• Tuberculosis and Respiratory Diseases
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• v.40 no.2
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• pp.91-97
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• 1993

Pulmonary surfactant is a lipoprotein complex composed primarily of phospholipid and lung specific apoproteins that reduces surface tension in the alveolus and maintains alveolar stability at low lung volume. Adult respiratory distress syndrome still carries a very high morbidity and mortality. The surfactant system is vital to the maintenance of proper lung function, any type of surfactant deficiency, whether primary or secondary, will contribute significantly to the development of pulmonary pathophysiology. Various mechanisms in adult respiratory distress syndrome may be responsible for such alterations in the surfactant system. Surfactant replacement is now an established treatment for neonatal respiratory distress syndrome, reducing both incidence of complications and mortality. With the current knowledge of surfactant physiology and the pathophysiology of the adult respiratory distress syndrome exogenous surfactant treatment or stimulation of endogenous surfactant synthesis and secretion will prove to be beneficial in preventing and treating the adult respiratory distress syndrome. The study of clinical surfactant therapy for adult respiratory distress syndrome is just beginnig and this can be viewed as an area with exciting potential. As soon as surfactant preparations become more widely available trials should begin to define the role of surfactant treatment in the adult respiratory distress syndrome as an adjunct to available treatment techniques.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.1-6
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• 2010

Transient tachypnea of the newborn (TTN), respiratory distress syndrome (RDS), and persistent pulmonary hypertension of the newborn (PPHN) are the three most common disorders that cause respiratory distress after birth. An understanding of the pathophysiology of these disorders and the development of effective therapeutic strategies is required to control these conditions. Here, we review recent papers on the pathogenesis and treatment of neonatal respiratory disease.

• Tuberculosis and Respiratory Diseases
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• v.79 no.3
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• pp.188-192
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• 2016

Antisynthetase syndrome has been recognized as an important cause of autoimmune inflammatory myopathy in a subset of patients with polymyositis and dermatomyositis. It is associated with serum antibody to aminoacyl-transfer RNA synthetases and is characterized by a constellation of manifestations, including fever, myositis, interstitial lung disease, mechanic's hand-like cutaneous involvement, Raynaud phenomenon, and polyarthritis. Lung disease is the presenting feature in 50% of the cases. We report a case of a 60-year-old female with acute respiratory distress syndrome (ARDS), which later proved to be an unexpected and initial manifestation of anti-Jo-1 antibody-positive antisynthetase syndrome. The present case showed resolution of ARDS after treatment with high-dose corticosteroids. Given that steroids are not greatly beneficial in the treatment of ARDS, it is likely that the improvement of the respiratory symptoms in this patient also resulted from the prompt suppression of the inflammatory systemic response by corticosteroids.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.357-360
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• 2022

Patients with severe coronavirus disease 2019 (COVID-19) acute respiratory distress syndrome (ARDS) may exhibit pulmonary fibrosis after the viral illness resolves. Some of these patients may experience severe functional lung impairment, and thus require transplants to prevent death or maintain a tolerable quality of life. Considering the reversibility of COVID-19 ARDS, lung transplant candidates are observed for 1-2 months and must be selected very carefully before transplantation. As the short-term outcomes of such patients are comparable to those of patients with other indications for transplantation, lung transplantation should be actively considered.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.1-7
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• 2012

Extracorporeal Membrane Oxygenation (ECMO) support to tissue oxygenation has been shown to improve survival in patients with life threatening respiratory distress syndrome or cardiac failure. Extracorporeal life support such as ECMO, including extracorporeal $CO_2$ removal ($ECCO_2R$), is used as temporary support until successful recovery of organs. A recently published multicentre randomized controlled trial, known as the CESAR (conventional ventilation or extracorporeal membrane oxygenation for severe adult respiratory failure) trial, was the first trial to demonstrate the utility of ECMO in acute respiratory distress syndrome (ARDS). During the 2009 influenza A (H1N1) pandemic, there were many reports of patients with severe ARDS related to H1N1 infection treated with ECMO. These reports revealed a high survival rate and effectiveness of ECMO. In this review, we explain the indication of ECMO clinical application, the practical types of ECMO, and complications associated with ECMO. In addition, we explain recent new ECMO technology and management of patients during ECMO support.

