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Respiratory acidosis

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https://www.readbyqxmd.com/read/28104101/preventing-hospitalizations-from-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#1
REVIEW
Jessica E Burchette, G Douglas Campbell, Stephen A Geraci
Chronic obstructive lung disease is among the leading causes of adult hospital admissions and readmissions in the United States. Preventing acute exacerbations is the primary approach in therapy. Combinations of smoking cessation, pulmonary rehabilitation, vaccinations and inhaled and oral medications may all reduce the overall risk of acute exacerbations. When prevention is unsuccessful, treatment of exacerbations often does not require hospitalization but can be safely executed in the outpatient setting. In the patient who does not require mechanical ventilation or who manifests respiratory acidosis, oxygen supplementation, frequent short-acting inhaled bronchodilators, oral corticosteroids and often antibiotics can abort the decompensation and sometimes return the patient to his or her pre-attack baseline lung function...
January 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28101662/strategies-to-prevent-cast-formation-in-patients-with-plastic-bronchitis-undergoing-heart-transplantation
#2
John J Parent, Robert K Darragh, Jeffrey G Gossett, Thomas D Ryan, Chet R Villa, Angela Lorts, John L Jefferies, Jeffrey A Towbin, Clifford Chin
Plastic bronchitis, a rare complication after Fontan palliation, carries a high morbidity and mortality risk. Heart transplantation is an effective treatment option, but casts may occur in the early post-operative period. We present a case series detailing peri-operative management strategies to minimize morbidity and mortality related to plastic bronchitis in patients undergoing heart transplantation. Patient 1 received no treatment pre-, intra-, or post-transplant for prevention of bronchial casts and developed severe respiratory acidosis 18 h following transplant...
January 19, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28099641/sepsis-related-acute-respiratory-distress-syndrome-in-children-with-cancer-the-respiratory-dynamics-of-a-devastating-condition
#3
Rodrigo Genaro Arduini, Orlei Ribeiro de Araujo, Dafne Cardoso Bourguignon da Silva, Andreza Almeida Senerchia, Antonio Sergio Petrilli
Objective: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome. Methods: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28096226/disseminated-adenovirus-infection-causing-severe-ards
#4
Steven J Campbell, Jessica A Kynyk, John A Davis
A previously healthy young man with a rare genetic condition presented with severe acute respiratory distress syndrome secondary to pneumonia with septic shock. He did not improve with conventional therapy for his known causal organism thus prompting further workup. He was found to be profoundly immunosuppressed raising our suspicion for atypical organisms. A bronchoalveolar lavage sample was positive via PCR for adenovirus which we suspect exacerbated a pre-existing bacterial pneumonia and led to a severe and non-responsive respiratory failure...
January 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28095826/non-invasive-respiratory-support-for-infants-with-bronchiolitis-a-national-survey-of-practice
#5
H Turnham, R S Agbeko, J Furness, J Pappachan, A G Sutcliffe, P Ramnarayan
BACKGROUND: Bronchiolitis is a common respiratory illness of early childhood. For most children it is a mild self-limiting disease but a small number of children develop respiratory failure. Nasal continuous positive airway pressure (nCPAP) has traditionally been used to provide non-invasive respiratory support in these children, but there is little clinical trial evidence to support its use. More recently, high-flow nasal cannula therapy (HFNC) has emerged as a novel respiratory support modality...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28073937/activity-of-tachykinin1-expressing-pet1-raphe-neurons-modulates-the-drive-to-breathe
#6
Morgan L Hennessy, Andrea Corcoran, Rachael D Brust, Eugene E Nattie, Susan Dymecki
: Homeostatic control of breathing, heart rate, and body temperature relies on circuits within the brainstem modulated by the neurotransmitter serotonin (5-HT). Mounting evidence points to specialized neuronal subtypes within the 5-HT system, which have borne out in functional studies, including the modulation of distinct facets of homeostatic control. These functional differences, read out at the organismal level, are likely subserved by differences among 5-HT neuron subtypes at the cellular and molecular levels, including differences in the capacity to co-express other neurotransmitters such as glutamate, GABA, thyrotropin releasing hormone, and substance P encoded by the Tachykinin-1 (Tac1) gene...
