- Outcomes of extracorporeal membrane oxygenation in adult patients with hypoxemic respiratory failure refractory to mechanical ventilation. [Journal Article]
- RMRespir Med Case Rep 2018; 25:220-224
- CONCLUSIONS: This clinical study in a small series of ICU patients treated with ECMO confirms the usefulness of this technique as a ventilatory support in patients with refractory hypoxemic respiratory failure. However, the indication of this procedure is also committed to an ethical reflection considering the possible futility of the measure on a case-by-case basis and associated complications.
- [A Case of Mediastinal Small Cell Lung Cancer in a Patient Receiving Mechanical Ventilation Who Was Successfully Treated with Chemotherapy and Finally Extubated]. [Journal Article]
- GTGan To Kagaku Ryoho 2018; 45(9):1335-1337
- CONCLUSIONS: Even though patients with lung cancer develop respiratory failure and need invasive mechanical ventilation, they may be treated with effective chemotherapy and may be weaned from ventilation.
- Regional expiratory time constants in severe respiratory failure estimated by electrical impedance tomography: a feasibility study. [Journal Article]
- CCCrit Care 2018 Sep 21; 22(1):221
- CONCLUSIONS: EIT-based determination of breath-by-breath regional expiratory time constants is technically feasible, reliable and valid in invasively ventilated patients with severe respiratory failure and provides a promising tool to individually adjust mechanical ventilation in response to the patterns of regional airflow obstruction.
- Apelin-13 Administration Protects Against LPS-Induced Acute Lung Injury by Inhibiting NF-κB Pathway and NLRP3 Inflammasome Activation. [Journal Article]
- CPCell Physiol Biochem 2018 Sep 20; 49(5):1918-1932
- CONCLUSIONS: Taken together, these data suggest that apelin-13 administration ameliorates LPS-induced acute lung injury by suppressing ROS formation, as well as by inhibiting the NF-κB pathway and the activation of the NLRP3 inflammasome in the lungs.
- Inflammatory Markers in Patients Using Domiciliary Non-invasive Mechanical Ventilation: C Reactive Protein, Procalcitonin, Neutrophil Lymphocyte Ratio. [Journal Article]
- FPFront Public Health 2018; 6:245
- Aim: Early identification and treatment of infections in patients using domiciliary non-invasive mechanical ventilation (NIMV) due to chronic respiratory failure (CRF) can reduce hospital admissions...
Aim: Early identification and treatment of infections in patients using domiciliary non-invasive mechanical ventilation (NIMV) due to chronic respiratory failure (CRF) can reduce hospital admissions. We assessed C-reactive protein (CRP), procalcitonin, and neutrophil lymphocyte ratio (NLR) as indicators of infection/inflammation. Methods: The study was designed as a retrospective, observational, cross-sectional study, and was performed in 2016 in an intensive care unit outpatient clinic in patients using NIMV. Patients who came to the outpatient clinic with dyspnea, increased sputum, increased prothrombin, and who had hemogram, procalcitonin, and serum CRP, NLR, and PLT/MPV levels assessed, were enrolled into the study. Demographic characteristics, co-morbid diseases, respiratory symptoms, hemogram, biochemistry, CRP, and procalcitonin values in stable and acute attack patients were recorded from patient files. The descriptive statistics and CRP, NLR, and procalcitonin values were assessed. Results: During the study period, 49 patients (24 female) with chronic obstructive pulmonary disease (COPD, n = 24), obesity hypoventilation syndrome (OHS, n = 15), or interstitial lung disease, n = 10), and having had three inflammatory markers assessed, were included in the study. Their mean age was 67 (SD ± 12). Stable patients vs. those who had an acute attack was 41 vs. eight, and within 7 days of outpatient admission four patients were hospitalized. CRP, NLR, and PLT/MPV values were similar in patients' who had sputum purulence, and an increase in dyspnea and sputum, but procalcitonin was significantly higher in patients who had an acute attack. Procalcitonin was not correlated with CRP, NLR, and PLT/MPV. Conclusions: Patients with CRF had similar levels of CRP and NLR during a stable and acute attack state. Procalcitonin may be a better marker for therapeutic decisions in advanced chronic inflammatory diseases.
- Surgical embolectomy for acute massive pulmonary embolism: state of the art. [Review]
- JTJ Thorac Dis 2018; 10(8):5154-5161
- Massive pulmonary embolism (PE) is a severe condition that can potentially lead to death caused by right ventricular (RV) failure and the consequent cardiogenic shock. Despite the fact thrombolysis i...
Massive pulmonary embolism (PE) is a severe condition that can potentially lead to death caused by right ventricular (RV) failure and the consequent cardiogenic shock. Despite the fact thrombolysis is often administrated to critical patients to increase pulmonary perfusion and to reduce RV afterload, surgical treatment represents another valid option in case of failure or contraindications to thrombolytic therapy. Correct risk stratification and multidisciplinary proactive teams are critical factors to dramatically decrease the mortality of this global health burden. In fact, the worldwide incidence of PE is 60-70 per 100,000, with a mortality ranging from 1% for small PE to 65% for massive PE. This review provides an overview of the diagnosis and management of this highly lethal pathology, with a focus on the surgical approaches at the state of the art.
- Pulmonary mechanics and gas exchange characteristics in uncommon etiologies of acute respiratory distress syndrome. [Journal Article]
- JTJ Thorac Dis 2018; 10(8):5030-5038
- CONCLUSIONS: Within a diverse cohort having less common presentations of ARDS, there was apparent variability in the distribution of CRS, VD/VT compared to differences oxygenation dysfunction. Elevated pulmonary dead space still identified patients with higher mortality, as is the case with more common causes of ARDS.
- Extended use of the modified Berlin Definition based on age-related subgroup analysis in pediatric ARDS. [Journal Article]
- WMWien Med Wochenschr 2018 Sep 19
- CONCLUSIONS: This study is a valuable report about pediatric patients with ARDS and allows for an important extension of the application of the modified Berlin Definition in all age groups.
- Comparison of high flow nasal cannula oxygen and conventional oxygen therapy on ventilatory support duration during acute-on-chronic respiratory failure: study protocol of a multicentre, randomised, controlled trial. The 'HIGH-FLOW ACRF' study. [Journal Article]
- BOBMJ Open 2018 Sep 19; 8(9):e022983
- This study protocol describes a trial designed to investigate whether high-flow heated and humidified nasal oxygen (HFHO) therapy in patients with hypercapnic acute respiratory failure (ARF) reduces ...
This study protocol describes a trial designed to investigate whether high-flow heated and humidified nasal oxygen (HFHO) therapy in patients with hypercapnic acute respiratory failure (ARF) reduces the need of non-invasive ventilation (NIV).
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- Clinical Significance of Upper Airway Virus Detection in Critically Ill Hematology Patients. [Journal Article]
- AJAm J Respir Crit Care Med 2018 Sep 19
- CONCLUSIONS: Respiratory virus detection in the upper airway by multiplex PCR assay is common in critically ill hematology patients. In patients with ARF, respiratory virus detection was independently associated with ICU mortality. Multiplex PCR assay may prove helpful for the risk stratification of hematology patients with ARF. Studies to understand whether respiratory tract viruses play a causal role in outcomes are warranted.