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lung,respiratory, pulmonary ,mechanical ventilation, sepsis

Smruti B Vaishnav, Bhalendu Vaishnav, Kailas N Desai, Nitin S Raithatha, Neeta S Bose
BACKGROUND: There is a dearth of studies on the clinical profile and therapeutic aspects of critically ill obstetric patients from rural areas, especially those requiring tertiary care support and ventilator therapy. METHODS: We retrospectively analysed the aetiological, clinical, interventional and outcome-related factors of obstetric patients requiring mechanical ventilation in western India. We analysed factors that influence seeking of antenatal care, pregnancy and its complications, severity assessment score, indications and initiation of mechanical ventilation, multiorgan failure and their correlation with maternal mortality...
March 2016: National Medical Journal of India
Elisa Estenssoro, Arnaldo Dubin
Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance...
2016: Medicina
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Léa Fialkow, Maurício Farenzena, Iuri Christmann Wawrzeniak, Janete Salles Brauner, Sílvia Regina Rios Vieira, Alvaro Vigo, Mary Clarisse Bozzetti
OBJECTIVES: To determine the characteristics, the frequency and the mortality rates of patients needing mechanical ventilation and to identify the risk factors associated with mortality in the intensive care unit (ICU) of a general university hospital in southern Brazil. METHOD: Prospective cohort study in patients admitted to the ICU who needed mechanical ventilation for at least 24 hours between March 2004 and April 2007. RESULTS: A total of 1,115 patients admitted to the ICU needed mechanical ventilation...
March 2016: Clinics
A Vieillard-Baron, M Matthay, J L Teboul, T Bein, M Schultz, S Magder, J J Marini
RATIONALE: Acute respiratory distress syndrome (ARDS) is frequently associated with hemodynamic instability which appears as the main factor associated with mortality. Shock is driven by pulmonary hypertension, deleterious effects of mechanical ventilation (MV) on right ventricular (RV) function, and associated-sepsis. Hemodynamic effects of ventilation are due to changes in pleural pressure (Ppl) and changes in transpulmonary pressure (TP). TP affects RV afterload, whereas changes in Ppl affect venous return...
May 2016: Intensive Care Medicine
J N Gonzales, R Lucas, A D Verin
Acute Respiratory Distress Syndrome (ARDS) is a severe lung inflammatory disorder with a 30-50% mortality. Sepsis and pneumonia are the leading causes of ARDS. On the cellular level there is pulmonary capillary endothelial cell permeability and fluid leakage into the pulmonary parenchyma, followed by neutrophils, cytokines and an acute inflammatory response. When fluid increases in the interstitium then the outward movement continues and protein rich fluid floods the alveolar spaces through the tight junctions of the epithelial cells...
June 4, 2015: Austin Journal of Vascular Medicine
Philip Toner, Danny Francis McAuley, Murali Shyamsundar
Sepsis is a common condition that is associated with significant morbidity, mortality and health-care cost. Pulmonary and non-pulmonary sepsis are common causes of the acute respiratory distress syndrome (ARDS). The mortality from ARDS remains high despite protective lung ventilation, and currently there are no specific pharmacotherapies to treat sepsis or ARDS. Sepsis and ARDS are characterised by activation of the inflammatory cascade. Although there is much focus on the study of the dysregulated inflammation and its suppression, the associated activation of the haemostatic system has been largely ignored until recently...
October 23, 2015: Critical Care: the Official Journal of the Critical Care Forum
Chien-Ho Tsai, Yi-Chun Lai, Shih-Chieh Chang, Cheng-Yu Chang, Wei-Shu Wang, Mei-Kang Yuan
BACKGROUND: Video-assisted thoracoscopic surgery (VATS) with decortication is a major treatment for thoracic empyema in the fibropurulent stage. Compared to open thoracotomy, VATS decortication has similar efficacy but fewer postoperative complications in the treatment of thoracic empyema. The role of VATS decortication in the elderly had rarely been investigated. METHODS: From January 2006 to August 2011, we retrospectively enrolled 33 patients older than 65 years diagnosed as thoracic empyema and treated with VATS decortication...
January 2016: Journal of the Chinese Medical Association: JCMA
Erika P Plata-Menchaca, V M De la Puente-Diaz de Leon, Adriana G Peña-Romero, Eduardo Rivero-Sigarroa
Introduction. Pulmonary hemorrhage secondary to disseminated strongyloidiasis is an unusual, well-recognized entity in immunocompromised patients with autoimmune disease, which is associated with the hyperinfection syndrome, sepsis, and a high mortality rate. Case Presentation. We present a case of a 44-year-old Mexican woman with systemic lupus erythematosus and acute bacterial meningitis who developed pulmonary hemorrhage with acute respiratory failure requiring mechanical ventilation, treated with broad spectrum systemic antibiotics and high dose methylprednisolone, who subsequently developed a characteristic purpuric skin eruption and septic shock and died two days later of refractory hypoxemia caused by massive pulmonary bleeding...
