104,541 results match your criteria Respiratory Failure


Risk stratification for short-term mortality at hospital admission for acute exacerbations of COPD.

Respirology 2019 Mar 21. Epub 2019 Mar 21.

Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.

Background And Objective: Exacerbations of chronic obstructive pulmonary disease (ECOPD) are associated with increased in-hospital and short-term mortality. Developing an easy-to-use model to predict adverse outcomes will be useful in daily clinical practice and will facilitate management decisions. We aimed to assess mortality rates and potential predictors for short-term mortality after severe ECOPD. Read More

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http://dx.doi.org/10.1111/resp.13538DOI Listing

Nasal High Flow Therapy: Role of FiO2 in ROX Index.

Authors:
Stanislav Tatkov

Am J Respir Crit Care Med 2019 Mar 21. Epub 2019 Mar 21.

Fisher & Paykel Healthcare, East Tamaki, New Zealand ;

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http://dx.doi.org/10.1164/rccm.201902-0376LEDOI Listing

Success or Failure of High Flow Nasal Oxygen Therapy: ROX Index is Good, Modified ROX May Be Better.

Am J Respir Crit Care Med 2019 Mar 21. Epub 2019 Mar 21.

Hospital Morales Meseguer, Intensive Care Unit, Murcia, Spain ;

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http://dx.doi.org/10.1164/rccm.201902-0419LEDOI Listing

Reply to Tatkov and to Karim and Esquinas.

Am J Respir Crit Care Med 2019 Mar 21. Epub 2019 Mar 21.

Hopital Louis-Mourier, 26931, Colombes, Île-de-France, France.

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http://dx.doi.org/10.1164/rccm.201903-0571LEDOI Listing

[Human Psittacosis: A Case Report].

Acta Med Port 2019 Feb 28;32(2):161-164. Epub 2019 Feb 28.

Serviço de Doenças Infeciosas. Centro Hospitalar do Porto. Porto. Portugal.

Psittacosis is a rare disease caused by Chlamydophila psittaci, an intracellular bacteria transmitted by contaminated birds. The clinical and radiological presentations are nonspecific. We describe a case of a 42-year-old woman, with known exposure to birds, who presented to the emergency department with one-week evolution of myalgia, polyarthritis, and respiratory symptoms. Read More

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http://dx.doi.org/10.20344/amp.10079DOI Listing
February 2019

A model to predict ventilator requirement in Myotonic Dystrophy Type 1.

Muscle Nerve 2019 Mar 21. Epub 2019 Mar 21.

MRC Centre for Neuromuscular Diseases, National Hospital for Neurology and Neurosurgery, Queen Square, WC1N 3BG, UK.

Introduction: Respiratory failure is one of the commonest causes of mortality in myotonic dystrophy type 1 (DM1). The variation in the DM1 phenotype causes difficulty in clinically predicting the severity of respiratory involvement, and parameters such as daytime somnolence are insensitive for identifying patients who require continuous or bi-level Nocturnal Positive Airway Pressure (NPAP).

Methods: We have retrospectively analysed a cohort of 126 adult onset DM1 patients at the point of their first respiratory assessment to identify significant factors in predicting ventilator requirement. Read More

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http://dx.doi.org/10.1002/mus.26471DOI Listing

[Different Prevalences of Pneumological Disease Patterns in Outpatient and Inpatient Care].

Pneumologie 2019 Mar 20. Epub 2019 Mar 20.

Institut für Pneumologie an der Universität zu Köln, Krankenhaus Bethanien, Solingen.

Background:  Evaluating the focus of treatment in pneumological inpatient and outpatient care is of special interest due to its impact on physician, patient and research. This work describes differences and commonalities in the focus of treatment of current pneumological inpatient and outpatient care and discusses their impact on patient, physician and research.

Methods:  This study compares the inpatient and outpatient sector based on the prevalence of ICD codes of a pneumological specialist clinic (5. Read More

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http://dx.doi.org/10.1055/a-0814-0113DOI Listing

Determination of the Effects of Prone Position on Oxygenation in Patients with Acute Respiratory Failure Under Mechanical Ventilation in ICU.

J Med Life 2018 Oct-Dec;11(4):274-280

Health School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.

Patients under mechanical ventilation are usually in the supine position due to various arterial/venous tubes attached to them. Although many studies emphasize the advantages of prone position for oxygenation, some studies enumerate its disadvantages. The aim of the present research was to determine the effect of prone position on oxygenation of patients with Acute Respiratory Failure (ARF) under mechanical ventilation in the Intensive Care Unit (ICU). Read More

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http://dx.doi.org/10.25122/jml-2018-0028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6418337PMC

Twenty-eight-day mortality in lung cancer patients with metastasis who initiated mechanical ventilation in the emergency department.

