scholarly journals COVID-19 Infection

2020 ◽  
Vol 132 (6) ◽  
pp. 1346-1361 ◽  
Author(s):  
John R. Greenland ◽  
Marilyn D. Michelow ◽  
Linlin Wang ◽  
Martin J. London
Keyword(s):  
Respiratory Failure ◽  
Care Management ◽  
Distress Syndrome ◽  
Healthcare Providers ◽  
Healthcare Systems ◽  
Health Organizations ◽  
Hypoxemic Respiratory Failure ◽  
Major Health ◽  
Intensive Care Management ◽  
Potential Therapeutics

Abstract Healthcare systems worldwide are responding to Coronavirus Disease 2019 (COVID-19), an emerging infectious syndrome caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. Patients with COVID-19 can progress from asymptomatic or mild illness to hypoxemic respiratory failure or multisystem organ failure, necessitating intubation and intensive care management. Healthcare providers, and particularly anesthesiologists, are at the frontline of this epidemic, and they need to be aware of the best available evidence to guide therapeutic management of patients with COVID-19 and to keep themselves safe while doing so. Here, the authors review COVID-19 pathogenesis, presentation, diagnosis, and potential therapeutics, with a focus on management of COVID-19–associated respiratory failure. The authors draw on literature from other viral epidemics, treatment of acute respiratory distress syndrome, and recent publications on COVID-19, as well as guidelines from major health organizations. This review provides a comprehensive summary of the evidence currently available to guide management of critically ill patients with COVID-19.

scholarly journals Drug Overdosage in Children

1974 ◽  
Vol 2 (4) ◽  
pp. 303-309 ◽  
Author(s):  
T. C. K. Brown ◽  
F. I. Bishop ◽  
G. C. Mullins
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Emergency Treatment ◽  
Care Management ◽  
Tricyclic Antidepressants ◽  
Conscious State ◽  
Circulatory Failure ◽  
Intensive Care Management ◽  
Drug Overdosage

The epidemiology and prevention of drug overdosage in children is discussed. The emergency treatment of acute drug overdosage is outlined together with aspects of the intensive care management in relation to conscious state, convulsions, respiratory failure, circulatory failure and arrhythmias with some emphasis on tricyclic antidepressants.

scholarly journals Severe Bronchial Asthma: Factors Influencing Intensive Care Management and Outcome

1977 ◽  
Vol 5 (1) ◽  
pp. 11-18 ◽  
Author(s):  
O. F. James ◽  
R. M. Mills ◽  
K. Murree Allen
Keyword(s):  
At Risk ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Bronchial Asthma ◽  
Steroid Therapy ◽  
Care Management ◽  
Hospital Management ◽  
Intensive Care Management ◽  
Factors Influencing

Over a seven year period 2933 patients were admitted with asthma. Respiratory failure occurred on 106 occasions. A total of 26 patients died including 11 of the 106 who developed respiratory failure. The intra-hospital management of asthma is outlined. The experience is analysed to indicate those patients particularly at risk. These include those who develop pneumothorax, have associated chest infections or have recently ceased steroid therapy.

Weaning from mechanical ventilation: patterns in young children recovering from acute hypoxemic respiratory failure

1998 ◽  
Vol 7 (5) ◽  
pp. 335-345 ◽  
Author(s):  
MA Curley ◽  
JC Fackler
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Young Children ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Weaning From Mechanical Ventilation ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure

