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Acute Respiratory Failure in adults

Maxwell Osei-Ampofo, Alfred Aidoo, Akwasi Antwi-Kusi, Obiageli Joan Ofungwu, Solomon Nii-Kotey Kotey, Moses Siaw-Frimpong, Osuoji Chiedozie, Matthew J Tafoya, Torben K Becker
Introduction: Respiratory failure is commonly seen in African emergency centres and intensive care units, but little is known about the need for intubation and mechanical ventilation. Methods: From April to October 2017, we recorded the number of patients intubated and ventilated in the emergency centre and intensive care unit at Komfo Anokye Teaching Hospital in Kumasi, Ghana on a daily basis. We assessed patients for presence of acute respiratory distress syndrome (ARDS) using the Kigali Modification of the Berlin ARDS criteria...
December 2018: African Journal of Emergency Medicine Revue Africaine de la Médecine D'urgence
Elie Azoulay, Djamel Mokart, Achille Kouatchet, Alexandre Demoule, Virginie Lemiale
Acute respiratory failure occurs in up to half of patients with haematological malignancies and 15% of those with solid tumours or solid organ transplantation. Mortality remains high. Factors associated with mortality include a need for invasive mechanical ventilation, organ dysfunction, older age, frailty or poor performance status, delayed intensive care unit admission, and acute respiratory failure due to an invasive fungal infection or unknown cause. In addition to appropriate antibacterial therapy, initial clinical management aims to restore oxygenation and predict the most probable cause based on variables related to the underlying disease, acute respiratory failure characteristics, and radiographic findings...
December 7, 2018: Lancet Respiratory Medicine
Timothee Bonifay, Christelle Prince, Clarisse Neyra, Magalie Demar, Dominique Rousset, Hatem Kallel, Mathieu Nacher, Félix Djossou, Loïc Epelboin
BACKGROUND: French Guiana (FG) was the first country in South America to declare chikungunya virus infection (CHIKV). The outbreak affected about 16,000 persons between February 2014 and October 2015, with several atypical cases, but only two fatal cases. We aimed to describe the clinical presentation of patients hospitalized for CHIKV infection, to estimate and identify risk factors of unusual and severe forms in adult patients. MATERIALS AND METHODS: A monocentric retrospective study was conducted in Cayenne hospital, the main city and the main hospital in FG, from March 1st 2014 to August 31st 2015...
2018: PloS One
Andrew J Boyle, Michael C Sklar, James J McNamee, Daniel Brodie, Arthur S Slutsky, Laurent Brochard, Daniel F McAuley
As a result of technical improvements, extracorporeal carbon dioxide removal (ECCO2 R) now has the potential to play an important role in the management of adults with acute respiratory failure. There is growing interest in the use of ECCO2 R for the management of both hypoxaemic and hypercapnic respiratory failure. However, evidence to support its use is scarce and several questions remain about the best way to implement this therapy, which can be associated with serious side-effects. This Review reflects the consensus opinion of an international group of clinician scientists with expertise in managing acute respiratory failure and in using ECCO2 R therapies in this setting...
November 2018: Lancet Respiratory Medicine
Charles Langelier, Katrina L Kalantar, Farzad Moazed, Michael R Wilson, Emily D Crawford, Thomas Deiss, Annika Belzer, Samaneh Bolourchi, Saharai Caldera, Monica Fung, Alejandra Jauregui, Katherine Malcolm, Amy Lyden, Lillian Khan, Kathryn Vessel, Jenai Quan, Matt Zinter, Charles Y Chiu, Eric D Chow, Jenny Wilson, Steve Miller, Michael A Matthay, Katherine S Pollard, Stephanie Christenson, Carolyn S Calfee, Joseph L DeRisi
Lower respiratory tract infections (LRTIs) lead to more deaths each year than any other infectious disease category. Despite this, etiologic LRTI pathogens are infrequently identified due to limitations of existing microbiologic tests. In critically ill patients, noninfectious inflammatory syndromes resembling LRTIs further complicate diagnosis. To address the need for improved LRTI diagnostics, we performed metagenomic next-generation sequencing (mNGS) on tracheal aspirates from 92 adults with acute respiratory failure and simultaneously assessed pathogens, the airway microbiome, and the host transcriptome...
November 27, 2018: Proceedings of the National Academy of Sciences of the United States of America
Lucile Regard, Clémence Martin, Guillaume Chassagnon, Pierre-Régis Burgel
Cystic fibrosis (CF) is a genetic disease that primarily affects the respiratory system and often leads to respiratory failure and premature death. Although pulmonary complications contribute to 85% of deaths, non-pulmonary complications are responsible for significant morbidity and mortality in adults with CF. Areas covered: This review summarizes acute and chronic non-pulmonary complications in CF patients, with emphasis on emerging complications and in the context of the current growth and aging of the CF adult population...
