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Chronic Respiratory Failure

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https://www.readbyqxmd.com/read/29331311/prediction-of-mortality-in-patients-with-chronic-obstructive-pulmonary-disease-with-the-new-global-initiative-for-chronic-obstructive-lung-disease-2017-classification-a-cohort-study
#1
Anne Gedebjerg, Szimonetta Komjáthiné Szépligeti, Laura-Maria Holm Wackerhausen, Erzsébet Horváth-Puhó, Ronald Dahl, Jens Georg Hansen, Henrik Toft Sørensen, Mette Nørgaard, Peter Lange, Reimar Wernich Thomsen
BACKGROUND: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification separates the spirometric 1-4 staging from the ABCD groups defined by symptoms and exacerbations. Little is known about how this new classification predicts mortality in patients with chronic obstructive pulmonary disease (COPD). We aimed to establish the predictive ability of the GOLD 2017 classification, compared with earlier classifications, for all-cause and respiratory mortality, both when using its main ABCD groups and when further subdividing according to spirometric 1-4 staging...
January 10, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29327348/respiratory-dysfunction-progresses-with-age-in-kcna1-null-mice-a-model-of-sudden-unexpected-death-in-epilepsy
#2
Kristina A Simeone, Jodi Hallgren, Charles S Bockman, Ankita Aggarwal, Vikash Kansal, Lauren Netzel, Shruthi H Iyer, Stephanie A Matthews, Malavika Deodhar, Peter J Oldenburg, Peter W Abel, Timothy A Simeone
OBJECTIVE: Increased breathing rate, apnea, and respiratory failure are associated with sudden unexpected death in epilepsy (SUDEP). We recently demonstrated the progressive nature of epilepsy and mortality in Kcna1-/- mice, a model of temporal lobe epilepsy and SUDEP. Here we tested the hypothesis that respiratory dysfunction progresses with age in Kcna1-/- mice, thereby increasing risk of respiratory failure and sudden death (SD). METHODS: Respiratory parameters were determined in conscious mice at baseline and following increasing doses of methacholine (MCh) using noninvasive airway mechanics (NAM) systems...
January 12, 2018: Epilepsia
https://www.readbyqxmd.com/read/29327047/histopathological-and-inflammatory-features-of-chronically-discharging-open-mastoid-cavities-secondary-analysis-of-a-randomized-clinical-trial
#3
Darius Henatsch, Sultan Alsulami, Adriaan M Duijvestijn, Jack P Cleutjens, Carine J Peutz-Kootstra, Robert J Stokroos
Importance: Many patients with an open radical mastoid cavity experience therapy-resistant otorrhea. Little is known about the underlying histopathological substrate of unstable cavities and the correlation with treatment failure. Objective: To study the histopathological and inflammatory features of chronically discharging open radical mastoid cavities and the influence of different treatments. Design, Setting, and Participants: This secondary analysis of a randomized clinical trial was a histopathology study of tissue samples of a cohort of 30 patients with a chronically discharging open mastoid cavity...
January 11, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#4
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29322217/-functional-diagnostics-in-pneumology
#5
REVIEW
M Held, S Baron, B Jany
Alongside imaging techniques, pulmonary function testing helps in the diagnosis of underlying disorders such as asthma and chronic obstructive pulmonary disease (COPD) or fibrosing lung disease. However, disease severity grading is also important, as well as disease follow-up under therapy. The value of spirometry as a first-line diagnostic test, whole-body plethysmography in advanced diagnostics, the measurement of transfer factor, as well as blood gas analysis are outlined. The importance of spiroergometry, echocardiography, and right-heart catheterization, particularly in the functional assessment of pulmonary vascular disorders, is described...
January 10, 2018: Der Internist
https://www.readbyqxmd.com/read/29321935/desquamative-interstitial-pneumonia-complicated-by-diffuse-alveolar-haemorrhage
#6
Ayako Matsuo, Nobuhiro Matsumoto, Akiko Kitamura, Hironobu Tsubouchi, Shigehisa Yanagi, Masamitsu Nakazato
We report a rare case of desquamative interstitial pneumonia (DIP) with diffuse alveolar haemorrhage (DAH). A 56-year-old man diagnosed with DIP by surgical lung biopsy 2 years ago was admitted to our hospital because of severe acute respiratory failure. The DIP had progressed despite smoking cessation. On admission, the patient appeared extremely ill, and physical examination revealed respiratory distress. The patient required mechanical ventilation. High-resolution computed tomography showed diffuse ground glass opacity in both lungs...
