CUTE RESPIRATORY DISTRESS syndrome (ARDS) was originally termed the adult respiratory distress syndrome because it resembled the clinical picture of infant respiratory distress syndrome (IRDS), and both exhibited hyaline membranes at autopsy. 1,2 Avery and Mead 3 first reported that lung surfactant quantity and activity were abnormal in infants with IRDS and surfactant replacement has subsequently become standard therapy for premature infants at risk for or having IRDS. Petty and Ashbaugh 2 described qualitative and quantitative surfactant deficiencies in their initial description of ARDS and the subsequent scientific literature (recently reviewed by Notter 4) has supported the role of surfactant dysfunction in both ARDS and less severe acute lung injury (ALI). 5 Surfactant replacement in ARDS and ALI has been Author Affiliations and Participating Hospitals and Collaborating Investigators are listed at the end of this article. Financial Disclosures: Dr Willson has received research grants from ONY Inc (Amherst, NY). Dr Egan is president and equity owner of ONY Inc.
The mortality rate in pediatric septic shock is lower than has been previously reported. Oncologic illness in the absence of bone marrow transplantation does not appear to be associated with an increased mortality rate in children with septic shock. Bone marrow transplantation patients have an increased mortality rate compared with other patients with septic shock. Mortality from septic shock occurs most frequently in the context of multiple organ system failure.
This article details how computers have changed life for those of us in pediatric intensive care. A week of clinical activity is described, with a focus on the interactions with computer systems that have become an integral part of patient-care activities for many of us. It becomes clear that the boundaries between personal computers, hospital systems, and the Internet are often not sharply defined. Resources that are used every week may include those residing on a personal digital assistant, on the hospital's electronic medical record, or on a distant site on the World Wide Web. Key resources on the Internet (World Wide Web and e-mail) are identified. The technical underpinnings, particularly the network that provides the infrastructure for various resources, are described.
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