Epidemiology of Neonatal Disorders of Respiration

It is well known that signs of respiratory distress or disease (RD), such as high breathing frequency, chest wall retractions, grunting, and cyanosis, are common in newborn infants. The signs may be very transient or develop into a potentially life-threatening condition. When they are first observed, they often have a very ambiguous prognostic significance.

Download Full-text

Congenital bilateral choanal atresia- Endonasal endoscopic surgery- Report of two cases

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v24i1.45347 ◽

2020 ◽

Vol 24 (1) ◽

pp. 85-89

Author(s):

Sheikh Hasanur Rahman ◽

Mohammad Idrish Ali ◽

Kamrul Hasan Tarafder ◽

Md Habibur Rahman ◽

Rokeya Begum

Keyword(s):

Respiratory Distress ◽

Choanal Atresia ◽

Neck Surgery ◽

Charge Syndrome ◽

Definitive Treatment ◽

Threatening Condition ◽

Life Threatening ◽

History Of ◽

Rubber Catheter ◽

Medical University

Congenital choanal atresia (CCA) is the development failure of the nasal cavity to communicate with nasopharynx. It is an uncommon congenital anomaly of nose with an incidence of approximately 1 in 5000-7000 live births. Choanal atresia is caused by failure of resorption of the nasobuccal membrane during embryonic development. Choanal atresia has a significant association with CHARGE syndrome. Surgical intervention is recommended in the first weeks of life in bilateral cases because this is a life threatening condition. Two cases of congenital bilateral choanla atresia (CCA) was admitted in the department of Otolaryngology & Head-Neck Surgery at Bangabandhu Sheikh Mujib Medical University (BSMMU) with the complaints of intermittent attacks of cyanosis, dyspnea, respiratory distress and history of inability to take feeds. On examination both babies had respiratory distress, mucoid discharge from both nasal cavities. A soft rubber catheter was passed into both nares revealed the diagnosis of bilateral CCA which was confirmed by flexible nasoendoscopy. Bilateral CCA was managed with a nasopharyngeal airway. Surgery is the definitive treatment with two main approaches namely transnasal and transpalatal. We discuss successful management of two neonates with bilateral CCA by endonasal endoscopic approach. Bangladesh J Otorhinolaryngol; April 2018; 24(1): 85-89

Download Full-text

Hypertension, pre-eclampsia and eclampsia: Monitoring and outcome of pregnancy

Medicinski pregled ◽

10.2298/mpns0612556g ◽

2006 ◽

Vol 59 (11-12) ◽

pp. 556-559 ◽

Cited By ~ 3

Author(s):

Ilija Grujic ◽

Ljubomir Milasinovic

Keyword(s):

Maternal Mortality ◽

Newborn Infants ◽

Neonatal Morbidity ◽

Pregnancy Induced Hypertension ◽

Induced Hypertension ◽

Threatening Condition ◽

Life Threatening ◽

Appropriate Therapy ◽

Unique Definition

Introduction. Pregnancy-induced hypertension, pre-eclampsia and eclampsia are parts of the hypertensive syndrome which is a life-threatening condition both for mother and fetus. Apart from being associated with unpredictable onset, it is incurable, except by ending the pregnancy. Its incidence is approximately between 6 - 10% of pregnant women. There is no unique definition and classification of the hypertensive syndrome in pregnancy, i.e. they differ from one expert group to another. Risks of pregnancy-induced hypertension. Pregnancy-induced hypertension syndrome can cause placental abruption, intracranial hemorrhage, liver lesions, acute renal disorders and disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), hypervolemia and inhalation of gastric content, due to deep sedation. Treatment of pregnancy-induced hypertension. Delivery is always appropriate therapy for the mother, but may not be a good solution for the fetus. Standard treatment of pre-eclampsia includes: anticonvulsive therapy, antihypertensive therapy, excessive fluid administration, and if necessary, management of oliguria, DIC, pulmonary edema and recovery of liver function. The outcome of pregnancy-induced hypertension (perinatal and maternal mortality). Maternal mortality due to pregnancy-induced hypertension is 15 - 33% out of the total number of maternal deaths. Newborn infants of mothers with pregnancy-induced hypertension present with intrauterine growth retardation, prematurity, dysmaturity and necrotizing enterocolitis. Pregnancy-induced hypertension is one of the major causes of maternal and fetal/neonatal morbidity and mortality. .

