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Respiratory failure

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https://www.readbyqxmd.com/read/29043834/higher-peep-versus-lower-peep-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#1
Allan J Walkey, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. OBJECTIVE: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. METHODS: We performed a systematic review and meta-analysis of clinical trials investigating mechanical ventilation strategies using higher versus lower PEEP levels...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29042427/predictors-of-death-in-adults-with-duchenne-muscular-dystrophy-associated-cardiomyopathy
#2
Daniel Cheeran, Shaida Khan, Rohan Khera, Anish Bhatt, Sonia Garg, Justin L Grodin, Robert Morlend, Faris G Araj, Alpesh A Amin, Jennifer T Thibodeau, Sandeep Das, Mark H Drazner, Pradeep P A Mammen
BACKGROUND: Duchenne muscular dystrophy (DMD) is frequently complicated by development of a cardiomyopathy. Despite significant medical advances provided to DMD patients over the past 2 decades, there remains a group of DMD patients who die prematurely. The current study sought to identify a set of prognostic factors that portend a worse outcome among adult DMD patients. METHODS AND RESULTS: A retrospective cohort of 43 consecutive patients was followed in the adult UT Southwestern Neuromuscular Cardiomyopathy Clinic...
October 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29040413/bilateral-cavitary-multidrug-or-extensively-drug-resistant-tuberculosis-role-of-surgery
#3
Galina Yu Marfina, Kirill B Vladimirov, Armen O Avetisian, Anna A Starshinova, Grigorii G Kudriashov, Evgenii G Sokolovich, Piotr K Yablonskii
OBJECTIVES: Cavitary disease and bilateral lesions are among the risk factors for poor outcome of pulmonary tuberculosis (TB). Our aim was to explore the value and limits of surgery in patients with advanced TB. METHODS: A retrospective study of 57 consecutive patients who underwent thoracic surgery for culture-positive bilateral cavitary pulmonary TB was performed. Forty-four (77.2%) patients were men and 13 (22.8%) patients were women; their ages were in the range of 18-61 years...
October 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29040168/failure-of-isoflurane-cardiac-preconditioning-in-obese-type-2-diabetic-mice-involves-aberrant-regulation-of-microrna-21-endothelial-nitric-oxide-synthase-and-mitochondrial-complex-i
#4
Zhi-Dong Ge, Yingchuan Li, Shigang Qiao, Xiaowen Bai, David C Warltier, Judy R Kersten, Zeljko J Bosnjak, Mingyu Liang
BACKGROUND: Diabetes impairs the cardioprotective effect of volatile anesthetics, yet the mechanisms are still murky. We examined the regulatory effect of isoflurane on microRNA-21, endothelial nitric-oxide synthase, and mitochondrial respiratory complex I in type II diabetic mice. METHODS: Myocardial ischemia/reperfusion injury was produced in obese type 2 diabetic (db/db) and C57BL/6 control mice ex vivo in the presence or absence of isoflurane administered before ischemia...
October 17, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29038734/dilemma-in-management-a-patient-with-active-systemic-lupus-erythematosus-presenting-with-pulmonary-cavitary-lesion
#5
Van T La, Kathleen Teves, Vaneet K Sandhu
Pulmonary manifestations of systemic lupus erythematosus (SLE) include, but are not limited to, pneumonia, interstitial pneumonitis, atelectasis and pleural effusion. Cavitary lung lesions are rarely associated with SLE. We present herein the case of a female patient with SLE and lupus nephritis who presented to the hospital with respiratory failure, rash and arthralgias. She was found to have a cavitary lung lesion most concerning for infection. However, despite an extensive inpatient antibiotic course, her symptoms persisted...
