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Respiratory failure

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https://www.readbyqxmd.com/read/28634172/identifying-an-oxygenation-index-threshold-for-increased-mortality-in-acute-respiratory-failure
#1
Brandon G Hammond, Pamela Garcia-Filion, Paul Kang, Mounica Y Rao, Brigham C Willis, Heidi J Dalton
BACKGROUND: The objective of this work was to examine current oxygenation index (OI) data and outcomes using electronic medical record data to identify a specific OI value associated with mortality. METHODS: This study was a retrospective electronic medical record data review from the pediatric ICU of Phoenix Children's Hospital, with data mining for variables to calculate OIs on subjects age 1 month to 20 y mechanically ventilated >24 h, excluding those with known intracardiac shunts or cyanotic heart disease...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28633270/surgical-correction-for-a-neonate-with-ebstein-s-anomaly-associated-with-tetralogy-of-fallot
#2
Ling-Yi Wei, Jin-Chung Shih, En-Ting Wu, Shyh-Jye Chen, Yih-Sharng Chen, Shu-Chien Huang
Ebstein's anomaly in combination with tetralogy of Fallot (TOF) is rare. We report a male infant with these combined anomalies who presented with severe cyanosis, heart failure, and respiratory distress after birth. Biventricular repair was successfully performed with 1-stage correction of his ventricular septal defect (VSD), right ventricular outflow tract (RVOT) obstruction, and tricuspid regurgitation. The downward displaced tricuspid valve was also restored to the normal annulus position. The infant recovered well...
July 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28632754/permissive-hypercapnia-for-severe-acute-respiratory-distress-syndrome-in-immunocompromised-children-a-single-center-experience
#3
Hans Fuchs, Nicola Rossmann, Manuel B Schmid, Manfred Hoenig, Ulrich Thome, Benjamin Mayer, Daniel Klotz, Helmut D Hummler
BACKGROUND: Controlled hypoventilation while accepting hypercapnia has been advocated to reduce ventilator-induced lung injury. The aim of the study was to analyze outcomes of a cohort of immunocompromised children with acute respiratory distress syndrome (ARDS) ventilated with a strategy of stepwise increasing PCO2 targets up to 140 mm Hg. METHODS: Retrospective analysis of outcomes of a cohort of children with oncologic disease or after stem cell transplantation and severe respiratory failure in comparison with a historical control cohort...
2017: PloS One
https://www.readbyqxmd.com/read/28631763/-noninvasive-ventilation-general-characteristics-indications-and-review-of-the-literature
#4
Fabio Vagnarelli, Marco Marini, Giorgio Caretta, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Daniela Pini, Alessandro Navazio, Renata De Maria, Serafina Valente, Michele Massimo Gulizia
Noninvasive ventilation (NIV), including both continuous and bilevel positive airway pressure, plays a pivotal role in the treatment of acute respiratory failure secondary to acute heart failure. For an appropriate use of NIV, it is essential to consider the underlying pathophysiological principles, the differences between the different modes of ventilation, the main indications, contraindications and complications. The aim of this review is also to give practical guidance on how and when to start NIV at the bedside, how to monitor the response and how to choose the most appropriate interface...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28631088/etiologies-diagnostic-work-up-and-outcomes-of-acute-respiratory-distress-syndrome-with-no-common-risk-factor-a-prospective-multicenter-study
#5
Nicolas de Prost, Tài Pham, Guillaume Carteaux, Armand Mekontso Dessap, Christian Brun-Buisson, Eddy Fan, Giacomo Bellani, John Laffey, Alain Mercat, Laurent Brochard, Bernard Maître
BACKGROUND: Patients meeting the Berlin definition for the acute respiratory distress syndrome (ARDS) might lack exposure to one or more "common" risk factors and exhibit different clinical phenotype and outcomes. We aimed to compare the clinical presentation and outcome of ARDS patients with or without risk factors, the impact on hospital mortality, and to assess the diagnostic work-up performed. The current study is an ancillary analysis of an international, multicenter, prospective cohort study (the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure, LUNG SAFE)...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28629636/nasal-high-flow-oxygen-therapy-in-the-ward-setting-a-prospective-observational-study
#6
Alison M Pirret, Susan F Takerei, Claire L Matheson, Meghan Kelly, Wharewaina Strickland, Joanne Harford, Nicola E Jepsen, Lisa J Welsh, Chloe P A Allan
BACKGROUND: Whilst research demonstrates the benefits of nasal high flow oxygen in the intensive care setting, limited literature exists on its benefits in ward patients. OBJECTIVES: This study evaluated the use of nasal high flow oxygen in adult ward patients with respiratory failure or at risk of respiratory deterioration. Primary outcome was an improvement in pulmonary function as indicated by decreases in respiratory and heart rates and an increase in arterial oxygen saturation via pulse oximetry...