January 10, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28065973/is-potassium-thiosulfate-a-poison-is-it-safe-a-case-series
#7
Cigdem Ozpolat, Arzu Denizbasi, Ozge Onur, Serkan Emre Eroglu, Haldun Akoglu
Potassium Thiosulfate is a liquid substance used for producing fertilizers. In this case series, we present five patients who have been exposed to potassium thiosulfate inhalation. Three of them were intubated in the scene by paramedics because of confusion and respiratory depression. They had refractory status epilepticus. The other two were exposed during trying to help the others for getting out, they presented to ED with nausea, vomiting and headache. One of the intubated patients died on the 4th day of his follow-up at ICU...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28057371/3-meo-pcp-intoxication-in-two-young-men-first-in-vivo-detection-in-italy
#8
Elisabetta Bertol, Jennifer Pascali, Diego Palumbo, Valeria Catalani, Maria Grazia Di Milia, Alessia Fioravanti, Francesco Mari, Fabio Vaiano
3-MeO-PCP or 3-methoxyphencyclidine is a derivative of phencyclidine. It acts as a dissociative anesthetic and it has allegedly hallucinogenic and sedative effects. There are almost no documented intoxication cases and references about its pharmacology and toxicity in literature. This study presents two concomitant intoxication cases due to consumption of 3-MeO-PCP and alcohol. A 19 (A) and a 21 years old (B) men were brought to Santa Maria Nuova Hospital in a comatose state (Glasgow score 3). They showed respiratory acidosis, right anisocoria with mydriatic pupils and hypothermia...
December 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#9
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28051570/severe-hypoxemia-in-muskoxen-ovibos-moschatus-immobilized-with-etorphine-and-xylazine-corrected-with-supplemental-nasal-oxygen
#10
Marianne Lian, Sven Björck, Jon M Arnemo, Núria Fandos Esteruelas, Martine Angel, Solveig C Minsaas, Krista L Jones, Alina L Evans
Twenty-three muskoxen ( Ovibos moschatus ) housed in a captive facility for rewilding in Sweden were chemically immobilized for annual health evaluations and hoof trimming. The muskoxen were darted in May to September (2012-2015) in their holding pen with etorphine (0.015 mg/kg) and xylazine (0.1 mg/kg) intramuscularly. Twenty-two of the 23 animals were immobilized with a single dart injection. The mean (SD) induction time was 4 (2) min. Arterial blood gases were collected from 18 animals. All animals were severely hypoxemic with varying degrees of respiratory acidosis...
January 4, 2017: Journal of Wildlife Diseases
https://www.readbyqxmd.com/read/28050802/the-effectiveness-of-apneic-oxygenation-during-tracheal-intubation-in-various-clinical-settings-a-narrative-review
#11
David T Wong, Amanda J Yee, Siaw May Leong, Frances Chung
PURPOSE: During the process of tracheal intubation, patients are apneic or hypoventilating and are at risk of becoming hypoxemic. This risk is especially high in patients with acute or chronic respiratory failure and accompanying compromised respiratory reserve. To address this concern, apneic oxygenation can be administered during tracheal intubation to aid in maintaining arterial oxygen saturation. The objective of this narrative review is to examine the utilization of apneic oxygenation within the operating room, intensive care unit (ICU), emergency department, and pre-hospital settings and to determine its efficacy compared with controls...
January 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28049485/the-dangers-of-accepting-a-single-diagnosis-case-report-of-concurrent-plasmodium-knowlesi-malaria-and-dengue-infection
#12
Soon Eu Chong, Rhendra Hardy Mohamad Zaini, Siti Suraiya, Kok Tong Lee, Jo Anne Lim
BACKGROUND: Dengue and malaria are two common, mosquito-borne infections, which may lead to mortality if not managed properly. Concurrent infections of dengue and malaria are rare due to the different habitats of its vectors and activities of different carrier mosquitoes. The first case reported was in 2005. Since then, several concurrent infections have been reported between the dengue virus (DENV) and the malaria protozoans, Plasmodium falciparum and Plasmodium vivax. Symptoms of each infection may be masked by a simultaneous second infection, resulting in late treatment and severe complications...
January 3, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28040730/mutations-in-the-accessory-subunit-ndufb10-result-in-isolated-complex-i-deficiency-and-illustrate-the-critical-role-of-intermembrane-space-import-for-complex-i-holoenzyme-assembly
#13
Marisa W Friederich, Alican J Erdogan, Curtis R Coughlin, Mihret T Elos, Hua Jiang, Courtney O'Rourke, Mark A Lovell, Eric Wartchow, Katherine Gowan, Kathryn C Chatfield, Wallace S Chick, Elaine Spector, Johan L K Van Hove, Jan Riemer
An infant presented with fatal infantile lactic acidosis and cardiomyopathy, and was found to have profoundly decreased activity of respiratory chain complex I in muscle, heart and liver. Exome sequencing revealed compound heterozygous mutations in NDUFB10, an accessory subunit located within the PD part of complex I. One mutation resulted in a premature stop codon and absent protein, while the second mutation replaced the highly conserved cysteine 107 with a serine residue. Protein expression of NDUFB10 was decreased in muscle and heart, and less so in liver and fibroblasts, resulting in perturbed assembly of the holoenzyme at the 830 kDa stage...