Sci Rep 2019 Mar 20;9(1):4941. Epub 2019 Mar 20.

Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Few data are available regarding treatment outcomes in lung cancer patients with metastasis who initiated mechanical ventilation in the emergency department (ED). We aimed to evaluate 28-day mortality in lung cancer patients with metastasis who initiated mechanical ventilation in the ED. Patients with solid malignancy who initiated mechanical ventilation in the ED of a tertiary hospital were retrospectively identified and stratified into four groups according to the presence of lung cancer and metastasis. Read More

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http://dx.doi.org/10.1038/s41598-019-39671-8DOI Listing

Sacubitril/valsartan effect on left ventricular remodeling: the case of a super-responder.

Curr Med Res Opin 2019 Mar 20. Epub 2019 Mar 20.

a Department of Cardiology , Policlinico Casilino , Rome , Italy.

Sacubitril/Valsartan has been shown to improve clinical outcomes in patients with heart failure and reduced ejection fraction (HFrEF), but its effect on left ventricular (LV) systolic function and reverse remodeling parameters remain to be established. We hereby describe the case of a 41-year old man with HFrEF and severe reduction of left ventricular ejection fraction (LVEF). Patient was first treated by triple HF therapy (betablocker, angiotensin converting enzyme inhibitor and mineralocorticoid antagonist), but after three months he was still symptomatic and with an LVEF firmly low. Read More

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http://dx.doi.org/10.1080/03007995.2019.1598704DOI Listing

Effects of intratracheal captopril on severely meconium-injured piglet lungs.

J Chin Med Assoc 2019 Mar 11. Epub 2019 Mar 11.

Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.

Background: Severe meconium aspiration syndrome (MAS) may cause intractable respiratory failure in neonates. Targeting the renin-angiotensin system may be an effective way to treat such pulmonary dysfunction. Captopril has the potential to mitigate the severity of lung injury by inhibiting angiotensin-converting enzyme. Read More

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http://dx.doi.org/10.1097/JCMA.0000000000000044DOI Listing

Long-term ventilation for children with chronic lung disease of infancy.

Curr Opin Pediatr 2019 Mar 18. Epub 2019 Mar 18.

Section of Pulmonary Medicine and Pediatric Heart Lung Center, Department of Pediatrics, University of Colorado, School of Medicine, Aurora, Colorado, USA.

Purpose Of Review: Modern medical advances have resulted in an increased survival after extremely preterm birth. However, some infants will develop severe bronchopulmonary dysplasia (BPD) and fail to wean from invasive or noninvasive positive pressure support. It remains unclear which infants will benefit from tracheostomy placement for chronic ventilation. Read More

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http://dx.doi.org/10.1097/MOP.0000000000000757DOI Listing

The battle against SARS and MERS coronaviruses: Reservoirs and Animal Models.

Animal Model Exp Med 2018 Jun 28;1(2):125-133. Epub 2018 Jul 28.

Institute of Laboratory Animal Sciences Chinese Academy of Medical Sciences (CAMS) & Comparative Medicine Center Peking Union Medical College (PUMC) Key Laboratory of Human Disease Comparative Medicine Ministry of Health Key Laboratory for Animal Models of Emerging and Reemerging Infectious Beijing China.

In humans, infection with the coronavirus, especially the severe acute respiratory syndrome coronavirus (SARS-CoV) and the emerging Middle East respiratory syndrome coronavirus (MERS-CoV), induces acute respiratory failure, resulting in high mortality. Irregular coronavirus related epidemics indicate that the evolutionary origins of these two pathogens need to be identified urgently and there are still questions related to suitable laboratory animal models. Thus, in this review we aim to highlight key discoveries concerning the animal origin of the virus and summarize and compare current animal models. Read More

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http://dx.doi.org/10.1002/ame2.12017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388065PMC

Hunt for the Shunt: An Unusual Case of Late-onset Hydrothorax in a Patient on Peritoneal Dialysis.

Cureus 2019 Jan 7;11(1):e3839. Epub 2019 Jan 7.

Gastroenterology, Syracuse Veteran's Affairs Medical Center, Syracuse, USA.

Hydrothorax is a rare complication of peritoneal dialysis occurring in about 2% of continuous ambulatory peritoneal dialysis (CAPD) patients. These effusions occur soon after the onset of dialysis and are usually right-sided. We describe an unusual case of late-onset, left-sided, and recurrent effusions in the setting of CAPD. Read More

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http://dx.doi.org/10.7759/cureus.3839DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411329PMC
January 2019

Hemophagocytic Lymphohistiocytosis in Pregnancy: A Case Series and Review of the Current Literature.