February 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29319542/supplemental-oxygen-in-patients-with-stable-chronic-obstructive-pulmonary-disease-evidence-from-nocturnal-oxygen-treatment-trial-to-long-term-oxygen-treatment-trial
#7
Umur Hatipoğlu, James K Stoller
PURPOSE OF REVIEW: Oxygen therapy was the first treatment shown to prolong life in patients with chronic obstructive pulmonary disease (COPD) and has been joined by lung volume reduction surgery in selected patients with emphysema, smoking cessation, and potentially noninvasive ventilation in chronic hypercapneic respiratory failure. Although there is consensus around the survival-enhancing effect of supplemental oxygen (SupplO2) for patients with chronic severe hypoxemia at rest, the impact of SupplO2 for COPD patients with moderate hypoxemia and exertional desaturation had been less clear...
January 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29319038/noninvasive-ventilation-neurally-adjusted-ventilator-assist-for-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#8
Vijay Hadda, Tajamul Hussain Shah, Karan Madan, Anant Mohan, Gopi C Khilnani, Randeep Guleria
Patient-ventilator asynchrony is common with noninvasive ventilation (NIV) used for management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Neurally adjusted ventilator assist (NAVA) is a mode of ventilatory support which can minimize the patient-ventilator asynchrony. Delivering NIV with NAVA (NIV-NAVA) during acute exacerbation of COPD seems a logical approach and may be useful in reducing patient-ventilator asynchrony. However, there are no published reports which describe the use of NIV-NAVA for management of acute exacerbation of COPD...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29317401/acute-and-chronic-increases-of-circulating-fstl1-normalize-energy-substrate-metabolism-in-pacing-induced-heart-failure
#9
Mitsuru Seki, Jeffery C Powers, Sonomi Maruyama, Maria A Zuriaga, Chia-Ling Wu, Clara Kurishima, Lydia Kim, Jesse Johnson, Anthony Poidomani, Tao Wang, Eric Muñoz, Sudarsan Rajan, Joon Y Park, Kenneth Walsh, Fabio A Recchia
BACKGROUND: FSTL1 (follistatin-like protein 1) is an emerging cardiokine/myokine that is upregulated in heart failure (HF) and is found to be cardioprotective in animal models of cardiac injury. We tested the hypothesis that circulating FSTL1 can affect cardiac function and metabolism under baseline physiological conditions and in HF. METHODS AND RESULTS: FSTL1 was acutely (10 minutes) or chronically (2 weeks) infused to attain clinically relevant blood levels in conscious dogs with cardiac tachypacing-induced HF...
January 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29316277/modification-of-oxygen-concentrators-based-on-questionnaire-survey
#10
Masahiro Shinoda, Masaharu Shinkai, Akimichi Nagashima, Kenjiro Nagai, Kei Takagi, Takeshi Kaneko
BACKGROUND: In this study, we conducted a questionnaire survey to clarify and improve problems related to oxygen concentrators. METHODS: Using a questionnaire survey of 30 patients receiving long-term oxygen therapy for chronic respiratory failure, we investigated the necessity of using a remote controller, portability, fire prevention system, built-in battery type and so on. Patients were divided into two groups according to age, sex, underlying conditions, and amount of oxygen prescribed, then analyzed accordingly...