November 24, 2018: Expert Review of Respiratory Medicine
Yun-Ru Lai, Jr-Rung Lin, Wen-Neng Chang, Nai-Wen Tsai, Chih-Cheng Huang, Hung-Chen Wang, Yu-Jih Su, Wei-Che Lin, Ben-Chung Cheng, Chih-Min Su, Sheng-Yuan Hsiao, Chun-En Kuo, Cheng-Hsien Lu
BACKGROUND: Although corticosteroids are an effective anti-inflammatory adjuvant therapy, the role of adjunctive steroid therapy in treating adult bacterial meningitis in Taiwan remains controversial. METHODS: Cases of acute bacterial meningitis were identified from the annual hospitalization discharge claims of the National Health Insurance Research Database using International Classification of Diseases, Ninth Revision codes from January 2000 to December 2013...
November 19, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Shigeki Kushimoto, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Toru Hifumi, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando
BACKGROUND: Sepsis is a leading cause of death and long-term disability in developed countries. A comprehensive report on the incidence, clinical characteristics, and evolving management of sepsis is important. Thus, this study aimed to evaluate the characteristics, management, and outcomes of patients with severe sepsis in Japan. METHODS: This is a cohort study of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis, and Trauma (FORECAST) study, which was a multicenter, prospective cohort study conducted at 59 intensive care units (ICUs) from January 2016 to March 2017...
November 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
Shaur-Zheng Chong, Chih-Yuan Fang, Hsiu-Yu Fang, Huang-Chung Chen, Chien-Jen Chen, Cheng-Hsu Yang, Chi-Ling Hang, Hon-Kan Yip, Chiung-Jen Wu, Wei-Chieh Lee
BACKGROUND: Acute fulminant myocarditis (AFM) is a serious disease that progresses rapidly, and leads to failing respiratory and circulatory systems. When medications fail to reverse the patient's clinical course, extracorporeal membrane oxygenation (ECMO) is considered the most effective, supportive and adjunct strategy. In this paper we analyzed our experience in managing AFM with ECMO support. METHODS: During October 2003 and February 2017, a total of 35 patients (≥18 years) were enrolled in the study...
November 20, 2018: Journal of Clinical Medicine
Stavros Dimopoulos, Holly Joyce, Luigi Camporota, Guy Glover, Nicholas Ioannou, Christopher J Langrish, Andrew Retter, Christopher I S Meadows, Nicholas A Barrett, Stephen Tricklebank
OBJECTIVES: To investigate the safety of percutaneous dilatational tracheostomy in severe respiratory failure patients during veno-venous extracorporeal membrane oxygenation support. DESIGN: A single-center, retrospective, observational cohort study. SETTING: Tertiary referral severe respiratory failure center, university teaching hospital. PATIENTS: Severe respiratory failure patients consecutively admitted and supported with veno-venous extracorporeal membrane oxygenation between January 2010 and December 2015...
November 13, 2018: Critical Care Medicine
Sunkaru Touray, Baboucarr Sanyang, Gregory Zandrow, Isatou Touray
BACKGROUND: The Gambia is going through a rapid epidemiologic transition with a dual disease burden of infections and non-communicable diseases occurring at the same time. Acute, time-sensitive, medical emergencies such as trauma, obstetric emergencies, respiratory failure, and stroke are leading causes of morbidity and mortality among adults in the country.ProblemData on medical emergency care and outcomes are lacking in The Gambia. Data on self-reported medical emergencies among adults in a selection of Gambian communities are presented in this report...
November 15, 2018: Prehospital and Disaster Medicine
Qi-Wen Deng, Wen-Cheng Tan, Bing-Cheng Zhao, Shi-Hong Wen, Jian-Tong Shen, Miao Xu
BACKGROUND: Whether goal-directed fluid therapy based on dynamic predictors of fluid responsiveness (GDFTdyn) alone improves clinical outcomes in comparison with standard fluid therapy among patients undergoing surgery remains unclear. METHODS: PubMed, EMBASE, the Cochrane Library and were searched for relevant studies. Studies comparing the effects of GDFTdyn with that of standard fluid therapy on clinical outcomes among adult patients undergoing surgery were considered eligible...
November 14, 2018: Critical Care: the Official Journal of the Critical Care Forum
Stephanie L Buzzard, Brittany D Bissell, Melissa L Thompson Bastin
Introduction: Ehrlichia are obligate intracellular pathogens transmitted to vertebrates by ticks. Case presentation: We report the case of a 59-year-old man who presented to the University of Kentucky Albert B. Chandler Medical Center (Lexington, KY, USA) after being found fallen down in the woods. A lumbar puncture revealed what appeared to be bacterial meningitis, yet cerebrospinal fluid cultures, Gram stains and a meningitis/encephalitis panel were inconclusive...
