Seating and pressure support needs of people with cancer in the cervix or rectum: a case series on the clinical usefulness of pressure mapping assessment

2008 ◽  
Vol 17 (3) ◽  
pp. 298-305 ◽  
Author(s):  
M.D. STINSON ◽  
A.P. PORTER-ARMSTRONG
Keyword(s):  
Pressure Support ◽  
Case Series ◽  
Clinical Usefulness ◽  
Support Needs ◽  
Pressure Mapping

824 Case Series on the Use of Volume Assured Pressure Support in Patients with Chronic Pulmonary Disease and Progressive Hypercapnia

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A321-A322
Author(s):  
William LeMaster ◽  
Dale Jun ◽  
Sharon De Cruz ◽  
Michelle Zeidler ◽  
Rajan Saggar
Keyword(s):  
Respiratory Failure ◽  
Lung Disease ◽  
Pulmonary Disease ◽  
Lung Diseases ◽  
Lung Transplant ◽  
Pressure Support ◽  
Case Series ◽  
Chronic Obstructive ◽  
Hypoxemic Respiratory Failure ◽  
Chronic Lung Diseases

Abstract Introduction Chronic hypercapnia results from destruction of lung parenchyma which occurs in chronic lung diseases including interstitial lung disease (ILD), bronchiectasis, and chronic lung transplant rejection. Many patients with these diseases will experience progressive respiratory failure eventually requiring consideration of transplantation or re-transplantation. Due to physiologic changes in sleep including reduction in tidal volume, worsening air tapping, and REM atonia, hypoventilation can be exacerbated during the sleeping hours. We present four patients who were prescribed nocturnal Volume Assured Pressure Support VAPS for their progressive hypercapnia. Report of case(s) Subject 1 is a 72 year old female with severe bronchiectasis and restrictive lung disease due to TB pneumonia at a young age. Subject 2 is a 45 year old male with history of pulmonary cavitation due to extensive TB disease when he was younger. Subject 3 is a 45-year-old woman with rheumatoid arthritis related ILD with associated pulmonary arterial hypertension. Subject 4 is a 74 year old patient with a bilateral lung transplant for IPF complicated by bronchiolitis obliterans syndrome who presented with progressive dyspnea and hypercapnia. Despite optimal therapy, all of these patients were admitted for hypercapnic and hypoxemic respiratory failure requiring treatment with BPAP then transitioned to nocturnal VAPS on discharge. For all patients, dyspnea and pCO2 improved as outpatients although all patients did eventually experience an exacerbation of their lung disease requiring repeat admission. Conclusion Due to the physiologic changes that occur with sleep, patients with severe lung disease may experience worsening CO2 retention while sleeping. There is little data assessing the use of chronic nocturnal non-invasive ventilation (NIV) to treat the hypercapnia of chronic lung diseases other than chronic obstructive pulmonary disease, extra-thoracic restriction, and neuromuscular disease. In this case series, nocturnal VAPS stabilized and/or reduced pCO2 in patients with pulmonary parenchymal disease of various etiologies. Additional studies are needed to assess long term effects of VAPS in these patients, including exacerbations, symptoms, and overall mortality. Support (if any):

scholarly journals Evaluation of Short-term Outcomes of Tracheostomy Procedures in a NICU Population With High Ventilator Settings

2021 ◽  
pp. 019459982199622
Author(s):  
Laura Banks ◽  
Noah Worobetz ◽  
Erin Hamersley ◽  
Amanda Onwuka ◽  
Edward Shepherd ◽  
...  
Keyword(s):  
Tracheostomy Tube ◽  
Neonatal Intensive Care ◽  
Pressure Support ◽  
Chart Review ◽  
Intraoperative Complications ◽  
Case Series ◽  
Peak Inspiratory Pressure ◽  
Tube Placement ◽  
Short Term ◽  
Ventilator Settings

