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Acute Respiratory Failure in adults

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https://read.qxmd.com/read/30898964/disseminated-pulmonary-histoplasmosis-in-immunocompetent-patients-a-common-epidemiological-exposure
#1
Michael Klein, Mirza Khan, Jorge L Salinas, Rolando Sanchez
We describe the initial presentation, diagnostic work-up and treatment of three adult immunocompetent men who presented within a short time frame of each other to an academic medical centre with acute respiratory distress syndrome. Their presentation was found to be secondary to a large inoculum of histoplasmosis from remodelling a building with bat droppings infestation. We discuss the pathophysiology of histoplasmosis and highlight the importance of exposure history in patients with acute respiratory failure and why patients with the occupational risk of exposure to fungal inoculum should wear protective respirator gear...
March 20, 2019: BMJ Case Reports
https://read.qxmd.com/read/30898520/non-invasive-ventilation-versus-high-flow-nasal-cannula-oxygen-therapy-with-apnoeic-oxygenation-for-preoxygenation-before-intubation-of-patients-with-acute-hypoxaemic-respiratory-failure-a-randomised-multicentre-open-label-trial
#2
Jean-Pierre Frat, Jean-Damien Ricard, Jean-Pierre Quenot, Nicolas Pichon, Alexandre Demoule, Jean-Marie Forel, Jean-Paul Mira, Rémi Coudroy, Guillaume Berquier, Benoit Voisin, Gwenhaël Colin, Bertrand Pons, Pierre Eric Danin, Jérome Devaquet, Gwenael Prat, Raphaël Clere-Jehl, Franck Petitpas, Emmanuel Vivier, Keyvan Razazi, Mai-Anh Nay, Vincent Souday, Jean Dellamonica, Laurent Argaud, Stephan Ehrmann, Aude Gibelin, Christophe Girault, Pascal Andreu, Philippe Vignon, Laurence Dangers, Stéphanie Ragot, Arnaud W Thille
BACKGROUND: Non-invasive ventilation has never been compared with high-flow oxygen to determine whether it reduces the risk of severe hypoxaemia during intubation. We aimed to determine if preoxygenation with non-invasive ventilation was more efficient than high-flow oxygen in reducing the risk of severe hypoxaemia during intubation. METHODS: The FLORALI-2 multicentre, open-label trial was done in 28 intensive care units in France. Adult patients undergoing tracheal intubation for acute hypoxaemic respiratory failure (a partial pressure of arterial oxygen [PaO2 ] to fraction of inspired oxygen [FiO2 ] ratio of ≤300 mm Hg) were randomly assigned (1:1; block size, four participants) to non-invasive ventilation or high-flow oxygen during preoxygenation, with stratification by PaO2 /FiO2 ratio (≤200 mm Hg vs >200 mm Hg)...
March 14, 2019: Lancet Respiratory Medicine
https://read.qxmd.com/read/30875355/quality-of-life-and-lung-function-in-survivors-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#3
Giacomo Grasselli, Vittorio Scaravilli, Daniela Tubiolo, Riccarda Russo, Francesco Crimella, Francesca Bichi, Letizia Corinna Morlacchi, Eleonora Scotti, Lorenzo Patrini, Luciano Gattinoni, Antonio Pesenti, Davide Chiumello
WHAT WE ALREADY KNOW ABOUT THIS TOPIC: Extracorporeal membrane oxygenation is used in severe acute respiratory distress syndrome; whereas the long-term complications among survivors of acute respiratory distress syndrome treated without extracorporeal membrane oxygenation are well described, the status of extracorporeal membrane oxygenation survivors is poorly understood WHAT THIS ARTICLE TELLS US THAT IS NEW: In a single-center cohort of acute respiratory distress syndrome survivors, management with (vs...
April 2019: Anesthesiology
https://read.qxmd.com/read/30872398/obesity-hypoventilation-syndrome
#4
Juan F Masa, Jean-Louis Pépin, Jean-Christian Borel, Babak Mokhlesi, Patrick B Murphy, Maria Ángeles Sánchez-Quiroga
Obesity hypoventilation syndrome (OHS) is defined as a combination of obesity (body mass index ≥30 kg·m-2 ), daytime hypercapnia (arterial carbon dioxide tension ≥45 mmHg) and sleep disordered breathing, after ruling out other disorders that may cause alveolar hypoventilation. OHS prevalence has been estimated to be ∼0.4% of the adult population. OHS is typically diagnosed during an episode of acute-on-chronic hypercapnic respiratory failure or when symptoms lead to pulmonary or sleep consultation in stable conditions...