Case Rep Obstet Gynecol 2019 12;2019:9695367. Epub 2019 Feb 12.

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.

Background: Hemophagocytic lymphohistiocytosis (HLH) is a rare disease that can be fatal in pregnancy. We report two cases of severe HLH that highlight etoposide use in pregnancy.

Case 1: 28-year-old G2P1 with lupus presented at 18 weeks with acute hypoxic respiratory failure, hepatic dysfunction, leukopenia, thrombocytopenia, and elevated ferritin. Read More

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http://dx.doi.org/10.1155/2019/9695367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6390238PMC
February 2019

Outcome of Frail Do-Not-Intubate Subjects With End-Stage Chronic Respiratory Failure and Their Opinion of Noninvasive Ventilation to Reverse Hypercapnic Coma.

Respir Care 2019 Mar 19. Epub 2019 Mar 19.

Department of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens, France.

Background: The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication.

Methods: A prospective observational case-control study was conducted in 3 French tertiary care hospitals during a 2-y period. Read More

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http://dx.doi.org/10.4187/respcare.06346DOI Listing

Pediatric Respiratory Therapists Lack a Standard Mental Model for Managing the Patient Who Is Difficult to Ventilate: A Video Review.

Respir Care 2019 Mar 19. Epub 2019 Mar 19.

The Johns Hopkins Medicine Simulation Center, The Johns Hopkins University, Department of Pediatric Anesthesiology and Critical Care Medicine, Baltimore, Maryland.

Background: All health-care providers who care for infants and children should be able to effectively provide ventilation with a bag and a mask. Respiratory therapists (RTs'), as part of rapid response teams, need to quickly identify the need for airway support and use adjunct airway interventions when subjects are difficult to mask ventilate. Before implementation of an educational curriculum for airway management, we assessed whether pediatric RTs' who enter the room of a simulated infant mannequin in severe respiratory distress are able to apply bag-mask ventilation within 60 s and implement 2 adjunct airway maneuvers in a patient who is difficult to ventilate. Read More

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http://dx.doi.org/10.4187/respcare.06369DOI Listing

Acute respiratory distress syndrome. Half a century of its description

Rev Med Inst Mex Seguro Soc 2019 Mar 15;56(6):558-561. Epub 2019 Mar 15.

Secretaría de Salud, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Jefatura de Áreas Críticas. Ciudad de México, México

It has been 50 years since the first description of the respiratory distress syndrome or acute respiratory distress syndrome (ARDS), advances from the physiopathological view are immense, unfortunately, the case fatality rate has had little variation, it is important to disseminate the knowledge to achieve the proper diagnosis and treatment. Read More

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Voice and swallowing dysfunction in X-linked dystonia parkinsonism.

Laryngoscope 2019 Mar 19. Epub 2019 Mar 19.

Department of Neurology, Jose R. Reyes Memorial Medical Center, Manila, Philippines.

Objectives: To systematically characterize and describe voice and swallowing manifestations in patients with X-linked dystonia parkinsonism (XDP) and correlate with quality-of-life (QOL) measures.

Methods: Thirty-four patients with XDP with communication and swallowing difficulties underwent neurological examination, head and neck examination, nasopharyngoscopy, QOL surveys (Swallowing Quality of Life questionnaire [SWAL-QOL] and Voice Handicap Index [VHI]), and functional endoscopic evaluation of swallowing (FEES) to assess the extent of dysfunction.

Results: All patients showed high rates of lingual, oromandibular, and laryngeal dysfunction, as well as severe QOL changes in swallowing and communication ability. Read More

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http://dx.doi.org/10.1002/lary.27897DOI Listing

Center Effects in Hospital Mortality of Critically Ill Patients With Hematologic Malignancies.

Crit Care Med 2019 Mar 19. Epub 2019 Mar 19.

Service de Biostatistique et Information Médicale, AP-HP Hôpital Saint Louis, Paris, France.

Objectives: We aimed to investigate center effects on hospital mortality of ICU patients with hematologic malignancies and to explore interactions between center and patients characteristics.

Design: Multicenter prospective cohort.

Setting: Seventeen ICUs across France and Belgium. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003717DOI Listing
March 2019
1 Read

Sugammadex is changing the paradigm in neuromuscular blockade in patients with myotonic dystrophy.

J Perioper Pract 2019 Mar 19:1750458919838412. Epub 2019 Mar 19.

Centro Hospitalar de Setúbal, Setúbal, Portugal.

