scholarly journals Respiratory Failure Associated with Ascariasis in a Patient with Immunodeficiency

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Lanocha Aleksandra ◽  
Zdziarska Barbara ◽  
Lanocha-Arendarczyk Natalia ◽  
Kosik-Bogacka Danuta ◽  
Guzicka-Kazimierczak Renata ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Bone Marrow ◽  
Intensive Care ◽  
Respiratory Failure ◽  
General Condition ◽  
Risk Groups ◽  
Parasitic Diseases ◽  
Industrialized Countries ◽  
Recent Immigrants ◽  
Good General Condition

In industrialized countries, risk groups for parasitic diseases include travelers, recent immigrants, and patients with immunodeficiency following chemotherapy and radiotherapy and AIDS. A 66-year-old Polish male was admitted in December 2012 to the Department of Haematology in a fairly good general condition. On the basis of cytological, cytochemical, immunophenotypic, and cytogenetic analysis of bone marrow, the patient was diagnosed with acute myeloblastic leukemia. On the 7th day of hospitalization in the Department of Haematology, patient was moved to the Intensive Care Unit (ICU) due to acute respiratory and circulatory failure. In March 2013, 3 months after the onset of respiratory failures, a mature form ofAscarisspp. appeared in the patient’s mouth. This report highlights the importance of considering anAscarisinfection in patients with low immunity presenting no eosinophilia but pulmonary failure in the central countries of Europe.

scholarly journals Higher Acid-Base Imbalance Associated with Respiratory Failure Could Decrease the Survival of Patients with Scrub Typhus during Intensive Care Unit Stay: A Gene Set Enrichment Analysis

2019 ◽  
Vol 8 (10) ◽  
pp. 1580 ◽  
Author(s):  
Kyoung Min Moon ◽  
Kyueng-Whan Min ◽  
Mi-Hye Kim ◽  
Dong-Hoon Kim ◽  
Byoung Kwan Son ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Scrub Typhus ◽  
Enrichment Analysis ◽  
Gene Set Enrichment Analysis ◽  
Acid Base ◽  
Gene Set Enrichment ◽  
Gene Set ◽  
Gene Sets

Ninety percent of patients with scrub typhus (SC) with vasculitis-like syndrome recover after mild symptoms; however, 10% can suffer serious complications, such as acute respiratory failure (ARF) and admission to the intensive care unit (ICU). Predictors for the progression of SC have not yet been established, and conventional scoring systems for ICU patients are insufficient to predict severity. We aimed to identify simple and robust indicators to predict aggressive behaviors of SC. We evaluated 91 patients with SC and 81 non-SC patients who were admitted to the ICU, and 32 cases from the public functional genomics data repository for gene expression analysis. We analyzed the relationships between several predictors and clinicopathological characteristics in patients with SC. We performed gene set enrichment analysis (GSEA) to identify SC-specific gene sets. The acid-base imbalance (ABI), measured 24 h before serious complications, was higher in patients with SC than in non-SC patients. A high ABI was associated with an increased incidence of ARF, leading to mechanical ventilation and worse survival. GSEA revealed that SC correlated to gene sets reflecting inflammation/apoptotic response and airway inflammation. ABI can be used to indicate ARF in patients with SC and assist with early detection.

scholarly journals Early resuscitation orders in hospitalized oldest-old with COVID-19: A multicenter cohort study

2021 ◽  
pp. 026921632110183
Author(s):  
Ruth Piers ◽  
Eva Van Braeckel ◽  
Dominique Benoit ◽  
Nele Van Den Noortgate
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Hospital Mortality ◽  
Oldest Old ◽  
Case Report Form ◽  
Resuscitation Orders ◽  
Intensive Care Admission ◽  
Treatment Limitation ◽  
Early Decision

Background: In particular older people are at risk of mortality due to corona virus disease 2019 (COVID-19). Advance care planning is essential to assist patient autonomy and prevent non-beneficial medical interventions. Aim: To describe early (taken within 72 h after hospital admission) resuscitation orders in oldest-old hospitalized with COVID-19. Setting/participants: A cohort of patients aged 80 years and older admitted to the acute hospital in March and April 2020 with COVID-19 were retrospectively recruited from 10 acute hospitals in Belgium. Recruitment was done through a network of geriatricians. Results: Overall, 766 octogenarians were admitted of whom 49 were excluded because no therapeutic relationship with the geriatrician and six because of incomplete case report form. Early decisions not to consider intensive care admission were taken in 474/711 (66.7%) patients. This subgroup was characterized by significantly higher age, higher number of comorbidities and higher frailty level. There was a significant association between the degree of the treatment limitation and the degree of premorbid frailty ( p < 0.001). Overall in-hospital mortality was 41.6% in patients with an early decision not to consider intensive care admission (67.1% in persons who developed respiratory failure vs 16.7% in patients without respiratory failure ( p < 0.001)). Of 104 patients without early decision not to consider intensive care admission but who developed respiratory failure, 59 were eventually not transferred to intensive care unit with in-hospital mortality of 25.4%; 45 were transferred to the intensive care unit with mortality of 64.4%. Conclusions: Geriatricians applied all levels of treatment in oldest-old hospitalized with COVID-19. Early decisions not to consider intensive care admission were taken in two thirds of the cohort of whom more than 50% survived to hospital discharge by means of conservative treatment.