March 31, 2019: European Respiratory Review: An Official Journal of the European Respiratory Society
https://read.qxmd.com/read/30863575/clinical-implications-of-the-initial-saps-ii-in-veno-arterial-extracorporeal-oxygenation
#5
Hee Sung Lee, Hyoung Soo Kim, Sun Hee Lee, Song Am Lee, Jae Joon Hwang, Jae Bum Park, Yo Han Kim, Hyoung Ju Moon, Woo Surng Lee
Background: Prediction of survival and weaning probability in VA ECMO (veno-arterial extracorporeal membrane oxygenation) patients could be of great benefit for real-time decision making on VA ECMO initiation in critical ill patients. We investigated whether the SAPS II score would be a real-time determinant for VA ECMO initiation and could be a predictor of survival and weaning probability in patients on VA ECMO. Methods: Between January 1, 2010 and December 31, 2014, VA ECMO was carried out on 135 adult patients suffering from primary cardiogenic shock...
January 2019: Journal of Thoracic Disease
https://read.qxmd.com/read/30862988/ecmo-for-adults-with-severe-respiratory-failure
#6
Jonathan Kozinn, W Cole Wrisinger
The technology to provide Extracorporeal Life Support (ELS) has existed for over four decades. Its use has increased markedly in the last decade, initially in response to severe Acute Respiratory Distress Syndrome (ARDS) in adults during the 2009 H1N1 influenza epidemic and continuing with the increasing acceptance of Extracorporeal Membrane Oxygenation (ECMO) for the treatment of severe respiratory failure in adults from other causes.1 We highlight the use of ECMO, particularly at our institution.
January 2019: Missouri Medicine
https://read.qxmd.com/read/30857910/early-high-flow-nasal-cannula-oxygen-therapy-in-adults-with-acute-hypoxemic-respiratory-failure-in-the-ed-a-before-after-study
#7
Jean Macé, Nicolas Marjanovic, Farnam Faranpour, Olivier Mimoz, Marc Frerebeau, Mathieu Violeau, Pierre-Alexis Bourry, Jérémy Guénézan, Arnaud W Thille, Jean-Pierre Frat
OBJECTIVES: To compare clinical impact after early initiation of high-flow nasal cannula oxygen therapy (HFNC) versus standard oxygen in patients admitted to an emergency department (ED) for acute hypoxemic respiratory failure. METHODS: We performed a prospective before-after study at EDs in two centers including patients with acute hypoxemic respiratory failure defined by a respiratory rate above 25 breaths/min or signs of increased breathing effort under additional oxygen for a pulse oximetry above 92%...
March 5, 2019: American Journal of Emergency Medicine
https://read.qxmd.com/read/30855325/incidence-and-risk-factors-for-cannula-related-venous-thrombosis-after-venovenous-extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-respiratory-failure
#8
Christoph Fisser, Christoph Reichenbächer, Thomas Müller, Roland Schneckenpointner, Maximilian V Malfertheiner, Alois Philipp, Maik Foltan, Dirk Lunz, Florian Zeman, Matthias Lubnow
OBJECTIVES: Venovenous extracorporeal membrane oxygenation is indicated in patients with severe refractory acute respiratory failure. Venous thrombosis due to indwelling catheters is a frequent complication. The aim of this study was to analyze the incidence of cannula-related thrombosis and its risk factors after venovenous extracorporeal membrane oxygenation. DESIGN: Retrospective observational study. SETTING: A medical ICU at the University Hospital Regensburg...
January 11, 2019: Critical Care Medicine
https://read.qxmd.com/read/30852002/outcomes-of-severe-h1n1-pneumoniae-a-retrospective-study-at-intensive-care-units
#9
Shih-Hong Li, Meng-Jer Hsieh, Shih-Wei Lin, Li-Pang Chuang, Chung-Shu Lee, Li-Chung Chiu, Chih-Hao Chang, Han-Chung Hu, Chung-Chi Huang, Kuo-Chin Kao
BACKGROUND: The incidence of acute respiratory distress syndrome (ARDS) and the mortality rate of H1N1 influenza pneumonia are unclear. The aim of this study is to investigate the clinical features and outcomes of adult patients admitted to intensive care units (ICUs) with H1N1 pneumonia related ARDS. METHODS: This retrospective study included patients with confirmed H1N1 influenza pneumonia admitted to the ICUs of a medical center between July 2009 and May 2014...
March 7, 2019: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://read.qxmd.com/read/30841017/current-status-of-noninvasive-ventilation-use-in-korean-intensive-care-units-a-prospective-multicenter-observational-study
#10
Hyunseung Nam, Jae Hwa Cho, Eun Young Choi, Youjin Chang, Won Il Choi, Jae Joon Hwang, Jae Young Moon, Kwangha Lee, Sei Won Kim, Hyung Koo Kang, Yun Su Sim, Tai Sun Park, Seung Yong Park, Sunghoon Park
BACKGROUND: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. METHODS: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. RESULTS: A total of 156 patients treated with NIV were enrolled (mean age, 71...
