ABSTRACT
Management of respiratory failure in acute respiratory distress syndrome (ARDS) typically requires ventilatory assistance. If traditional approaches to mechanical ventilation and adjunctive measures fail to succeed in achieving adequate oxygenation, alternative measures should be considered. We describe an ARDS patient with respiratory failure caused by a severe Chlamydiaceae species community-acquired pneumonia (CAP). Aerosolized prostacyclin (PGI(2)) treatment was successfully instituted for refractory hypoxemia.
Subject(s)
Chlamydiaceae Infections/drug therapy , Epoprostenol/therapeutic use , Platelet Aggregation Inhibitors/therapeutic use , Pneumonia, Bacterial/drug therapy , Respiratory Distress Syndrome/drug therapy , Administration, Inhalation , Humans , Male , Middle Aged , Pneumonia, Bacterial/microbiology , Respiratory Distress Syndrome/microbiologyABSTRACT
Studies were performed to determine the DNA interactions of and the induction of cytotoxic effects by the radical cation (CPZ+.) formed enzymatically from chlorpromazine (CPZ): in the presence of native DNA the lifetime of CPZ+. is markedly increased. The decreased reactivity of CPZ+. in the presence of native DNA and the concomitant increased viscosity of CPZ+.-DNA complexes strongly support the assumption that CPZ+. does form intercalation complexes with DNA. The relative strong bacteriotoxicity of CPZ+. hindered the accurate determination of mutagenesis in various Salmonella indicator strains, but a test for repairable DNA damage in Escherichia coli using various repair-deficient strains indicated that the cytotoxic action of CPZ+. is in part due to DNA alterations which can be excised in wild-type DNA repair-proficient strains. After activation of CPZ with long wavelength UV light, genetic effects are observed in S. typhimurium strain TA98, as well as in the E. coli tester strains. The possible role of CPZ+. in the photosensitization of CPZ is discussed.
