Respiratory Failure Publications (95019)
Respiratory Failure Publications
Survival methods were used to determine the relationship among blood component ratios and inflammatory complications.
Patients were primarily male (68%), Caucasians (89%), aged 39 ± 14 years, involved in a motor vehicle collision (53%). Eighty-six percent of patients developed an inflammatory complication; 76% developed organ failure, 27% ventilator-associated pneumonia, and 24% acute respiratory distress syndrome. Injury severity, sex, and total PRBC transfusion volume, not blood component ratio, predicted inflammatory complications.
Increased understanding of factors associated with inflammation after trauma and PRBC transfusion is needed.
Of 986 participants, 110 had lactate and pyruvate levels collected on the same day. Of the 110, the etiology of PALF was a mitochondrial disorder in 8 (7%), indeterminate in 65 (59%), and an alternative diagnosis in 37 (34%). Lactate, pyruvate, and L:P were similar among the 3 etiologic groups. There was no significant association between the initial lactate or L:P and biochemical variables of clinical severity or clinical outcome at 21 days.
A serum lactate ≥ 2.5 mmol/L and/or elevated L:P was common in all causes of PALF, not limited to those with a mitochondrial etiology, and did not predict 21-day clinical outcome.
The neuroprotective properties of neural stem cells (NSCs) and the paracrine signaling of mesenchymal stem cells (MSCs) have been examined in multiple pre-clinical trials of ALS with promising results. The data from these initial trials indicate a reduction in the rate of disease progression. The mechanism through which stem cells achieve this reduction is of major interest. Here, we review the to-date pre-clinical and clinical therapeutic approaches employing stem cells, and discuss the most promising ones.
Natural history: the natural history of the disease is very heterogeneous, ranging from auto-regressive lesions to a disease affecting multiple organs with fatal consequences, while some lesions may be responsible for permanent sequels. A multidisciplinary approach: the perception of disease from physicians varies greatly depending on their speciality and experience, as well as the presentation of the disease or the short-term treatment outcomes. But whatever the initial view of the treating physician, a multidisciplinary approach to the LCH is recommended as well as the coordination of the necessary care of this systemic disease and its associated morbidity.
current treatment protocols, adapted to the situation of each patient, provide a survival of 98% in children. The sequels, such as diabetes insipidus, hormonal deficits, deafness and even more rarely respiratory failure and sclerosing cholangitis are seen in up to 30% of children.
Multiple correspondence analysis (MCA) was used to assess the distribution of morbidities. LR models were used to study clinical variables related with death or readmission. The median age was 80y, predominantly women and with multiple morbidities. As it was expected, CVRF were the main associated comorbidities followed by respiratory diseases, CKD and chronic anaemia. In the MCA, all the CVRF clustered around the origin so they explained little of the total inertia. Male sex, young age, IHD, obesity and lung disease were more common in reduced EF whereas female, older age and thyroid disease were more common in preserved EF. The confidence ellipses for death in hospitalization or during the follow-up or for readmissions overlapped, so it was not possible to identify clusters of morbidities to predict outcomes. The main causes for AHF were infections, anaemia and RVR in AF. Nearly 16% died during the hospitalization whereas 25.6% died and 56.3% were re-hospitalized during the following year after the discharge. Previous or repeated admissions to the hospital were the best single predictors for death or readmission.
Strategies to control infections, anaemia and AF, in the outpatient settings, might help to reduce the burden of AHF, although this remains to be proven.
We report a patient suffering from NBL 4S who required double lifesaving liver transplantation. Abdominal and respiratory complications due to hepatomegaly are crucial determinants for treatment intensity and duration in 4S NBL [1,2] . We provide an algorithm in order to facilitate the clinical decision when dealing with similar potentially life-threatening events.
The objective of this retrospective study was to explore and characterize dynamic FVC measures in 51 individuals with two common subtypes of CMD, COL6-RD, and LAMA2-RD.
We compared sitting and supine FVC in patients with confirmed mutation(s) in either COL6 or LAMA2. We investigated influences of age, CMD subtype, gender, race, ambulatory status, and non-invasive positive pressure ventilation (NIPPV) status on FVC percent predicted (FVCpp) and ΔFVC.
COL6-RD participants exhibited a significant difference between sitting and supine mean FVCpp (sitting 66.1, supine 55.1; P < 0.0001) and were 5.4 times more likely to have -ΔFVC >20% than those with LAMA2-RD when controlling for ambulant status. FVCpp sitting correlated inversely with age in individuals ≤18 years.
FVCpp sitting decreases progressively in childhood in both CMD subtypes. However, our results point to a difference in diaphragmatic involvement, with COL6-RD individuals having more disproportionate diaphragmatic weakness than LAMA2-RD. A ΔFVC of greater than -20% should continue to be used to prompt evaluation of sleep-disordered breathing. Timely initiation of NIPPV may be indicated to treat nocturnal hypoventilation. Pediatr Pulmonol. © 2017 Wiley Periodicals, Inc.
A review of methodology in establishing an adult respiratory ECMO center is provided.
7 years after the establishment of the first respiratory ECMO center in Croatia the hospital mortality was 44% and ECMO procedure survival was 71%. With this data, our results are comparable to an average extracorporeal life support organization (ELSO) center.
Our results demonstrate that a successful adult respiratory ECMO center can be established under emergency conditions even in less developed countries like Croatia. Today Croatia's respiratory ECMO network is insufficiently organized and the Ministry of Health should provide a comprehensive, national, ECMO network strategy. Currently, and contrary to the opinion of the world's leading experts, any hospital in Croatia is allowed to perform the ECMO procedure without any control or validation. Only if health-policy makers in Croatia reconsider this issue will we be able to provide the best care possible for respiratory ECMO patients at the national level.
Their demographics, clinical imaging data, bronchoscopic and histopathological findings, and outcomes were recorded.
This study included 31 patients who had been diagnosed as having IFT, comprising 24 men and 7 women with a mean age of 64.7 ± 13.7 years. All patients developed respiratory failure and received mechanical ventilation before diagnosis. Eighteen (58.1%) patients had diabetes mellitus, and 12 (38.7%) had chronic lung disease. Four (12.9%) patients had hematologic disease, and none of the patients had neutropenia. Twenty-five (80.6%) patients were diagnosed as having proven IFT, and the remaining patients had probable IFT. Aspergillus spp. (61.3%) were the most common pathogenic species, followed by Mucorales (25.8%) and Candida spp. (6.5%). The diagnoses in six (19.4%) patients were confirmed only through bronchial biopsy and histopathological examination, whereas their cultures of bronchoalveolar lavage fluid were negative for fungi. The overall in-hospital mortality rate was 93.5%.
IFT in critically ill patients results in a high mortality rate. Diabetes mellitus is the most prevalent underlying disease, followed by chronic lung disease. In addition to Aspergillus spp., Mucorales is another crucial pathogenic species. Bronchial lesion biopsy is the key diagnostic strategy.