Comparative study between noninvasive positive pressure ventilation and invasive mechanical ventilation in patients with respiratory failure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohammed N Al Shafi'i ◽  
Doaa M. Kamal El-din ◽  
Mohammed A. Abdulnaiem Ismaiel ◽  
Hesham M Abotiba
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Positive Pressure Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Significant Difference

Abstract Background Noninvasive positive pressure ventilation (NIPPV) has been increasingly used in the management of respiratory failure in intensive care unit (ICU). Aim of the Work is to compare the efficacy and resource consumption of NIPPMV delivered through face mask against invasive mechanical ventilation (IMV) delivered by endotracheal tube in the management of patients with acute respiratory failure (ARF). Patients and Methods This prospective randomized controlled study included 78 adults with acute respiratory failure who were admitted to the intensive care unit. The enrolled patients were randomly allocated to receive either noninvasive ventilation or conventional mechanical ventilation (CMV). Results Severity of illness, measured by the simplified acute physiologic score 3 (SAPS 3), were comparable between the two patient groups with no significant difference between them. Both study groups showed a comparable steady improvement in PaO2:FiO2 values, indicating that NIPPV is as effective as CMV in improving the oxygenation of patients with ARF. The PaCO2 and pH values gradually improved in both groups during the 48 hours of ventilation. 12 hours after ventilation, NIPPMV group showed significantly more improvement in PaCO2 and pH than the CMV group. The respiratory acidosis was corrected in the NIPPV group after 24 hours of ventilation compared with 36 hours in the CMV group. NIPPV in this study was associated with a lower frequency of complications than CMV, including ventilator acquired pneumonia (VAP), sepsis, renal failure, pulmonary embolism, and pancreatitis. However, only VAP showed a statistically significant difference. Patients who underwent NIPPV in this study had lower mortality, and lower ventilation time and length of ICU stay, compared with patients on CMV. Intubation was required for less than a third of patients who initially underwent NIV. Conclusion Based on our study findings, NIPPV appears to be a potentially effective and safe therapeutic modality for managing patients with ARF.

scholarly journals Interrelated factors of tracheostomy in critically ill pediatric patients during their stay at ICU or PICU in Japan: a data-based analysis

2020 ◽  
Author(s):  
Tadashi Ishihara ◽  
Hiroshi Tanaka
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Critically Ill ◽  
Chronic Conditions ◽  
Large Scale ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Chromosomal Anomalies ◽  
Multicenter Cohort Study

Abstract Background The most common current indications of pediatric tracheostomy include prolonged ventilator dependence, often resulting from the consequences of prematurity and bronchopulmonary dysfunction, and upper airway obstruction resulting either from craniofacial or structural abnormalities of the upper airway or from hypotonia stemming from neurological or neuromuscular disturbance. The purpose of this study was to describe the indications, epidemiology, frequency, and associated factors for tracheostomy in critical pediatric patients admitted to the intensive care unit (ICU) or pediatric intensive care unit (PICU) by using the large amount of data available in the Japanese Registry of Pediatric Acute Care (JaRPAC). Methods In this retrospective multicenter cohort study, we collected data concerning pediatric tracheostomy from the JaRPAC database involving patients aged ≤ 16 years who had no tracheostomy when admitted to ICU or PICU between April 2014 and March 2017. The patients were divided into two groups: those with tracheostomies when they were discharged from the ICU or PICU and patients without tracheostomies. Interrelated factors of tracheostomy were investigated. Results A total of 23 hospitals participated, involving 6,199 pediatric patients registered in the JaRPAC database during the study period. Of the registered pediatric patients, 5,769 (95%) patients were admitted to the ICU or PICU without tracheostomies. Among the patients, 181 patients (3.1%) had undergone tracheostomies. There were significant differences in the number of chronic conditions (134, 74.0% versus 3096, 55.4%, p < 0.01), chromosomal anomalies (19, 10.5% versus 326, 5.8%, p < 0.01), urgent admission (151, 83.4% versus 3093, 55.4%, p < 0.01). More tracheostomies were performed on patients who were admitted for respiratory failure (61, 33.7% versus 926, 16.1%, p < 0.01) and for post-CPA resuscitation (40, 22.1% versus 71, 1.1%, p < 0.01). Conclusions This is the first report to use a large-scale registry of critically ill pediatric patients in Japan to describe the interrelated factors of tracheostomies during their stay in ICUs or PICUs. Chronic conditions (especially for neuromuscular disease), chromosomal anomaly, urgent admission, admission due to respiratory failure, or treatment for post-CPA resuscitation all had the possibility to be risk factors for tracheostomy.

scholarly journals Is the Jury Out or In?

2019 ◽  
pp. 743-760
Author(s):  
Anna M. May ◽  
Thomas R. Gildea ◽  
Reena Mehra
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Obstructive Sleep Apnea ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Perioperative Complications ◽  
Health Care Expenditures ◽  
Level Of Care ◽  
Obstructive Sleep ◽  
Respiratory Management

This case illustrates potential perioperative complications associated with obstructive sleep apnea (OSA): respiratory decompensation sometimes leading to morbidity, mortality, increase in the level of care, and increased health care expenditures. OSA is common and affects more than 40% of the surgical population. However, an estimated 85% of those with OSA are undiagnosed preoperatively. This chapter describes an individual with severe OSA complicated by perioperative respiratory failure who required intensive care unit admission and emergent reintubation. This case is used to highlight perioperative considerations for OSA screening, testing, and treatment with a focus on respiratory management based on guideline recommendations. This case underscores the most common types and timing of such postoperative complications and ways to prevent and treat them.

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