Mechanical Ventilation in the Respiratory Distress Syndrome: A Controlled Trial

Murdock, A. I.; Linsao, L.; Reid, M; Sutton, M. D.; Tilak, K. S.; Ulan, O. A.; Swyer, Paul R.

doi:10.1136/adc.45.243.624

Cited by 41 publications

(18 citation statements)

References 21 publications

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“…Reid et al (1967) showed a significantly lower mortality among ventilated infants 1000-2000 g compared with controls, though numbers particularly of very low birthweight infants (<1500 g), were small. Murdock et al (1970) on the other hand were only able to show such benefit for infants over 2000 g. Since these early studies were published refinements in ventilator technique have been made (Reynolds, 1975), means of ventilation which can sometimes avoid endotracheal intubation such as the use of a tightly fitting face mask, or a negative pressure respirator have been devised, and continuous positive airway pressure (Gregory et al, 1971) has been introduced. The latter may reduce the need for mechanical ventilation both in hyaline membrane disease and in recurrent apnoea.…”

Section: Discussionmentioning

confidence: 99%

Neurological sequelae in children surviving mechanical ventilation in the neonatal period.

Marriage¹,

Davies²

1977

Archives of Disease in Childhood

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Section: Discussionmentioning

confidence: 99%

Neurological sequelae in children surviving mechanical ventilation in the neonatal period.

Marriage¹,

Davies²

1977

Archives of Disease in Childhood

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“…A few years later, CPAP was found to reduce minute ventilation and improve oxygenation in neonates with RDS (32)(33)(34)(35)(36)(37). While Ashbaugh and colleagues (31) attributed the beneficial effect of PEEP to its ability to reopen or recruit atelectatic alveoli and prevent alveolar collapse at end-exhalation (problems that they related to abnormalities in surfactant, see below), others have suggested that the decrease in cardiac output produced by PEEP is responsible for both the reduction in shunt and the increase in high V A /Q regions and dead space that occurs.…”

Section: Effects Of Peepmentioning

confidence: 99%

Gas Exchange in the Respiratory Distress Syndromes

Albert

Jobe

2012

Comprehensive Physiology

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This article describes the gas exchange abnormalities occurring in the acute respiratory distress syndrome seen in adults and children and in the respiratory distress syndrome that occurs in neonates. Evidence is presented indicating that the major gas exchange abnormality accounting for the hypoxemia in both conditions is shunt, and that approximately 50% of patients also have lungs regions in which low ventilation-to-perfusion ratios contribute to the venous admixture. The various mechanisms by which hypercarbia may develop and by which positive end-expiratory pressure improves gas exchange are reviewed, as are the effects of vascular tone and airway narrowing. The mechanisms by which surfactant abnormalities occur in the two conditions are described, as are the histological findings that have been associated with shunt and low ventilation-to-perfusion.

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“…In 1967, Reid et al [17] reported that more infants with respiratory distress syndrome (RDS) survived if they were randomised to IPPV than to 'a modified Usher regimen' (O 2 and IV NaHCO 3 and glucose) between 3 and 6 h of age (8/10 survivors compared to 2/10). In 1970, Murdock et al [18] reported the results of a randomised comparison of ventilation with various different machines (including a negative pressure ventilator) and supplemental ambient O 2 for 221 outborn infants with RDS. Survival increased significantly amongst ventilated infants 6 33 weeks' gestation (36/92 vs. 6/26); no difference was seen amongst less mature infants.…”

Section: Respiratory Support For Extremely Preterm/elbw Infantsmentioning

confidence: 99%

‘Resuscitation’ of Extremely Preterm and/or Low-Birth-Weight Infants – Time to ‘Call It’?

O’Donnell¹

2008

Neonatology

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Since ancient times, various methods have been used to revive apparently stillborn infants; many were of dubious efficacy and had the potential to cause harm. Based largely on studies of acutely asphyxiated term animal models, clinical assessment and positive pressure ventilation have become the cornerstones of neonatal resuscitation over the last 40 years. Over the last 25 years, care of extremely preterm infants in the delivery room has evolved from a policy of indifference to one of increasingly aggressive support. The survival of these infants has improved considerably in recent years; this has not, however, necessarily been due to more aggressive resuscitation. Urban myths have evolved that all extremely preterm infants died before they were intubated, and that all such infants need to immediately intubated or they will quickly die. This has never been true. Clinical assessment of infants at birth is subjective. Also, many techniques used to support preterm infants at birth have not been well studied and there is evidence that they may be harmful. It may thus be argued that many of our well-intentioned resuscitation interventions are of dubious efficacy and have the potential to cause harm. ‘Resuscitation’ is an emotive term which means ‘restoration of life’. Death, thankfully, is a rare presentation in the delivery room. Therefore, concerning neonatal ‘resuscitation’, it is time to ‘call it’ something else. This will allow us to dispassionately distinguish preterm infants who are dead, or nearly dead, from those who are merely at high risk of parenchymal lung disease. We may then be able to refine our interventions and determine what methods of support benefit these infants most.

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Mechanical Ventilation in the Respiratory Distress Syndrome: A Controlled Trial

Abstract: (1970). Archives

Cited by 41 publications

References 21 publications

Neurological sequelae in children surviving mechanical ventilation in the neonatal period.

Neurological sequelae in children surviving mechanical ventilation in the neonatal period.

Gas Exchange in the Respiratory Distress Syndromes

‘Resuscitation’ of Extremely Preterm and/or Low-Birth-Weight Infants – Time to ‘Call It’?

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