January 8, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29315693/nacseld-acute-on-chronic-liver-failure-nacseld-aclf-score-predicts-30-day-survival-in-hospitalized-patients-with-cirrhosis
#11
Jacqueline G O'Leary, K Rajender Reddy, Guadalupe Garcia-Tsao, Scott W Biggins, Florence Wong, Michael B Fallon, Ram M Subramanian, Patrick S Kamath, Paul Thuluvath, Hugo E Vargas, Benedict Maliakkal, Puneeta Tandon, Jennifer Lai, Leroy R Thacker, Jasmohan S Bajaj
NACSELD (North American Consortium for the Study of End-Stage Liver Disease) definition of acute-on-chronic liver failure (NACSELD-ACLF) as ≥2 extra-hepatic organ failures has been proposed as a simple bedside tool to assess risk of mortality in hospitalized patients with cirrhosis. We validated NACSELD-ACLF's ability to predict 30-day survival (defined as in-hospital death or hospice discharge) in a separate multicenter prospectively enrolled cohort of both infected and uninfected hospitalized patients with cirrhosis...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29313987/variable-role-of-carotid-bodies-in-cardiovascular-responses-to-exercise-hypoxia-and-hypercapnia-in-spontaneously-hypertensive-rats
#12
Wioletta Pijacka, Pedro L Katayama, Helio C Salgado, Gisele S Lincevicius, Ruy R Campos, Fiona D McBryde, Julian F R Paton
The carotid body has recently emerged as a promising therapeutic target for treating cardiovascular disease, however the potential impact of carotid bodies removal on the dynamic cardiovascular responses to acute stressors such as exercise, hypoxia and hypercapnia in hypertension is an important safety consideration that has not been studied. We first validated a novel surgical approach to selectively resect the carotid bodies bilaterally (CBR) sparing the carotid sinus baroreflex. Second, we evaluated the impact of CBR on the cardiovascular responses to exercise, hypoxia and hypercapnia in the conscious, chronically instrumented spontaneously hypertensive (SH) rats...
January 5, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29308831/anemia-hypoalbuminemia-and-elevated-troponin-levels-as-risk-factors-for-respiratory-failure-in-patients-with-severe-exacerbations-of-chronic-obstructive-pulmonary-disease-requiring-invasive-mechanical-ventilation
#13
Gordana Pavliša, Marina Labor, Hrvoje Puretić, Ana Hećimović, Marko Jakopović, Miroslav Samaržija
AIM: To determine in-hospital and post-discharge mortality, readmission rates, and predictors of invasive mechanical ventilation (IMV) in patients treated at intensive care unit (ICU) due to acute exacerbations of chronic obstructive pulmonary disease (AECOPD). METHODS: A retrospective observational cohort study included all patients treated at a respiratory ICU for AECOPD during one year. A total of 62 patients (41 men) with mean age 68.4±10.4 years were analyzed for outcomes including in-hospital and post-discharge mortality, readmission rates, and IMV...
December 31, 2017: Croatian Medical Journal
https://www.readbyqxmd.com/read/29308756/-establishment-of-multiple-organ-dysfunction-syndrome-early-warning-score-in-patients-with-severe-trauma-and-its-clinical-significance-a-multicenter-study
#14
Wenjuan Huang, Song Qin, Yu Sun, Shangqi Yin, Xia Fan, Qi Huang, Tao Chen, Huaping Liang
OBJECTIVE: To explore the risk factors of multiple organ dysfunction syndrome (MODS) in severe trauma patients, put forward a new warning scoring system of MODS, and to provide a more accurate scoring method for doctors to judge the clinical condition and prognosis of patients. METHODS: Clinical data of 342 patients with severe trauma admitted to intensive care unit (ICU) of the Affiliated Hospital of Zunyi Medical College and Daping Hospital of the Third Military Medical University from January 1st, 2015 to December 31st, 2016 were retrospectively analyzed...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29305266/pre-emptive-awake-airway-management-under-dexmedetomidine-sedation-in-a-parturient-with-spinal-muscular-atrophy-type-2
#15
C A Godlewski, P F Castellanos
Historically, pregnancy in females with spinal muscular atrophy was contraindicated due to the great risk to the parturient, but with improved management and increased survival more patients are becoming pregnant. We describe the management of a pregnant patient with spinal muscular atrophy type-2, who had severe restrictive lung disease, extensive spinal fusion that precluded neuraxial anesthesia, and chronic respiratory failure on nocturnal Bilevel Positive Airway Pressure. Airway management was further complicated by limited mouth opening and cervical spine ankylosis...
