scholarly journals Mechanical ventilator support and prone positioning in COVID-19 related pneumonia

2021 ◽  
Author(s):  
Rungsun Bhurayanontachai
Keyword(s):  
Respiratory Symptoms ◽  
Epidemiologic Study ◽  
Multiple Organ ◽  
Positive Pressure ◽  
High Morbidity ◽  
Mechanical Ventilator ◽  
Prone Positioning ◽  
Ventilator Support ◽  
Global Pandemic ◽  
The Common

COVID-19 is currently a global pandemic that cause high morbidity and mortality, particularly in the critical cases. The common presentation is among the common respiratory symptoms and could be deteriorated to multiple organ failure. From the previous epidemiologic study, approximate 15% of cases developed pneumonia and 5% required intensive care admission. The optimal respiratory care including oxygen support are the key for hypoxic respiratory failure from severe COVID-19. Several devices have been practically suggested for respiratory symptoms included high flow nasal cannula (HFNC), non-invasive positive pressure ventilator (NIV) via either common facial mask or helmet. However, some patients did not improve with those devices, that become more respiratory distress and eventually required intubation and mechanical ventilator support. In this brief review, the author will pay attention on the mechanical ventilator support and prone positioning for COVID-19 pneumonia.

scholarly journals Hemophagocytosis, hyper-inflammatory responses, and multiple organ damages in COVID-19-associated hyperferritinemia

2021 ◽  
Author(s):  
Guiying Dong ◽  
Jianbo Yu ◽  
Weibo Gao ◽  
Wei Guo ◽  
Jihong Zhu ◽  
...  
Keyword(s):  
General Practice ◽  
Multivariate Analysis ◽  
Inflammatory Responses ◽  
Multiple Organ ◽  
Hospital Death ◽  
Mechanical Ventilator ◽  
Chronic Pulmonary Disease ◽  
Ventilator Support ◽  
The Relationship ◽  
D Dimer

Abstract Hyperferritinemia comes to light frequently in general practice. However, the characteristics of COVID-19-associated hyperferritinemia and the relationship with the prognosis were not well described. The retrospective study included 268 documented COVID-19 patients. They were divided into the hyperferritinemia group (≥ 500 µg/L) and the non-hyperferritinemia group (< 500 µg/L). The prevalence of fever and thrombocytopenia and the proportion of patients with mechanical ventilator support and in-hospital death were much higher in the hyperferritinemia group (P < 0.001). The hyperferritinemia patients showed higher median IL-6, D-dimer, and hsCRP (P < 0.001) and lowered FIB level (P = 0.036). The hyperferritinemia group had a higher proportion of patients with AKI, ARDS, and CSAC (P < 0.001). According to the multivariate analysis, age, chronic pulmonary disease, and hyperferritinemia were found to be significant independent predictors for in-hospital mortality [HR 1.041 (95% CI 1.015–1.068), P = 0.002; HR 0.427 (95% CI 0.206–0.882), P = 0.022; HR 6.176 (95% CI 2.447–15.587), P < 0.001, respectively]. The AUROC curve was 0.88, with a cut-off value of ≥ 971 µg/L. COVID-19 patients with hyperferritinemia had a high proportion of organ dysfunction, were more likely to show hyper-inflammation, progressed to hemophagocytic lymphohistiocytosis, and indicated a higher proportion of death.

scholarly journals COVID-19-Induced Hyperleucocytosis in Chronic Lymphocytic Leukaemia

2021 ◽  
Author(s):  
Balraj Singh ◽  
Sarah Ayad ◽  
Parminder Kaur ◽  
Ro-Jay Reid ◽  
Sachin Gupta ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Chronic Lymphocytic Leukaemia ◽  
Respiratory Symptoms ◽  
Lymphocytic Leukaemia ◽  
Wide Spectrum ◽  
Multiple Organ ◽  
Global Pandemic ◽  
Organ Systems ◽  
Wbc Count ◽  
Novel Coronavirus

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for the current global pandemic, coronavirus disease 2019 (COVID-19). COVID-19 usually presents with respiratory symptoms but can affect multiple organ systems. A wide spectrum of complications can occur depending upon the comorbidities of patients. There is limited literature available regarding the presentation and outcome of COVID-19 in chronic lymphocytic leukaemia (CLL) patients. We report 2 cases of COVID-19-induced hyperleucocytosis (WBC count >100,000/?l) in CLL patients.

