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Acute respiratory failure

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https://www.readbyqxmd.com/read/27908313/-epiphrenic-oesophageal-diverticulum-with-an-oesophagobronchial-fistula-resulting-in-a-lung-abscess
#1
Malene Børgager, Shadi Andos, Jesper Durup, Peter Bjørn Licht
Epiphrenic oesophageal diverticula are rare and often asymptomatic. In this case report a 58-year-old woman was diagnosed with an epiphrenic oesophageal diverticulum, which developed an oesophagobronchial fistula leading to a pulmonary abscess in the right lower lobe, septicaemia and acute respiratory failure. The patient underwent right lower lobectomy and the diverticulum was stapled off the oesophagus. The post-operative course was uneventful. This complication is only rarely described previously.
November 21, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#2
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27905694/high-flow-oxygen-therapy-in-adult-critically-ill-patients
#3
Lorenzo Del Sorbo, Alice Vendramin, Sangeeta Mehta
High flow oxygen therapy is characterized for its ability to meet or exceed the high peak inspiratory flow of the patients with acute respiratory failure. Despite the lack of definitive evidence regarding its efficacy in improving clinically significant outcomes, its application has been rapidly spreading over the last decade. In this review we discuss the potential physiologic mechanisms of benefit as well as the most recent clinical trials investigating its role in adult critically ill patient.
December 1, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#4
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#5
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#6
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#7
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27896329/myasthenia-gravis-with-acute-respiratory-failure-in-the-emergency-department
#8
Hasan Huseyin Kozak, Ali Ulvi Uca, Turgut Teke, Mustafa Altas, Emine Karatas
Acute respiratory failure (ARF) is defined as a sudden malfunction in the ability of respiratory system to maintain adequate gas exchange. Acute hypercapnic respiratory failure develops as a result of ventilation deficiency and it is defined as an increase of PaCO2 above 45 mmHg. Myasthenia Gravis (MG) is a sporadically developing auto-immune deficiency where the neuro-muscular transmission is affected and it is one of the important reasons for neurologically-induced respiratory distress. Here, we report a case of a 75-year-old male patient previously undiagnosed MG, who presented with ARF...
June 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27894507/do-simple-beside-lung-function-tests-predict-morbidity-after-rib-fractures
#9
Christopher A Butts, John J Brady, Sara Wilhelm, Laura Castor, Alicia Sherwood, Abby McCall, John Patch, Pamela Jones, Vicente Cortes, Adrian W Ong
BACKGROUND: We evaluated if incentive spirometry volume (ISV) and peak expiratory flow rate (PEFR) could predict acute respiratory failure (ARF) in patients with rib fractures. METHODS: Normotensive, co-operative patients were enrolled prospectively. ISV and PEFR were measured on admission, at 24 h and at 48 h by taking the best of three readings each time. The primary outcome, ARF, was defined as requiring invasive or noninvasive positive pressure ventilation...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27893506/the-hospital-course-of-a-successfully-treated-patient-with-respiratory-failure-beginning-to-end
#10
T Brian Callister
The successful treatment of a patient with acute respiratory failure is a complex undertaking that requires clinical competence, evidence-based interventions, seamless coordination of care transitions, and transparent open communication among all members of the health care team. Many of the processes of care in these critically ill patients are reassuringly consistent across services, across hospitals, across health systems, and even across the country. Although the clinical course of such complicated patients can be extremely unpredictable, we are fortunate that the professional, technical, and psychosocial aspects of care for these patients can be relatively orderly, evidence-based, and transparent...
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27892925/a-mouse-model-for-mers-coronavirus-induced-acute-respiratory-distress-syndrome
#11
Adam S Cockrell, Boyd L Yount, Trevor Scobey, Kara Jensen, Madeline Douglas, Anne Beall, Xian-Chun Tang, Wayne A Marasco, Mark T Heise, Ralph S Baric
Middle East respiratory syndrome coronavirus (MERS-CoV) is a novel virus that emerged in 2012, causing acute respiratory distress syndrome (ARDS), severe pneumonia-like symptoms and multi-organ failure, with a case fatality rate of ∼36%. Limited clinical studies indicate that humans infected with MERS-CoV exhibit pathology consistent with the late stages of ARDS, which is reminiscent of the disease observed in patients infected with severe acute respiratory syndrome coronavirus. Models of MERS-CoV-induced severe respiratory disease have been difficult to achieve, and small-animal models traditionally used to investigate viral pathogenesis (mouse, hamster, guinea-pig and ferret) are naturally resistant to MERS-CoV...
November 28, 2016: Nature Microbiology
https://www.readbyqxmd.com/read/27892596/extracorporeal-membrane-oxygenation-support-in-trauma-versus-nontrauma-patients-with-noninfectious-acute-respiratory-failure
#12
Hyoung Soo Kim, Sang Ook Ha, Sang Jin Han, Hyun-Sook Kim, Sun Hee Lee, Ki-Suck Jung, Sunghoon Park
The utility of extracorporeal membrane oxygenation (ECMO) in patients with acute respiratory distress syndrome (ARDS) of noninfectious origin remains unclear. Data on patients with ARDS of noninfectious origin who underwent ECMO were reviewed retrospectively. We compared the pre-ECMO characteristics and hospital outcomes of patients with traumatic and nontraumatic ARDS. In total, 23 patients (trauma, n = 9; nontrauma, n = 14) were included in the study. The mean patient age was 42 years, there were three females, and the mean pre-ECMO Simplified Acute Physiologic Score (SAPS) II was 60...
