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Respiratory failure the 4

Alessandra Buja, Mirko Claus, Lucia Perin, Michele Rivera, Maria Chiara Corti, Francesco Avossa, Elena Schievano, Stefano Rigon, Roberto Toffanin, Vincenzo Baldo, Giovanna Boccuzzo
INTRODUCTION: Patients with complex health care needs (PCHCN) are individuals who require numerous, costly care services and have been shown to place a heavy burden on health care resources. It has been argued that an important issue in providing value-based primary care concerns how to identify groups of patients with similar needs (who pose similar challenges) so that care teams and care delivery processes can be tailored to each patient subgroup. Our study aims to describe the most common chronic conditions and their combinations in a cohort of elderly PCHCN...
2018: PloS One
Andrew J Chin, Andrea D Fischione, Ryan Shilian, Lauren M Walter, Susan M Ratay, Tamar Y Bejanishvili, Jonathan H Wynbrandt, Michael P Rowane
Context: Rib raising is an osteopathic manipulative treatment modality that can help patients with various respiratory conditions to improve their work of breathing. However, the tolerance of this technique in hospitalized patients has not been assessed in a systematic manner. We hypothesized that rib raising would be a well-tolerated treatment modality for hospitalized patients admitted for asthma, pneumonia, chronic obstructive pulmonary disease, and/or congestive heart failure. Objective: To determine hospitalized patients' tolerance of rib raising through a prospective pilot study...
December 17, 2018: Journal of the American Osteopathic Association
Philippe Bordier, Aurelia Lataste
Purpose: The SERVE-HF study reported a risk of cardiovascular death associated with adaptive servo-ventilation (ASV) for central sleep apnea in patients with chronic heart failure with reduced left ventricular ejection fraction (LVEF). Therefore, we adopted in May 2015 a safety procedure in our 32 patients with ASV since 2006. It led to ASV removal in four patients due to ≤45% LVEF. At the end of the procedure we noted eight cases of death. This high 25% mortality rate led us to study these cases...
2019: Respiratory Medicine Case Reports
Hassan Alkhawam, Rahil Rafeedheen, Elsayed Abo-Salem
Right ventricular (RV) dysfunction following surgical implantation of a left ventricular assist device (LVAD) is a well-documented phenomenon, and it is associated with poor outcomes. We are reporting a 25-year-old male patient who presented to the hospital with flu-like symptoms, hypotension and acute hypoxic respiratory failure. The patient's Laboratory data was significant for elevated troponin, and his Chest X-ray showed acute pulmonary edema. Echocardiogram revealed reduced left ventricular (LV) ejection fraction and normal RV function...
December 11, 2018: Heart & Lung: the Journal of Critical Care
Giuseppe Regolisti, Luigi Gerra, Francesca Di Mario, Marco Delsante, Giovani Piotti, Chiara Cantarelli, Giovani Piotti, Santo Morabito, Marco Brambilla, Vincenzo Cantaluppi, Umberto Maggiore, Enrico Fiaccadori
Acute Kidney Injury (AKI) is an important issue for the healthcare system, as it is associated with high mortality and increased risk of readmission, with consequent elevated healthcare resource utilization. We investigated the incidence of AKI based on the examination of the discharge cards of all patients admitted between January 1 2011 and December 31 2015 at the Parma University Hospital, as well as the frequency and type of 30-day hospital readmission in the patients discharged with a first AKI diagnosis (index admission)...
December 2018: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Emidio M Sivieri, Eric Eichenwald, Salma M Bakri, Soraya Abbasi
OBJECTIVE: This study compared CO2 clearance in a premature infant lung model connected to a high flow nasal cannula (HFNC) system supplied with oscillatory versus non-oscillatory flow. DESIGN/METHODS: The lung model was set to compliance 1.0 mL/cmH2 O, RR 60 breaths/min, and 6 mL tidal volume. A 100% CO2 was injected at a constant 15 mL/min. To create oscillation, HFNC flow was interrupted at rates of 4-6-8 and 10 Hz. equilibrated end-tidal CO2 (ETCO2 ) was recorded with and without oscillation at set flows of 2-8 L/min and repeated for each oscillation frequency...
December 14, 2018: Pediatric Pulmonology
Vidur Bhalla, Kevin J Sykes, Jennifer A Villwock, D David Beahm, Stanley W McClurg, Alexander G Chiu
BACKGROUND: Previous studies have demonstrated a high failure rate of endoscopic sinus surgery (ESS) with Draf IIa in patients with diffuse polyposis, asthma, and aspirin-exacerbated respiratory disease. A high percentage of these patients progress to endoscopic modified Lothrop procedure (EMLP). We describe a modification of the Draf IIb with a superior septectomy (IIb+SS), which may provide similar therapeutic benefit as demonstrated by the distribution of sinus irrigations in the sinus cavity with ESS with IIb+SS vs ESS with EMLP IIb+SS vs ESS with EMLP...