Myotonic dystrophy type 1 is a rare neuromuscular disease that represents a challenge to anaesthetic management. Most of the literature does not recommend the usage of neuromuscular blocking agents, if general anaesthesia is needed in these patients. Depolarising neuromuscular blocking agents like suxamethonium are contraindicated, and there might be an increased sensitivity to non-depolarising agents like rocuronium with greater risk of postoperative residual neuromuscular blockade and consequent respiratory failure. Read More

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http://dx.doi.org/10.1177/1750458919838412DOI Listing

High flow nasal cannula compared with conventional oxygen therapy for acute hypoxemic respiratory failure: a systematic review and meta-analysis.

Intensive Care Med 2019 Mar 19. Epub 2019 Mar 19.

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.

Background: This systematic review and meta-analysis summarizes the safety and efficacy of high flow nasal cannula (HFNC) in patients with acute hypoxemic respiratory failure.

Methods: We performed a comprehensive search of MEDLINE, EMBASE, and Web of Science. We identified randomized controlled trials that compared HFNC to conventional oxygen therapy. Read More

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http://dx.doi.org/10.1007/s00134-019-05590-5DOI Listing

Comparison of heated humidified high-flow nasal cannula flow rates (1-L·kg·min vs 2-L·kg·min ) in the management of acute bronchiolitis.

Pediatr Pulmonol 2019 Mar 18. Epub 2019 Mar 18.

Department of Pediatrics, Division of Emergency Medicine, School of Medicine, Ege University, Izmir, Turkey.

Objective: We aimed to compare the heated humidified high-flow nasal cannula (HHHFNC) flow rate of 1-L·kg·min (1 L) with 2-L·kg·min (2 L) in patients with severe bronchiolitis presenting to the pediatric emergency department.

Study Design: We performed a study in which all patients were allocated to receive these two flow rates. The primary outcome was admitted as treatment failure, which was defined as a clinical escalation in respiratory status. Read More

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http://dx.doi.org/10.1002/ppul.24318DOI Listing

Comparison of high flow nasal cannula with noninvasive ventilation in chronic obstructive pulmonary disease patients with hypercapnia in preventing postextubation respiratory failure: A pilot randomized controlled trial.

Res Nurs Health 2019 Mar 18. Epub 2019 Mar 18.

Department of Pulmonary and Critical Care Medicine, Binzhou Medical University Hospital, Binzhou Medical University, Binzhou, China.

High flow nasal cannula (HFNC) has been shown to improve extubation outcomes in patients with hypoxemia, but the role of HFNC in weaning patients with chronic obstructive pulmonary disease (COPD) with hypercapnia from invasive ventilation is unclear. We compared the effects of HFNC to noninvasive ventilation (NIV) on postextubation vital signs and arterial blood gases (ABGs) among patients with COPD. Other outcomes included comfort scores, need for bronchoscopy, use of pulmonary medications, and chest physiotherapy. Read More

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http://dx.doi.org/10.1002/nur.21942DOI Listing

Management of ocular allergy.

Allergy 2019 Mar 19. Epub 2019 Mar 19.

CHU Estaing, Unité d'Allergologie de l'Enfant CHU Estaing 63003 Clermont-Ferrand Cedex1, France.

The treatment and management of ocular allergy (OA) remains a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists and pharmacists. We performed a systematic review of all relevant publications in Medline, SCOPUS and WebScience including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA. Read More

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http://dx.doi.org/10.1111/all.13786DOI Listing

[Preclinical emergency anesthesia : A current state analysis from 2015-2017].

Anaesthesist 2019 Mar 18. Epub 2019 Mar 18.

Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Ludwigshafen, Bremserstr. 79, 67063, Ludwigshafen am Rhein, Deutschland.

Background And Objective: Due to multiple factors the performance of preclinical emergency anesthesia is fraught with risks even for experienced emergency physicians. In order to support emergency physicians in monitoring and management of anesthesia, the German practice management guidelines for preclinical emergency anesthesia in adults were published in 2015; however, current data on adherence to the guidelines are not available.

Material And Methods: In a retrospective register analysis of preclinical anesthesia from 2015-2017 in Baden-Württemberg, the recorded anesthetic agents, monitoring, airway management and medical disciplines of emergency physicians were analyzed. Read More

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http://dx.doi.org/10.1007/s00101-019-0562-6DOI Listing

Effects of Budesonide Combined with Noninvasive Ventilation on PCT, sTREM-1, Chest Lung Compliance, Humoral Immune Function and Quality of Life in Patients with AECOPD Complicated with Type II Respiratory Failure.

Open Med (Wars) 2019 2;14:271-278. Epub 2019 Mar 2.

Department of Emergency, 1st Hospital of Yulin, Yulin City, Shaanxi Province 719000, China.

