Treatment of severe acute respiratory distress syndrome: a final report on a phase I study.
Adult respiratory distress syndrome (ARDS) has a high mortality. Its only effective treatment is respiratory therapy. If this fails mortality is probably 100 per cent. No other treatment for ARDS has proved effective including "magic bullets." Twenty patients suffering from ARDS secondary to trauma and/or sepsis failed to respond to treatment with mechanical ventilation and positive end-expiratory pressure. On the assumption that disseminated intravascular coagulation initiates ARDS by occluding the pulmonary microcirculation with microclots, the patients were treated with plasminogen activators. The patients responded with significant improvement in partial pressure of oxygen in arterial blood. No bleeding occurred and clotting parameters remained normal. We conclude that ARDS can be safely treated with plasminogen activator.
Hardaway
R M
RM
Department of Surgery, Texas Tech University School of Medicine, El Paso 79902, USA.
Harke
H
H
Tyroch
A H
AH
Williams
C H
CH
Vazquez
Y
Y
Krause
G F
GF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001784:Blood Gas Analysis; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications; D010100:Oxygen / Q000097:blood; D010960:Plasminogen Activators / Q000494:pharmacology / Q000627:therapeutic use*; D012121:Respiration, Artificial; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000401:mortality; D018805:Sepsis / Q000150:complications; D012720:Severity of Illness Index; D013300:Streptokinase / Q000494:pharmacology / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000494:pharmacology / Q000627:therapeutic use*
D013300:Streptokinase; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator; D010100:Oxygen