2015: Case Reports in Critical Care
Erik K Hartmann, Alexander Ziebart, Rainer Thomas, Tanghua Liu, Arno Schad, Martha Tews, Bernd Moosmann, Jens Kamuf, Bastian Duenges, Serge C Thal, Matthias David
BACKGROUND: The lectin-like domain of TNF-α can be mimicked by synthetic TIP peptides and represents an innovative pharmacologic option to treat edematous respiratory failure. TIP inhalation was shown to reduce pulmonary edema and improve gas exchange. In addition to its edema resolution effect, TIP peptides may exert some anti-inflammatory properties. The present study therefore investigates the influence of the inhaled TIP peptide AP318 on intrapulmonary inflammatory response in a porcine model of systemic sepsis...
2015: BMC Pulmonary Medicine
Erik K Hartmann, Alexander Ziebart, Rainer Thomas, Tanghua Liu, Arno Schad, Martha Tews, Bernd Moosmann, Jens Kamuf, Bastian Duenges, Serge C Thal, Matthias David
BACKGROUND: The lectin-like domain of TNF-α can be mimicked by synthetic TIP peptides and represents an innovative pharmacologic option to treat edematous respiratory failure. TIP inhalation was shown to reduce pulmonary edema and improve gas exchange. In addition to its edema resolution effect, TIP peptides may exert some anti-inflammatory properties. The present study therefore investigates the influence of the inhaled TIP peptide AP318 on intrapulmonary inflammatory response in a porcine model of systemic sepsis...
December 2015: BMC Pulmonary Medicine
Tomoyuki Endo, Shigeki Kushimoto, Satoshi Yamanouchi, Teruo Sakamoto, Hiroyasu Ishikura, Yasuhide Kitazawa, Yasuhiko Taira, Kazuo Okuchi, Takashi Tagami, Akihiro Watanabe, Junko Yamaguchi, Kazuhide Yoshikawa, Manabu Sugita, Yoichi Kase, Takashi Kanemura, Hiroyuki Takahashi, Yuuichi Kuroki, Hiroo Izumino, Hiroshi Rinka, Ryutarou Seo, Makoto Takatori, Tadashi Kaneko, Toshiaki Nakamura, Takayuki Irahara, Nobuyuki Saito
BACKGROUND: In patients with severe sepsis, depression of cardiac performance is common and is often associated with left ventricular (LV) dilatation to maintain stroke volume. Although it is essential to optimize cardiac preload to maintain tissue perfusion in patients with severe sepsis, the optimal preload remains unknown. This study aimed to evaluate the reliability of global end-diastolic volume index (GEDI) as a parameter of cardiac preload in the early phase of severe sepsis. METHODS: Ninety-three mechanically ventilated patients with acute lung injury/acute respiratory distress syndrome secondary to sepsis were enrolled for subgroup analysis in a multicenter, prospective, observational study...
2013: Journal of Intensive Care
Carmen Pizarro, Dirk Skowasch, Georg Nickenig, Daniel Thomas, Marcel Kaminski
History and clinical findings | A 57-year-old woman with a history of emphysematous COPD GOLD D and homozygotic alpha-1-antitrypsin deficiency presented with aggravated dyspnoea, presyncope and left thoracic chest pain. 12 years previously Stanford type B dissection had been conservatively treated. Examinations | Chest radiograph revealed extended infiltrates of the left lower lobe. Seen together with elevated inflammatory values and the patient´s hemodynamic instability it pointed at a pneumonia-driven septic shock...
January 2015: Deutsche Medizinische Wochenschrift
Nadir Yehya, Yi Xin, Yousi Oquendo, Maurizio Cereda, Rahim R Rizi, Susan S Margulies
Sepsis is a leading cause of respiratory failure requiring mechanical ventilation, but the interaction between sepsis and ventilation is unclear. While prior studies demonstrated a priming role with endotoxin, actual septic animal models have yielded conflicting results regarding the role of preceding sepsis on development of subsequent ventilator-induced lung injury (VILI). Using a rat cecal ligation and puncture (CLP) model of sepsis and subsequent injurious ventilation, we sought to determine if sepsis affects development of VILI...
