scholarly journals Experience of N-acetylcysteine airway management in the successful treatment of one case of critical condition with COVID-19

2020 ◽  
Author(s):  
Yan Liu ◽  
Guoshi Luo ◽  
Xin Qian ◽  
Chenglin Wu ◽  
Yijun Tang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Airway Management ◽  
Critical Condition ◽  
Respiratory Support ◽  
Artificial Airway ◽  
Anastomotic Fistula ◽  
Management Experience ◽  
Novel Coronavirus ◽  
Acid Test

Abstract Object: To report the successful diagnosis and treatment of a patient with critical condition of novel coronavirus pneumonia (COVID-19) and to summarize its clinical features and airway management experience in successful treatment.Methods: Retrospectively analyzed the successful management of one case of COVID-19 with critical condition combined respiratory failure and discussed the clinical characteristics and airway management of the patient in conjunction with a review of the latest literature.Results: A patient with an anastomotic fistula after radical treatment of esophageal cancer and right-side encapsulated pyopneumothorax was admitted with cough and dyspnea and was diagnosed with novel coronavirus pneumonia and malnutrition by pharyngeal swab nucleic acid test in combination with chest CT. The patient was treated with antibiotics, antiviral and antibacterial medications, respiratory support, expectorant nebulization, and nutritional support, expressed progressive deterioration. Endotracheal intubation and mechanical ventilation were performed since the onset of the type Ⅱ respiratory failure on the 13th day of admission. The patient had persistent refractory hypercapnia after mechanical ventilation. Based on the treatment mentioned above, combined with repeated bronchoalveolar lavage by using N-acetylcysteine ​​(NAC) inhalation solution, the patient's refractory hypercapnia was gradually improved. It was cured and discharged after being given the mechanical ventilation for 26 days as well as 46 days of hospitalization, currently is surviving well.Conclusion: Patients with severe conditions of novel coronavirus pneumonia often encounter bacterial infection in their later illness-stages. They may suffer respiratory failure and refractory hypercapnia that is difficult to improve due to excessive mucus secretion leading to small airway obstruction. In addition to the use of reasonable antibiotics and symptomatic respiratory support and other treatment, timely artificial airway and repeated bronchoalveolar NAC inhalation solution lavage, expectorant and other airway management are essential for such patients.

Computational Analysis of a Wearable Artificial Pump Lung Device in Terms of Rotor/Stator Interactions

2009 ◽  
Author(s):  
M. Ertan Taskin ◽  
Tao Zhang ◽  
Bartley P. Griffith ◽  
Zhongjun J. Wu
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Gas Exchange ◽  
Extracorporeal Membrane Oxygenation ◽  
Lung Disease ◽  
Computational Analysis ◽  
Respiratory Support ◽  
Membrane Oxygenation ◽  
Current Therapies

Lung disease is America’s third largest killer, and responsible for one in seven deaths [1]. Most lung disease is chronic, and respiratory support is essential. Current therapies for the respiratory failure include mechanical ventilation and bed-side extracorporeal membrane oxygenation (ECMO) devices which closely simulate the physiological gas exchange of the natural lung.

scholarly journals Respiratory Care in Children with COVID-19

2021 ◽  
Author(s):  
Shalu Gupta ◽  
Suresh K. Angurana ◽  
Virendra Kumar
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Distress ◽  
Health Care Providers ◽  
Respiratory System ◽  
Oxygen Delivery ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Critically Ill Children ◽  
Care Providers ◽  
Novel Coronavirus

AbstractThe novel coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is causing significant morbidity and mortality worldwide. The common presentations in children include involvement of respiratory system leading to pneumonia and acute respiratory distress syndrome, as well as multiorgan dysfunction syndrome and multisystem inflammatory syndrome in children (MIS-C). Pediatric COVID-19 is a milder disease as compared with the adults. Also, there is rise in MIS-C cases which is a hyperinflammatory condition temporally associated with SARS-CoV-2. Since respiratory system is predominantly involved, few of these critically ill children often require respiratory support which can range from simple oxygen delivery devices, high-flow nasal cannula (HFNC), noninvasive ventilation (NIV), invasive mechanical ventilation, and extracorporeal membrane oxygenation (ECMO). Most of the oxygen delivery devices and respiratory interventions generate aerosols and pose risk of transmission of virus to health care providers (HCPs). The use of HFNC and NIV should be limited to children with mild respiratory distress preferably in negative pressure rooms and with adequate personnel protective equipments (PPEs). However, there should be low thresholds for intubation and invasive mechanical ventilation in the event of clinical deterioration while on any respiratory support. The principle of providing respiratory support requires special droplet and air-borne precautions to limit exposure or transmission of virus to HCPs and at the same time ensuring safety of the patient.

