scholarly journals TATALAKSANA GAGAL NAFAS AKUT AKIBAT EDEM PARU AKUT PADA PASIEN DENGAN HIPERTENSI

2021 ◽  
Vol 4 (1) ◽  
pp. 26-32
Author(s):  
Matdhika Sakti ◽  
Ferianto Ferianto ◽  
Dea Vilia Siswoyo ◽  
Fifi Candita ◽  
Ria Finola Ifani
Keyword(s):  
Respiratory Failure ◽  
Syringe Pump ◽  
Failure Type

Gagal nafas merupakan kondisi kegagalan fungsi sistem respirasi dalam pertukaran gas  di mana PaO2 < 60 mmHg dan/ PaCO2 > 50 mmHg. Telah dilakukan tindakan kepada seorang pasien laki-laki berusia tujuh puluh satu tahun dengan berat badan 70kg yang di bawa ke IGD RSUD Kota Dumai dengan keadaan penurunan kesadaran. Dari alloanamnesa terhadap keluarga pasien, diketahui sebelumnya pasien mengeluhkan sesak nafas yang muncul tiba-tiba. Pasien memiliki riwayat penyakit jantung yang diketahui sejak 6 bulan terakhir dan hipertensi tidak terkontrol. Pasien didiagnosis dengan respiratory failure type 1 et causa cardiogenic pulmonary oedem. Saat di ICU, saturasi O2 pasien turun menjadi 77% sehingga pasien diberikan bagging untuk bantuan nafas kemudian saturasi O2 naik menjadi 90%, kemudian pasien mengalami apneu, asistol dan arteri karotis tidak teraba sehingga dilakukan RJP kompresi: ventilasi 30:2 dengan total 15 siklus dan pasien mengalami ROSC. Pasien kemudian dipasang intubasi dan dibantu ventilator, saturasi O2 menjadi 99%. Sebelumnya pasien diberikan midazolam 15mg di dalam 50ml NaCl melalui syringe pump dan fentanyl 2 ampul dalam 50cc NaCl 50ml melalui syringe pump. Kemudian, pola nafas tidak efektif dan keadaan umum memburuk, ventilator diubah menjadi mode PCAC kemudian pernafasan kembali adekuat dan hemodinamik pasien stabil. Kemudian pada pasien dilakukan weaning ventilator.

Respiratory failure

2018 ◽  
Author(s):  
Matt Wise ◽  
Simon Barry
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Partial Pressure ◽  
Acute Onset ◽  
Type I ◽  
Failure Type ◽  
Arterial Blood ◽  
Ventilation Failure

Respiratory failure is a syndrome characterized by defective gas exchange due to inadequate function of the respiratory system. There is a failure to oxygenate blood (hypoxaemia) and/or eliminate carbon dioxide (hypercapnia). Hypoxaemia is defined as an arterial blood partial pressure of oxygen (PaO2) of <8 kPa, and hypercapnia as an arterial blood partial pressure of carbon dioxide (PaCO2) of >6 kPa. Respiratory failure is divided into two different types, conventionally referred to as type 1 and type 2. The distinction between these two is important because it emphasizes not only different their pathophysiological mechanisms and etiologies, but also different treatments. The preferred terminology and definitions are as follows: oxygenation failure (type I respiratory failure), PaO2 of <8 kPa; ventilation failure (type 2 respiratory failure), PaCO2 >6 kPa. Respiratory failure may be acute (onset over hours to days), or chronic (developing over months to years); alternatively, there may be an acute deterioration of a chronic state.

Respiratory failure in infants due to spinal muscular atrophy with respiratory distress type 1

2006 ◽  
Vol 32 (11) ◽  
pp. 1851-1855 ◽  
Author(s):  
Alberto Giannini ◽  
Anna Maria Pinto ◽  
Giordano Rossetti ◽  
Edi Prandi ◽  
Danilo Tiziano ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress ◽  
Spinal Muscular Atrophy ◽  
Muscular Atrophy

scholarly journals MICROSCOPIC POLYANGIITIS PRESENTING AS DIFFUSE PULMONARY HEMORRHAGE AND ACUTE TYPE-1 RESPIRATORY FAILURE

CHEST Journal ◽  
2020 ◽  
Vol 158 (4) ◽  
pp. A2551
Author(s):  
Rasheed Musa ◽  
Ibrahim Haddad ◽  
Mahmoud El Iskandarani ◽  
Sajin Karakattu ◽  
Adel El Abbassi ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Microscopic Polyangiitis ◽  
Pulmonary Hemorrhage ◽  
Acute Type

Natural History of Type 1 Spinal Muscular Atrophy in a Series of Argentinian Children