OBJECTIVE: The purpose of the study was to describe the patterns of weaning from mechanical ventilation in young children recovering from acute hypoxemic respiratory failure. METHODS: Decision-making rules on progressive weaning were developed and applied to existing data on 82 patients 2 weeks to 6 years old in the Pediatric Acute Respiratory Distress Syndrome Data Set. RESULTS: Three patterns of weaning progress were detected: sprint, consistent, and inconsistent. Length of ventilation and weaning progressively increased from the sprint, to the consistent, to the inconsistent subset. Patients in the inconsistent subset were most likely to have a systemic (sepsis or shock) trigger of acute respiratory distress syndrome and to be rated as having at least moderate disability at discharge. Hypothesis-generating univariate and then multivariate logistic regression analyses indicated that patients who experienced more days of mechanical ventilation before the start of weaning and who had a higher oxygenation index during the weaning process were most likely to have an inconsistent pattern of weaning. CONCLUSION: Patterns of weaning are discernible in a population of young children and indicate a subset at risk for inconsistent weaning. Knowing the patterns of weaning may help clinicians anticipate, perhaps plot, and then modulate a patient's weaning trajectory.

scholarly journals Diagnosis and Management of Acute Respiratory Distress Syndrome in a Time of COVID-19

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1053
Author(s):  
Shayan Kassirian ◽  
Ravi Taneja ◽  
Sanjay Mehta
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Clinical Outcomes ◽  
Distress Syndrome ◽  
Respiratory Support ◽  
Hypoxemic Respiratory Failure ◽  
Non Invasive ◽  
The Right

Acute respiratory distress syndrome (ARDS) remains a serious illness with significant morbidity and mortality, characterized by hypoxemic respiratory failure most commonly due to pneumonia, sepsis, and aspiration. Early and accurate diagnosis of ARDS depends upon clinical suspicion and chest imaging. Coronavirus disease 2019 (COVID-19) is an important novel cause of ARDS with a distinct time course, imaging and laboratory features from the time of SARS-CoV-2 infection to hypoxemic respiratory failure, which may allow diagnosis and management prior to or at earlier stages of ARDS. Treatment of ARDS remains largely supportive, and consists of incremental respiratory support (high flow nasal oxygen, non-invasive respiratory support, and invasive mechanical ventilation), and avoidance of iatrogenic complications, all of which improve clinical outcomes. COVID-19-associated ARDS is largely similar to other causes of ARDS with respect to pathology and respiratory physiology, and as such, COVID-19 patients with hypoxemic respiratory failure should typically be managed as other patients with ARDS. Non-invasive respiratory support may be beneficial in avoiding intubation in COVID-19 respiratory failure including mild ARDS, especially under conditions of resource constraints or to avoid overwhelming critical care resources. Compared to other causes of ARDS, medical therapies may improve outcomes in COVID-19-associated ARDS, such as dexamethasone and remdesivir. Future improved clinical outcomes in ARDS of all causes depends upon individual patient physiological and biological endotyping in order to improve accuracy and timeliness of diagnosis as well as optimal targeting of future therapies in the right patient at the right time in their disease.

scholarly journals The Application of Morning Routine for Patients with Critical Illness in Intensive Care Units: A Case Report

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Juliana G.E.P Massie ◽  
Agung Waluyo ◽  
Kharisma Adytama Putra
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Critical Illness ◽  
Nursing Care ◽  
Care Management ◽  
Distress Syndrome ◽  
Nursing Interventions ◽  
Care Environment ◽  
Holistic Nursing

<p>Respiratory failure is still the main cause of morbidity and mortality at the Intensive Care Unit. One of the abnormalities in the respiratory system that can cause respiratory failure is Acute Respiratory Distress Syndrome (ARDS). This condition is a respiratory emergency characterized by a progressive decrease in oxygen after a serious illness or injury. Critical illness and treatment in the Intensive Care Unit are a less pleasant experience for patients and affect the patients’ psychologies. The unstable psychical conditions of the patients during the treatments also influence the physical condition of the patients and it affected to the length of the stay, the risk for complications, and nosocomial infections. Patients’ ability to be adapted to the intensive care environment is one of the keys to the success of the nursing care for the critical cases. The purpose of this study is to describe the comprehensive and holistic nursing care management in ARDS cases at the Intensive Care Unit. One of the focuses of the nursing interventions, in this study, is the environmental and intensive care atmosphere modifications of the intensive care unit called the morning routine.</p>

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