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Chronic Respiratory Failure

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https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#1
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28522765/exercise-training-in-tg%C3%AE-q-44-mice-during-the-progression-of-chronic-heart-failure-cardiac-vs-peripheral-soleus-muscle-impairments-to-oxidative-metabolism
#2
Bruno Grassi, Joanna Majerczak, Eleonora Bardi, Alessia Buso, Marina Comelli, Stefan Chlopicki, Magdalena Guzik, Irene Mavelli, Zenon Nieckarz, Desy Salvadego, Urszula Tyrankiewicz, Tomasz Skorka, Roberto Bottinelli, Jerzy A Zoladz, Maria Antonietta Pellegrino
Cardiac function, skeletal (soleus) muscle oxidative metabolism and the effects of exercise training were evaluated in a transgenic murine model (Tgαq*44) of chronic heart failure (CHF) during the critical period between the occurrence of an impairment of cardiac function and the stage at which overt cardiac failure ensues (i.e. from 10 to 12 months of age). Forty-eight Tgαq*44 mice and 43 wild-type (WT) FVB controls were randomly assigned to control groups and to groups undergoing 2 months of intense exercise training (spontaneous running on a instrumented wheel)...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28520806/als-skeletal-muscle-shows-enhanced-tgf-%C3%AE-signaling-fibrosis-and-induction-of-fibro-adipogenic-progenitor-markers
#3
David Gonzalez, Osvaldo Contreras, Daniela L Rebolledo, Juan Pablo Espinoza, Brigitte van Zundert, Enrique Brandan
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease in which upper and lower motoneurons degenerate leading to muscle wasting, paralysis and eventually death from respiratory failure. Several studies indicate that skeletal muscle contributes to disease progression; however the molecular mechanisms remain elusive. Fibrosis is a common feature in skeletal muscle under chronic damage conditions such as those caused by muscular dystrophies or denervation. However, the exact mechanisms of fibrosis induction and the cellular bases of this pathological response are unknown...
2017: PloS One
https://www.readbyqxmd.com/read/28516132/life-threatening-hypercalcemia-during-prodrome-of-pneumocystis-jiroveci-pneumonia-in-an-immunocompetent-infant
#4
Judith Sebestyen VanSickle, Tarak Srivastava, Uri S Alon
Severe hypercalcemia in infants is usually attributed to genetic etiologies and less commonly to acquired ones. An 8-week-old girl presented with failure to thrive, mild respiratory distress, and life-threatening hypercalcemia (23.5 mg/dL). Serum 1,25(OH)2-vitamin D (1,25(OH)2-D) level was elevated and parathyroid hormone undetectable. Evaluation for genetic mutations and malignant etiologies of hypercalcemia was negative. Treatment with intravenous hydration, loop diuretic, and calcitonin failed to correct the hypercalcemia, which was subsequently controlled with bisphosphonate therapy...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28515334/central-acting-therapeutics-alleviate-respiratory-weakness-caused-by-heart-failure-induced-ventilatory-overdrive
#5
Andrew J Foster, Mathew J Platt, Jason S Huber, Ashley L Eadie, Alicia M Arkell, Nadya Romanova, David C Wright, Todd E Gillis, Coral L Murrant, Keith R Brunt, Jeremy A Simpson
Diaphragmatic weakness is a feature of heart failure (HF) associated with dyspnea and exertional fatigue. Most studies have focused on advanced stages of HF, leaving the cause unresolved. The long-standing theory is that pulmonary edema imposes a mechanical stress, resulting in diaphragmatic remodeling, but stable HF patients rarely exhibit pulmonary edema. We investigated how diaphragmatic weakness develops in two mouse models of pressure overload-induced HF. As in HF patients, both models had increased eupneic respiratory pressures and ventilatory drive...
May 17, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28509429/chronic-kidney-disease-a-likely-underestimated-component-of-multimorbidity-in-older-patients-with-chronic-obstructive-pulmonary-disease
#6
REVIEW
Andrea Corsonello, Filippo Aucella, Claudio Pedone, Raffaele Antonelli-Incalzi
The coexistence of chronic kidney disease and chronic obstructive pulmonary disease, two age-related conditions, has important clinical and prognostic implications. Respiratory failure is associated with important changes in glomerular and tubulointerstitial function. In contrast, renal failure can affect lung function, mainly by adding a restrictive component or causing complications, such as uremic pulmonary edema and pleural effusion. The effect of age on renal and pulmonary function adds to the complexity of the interplay between the kidney and the lung in these patients...
