Search results for "respiratory failure"
showing 10 items of 110 documents
Nasal pressure swings as the measure of inspiratory effort in spontaneously breathing patients with de novo acute respiratory failure.
2022
Abstract Background Excessive inspiratory effort could translate into self-inflicted lung injury, thus worsening clinical outcomes of spontaneously breathing patients with acute respiratory failure (ARF). Although esophageal manometry is a reliable method to estimate the magnitude of inspiratory effort, procedural issues significantly limit its use in daily clinical practice. The aim of this study is to describe the correlation between esophageal pressure swings (ΔPes) and nasal (ΔPnos) as a potential measure of inspiratory effort in spontaneously breathing patients with de novo ARF. Methods From January 1, 2021, to September 1, 2021, 61 consecutive patients with ARF (83.6% related to COVID…
Right diaphragmatic injury and lacerated liver during a penetrating abdominal trauma: case report and brief literature review
2014
Introduction: Diaphragmatic injuries are rare consequences of thoracoabdominal trauma and they often occur in association with multiorgan injuries. The diaphragm is a difficult anatomical structure to study with common imaging instruments due to its physiological movement. Thus, diaphragmatic injuries can often be misunderstood and diagnosed only during surgical procedures. Diagnostic delay results in a high rate of mortality. Methods: We report the management of a clinical case of a 45-old man who came to our observation with a stab wound in the right upper abdomen. The type or length of the knife used as it was extracted from the victim after the fight. CT imaging demonstrated a right hem…
Barotrauma during Noninvasive Respiratory Support in COVID-19 Pneumonia Outside ICU: The Ancillary COVIMIX-2 Study
2023
Background: Noninvasive respiratory support (NIRS) has been extensively used during the COVID-19 surge for patients with acute respiratory failure. However, little data are available about barotrauma during NIRS in patients treated outside the intensive care unit (ICU) setting. Methods: COVIMIX-2 was an ancillary analysis of the previous COVIMIX study, a large multicenter observational work investigating the frequencies of barotrauma (i.e., pneumothorax and pneumomediastinum) in adult patients with COVID-19 interstitial pneumonia. Only patients treated with NIRS outside the ICU were considered. Baseline characteristics, clinical and radiological disease severity, type of ventilatory support…
Perioperative diaphragm point-of-care ultrasound as a prediction tool of postoperative respiratory failure in high-risk patients: A feasibility study…
2021
Abstract Introduction Respiratory muscle function in the postoperative period is a key to whether a patient develops Postoperative Respiratory Failure (PRF) or not. PRF occurs when the gas exchange does not meet metabolic needs. Ipsilateral paralysis of the hemidiaphragm after interscalenic brachial plexus block (ISB) causes an acute reduction of respiratory muscle function. This reduction does not cause PRF when the contralateral hemidiaphragm generates enough gas exchange to meet metabolic demands. Objectives To study the evolution of hemidiaphragmatic muscle function during the perioperative period with diaphragmatic ultrasound (D-POCUS), and use it as an innovative tool to predict PRF, …
Noninvasive Ventilation in Critically Ill Patients
2015
Since its first application in the late 1980s, noninvasive ventilation (NIV) has been the first-line intervention for certain forms of acute respiratory failure. NIV may be delivered through the patient's mouth, nose, or both using noninvasive intermittent positive pressure ventilation or continuous positive airway pressure. When applied appropriately, NIV may reduce morbidity and mortality and may avert iatrogenic complications and infections associated with invasive mechanical ventilation. This article provides physicians and respiratory therapists with a comprehensive, practical guideline for using NIV in critical care. © 2015 Elsevier Inc.
Why, whether and how to use high-flow nasal therapy in acute exacerbations of chronic obstructive pulmonary disease
2021
Noninvasive ventilation (NIV) represents the standard of care for respiratory support of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) developing acute hypercapnic respiratory failure (AHRF) [1]. NIV has been shown to reduce patient’s work of breathing and mortality and be feasibly implemented in various hospital location facilities at different timing, based on the severity of AHRF [2] and it is also widely used in clinical practice by physicians [3]. However, clinicians’ knowledge, experience and expertise in the management of NIV are crucial for its success in order to overcome common problems that may lower its effectiveness such as patients’ discomf…
Parathyroid hormone serum concentration kinetic profile in critically ill patients undergoing continuous renal replacement therapies: a prospective o…
2021
Introduction: Elevated serum parathormone (PTH) levels have been observed in acute kidney injury and are related to calcium-phosphate metabolism disturbance, decreased renal production of 1,25 dihydroxyvitamin D3, impaired renal PTH excretion, and other renal-independent factors. There are no data regarding PTH concentration kinetics in critically ill patients undergoing continuous renal replacement therapies (CRRT) in an intensive care setting. The primary objective of this study was to investigate trends in PTH serum levels in critically ill patients with multiorgan failure undergoing CRRT, by performing periodic PTH measurements in the acute phase of critical illness. Material and method…
Characteristics of patients with mucopolysaccharidosis type II who have received a bone marrow transplant: Data from the Hunter Outcome Survey
2019
Mucopolysaccharidosis type II (MPS II Hunter syndrome) is a rare, life-limiting, X-linked lysosomal storage disease. The Hunter Outcome Survey (HOS) is a Shire-sponsored, global, observational registry initiated in 2005 that collects real-world data on the natural history of MPS II and long-term treatment with enzyme replacement therapy (ERT) with idursulfase. Patients receiving other forms of pharmacological ERT are excluded from HOS but individuals who have received a bone marrow transplant (BMT) may be enrolled. This analysis examined the characteristics of 36 male patients in HOS from Europe and North America who had received a BMT (March 2018 data). In total, 22 patients (61.1%) were E…
Noninvasive Continuous Positive Airway Pressure Response in Bronchiectasis Exacerbations: Key Practical Aspects and Topics
2016
Bronchiectasis is a progressive lung disease characterized by gradual airflow obstruction secondary to mucus plugging, excessive airway inflammation, and parenchymal destruction. Continuous positive airway pressure (CPAP) has been shown to promote recruitment of the flooded alveoli, decrease the ventilation-perfusion mismatch, and relieve dyspnea in patients with bronchiectasis exacerbations. It has also been proven to improve respiratory mechanics and reduce the work of breathing. It can be also successfully adopted in promoting mucus clearance and preventing desaturation during chest physiotherapy and exercise. However, validated criteria for starting CPAP treatment in bronchiectasis are …
High flow nasal therapy in immunocompromised patients with acute respiratory failure: A systematic review and meta-analysis.
2019
Abstract Purpose The role of high-flow nasal therapy (HFNT) as compared to conventional oxygen therapy (COT) in immunocompromised patients admitted to intensive care unit (ICU) with acute respiratory failure (ARF) remains unclear. We conducted a systematic review and meta-analysis in order to address this issue. Methods We searched PubMed, Medline and Embase until November 7th, 2018. Randomized controlled trials (RCTs), non-randomized prospective and retrospective evidence were selected. Observational studies were considered for sensitivity analysis. Primary outcome was mortality rate; intubation rate was a secondary outcome. Results We included four studies in the primary analysis: one RCT…