Objective To investigate whether tracheostomy placement in infants requiring high ventilator pressure is safe and effective. Study Design Case series with chart review. Setting Tertiary children’s hospital. Methods Fifty ventilator-dependent neonatal intensive care unit patients who underwent tracheotomy from 2009 to 2018 were included. Patients requiring high ventilator pressures were compared to those requiring low ventilator pressures. Demographics, comorbidities, and surgical and clinical data were recorded. Results Thirty-two percent (n = 16) had low ventilator settings at the time of tracheostomy tube placement, and 68% (n = 34) had high ventilator settings. The median peak inspiratory pressure of the high ventilator group was 29.5 cm H2O, positive end-expiratory pressure (PEEP) was 8 cm H2O, mean airway pressure was 13 cm H2O, pressure support (PS) was 14 cm H2O, PS above PEEP was 6 cm H2O, and inspiratory time was 0.65 seconds. The high ventilator cohort had a higher median age at the time of surgery compared to the low ventilator group ( P = .02). Female patients were more likely to have high ventilator settings ( P = .02). There were no intraoperative complications or deaths within the first 7 days of tracheostomy tube placement. Pneumonia incidence and rate of mortality during admission did not vary by ventilator settings ( P = .92 and P = .94, respectively). Conclusion Few differences in tracheostomy tube placement outcomes were observed for patients with high ventilator settings compared to low ventilator settings. These data demonstrate that patients requiring high ventilator pressures can benefit from tracheostomy tube placement with no additional short-term risks.

Poster 60 Defining Safe Head-of-the-Bed Inclination in Patients with Decubitus Wounds Laying on a Dolphin Fluid Immersion Simulation Mattress Using Pressure Mapping: A Case Series

PM&R ◽  
2016 ◽  
Vol 8 (9) ◽  
pp. S180-S181
Author(s):  
Christina G. Zaccarini ◽  
Sarah Laue ◽  
Kara Murphy ◽  
Diya Goorah ◽  
Victoria Kung ◽  
...  
Keyword(s):  
Case Series ◽  
Pressure Mapping

Thlaspi bursa pastoris in Treatment of Urinary Stones: A Case Series

Homeopathy ◽  
2020 ◽  
Vol 109 (04) ◽  
pp. 238-242
Author(s):  
Chintamani Nayak ◽  
Amulya Ratna Sahoo ◽  
Chaturbhuja Nayak
Keyword(s):  
Treatment Effect ◽  
Ureteral Obstruction ◽  
Clinical Symptoms ◽  
Causal Attribution ◽  
Case Series ◽  
Renal Stones ◽  
Clinical Usefulness ◽  
Urinary Stones ◽  
Common Cause ◽  
Short Span

Abstract Background Urinary stones are the most common cause of acute ureteral obstruction. The homeopathic medicine Thlaspi bursa pastoris (TBP) has many symptoms similar to the typical symptoms of urolithiasis, yet its clinical usefulness has not been well documented. Patients In this study, the clinical symptoms of each of five patients, along with ultrasonographic evidence, were taken for the assessment of the outcome. TBP was prescribed in potency 30c and/or 200c to each patient on the basis of the main symptoms, typically dysuria, retention of urine and haematuria. Each case was followed for up to 6 months. Assessment of causal attribution of treatment effect was performed using the Modified Naranjo Criteria. Results There was full recovery of all five patients and post-treatment ultrasonography showed no calculi remaining. The Modified Naranjo Criteria total score for each patient was either +8/13 or +9/13. Conclusion TBP was observed to be effective in eliminating renal stones within a short span of time and without any complications.

scholarly journals 1262 Case Series on the Use of Volume Assured Pressure Support (VAPS) in Patients with Interstitial Lung Disease and Progressive Hypercapnia