• Tuberculosis and Respiratory Diseases
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• v.79 no.2
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• pp.53-57
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• 2016

Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

• Journal of Chest Surgery
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• v.32 no.1
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• pp.38-42
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• 1999

Background: In neonatal respiratory distress syndrome patients, various types of pulmonary air leak contributes to elevate morbity and mortality. Although early surgical interventions can provide better results in several cases, whole clinical outcomes are poor. This study was designed to investigate the clinical aspects of pulmonary air leak in the neonatal respiratory distress syndrome patients and major contributing factors to mortality. Material and Method : We retrospectively evaluated 48 cases of pulmonary air leak in the neonatal respiratory distress syndrome patients from September 1994 to May 1997. Result: There were 15 cases of primary and 33 cases of secondary pulmonary air leakages. The prominent manifestations were pure interstitial emphysema in 19 cases(39.9%) and combined pneumothorax in 19 cases(39.9%). In clinical aspects, normal birth weight was dominant(83.4%), the onset occurred within 24 hours was in 28 cases(58.8%). The pulmonary diseases were meconium aspiration syndrome(25.2%) and hyaline membrane disease(33.2%). The overall hospital mortality was 25.2%, and the majority were hyaline membrane diseases. Conclusion: Although the overral mortality rate of these diseases were high, more detailed studies about immediate treatement, perinatal prevention, intensive care to geriatric problems were needed individually to improve outcomes.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.64-67
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• 2017

A 52-year-old male patient who underwent multiple wedge resections experienced postoperative acute respiratory distress syndrome in both lungs after Viscum album pleurodesis. Despite initial rapid deterioration in clinical condition and rapid progression of bilateral lung infiltration, he exhibited a relatively smooth clinical recovery with marked response to glucocorticoid treatment. Our case report suggests that care must be taken to guard against the development of acute respiratory complications in the use of Viscum album for pleurodesis. However, in view of the clinically benign course, initial aggressive management of complications can prevent suffering and sequelae.

• Annals of Geriatric Medicine and Research
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• v.22 no.4
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• pp.200-203
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• 2018

Strongyloides stercoralis is an intestinal nematode that occurs sporadically in temperate areas like Korea. People who are in the immunosuppressed state, over the age of 65 or under the corticosteroid therapy are at risk for developing Strongyloides hyperinfection syndrome. Acute respiratory distress syndrome (ARDS) with alveolar hemorrhage is a rare presentation of Strongyloides hyperinfection. A 78-year-old man had been irregularly injected corticosteroid on his knees, but did not have any immunosuppressive disease. He was initially diagnosed with ARDS and septic shock. Bronchoalveolar lavage (BAL) fluid was bloody and its cytology revealed helminthic larvae identified as S. stercoralis. Results of Cytomegalovirus polymerase chain reaction (PCR), Pneumocystis jirovecii PCR, and Aspergillus antigen testing of the BAL fluid were positive. The clinical progress quickly deteriorated with multiple organ failure, shock and arrhythmia, so he finally died. This is a rare case of ARDS in an older patient without any known immunosuppressive conditions, with alveolar hemorrhage and S. stercoralis being found via BAL.

• Childhood Kidney Diseases
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• v.25 no.2
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• pp.122-127
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• 2021

C1q nephropathy is a rare glomerulopathy that typically presents with nephrotic syndrome in children. Treatment with immunosuppressive agents renders patients vulnerable to infection and its complications. Gastroenteritis is common in children, and rotavirus is a leading cause. Extraintestinal manifestations of rotavirus have recently been reported; however, there is a paucity of cases exploring the involvement of a rotavirus on the respiratory system. Acute respiratory distress syndrome (ARDS) is a rapid onset respiratory failure characterized by noncardiogenic pulmonary edema and hypoxemia. Causes of ARDS include sepsis, pneumonia, pancreatitis, aspiration, and trauma. In this paper, we report a case of ARDS after rotavirus infection in a child with C1q nephropathy who had been treated with immunosuppressive agents.