Search results for "PULMONARY"
showing 10 items of 3030 documents
VENTILATOR CONFIGURATION IN CHILDREN ON LONG TERM HOME VENTILATION DURING THE COVID19 PANDEMIC
2021
Evaluation of a multicomponent grading system for obstructive sleep apnoea: the Baveno classification
2021
New findings on pathophysiology, epidemiology, and outcome have raised concerns on the relevance of the apnoea–hypopnoea index (AHI) in the classification of obstructive sleep apnoea (OSA) severity. Recently, a multicomponent grading system decision integrating symptomatology and comorbidities (Baveno classification), was proposed to characterise OSA and to guide therapeutic decisions. We evaluated whether this system reflects the OSA population, whether it translates into differences in outcomes, and whether the addition of AHI improves the scheme. A total of 14 499 OSA patients from the European Sleep Apnoea Database cohort were analysed. The groups were homogeneously distributed and were…
Continuous professional development: Elevating sleep and breathing disorder education in europe
2020
Sleep and breathing disorders are highly prevalent, representing a growing subspecialty of respiratory medicine. The term sleep disordered breathing (SDB) encompasses a range of conditions characterised by abnormal breathing during sleep, from chronic or habitual snoring, to frank obstructive sleep apnoea (OSA) or, in some cases, central sleep apnoea (CSA) and hypoventilation syndromes. OSA is the commonest form of SDB, leading to many potential consequences and adverse clinical outcomes, including excessive daytime sleepiness, impaired daytime function, metabolic dysfunction, and an increased risk of cardiovascular disease and mortality [1]. The estimated reported prevalence of moderate-to…
Sleep breathing disorders: have we reached the tipping point?
2018
In recent decades, the study of sleep breathing disorders has accelerated and increased our overall knowledge of sleep disorders in general. This now represents a real challenge to the health system due to the high prevalence, morbidity and mortality with concomitant social and economic repercussions [1].
Continuing professional development: introducing the ERS International Certificate in Respiratory Sleep Medicine
2017
What is the greatest challenge in the delivery of quality care to respiratory disease patients? Is it lack of resources, avoidable harm to patients, or more complex disease presentation? Healthcare delivery has been in the media spotlight in recent months across many countries and the question of how to deliver safe, effective and efficient care to patients remains at the forefront of political agendas at a national level. Education is the passport to the future and the European Respiratory Society (ERS) is in the unique position of being able to work with the most respected respiratory experts internationally in order to design and deliver educational activities to raise standards of train…
Unstable control of breathing can lead to ineffective noninvasive ventilation in amyotrophic lateral sclerosis
2019
Upper airway obstruction with decreased central drive (ODCD) is one of the causes of ineffective noninvasive ventilation (NIV) in amyotrophic lateral sclerosis (ALS). The aim of this study is to determine the mechanism responsible for ODCD in ALS patients using NIV. This is a prospective study that included ALS patients with home NIV. Severity of bulbar dysfunction was assessed with the Norris scale bulbar subscore; data on upper or lower bulbar motor neuron predominant dysfunction on physical examination were collected. Polysomnography was performed on every patient while using NIV and the ODCD index (ODCDI: number of ODCD events/total sleep time) was calculated. To determine the possible …
Alternative mechanisms for tiotropium
2009
Tiotropium is commonly used in the treatment of chronic obstructive pulmonary disease. Although largely considered to be a long-acting bronchodilator, its demonstrated efficacy in reducing the frequency of exacerbations and preliminary evidence from early studies indicating that it might slow the rate of decline in lung function suggested mechanisms of action in addition to simple bronchodilation. This hypothesis was examined in the recently published UPLIFT study and, although spirometric and other clinical benefits of tiotropium treatment extended to four years, the rate of decline in lung function did not appear to be reduced by the addition of tiotropium in this study. This article summ…
Use of Helmet CPAP in COVID-19 – A practical review
2021
Helmet CPAP (H-CPAP) has been recommended in many guidelines as a noninvasive respiratory support during COVID-19 pandemic in many countries around the world. It has the least amount of particle dispersion and air contamination among all noninvasive devices and may mitigate the ICU bed shortage during a COVID surge as well as a decreased need for intubation/mechanical ventilation. It can be attached to many oxygen delivery sources. The MaxVenturi setup is preferred as it allows for natural humidification, low noise burden, and easy transition to HFNC during breaks and it is the recommended transport set-up. The patients can safely be proned with the helmet. It can also be used to wean the p…
Exploring Associations Between Respiratory Mechanics and Survival in Immunocompromised Patients With ARDS.
2020
Thanks to improvements in organ support strategies and to advances in the treatment of solid and hematological tumors, outcome of immunocompromised patients requiring ICU admission has improved impressively over the last decade . For this reason, the number of immunocompromised patients admitted to the ICU and deemed candidates for invasive therapies is steadily increasing. Acute respiratory failure (ARF) is the leading cause of hospital and ICU admission, but the optimal first-line reatment of respiratory failure in these patients remains to be determined
Authors' reply-multi-organ ultrasonography: a stethoscope for the body
2018
We read with great interest the letter from Sakka et al . (1) commenting our article (2) on comprehensive haemodynamic monitoring in patients with acute respiratory distress syndrome (ARDS) and traumatic brain injury (TBI). We agree with the authors that haemodynamic monitoring has to be implemented in patients with ARDS complicating TBI.