Intensive care of a complicated form of asthmatic status (clinical case)

2019 ◽  
Vol 2 (31) ◽  
pp. 46-51
Author(s):  
D. A. Temerov ◽  
L. V. Vorobyova ◽  
S. V. Vyzhevsky ◽  
S. B. Savchenkov ◽  
Yu. V. Marchenkov
Keyword(s):  
Clinical Case ◽  
Mixture Distribution ◽  
Severe Pneumonia ◽  
Control Mode ◽  
Respiratory Support ◽  
Oxygen Mixture ◽  
Bronchial Obstruction ◽  
Optimal Regime ◽  
Pulmonary Barotrauma ◽  
Airway Patency

The article presents a clinical case of successful treatment of a patient with prolonged asthmatic status. The pathogenesis of purulent-septic and other life-threatening complications developing as a result of the above critical condition is described. The positive effect of a differentiated approach in conducting respiratory support depending on the stage of the disease is justified: at the beginning, when airway obstruction is in the foreground, and in the future, when restrictive respiratory disorders develop. When conducting respiratory support, the most reasonable methods for ensuring airway patency were selected. The necessity of neurovegetative blockade and myoplegia for the prevention of pulmonary barotrauma during respiratory support by aggressive ventilation modes and with the goal of antihypoxic protection of the brain is emphasized. During the treatment of the patient, it was confirmed that the optimal regime for obstruction of the bronchi is forced volume-cyclic ventilation of the lungs to provide the necessary minute volume of breathing, and in severe pneumonia, in the case of relief of bronchial obstruction, respiratory support is carried out in pressure control mode for better air-oxygen mixture distribution in the airways. The need for early tracheostomy and daily therapeutic fibrobronchoscopy to ensure airway patency and treat pneumonia has been confirmed.

scholarly journals Severe pneumonia with anemic syndrome.

2018 ◽  
Vol 96 (3) ◽  
pp. 267-272
Author(s):  
Dmitry A. Arkhangelsky ◽  
V. P. Butikov ◽  
Yu. N. Zakrevsky ◽  
Yu. E. Barachevsky ◽  
A. G. Shevchenko ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Clinical Case ◽  
Severe Pneumonia ◽  
Medical Evacuation ◽  
Respiratory Index

The question of determining the criteria for medical evacuation of patients with severe pneumonia from remote regions is still poorly understood. Presented a clinical case of successful evacuation of a patient with severe pneumonia with the presence of anemia. The aim of the study was to evaluate anemia as a prediction of the possible development of acute respiratory failure in patients with pneumonia. Statistically significant associations of increased respiratory index (РаО2/FiO2) with hemoglobin levels (r=0,689 p=0.001) and the number of blood erythrocytes (r=0,683 p=0,001).

scholarly journals Complicated Course of Coronavirus COVID-19 Infection in the old Patient with Severe Cardiac Pathology: a Clinical Case Study

Kardiologiia ◽  
2021 ◽  
Vol 61 (3) ◽  
pp. 115-120
Author(s):  
S. A. Boldueva ◽  
I. A. Ruslyakova ◽  
O. V. Zakharova ◽  
M. V. Rozhdestvenskaya
Keyword(s):  
Ventricular Arrhythmias ◽  
Clinical Case ◽  
Severe Pneumonia ◽  
Cardiac Pathology ◽  
Cardiovascular Pathology ◽  
Clinical Case Study ◽  
Acute Myocardial Injury ◽  
Complicated Course ◽  
Clinically Significant

The article describes a clinical case of the COVID-19 viral infection complicated with severe pneumonia, “cytokine storm”, bacteriemia, and acute myocardial injury with decompensated chronic heart failure, ventricular arrhythmias, and formation of an intracardiac thrombus in an elderly patient with underlying clinically significant cardiovascular pathology. 

Clinical case of the bronchial obstruction syndrome: COPD or asthma?

Therapy ◽  
2019 ◽  
Vol 3_2019 ◽  
pp. 144-146
Author(s):  
Epishina Ya.S. Epishina ◽  
Khazov D.A. Khazov ◽  
Solodun M.V. Solodun ◽  
Keyword(s):  
Clinical Case ◽  
Bronchial Obstruction

scholarly journals Practical guidance for oxygen treatment and respiratory support of patients with COVID-19 infection before admission to intensive care unit

2020 ◽  
Vol 30 (2) ◽  
pp. 151-163
Author(s):  
S. N. Avdeev ◽  
N. N. Tsareva ◽  
Z. M. Merzhoeva ◽  
N. V. Trushenko ◽  
A. I. Yaroshetskiy
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Therapy ◽  
Life Support ◽  
Severe Pneumonia ◽  
Lung Ventilation ◽  
Respiratory Support ◽  
Early Intubation ◽  
High Death ◽  
Practical Guidelines