Objective: Our objective is to explore the effects of budesonide combined with noninvasive ventilation on procalcitonin (PCT), soluble myeloid cell triggering receptor-1 (sTREM-1), thoracic and lung compliance, humoral immune function, and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with type II respiratory failure.

Methods: There were 82 patients with AECOPD complicated with type II respiratory failure admitted into our hospital between March, 2016-September, 2017. They were selected and randomly divided into observation group (n=41) and control group (n=41). Read More

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http://dx.doi.org/10.1515/med-2019-0023DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419390PMC
March 2019
1 Read

A case of tracheobronchomalacia due to relapsing polychondritis treated with Montgomery T-tube.

SAGE Open Med Case Rep 2019 8;7:2050313X19832164. Epub 2019 Mar 8.

Department of Internal Medicine, Haeundae Paik Hospital, College of Medicine, Inje University, Busan, Republic of Korea.

Relapsing polychondritis is a rare and multi-system autoimmune disease of unknown etiology characterized by inflammation and destruction of cartilaginous structures. Its clinical manifestations include recurrent chondritis of the ears, nose, pinna, peripheral joints, and laryngotracheobronchial tree and can be life-threatening in advanced cases of laryngotracheal stenosis. Because of the rarity of relapsing polychondritis and lack of understanding of its pathogenesis, there is no standard medical therapy, and treatment is tailored according to disease activity and site of organ involvement. Read More

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http://dx.doi.org/10.1177/2050313X19832164DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410384PMC

Acute Exacerbation of Idiopathic Pulmonary Fibrosis.

Authors:
Tomoo Kishaba

Medicina (Kaunas) 2019 Mar 16;55(3). Epub 2019 Mar 16.

Department of Respiratory Medicine, Okinawa Chubu Hospital, 904-2293 Miyazato 281, Uruma City, Okinawa, Japan.

Idiopathic pulmonary fibrosis (IPF) is the most common form of idiopathic interstitial pneumonia. Idiopathic pulmonary fibrosis is often seen in elderly men who smoke. A diagnosis of IPF is based on a combination of a detailed clinical history, specific physical examination, laboratory findings, pulmonary function tests, high-resolution computed tomography (HRCT) of the chest, and histopathology. Read More

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http://dx.doi.org/10.3390/medicina55030070DOI Listing

[Effect of obstructive sleep apnea on the severity of acute pulmonary thromboembolism].

Zhonghua Yi Xue Za Zhi 2019 Mar;99(10):739-743

Department of Respiratory and Critical Care Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing100029, China.

To investigate the effect of obstructive sleep apnea (OSA) on the severity of acute pulmonary thromboembolism (PTE). Clinical data of patients with acute PTE and OSA who were admitted to Anzhen Hospital from January 2015 to December 2017 were retrospectively analyzed in this study.According to the apnea hypopnea index (AHI), patients were divided into AHI≤15/h group and AHI>15/h group. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2019.10.006DOI Listing

[Investigation and analysis of 7 cases of acute lung injury caused by a welding operation].

Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2019 Jan;37(1):60-62

Jiangxi Occupational Disease Prevention and Control, Institute Jiangxi Vocational Hospital, Nanchang 330006, China.

Throughing the investigation and analysis of seven cases of acute lung injury caused by a welding operation, the hazards and production pathways of harmful gases such as phosgene and nitrogen oxides are understood, which will serve as a reference for preventing similar events in the future. Throughing the accident scene environment investigation and clinical case analysis, combined with the laboratory test results, carried on the comprehensive analysis. The accident caused a total of 7 people to suffer from acute lung injury to varying degrees. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1001-9391.2019.01.014DOI Listing
January 2019
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Detection of bovine herpesvirus 1 in genital organs of naturally infected cows.

Theriogenology 2019 Mar 8;130:125-129. Epub 2019 Mar 8.

Department of Veterinary, Division of Preventive Medicine and Public Health, Federal University of Vicosa, University Campus, PH Rolfs avenue, 36570-000, Vicosa, Minas Gerais, Brazil.

Bovine herpesvirus 1 (BoHV-1) is a causative agent of respiratory diseases in cattle, and infection with BoHV-1 can cause reproductive failure. There are few studies regarding infections in natural conditions in the reproductive organs of bovine animals. In this context, this study investigated the presence of BoHV-1 in the uterus, oviducts, and ovarian tissues of naturally infected cows. Read More

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http://dx.doi.org/10.1016/j.theriogenology.2019.03.003DOI Listing

Noninvasive ventilation in critically ill patients with the Middle East respiratory syndrome.

