Patient Respiratory Status Research Articles

Acute respiratory failure Survival following ten days' support with a membrane lung

An 11-year-old boy with acute lymphoblastic leukemia in remission developed a bilateral pneumonia which rapidly progressed to acute respiratory failure. During 9 days of intensive therapy the patient's respiratory status progressively deteriorated. When it became impossible to maintain the arterial oxygen tension (PAO2) above 40 mm.Hg by conventional means, extracorporeal blood-gas exchange with a membrane lung was begun. After 5 days of bypass the patient's respiratory function began to improve, and he was weaned from the membrane lung on the tenth day. Seven days later he was discharged from the hospital and is currently in excellemt health 23 months after bypass. This perfusion, the longest successful effort to provide respiratory assist with a membrane lung, attests to the efficacy of this therapeutic modality.

SINGLE-LUNG TRANSPLANTATION IN EMPHYSEMA

A patient with severe bilateral emphysema has survived more than 31/2 months after receiving a single-lung allograft. At least seven presumed episodes of rejection were identified and reversed by massive pulsed intravenous doses of methyl prednisolone. When allograft rejection was controlled, no serious or progressive ventilation-perfusion imbalances occurred and the allograft provided the majority of effective ventilation and pulmonary blood-flow, with consequent improvement in the patient's respiratory status.

Simplified bedside evaluation of respiratory insufficiency.

What is needed to evaluate respiratory insufficiency? The essentials are simple—the physician's senses, his knowledge of chest wall and cardiovascular changes in insufficiency, a stethoscope, a 6 in. ruler, a box of matches, a tape measure, a De Bono whistle, and a sphygmomanometer. With these he can clinically assess and measure a patient's respiratory status.