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Neumología

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8 papers 0 to 25 followers
https://www.readbyqxmd.com/read/26233619/assessment-of-acute-asthma-severity-in-the-ed-are-heart-and-respiratory-rates-relevant
#1
Gustavo J Rodrigo, Hugo Neffen
BACKGROUND: Assessment of acute asthma severity in the emergency department (ED) determines the appropriate initial therapy. The aim of this study was to evaluate the usefulness of heart and respiratory rates as determinants of severity of asthma exacerbations. METHODS: It was a pooled analysis of individual patient data from different controlled clinical trials performed over a 9-year period. The sample was characterized by patients with a diagnosis of asthma, age 18 to 50 years, and a forced expiratory volume in the first second (FEV1) or a peak expiratory flow less than or equal to 50% of predicted at ED presentation...
November 2015: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28160237/management-of-patients-presenting-with-haemoptysis-to-a-tertiary-care-italian-emergency-department-the-florence-haemoptysis-score-flhasc
#2
Simone Vanni, Simone Bianchi, Sofia Bigiarini, Claudia Casula, Marco Brogi, Stefano Orsi, Manlio Acquafresca, Lorenzo Corbetta, Stefano Grifoni
We analysed the clinical features and diagnostic workup of patients presenting with haemoptysis to an Italian teaching hospital to derive an easy-to-use clinical score to guide risk stratification and initial management in the emergency department (ED). We retrospectively reviewed clinical records of consecutive patients with haemoptysis over 1 year. A pre-specified set of variables, including demographic data, vital signs, type of expectorate (pure blood vs. blood-streaked sputum), comorbidities, and diagnostic tests and treatments was originally registered...
February 3, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27799757/a-review-of-nebulized-drug-delivery-in-copd
#3
REVIEW
Donald P Tashkin
Current guidelines recommend inhaled pharmacologic therapy as the preferred route of administration for treating COPD. Bronchodilators (β2-agonists and antimuscarinics) are the mainstay of pharmacologic therapy in patients with COPD, with long-acting agents recommended for patients with moderate to severe symptoms or those who are at a higher risk for COPD exacerbations. Dry powder inhalers and pressurized metered dose inhalers are the most commonly used drug delivery devices, but they may be inadequate in various clinical scenarios (eg, the elderly, the cognitively impaired, and hospitalized patients)...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#4
REVIEW
Gregory A Schmidt
The foundation of mechanical ventilation for acute respiratory distress syndrome involves limiting lung overdistention by using small tidal volumes or transpulmonary pressures. Potential for additional lung recruitment with higher positive end-expiratory pressure (PEEP) should be assessed. When stress index indicates tidal recruitment-derecruitment, PEEP is increased to higher values. Alternatively, a high PEEP table is used in all patients. When these conventional approaches are insufficient to sustain acceptable gas exchange, rescue is attempted using extracorporeal therapies, airway pressure-release ventilation, inhaled vasodilators, or high-frequency oscillatory ventilation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/28000593/chronic-obstructive-pulmonary-disease-copd
#5
Laura Feetham, Aaron van Dorn
No abstract text is available yet for this article.
January 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27935926/hyponatremia-in-patients-with-community-acquired-pneumonia
#6
L Karki, B Thapa, M K Sah
INTRODUCTION: Community acquired pneumonia is one the frequent cause of hospital admissions. Whereas, hyponatremia is a common electrolyte abnormality in hospitalized patients and has been shown to be associated with considerable morbidity and mortality. We aim to studyt the association of hyponatremia with community acquired pneumonia in terms of morbidity and mortality. METHODS: A prospective observational hospital based study was conducted in a hospital for a year...
April 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/26045965/mechanical-ventilation-of-acute-respiratory-distress-syndrome
#7
REVIEW
Ryoichi Ochiai
Acute respiratory distress syndrome (ARDS) has been intensively and continuously studied in various settings, but its mortality is still as high as 30-40 %. For the last 20 years, lung protective strategy has become a standard care for ARDS, but we still do not know the best way to ventilate patients with ARDS. Tidal volume itself does not seem to have an important role to develop ventilator-induced lung injury (VILI), but the driving pressure, which is inspiratory plateau pressure-PEEP, is the most important to predict and affect the outcome of ARDS, though there is no safe limit for the driving pressure...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/27063348/negative-pressure-pulmonary-edema
#8
Mallar Bhattacharya, Richard H Kallet, Lorraine B Ware, Michael A Matthay
Negative-pressure pulmonary edema (NPPE) or postobstructive pulmonary edema is a well-described cause of acute respiratory failure that occurs after intense inspiratory effort against an obstructed airway, usually from upper airway infection, tumor, or laryngospasm. Patients with NPPE generate very negative airway pressures, which augment transvascular fluid filtration and precipitate interstitial and alveolar edema. Pulmonary edema fluid collected from most patients with NPPE has a low protein concentration, suggesting hydrostatic forces as the primary mechanism for the pathogenesis of NPPE...
October 2016: Chest
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