December 12, 2018: International Forum of Allergy & Rhinology
Samiah Al-Zaidy, A Simon Pickard, Kavitha Kotha, Lindsay N Alfano, Linda Lowes, Grace Paul, Kathleen Church, Kelly Lehman, Douglas M Sproule, Omar Dabbous, Benit Maru, Katherine Berry, W David Arnold, John T Kissel, Jerry R Mendell, Richard Shell
BACKGROUND: Spinal Muscular Atrophy type 1 (SMA1) is a rare genetic neuromuscular disease where 75% of SMA1 patients die/require permanent-ventilation by 13.6 months. This study assessed the health outcomes of SMA1 infants treated with AVXS-101 gene replacement therapy. METHODS: Twelve genetically confirmed SMA1 infants with homozygous deletions of the SMN1 gene and two SMN2 gene copies received a one-time intravenous proposed therapeutic dose of AVXS-101 in an open label study conducted between December 2014 and 2017...
December 12, 2018: Pediatric Pulmonology
Ryan T Ericksen, Cecilia Guthrie, Timothy Carroll
OBJECTIVES: Viral bronchiolitis is a frequent cause of pediatric hospitalization and respiratory failure. Procalcitonin (PCT) is a biomarker used to identify serious bacterial infection and can distinguish bacterial and viral infections. Concomitant bacterial pneumonia is not rare in viral bronchiolitis and can lead to a worse clinical course. This study examined the use of PCT in pediatric patients with respiratory failure attributed to viral bronchiolitis to predict concomitant bacterial pneumonia...
December 14, 2018: Clinical Pediatrics
Wei Feng, Haibin Li, Shuo Wang, Nicholas Van Halm-Lutterodt, Ji An, Yue Liu, Mengyang Liu, Xiaonan Wang, Xiuhua Guo
BACKGROUND: Few studies have explored PM10 's connection with specific respiratory and cardiovascular emergency department admissions (EDAs). This study aimed to examine the overall effects of PM10 on EDAs for cardiovascular and respiratory diseases, including specifically, cerebrovascular events (CVE), ischemic heart disease (IHD), arrhythmia, heart failure (HF), upper respiratory tract infection (URTI), lower respiratory tract infection (LRTI), chronic obstructive pulmonary disease (COPD) and asthma...
December 6, 2018: Science of the Total Environment
Alpesh Amin, W Richey Neuman, Melissa Lingohr-Smith, Brandy Menges, Jay Lin
INTRODUCTION: Venous thromboembolism (VTE) is a leading cause of preventable morbidity and mortality among hospitalized patients in the US. The objectives of this study were to examine VTE prophylaxis patterns and risk for VTE events during hospitalization and post-discharge among patients hospitalized for acute illnesses in the US. METHODS: Acutely ill hospitalized patients were identified from the MarketScan databases (January 1, 2012-June 30, 2015). Proportions of patients that received inpatient and/or outpatient VTE prophylaxis were determined...
December 12, 2018: Advances in Therapy
Allen Brinker, Carmen Cheng, Vicky Chan
Importance: The US Food and Drug Administration (FDA) conducts ongoing public health safety surveillance for drug and therapeutic biologic products. Identifying cases of acute and subacute noninfectious pneumonia supports the public health mission of the FDA. Objective: To identify and analyze postmarketing cases of noninfectious pneumonia associated with ustekinumab use. Design, Setting, and Participants: This retrospective analysis of postmarketing (spontaneous) case reports reviewed the FDA Adverse Event Reporting System (FAERS) and the PubMed databases from September 25, 2009, through November 20, 2017...
December 12, 2018: JAMA Dermatology
Lara El Khoury, Richard Furie
Human granulocytic anaplasmosis (HGA) is a tickborne rickettsial disease caused by the bacterium Anaplasma phagocytophilum. Reported cases have increased with the highest incidence in the Northeast. To our knowledge, this is the first report of anaplasmosis associated with an inflammatory arthritis. A 64-year-old man, with a history of Crohn's disease controlled on budesonide, presented to the emergency room in August 2017 with a week history of headache, sore throat, fever, myalgias, rash, and joint pain. There was no clinical evidence of active Crohn's disease...
December 11, 2018: Clinical Rheumatology
Qiang Fu, Li Wang, Luling Li, Yifan Li, Ran Liu, Yi Zheng
BACKGROUND: Factors associated with progression and survivals in rheumatoid arthritis-associated interstitial lung disease (RA-ILD) have not been described in a large center China cohort. METHODS: Seven-hundred and ninety-one consecutive RA patients who completed lung HRCT were considered as potential participants in this retrospective cohort study. Determinants of ILD progression were identified through multivariable logistic analysis. Cox hazards analysis was used to determine significant variables associated with survival...
