Search results for "respiratory tract"
showing 10 items of 1170 documents
Role of biomarkers in the management of antibiotic therapy: an expert panel review II: clinical use of biomarkers for initiation or discontinuation o…
2013
Abstract Biomarker-guided initiation of antibiotic therapy has been studied in four conditions: acute pancreatitis, lower respiratory tract infection (LRTI), meningitis, and sepsis in the ICU. In pancreatitis with suspected infected necrosis, initiating antibiotics best relies on fine-needle aspiration and demonstration of infected material. We suggest that PCT be measured to help predict infection; however, available data are insufficient to decide on initiating antibiotics based on PCT levels. In adult patients suspected of community-acquired LRTI, we suggest withholding antibiotic therapy when the serum PCT level is low (<0.25 ng/mL); in patients having nosocomial LRTI, data are insuf…
Dimensional analysis of the upper airway in obstructive sleep apnoea syndrome patients treated with mandibular advancement device: A bi‐ and three‐di…
2020
BACKGROUND The efficiency of the mandibular advancement device (MAD) in patients with obstructive sleep apnoea syndrome (OSAS) has been demonstrated. Nevertheless, the behaviour of the upper airway once MAD is placed and titrated, and its correlation with the apnoea-hypopnoea index (AHI) is still under discussion. OBJECTIVES To analyse the morphological changes of the upper airway through a bi- and three-dimensional study and correlate it with the polysomnographic variable, AHI. METHODS Patients were recruited from two different hospitals for the treatment of OSAS with a custom-made MAD. A cone-beam computer tomography and a polysomnography were performed at baseline and once the MAD was ti…
SARS-CoV-2 RNA load in the lower respiratory tract, viral RNAemia and N-antigenemia in critically ill adult COVID-19 patients: relationship with biom…
2021
ABSTRACTBackgroundLittle is known about the comparative kinetics of SARS-CoV-RNA load in the lower respiratory tract and in blood compartment in patients admitted to the intensive care unit, and how these relate to biomarkers of COVID-19 severity.MethodsSeventy-three consecutive critically ill COVID-19 patients (median age, 65 years) were recruited. Serial lower respiratory tract (n=165) and plasma (n=340) specimens were collected. RT-PCR and lateral flow immunochromatography assay were used for SARS-CoV-2 RNA quantitation and N protein detection in plasma, respectively. Serum levels of inflammatory and tissue-damage biomarkers in paired specimens were analyzed.ResultsSARS-CoV-RNA was detec…
Mild obstructive sleep apnoea (OSA) and arterial hypertension in the EuropeanSleep Apnoea Database (ESADA) cohort study.
2018
Background: Mild obstructive sleep apnoea (OSA) is highly prevalent, however its association with important clinical outcomes like arterial hypertension remains unknown. Aims and Objectives: To investigate the association between mild OSA and arterial hypertension in the European Sleep Apnoea Database (ESADA) cohort after adjusting for relevant confounding factors. Methods: A multicentric sample of 4974 adults from the ESADA cohort who showed simple snoring or mild OSA at cardiorespiratory polygraphy was studied. We compared the predictive value of mild OSA (AHI 5- Results: Arterial hypertension prevalence was 37% in mild OSA patients (n=2457) compared to 20% in non-apnoeic snorers (n=2517,…
Resumption of Ventilation at the End of Obstructive Sleep Apneas is not Determined by Diaphragmatic Fatigue
1988
In patients affected by obstructive sleep apnea syndrome (OSAS) a progressive increase of the force developed by the respiratory muscles is usually observed during the occlusive phase before upper airway patency is resumed (Onal and Lopata, 1986).
Effects of PEEP on Residual Vascularization in Oesophageal Substitution Gastroplasty by Surface Oximetry-Capnometry and Photoplethysmography
2003
<i>Objective:</i> To evaluate the effects of positive end-expiratory pressure (PEEP) on residual vascularization in gastric tubes for oesophageal replacement. <i>Design:</i> Experimental open study. <i>Materials:</i> Eleven mongrel dogs. <i>Methods:</i> Intestinal parietal blood flow was evaluated by photoplethysmography (PPG) and measurement of surface oxygen (PsO<sub>2</sub>) and carbon dioxide (PsCO<sub>2</sub>) tensions under basal conditions. After Akiyama’s tubular gastroplasty, three levels of PEEP were administered. At each level, fluids were infused to counter the drop in cardiac output. PPG, surface gas tensio…
Positive airway pressure level based upper airway collapsibility classification - the European Sleep Apnea Database (ESADA)
2021
Background and objectives: Obstructive sleep apnea (OSA) patients with mild upper airway collapsibility represents a target group for potential non-positive airway pressure (PAP) treatment. We studied the clinical characteristics of this endotypic group in a large Pan-European sleep apnea registry. Methods: A retrospective analysis was performed in 2541 OSA patients with fixed PAP treatment (male 74%, age 53±11 years, body mass index [BMI] 33±6 kg/m2, apnea-hypopnea index [AHI] 41±25 events/h at baseline). Therapeutic PAP level ≤8 cm H2O was used as the cut-off to classify patients with mild upper airway collapsibility (Landry SA et al. Sleep 2017; 40:6). Results: Mean pressure of the PAP t…
Radiologische Verlaufskontrolle der Thoraxorgane beim Intensivpflegepatienten
1991
Correlation between chest radiographs and clinical indicators was studied in 212 patients in intensive care. 1. There was good correlation between raised pulmonary artery pressure and radiological signs of left heart insufficiency, but not with the value of central venous pressure. 2. Fever and leukocytosis nearly always precede radiological evidence of pneumonia; their persistence does not necessarily indicate persistent pneumonia. 3. Pneumonias, effusions, atelectases and emboli are more common on the right. 4. More than 70% of central venous catheters were incorrectly placed; most commonly, the catheter was placed too low. Life-threatening complications occurred in 1.3%.
[I062] The roles of radiographers in medical imaging and radiotherapy in Europe
2018
Very fast development of technologies in medical imaging and therapy has changed the role of radiographer in Europe. Over the past ten years education and necessary skills and competencies for radiographers has become more similar in most EU countries due to input of EFRS Educational Wing, but there are still rather significant differences in the roles of radiographers between countries. Role expansion is often initiated by external and internal factors that lead to advanced practice for radiographers. However, there is also a limiting factor that functions as a barrier for development of radiographer’s role and mainly that is connected to resistance when radiologists/medical physicists obj…
Obesity and Obstructive Sleep Apnea
2021
Obstructive sleep apnea (OSA) is characterized by upper airway collapse during sleep. Chronic intermittent hypoxia, sleep fragmentation, and inflammatory activation are the main pathophysiological mechanisms of OSA. OSA is highly prevalent in obese patients and may contribute to cardiometabolic risk by exerting detrimental effects on adipose tissue metabolism and potentiating the adipose tissue dysfunction typically found in obesity. This chapter will provide an update on: (a) the epidemiological studies linking obesity and OSA; (b) the studies exploring the effects of intermittent hypoxia and sleep fragmentation on the adipose tissue; (c) the effects of OSA treatment with continuous positi…