Influenza Other Respir Viruses 2019 Mar 18. Epub 2019 Mar 18.

Intensive Care Department, King Abdullah International Medical Research Center, College of Medicine, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Background: Noninvasive ventilation (NIV) has been used in patients with the Middle East respiratory syndrome (MERS) with acute hypoxemic respiratory failure, but the effectiveness of this approach has not been studied.

Methods: Patients with MERS from 14 Saudi Arabian centers were included in this analysis. Patients who were initially managed with NIV were compared to patients who were managed only with invasive mechanical ventilation (invasive MV). Read More

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http://dx.doi.org/10.1111/irv.12635DOI Listing

Prenatal brain development as a target for urban air pollution.

Basic Clin Pharmacol Toxicol 2019 Mar 18. Epub 2019 Mar 18.

ISGlobal, Barcelona, Spain.

Air pollution is the main urban-related environmental hazard and one of the major contributors to the global burden of disease based on its cardio-vascular-respiratory impacts. In children, exposure to urban air pollution is associated, among others, with decelerated neurodevelopment early in life and increased risk of neurodevelopmental problems such as attention deficit-hyperactivity disorder, autism spectrum disorders, academic failure and the start of Alzheimer's pathogenesis. However, the evidence of the effects of air pollution on brain development is still inadequate, mainly due to the limitations in (i) characterizing brain development (most studies were based on subjective tools such as questionnaires or neuropsychological tests) and (ii) air pollution exposure (most studies only used residential levels based on geographical modelling and also overlooking the variation in the mixture of air pollutants as well as the composition and hence toxicity of particulate pollutants in different settings), (iii) the lack of studies during the most vulnerable stages of brain development (foetal and early life (first two years postnatally)), and (iv) the lack of structural and functional imaging data underlying these effects. Read More

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http://dx.doi.org/10.1111/bcpt.13226DOI Listing

Evaluation of pulmonary artery stiffness in newly diagnosed adult patients with asthma.

Echocardiography 2019 Mar 18. Epub 2019 Mar 18.

Department of Allergy and Respiratory Diseases, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey.

Background: There are limited studies on the effects of asthma on cardiac function. Right ventricular dysfunction and pulmonary hypertension are cardiovascular complications that may be seen in advanced stages of the disease. Pulmonary artery stiffness (PAS), is a promising, relatively new echocardiographic index that has been reported to increase in right ventricular failure, providing information about pulmonary vascular bed. Read More

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http://dx.doi.org/10.1111/echo.14309DOI Listing

Handling Oxygenation Targets in the Intensive Care Unit (HOT-ICU)-Protocol for a randomised clinical trial comparing a lower vs a higher oxygenation target in adults with acute hypoxaemic respiratory failure.

Acta Anaesthesiol Scand 2019 Mar 18. Epub 2019 Mar 18.

Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark.

Background: Acutely ill adults with hypoxaemic respiratory failure are at risk of life-threatening hypoxia, and thus oxygen is often administered liberally. Excessive oxygen use may, however, increase the number of serious adverse events, including death. Establishing the optimal oxygenation level is important as existing evidence is of low quality. Read More

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http://dx.doi.org/10.1111/aas.13356DOI Listing

ECLS for Legionella: All Ages Welcome in the ELSO Registry.

ASAIO J 2019 Mar 13. Epub 2019 Mar 13.

From the University of Washington/Seattle Children's Hospital, Seattle, Washington.

We describe the use of extracorporeal life support (ECLS) for Legionellosis in the pediatric and adult populations and report complications, morbidity, and mortality by conducting a retrospective review of patients from the Extracorporeal Life Support Organization registry, including two cases at our pediatric institution. A total of 194 patients with ECLS for Legionella pneumophila infection who received ECLS were included in the analysis. Overall survival was 71%. Read More

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http://dx.doi.org/10.1097/MAT.0000000000000985DOI Listing
March 2019
3 Reads

Successful Resuscitation Using Extracorporeal Membrane Oxygenation of 2 Patients With Severe Liver Rupture: A Case Report.

A A Pract 2019 Mar 14. Epub 2019 Mar 14.

Anesthesiology and Critical Care Medicine.

Extracorporeal membrane oxygenation is a rescue treatment for respiratory or cardiac failure. Its use is limited in patients predisposed to bleeding due to heparin administration. We present 2 patients with deranged coagulation after liver rupture successfully treated by extracorporeal membrane oxygenation. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000996DOI Listing

Transpulmonary thermodilution techniques in the haemodynamically unstable patient.

Curr Opin Crit Care 2019 Mar 14. Epub 2019 Mar 14.

Service de Médecine Intensive-Réanimation, Hôpital de Bicêtre, Hôpitaux Universitaires Paris-Sud.

