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management of ards

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https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#1
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28441233/acute-respiratory-distress-syndrome-due-to-tuberculosis-in-a-respiratory-icu-over-a-16-year-period
#2
Valliappan Muthu, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal, Ritesh Agarwal
OBJECTIVE: Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. DESIGN: Retrospective analysis of all subjects admitted with acute respiratory distress syndrome over the last 16 years. SETTING: Respiratory ICU of a tertiary care hospital in North India...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28432405/-extracorporeal-membrane-oxygenation-system-selection-contra-indications-and-management
#3
T Staudinger
There are a large number of extracorporeal membrane oxygenation (ECMO) systems and configurations. Thorough planning and evaluation of specific therapeutic needs are necessary to tailor ECMO therapy to the individual patient situation. Indications tend towards lowering the threshold towards respiratory ECMO. Patients with severe acute respiratory distress syndrome (ARDS) not improving to optimization of ventilation and supportive therapeutic measures potentially qualify for ECMO. Contraindications are relative and have to be considered in the light of the individual risk-benefit ratio...
April 21, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#4
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28424322/kaposi-sarcoma-inflammatory-cytokine-syndrome-kics-a-rare-but-potentially-treatable-condition
#5
Michael Karass, Emily Grossniklaus, Talal Seoud, Sanjay Jain, Daniel A Goldstein
Kaposi sarcoma inflammatory cytokine syndrome (KICS) is a newly-described condition affecting individuals who are HIV-positive and are infected with human herpesvirus 8 (HHV-8). This is a syndrome that in some ways mimics severe sepsis with associated acute respiratory distress syndrome, possibly requiring a ventilator and vasopressor support. However, unlike severe sepsis, antibiotics provide no benefit. Management of KICS has not been fully elucidated because of its high mortality rate. However, the syndrome has been successfully treated in some cases with immunomodulatory therapy...
April 19, 2017: Oncologist
https://www.readbyqxmd.com/read/28423094/complications-of-chronic-necrotizing-pulmonary-aspergillosis-review-of-published-case-reports
#6
Aleksandra Barac, Tatjana Adzic Vukicevic, Aleksandra Dudvarski Ilic, Salvatore Rubino, Vladimir Zugic, Goran Stevanovic
Chronic necrotizing pulmonary aspergillosis (CNPA), a form of chronic pulmonary aspergillosis (CPA), affects immunocompetent or mildly immunocompromised persons with underlying pulmonary disease. These conditions are associated with high morbidity and mortality and often require long-term antifungal treatment. The long-term prognosis for patients with CNPA and the potential complications of CNPA have not been well documented. The aim of this study was to review published papers that report cases of CNPA complications and to highlight risk factors for development of CNPA...
April 13, 2017: Revista do Instituto de Medicina Tropical de São Paulo
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#7
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403799/descriptive-analysis-of-mortality-predictors-in-h1n1-influenza-in-south-indian-patients
#8
Kanav Khera, Ajit Singh, Girish Thunga, Jatin Agarwal, Shivanshu Awasthi, Jewel Maria Francis, Rama Bhat
BACKGROUND: H1N1 (hemagglutinin-H-neuroaminidase-N) influenza infection is associated with high morbidity and mortality because of associated complications and related factors. Predictors of mortality in H1N1 patients are studied with very few without seasonal/pandemic declaration. This study was carried out to describe the clinical features, complications and different risk factors that affect the outcome in the patients with confirmed H1N1influenza infection. METHODS: A retrospective study was done in Kasturba Medical College Hospital, Manipal, India by analyzing the medical records of 141 patients admitted from January, 2011 to June, 2015...