October 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29038412/-effects-of-high-frequency-jet-ventilation-on-respiratory-failure-after-total-arch-replacement-due-to-acute-aortic-dissection-with-morbid-obesity-report-of-a-case
#6
Motoyuki Kumagai, Junichiro Nishizawa, Kazuhiro Takatoku, Takashi Ohba
A 55-year-old morbidly obese woman [body mass index (BMI) 51.2] developed acute type A aortic dissection, and she also presented with significant hypoxemia and hypercapnia. She underwent a successful emergency total arch replacement, but severe hypoxemia persisted and Pao2/Fio2 lowered to 71.9 mmHg. We therefore applied high frequency jet ventilation (HFJV), which soon improved the hypoxemia without hemodynamic compromise. HFJV was discontinued three days later, when her Pao2/Fio2 improved to 170.0 mmHg. Weaning from the respirator was initiated on postoperative day 13...
October 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29037960/effect-of-procalcitonin-guided-antibiotic-treatment-on-mortality-in-acute-respiratory-infections-a-patient-level-meta-analysis
#7
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Djillali Annane, Konrad Reinhart, Ann R Falsey, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Carolina F Oliveira, Vera Maravić-Stojković, Alessia Verduri, Bianca Beghé, Bin Cao, Yahya Shehabi, Jens-Ulrik S Jensen, Caspar Corti, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Matthias Briel, Beat Mueller
BACKGROUND: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings. METHODS: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control...
October 13, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29037770/dietary-nitrate-supplementation-opposes-the-elevated-diaphragm-blood-flow-in-chronic-heart-failure-during-submaximal-exercise
#8
Joshua R Smith, Scott K Ferguson, K Sue Hageman, Craig A Harms, David C Poole, Timothy I Musch
Chronic heart failure (CHF) results in a greater cost of breathing and necessitates an elevated diaphragm blood flow (BF). Dietary nitrate (NO3‾) supplementation lowers the cost of exercise. We hypothesized that dietary NO3‾ supplementation would attenuate the CHF-induced greater cost of breathing and thus the heightened diaphragm BF during exercise. CHF rats received either 5days of NO3‾-rich beetroot (BR) juice (CHF+BR, n=10) or a placebo (CHF, n=10). Respiratory muscle BFs (radiolabeled microspheres) were measured at rest and during submaximal exercise (20m/min, 5% grade)...
October 13, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29037393/aerobic-function-in-mitochondria-persists-beyond-death-by-heat-stress-in-insects
#9
Erica C Heinrich, Emilie M Gray, Ashley Ossher, Stephen Meigher, Felix Grun, Timothy J Bradley
The critical thermal maximum (CTmax) of insects can be determined using flow-through thermolimit respirometry. It has been demonstrated that respiratory patterns cease and insects do not recover once the CTmax temperature has been reached. However, if high temperatures are maintained following the CTmax, researchers have observed a curious phenomenon whereby the insect body releases a large burst of carbon dioxide at a rate and magnitude that often exceed that of the live insect. This carbon dioxide release has been termed the post-mortal peak (PMP)...
October 2017: Journal of Thermal Biology
https://www.readbyqxmd.com/read/29037221/high-flow-oxygen-via-nasal-cannulae-in-patients-with-acute-hypoxemic-respiratory-failure-a-systematic-review-and-meta-analysis
#10
Murdoch Leeies, Eric Flynn, Alexis F Turgeon, Bojan Paunovic, Hal Loewen, Rasheda Rabbani, Ahmed M Abou-Setta, Niall D Ferguson, Ryan Zarychanski
BACKGROUND: We performed a systematic review and meta-analysis to evaluate the efficacy and safety of high-flow oxygen via nasal cannulae (HFNC) compared to non-invasive ventilation (NIV) and/or standard oxygen in patients with acute, hypoxemic respiratory failure. METHODS: We reviewed randomized controlled trials from CENTRAL, EMBASE, MEDLINE, Scopus and the International Clinical Trials Registry Platform (inception to February 2016), conference proceedings, and relevant article reference lists...