Purpose Of Review: Transpulmonary thermodilution (TPTD) devices invasively measure not only cardiac output but also several other haemodynamic variables estimating cardiac preload and systolic function, the lung oedema and the pulmonary permeability. In light of the recent literature, we describe how different indices are measured, emphasize their clinical interest and list potential limits and side-effects of the technique.

Recent Findings: Estimation of cardiac output measurement with TPTD is now well established, at least when compared with the pulmonary artery catheter. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000608DOI Listing
March 2019
2 Reads

Office-Based Sedation/General Anesthesia for COPD Patients, Part II.

Anesth Prog 2019 ;66(1):44-51

Private Practice, CarePoint Anesthesia, Denver, Colorado.

The safe treatment of patients with chronic obstructive pulmonary disease (COPD) in dental office office-based settings can be quite complex without a current understanding of the etiology, course, severity, and current treatment modalities of the disease. The additional concerns of providing sedation and/or general anesthesia to patients with COPD in settings outside of a hospital demand thorough investigation of individual patient presentation and realistic development of planned treatment that patients suffering from this respiratory condition can tolerate. Along with other co-morbidities, such as advanced age and potential significant cardiovascular compromise, the dental practitioner providing sedation or general anesthesia must tailor any treatment plan to address multiple organ systems and mitigate risks of precipitating acute respiratory failure from inadequate pain and/or anxiety control. Read More

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http://www.anesthesiaprogress.org/doi/10.2344/anpr-66-02-05
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http://dx.doi.org/10.2344/anpr-66-02-05DOI Listing
January 2019
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Intravenous Sedation in Arnold-Chiari Malformation With Respiratory Failure.

Anesth Prog 2019 ;66(1):37-41

Department of Dental Anesthesiology, Nippon Dental University School of Life Dentistry, Tokyo, Japan.

Type II Arnold-Chiari malformation (ACM) is an abnormality in which the cerebellum, pons, and medulla oblongata are displaced downward into the spinal cord. Type II ACM is often complicated by respiratory depression, sleep-disordered breathing, and deglutition disorder as a result of medullary dysfunction and impairment of the lower cranial nerves. Bending and stretching of the neck is restricted, and anesthetic management is problematic in patients with the disorder. Read More

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http://dx.doi.org/10.2344/anpr-66-01-06DOI Listing
January 2019

Transient Tachypnea of the Newborn Is Associated With an Increased Risk of Hospitalization Due to Respiratory Syncytial Virus Bronchiolitis.

Pediatr Infect Dis J 2019 Apr;38(4):419-421

From the Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.

Background: Transient tachypnea of the newborn (TTN) is a self-limiting respiratory disorder, resulting from a failure to clear the lungs of perinatal fluid. As similar pathophysiologic features are present in children with respiratory syncytial virus (RSV) bronchiolitis, we hypothesized that these two conditions may be connected.

Methods: This was a population-based cohort study that included all children born in term (≥37 weeks of gestation) without congenital malformations in Finland between 1996 and 2015. Read More

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http://dx.doi.org/10.1097/INF.0000000000002057DOI Listing

High-Flow Oxygen Therapy After Noninvasive Ventilation Interruption in Patients Recovering From Hypercapnic Acute Respiratory Failure: A Physiological Crossover Trial.

Crit Care Med 2019 Mar 15. Epub 2019 Mar 15.

Intensive Care Unit, University Hospital Mater Domini, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.

Objectives: Assessing gas exchange, diaphragm function, respiratory rate, and patient comfort during high-flow oxygen therapy and standard oxygen at the time of noninvasive ventilation discontinuation.

Design: Randomized crossover physiologic study.

Setting: Two ICUs. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003740DOI Listing

Status asthmaticus requiring extracorporeal membrane oxygenation associated with rhinovirus infection.

J Asthma 2019 Mar 18:1-4. Epub 2019 Mar 18.

a Division of Pulmonology , Nemours/Alfred I. duPont Hospital for Children , Wilmington , DE , USA.

Objective: Evolving research links human rhinovirus (HRV) with status asthmaticus (SA) as well as severe respiratory illness in patients with atopy and asthma. This case series reviews five episodes of HRV-associated SA that required extracorporeal membrane oxygenation (ECMO).

Methods: Charts of four patients, five total episodes of ECMO, with SA secondary to HRV were reviewed in this IRB-approved case series. Read More

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http://dx.doi.org/10.1080/02770903.2019.1565826DOI Listing

Comorbidity Index as a Predictor of Mortality in Pediatric Patients With Solid Tumors.

Front Pediatr 2019 1;7:48. Epub 2019 Mar 1.