March 1, 2015: American Journal of Physiology. Lung Cellular and Molecular Physiology
K M Lebedinskiĭ, D A Artiukov, M V Borisov, T A Gromova, O A Slivin
The article deals with a case of conventional mechanical ventilation in 75 y.o. woman with the background of uncompensated diabetes mellitus, suffering from bilateral pneumonia with predominantly left-sided lesion and severe sepsis. The conventional mechanical ventilation with high pressure levels led to arterial hypoxemia with P/F ratio 52. Independent lung ventilation immediately increased oxygenation up to P/F ratio 225 and evidently improved left lung aeration. The case demonstrates that while applying high pressures to open alveoli, we could not only provoke ventilator-induced lung injury and low cardiac output, but also "squeeze out" pulmonary perfusion from ventilated areas to non-ventilated ones with less intraalveolar pressure levels...
July 2014: Anesteziologiia i Reanimatologiia
Luis Alfonso Pérez, Diana Marcela González, Karen Margarita de Jesús Álvarez, Luis Alfonso Díaz-Martínez
INTRODUCTION: Continuous positive airway pressure (CPAP) is useful in low birth weight infants with respiratory distress, but it is not known if it is a better alternative to mechanical ventilation after early pulmonary surfactant administration. OBJECTIVE: To compare the incidence of adverse events in 28 to 32-week newborns with respiratory distress managed with mechanical ventilation or CPAP after early surfactant administration. MATERIALS AND METHODS: In total, 176 newborns were treated with CPAP and 147 with mechanical ventilation, all with Apgar scores >3 at five minutes and without apnea...
October 2014: Biomédica: Revista del Instituto Nacional de Salud
Valéria Cabral Neves, Adriana Koliski, Dinarte José Giraldi
Recent changes were introduced in acute hypoxemic respiratory failure children ventilation methods. There are evidences that less aggressive ventilation strategies can improve severe pulmonary injury survival. Experimental trials evidenced a relationship between inappropriate ventilatory measures and delayed acute pulmonary injury improvement, or even worsening. From this, a protective ventilatory measure arises in combination with alveolar recruitment maneuver. This association is believed in clinical practice to determine importantly reduced morbidity and mortality as well as reduced mechanic ventilation-induced injuries...
December 2009: Revista Brasileira de Terapia Intensiva
Xue-Zhong Xing, Yong Gao, Hai-Jun Wang, Quan-Hui Yang, Chu-Lin Huang, Shi-Ning Qu, Hao Zhang, Hao Wang, Qing-Ling Xiao, Ke-Lin Sun
BACKGROUND: This study aimed to investigate the risk factors and outcome of critically ill cancer patients with postoperative acute respiratory insufficiency. METHODS: The data of 190 critically ill cancer patients with postoperative acute respiratory insufficiency were retrospectively reviewed. The data of 321 patients with no acute respiratory insufficiency as controls were also collected. Clinical variables of the first 24 hours after admission to intensive care unit were collected, including age, sex, comorbid disease, type of surgery, admission type, presence of shock, presence of acute kidney injury, presence of acute lung injury/acute respiratory distress syndrome, acute physiologic and chronic health evaluation (APACHE II) score, sepsis-related organ failure assessment (SOFA), and PaO2/FiO2 ratio...
2013: World Journal of Emergency Medicine
Tao Zhang, Xiaojian Li, Zhongyuan Deng, Zhi Zhang, Wenbin Tang, Bin Chen, Qiang Bao, Menglong He
OBJECTIVE: To discuss the distribution of the respiratory complications in severely burned patients and the prevention and treatment experience against them. METHODS: Medical records of 922 adult patients with severe or extremely severe burn hospitalized in our burn ICU from January 2005 to December 2012 were screened and retrospectively analyzed, including patients transferred from other hospitals, patients with total burn area above 50% TBSA, the distribution and treatment of respiratory complications, and the mortality...
June 2014: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Naoki Aikawa, Yasushi Kawasaki
Acute respiratory distress syndrome is a serious condition that can arise following direct or indirect lung injury. It is heterogeneous and has a high mortality rate. Supportive care is the mainstay of treatment and there is no definitive pharmacological treatment as yet. Sivelestat is a neutrophil elastase inhibitor approved in Japan and the Republic of Korea for acute lung injury, including acute respiratory distress syndrome in patients with systemic inflammatory response syndrome. The aim of this review is to examine the clinical utility of sivelestat in different disease states, using data from nonclinical and clinical studies...
2014: Therapeutics and Clinical Risk Management
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