April 7, 2017: Infectious Disorders Drug Targets
https://www.readbyqxmd.com/read/28390055/extracorporeal-co2-removal-by-hemodialysis-in-vitro-model-and-feasibility
#9
Alexandra G May, Ayan Sen, Matthew E Cove, John A Kellum, William J Federspiel
BACKGROUND: Critically ill patients with acute respiratory distress syndrome and acute exacerbations of chronic obstructive pulmonary disease often develop hypercapnia and require mechanical ventilation. Extracorporeal carbon dioxide removal can manage hypercarbia by removing carbon dioxide directly from the bloodstream. Respiratory hemodialysis uses traditional hemodialysis to remove CO2 from the blood, mainly as bicarbonate. In this study, Stewart's approach to acid-base chemistry was used to create a dialysate that would maintain blood pH while removing CO2 as well as determine the blood and dialysate flow rates necessary to remove clinically relevant CO2 volumes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#10
Lu Chen, Guang-Qiang Chen, Kevin Shore, Orest Shklar, Concetta Martins, Brian Devenyi, Paul Lindsay, Heather McPhail, Ashley Lanys, Ibrahim Soliman, Mazin Tuma, Michael Kim, Kerri Porretta, Pamela Greco, Hilary Every, Chris Hayes, Andrew Baker, Jan O Friedrich, Laurent Brochard
BACKGROUND: Despite their potential interest for clinical management, measurements of respiratory mechanics in patients with acute respiratory distress syndrome (ARDS) are seldom performed in routine practice. We introduced a systematic assessment of respiratory mechanics in our clinical practice. After the first year of clinical use, we retrospectively assessed whether these measurements had any influence on clinical management and physiological parameters associated with clinical outcomes by comparing their value before and after performing the test...
April 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28368543/morbidity-and-mortality-associated-with-surgery-of-traumatic-c2-fractures-in-octogenarians
#11
Sanjay S Dhall, John K Yue, Ethan A Winkler, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore
BACKGROUND: Management of axis fractures in the elderly remains controversial. As the US population increasingly lives past 80 years, published C2 fracture morbidity/mortality profiles in younger cohorts (55+) have become less applicable to octogenarians. OBJECTIVE: To report associations between surgery and mortality, hospital length of stay and discharge disposition in octogenarians with traumatic C2 fractures. METHODS: Retrospective cohort study of 3847 patients age ≥ 80 years representing 17 702 incidents nationwide, divided into surgery/nonsurgery cohorts, using the National Sample Program of the National Trauma Data Bank from 2003 to 2012...
March 23, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28348947/legionella-pneumonia-associated-with-severe-acute-respiratory-distress-syndrome-and-diffuse-alveolar-hemorrhage-a-rare-association
#12
Muhammad Kashif, Ravi Patel, Bharat Bajantri, Gilda Diaz-Fuentes
Legionella pneumophila is a common, usually underreported and undiagnosed cause of community acquired pneumonia which can lead to significant morbidity and mortality. Diffuse alveolar hemorrhage rarely have been associated with legionella infection. We present a 61-year-old man with hypertension, diabetes mellitus and obesity admitted with severe acute respiratory distress syndrome. He was found to have Legionella pneumonia with associated diffuse alveolar hemorrhage diagnosed with bronchoscopic sequential bronchoalveolar lavage...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28343415/is-therapeutic-hypothermia-for-acute-respiratory-distress-syndrome-the-future
#13
Adam J Hayek, Heath D White, Shekhar Ghamande, Christopher Spradley, Alejandro C Arroliga
INTRODUCTION: Severe acute respiratory distress syndrome (ARDS) has a high mortality, and there is limited knowledge about management of severe ARDS refractory to standard therapy. Early evidence suggests that therapeutic hypothermia (TH) could be a viable treatment for acute respiratory failure. We present 2 cases where TH was successfully used to manage refractory ARDS on extracorporeal membrane oxygenation (ECMO) and a review of the literature around TH and acute respiratory failure...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28343152/the-answer-is-blowing-in-the-wind-an-uncommon-cause-for-severe-ards-accompanied-by-circulatory-insufficiency-requiring-extracorporeal-membrane-oxygenation
#14
Gunilla Einecke, Gernot Beutel, Marius M Hoeper, Jan T Kielstein
