Katrin Majari, Hossein Imani, Saeed Hosseini, Ali Amirsavadkouhi, Seyyed Hossein Ardehali, Razieh Khalooeifard
BACKGROUND: There are no data on the validity of the modified Nutrition Risk in the critically ill (m-NUTRIC)-score and Nutritional Risk Screening (NRS)-2002 Score in the Iranian intensive care unit (ICU) patients. The Malnutrition Universal Screening Tool (MUST) is still used in most ICUs of Iran. Our goal was to test the validity of these tools in the Iranian ICU population. METHODS: All adult patients (≥18 years) were included. The association between the nutritional risk scores and outcomes (longer-length of stay, prolonged-mechanical ventilation, and 28-day mortality) was assessed using the Multivariable Logistic regression...
October 18, 2020: JPEN. Journal of Parenteral and Enteral Nutrition
Charles W Stratton, Yi-Wei Tang, Hongzhou Lu
The 2019 novel coronavirus disease (COVID-19) now is considered a global public health emergency. One of the unprecedented challenges is defining optimal therapy for those patients with severe pneumonia and systemic manifestations of COVID-19. Optimal therapy should be largely based on the pathogenesis of infections caused by this novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Since the onset of COVID-19, there have been many prepublications and publications reviewing the therapy of COVID-19 as well as many prepublications and publications reviewing the pathogenesis of SARS-CoV-2...
October 19, 2020: Journal of Medical Virology
Mirja Mittermaier, Philipp Pickerodt, Florian Kurth, Laure Bosquillon de Jarcy, Alexander Uhrig, Carmen Garcia, Felix Machleidt, Panagiotis Pergantis, Susanne Weber, Yaosi Li, Astrid Breitbart, Felix Bremer, Philipp Knape, Marc Dewey, Felix Doellinger, Steffen Weber-Carstens, Arthur S Slutsky, Wolfgang M Kuebler, Norbert Suttorp, Holger Müller-Redetzky
Background: In face of the Coronavirus Disease (COVID)-19 pandemic, best practice for mechanical ventilation in COVID-19 associated Acute Respiratory Distress Syndrome (ARDS) is intensely debated. Specifically, the rationale for high positive end-expiratory pressure (PEEP) and prone positioning in early COVID-19 ARDS has been questioned. Methods: The first 23 consecutive patients with COVID-19 associated respiratory failure transferred to a single ICU were assessed...
October 11, 2020: EClinicalMedicine
Dengfeng Zheng, Zhongan Jiang, Jing Qu, Mingxing Zhang, Xiaoyan Hao, Guoliang Zhang, Jiuzhu Wang, Yapeng Wang
When a pipeline is under fire safety work construction, the stack effect of the pipeline will increase the diffusion rate of nitrogen, reduce the oxygen content, and cause asphyxia. To prove the influence of the stack effect of the pipeline on the nitrogen movement in the pipeline and put forward effective ventilation control measures, the formation mechanism, gas diffusion law, and ventilation parameters of the stack effect of the oil and gas pipelines are studied through theoretical derivation and numerical simulation...
October 13, 2020: ACS Omega
William R Hartman, Aaron S Hess, Joseph P Connor
Background: SARS-CoV-2 and its associated disease, COVID-19, has infected over seven million people world-wide, including two million people in the United States. While many people recover from the virus uneventfully, a subset of patients will require hospital admission, some with intensive care needs including intubation, and mechanical ventilation. To date there is no cure and no vaccine is available. Passive immunotherapy by the transfusion of convalescent plasma donated by COVID-19 recovered patients might be an effective option to combat the virus, especially if used early in the course of disease...