May 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28506729/-the-role-of-extracorporeal-removal-of-co2-ecco2r-in-the-management-of-respiratory-diseases
#7
J L Diehl, J Boisramé-Helms, A Chardon-Couteau, M Commereuc, J-L Augy, A Sokoloff, N Rivet, P Gaussem, D M Smadja, N Aissaoui
INTRODUCTION: The aim of extracorporeal removal of CO2 (ECCO2R) is to ensure the removal of CO2 without any significant effect on oxygenation. ECCO2R makes use of low to moderate extracorporeal blood flow rates, whereas extracorporeal membrane oxygenation (ECMO) requires high blood flows. STATE OF THE ART: For each ECCO2R device it is important to consider not only performance in terms of CO2 removal, but also cost and safety, including the incidence of hemolysis and of hemorrhagic and thrombotic complications...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28506089/long-term-oxygen-therapy-in-copd-patients-who-do-not-meet-the-actual-recommendations
#8
Begum Ergan, Stefano Nava
Chronic respiratory failure due to chronic obstructive pulmonary disease (COPD) is an increasing problem worldwide. Many patients with severe COPD develop hypoxemic respiratory failure during the natural progression of disease. Long-term oxygen therapy (LTOT) is a well-established supportive treatment for COPD and has been shown to improve survival in patients who develop chronic hypoxemic respiratory failure. The degree of hypoxemia is severe when partial pressure of oxygen in arterial blood (PaO2) is ≤55 mmHg and moderate if PaO2 is between 56 and 69 mmHg...
May 16, 2017: COPD
https://www.readbyqxmd.com/read/28501384/acute-heart-failure-in-the-emergency-department-the-safe-simeu-epidemiological-study
#9
Andrea Fabbri, Giulio Marchesini, Giorgio Carbone, Roberto Cosentini, Annamaria Ferrari, Mauro Chiesa, Alessio Bertini, Federico Rea
BACKGROUND: Patients with acute heart failure (AHF) have high rates of attendance to emergency departments (EDs), with significant health care costs. OBJECTIVES: We aimed to describe the clinical characteristics of patients attending Italian EDs for AHF and their diagnostic and therapeutic work-up. METHODS: We carried out a retrospective analysis on 2683 cases observed in six Italian EDs for AHF (January 2011 to June 2012). RESULTS: The median age of patients was 84 years (interquartile range 12), with females accounting for 55...
May 10, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28499979/inspiratory-muscle-training-improves-intercostal-and-forearm-muscle-oxygenation-in-patients-with-chronic-heart-failure-evidence-of-the-origin-of-the-respiratory-metaboreflex
#10
Adalgiza M Moreno, Alessandra C Toledo-Arruda, Jéssica S Lima, Carolina S Duarte, Humberto Vilacortta-Junior, Antonio C L Nóbrega
BACKGROUND: The impact of inspiratory muscle training (IMT) on respiratory and peripheral muscle oxygenation and perfusion during inspiratory muscle fatigue in patients with chronic heart failure has not been established. METHODS AND RESULTS: Twenty-six patients with chronic heart failure were randomly assigned to either 8 weeks of IMT or to a control group. Inspiratory fatigue was induced by a progressive inspiratory resistive loading protocol until there was an inability to sustain inspiratory pressure, when the inspiratory muscle metaboreflex should be activated...
May 9, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28495570/effect-of-chronic-heart-failure-in-older-rats-on-respiratory-muscle-and-hindlimb-blood-flow-during-submaximal-exercise
#11
Joshua R Smith, K Sue Hageman, Craig A Harms, David C Poole, Timothy I Musch
Submaximal exercise diaphragm blood flow (BF) is elevated in young chronic heart failure (CHF) rats, while it is unknown if this occurs in older animals. Respiratory and hindlimb muscle BFs (radiolabeled microspheres) were measured at rest and during submaximal exercise (20m/min, 5% grade) in older healthy (n=7) and CHF (n=6) Fischer 344X Brown Norway rats (27-29 mo old). Older CHF, compared to healthy, rats had greater (p<0.01) left ventricular end-diastolic pressure and right ventricle and lung weight (normalized to body weight)...
May 7, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28494170/why-high-intensity-nppv-is-favourable-to-low-intensity-nppv-clinical-and-physiological-reasons
#12
S B Schwarz, F S Magnet, W Windisch
High-intensity non-invasive positive pressure ventilation (NPPV) was originally described for chronic hypercapnic chronic obstructive pulmonary disease (COPD) patients in 2009, and refers to a specific ventilatory approach whereby NPPV settings are aimed at achieving the lowest arterial partial pressure of carbon dioxide (PaCO2) values possible. Thus, high-intensity NPPV requires ventilator settings to be increased in a stepwise approach to either an individually tolerated maximum, or to the levels necessary to achieve normocapnia...
May 11, 2017: COPD
https://www.readbyqxmd.com/read/28492143/a-direct-assay-for-measuring-free-25-hydroxyvitamin-d
#13
Heureux Nicolas, Ernst Lindhout, Leon Swinkels
Recent studies suggest that the concentration and genotype of vitamin D binding protein (VDBP) are important factors that determine the bioavailability of 25-hydroxyvitamin D [25(OH)D] in blood. Accumulating data indicate that, e.g., in pregnant women, hemodialysis patients, chronic kidney disease, liver failure, and bladder and pancreatic cancers, the measurement of free 25(OH)D in serum provides more relevant diagnostic information than measurement of total 25(OH)D. The aim of this study was to develop and validate an ELISA for direct measurement of free 25(OH)D in serum...