Infection, sepsis, and multiorgan dysfunction syndrome

2021 ◽  
pp. 945-955
Author(s):  
Jean-Louis Vincent
Keyword(s):  
Organ Failure ◽  
Time Window ◽  
Multiple Organ ◽  
High Morbidity ◽  
Source Of Infection ◽  
Complex Interactions ◽  
Organ Systems ◽  
Outcome Improvement ◽  
The Common ◽  
Sepsis And Septic Shock

Sepsis is the main cause of multiple organ failure and remains a concern because of the associated high morbidity and mortality. In recent years, important advances have been made in the understanding of the pathophysiology of sepsis. Sepsis and septic shock are the end result of complex interactions between infecting organisms and various elements of the host response. A key feature of the common sequence of organ failure is dysfunction of the cardiovascular system, including microcirculatory elements. Outcome improvement in sepsis is based on recognizing the process early and instituting effective therapies. The time window for intervention is relatively short, and treatment must promptly control the source of infection, restore haemodynamic homoeostasis, and support failing organ systems.

Unintended Pulmonary Artery Ligation during PDA Ligation

2016 ◽  
Vol 19 (4) ◽  
pp. 187 ◽  
Author(s):  
Dohun Kim ◽  
Si-Wook Kim ◽  
Hong-Ju Shin ◽  
Jong-Myeon Hong ◽  
Ji Hyuk Lee ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Ductus Arteriosus ◽  
Left Lung ◽  
Left Pulmonary Artery ◽  
Chest Ct ◽  
Mechanical Ventilator ◽  
Artery Ligation ◽  
Ventilator Support ◽  
Surgical Ligation ◽  
Emergent Operation

A 10-day-old boy was transferred to our hospital due to tachypnea. Patent ductus arteriosus (PDA), 4.8 mm in diameter, with small ASD was diagnosed on echocardiography. Surgical ligation of the ductus was performed after failure of three cycles of ibuprofen. However, the ductus remained open on routine postoperative echocardiography on the second postoperative day, and chest CT revealed inadvertent ligation of the left pulmonary artery (LPA) rather than the PDA. Emergent operation successfully reopened the clipped LPA and ligated the ductus on the same (second postoperative) day.<br />Mechanical ventilator support was weaned on postoperative day 21, and the baby was discharged on postoperative day 47 with a normal left lung shadow.

Hallazgos oftalmológicos en enfermedad de Fabry: relación de su severidad en una familia mexicana

2019 ◽  
Vol 1 (1) ◽  
pp. 43-49
Author(s):  
Araceli Borja Borja ◽  
Gabriela Salas Pérez ◽  
Pablo Radillo Díaz
Keyword(s):  
Premature Mortality ◽  
Retinal Vessel ◽  
Multiple Organ ◽  
High Morbidity ◽  
Lysosomal Storage ◽  
Enzyme Replacement ◽  
Non Invasive ◽  
High Incidence ◽  
Cornea Verticillata ◽  
Gla Gene

Introduction. Fabry disease (FD) is a lysosomal storage disorder associated with multiple organ dysfunction which eventually leads to high morbidity and premature mortality. Ophthalmologic findings in FD are very common and have been described extensively. We describe the ophthalmologic findings of a family diagnosed with FD at Hospital de Especialidades de Puebla and establish their relationship with other phenotypic findings. Cases Presentation. A renal, cardiac, audiological, neurological, and ophthalmologic evaluation was carried out. The disease was confirmed by GLA gene sequencing. The ophthalmologic assessment was focused on the changes described in the literature, as well as the search for other anomalies possibly related to the disease. All the patients had the c.260delA (P.Glu87Glyfs*34) mutation in the GLA gene. The main ophthalmologic finding in our patients was cornea verticillata (in 100 % of the female patients). Other ophthalmologic manifestations were dry eye, retinal vessel tortuosity, ametropia, chromatic vision disorders, ocular annexes, eyelids, and conjuntiva disorders. Conclusions. Most of the assessed patients showed ophthalmologic changes, consistent with the results described in the literature. A remarkable finding in the sample was the high incidence of changes in women, in whom one would not expect the disease to be as severe because they are heterozygous. Ophthalmologic abnormalities in FD require deeper evaluation to establish their possible use as markers of disease progression and/or enzyme replacement therapy initiation due to the benefit of the non-invasive nature of ophthalmologic evaluations.

Theory and Method and the Stakes of a Fragmented Discipline: Or, What Economics Taught Me About the Study of Religion

2020 ◽  
Author(s):  
Thomas A Lewis
Keyword(s):  
Religious Studies ◽  
The Public ◽  
Global Pandemic ◽  
Recent Developments ◽  
The Common ◽  
The Impact ◽  
Academic Study