2020: Translational medicine communications
Francesco Salton, Paola Confalonieri, G Umberto Meduri, Pierachille Santus, Sergio Harari, Raffaele Scala, Simone Lanini, Valentina Vertui, Tiberio Oggionni, Antonella Caminati, Vincenzo Patruno, Mario Tamburrini, Alessandro Scartabellati, Mara Parati, Massimiliano Villani, Dejan Radovanovic, Sara Tomassetti, Claudia Ravaglia, Venerino Poletti, Andrea Vianello, Anna Talia Gaccione, Luca Guidelli, Rita Raccanelli, Paolo Lucernoni, Donato Lacedonia, Maria Pia Foschino Barbaro, Stefano Centanni, Michele Mondoni, Matteo Davì, Alberto Fantin, Xueyuan Cao, Lucio Torelli, Antonella Zucchetto, Marcella Montico, Annalisa Casarin, Micaela Romagnoli, Stefano Gasparini, Martina Bonifazi, Pierlanfranco D'Agaro, Alessandro Marcello, Danilo Licastro, Barbara Ruaro, Maria Concetta Volpe, Reba Umberger, Marco Confalonieri
Background: In hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for intensive care unit (ICU) admission and mortality. Methods: We conducted a multicenter observational study to explore the association between exposure to prolonged, low-dose MP treatment and need for ICU referral, intubation, or death within 28 days (composite primary end point) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units...
October 2020: Open Forum Infectious Diseases
Chao Jin, Cong Tian, Yan Wang, Carol C Wu, Huifang Zhao, Ting Liang, Zhe Liu, Zhijie Jian, Runqing Li, Zekun Wang, Fen Li, Jie Zhou, Shubo Cai, Yang Liu, Hao Li, Zhongyi Li, Yukun Liang, Heping Zhou, Xibin Wang, Zhuanqin Ren, Jian Yang
Background: As global healthcare system is overwhelmed by novel coronavirus disease (COVID-19), early identification of risks of adverse outcomes becomes the key to optimize management and improve survival. This study aimed to provide a CT-based pattern categorization to predict outcome of COVID-19 pneumonia. Methods: One hundred and sixty-five patients with COVID-19 (91 men, 4-89 years) underwent chest CT were retrospectively enrolled. CT findings were categorized as Pattern 0 (negative), Pattern 1 (bronchopneumonia pattern), Pattern 2 (organizing pneumonia pattern), Pattern 3 (progressive organizing pneumonia pattern), and Pattern 4 (diffuse alveolar damage pattern)...
2020: Frontiers in Public Health
Hadith Rastad, Hanieh-Sadat Ejtahed, Armita Mahdavi-Ghorabi, Masoud Arzaghi, Anis Safari, Ehsan Shahrestanaki, Mohammad Rezaei, Mohammad Mahdi Niksima, Akram Zakani, Seyede Hanieh Dehghan Manshadi, Fatemeh Ochi, Shabnam Saedi, Zeinab Khodaparast, Neda Shafiabadi Hassani, Mehdi Azimzadeh, Mostafa Qorbani
Purpose: Diabetic's patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determine factors predicting poor outcomes in hospitalized diabetic patients with COVID-19 . Methods: This retrospective cohort study included all adult diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records...
October 9, 2020: Journal of Diabetes and Metabolic Disorders
Ambreen Iqbal Muhammad, Emma Jane Boynton, Samiha Naureen
To the best of our knowledge,there is no case report or data published regarding COVID pneumonitis presenting initially as pneumothorax.There are 3 case reports published to-date (30/5/2020) reporting secondary pneumothorax as complication in later stages of Acute respiratory distress syndrome (ARDS) secondary to COVID-19 in non-ventilated patients. We present here a case of COVID-19 disease presenting as tension pneumothorax after a week of symptoms and developing a second pneumothorax on other side post mechanical ventilation...
October 12, 2020: Respiratory Medicine Case Reports
Yoshimi Kawahara, Nobuto Nakanishi, Keiko Nomura, Jun Oto
No abstract text is available yet for this article.