Epidemiological Surveillance Unit, National Institute of Respiratory Diseases, Mexico City, Mexico.

The objective of this study was to determine whether a comorbidity index could be used to predict mortality in pediatric patients with chemotherapy-treated solid tumors. Pediatric patients who underwent chemotherapy treatment for solid tumors were included, and demographic, clinical, and comorbidity data were obtained from patient electronic records. A total of 196 pediatric patients with embryonic solid tumors were included. Read More

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http://dx.doi.org/10.3389/fped.2019.00048DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405632PMC

Effect of Hypoxemia in the Determination of Short-Term Prognosis of Coronary Artery Bypass Graft Patients: A Prospective Study.

Anesth Pain Med 2019 Feb 16;9(1):e81785. Epub 2019 Feb 16.

Department of Anesthesiology, Pain and Critical Care, Tehran University of Medical Sciences, Tehran, Iran.

Background: Respiratory failure and hypoxemia are the known complications of anesthesia and surgery. As a major surgery mainly at advanced ages, the coronary artery bypass graft (CABG) surgery could lead to hypoxemia in the early post-operative phase. Currently, the fraction of partial pressure of arterial oxygen to the fraction of inspired oxygen (PiO/FiO) is used to determine the severity of the respiratory assault. Read More

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http://dx.doi.org/10.5812/aapm.81785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408866PMC
February 2019

Pulmonary hypertension occurring with diazoxide use in a preterm infant with hypoglycemia.

Authors:
Ranjit I Kylat

Drug Healthc Patient Saf 2019 4;11:7-10. Epub 2019 Mar 4.

Division of Neonatal-Perinatal Medicine and Developmental Biology, Department of Pediatrics, The University of Arizona, College of Medicine, Tucson, AZ, USA,

Pharmacologic modulation to open the K channels with diazoxide is useful in treating hyperinsulinemia. Diazoxide is being used more often in neonates with hyperinsulinemic hypoglycemia. This report highlights a case of severe pulmonary hypertension (PH) with re-opening of ductus arteriosus in an extremely premature infant after the use of diazoxide. Read More

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http://dx.doi.org/10.2147/DHPS.S198255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6407670PMC

COPD classification models and mortality prediction capacity.

Int J Chron Obstruct Pulmon Dis 2019 7;14:605-613. Epub 2019 Mar 7.

Respiratory Department, Hospital Galdakao-Usansolo, Galdakao, Bizkaia, Spain,

Objective: Our aim was to assess the impact of comorbidities on existing COPD prognosis scores.

Patients And Methods: A total of 543 patients with COPD (FEV <80% and FEV/FVC <70%) were included between January 2003 and January 2004. Patients were stable for at least 6 weeks before inclusion and were followed for 5 years without any intervention by the research team. Read More

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http://dx.doi.org/10.2147/COPD.S184695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410748PMC

Crotalus durissus terrificus (viperidae; crotalinae) envenomation: Respiratory failure and treatment with antivipmyn TRI antivenom.

Toxicon 2019 Mar 14. Epub 2019 Mar 14.

Department of Experimental & Clinical Pharmacology, University of Minnesota, Minneapolis, MN, 55455, USA. Electronic address:

We report an envenomation to a professional herpetologist by a South American rattlesnake (Crotalus durissus terrificus) that resulted in respiratory failure, and therapeutic improvement following antivenom administration. A 56-year-old male was bitten on the left wrist by a Crotalus durissus terrificus (C. d. Read More

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http://dx.doi.org/10.1016/j.toxicon.2019.03.009DOI Listing

HVNI vs NIPPV in the treatment of acute decompensated heart failure: Subgroup analysis of a multi-center trial in the ED.

Am J Emerg Med 2019 Mar 3. Epub 2019 Mar 3.

Memorial Hermann The Woodlands Medical Center in The Woodlands, TX, USA; McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, TX, USA.

Background And Objective: Managing respiratory failure (RF) secondary to acute decompensated heart failure (ADHF) with non-invasive positive-pressure ventilation (NIPPV) has been shown to significantly improve morbidity and mortality in patients presenting to the emergency department (ED). This subgroup analysis compares high-velocity nasal insufflation (HVNI), a form of high-flow nasal cannula, with NIPPV in the treatment of RF secondary to ADHF with respect to therapy failure, as indicated by the requirement for intubation or all-cause arm failure including subjective crossover to the alternate therapy.

Methods: The subgroup analysis is from a larger randomized control trial of adults presenting to the ED with RF requiring NIPPV support. Read More

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http://dx.doi.org/10.1016/j.ajem.2019.03.002DOI Listing