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A480-A480
Author(s):  
William LeMaster ◽  
Dale Jun ◽  
Sharon De Cruz ◽  
Michelle Zeidler ◽  
Rajan Saggar
Keyword(s):  
Respiratory Failure ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Pressure Support ◽  
Case Series ◽  
Long Term Effects ◽  
Hypoxemic Respiratory Failure ◽  
Hypercapnic Respiratory Failure ◽  
Progressive Respiratory Failure ◽  
History Of

Abstract Introduction Many patients with interstitial lung disease (ILD) experience progressive respiratory failure. While various therapies are implemented for acute hypercapnic respiratory failure during inpatient ILD flares, there is little data regarding the management of chronic hypercapnia in ILD with nocturnal Volume Assured Pressure Support (VAPS). We present three patients who were prescribed nocturnal VAPS for their progressive hypercapnia as a bridge to lung transplantation. Report of Case Patient 1 is a 45-year-old woman with rheumatoid arthritis related ILD and progressive hypercapnia. Despite optimal therapy, her ILD resulted in an admission for hypercapnic and hypoxemic respiratory failure requiring treatment with BPAP, then transition to nocturnal VAPS on discharge. Dyspnea and pCO2 improved as an outpatient (Fig. 1). Patient 2 is a 70-year-old female with history of scleroderma associated ILD with severe PH and hypercapnia. Initiation of VAPS improved her pCO2 levels although she was readmitted after a few months of treatment for an ILD flare. Patient 3 is a 60-year-old patient with connective tissue disease related ILD who was admitted for respiratory failure due to pneumonia and was transitioned to BPAP for hypercapnic respiratory failure. Due to insurance issues she has been unable to obtain a home VAPS and her pCO2 remains elevated. A plot of each patient’s pCO2 over time is in Figure 1. Conclusion In patients with severe lung disease, the normal decrease in tidal volumes that occurs with sleep can result in CO2 retention. Non-invasive ventilation (NIV) is well-studied in both stable obstructive lung disease and exacerbations but there is little data examining the utility of NIV to treat the chronic hypercapnia of ILD. In this case series, nocturnal VAPS stabilized or reduced PCO2 in patients with ILD and hypercapnia. Additional studies are needed to assess long term effects of VAPS in these patients.

scholarly journals Study of the clinical usefulness of a dental drug system for selective reduction of mutans streptococci using a case series

2006 ◽  
Vol 48 (3) ◽  
pp. 111-116 ◽  
Author(s):  
Yoh Tamaki ◽  
Yoshiaki Nomura ◽  
Hiroaki Takeuchi ◽  
Hirohisa Ida ◽  
Hirohisa Arakawa ◽  
...  
Keyword(s):  
Case Series ◽  
Selective Reduction ◽  
Mutans Streptococci ◽  
Clinical Usefulness

scholarly journals Elective Percutaneous Coronary Intervention Performed During Contrast-Induced Hypotension

2021 ◽  
Author(s):  
Armaghan Y Soomro ◽  
Nureddin Almaddah ◽  
Vasili Lendel ◽  
Shiv Kumar Agarwal ◽  
Barry F. Uretsky
Keyword(s):  
Blood Pressure ◽  
Percutaneous Coronary Intervention ◽  
Pressure Support ◽  
Case Series ◽  
Coronary Intervention ◽  
Management Approach ◽  
Induced Hypotension ◽  
Contrast Reaction ◽  
Percutaneous Coronary ◽  
Severe Hypotension

Abstract Objectives: To demonstrate the feasibility and safety of performing percutaneous coronary intervention (PCI) during contrast reaction producing severe hypotension.Background: The development of profound hypotension due to a contrast reaction usually signals procedure termination. Methods and Results: We report successful completion of planned PCI with blood pressure support with vasopressors during contrast-induced hypotension in 9 procedures in 3 patients with previously known contrast reaction. Conclusions: This case series provides support for the feasibility and safety of performing successful planned PCI under blood pressure support in patients with contrast reaction causing severe hypotension. A management approach for considering intervention in the setting of contrast-induced hypotension is provided.

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