische Insuffizienz? In: Peter K (ed) Akute respiratorische Insuffizienz. Berlin: Springer-Verlag, 1980, pp 21–59.
Zapol WM, Snider M, Hill JD: Extracorporeal membrane oxygenation in severe acute respiratory failure. JAMA 242: 2193–2196, 1979.
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Lachmann, B., Danzmann, E., Haendly, B., Jonson, B. (1982). Ventilator settings and gas exchange in respiratory distress syndrome. In: Prakash, O. (eds) Applied Physiology in Clinical Respiratory Care. Developments in Critical Care Medicine and Anaesthesiology, vol 1. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-7567-5_9
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