scholarly journals The Use of Exogenous Lung Surfactant (Poractant Alfa) in Acute Respiratory Failure by Drowning

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mario Pezzi ◽  
Francesco Givigliano ◽  
Ottorino Perrone ◽  
Annamaria Scozzafava ◽  
Pietro Maglio ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Respiratory Distress ◽  
Lung Surfactant ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Lung Damage ◽  
Arterial Blood Gas ◽  
Natural Surfactant ◽  
Arterial Blood

Drowning is an acute respiratory failure as a result from immersion or submersion of the airways in a liquid medium (predominantly water). Inhalation of water causes severe lung damage due to the destruction of pulmonary surfactant, resulting in decreased lung elasticity, alveolar collapse, alteration of ventilation-perfusion ratio, intrapulmonary blood shunting, hypoxia, acute lung injury, and Acute Respiratory Distress Syndrome (ARDS). Poractant alfa (Curosurf®), a natural surfactant effective in the treatment of newborn respiratory distress, has been used in various forms of ARDS, but in drowning syndromes, experience is still poor. We describe a series of nine clinical cases of drowning, six adults and three children, treated in our Intensive Care Unit (ICU) with endobronchial administration of poractant alfa. After 24 and 48 hours of administration in all cases, there was an improvement in arterial blood gas analysis (ABG) parameters and imaging. All patients were discharged without clinical consequences.

An analysis of the treatment effect of two modes of oxygenation on patients with radiation pneumonia complicated by respiratory failure

2022 ◽  
pp. 1-12
Author(s):  
Dong Xing ◽  
Li Chen ◽  
Lantao Wang ◽  
Jing Jin ◽  
Dong Liu ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Tidal Volume ◽  
Blood Gas Analysis ◽  
Assisted Ventilation ◽  
Gas Analysis ◽  
Controlled Study ◽  
Apache Ii Score ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Radiation Pneumonia

BACKGROUND: Stereotactic radiotherapy (SBRT) is widely used in the treatment of thoracic cancer. OBJECTIVE: To evaluate the efficacy of a non-rebreather mask (NRBM) and high-flow nasal cannula (HFNC) in patients with radiation pneumonia complicated with respiratory failure. METHODS: This was a single-center randomized controlled study. Patients admitted to the EICU of the Fourth Hospital of Hebei Medical University were selected and divided into NRBM and HFNC group. Arterial blood gas analysis, tidal volume, respiratory rates and the cases of patients receiving invasive assisted ventilation were collected at 0, 4, 8, 12, 24, 48, and 72 h after admission. RESULTS: (1) The PaO2/FiO2, respiratory rates, and tidal volume between the two groups at 0, 4, 8, 12, 24, 48, and 72 h were different, with F values of 258.177, 294.121, and 134.372, all P< 0.01. These indicators were different under two modes of oxygenation, with F values of 40.671, 168.742, and 55.353, all P< 0.01, also varied with time, with an F value of 7.480, 9.115, and 12.165, all P< 0.01. (2) The incidence of trachea intubation within 72 h between HFNC and NRBM groups (23 [37.1%] vs. 34 [54.0%], P< 0.05). The transition time to mechanical ventilation in the HFNC and NRBM groups (55.3 ± 3.2 h vs. 45.9 ± 3.6 h, P< 0.05). (3) The risk of intubation in patients with an APACHE-II score > 23 was 2.557 times than score ⩽ 23, and the risk of intubation in the NRBM group was 1.948 times more than the HFNC group (P< 0.05). CONCLUSION: Compared with the NRBM, HFNC can improve the oxygenation state of patients with radiation pneumonia complicated with respiratory failure in a short time, and reduce the incidence of trachea intubation within 72 h.

scholarly journals Weil’s disease with haemoptysis and acute respiratory distress syndrome

2019 ◽  
Vol 12 (5) ◽  
pp. e229350
Author(s):  
Afroditi Roumpou ◽  
Ioanna Papaioannou ◽  
Christos Lampropoulos
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Blood Gas Analysis ◽  
Liver Function Tests ◽  
Respiratory Alkalosis ◽  
Gas Analysis ◽  
Arterial Blood Gas ◽  
Arterial Blood

A 35-year-old male patient reached the emergency department after an episode of massive haemoptysis a few hours ago. Fever and dyspnea were mentioned to be present the last 5 days. His medical history included only malaria, successfully treated 2 years ago. Clinical examination revealed high fever, jaundice, cyanosis, tachypnea and bilateral rales on pulmonary auscultation. Laboratory investigation showed high erythrocyte sedimentation rate and C reactive protein, leucocytosis, anaemia, mild thrombocytopaenia, renal impairment, hyperbilirubinaemia and abnormal liver function tests; arterial blood gas analysis showed respiratory alkalosis with severe hypoxia. Thoracic X-ray revealed bilateral pulmonary infiltrates, whereas abdominal and heart ultrasound detected hepatomegaly and small pericardial infusion, respectively. The diagnosis of leptospirosis along with acute respiratory distress syndrome was confirmed by positive IgMLeptospiraantibodies. Empirical treatment with triple antibiotic therapy and corticosteroids was applied. The patient was discharged after 1 week, without any symptoms and with almost normal laboratory tests.

scholarly journals Cushing’s reflex secondary to neck haematoma following thyroidectomy

2018 ◽  
pp. bcr-2018-226639
Author(s):  
K Devaraja ◽  
Dipak Ranjan Nayak ◽  
Abhishek Rao Kordcal ◽  
Sumeet Suresh Malapure
Keyword(s):  
Respiratory Distress ◽  
Index Case ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Jugular Veins ◽  
Nodular Goitre ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Toxic Nodular Goitre

Neck haematoma following thyroid surgery can present with respiratory distress which is generally attributed to airway obstruction. We recently had a 63-year-old female patient who underwent total thyroidectomy for toxic nodular goitre. However, within 4 hours of surgery, she developed sudden respiratory distress which was managed by prompt evacuation of the neck haematoma. Just before the haematoma evacuation, the patient had hypertension and bradycardia along with the distress. The arterial blood gas analysis sampled at that time was normal. Intraoperatively, the tracheal framework was found rigid and non-pliable. Considering the various clinical–biochemical findings observed, we think that the cause of the respiratory distress in the index case was transiently elevated intracranial pressure, secondary to bilateral internal jugular veins' compression. We hypothesise that in many patients with immediate postoperative neck haematoma, the Cushing’s reflex would at least contribute partly, if not solely to the respiratory distress.

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