February 28, 2019: Tuberculosis and Respiratory Diseases
https://read.qxmd.com/read/30819433/relation-of-concomitant-heart-failure-to-outcomes-in-patients-hospitalized-with-influenza
#11
Muhammad Siyab Panhwar, Ankur Kalra, Tanush Gupta, Dhaval Kolte, Sahil Khera, Deepak Bhatt, Mahazarin Ginwalla
Influenza is a major public health challenge. Patients hospitalized with influenza who also have heart failure (HF) may be at risk for worse outcomes compared with patients without HF. There is a lack of large studies examining this issue. We queried the 2013 to 2014 National Inpatient Sample for all adult patients (aged ≥ 18 years) admitted with influenza with and without concomitant HF. Using propensity score matching, patients were matched across demographics, discharge weights, and comorbidities. Outcomes included in-hospital mortality, complications, length of stay, and average hospital costs...
February 8, 2019: American Journal of Cardiology
https://read.qxmd.com/read/30803350/community-versus-hospital-acquired-pneumonia-in-patients-requiring-extracorporeal-membrane-oxygenation
#12
Chul Park, Soo Jin Na, Chi Ryang Chung, Yang Hyun Cho, Gee Young Suh, Kyeongman Jeon
BACKGROUND: Bacterial pneumonia is a major cause of acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO) support. However, it is unknown whether the type of pneumonia, community-acquired pneumonia (CAP) versus hospital-acquired pneumonia (HAP), should be considered when predicting outcomes for ARDS patients treated with ECMO. METHODS: We divided a sample of adult patients receiving ECMO for acute respiratory distress syndrome caused by bacterial pneumonia between January 2012 and December 2016 into CAP ( n = 21) and HAP ( n = 35) groups and compared clinical and bacteriological characteristics and outcomes...
January 2019: Therapeutic Advances in Respiratory Disease
https://read.qxmd.com/read/30789402/impact-of-body-temperature-abnormalities-on-the-implementation-of-sepsis-bundles-and-outcomes-in-patients-with-severe-sepsis-a-retrospective-sub-analysis-of-the-focused-outcome-research-on-emergency-care-for-acute-respiratory-distress-syndrome-sepsis-and-trauma
#13
Shigeki Kushimoto, Toshikazu Abe, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Seitaro Fujishima, Toshihiko Mayumi, Toru Hifumi, Yasukazu Shiino, Taka-Aki Nakada, Takehiko Tarui, Yasuhiro Otomo, Kohji Okamoto, Yutaka Umemura, Joji Kotani, Yuichiro Sakamoto, Junichi Sasaki, Shin-Ichiro Shiraishi, Kiyotsugu Takuma, Ryosuke Tsuruta, Akiyoshi Hagiwara, Kazuma Yamakawa, Tomohiko Masuno, Naoshi Takeyama, Norio Yamashita, Hiroto Ikeda, Masashi Ueyama, Satoshi Fujimi, Satoshi Gando
OBJECTIVES: To investigate the impact of body temperature on disease severity, implementation of sepsis bundles, and outcomes in severe sepsis patients. DESIGN: Retrospective sub-analysis. SETTING: Fifty-nine ICUs in Japan, from January 2016 to March 2017. PATIENTS: Adult patients with severe sepsis based on Sepsis-2 were enrolled and divided into three categories (body temperature < 36°C, 36-38°C, > 38°C), using the core body temperature at ICU admission...
February 14, 2019: Critical Care Medicine
https://read.qxmd.com/read/30786996/serious-adverse-events-and-lifetime-risk-of-reoperation-after-elective-shoulder-replacement-population-based-cohort-study-using-hospital-episode-statistics-for-england
#14
Richard S Craig, Jennifer C E Lane, Andrew J Carr, Dominic Furniss, Gary S Collins, Jonathan L Rees
OBJECTIVES: To provide accurate risk estimates of serious adverse events after elective shoulder replacement surgery for arthritis, including age and sex specific estimates of the lifetime risk of revision surgery. DESIGN: Population based cohort study. SETTING: Hospital episode statistics for NHS England, including civil registration mortality data. PARTICIPANTS: 58 054 elective shoulder replacements in 51 895 adults (aged ≥50 years) between April 1998 and April 2017...
February 20, 2019: BMJ: British Medical Journal
https://read.qxmd.com/read/30782739/incidence-of-hospitalisation-for-severe-complications-of-influenza-virus-infection-in-japanese-patients-between-2012-and-2016-a-cross-sectional-study-using-routinely-collected-administrative-data
#15
Hiroshi Yokomichi, Mie Mochizuki, Joseph Jonathan Lee, Reiji Kojima, Tetsuji Yokoyama, Zentaro Yamagata
OBJECTIVE: To calculate the incidence of hospitalisation due to acute respiratory failure, pneumonia, acute respiratory distress syndrome (ARDS), febrile seizures and encephalitis/encephalopathy among influenza-positive patients in Japan, where point-of-care tests are routinely used to diagnose influenza. DESIGN: A cross-sectional study using routinely collected data. SETTING: Japanese clinics and hospitals between 2012 and 2016. PARTICIPANTS: Japanese patients aged 0-74 years diagnosed with influenza by a rapid test in employment-related health insurance records...
