scholarly journals Anticoagulation in the obese patient with COVID-19-associated venous thromboembolism

2021 ◽  
Vol 14 (6) ◽  
pp. e242675
Author(s):  
John Peter McCormick ◽  
John Connaughton ◽  
Niamh McDonnell
Keyword(s):  
Pulmonary Angiography ◽  
Limited Data ◽  
Definitive Evidence ◽  
Non Invasive ◽  
Full Compliance ◽  
Non Invasive Ventilation ◽  
The Common ◽  
Common Problems ◽  
Underlying Mechanisms

A 61-year-old obese man who had recently tested positive for COVID-19 presented to the emergency department following an unwitnessed collapse, with a brief period of unresponsiveness. CT pulmonary angiography confirmed the presence of extensive bilateral pulmonary embolism despite the patient reporting full compliance with long-term dabigatran. The patient was initially anticoagulated with low-molecular-weight heparin and was treated with non-invasive ventilation and dexamethasone for COVID-19 pneumonia. He made a full recovery and was discharged on oral rivaroxaban. His case highlighted some of the common problems encountered when selecting an anticoagulation strategy for obese patients, as well as the lack of definitive evidence to guide treatment decisions. These challenges were further complicated by our incomplete understanding of the underlying mechanisms of COVID-19 coagulopathy, with limited data available regarding the optimal management of thromboembolic complications.

scholarly journals A comparative two-cohort study of pediatric patients with long term stay in ICUs

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia García Mancebo ◽  
Sara de la Mata Navazo ◽  
Estíbaliz López-Herce Arteta ◽  
Rosario Montero Mateo ◽  
Isabel María López Esteban ◽  
...  
Keyword(s):  
Healthcare Resources ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Number Of Patients ◽  
Single Center Study ◽  
High Flow Oxygen ◽  
Hospital Acquired ◽  
Complications And Mortality ◽  
Second Period

AbstractDuring the last decades, the number of patients with long stay admissions (LSA) in PICU has increased. The purpose of this study was to identify factors associated with PICU LSA, assessing healthcare resources use and changes in the profile of these patients. A retrospective, observational, single-center study was carried out. Characteristics of LSA were compared between two periods (2006–2010 and 2011–2015). During the earlier period there were 2,118 admissions (3.9% of them LSA), whereas during the second period, there were 1,763 (5.4% of them LSA) (p = 0.025). LSA accounted for 33.7% PICU stay days during the first period and 46.7% during the second (p < 0.001). Higher use of non-invasive ventilation (80.2% vs. 37.8%, p = 0.001) and high-flow oxygen therapy (68.8% vs. 37.8%, p = 0.005) was observed in the 2011–2015 cohort, whereas the use of arterial catheter (77.1% vs. 92.6%, p = 0.005), continuous infusion of adrenaline (55.2% vs. 75.9%, p = 0.004), and hemoderivative transfusion (74% vs. 89.2%, p = 0.010) was less frequent. In the 2006–2010 cohort, hospital-acquired infections were more common (95.2% vs. 68.8%, p < 0.001) and mortality was higher (26.8% vs. 13.8%, p = 0.026). The number of long-stay PICU admissions have increased entailing an intensive use of healthcare resources. These patients have a high risk for complications and mortality.

scholarly journals Framework for patient-ventilator asynchrony during long-term non-invasive ventilation

Thorax ◽  
2019 ◽  
Vol 74 (7) ◽  
pp. 715-717 ◽  
Author(s):  
Jesus Gonzalez-Bermejo ◽  
Jean-Paul Janssens ◽  
Claudio Rabec ◽  
Christophe Perrin ◽  
Frédéric Lofaso ◽  
...  
Keyword(s):  
Present Report ◽  
Time Windows ◽  
Clinical Impact ◽  
Positive Pressure ◽  
Systematic Analysis ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Polygraphic Recordings ◽  
Bench Testing

Episodes of patient-ventilator asynchrony (PVA) occur during acute and chronic non-invasive positive pressure ventilation (NIV). In long-term NIV, description and quantification of PVA is not standardised, thus limiting assessment of its clinical impact. The present report provides a framework for a systematic analysis of polygraphic recordings of patients under NIV for the detection and classification of PVA validated by bench testing. The algorithm described uses two different time windows: rate asynchrony and intracycle asynchrony. This approach should facilitate further studies on prevalence and clinical impact of PVA in long-term NIV.

scholarly journals 0886 LONG-TERM NON-INVASIVE VENTILATION THERAPIES IN CHILDREN: A SCOPING REVIEW

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A329-A329
Author(s):  
ML Castro Codesal ◽  
K Dehaan ◽  
R Featherstone ◽  
P Bedi ◽  
C Martinez Carrasco ◽  
...  
Keyword(s):  
Scoping Review ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals 0938 A SYSTEMATIC REVIEW OF ADHERENCE TO LONG-TERM NON-INVASIVE VENTILATION IN CHILDREN

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A348-A349
Author(s):  
B Alkhaledi ◽  
ML Castro Codesal ◽  
D Olmstead ◽  
R Featherstone ◽  
M Sebastianski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Importance of the PaCO2 from 3 to 6 months after initiation of long-term non-invasive ventilation

2010 ◽  
Vol 104 (12) ◽  
pp. 1850-1857 ◽  
Author(s):  
Tomomasa Tsuboi ◽  
Motoharu Ohi ◽  
Toru Oga ◽  
Kazuko Machida ◽  
Yuichi Chihara ◽  
...  
Keyword(s):  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Somatic treatments

2012 ◽  
Author(s):  
Raymond W. Lam
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Electroconvulsive Therapy ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Light Therapy ◽  
Limited Data ◽  
Non Invasive ◽  
Resistant Depression ◽  
Term Management

• Wake therapy, exercise and light therapy are non-invasive and clinically useful treatments.• Electroconvulsive therapy remains an effective, safe and well-tolerated treatment for patients with severe, psychotic or medication-resistant depression.• Repetitive transcranial magnetic stimulation is an emerging treatment with evidence for acute efficacy, but with limited data about long-term management....

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