October 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29034688/end-of-life-characteristics-and-palliative-care-provision-for-patients-with-motor-neuron-disease
#11
Hon Wai Benjamin Cheng, Oi Man Iman Chan, Chun Hung Red Chan, Wan Hung Chan, Koon Sim Fung, Kar Yin Wong
Motor neuron disease (MND) is a neurodegenerative disease and manifested as progressive decline in physical, respiratory, swallowing and communication function, and ultimately death. Traditional model of care was fragmented and did not match with multifacet needs of patients and carers. Furthermore, there could be lack of integrated care at end of life for patients with MND in most lower- and middle-income countries or in places with inadequate palliative care (PC) coverage. In view of this, a special workgroup for patients with MND, which includes neurologist, respiratory physician, rehabilitation specialist, and PC physician was formed in Hong Kong since year 2011...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29034344/hemocoagulase-might-not-control-but-worsen-gastrointestinal-bleeding-in-an-elderly-patient-with-type-ii-respiratory-failure
#12
Xingshun Qi, Jigang Wang, Xiaonan Yu, Valerio De Stefano, Hongyu Li, Chunyan Wu, Qingwei Zeng, Yongguo Zhang, Linan Ren, Hao Lin, Jiao Deng, Xiaozhong Guo
Hemocoagulase has been successfully used for the management of bleeding in patients undergoing surgery. Local spray of hemocoagulase during endoscopic therapy may be effective for the management of gastrointestinal bleeding. In China, intravenous infusion of hemocoagulase is given by some physicians for the treatment of gastrointestinal bleeding. However, the potential adverse events secondary to hemocoagulase, such as hypofibrinogenemia, are poorly recognized. In this paper, we reported an elderly patient with type II respiratory failure in whom hemocoagulase might induce hypofibrinogenemia and further worsen gastrointestinal bleeding...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29034094/antibiotic-therapy-supportive-treatment-and-management-of-immunomodulation-inflammation-response-in-community-acquired-pneumonia-review-of-recommendations
#13
REVIEW
Marco Mantero, Paolo Tarsia, Andrea Gramegna, Sonia Henchi, Nicolò Vanoni, Marta Di Pasquale
Community-acquired pneumonia is a common and serious disease, with high rates of morbidity and mortality. Management and treatment of community-acquired pneumonia are described in three main documents: the 2007 American Thoracic Society guidelines, the 2011 European Respiratory Society guidelines, and the 2009 British Thoracic Society guidelines, updated by the NICE in 2015. Despite the validity of current guidelines in improving prognosis and management of patients with community-acquired pneumonia, not all recommendations have high levels of evidence and there are still some controversial issues...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29033442/efficacy-of-oxycodone-for-dyspnea-in-end-stage-heart-failure-with-renal-insufficiency-a-case-report
#14
Masayuki Tanaka, Hirofumi Maeba, Takeshi Senoo, Junji Iwasaka, Aki Ohkita, Haruna Kita, Kazuki Uchitani, Yasuhiko Hirota
A 67-year-old man with dilated cardiomyopathy and renal insufficiency was admitted to our hospital with dyspnea secondary to end-stage heart failure. We introduced oxycodone for medically refractory dyspnea instead of morphine because of the patient's renal insufficiency. After the administration of oxycodone, his dyspnea was alleviated without any adverse opioid effects, such as respiratory depression. After treating his heart failure, he was able to leave the intensive care unit. Oxycodone may therefore be a reliable agent for the treatment of dyspnea in patients with end-stage heart failure and renal insufficiency...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29033435/clinical-features-of-nontuberculous-mycobacterial-pleurisy-a-review-of-12-cases
#15
Maiko Naito, Toshiya Maekura, Yu Kurahara, Masahiro Tahara, Naoya Ikegami, Yohei Kimura, Shoko Sonobe, Takehiko Kobayashi, Shojiro Minomo, Taisuke Tsuji, Kazunari Tsuyuguchi, Seiji Hayashi, Katsuhiro Suzuki
Objective The incidence of pulmonary nontuberculous mycobacterial (NTM) infections has increased in recent decades. Nevertheless, NTM pleurisy is still a rare disease. The objective of the present study was to elucidate the clinical features and outcomes of NTM pleurisy. Methods A retrospective study was undertaken of consecutive patients whose pleural effusion culture yielded NTM, from 2002 to 2016 at a respiratory hospital in Japan. The clinical features, treatment, and outcomes of these patients were analyzed...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29033412/emergency-caesarean-section-saved-both-an-anti-musk-antibody-positive-myasthenia-gravis-mother-with-pregnancy-induced-hypertension-and-her-premature-baby
#16
Yoshiaki Takahashi, Toru Yamashita, Ryuta Morihara, Yumiko Nakano, Kota Sato, Mami Takemoto, Nozomi Hishikawa, Yasuyuki Ohta, Kei Hayata, Hisashi Masuyama, Tomoka Okamura, Yosuke Washio, Koji Abe
We herein report the case of a 46-year-old pregnant woman with anti-muscle specific kinase (MuSK) antibody-positive myasthenia gravis (MG) who showed pregnancy-induced hypertension and developed respiratory failure at 30 weeks and 5 days of pregnancy, and who underwent an emergency caesarean section (CS). Her MG symptoms gradually improved in the subsequent weeks. The premature baby with positive MuSK antibodies was successfully delivered, but the male baby required temporary artificial ventilation. However, his condition also gradually improved over time...