January 17, 2019: BMJ Open
https://read.qxmd.com/read/30765037/venoarterial-ecmo-for-adults-jacc-scientific-expert-panel
#16
REVIEW
Maya Guglin, Mark J Zucker, Vanessa M Bazan, Biykem Bozkurt, Aly El Banayosy, Jerry D Estep, John Gurley, Karl Nelson, Rajasekhar Malyala, Gurusher S Panjrath, Joseph B Zwischenberger, Sean P Pinney
Venoarterial extracorporeal membrane oxygenation (ECMO) is a rescue therapy that can stabilize patients with hemodynamic compromise, with or without respiratory failure, for days or weeks. In cardiology, the main indications for ECMO include cardiac arrest, cardiogenic shock, post-cardiotomy shock, refractory ventricular tachycardia, and acute management of complications of invasive procedures. The fundamental premise underlying ECMO is that it is a bridge-to recovery, to a more durable bridge, to definitive treatment, or to decision...
February 19, 2019: Journal of the American College of Cardiology
https://read.qxmd.com/read/30742650/postoperative-respiratory-failure-in-liver-transplantation-risk-factors-and-effect-on-prognosis
#17
Alfonso Wolfango Avolio, Rita Gaspari, Luciana Teofili, Giuseppe Bianco, Giorgia Spinazzola, Paolo Maurizio Soave, Gianfranco Paiano, Alessandra Gioia Francesconi, Andrea Arcangeli, Nicola Nicolotti, Massimo Antonelli
BACKGROUND: Postoperative respiratory failure (PRF, namely mechanical ventilation >48 hours) significantly affects morbidity and mortality in liver transplantation (LTx). Previous studies analyzed only one or two categories of PRF risk factors (preoperative, intraoperative or postoperative ones). The aims of this study were to identify PRF predictors, to assess the length of stay (LoS) in ICU and the 90-day survival according to the PRF in LTx patients. METHODS: Two classification approaches were used: systematic classification (recipient-related preoperative factors; intraoperative factors; logistic factors; donor factors; postoperative ICU factors; postoperative surgical factors) and patient/organ classification (patient-related general factors; native-liver factors; new-liver factors; kidney factors; heart factors; brain factors; lung factors)...
2019: PloS One
https://read.qxmd.com/read/30740281/high-flow-nasal-cannula-mechanisms-of-action-and-adult-and-pediatric-indications
#18
REVIEW
Frank J Lodeserto, Thomas M Lettich, Salim R Rezaie
The use of the heated and humidified high-flow nasal cannula has become increasingly popular in the treatment of patients with respiratory failure through all age groups. This article will examine the main mechanisms of actions attributed to the use of the high-flow nasal cannula and review the indications in adult and pediatric populations (outside of the neonatal period). It is unclear which of the mechanisms of action is the most important, but it may depend on the cause of the patient's respiratory failure...
November 26, 2018: Curēus
https://read.qxmd.com/read/30723637/a-unique-case-of-severe-anemia-secondary-to-copper-deficiency-in-an-adult-patient
#19
Saad Atiq, James M Mobley, Osman O Atiq, Mohammad O Atiq, Nikhil Meena
Anemia is a frequently encountered problem in the healthcare system. Common causes of anemia include blood loss, followed by impaired red blood cell production and red blood cell destruction. This case demonstrates the need for cognizance of the less frequent causes of anemia. A 27-year-old male with a history of traumatic brain injury and quadriplegia with chronic respiratory failure on home ventilator support presented to the emergency department with dyspnea and no bowel movements for three days. The patient received nutrition via percutaneous endoscopic gastostromy (PEG) tube...
November 26, 2018: Curēus
https://read.qxmd.com/read/30720645/evidence-of-endotypes-in-pediatric-acute-hypoxemic-respiratory-failure-caused-by-sepsis
#20
Nadir Yehya, Neal J Thomas, Hector R Wong
OBJECTIVES: Subclassification based on clinical or biologic commonalities (endotypes) is one approach to reduce heterogeneity in acute hypoxemic respiratory failure. In adults, biomarker-defined endotypes of respiratory failure have been described, with differential outcome profiles and response to therapy. To date, no studies have tested whether endotypes exist in pediatric acute hypoxemic respiratory failure, although messenger RNA expression-based endotypes have been described in pediatric sepsis...
February 2019: Pediatric Critical Care Medicine
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