Acute Respiratory failure (ARF) is the leading cause of death in patients with severe COVID-19, who have been admitted to the hospital. Tradition - ally, it has been believed that with severe pneumonia complicated by ARF, survival can improve with the use of early intubation and artificial lung ventilation (ALV) in patients. However, according to recently published studies, COVID-19 has a very high death rate among patients receiving ALV. In case of early (pre-life support) start of oxygen therapy and respiratory support in patients with COVID-19 the need for transfer to the intensive care unit, tracheal intubation and ALV decreases, and therefore the prognosis improves. This article presents practical guidelines for oxygen therapy and respiratory support at the pre-life support in patients with COVID-19 infection complicated by ARF. 

scholarly journals Severe Pneumonia and Sepsis Caused by Dialister pneumosintes in an Adolescent

Pathogens ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 733
Author(s):  
Maximilian Kaiser ◽  
Meike Weis ◽  
Katharina Kehr ◽  
Verena Varnholt ◽  
Horst Schroten ◽  
...  
Keyword(s):  
Health Care ◽  
Acute Respiratory Distress Syndrome ◽  
Clinical Case ◽  
Distress Syndrome ◽  
Severe Pneumonia ◽  
Severe Infection ◽  
Ground Glass Opacity ◽  
Obese Female ◽  
Oral Switch ◽  
The Right

Background: Dialister pneumosintes (D. pneumosintes) is known to cause dental, periodontal or sinus infections. To date, the pathogen has only been described in a small number of cases with a severe infection. Case report: We describe the clinical case of a 13-year-old, obese female patient that presented with acute respiratory failure and sepsis. A CT-scan showed extensive bilateral patchy areas, subpleural and peribronchovascular consolidations with surrounding ground-glass opacity, extensive consolidations in the lower lobes of both lungs matching to a severe pneumonia and clinically emerging acute respiratory distress syndrome. Moreover, it showed extensive sinusitis of the right sinus frontalis, maxillaris and right cellulae ethmoidales. D. pneumosintes was isolated from an anaerobic blood culture obtained at admission. The antibiotic treatment included piperacillin/tazobactam and oral switch to ampicillin/sulbactam plus ciprofloxacin. Conclusions: We describe the first adolescent with severe systemic D. pneumosintes infection. Since the pathogen is difficult to culture the systemic virulence remains unclear. This work aims to sensitize health care specialists to consider D. pneumosintes infection in patients with periodontal or sinusal infection.

scholarly journals Clinical case of tuberculosis in infant with bronchial obstructive syndrome

2018 ◽  
pp. 161-165
Author(s):  
V. A. Klimenko ◽  
Y. A. Yanovskaya ◽  
Y. V. Pasichnik ◽  
O. Y. Marchenko
Keyword(s):  
Young Children ◽  
Lymph Nodes ◽  
Medical History ◽  
Clinical Case ◽  
Bronchial Obstruction ◽  
Pathogenetic Mechanism ◽  
Airway Compression

The objective of this article is to improve the etiology verification of the obstruction in young children by informing the physicians about the rare causes of obstructive syndrome which are difficult to diagnose, in particular about tuberculosis. Analyzed the clinical and medical history girls 6 months, presented data on the treatment and examination of the patient. The survey revealed that the main pathogenetic mechanism of bronchial obstruction of airway compression was increased bronchopulmonary lymph nodes on the background of specific tubercular process in lungs.

scholarly journals CHURG-STRAUSS SYNDROME: CLINICAL CASE AND ITS FEAUTURES

2019 ◽  
Vol 72 (4) ◽  
pp. 723-726
Author(s):  
Ivan P. Katerenchuk ◽  
Lidiya A. Tkachenko ◽  
Tetyana I. Yarmola ◽  
Viktoriya V. Talash ◽  
Savetik T. Rustamyan ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Course ◽  
Clinical Signs ◽  
Diagnostic Process ◽  
Bronchial Obstruction ◽  
Churg Strauss Syndrome ◽  
General Practioner ◽  
Strauss Syndrome ◽  
Time Diagnosis ◽  
Churg Strauss

Introduction: The article describes the clinical case devoted to the features of the clinical course of Churg-Strauss syndrome (eosinophilic granulomatous with systemic necrotizing vasculitis). Churg-Strauss syndrome is a disease that is rarely diagnosed because of presenting by high-variability clinical syndromes, that causes difficulties in diagnostic process, especially on the first visit of patient to the general practioner. The aim of the article is to show the clinical course feautures of the Churg-Strauss syndrome in the time of disease progression, as well as pecullarities and possibilities of in-time diagnosis of this disease. Clinical case: It was described a clinical case of Churg-Strauss syndrome in a 46-year-old woman, presenting with successively appeared signs of the disease that resulted in some difficulties of making in-time diagnosis. Conclusions: As Churg-Strauss syndrome is a low-spread disease presenting with high-variety of clinical signs and despite of the presence of clear diagnostic criterias Churg-Stross syndrome was diagnosed with delay in this clinical setting. General practitioner should remember that if the disease debuts by the signs of pneumonia with further appearance of signs of bronchial obstruction and eosinophilia, its necessary to perform diagnostic approaches with the aim to carry out the presence of the Churg-Strauss syndrome.