Download Full-text

Acute respiratory distress syndrome: An update and review

Journal of Translational Internal Medicine ◽

10.1515/jtim-2016-0012 ◽

2018 ◽

Vol 6 (2) ◽

pp. 74-77 ◽

Cited By ~ 14

Author(s):

Gautam Rawal ◽

Sankalp Yadav ◽

Raj Kumar

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Rescue Therapy ◽

Severe Hypoxemia ◽

Low Tidal Volume ◽

The Past ◽

Threatening Condition ◽

Life Threatening

Abstract Acute respiratory distress syndrome (ARDS) is a life threatening condition characterized by severe hypoxemia due to pulmonary gas exchange failure and was first recognized in 1960s.Since its first description, it has undergone intensive research in the past few decades to understand its pathogenesis and therapies. Despite this, the recommended therapies to decrease mortality in ARDS remain limited and include low-tidal volume mechanical ventilation, prone ventilation and recently, the ECMO rescue therapy in extreme cases. This review article will summarize the key features of ARDS with a brief overview of the therapeutic options in the management of ARDS.

Download Full-text

Tension Pneumomediastinum: A life-threatening condition in COVID-19 Patients

10.22541/au.161932814.48385850/v1 ◽

2021 ◽

Author(s):

Nissar Shaikh ◽

Gamal Al Ameri ◽

Muhsen Shaheen ◽

Wael Abdaljawad ◽

Sujith Prabhakaran ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Tract ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Clinical Entity ◽

Threatening Condition ◽

Life Threatening ◽

Increased Pressure

Tension pneumomediastinum (TPM) is a rare but potentially fatal clinical entity. This leads to leakage of air into the mediastinal cavity and increased pressure on thoracic vessels, respiratory tract, and the heart. We report a series of five cases of COVID-19 complicating into acute respiratory distress syndrome and developing TPM.

Download Full-text

Soliris to Stop Immune-Mediated Death in COVID-19 (SOLID-C19)—A Compassionate-Use Study of Terminal Complement Blockade in Critically Ill Patients with COVID-19-Related Adult Respiratory Distress Syndrome

Viruses ◽

10.3390/v13122429 ◽

2021 ◽

Vol 13 (12) ◽

pp. 2429

Author(s):

Thomas C. Pitts

Keyword(s):

Mortality Rate ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Standard Of Care ◽

Mechanically Ventilated ◽

Immune Mediated ◽

Threatening Condition ◽

Life Threatening ◽

Terminal Complement

Eculizumab, a terminal complement (C5)-inhibiting monoclonal antibody, was administered in five mechanically ventilated patients in life-threatening condition due to COVID-19-related acute respiratory distress syndrome (ARDS) between 23 March 2020 and 3 April 2020. Their clinical progress was monitored. The primary endpoint was mortality. One patient was excluded while two passed away. The remaining two patients survived. At the time of this study, the mortality rate in mechanically ventilated COVID-19 patients suffering from ARDS receiving the standard of care as their therapeutic regimen was reportedly as high as 97%. This pilot study demonstrates a 50% mortality rate in patients receiving eculizumab therapy.