December 30, 2016: Human Molecular Genetics
https://www.readbyqxmd.com/read/28007319/nasal-flaring-as-a-clinical-sign-of-respiratory-acidosis-in-patients-with-dyspnea
#14
José Gregorio Zorrilla-Riveiro, Anna Arnau-Bartés, Ramón Rafat-Sellarés, Dolors García-Pérez, Arantxa Mas-Serra, Rafael Fernández-Fernández
OBJECTIVE: To determine whether the presence of nasal flaring is a clinical sign of respiratory acidosis in patients attending emergency departments for acute dyspnea. METHODS: Single-center, prospective, observational study of patients aged over 15 requiring urgent attention for dyspnea, classified as level II or III according to the Andorran Triage Program and who underwent arterial blood gas test on arrival at the emergency department. The presence of nasal flaring was evaluated by two observers...
December 10, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28000205/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-ii-controlled-vs-spontaneous-ventilation
#15
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation)...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27997251/changes-of-respiratory-mechanics-in-copd-patients-from-stable-state-to-acute-exacerbations-with-respiratory-failure
#16
Piero Ceriana, Michele Vitacca, Annalisa Carlucci, Mara Paneroni, Lara Pisani, Stefano Nava
Symptoms, clinical course, functional and biological data during an exacerbation of chronic obstructive pulmonary disease (EXCOPD) have been investigated, but data on physiological changes of respiratory mechanics during a severe exacerbation with respiratory acidosis requiring noninvasive mechanical ventilation (NIMV) are scant. The aim of this study was to evaluate changes of respiratory mechanics in COPD patients comparing data observed during EXCOPD with those observed during stable state in the recovery phase...
December 20, 2016: COPD
https://www.readbyqxmd.com/read/27984607/-phenotypic-and-genetic-analysis-of-a-family-affected-with-microvillus-inclusion-disease
#17
Man Mao, Li Guo, Zhanhui Zhang, Bin Wang, Shanhua Huang, Yuanzong Song, Fengping Chen, Wangrong Wen
OBJECTIVE: To explore the clinical features and mutations of MYO5B gene in a family affected with microvillus inclusion disease. METHODS: Clinical data of an infant affected with microvillus inclusion disease was collected. Genomic DNA was extracted from peripheral blood samples from the patient and her parents. PCR amplification and Sanger sequencing were performed to analyze all the exons and their flanking sequences of the MYO5B gene. RESULTS: The patient presented with complicated manifestations including respiratory distress syndrome, dehydration, acidosis, bowel dilatation, liver and kidney dysfunction, and severe and intractable diarrhea...
December 10, 2016: Zhonghua Yi Xue Yi Chuan Xue za Zhi, Zhonghua Yixue Yichuanxue Zazhi, Chinese Journal of Medical Genetics
https://www.readbyqxmd.com/read/27973540/bicarbonate-increases-ischemia-reperfusion-damage-by-inhibiting-mitophagy
#18
Bruno B Queliconi, Alicia J Kowaltowski, Roberta A Gottlieb
During an ischemic event, bicarbonate and CO2 concentration increase as a consequence of O2 consumption and lack of blood flow. This event is important as bicarbonate/CO2 is determinant for several redox and enzymatic reactions, in addition to pH regulation. Until now, most work done on the role of bicarbonate in ischemia-reperfusion injury focused on pH changes; although reperfusion solutions have a fixed pH, cardiac resuscitation protocols commonly employ bicarbonate to correct the profound acidosis associated with respiratory arrest...
2016: PloS One
https://www.readbyqxmd.com/read/27966425/-lactic-acidosis-in-a-24-year-old-woman-with-status-asthmaticus
#19
Lana Ramazan-Yousif, Signe Albertsen, Troels K Bergmann, Poul Henning Madsen, Nick Phaff Steen
A 24-year-old woman with asthma presented with symptoms of upper airway infection and tachypnoea and wheezes. She had a history of admissions to intensive care units (ICU) due to respiratory insufficiency. The initial lactate concentration was 2.1 mmol/l. The treatment consisted of inhaled and intravenous β ² agonists. Hereafter, the lactate concentration rose to 9.8 mmol/l, and the patient was admitted to the ICU due to severe asthma exacerbation. The elevation of lactate concentration cleared after discontinuation of β ² agonist therapy...
December 12, 2016: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27942179/mixed-acid-base-disorder-secondary-to-topiramate-use-in-traumatic-brain-injury
#20
S Golla, U Anandh, A Balasubramaniam
We report a case of a man with traumatic brain injury. He was started on to prophylactic topiramate which led to a mixed acid-base disorder. He had severe metabolic acidosis secondary to renal tubular acidification defect and respiratory alkalosis secondary to hyperventilation. Withdrawal of the offending drug led to the prompt resolution of the acid-base disturbance.
November 2016: Indian Journal of Nephrology
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