June 16, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28628546/the-impact-of-multiple-viral-respiratory-infections-on-outcomes-for-critically-ill-children
#7
Jigar C Chauhan, Nicholas B Slamon
OBJECTIVE: Advances in molecular diagnosis have led to increased testing for single and multiviral respiratory infection in routine clinical practice. This study compares outcomes between single and multiviral respiratory infections in children younger than 5 years old admitted to the PICU with respiratory failure. DESIGN: Retrospective, single-center, cohort study. SETTING: Tertiary-care, freestanding children's hospital. PATIENTS: Children younger than 5 years old admitted to the PICU with respiratory failure and positive respiratory molecular panel...
June 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28627353/-ultrasonographic-evaluation-of-diaphragm-structure-and-function
#8
Feifei Wang, Xiaoping Zhu, Shaolin Ma
Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate, safe and noninvasive method of quantification of diaphragm structure and function...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28626634/an-unusual-late-onset-of-pulmonary-alveolar-microlithiasis-a-case-report-and-literature-review
#9
Alexandros Stamatopoulos, Davide Patrini, Sofoklis Mitsos, Reena Khiroya, Elaine Borg, Martin Hayward, David Lawrence, Nikolaos Panagiotopoulos
Pulmonary alveolar microlithiasis (PAM) is an uncommon genetic disorder associated with alveolar cell injury. This injury is caused in most cases by inactivating mutations in SLC34A2 gene, which is responsible for the production of a sodium-dependent phosphate co-transporter. The dysfunction or deficiency of this transporter leads to the aggregation of local phosphate intra-alveolarly and formation of microliths. Most of the patients are asymptomatic at the time of the diagnosis but as the disease progress it leads to fatal respiratory or cardiac failure...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28626373/biliary-pleural-fistula-following-portal-vein-embolization-for-perihilar-cholangiocarcinoma
#10
Mujtaba Mohammed, Katsuhiro Kobayashi, Mohammed Jawed
Biliary-pleural fistula (BPF), an abnormal communication between the biliary tract and pleural space, is a rare but potentially life-threatening complication following percutaneous biliary intervention. We report a case of BPF following portal vein embolization (PVE) in a 79-year-old woman with obstructive jaundice secondary to perihilar cholangiocarcinoma. The patient successfully underwent right-sided PVE; however, the patient developed a symptomatic right-sided bilious pleural effusion the following day...