scholarly journals Peculiarities of Respiratory Support in Patients with Severe Pathology during Air Ambulance Evacuation

2021 ◽  
pp. 67-72
Author(s):  
S.A. Gumenyuk ◽  
◽  
V.I. Potapov ◽  
A.Yu. Sysoev ◽  
◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Tracheal Intubation ◽  
Acute Respiratory Failure ◽  
Medical Care ◽  
Lung Ventilation ◽  
Respiratory Support ◽  
Emergency Medical Care ◽  
Airway Patency ◽  
Air Ambulance ◽  
Emergency Medical

The aim of the study is to identify and to analyze the features of respiratory support in patients with severe acute respiratory failure when performing air ambulance evacuation by light class helicopters by specialists of aeromedical teams. Materials and methods. We used materials containing data on the frequency and peculiarities of ventilator usage and tracheal intubation during emergency medical care for patients with acute respiratory failure over the last 5 years (2016-2020). During this period emergency medical care was provided to 53579 patients, 298 of whom were in extremely severe and serious condition requiring ventilator usage and tracheal intubation. The following methods were used in the study: historical, statistical, analytical. Results of the study and their analysis. Trauma prevailed among nosological forms in patients with acute respiratory failure. Artificial lung ventilation with tracheal intubation should be started before the patient is transported to the helicopter cabin. During air ambulance evacuation of patients with acute respiratory failure by helicopter of light class, doctors should take differentiated approach to the choice of type and mode of respiratory support and of method of airway patency assurance.

scholarly journals Clinical experience of using double bronchodilation therapy in patients with COPD

2019 ◽  
pp. 7-10
Author(s):  
I. V. Demko ◽  
M. G. Mamayeva ◽  
N. V. Gordeyeva ◽  
I. A. Solov’yeva ◽  
A. Yu. Kraposhina
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Exercise Tolerance ◽  
Clinical Case ◽  
Medical Problem ◽  
Chronic Obstructive ◽  
Delivery Vehicle ◽  
Obstructive Pulmonary Disease ◽  
Airway Patency

Chronic obstructive pulmonary disease is today one of the socially significant diseases, and its treatment remains a major medical problem.Currently, the main goals of treating patients with COPD are: eliminating symptoms and improving the quality of life, preventing exacerbations and reducing future risks, slowing the progression of the disease and reducing mortality.The article presents a clinical case from the practice of a patient with COPD who received tiotropium bromidi as monotherapy. The patient had significant impaired airway patency during spirometry, a decrease in exercise tolerance. The patient was assigned a new representative of combination preparations with a 24-hour action – Anoro Ellipta® (Vilanterol + Umeklidiniy) 22/55 mcg, with a new drug delivery vehicle. After 6 months of therapy with Anoro Ellipt®, the patient has increased exercise tolerance, improved pulmonary function, as well as quality of life. 

scholarly journals Hemophagocytic Lymphohistiocytosis in Children

Doctor Ru ◽  
2021 ◽  
Vol 20 (3) ◽  
pp. 66-69
Author(s):  
N.G. Bagdasaryan ◽  
◽  
G.S. Ayvazyan ◽  
L.A. Avetisyan ◽  
N.R. Mnatsakanyan ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Remission ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Case ◽  
Severe Pneumonia ◽  
Bone Marrow Smear ◽  
Cytostatic Agents ◽  
Key Points ◽  
Diagnostic Importance ◽  
Iv Immunoglobulin

Objective of the Paper: To present a clinical case of a 2.5-year girl hospitalised with severe pneumonia with associated hemophagocytic lymphohistiocytosis (HLH). Key Points. HLH is a syndrome, the clinical representation of which is a system sepsis-like inflammatory reaction; in the majority of cases, this condition is hardly diagnosed by paediatricians. Associated pancytopenia and hyperferritinaemia are of diagnostic importance. Here we present a clinical case of a 2.5-year girl who was hospitalised with severe pneumonia and associated HLH. As there is no common approach to the management of HLH, we summoned a board of doctors and decided to start steroid therapy (dexamethasone) and IV immunoglobulin (Octagam), and if there was no effect from therapy within a week, cytostatic agents would be added. The therapy was initiated promptly after macrophages had been found in bone marrow smear. Clinical and paraclinic improvements were noted on day 5, so aggressive immunosuppresion was not initiated. In a month there were no signs of organ dysfunction; the values normalised, and the child was discharged from the inpatient clinic. Conclusion. HLH is associated with high mortality, therefore, early diagnosis and therapy are critical. The specificity of this case is that we managed to promptly diagnose the condition, initiated treatment and achieved complete remission without aggressive immunosuppresion. Keywords: hemophagocytic lymphohistiocytosis, macrophages, pancytopenia.

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