January 2020: Acute Medicine & Surgery
Nan Zhang, Cheng Wang, Feng Zhu, Hong Mao, Peng Bai, Lu-Lu Chen, Tianshu Zeng, Miao-Miao Peng, Kang Li Qiu, Yixuan Wang, Muqing Yu, Shuyun Xu, Jianping Zhao, Na Li, Min Zhou
Background: Diabetes has been found to increase severity and mortality under the current pandemic of coronavirus disease of 2019 (COVID-19). Up to date, the clinical characteristics of diabetes patients with COVID-19 and the risk factors for poor clinical outcomes are not clearly understood. Methods: The study was retrospectively carried out on enrolled diabetes patients with laboratory confirmed COVID-19 infection from a designated medical center for COVID-19 from January 25th, 2020 to February 14th, 2020 in Wuhan, China...
2020: Frontiers in Endocrinology
Karolin Albert, Jeanne-Marie Krischer, Alexander Pfaffenroth, Sabrina Wilde, Elena Lopez-Rodriguez, Armin Braun, Bradford J Smith, Lars Knudsen
Mechanical ventilation of lungs suffering from microatelectases may trigger the development of acute lung injury (ALI). Direct lung injury by bleomycin results in surfactant dysfunction and microatelectases at day 1 while tissue elastance and oxygenation remain normal. Computational simulations of alveolar micromechanics 1-day post-bleomycin predict persisting microatelectases throughout the respiratory cycle and increased alveolar strain during low positive end-expiratory pressure (PEEP) ventilation. As such, we hypothesize that mechanical ventilation in presence of microatelectases, which occur at low but not at higher PEEP, aggravates and unmasks ALI in the bleomycin injury model...
2020: Frontiers in Physiology
By Mingyue Guo, Peng Xu, Tong Xiao, Ruikai He, Mingkui Dai, Yongming Zhang
Various organizations and societies around the globe have issued guidelines in response to the coronavirus disease (COVID-19) and virus (SARS-CoV-2). In this paper, heating, ventilating, and air-conditioning-related guidelines or documents in several major countries and regions have been reviewed and compared, including those issued by the American Society of Heating Refrigerating and Air-Conditioning Engineers, the Federation of European Heating, Ventilation, and Air Conditioning Associations, the Society of Heating, Air-Conditioning and Sanitary Engineers of Japan, Architectural Society of China, and the Chinese Institute of Refrigeration...
October 11, 2020: Building and Environment
Skyler Lentz, Matthew A Roginski, Tim Montrief, Mark Ramzy, Michael Gottlieb, Brit Long
INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral pathogen that causes the novel coronavirus disease of 2019 (COVID-19) and may result in hypoxemic respiratory failure necessitating invasive mechanical ventilation in the most severe cases. OBJECTIVE: This narrative review provides evidence-based recommendations for the treatment of COVID-19 related respiratory failure requiring invasive mechanical ventilation. DISCUSSION: In severe cases, COVID-19 leads to hypoxemic respiratory failure that may meet criteria for acute respiratory distress syndrome (ARDS)...
July 4, 2020: American Journal of Emergency Medicine
Yu Fang, Jun Zhou, Xun Ding, Gonghao Ling, Shanshan Yu
OBJECTIVE: To investigate chest computed tomography (CT) findings associated with severe COVID-19 pneumonia in the early recovery period. METHODS: We retrospectively analyzed the cases of patients diagnosed with severe COVID-19 pneumonia at a single center between January 12, 2020, and March 16, 2020. The twelve ICU patients studied had been diagnosed SARS-CoV-2 (COVID-19) nucleic acid positive. Patient clinical symptoms were relieved or disappeared, and basic clinical information and laboratory test results were collected...