2020 ◽  
Vol 7 (4) ◽  
pp. 453-458
Author(s):  
V. Aguerre ◽  
F. De Castro ◽  
J. Mozzoni ◽  
LP. Gravina ◽  
HV. Araoz ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Natural History ◽  
Muscular Atrophy ◽  
Survival Curve ◽  
Rank Test ◽  
Invasive Ventilation ◽  
Novel Treatments ◽  
Great Practice ◽  
Respiratory Intervention

Background: SMA1 natural history is characterized by early development of chronic respiratory failure. Respiratory interventions in type 1 SMA infants are subject to great practice variability. Nusinersen, has been recently approved in Argentina. The advent of novel treatments has highlighted the need for natural history studies reporting disease progression in type 1 SMA. Objective: To analyze the progression, respiratory interventions and survival based on the type of respiratory support in type 1SMA patients, in a third level pediatric hospital in Argentina. Methods: Cohort of SMA1 patients followed at the Interdisciplinary Program for the Study and Care of Neuromuscular Patients (IPNM). Patient survival was analyzed by using the Kaplan-Meier method. Log-rank test was performed to compare the survival curve for three respiratory intervention groups. Results: 59 patients. Mean age of symptom onset was 2.19 (±1.4) months, age at diagnosis was 3.9 (±2.1) months. Patients developed respiratory failure at 5.82 months (±2.32) and 13.8 months (±5.6) in Type 1B and Type 1C, respectively (p < 0.001) 53 p were SMA1B. Three copies were found in 1/6 SMA1C. Respiratory interventions: SRC 23 p (56.1%); SRC + NIV 8 p (19.5%); SRC + IV 10 p (24.4%). 8 patients were already on invasive ventilation when included in the IPNM. Patients with invasive ventilation showed longer survival. Conclusions: This series provides valuable information on respiratory intervention requirements and life expectancy in children with SMA1 before the implementation of novel treatments that increase the expression of the SMA protein.

Chronic respiratory failure in myotonic dystrophy type 1 (DM1): Incidence & risk factors

2017 ◽  
Author(s):  
Marie-Anne Melone ◽  
Maxime Patout ◽  
Antoine Cuvelier ◽  
Anne-Laure Bedat-Millet ◽  
Lucie Guyant-Marechal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Myotonic Dystrophy ◽  
Chronic Respiratory Failure ◽  
Myotonic Dystrophy Type 1 ◽  
Myotonic Dystrophy Type ◽  
Incidence Risk

Respiratory failure

2007 ◽  
pp. 49-56
Keyword(s):  
Respiratory Failure ◽  
Cor Pulmonale ◽  
Hypercapnic Respiratory Failure ◽  
Alveolar Level ◽  
Acute Hypercapnic Respiratory Failure ◽  
P Type

Acute hypoxaemic respiratory failure 50 Acute hypercapnic respiratory failure 52 Cor pulmonale 53 Type 1 respiratory failure occurs in the presence of a pO2 <8kPa with a normal or low pCO2. This is most commonly caused by a ventilation–perfusion mismatch at the alveolar level, with an increase in the alveolar–arterial (A–a) gradient (...

Acute respiratory failure

2020 ◽  
pp. 3867-3880
Author(s):  
Susannah Leaver ◽  
Jeremy Cordingley ◽  
Simon Finney ◽  
Mark Griffiths
Keyword(s):  
Respiratory Failure ◽  
Critical Illness ◽  
Acute Respiratory Failure ◽  
Critically Ill ◽  
System Failures ◽  
Life Saving ◽  
Delayed Recognition ◽  
Covert Infection

Acute respiratory failure is defined clinically by hypoxaemia with (type 2) or without (type 1) hypercapnia. It is one of the most common problems afflicting critically ill patients and is a common indication for transfer to an intensive care unit. Critical illness may be manifest solely as respiratory insufficiency, especially in patients with covert infection. Acute respiratory failure frequently coexists with other organ system failures in the critically ill, and delayed recognition of the condition adversely affects outcome. The signs of critical illness tend to be similar whatever the precipitating cause and are manifest in failure of the respiratory, cardiovascular, and neurological systems. Full and repeated physical examination may be required to assess the cause and severity of acute respiratory failure and its associated complications, but in severe cases should not delay the instigation of life-saving support and treatment.

scholarly journals A patient with myotonic dystrophy diagnosed after experiencing sudden respiratory failure: a case report