November 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29301855/gene-editing-as-a-promising-approach-for-respiratory-diseases
#16
Yichun Bai, Yang Liu, Zhenlei Su, Yana Ma, Chonghua Ren, Runzhen Zhao, Hong-Long Ji
Respiratory diseases, which are leading causes of mortality and morbidity in the world, are dysfunctions of the nasopharynx, the trachea, the bronchus, the lung and the pleural cavity. Symptoms of chronic respiratory diseases, such as cough, sneezing and difficulty breathing, may seriously affect the productivity, sleep quality and physical and mental well-being of patients, and patients with acute respiratory diseases may have difficulty breathing, anoxia and even life-threatening respiratory failure. Respiratory diseases are generally heterogeneous, with multifaceted causes including smoking, ageing, air pollution, infection and gene mutations...
January 4, 2018: Journal of Medical Genetics
https://www.readbyqxmd.com/read/29298971/an-autopsy-case-of-mesenteric-panniculitis-with-massive-pleural-effusions
#17
Hiroshi Kobayashi, Kenji Notohara, Tadashi Otsuka, Yuka Kobayashi, Masuo Ujita, Yuuki Yoshioka, Naomasa Suzuki, Ryuji Aoyagi, Riuko Ohashi, Toshimitsu Suzuki
BACKGROUND Mesenteric panniculitis (MP) is an idiopathic chronic inflammatory condition of the mesentery. The main symptoms include abdominal pain, abdominal distention, weight loss, fever, nausea, and vomiting. The patients also present with chylous ascites in 14% of the cases and chylous pleural effusion (CPE) in very rare occasions. Despite the previous view of excellent prognosis of MP, two recent papers reported several fatal cases. However, there are still only a few autopsy case reports that describe the macroscopic and histological details of MP cases...
January 4, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29290748/therapeutic-drug-monitoring-of-prolonged-infusion-aztreonam-for-multi-drug-resistant-pseudomonas-aeruginosa-a-case-report
#18
Jeffrey J Cies, Richard J LaCoursiere, Wayne S Moore, Arun Chopra
Aztreonam, a broad-spectrum monobactam, is typically reserved for multidrug resistant (MDR) infections. Pharmacokinetic (PK) data to guide dosing in children, however, are limited to healthy volunteers or nonintensive care unit (ICU) patients. Impaired antibiotic delivery into tissue remains a major concern and may explain the high morbidity and mortality associated with MDR infections. Therefore, evaluating the PK changes in pediatric ICU patients is necessary to elucidate the most appropriate antimicrobial regimen...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29289956/outcomes-and-predictors-of-mortality-after-mitral-valve-surgery-in-high-risk-elderly-patients-the-heidelberg-experience
#19
Sabreen Mkalaluh, Marcin Szczechowicz, Bashar Dib, Gabor Szabo, Matthias Karck, Alexander Weymann
BACKGROUND Overall, life expectancy at the age of 80 has significantly increased in the industrialized world and the proportion of this age class undergoing cardiac surgery has also grown. In this context, we have analyzed a contemporary series of octogenarians undergoing mitral valve surgery at our institution. MATERIAL AND METHODS We performed a retrospective analysis of 138 consecutive octogenarians receiving mitral valve surgery between January 2006 and April 2017. Preoperative comorbidities, early mortality, postoperative clinical course, and predictors of mortality were examined...
December 31, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29283682/domiciliary-high-flow-nasal-cannula-oxygen-therapy-for-stable-hypercapnic-copd-patients-a-multicenter-randomized-crossover-trial
#20
Kazuma Nagata, Takashi Kikuchi, Takeo Horie, Akira Shiraki, Takamasa Kitajima, Toru Kadowaki, Fumiaki Tokioka, Naohiko Chohnabayashi, Akira Watanabe, Susumu Sato, Keisuke Tomii
RATIONALE: A growing evidence base suggests a benefit of using high-flow nasal cannula oxygen therapy (HFNC) in the acute setting. However, the clinical benefit of domiciliary use of HFNC in patients with chronic hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD) remains unclear. OBJECTIVES: To evaluate the efficacy and safety of HFNC use in stable COPD patients. METHODS: This was a multicenter, randomized crossover trial comparing HFNC plus long-term oxygen therapy (HFNC/LTOT) with LTOT-only in 32 adults with stable hypercapnic COPD...
December 28, 2017: Annals of the American Thoracic Society
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