July 19, 2020: American Journal of Emergency Medicine
André Dos Santos Rocha, Roberta Südy, Ferenc Peták, Walid Habre
BACKGROUND: Mechanical ventilation during status asthmaticus is challenging and increases the risk of severe complications. We recently reported the value of physiologically variable ventilation (PVV) in healthy and acutely injured lungs. We investigated whether PVV provides benefits compared with pressure-controlled ventilation (PCV) in an experimental model of severe acute asthma. METHODS: Allergen-sensitised rabbits were anaesthetised and randomised to either PCV (n=10) or PVV (n=12) during sustained bronchoconstriction induced by allergen and cholinergic stimuli for 6 h...
October 15, 2020: British Journal of Anaesthesia
Brendan McClafferty, Ibrahim Umer, Gary Fye, Douglas Kepko, Ricci Kalayanamitra, Zainab Shahid, Devyani Ramgobin, Alice Cai, Andrew Groff, Abani Bhandari, Chander Shekher Aggarwal, Ravi Patel, Dhirisha Bhatt, Hyma Polimera, Nitasa Sahu, Ramarao Vunnam, Reshma Golamari, Ashutosh Kumar, Rohit Jain
One of the major concerns of the health care community and the public surrounding the SARS-CoV-2 pandemic is the availability and use of ventilators. Unprecedented surges of patients presented to intensive care units across the country, with older adults making up a large proportion of the patient population. This paper illustrates contemporary approaches to critical illness myopathy (CIM), critical illness polyneuropathy (CIP), and critical illness polyneuromyopathy (CIPNM) in older patients, including incidence, risk factors, mechanisms for pathology, diagnosis, contemporary treatment approaches, and outcomes...
September 2020: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Giada Procopio, Anna Cancelliere, Enrico Maria Trecarichi, Maria Mazzitelli, Eugenio Arrighi, Graziella Perri, Francesca Serapide, Corrado Pelaia, Elena Lio, Maria Teresa Busceti, Maria Chiara Pelle, Marco Ricchio, Vincenzo Scaglione, Chiara Davoli, Paolo Fusco, Valentina La Gamba, Carlo Torti, Girolamo Pelaia
The worldwide spread of coronavirus disease 2019 (COVID-19), caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) in March 2020. According to clinical studies carried out in China and Italy, most patients experience mild or moderate symptoms; about a fifth of subjects develop a severe and critical disease, and may suffer from interstitial pneumonia, possibly associated with acute respiratory distress syndrome (ARDS) and death...
January 2020: Therapeutic Advances in Respiratory Disease
Ingrid Nysveen, Mirza Jusufovic, Svein Martin Luth, Vidar Gundersen, Inger Marie Skogseid
BACKGROUND/CASE PRESENTATION: A man in his fifties with advanced Parkinson´s disease was admitted with increasing motor fluctuations including dyskinesias, as well as hallucinations and delusions. After reduction of oral dopaminergic treatment, the dyskinesias improved, but the psychotic symptoms persisted. They were perceived as levodopa-induced, despite concurrent prominent bradykinetic-rigid symptoms. Dopaminergic treatment was therefore discontinued. He subsequently developed hyperthermia, severe generalised rigidity and akinesia, and autonomic instability...
October 13, 2020: Tidsskrift for Den Norske Lægeforening: Tidsskrift for Praktisk Medicin, Ny Række
Anna Joong, Jeffrey G Gossett, Elizabeth D Blume, Philip Thrush, Elfriede Pahl, Michael C Mongé, Carl L Backer, Angira Patel
BACKGROUND: Minimal data exist on clinical decision-making in VAD implantation in pediatrics. This study aims to identify areas of consensus/variability among pediatric VAD physicians in determining eligibility and factors that guide decision-making. METHODS: An 88-item survey with clinical vignettes was sent to 132 pediatric HT cardiologists and surgeons at 37 centers. Summary statistics are presented for the variables assessed. RESULTS: Total respondents were 65 (72% cardiologists, 28% surgeons) whose centers implanted 1-5 (34%), 6-10 (40%), or >10 (26%) VADs in the past year...
October 18, 2020: Pediatric Transplantation
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