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Noriaki Nishihara ◽  
Shunsuke Tachibana ◽  
Hajime Sonoda ◽  
Michiaki Yamakage
Keyword(s):  
Respiratory Failure ◽  
Myotonic Dystrophy ◽  
Delayed Diagnosis ◽  
Neuromuscular Diseases ◽  
Acute Onset ◽  
Myotonic Dystrophy Type 1 ◽  
Myotonic Dystrophy Type ◽  
Case Presentation ◽  
Multiple Organs

Abstract Background Myotonic dystrophy is a disorder affecting multiple organs including skeletal muscles and causes respiratory failure. We describe a patient who developed respiratory failure, with delayed diagnosis of myotonic dystrophy type 1 as the cause. Case presentation A 62-year-old woman developed acute onset of dyspnea after showing hypertension and tachycardia and was transported to our hospital. On arrival at our institution, SpO2 was 80% with a non-rebreather mask. With a diagnosis of acute phase heart failure, she underwent tracheal intubation. However, weaning from the respirator was difficult in the intensive care unit (ICU). A detailed interview revealed that her brother was affected with myotonic dystrophy type 1. She was also diagnosed with myotonic dystrophy type 1 by a genetic test. Conclusions Taking a careful past and family history and prompt genetic testing is required on suspicion of neuromuscular diseases in a patient with respiratory failure by an unknown cause.

scholarly journals P.062 Burden of illness of spinal muscular atrophy (SMA): an update

2019 ◽  
Vol 46 (s1) ◽  
pp. S30-S31
Author(s):  
M Droege ◽  
O Dabbous ◽  
R Arjunji ◽  
M Gauthier-Loiselle ◽  
M Cloutier ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Resource Use ◽  
Treatment Initiation ◽  
Healthcare Resource ◽  
Muscular Atrophy ◽  
Burden Of Illness ◽  
Claims Analysis ◽  
Medical Visits

Background: In this retrospective claims analysis, real-world healthcare resource use (HRU) and costs among SMA type 1 (SMA1) patients were assessed. Methods: SMA1 patients were identified from Symphony Health’s Integrated Dataverse® (09/01/2016–08/31/2018). The study period spanned from the index date (date of first SMA1 diagnosis after nusinersen approval [12/23/2016]) until death/end of available data. HRU and costs per-patient-per-year (PPPY; 2018USD) were described during the study period for all patients and after treatment initiation for nusinersen-treated patients. Results: A total of 349 SMA1 patients (median age=1 year; 55.6% female) with median follow-up of 7.9 months were included. The proportion of patients receiving mechanical ventilation, nutritional support, and physical therapy/rehabilitation was 46.4%, 46.1%, and 22.6%. Patients had, on average, 59.4 days with medical visits/year (14.1 inpatient, 13.4 respiratory failure-related). The 45 nusinersen-treated patients had, on average, 56.6 days with medical visits/year (4.6 inpatient, 11.4 respiratory failure-related). Excluding nusinersen-related costs, mean healthcare costs PPPY were $137,627 (median: $43,167) for all patients and $92,618 ($29,425) for nusinersen-treated patients. Mean nusinersen-related costs were $191,909 ($144,487) per month for the first 3 months post-initiation and $36,882 ($16,132) per month thereafter. Conclusions: HRU and costs associated with SMA1 are substantial, even among patients treated with nusinersen.

scholarly journals Neuroleptic malignant-like syndrome causing thrombocytopaenia: a rare association

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-227089 ◽  
Author(s):  
Harsh Sahu ◽  
Mouna Bidarguppe Manjunath ◽  
Animesh Ray ◽  
Naval Kishore Vikram
Keyword(s):  
Respiratory Failure ◽  
Clinical Features ◽  
Creatine Phosphokinase ◽  
Total Leucocyte Count ◽  
Muscle Rigidity ◽  
Laboratory Examination ◽  
Fatal Complication ◽  
Dopaminergic Drugs ◽  
History Of

Neuroleptic malignant-like syndrome is a rare but potentially fatal complication of sudden withdrawal of dopaminergic drugs. Clinical features are similar to that of neuroleptic malignant syndrome (NMS) like hyperthermia, autonomic dysfunction, altered sensorium, muscle rigidity; but instead of history of neuroleptic use, there is history of withdrawal of dopaminergic drugs. Laboratory examination generally show elevated creatine phosphokinase levels and may show elevated total leucocyte count. Thrombocytopaenia has been very rarely reported with NMS but it has not been reported with NM-like syndrome. Here, we discuss a case of Parkinson’s disease which presented with typical clinical features and risk factors of NM-like syndrome associated with thrombocytopaenia and type 1 respiratory failure. He was treated with bromocriptine and supportive care. Thrombocytopaenia and respiratory failure resolved with above treatment. The patient improved clinically and was successfully discharged on day 12 of admission.

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