May 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28626190/miliary-tuberculosis-in-a-young-woman-with-hemophagocytic-syndrome-a-case-report-and-literature-review
#11
Mina Asaji, Kazunori Tobino, Koujin Murakami, Yuki Goto, Takuto Sueyasu, Saori Nishizawa, Kohei Yoshimine, Miyuki Munechika, Yuki Ko, Yuki Yoshimatsu, Kosuke Tsuruno, Hiromi Ide, Hiroyuki Miyajima, Noriyuki Ebi
We herein report a rare case of miliary tuberculosis-associated hemophagocytic syndrome (HPS) complicated with respiratory failure. A 19-year-old Japanese woman with a fever, general malaise, and chest radiograph abnormalities was referred to our hospital. After admission, she developed respiratory failure with pancytopenia. A histological examination of lung and bone marrow biopsy samples revealed noncaseating granulomas without evidence of acid-fast bacilli or lymphoma. In addition, a bone marrow biopsy showed marked histiocyte hyperplasia with hemophagocytosis, and a bronchoalveolar lavage fluid culture grew Mycobacterium tuberculosis...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28625752/neurologic-complications-of-extracorporeal-membrane-oxygenation-a-review
#12
REVIEW
Ashleigh Xie, Phillip Lo, Tristan D Yan, Paul Forrest
OBJECTIVE: To review the evidence on neurologic complications in adult extracorporeal membrane oxygenation (ECMO) patients with regard to incidence, pathophysiology, risk factors, diagnosis, monitoring techniques, prevention, and management. DESIGN: Literature review. SETTING: Observational studies and case reports from a variety of institutions. PARTICIPANTS: Adult ECMO patients. INTERVENTIONS: Six electronic databases were searched from their dates of inception to October 2016...
March 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28625122/a-ten-year-review-of-chronic-cor-pulmonale-secondary-to-respiratory-diseases-in-ghana
#13
Collins Oduro-Boatey, Della Adzosii
Chronic cor pulmonale is defined as right ventricular failure secondary to pulmonary hypertension. Our study reviewed all cases of chronic cor pulmonale secondary to respiratory diseases in a ten-year period (2004-20014) in the Department of Child Health, Korle-Bu Teaching Hospital, Ghana. Nine cases of chronic cor pulmonale were recorded during the period. The age range was 1-9 years (average age = 3 years). Obstructive sleep apnoea secondary to adenoid hypertrophy was the commonest cause of pulmonary hypertension...
January 1, 2017: Tropical Doctor
https://www.readbyqxmd.com/read/28624991/a-new-global-and-comprehensive-model-for-icu-ventilator-performances-evaluation
#14
Nicolas S Marjanovic, Agathe De Simone, Guillaume Jegou, Erwan L'Her
BACKGROUND: This study aimed to provide a new global and comprehensive evaluation of recent ICU ventilators taking into account both technical performances and ergonomics. METHODS: Six recent ICU ventilators were evaluated. Technical performances were assessed under two FIO2 levels (100%, 50%), three respiratory mechanics combinations (Normal: compliance [C] = 70 mL cmH2O(-1)/resistance [R] = 5 cmH2O L(-1) s(-1); Restrictive: C = 30/R = 10; Obstructive: C = 120/R = 20), four exponential levels of leaks (from 0 to 12...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28624560/intracranial-hypotension-following-traumatic-brain-injury-a-diagnostic-and-therapeutic-challenge
#15
Jacob Chen Ming Low, Anan Shtaya, Samantha Hettige
BACKGROUND: Intracranial hypotension (IH) is a recognised cause of coma, however, the diagnosis is often challenging, especially in patients with superimposed traumatic brain injury (TBI). CASE REPORT: We report a case of a 67-year-old patient who became comatose following evacuation of bilateral acute subdural haematomas with concurrent respiratory failure. Imaging and intraparenchymal intracranial pressure (ICP) monitoring confirmed secondary IH. She was managed with an epidural blood patch, and a 72 hours period in the trendelenberg position guided by ICP monitoring and clinical assessment...
June 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28624388/geo-economic-variations-in-epidemiology-patterns-of-care-and-outcomes-in-patients-with-acute-respiratory-distress-syndrome-insights-from-the-lung-safe-prospective-cohort-study
#16
John G Laffey, Fabiana Madotto, Giacomo Bellani, Tài Pham, Eddy Fan, Laurent Brochard, Pravin Amin, Yaseen Arabi, Ednan K Bajwa, Alejandro Bruhn, Vladimir Cerny, Kevin Clarkson, Leo Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Jose A Lorente, Lia McNamee, Nicolas Nin, Jose Emmanuel Palo, Lise Piquilloud, Haibo Qiu, Juan Ignacio Silesky Jiménez, Andres Esteban, Daniel F McAuley, Frank van Haren, Marco Ranieri, Gordon Rubenfeld, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). METHODS: LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensive-care units in 50 countries across six continents...