November 28, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27891260/intravenous-vitamin-c-administered-as-adjunctive-therapy-for-recurrent-acute-respiratory-distress-syndrome
#13
Amit Bharara, Catherine Grossman, Daniel Grinnan, Aamer Syed, Bernard Fisher, Christine DeWilde, Ramesh Natarajan, Alpha A Berry Fowler
This case report summarizes the first use of intravenous vitamin C employed as an adjunctive interventional agent in the therapy of recurrent acute respiratory distress syndrome (ARDS). The two episodes of ARDS occurred in a young female patient with Cronkhite-Canada syndrome, a rare, sporadically occurring, noninherited disorder that is characterized by extensive gastrointestinal polyposis and malabsorption. Prior to the episodes of sepsis, the patient was receiving nutrition via chronic hyperalimentation administered through a long-standing central venous catheter...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27891001/rigid-bronchoscopic-management-of-acute-respiratory-failure-in-a-30-year-old-woman
#14
Karan Madan, Ashesh Dhungana, Neha Kawatra Madan, Anant Mohan, Vijay Hadda, Rakesh Garg, Deepali Jain, Randeep Guleria
A 30-year-old woman presented with a history of progressive shortness of breath, cough, and hoarseness. Stridor was audible on examination. Chest X-ray showed normal lung fields and contrast-enhanced computed tomography thorax showed lower tracheal occlusion with endoluminal growth. Diagnostic flexible bronchoscopy demonstrated multiple whitish glistening nodules over both vocal cords and lower tracheal occlusion by whitish nodular growth. In view of critical central airway obstruction, rigid bronchoscopy and excision of the lower tracheal growth were performed...
November 2016: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/27890033/il-8-il-17-gene-variations-and-the-susceptibility-to-severe-viral-bronchiolitis
#15
L A Pinto, L A DE Azeredo Leitão, M Mocellin, P Acosta, M T Caballero, R Libster, J E Vargas, F Polack, T Comaru, R T Stein, A P DE Souza
Clinical manifestations of acute bronchiolitis (AB) vary from minimal disease to severe respiratory failure. The response to respiratory viral infections is possibly influenced by genetic polymorphisms linked to the regulation of the inflammatory response. In the present study, we investigated whether interleukin-8 (IL-8) and interleukin-17 (IL-17) genetic variants are associated with the severity of AB. A group of Brazilian infants hospitalized with AB and a control group (infants with no or mild AB, without hospitalization) were genotyped for four IL-8/IL-17 variations...
November 28, 2016: Epidemiology and Infection
https://www.readbyqxmd.com/read/27889372/-non-invasive-ventilation-in-children-do-we-need-more-evidence
#16
G Mortamet, G Emeriaud, P Jouvet, B Fauroux, S Essouri
Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care...
November 23, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27888983/high-flow-nasal-cannula-versus-conventional-oxygen-therapy-and-non-invasive-ventilation-in-adults-with-acute-hypoxemic-respiratory-failure-a-systematic-review
#17
REVIEW
Chi Chan Lee, Dhruti Mankodi, Sameer Shaharyar, Sharmila Ravindranathan, Mauricio Danckers, Pablo Herscovici, Molly Moor, Gustavo Ferrer
INTRODUCTION: Humidified oxygen via a high flow nasal cannula (HFNC) is a form of supplemental oxygen therapy that has significant theoretical advantages over conventional oxygen therapy (COT). However, the clinical role of HFNC in acute hypoxemic respiratory failure (AHRF) has not been well established. This review compares the efficacy of HFNC with COT and non-invasive ventilation (NIV) in patients with AHRF. METHODS: Studies reviewed were selected based on relevance from a systematic literature search conducted in Medline and EMBASE to include all published original research through May 2016...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27888814/diaphragmatic-dysfunction-after-thoracic-operations
#18
Henning Gaissert, Susan R Wilcox
The perioperative management of diaphragmatic weakness and phrenic nerve dysfunction is complex, due to varied etiologies and clinical presentations. The factors leading to diaphragmatic weakness may culminate after the operation with transient or persistent respiratory failure. This review discusses diaphragmatic disorders and postoperative respiratory failure caused by unilateral or bilateral diaphragmatic impairment. The origins of neuromuscular weakness involving the diaphragm are diverse, and often lie within the domains of different medical specialties, with only a portion of the condition related to surgical intervention...
November 26, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/27888550/mesenchymal-stem-stromal-cells-biology-and-preclinical-evidence-for-therapeutic-potential-for-organ-dysfunction-following-trauma-or-sepsis
#19
Michael A Matthay, Shibani Pati, Jae-Woo Lee
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have anti-microbial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients...
November 26, 2016: Stem Cells
https://www.readbyqxmd.com/read/27882252/sj%C3%A3-gren-s-syndrome-complicated-by-myeloid-natural-killer-cell-precursor-acute-leukemia-case-report-and-review-of-the-literature
#20
Hao Feng, Jianlin Qiao, Ningning Ding, Wei Chen, Kunming Qi, Xiuying Pan, Jiang Cao, Kailin Xu
We report a case of Sjögren's syndrome (SS) complicated by myeloid/natural killer (NK) cell precursor acute leukemia (M/NKPAL). A 75-year-old woman with a previous SS history for 2 years was routinely treated. Peripheral blood progenitor cells were increased, and subsequent bone marrow cell morphology examination showed the presence of acute myeloid leukemia type M4. However, flow cytometry analysis revealed that CD7/CD56/CD33/CD34/HLA-DR/cCD3 were all positive and myeloperoxidase- (MPO-) specific staining, other T cells, NK cells, and myeloid markers were all negative...
2016: Case Reports in Hematology
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