October 16, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29033358/predictive-factors-of-early-postoperative-respiratory-complications-after-tonsillectomy-in-children-with-unidentified-risks-for-this-complication
#17
Florence Julien-Marsollier, Pierre Salis, Rachida Abdat, Thierno Diallo, Thierry van Den Abbelle, Souhayl Dahmani
INTRODUCTION: Tonsillectomy is considered as a therapeutic option in obstructive sleep apnoea syndrome (OSAS). Postoperative respiratory failure is a complication that can require respiratory support. The main objective of our study is to determine risk factors of postoperative respiratory complications in children undergoing tonsillectomy. MATERIAL AND METHODS: This is a retrospective single centre observational study including patients with unanticipated postoperative respiratory failure...
October 12, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29032960/correlation-between-oxyhaemoglobin-saturation-by-pulse-oximetry-and-partial-pressure-of-oxygen-in-patients-with-acute-respiratory-failure
#18
C Cinesi-Gómez, P García-García, I López-Pelayo, J I Giménez, L M González-Torres, E Bernal-Morell
OBJECTIVES: To ascertain the correlation between the partial pressure of oxygen (PaO2) and oxyhaemoglobin saturation by pulse oximetry (SpO2) in patients who were admitted to the emergency department with suspected acute respiratory failure. MATERIAL AND METHODS: A prospective, observational multicentre study was conducted in the emergency departments of 3 Spanish hospitals. RESULTS: The study included 166 patients who presented mean±standard deviation PaO2, SpO2 and fraction of inspired oxygen (FiO2) values of 61...
October 12, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/29032897/prevnar-13-vaccine-failure-in-a-mouse-model-for-vitamin-a-deficiency
#19
Rhiannon R Penkert, Amy Iverson, Jason W Rosch, Julia L Hurwitz
Streptococcus pneumoniae (pneumococcus) is responsible for serious pediatric respiratory infections, and kills close to one million children under the age of five each year. Unfortunately, the Prevnar-13 vaccine (PCV-13) that is used to protect children from the serious consequences of pneumococcus infections is not always successful. Given that vitamin A deficiency (VAD) is known to affect children in both developed and developing countries, we asked if VAD could be responsible, at least in part, for PCV-13 vaccine failures...
November 1, 2017: Vaccine
https://www.readbyqxmd.com/read/29032064/laparoscopic-and-robotic-assisted-hysterectomy-for-uterine-leiomyomas-a-comparison-of-complications-and-costs
#20
Tin Yan Tina Ngan, Andrew Zakhari, Nicholas Czuzoj-Shulman, Togas Tulandi, Haim Arie Abenhaim
OBJECTIVE: Robotic surgery is increasingly being used for treatment of malignant and benign gynaecologic diseases. The purpose of our study is to compare patient perioperative complications and costs of laparoscopic versus robotic-assisted hysterectomy for uterine leiomyomas. METHODS: A retrospective cohort study using the Nationwide Inpatient Sample database from the United States was conducted, comparing patients who underwent robotic-assisted hysterectomy and laparoscopic hysterectomy (total laparoscopic hysterectomy and laparoscopic-assisted vaginal hysterectomy) for uterine fibroids between 2008 and 2012...
October 11, 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
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