scholarly journals The Way of Severe Nursing of Respiratory System Failure

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Qiongshan Liu ◽  
Weichao Li
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Ph Value ◽  
Respiratory Dysfunction ◽  
Airway Patency ◽  
Main Research ◽  
Artificial Airway ◽  
Group A ◽  
Group B ◽  
The Way

Respiratory failure is the most common clinical symptom, seriously endangering people’s health, which is mainly caused by a series of reasons, leading to serious respiratory dysfunction and severe pulmonary respiratory disorders, damaging the pulmonary airway function, and causing disability to maintain normal human gas exchange activities. At present, the main treatment of respiratory failure is to use the ventilator to help patients exchange gas and keep their breathing unobstructed. The nursing method is also around the artificial airway mechanical ventilation. The nursing of patients with respiratory failure is mainly respiratory nursing and psychological nursing. In this paper, the main research is to explore the way of severe nursing of respiratory failure. Before the nursing of respiratory failure, we should carry out nursing detection of the ventilator and test its performance, tightness, pipeline safety, and airway patency. Then carrying on the respiratory failure mechanical ventilation nursing and clarifying its mechanical ventilation nursing process is the main work of intensive care, at the same time, giving consideration to the psychological nursing of respiratory failure and implementing comprehensive nursing. In this paper, 50 patients were selected and divided into group A and group B; group A was given comprehensive nursing, and group B was given general nursing. The experimental results show that a series of situations in group A are more optimistic than those in group B. There was no doubt that the PH value of the two groups changed significantly 6 months after discharge. The pO2 value of group A was higher than that before discharge, while the pCO2 value of group B was unstable and increased. The pO2 value of group A was 55.52 before discharge and 62.36 six months after discharge. The pCO2 value of group A was 54.31 before discharge and 50.61 six months after discharge. The pCO2 value of group B was 55.23 before discharge and 57.34 six months after discharge.

scholarly journals Outcomes and characteristics of COVID-19 patients treated with CPAP/ HFNO outside of the intensive care setting

2021 ◽  
pp. 00318-2021
Author(s):  
Dominic L Sykes ◽  
Michael G Crooks ◽  
Khaing Thu Thu ◽  
Oliver I Brown ◽  
Theodore J p Tyrer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Care Setting ◽  
Treatment Options ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Intensive Care Setting ◽  
Non Invasive ◽  
Significant Difference

BackgroundContinuous Positive Airway Pressure (CPAP) and High Flow Nasal Oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to COVID-19 pneumonia. Limited data are available for patients treated with non-invasive respiratory support outside of the intensive care setting.MethodsIn this single-centre observational study we observed the characteristics, physiological observations, laboratory tests, and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with non-invasive respiratory support outside of the intensive care setting.ResultsWe report the outcomes of 140 patients (Mean Age=71.2 [sd=11.1], 65% Male [n=91]) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.ConclusionsCPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.

scholarly journals Mechanical Ventilation in Pregnancy Due to COVID-19: A Cohort of Three Cases

2020 ◽  
Vol 37 (10) ◽  
pp. 1066-1069 ◽  
Author(s):  
Elizabeth Lucarelli ◽  
Claudia Behn ◽  
Susan Lashley ◽  
Dorothy Smok ◽  
Carlos Benito ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Adverse Effects ◽  
Pregnant Women ◽  
Mechanically Ventilated ◽  
Key Points ◽  
Novel Coronavirus ◽  
In Pregnancy

We describe our experience with three pregnant women with novel coronavirus disease 2019 (COVID-19) who required mechanical ventilation. Recent data suggest a mortality of 88% in nonpregnant patients with COVID-19 who require intubation and mechanical ventilation. The three women we report were intubated and mechanically ventilated during pregnancy due to respiratory failure and pneumonia resulting from COVID-19. After several days of ventilation, all three were successfully weaned off mechanical ventilation and extubated, and are continuing their pregnancies with no demonstrable adverse effects. Our experience suggests that the mortality in pregnant women with COVID-19 requiring mechanical ventilation is not necessarily as high as in nonpregnant patients with COVID-19. Key Points

Respiratory support

2016 ◽  
Keyword(s):  
Mechanical Ventilation ◽  
Airway Management ◽  
Assessment Tools ◽  
Respiratory Support ◽  
Non Invasive ◽  
Advanced Airway ◽  
Practical Guidance ◽  
Set Up ◽  
Airway Devices ◽  
Healthy Lung

The aim of the respiratory support chapter is to provide the retrievalist with an armamentarium of information regarding advanced airway management. The chapter details the approach to the difficult airway with assessment tools and clinical features. Airway devices are discussed and intubation methods outlined. Practical guidance is provided on how to set up your non-invasive and invasive modes of ventilation with sections on mechanical ventilation of the healthy lung.

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