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Respiratory Complications: Acute Respiratory Distress Syndrome, Chylothorax, Diaphragmatic Palsy, and Functional and Respiratory Physiotherapy

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Critical Care of Children with Heart Disease
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Abstract

Acute respiratory distress syndrome (ARDS), also called noncardiogenic pulmonary edema, is an uncommon postoperative complication after pediatric cardiac surgery, heart transplantation, and cardiopulmonary bypass. Several large prospective trials studying ARDS in medical and surgical patients have been completed, but postoperative cardiac patients were not specifically studied. Despite this, it is necessary for those caring for critically ill children with heart disease to understand the pathophysiology, clinical course, and therapies used to treat ARDS.

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References

  1. Bernard GR, Artigas A, Brigham KL, et al. The American-European Consensus conference on ARDS: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med. 1994;159:818–824.

    Google Scholar 

  2. Brower RG, Matthay MA, Morris A, et al. National Heart, Lung and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung inury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–1308.

    Article  Google Scholar 

  3. Amato MBP, Barbas CSV, Medeiros DM, et al. Effect of protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998;338:347–54.

    Article  PubMed  CAS  Google Scholar 

  4. Curley MA, Hibbard PL, Fineman LD, et al. Effect of prone positioning on clinical outcomes in children with acute lung injury. JAMA. 2005;294:229–237.

    Article  PubMed  CAS  Google Scholar 

  5. Arnold JH, Hanson JH, Toro-Figuero LO, et al. Prospective, randomized comparison of high-frequency oscillatory ventilation and conventional mechanical ventilation in pediatric respiratory falure. Crit Care Med. 1994;22:1530–1539.

    PubMed  CAS  Google Scholar 

  6. Dellinger RP, Zimmerman JL, Taylor RW, et al. Effects on inhaled nitric oxide in patients with acute respiratory distress syndrome: results of a randomized, phase II trial. Inhaled Nitric Oxide in ARDS Study Group. Crit Care Med. 1998;26:15–23.

    Article  PubMed  CAS  Google Scholar 

  7. Willson DF, Thomas NJ, Markovitz BP, et al. Effect of exogenous surfactant (calfactant) in pediatric acute lung injury: a randomized controlled trial. JAMA. 2005;293:473–476.

    Article  Google Scholar 

  8. Bernard GR, Luce JM, Sprung CL, et al. High-dose corticosteroids in patients with adult respiratory distress syndrome. N Engl J Med. 1987;317:1565–1570.

    Article  PubMed  CAS  Google Scholar 

  9. Bone RC, Fisher CJ Jr, Clemmer TP, et al. Early methylprednisolone treatment for septic syndrome and the adult respiratory distress syndrome. Chest. 1987;92:1032–1036.

    Article  PubMed  CAS  Google Scholar 

  10. Luce JM, Montgomery AB, Marks JD, et al. Ineffectiveness of high-dose methylprednisolone in preventing parenchymal lung injury and improving mortality in patients with septic shock. Am Rev Respir Dis. 1988;138:62–68.

    Article  PubMed  CAS  Google Scholar 

  11. Weigelt JA, Norcross JF, Borman KR, et al. Early steroid therapy for respiratory failure. Arch Surg. 1985;120:536–540.

    Article  PubMed  CAS  Google Scholar 

  12. Meduri GU, Belenchia JM, Estes RJ, et al. Fibroproliferative phase of ARDS: clinical findings and effects of corticosteroids. Chest. 1991;100:942–952.

    Google Scholar 

  13. Meduri GU, Headley AS, Golden E, et al. Effect of prolonged methylprednisolone therapy in unresolving acute respiratory distress syndrome: a randomized controlled trial. JAMA. 1998;280:159–165.

    Article  PubMed  CAS  Google Scholar 

  14. Steinberg KP, Hudson LD, et al. National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Efficacy and safety of corticosteroids for persistent acute respiratory distress syndrome. N Engl J Med. 2006;354:1671–1684.

    Article  PubMed  CAS  Google Scholar 

  15. Chan SY, Lau W, Wong WH, et al. Chylothorax in children after congenital heart surgery. Ann Thorac Surg. 2006;82:1650–1656; Landvoigt MT, Mullet CJ. Octreotide efficacy in the treatment of chylothoraces following cardiac surgery in infants and children. Pediatr Crit Care Med. 2006;7:245–248.

    Article  PubMed  Google Scholar 

  16. Landvoigt MT, Mullet CJ. Octreotide efficacy in the treatment of chylothoraces following cardiac surgery in infants and children. Pediatr Crit Care Med. 2006;7:245–248.

    Article  PubMed  Google Scholar 

  17. Marts BC, Naunheim KS, Fiore AC, Pennington DG. Conservative versus surgical management of chylothorax. Am J Surg. 1992;164:523–524.

    Article  Google Scholar 

  18. Akay TH, Ozkan S, Gultekin B, et al. Diaphragmatic paralysis after cardiac surgery in children: incidence, prognosis, and surgical management. Pediatr Surg Int. 2006;22:341–346.

    Article  PubMed  Google Scholar 

  19. Lemmer J, Stiller B, Heise G. Postoperative phrenic nerve palsy: early clinical implications and management. Intensive Care Med. 2006;32:1227–1233.

    Article  PubMed  Google Scholar 

  20. Placidi G, Cornacchia M, Polese G, et al. Chest physiotherapy with positive airway pressure: a pilot study of short-term effects on sputum clearance in patients with cystic fibrosis and severe airway obstruction. Respir Care. 2006;51:1145–1153.

    PubMed  Google Scholar 

  21. Dohna-Schwake C, Ragette R, Teschler H. IPPB-assisted coughing in neuromuscular disorders. Pediatr Pulmonol. 2006;41:551–557.

    Article  PubMed  Google Scholar 

  22. Homnick DN. Mechanical insufflation-exsufflation for airway mucus clearance. Respir Care. 2007;52:1296–1305.

    PubMed  Google Scholar 

  23. LB Ware, Matthay MA. The acute respiratory distress syndrome. N Engl J Med. 2000;342:1339.

    Article  Google Scholar 

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Correspondence to Jennifer Exo .

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Exo, J., Muñoz, R. (2009). Respiratory Complications: Acute Respiratory Distress Syndrome, Chylothorax, Diaphragmatic Palsy, and Functional and Respiratory Physiotherapy. In: Munoz, R., Morell, V., Cruz, E., Vetterly, C. (eds) Critical Care of Children with Heart Disease. Springer, London. https://doi.org/10.1007/978-1-84882-262-7_56

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  • DOI: https://doi.org/10.1007/978-1-84882-262-7_56

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  • Online ISBN: 978-1-84882-262-7

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