We report a rare complication in an immunosuppressed patient with IgA nephropathy who suffered from severe acute respiratory distress syndrome, severe capillary leakage and shock after placement of a double lumen central venous catheter. He could be successfully treated by extracorporeal membrane oxygenation (ECMO) and therapeutic plasma exchange. This report highlights the severity of late-onset complications of catheter placements and shows the potential of ECMO treatment for the management of acute illnesses with bridge to recovery...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342704/trends-in-the-presentation-surgical-treatment-and-outcomes-of-tethered-cord-syndrome-a-nationwide-study-from-2001-to-2010
#15
Cyrus M Jalai, Charles Wang, Bryan J Marascalchi, Samantha R Horn, Gregory W Poorman, Olivia J Bono, Anthony K Frempong-Boadu, Peter G Passias
OBJECTIVE: This is a nationwide query into surgical management techniques for tethered cord syndrome, focusing on patient demographic, hospital characteristics, and treatment outcomes. Our hypothesis is that detethering vs. fusion for TCS results in different in-hospital complications. MATERIALS AND METHODS: Retrospective review of the Nationwide Inpatient Sample 2001-2010. Inclusion: TCS discharges undergoing detethering or fusion. Sub-analysis compared TCS cases by age (pediatric [≤9years] vs...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28324171/risk-factors-for-delayed-gastric-emptying-after-esophagectomy
#16
Frank Benedix, Tobias Willems, Siegfried Kropf, Daniel Schubert, Patrick Stübs, Stephanie Wolff
PURPOSE: Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy with gastric tube reconstruction. Little is known about risk factors that can predict this debilitating complication. METHODS: Patients who underwent elective esophagectomy from 2008 to 2016 in a single center were retrospectively reviewed. Diagnosis of DGE was based on clinical, radiological, and endoscopic findings. Uni- and multivariate analyses were performed to identify patient-, tumor-, and procedure-related factors that increase the risk of DGE...
March 21, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28324091/association-between-dabigatran-vs-warfarin-and-risk-of-osteoporotic-fractures-among-patients-with-nonvalvular-atrial-fibrillation
#17
Wallis C Y Lau, Esther W Chan, Ching-Lung Cheung, Chor Wing Sing, Kenneth K C Man, Gregory Y H Lip, Chung-Wah Siu, Joanne K Y Lam, Alan C H Lee, Ian C K Wong
Importance: The risk of osteoporotic fracture with dabigatran use in patients with nonvalvular atrial fibrillation (NVAF) is unknown. Objective: To investigate the risk of osteoporotic fracture with dabigatran vs warfarin in patients with NVAF. Design, Setting, and Participants: Retrospective cohort study using a population-wide database managed by the Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through 2014 and prescribed dabigatran or warfarin were matched by propensity score at a 1:2 ratio with follow-up until July 31, 2016...
March 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28316302/high-frequency-oscillatory-ventilation-hfov-as-primary-ventilator-strategy-in-the-management-of-severe-acute-respiratory-distress-syndrome-ards-with-pneumothorax-in-the-setting-of-trauma
#18
Kartik Prabhakaran, Daniel Hagler, Dominick Vitale, Alejandro Betancourt, Patrizio Petrone, Corrado P Marini
No abstract text is available yet for this article.
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28303154/mesenchymal-stem-cell-administration-in-patients-with-chronic-obstructive-pulmonary-disease-state-of-the-science
#19
REVIEW
Shih-Lung Cheng, Ching-Hsiung Lin, Chao-Ling Yao
Patients with chronic obstructive pulmonary disease (COPD) have chronic, irreversible airway inflammation; currently, there is no effective or curative treatment and the main goals of COPD management are to mitigate symptoms and improve patients' quality of life. Stem cell based therapy offers a promising therapeutic approach that has shown potential in diverse degenerative lung diseases. Preclinical studies have demonstrated encouraging outcomes of mesenchymal stem/stromal cells (MSCs) therapy for lung disorders including emphysema, bronchopulmonary dysplasia, fibrosis, and acute respiratory distress syndrome...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28284294/optimal-strategies-for-severe-acute-respiratory-distress-syndrome
#20
REVIEW
Jeremy W Cannon, Jacob T Gutsche, Daniel Brodie
Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation...
April 2017: Critical Care Clinics
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