Download Full-text

Surgical Management of Life-Threatening Thyroid Haematoma following Occult Blunt Neck Trauma

Case Reports in Endocrinology ◽

10.1155/2016/4307695 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ronak Ved ◽

Neil Patel ◽

Michael Stechman

Keyword(s):

Respiratory Distress ◽

Follicular Adenoma ◽

Definitive Treatment ◽

Multinodular Goitre ◽

Neck Trauma ◽

Anterior Neck ◽

Severe Respiratory Distress ◽

Blunt Neck Trauma ◽

Threatening Condition ◽

Life Threatening

A 42-year-old man arrived at the emergency department in severe respiratory distress, requiring immediate intubation and ventilation. An emergency computed tomography (CT) neck scan identified a substantial haematoma within a multinodular goitre, necessitating an emergency total thyroidectomy. It was later discovered that the patient had been the victim of an assault involving blunt trauma to the anterior neck. Five days postoperatively the patient was extubated and was well enough to self-discharge the following day. Pathology revealed the lesion to be a ruptured follicular adenoma within his multinodular goitre. Signs of this rare but life-threatening condition may be subtle on initial presentation, particularly if the patient is obtunded. Patients with suspected blunt neck trauma should be observed for signs of respiratory distress. If this develops, the patient should be intubated to facilitate CT scan, and if thyroid haematoma is confirmed, emergency thyroidectomy is the definitive treatment.

Download Full-text

CLINICAL EVALUATION OF RESPIRATORY INSUFFICIENCY IN NEWBORN INFANTS

PEDIATRICS ◽

10.1542/peds.16.4.427 ◽

1955 ◽

Vol 16 (4) ◽

pp. 427-437

Author(s):

Herbert C. Miller ◽

Eugene V. Conklin

Keyword(s):

Respiratory Distress ◽

Respiratory Rate ◽

Chest Wall ◽

Clinical Evaluation ◽

Respiratory Insufficiency ◽

Oxygen Therapy ◽

Newborn Infants ◽

Clinical Observations ◽

Respiratory Behavior

Detailed clinical observations were made on the respiratory behavior of 96 newborn infants, 69 of whom were prematurely born. It was found that the infants could be divided into 3 main groups depending on the trend taken by their respiratory rates during the first few hours following birth. All of the severe respiratory insufficiency and all the deaths occurred in the group of infants whose respiratory rates were approximately normal during the first hour but subsequently increased to 60 or more per minute sometime during the next 2 days. Some of the latter infants died during this 48-hour period of initial respiratory distress; others appeared to recover and some of these died a few days later. There was a greater tendency for infants whose birth weights were 1500 gm. or less to have an increase in their respiratory rates during the first day or two following birth than for infants who weighed more than 1500 gm. at birth. The trend of the respiratory rate was helpful in planning oxygen therapy during the first 2 days. Satisfactory criteria for using oxygen therapy after the first 2 days were not developed from the data in this study. Retraction of the chest wall on inspiration during the first 24 hours was minimal or absent in infants whose respiratory rates did not increase after the first hour.

Download Full-text

The Role of Exosomes in Bronchoalveloar Lavage from Patients with Acute Respiratory Distress Syndrome

Journal of Clinical Medicine ◽

10.3390/jcm8081148 ◽

2019 ◽

Vol 8 (8) ◽

pp. 1148 ◽

Cited By ~ 2

Author(s):

Kim ◽

Hong ◽

Lim ◽

Koh ◽

Jang ◽

...

Keyword(s):

Acute Respiratory Distress Syndrome ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Cytokines And Chemokines ◽

Potential Biomarker ◽

Cargo Proteins ◽

Threatening Condition ◽

Life Threatening

Background: Acute respiratory distress syndrome (ARDS) is a life-threatening condition caused by pulmonary and extrapulmonary insults. Exosomes are considered a major cell-to-cell communicator and immune modulator. However, their role in ARDS remains unclear. In this study, we investigated whether exosomes could be a potential biomarker of ARDS. Methods: We isolated exosomes from bronchoalveolar lavage (BAL) of patients with ARDS. The correlation between the level of exosomes with clinical data, including etiology, oxygenation, and 28-day mortality was analyzed. Enzyme-linked immune sorbent assays and western blotting were carried out to characterize BAL exosomes. Immune modulating response of exosomes was investigated by in vitro examination. Results: From 158 patients, we isolated mean 1568.9 µg/mL BAL exosomes, which presented a negative correlation with the PaO2/FiO2 ratio. The level of exosomes did not correlate with 28-day mortality but was elevated in the infectious etiology of ARDS. The exosomes have cargo proteins associated with apoptosis, necroptosis, and autophagy. An in vitro stimulation study revealed that BAL exosomes could induce the production of proinflammatory cytokines and chemokines, but those from patients with ARDS suppressed the production of vascular endothelial growth factor. Conclusions: In ARDS, exosomes are released in alveolar space, and the level is correlated with the etiology of ARDS. BAL exosomes could play an immune-modulating role by controlling the production of cytokines.