December 7, 2018: Clinical Rheumatology
Rosanna Vaschetto, Federico Longhini, Paolo Persona, Carlo Ori, Giulia Stefani, Songqiao Liu, Yang Yi, Weihua Lu, Tao Yu, Xiaoming Luo, Rui Tang, Maoqin Li, Jiaqiong Li, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Zhaochen Jin, Jun Yan, Ruiqiang Zheng, Jingjing Yin, Stefania Guido, Francesco Della Corte, Tiziano Fontana, Cesare Gregoretti, Andrea Cortegiani, Antonino Giarratano, Claudia Montagnini, Silvio Cavuto, Haibo Qiu, Paolo Navalesi
PURPOSE: Noninvasive ventilation (NIV) may facilitate withdrawal of invasive mechanical ventilation (i-MV) and shorten intensive care unit (ICU) length of stay (LOS) in hypercapnic patients, while data are lacking on hypoxemic patients. We aim to determine whether NIV after early extubation reduces the duration of i-MV and ICU LOS in patients recovering from hypoxemic acute respiratory failure. METHODS: Highly selected non-hypercapnic hypoxemic patients were randomly assigned to receive NIV after early or standard extubation...
December 10, 2018: Intensive Care Medicine
Lenise C B C Fernandes, Italo M de Oliveira, Paula Frassinetti C B C Fernandes, João David de Souza Neto, Maria do Socorro Q Farias, Nilce A de Freitas, Nasser C Magalhães, Fernando Bacal
Background: To assess the impact of heart transplantation (HT) on the recovery of peripheral and respiratory muscle mass and strength in patients with congestive heart failure. Methods: The study included 23 patients with an indication for HT (patients in the waiting list [WL] group). These patients were monitored for 1.5 to 3 years after HT; 8 died before 6 months of follow-up, 15 patients completed the early follow-up period of 6 months after HT (FU6m group), 4 died between 6 months and 3 years after HT, and 11 patients completed the late follow-up period 1...
November 2018: Transplantation Direct
Eduardo Chacon, Valery Vilchez, Pedro Eman, Francesc Marti, Gareth Morris-Stiff, Adam Dugan, Lilia Turcios, Roberto Gedaly
OBJECTIVE: To determine predictors of critical care complications (CCC) in patients undergoing hepatectomy. METHODS: All hepatectomy patients in NSQIP from 2012 to 2016 were analyzed. CCC included prolonged ventilation (>48 h), sepsis/septic shock, renal failure/insufficiency, cardiac arrest/AMI and pulmonary embolism. RESULTS: A total of 21,443 patients underwent hepatectomy during the study period. Overall rate of CCC was 11%, with the most common being sepsis/septic shock (6...
November 30, 2018: American Journal of Surgery
Kaitlin M Best, Lisa A Asaro, Martha A Q Curley
OBJECTIVE: To compare current analgesia and sedation management practices between critically ill children with pre-existing cognitive impairment and critically ill neurotypical children, including possible indicators of therapeutic efficacy. STUDY DESIGN: This study used secondary analysis of prospective data from the RESTORE clinical trial, with 2449 children admitted to the pediatric intensive care unit and receiving mechanical ventilation for acute respiratory failure...
December 5, 2018: Journal of Pediatrics
Cristina Ramos-Navarro, Manuel Sánchez-Luna, Susana Zeballos-Sarrato, Noelia González-Pacheco
OBJECTIVE: To assess the impact of beractant treatment using the less invasive surfactant administration (LISA) technique on perinatal outcomes in a prospective cohort of preterm infants with respiratory distress syndrome (RDS). RDS Design: Single-center prospective study conducted in a Department of Neonatology of a tertiary care university-affiliated hospital in Madrid, Spain. METHODS: Preterm infants born at < 31 + 6 weeks' gestation attended in the neonatal intensive care unit (NICU) between 2012 and 2016...
December 9, 2018: Journal of Maternal-fetal & Neonatal Medicine
Jens Spiesshoefer, Maximilian Spieker, Simon Klose, Stefanie Keymel, Matthias Boentert, Stefan Krüger, Patrick Horn, Malte Kelm, Ralf Westenfeld
PURPOSE: This study tested the hypothesis that a reduction of pulmonary congestion achieved by a reduction of mitral regurgitation (MR) severity in heart failure (HF) patients is associated with reduced event lengths of sleep-disordered breathing (SDB). METHODS: We prospectively enrolled 20 consecutive HF patients who underwent MitraClip implantation. Patients underwent cardiorespiratory polygraphic recording prior to and after percutaneous mitral valve repair (PMVR)...
December 6, 2018: Sleep & Breathing, Schlaf & Atmung
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