September 2018: JMM Case Reports
Shahd Horie, Hector Esteban Gonzalez, John G Laffey, Claire H Masterson
Acute respiratory distress syndrome (ARDS) is driven by a severe pro-inflammatory response resulting in lung damage, impaired gas exchange and severe respiratory failure. There is no specific treatment that effectively improves outcome in ARDS. However, in recent years, cell therapy has shown great promise in preclinical ARDS studies. A wide range of cells have been identified as potential candidates for use, among these are mesenchymal stromal cells (MSCs), which are adult multi-lineage cells that can modulate the immune response and enhance repair of damaged tissue...
September 2018: Journal of Thoracic Disease
Xinqian Zhao, Jing He, Guoyan Xie, Song Xu, Jun Xie, Youyuan Chen, Hui Wu
Acute lung injury (ALI) is a serious clinical syndrome that can cause respiratory failure and threaten the life of the patients. A biomarker that can predict the syndrome can contribute to a better clinical management of the patients. In adults, genetic polymorphisms in inflammatory-response genes have been shown to be a promising biomarker. However, the pathogenesis of ALI in adult is known to be different from that in children and no previous study has investigated the association between inflammatory gene polymorphisms and pediatric ALI (PALI) risk...
November 6, 2018: Gene
Rachelle Buchbinder, Renea V Johnston, Kobi J Rischin, Joanne Homik, C Allyson Jones, Kamran Golmohammadi, David F Kallmes
BACKGROUND: Percutaneous vertebroplasty remains widely used to treat osteoporotic vertebral fractures although our 2015 Cochrane review did not support its role in routine practice. OBJECTIVES: To update the available evidence of the benefits and harms of vertebroplasty for treatment of osteoporotic vertebral fractures. SEARCH METHODS: We updated the search of CENTRAL, MEDLINE and Embase and trial registries to 15 November 2017. SELECTION CRITERIA: We included randomised and quasi-randomised controlled trials (RCTs) of adults with painful osteoporotic vertebral fractures, comparing vertebroplasty with placebo (sham), usual care, or another intervention...
November 6, 2018: Cochrane Database of Systematic Reviews
Aklak Choudhury, Gregor Young, Beshoy Reyad, Nirali Shah, Radhea Rahman
The British Thoracic Society recommends oxygen delivery to achieve target oxygen saturation range between 94% and 98% for medically unwell adult patients, and 88% to 92% in patients at risk of hypercapnic respiratory failure. Interviews with our medical and nursing staff suggested that oxygen was sometimes being given to patients without a valid order and there was a failure to titrate oxygen to the stated oxygen saturation range. Our aim was to improve appropriate oxygen delivery to 90% of our patients on a 30-bedded respiratory ward within 3 months...
2018: BMJ Open Quality
Marwa Ghazaly, Simon Nadel
Respiratory Syncytial Virus (RSV) is the most common cause of Acute Bronchiolitis (AVB) in infants. AVB causes significant morbidity and mortality worldwide, most deaths occurring in the developing world. AVB causes respiratory distress in infants, leading to respiratory failure in some cases. Disease is more severe in infants with risk factors, such as prematurity, chronic cardiac and lung disease and immunodeficiency. Areas covered: Despite major advances in supportive care in the developed world, which has led to a significant reduction in mortality, treatment remains symptomatic and supportive...
November 1, 2018: Expert Review of Anti-infective Therapy
Mikhail A Dziadzko, Paul J Novotny, Jeff Sloan, Ognjen Gajic, Vitaly Herasevich, Parsa Mirhaji, Yiyuan Wu, Michelle Ng Gong
BACKGROUND: Acute respiratory failure occurs frequently in hospitalized patients and often starts before ICU admission. A risk stratification tool to predict mortality and risk for mechanical ventilation (MV) may allow for earlier evaluation and intervention. We developed and validated an automated electronic health record (EHR)-based model-Accurate Prediction of Prolonged Ventilation (APPROVE)-to identify patients at risk of death or respiratory failure requiring >= 48 h of MV...
October 30, 2018: Critical Care: the Official Journal of the Critical Care Forum
Emanuele Rezoagli, Stefano Gatti, Silvia Villa, Giulia Villa, Stefano Muttini, Fabio Rossi, Loredana Faraldi, Roberto Fumagalli, Giacomo Grasselli, Giuseppe Foti, Giacomo Bellani
INTRODUCTION: ABO blood type A was reported to correlate with an increased risk of acute respiratory distress syndrome (ARDS) in white patients with severe sepsis and major trauma compared with patients with other blood types. Information regarding ABO phenotypes and major outcomes in patients with ARDS is unavailable. The primary aim was to determine the relationship between ABO blood type A and intensive care unit (ICU) mortality in patients with acute hypoxemic respiratory failure (AHRF)...
2018: PloS One
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