Recognition and treatment of adult respiratroy distress syndrome secondary to viral interstitial pneumonia.

Four cases of adult respiratory distress syndrome secondary to viral interstital pneumonia were treated successfully. The illnesses started with a prodrome of upper respiratory symptoms. The development of dyspnea was a key symptom from which point respiratory failure developed within 24 to 48 hours. Chest roentgenograms showed alveolar infiltrative patterns which later became coalescent. The clinical course consisted of fever, dyspnea, hypoxia and acidosis, There was no response to therapy with antibiotics, 100 per cent oxygen by mask and intermittent positive pressure breathing (IPPB) over the first 24 hours. Supportive therapy then initiated included endotracheal intubation, the administration of humidified oxygen by volume cycled respirator with positive end expiratory pressures of 10 to 15 cm H2O and corticosteroids. It is concluded that early recognition of the syndrome, coupled with prompt insituition of aggressive supportive respiratory management may be lifesaving in patints with severe interstitial pneumonia.