scholarly journals Acute Respiratory Distress Syndrome in Preterm Newborns (Morphological Study)

2020 ◽  
Vol 16 (1) ◽  
pp. 35-44
Author(s):  
S. A. Perepelitsa
Keyword(s):  
Body Weight ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Distress Syndrome ◽  
Hyaline Membranes ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Preterm Newborns

The aim of the study is to provide a rationale for the morphological diagnostic criteria of respiratory distress syndrome (RDS) and acute respiratory distress syndrome of the newborn (ARDSN) in extremely preterm newborn infants.Materials and methods. Autopsy protocols of 31 newborns were studied. The average gestational age of children was 28.9±5.3 weeks, body weight at birth was 1404±945 grams. Fifty eight percent of newborns in the sample had extremely low body weight (ELBW). At birth, all newborns were found to have severe asphyxia, and the median score on the Apgar scale at the 1st minute of life was 3 [2; 5] points. In all cases there was an unfavorable course of the disease. The median life span was 72 [22; 181] hours.The results of the study. The study revealed two variants of hyaline membrane formation in preterm newborns with acute respiratory failure. Hyaline membranes in the lungs were found in 93.5% of newborns, in 51.6% of cases there was ARDSN due to the primary surfactant deficiency, in 41.9% of children ARDS was due to immature lung being exposed to various direct and indirect damaging factors. In all cases a distinct morphological pattern in newborns with the hyaline membranes was identified: immaturity and antenatal damage to air-blood barrier, pneumonia, microaspiration, ischemia of the lungs.Conclusion. Acute respiratory distress syndrome is typical for 41.9% of extremely preterm infants, its development is favored by exposure of immature lungs to direct (congenital pneumonia, amniotic fluid aspiration) and indirect (severe perinatal hypoxia with ischemia, shock, hemorrhagic syndrome) damaging factors. Morphological signs of ARDS were most often found in newborns with congenital pneumonia, asphyxia, neonatal aspiration of amniotic fluid.

scholarly journals Successful Extracorporeal Membrane Oxygenation in the Management of Acute Respiratory Distress Syndrome and Cardiopulmonary Collapse Secondary to Amniotic Fluid Embolism

2019 ◽  
Author(s):  
Sumon Roy ◽  
Nishit Biniwale ◽  
Venkata Pendela ◽  
Patricia Oates ◽  
Katrina Wojciechowski ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Extracorporeal Membrane Oxygenation ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Distress Syndrome ◽  
Amniotic Fluid Embolism ◽  
Successful Implementation ◽  
Membrane Oxygenation ◽  
First Case

Amniotic fluid embolism (AFE) is one of the most devastating complications of pregnancy that typically manifests as acute cardiopulmonary collapse during delivery or in the postpartum period. The potential role of extracorporeal membrane oxygenation (ECMO) as a management technique in severe cases of AFE remains largely unknown. In this report, we present the first case, to our knowledge, of successful implementation of ECMO as a life-saving measure in a case of hemorrhagic shock due to postpartum bleeding complicated by severe AFE leading to acute respiratory distress syndrome (ARDS) ultimately requiring tracheostomy. Hemodynamic decompensation is often rapid but transient in cases of severe AFE, and we recommend early consideration of ECMO implementation given its vital utility in these critical moments.

scholarly journals Synthetic surfactant with a recombinant surfactant protein C analogue improves lung function and attenuates inflammation in a model of acute respiratory distress syndrome in adult rabbits

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
J. Zebialowicz Ahlström ◽  
F. Massaro ◽  
P. Mikolka ◽  
R. Feinstein ◽  
G. Perchiazzi ◽  
...  
Keyword(s):  
Body Weight ◽  
Acute Respiratory Distress Syndrome ◽  
Lung Function ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Protein C ◽  
Distress Syndrome ◽  
Surfactant Protein ◽  
Lung Oedema ◽  
Surfactant Protein C

Abstract Aim In acute respiratory distress syndrome (ARDS) damaged alveolar epithelium, leakage of plasma proteins into the alveolar space and inactivation of pulmonary surfactant lead to respiratory dysfunction. Lung function could potentially be restored with exogenous surfactant therapy, but clinical trials have so far been disappointing. These negative results may be explained by inactivation and/or too low doses of the administered surfactant. Surfactant based on a recombinant surfactant protein C analogue (rSP-C33Leu) is easy to produce and in this study we compared its effects on lung function and inflammation with a commercial surfactant preparation in an adult rabbit model of ARDS. Methods ARDS was induced in adult New Zealand rabbits by mild lung-lavages followed by injurious ventilation (VT 20 m/kg body weight) until P/F ratio < 26.7 kPa. The animals were treated with two intratracheal boluses of 2.5 mL/kg of 2% rSP-C33Leu in DPPC/egg PC/POPG, 50:40:10 or poractant alfa (Curosurf®), both surfactants containing 80 mg phospholipids/mL, or air as control. The animals were subsequently ventilated (VT 8–9 m/kg body weight) for an additional 3 h and lung function parameters were recorded. Histological appearance of the lungs, degree of lung oedema and levels of the cytokines TNFα IL-6 and IL-8 in lung homogenates were evaluated. Results Both surfactant preparations improved lung function vs. the control group and also reduced inflammation scores, production of pro-inflammatory cytokines, and formation of lung oedema to similar degrees. Poractant alfa improved compliance at 1 h, P/F ratio and PaO2 at 1.5 h compared to rSP-C33Leu surfactant. Conclusion This study indicates that treatment of experimental ARDS with synthetic lung surfactant based on rSP-C33Leu improves lung function and attenuates inflammation.

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