Download Full-text

Respiratory Distress Syndrome Associated with Erythrodermic Psoriasis

Case Reports in Dermatology ◽

10.1159/000511368 ◽

2021 ◽

pp. 83-88

Author(s):

Lamya Noure ◽

Kirley Küçük ◽

Sylvain Raoul Simeni Njonnou ◽

Véronique Del Marmol ◽

Jonathan M. White ◽

...

Keyword(s):

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Early Recognition ◽

Past History ◽

High Dose ◽

Threatening Condition ◽

Erythrodermic Psoriasis ◽

Life Threatening ◽

Dose Corticosteroid

Erythrodermic psoriasis is an uncommon and severe variant of psoriasis which may be associated with rare and severe complications such as acute respiratory distress syndrome. Early recognition of this life-threatening condition can allow prompt appropriate treatment. We report the case of a 69-year-old man with a long history of psoriasis who developed acute respiratory distress during a disease flare-up. There was no relevant past history (except for mild emphysema), known allergy, or recent treatment. Chest X-ray revealed new bilateral infiltrates, confirmed at chest computed tomography scan. Repeated cultures on aspirate of the bronchoalveolar lavage remained negative for viruses, bacteria, and parasites. Cardiac ultrasound was normal and high-dose corticosteroid therapy was initiated. Within a few days his clinical and radiological status improved significantly.

Download Full-text

Computed Tomography Angiography Assessment of Acute Aortic Syndromes: Classification, Differentiating Imaging Features, and Imaging Interpretation Pitfalls

Canadian Association of Radiologists Journal ◽

10.1177/08465371211001525 ◽

2021 ◽

pp. 084653712110015 ◽

Cited By ~ 1

Author(s):

Mana Modares ◽

Kate Hanneman ◽

Maral Ouzounian ◽

Jennifer Chung ◽

Elsie T. Nguyen

Keyword(s):

Computed Tomography ◽

Computed Tomography Angiography ◽

Prognostic Significance ◽

Intramural Hematoma ◽

Classification Systems ◽

Imaging Features ◽

Management Options ◽

Acute Aortic Syndromes ◽

Threatening Condition ◽

Life Threatening

An acute aortic syndrome (AAS) is an important life-threatening condition that requires early detection and management. Acute intramural hematoma (IMH), aortic dissection (AD) and penetrating atherosclerotic ulcer (PAU) are included in AAS. ADs can be classified using the well-known Stanford or DeBakey classification systems. However, these classification systems omit description of arch dissections, anatomic variants, and morphologic features that impact outcome. The Society for Vascular Surgery and Society of Thoracic Surgeons (SVS-STS) have recently introduced a classification system that classifies ADs according to the location of the entry tear (primary intimomedial tear, PIT) and the proximal and distal extent of involvement, but does not include description of all morphologic features that may have diagnostic and prognostic significance. This review describes these classification systems for ADs and other AAS entities as well as their limitations. Typical computed tomography angiography (CTA) imaging appearance and differentiating features of ADs, limited intimal tears (LITs), IMHs, intramural blood pools (IBPs), ulcer-like projections (ULPs), and PAUs will be discussed. Furthermore, this review highlights common imaging interpretation pitfalls, what should be included in a comprehensive CTA report, and provides a brief overview of current management options.

Download Full-text