May 11, 2017: Journal of AOAC International
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#14
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28485522/effects-of-1-month-withdrawal-of-ventilatory-support-in-hypercapnic-myotonic-dystrophy-type-1
#15
Fergal J O'Donoghue, Jean-Christian Borel, Yves Dauvilliers, Patrick Levy, Renaud Tamisier, Jean-Louis Pépin
BACKGROUND AND OBJECTIVE: The benefits of domiciliary non-invasive ventilation (NIV) in myotonic dystrophy type 1 (DM1) are unclear. We sought to determine the effects of elective discontinuation of ventilatory support for 1 month in DM1 patients receiving NIV for chronic hypercapnic respiratory failure. METHODS: At baseline, 12 patients underwent polysomnography, and assessment of subjective (Epworth Sleepiness Scale) and objective (Oxford Sleep Resistance Test) sleepiness, fatigue (Fatigue Severity Scale), respiratory function including muscle strength, arterial blood gas (ABG), hypercapnic ventilatory response (HCVR), Blood Pressure, peripheral arterial tonometry (PAT) and pulse wave velocity (PWV)...
May 9, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28485315/assessment-of-1-year-outcomes-in-survivors-of-severe-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation-or-mechanical-ventilation-a-prospective-observational-study
#16
Zhi-Yong Wang, Tong Li, Chun-Ting Wang, Lei Xu, Xin-Jing Gao
BACKGROUND: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population. METHODS: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28484507/sulphurous-mineral-waters-new-applications-for-health
#17
REVIEW
Jose Manuel Carbajo, Francisco Maraver
Sulphurous mineral waters have been traditionally used in medical hydrology as treatment for skin, respiratory, and musculoskeletal disorders. However, driven by recent intense research efforts, topical treatments are starting to show benefits for pulmonary hypertension, arterial hypertension, atherosclerosis, ischemia-reperfusion injury, heart failure, peptic ulcer, and acute and chronic inflammatory diseases. The beneficial effects of sulphurous mineral waters, sulphurous mud, or peloids made from sulphurous mineral water have been attributed to the presence of sulphur mainly in the form of hydrogen sulphide...
2017: Evidence-based Complementary and Alternative Medicine: ECAM
https://www.readbyqxmd.com/read/28479114/bronchopulmonary-dysplasia-where-have-all-the-stem-cells-gone-origin-and-potential-function-of-resident-lung-stem-cells
#18
Marius Alexander Möbius, Bernard Thébaud
Celebrating its 50(th) anniversary in 2017, bronchopulmonary dysplasia (BPD) - the chronic lung disease of prematurity that follows ventilator and O2 therapy for acute respiratory failure - remains the most frequent complication of extreme prematurity. Survival of premature infants born at increasingly earlier stages of gestation has made the prevention of lung injury increasingly challenging. BPD is postulated to be a misdirection of many functions in the developing lung including growth factor signalling and matrix as well as cellular composition, resulting in impaired alveolar and lung vascular growth...
May 4, 2017: Chest
https://www.readbyqxmd.com/read/28474647/outpatient-drainage-for-patients-with-spontaneous-pneumothorax-over-50-years-of-age
#19
Atsushi Sano, Takuma Yotsumoto, Takehiro Tsuchiya
INTRODUCTION: The British Thoracic Society has reported a lower success rate for aspiration of spontaneous pneumothorax in patients over 50 years of age. Outpatient drainage therapy is used to manage spontaneous pneumothorax at some institutions. We examined the effect of age on outpatient drainage therapy outcomes. MATERIALS AND METHODS: We reviewed the records of 68 patients who underwent outpatient drainage therapy with a thoracic vent between December 2012 and April 2015, which included 11 patients over 50 years of age...
May 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28471606/upper-respiratory-tract-infection-among-dialysis-patients
#20
Keren Cohen-Hagai, Ilan Rozenberg, Ze'ev Korzets, Tali Zitman-Gal, Yael Einbinder, Sydney Benchetrit
BACKGROUND: Upper respiratory tract infection (URTI) occurs frequently in the general population and is considered a benign self-limited disease. Dialysis patients constitute a high risk population whose morbidity and mortality rate as a result of URTI is unknown. OBJECTIVES: To assess the local incidence, morbidity and mortality of URTI in dialysis patients compared to the general population. METHODS: In this retrospective cohort study we reviewed the charts of all chronic dialysis patients diagnosed with URTI at Meir Medical Center, Kfar Saba, Israel during the 2014-2015 winter season...
September 2016: Israel Medical Association Journal: IMAJ
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