June 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28624032/epidural-analgesia-for-traumatic-rib-fractures-is-associated-with-worse-outcomes-a-matched-analysis
#17
Katherine M McKendy, Lawrence F Lee, Kerianne Boulva, Dan L Deckelbaum, David S Mulder, Tarek S Razek, Jeremy R Grushka
BACKGROUND: The optimal method of pain control for patients with traumatic rib fractures is unknown. The aim of this study was to determine the effect of epidural analgesia on respiratory complications and in-hospital mortality in patients with rib fractures. METHODS: Adult patients at a level I trauma center with ≥1 rib fracture from blunt trauma were included (2004-2013). Those with a blunt-penetrating mechanism, traumatic brain injury, or underwent a laparotomy or thoracotomy were excluded...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623885/monitoring-the-electric-activity-of-the-diaphragm-during-noninvasive-positive-pressure-ventilation-a-case-report
#18
Fabia Diniz-Silva, Anna Miethke-Morais, Adriano M Alencar, Henrique T Moriya, Pedro Caruso, Eduardo L V Costa, Juliana C Ferreira
BACKGROUND: In patients with post-extubation respiratory distress, delayed reintubation may worsen clinical outcomes. Objective measures of extubation failure at the bedside are lacking, therefore clinical parameters are currently used to guide the need of reintubation. Electrical activity of the diaphragm (EAdi) provides clinicians with valuable, objective information about respiratory drive and could be used to monitor respiratory effort. CASE PRESENTATION: We describe the case of a patient with Chronic Obstructive Pulmonary Disease (COPD), from whom we recorded EAdi during four different ventilatory conditions: 1) invasive mechanical ventilation, 2) spontaneous breathing trial (SBT), 3) unassisted spontaneous breathing, and 4) Noninvasive Positive Pressure Ventilation (NPPV)...
June 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28623282/a-nationwide-study-of-severe-and-protracted-diarrhoea-in-patients-with-primary-immunodeficiency-diseases
#19
Wen-I Lee, Chien-Chang Chen, Tang-Her Jaing, Liang-Shiou Ou, Chuen Hsueh, Jing-Long Huang
Diarrhoea lasting longer than 14 days and failing to respond to conventional management is defined as severe and protracted diarrhoea (SD). In this study, we investigated the prevalence, pathogens and prognosis of SD in primary immunodeficiency diseases (PIDs). Among 246 patients with predominantly paediatric-onset PIDs from 2003-2015, 21 [Btk (six), IL2RG (four), WASP, CD40L, gp91 (three each), gp47, RAG2 (one each)] and five [CVID (four), SCID (one)] without identified mutations had SD before prophylactic treatment...
June 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28620674/organ-dysfunction-and-failure-following-brain-death-do-not-preclude-successful-donation
#20
Eno-Obong I Essien, Nehu Parimi, Jennifer Gutwald-Miller, Tyree Nutter, Thomas M Scalea, Deborah M Stein
BACKGROUND: Organ dysfunction is common after neurologic determination of death (NDD) but before organ collection. Reliable markers for graft success following transplant of these organs would be useful. We sought to determine the relationship between the donor after neurologic determination of death (DNDD) pathophysiology and successful organ donation. METHODS: Donor information was obtained through the local organ procurement organization. Donor demographics and clinical data points for cardiovascular, renal, respiratory, hepatic, hematological and neuroendocrine systems were reviewed 12 h before and 12 h after neurologic determination of death was declared...
June 15, 2017: World Journal of Surgery
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