Abstract As a discipline, the academic study of religion is strikingly fragmented, with little engagement or shared criteria of excellence across subfields. Although important recent developments have expanded the traditions and peoples studied as well as the methods used, the current extent of fragmentation limits the impact of this diversification and pluralization. At a moment when the global pandemic is catalyzing profound pressures on our universities and disciplines, this fragmentation makes it difficult to articulate to the public, to non-religious studies colleagues, and to students why the study of religion matters. We therefore too often fall back on platitudes. I argue for a revitalized methods and theories conversation that connects us even as it bears our arguments and disagreements about what we do and how. Courses in methods and theories in the study of religion represent the most viable basis we have for bringing the academic study of religion into the common conversation or argument that constitutes a discipline without sacrificing our pluralism.

scholarly journals Early conscious prone positioning in patients with COVID-19 receiving continuous positive airway pressure: a retrospective analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000711 ◽  
Author(s):  
Stuart Winearls ◽  
Ema L Swingwood ◽  
Charlotte L Hardaker ◽  
Amy M Smith ◽  
Fraser M Easton ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Arterial Oxygen ◽  
Prone Positioning ◽  
Mechanically Ventilated ◽  
Global Pandemic ◽  
High Care ◽  
Randomised Controlled

The global pandemic of COVID-19 has challenged the management of hypoxaemic respiratory failure and strained intensive care unit resources. While prone positioning (PP) is an established therapy in mechanically ventilated patients with acute respiratory distress syndrome (ARDS), its role in conscious patients is less well defined. We retrospectively reviewed our experience of implementing early PP in a cohort of 24 patients with acute hypoxaemic respiratory failure due to COVID-19 who required support with continuous positive airway pressure (CPAP). The use of PP alongside CPAP significantly increased both the ROX index and arterial oxygen pressure:fractional inspired oxygen (PaO2:FiO2) ratio from baseline values (ROX index: 7.0±2.5 baseline vs 11.4±3.7 CPAP+PP, p<0.0001; PaO2:FiO2 ratio: 143±73 mm Hg baseline vs 252±87 mm Hg CPAP+PP, p<0.01), and the changes to both the ROX index and PaO2:FiO2 ratio remained significant 1 hour after cessation of proning. The mean duration of PP in the first 24 hours was 8±5 hours. Few complications were observed and PP was continued for a mean of 10±5 days. From our experience in a dedicated COVID-19 respiratory high care unit, PP alongside CPAP therapy was feasible, tolerated, safe and improved oxygenation. The use of conscious PP in ARDS warrants further investigation in randomised controlled trials.

Lung regional stress and strain as a function of posture and ventilatory mode

2011 ◽  
Vol 110 (5) ◽  
pp. 1374-1383 ◽  
Author(s):  
Gaetano Perchiazzi ◽  
Christian Rylander ◽  
Antonio Vena ◽  
Savino Derosa ◽  
Debora Polieri ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Volume Control ◽  
Dynamic Strain ◽  
Positive Pressure ◽  
Stress And Strain ◽  
Prone Positioning ◽  
Ventilatory Mode ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

During positive-pressure ventilation parenchymal deformation can be assessed as strain (volume increase above functional residual capacity) in response to stress (transpulmonary pressure). The aim of this study was to explore the relationship between stress and strain on the regional level using computed tomography in anesthetized healthy pigs in two postures and two patterns of breathing. Airway opening and esophageal pressures were used to calculate stress; change of gas content as assessed from computed tomography was used to calculate strain. Static stress-strain curves and dynamic strain-time curves were constructed, the latter during the inspiratory phase of volume and pressure-controlled ventilation, both in supine and prone position. The lung was divided into nondependent, intermediate, dependent, and central regions: their curves were modeled by exponential regression and examined for statistically significant differences. In all the examined regions, there were strong but different exponential relations between stress and strain. During mechanical ventilation, the end-inspiratory strain was higher in the dependent than in the nondependent regions. No differences between volume- and pressure-controlled ventilation were found. However, during volume control ventilation, prone positioning decreased the end-inspiratory strain of dependent regions and increased it in nondependent regions, resulting in reduced strain gradient. Strain is inhomogeneously distributed within the healthy lung. Prone positioning attenuates differences between dependent and nondependent regions. The regional effects of ventilatory mode and body positioning should be further explored in patients with acute lung injury.

Covid-19 And Sudden Death with Pulmonary Manifestations- A Case Report

2021 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Sudden Death ◽  
Common Cold ◽  
Respiratory Symptoms ◽  
Transmission Dynamics ◽  
Pulmonary Manifestations ◽  
The Family ◽  
The Common ◽  
Virus Strains

Covid 19 being a pandemic has uniformly and bizarrely affected the globe in a most unpredictable manner. So it becomes very important to unravel the transmission dynamics and the effect of the virus which has made it a deadly virus so far. Covid 19 is a member of coronavirus family, which also includes the SARS virus (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Symptoms) virus. The family of Coronavirus includes virus strains that the common cold and flu are caused [1].

Mechanical Ventilator Support

2005 ◽  
pp. 489-500
Author(s):  
Karl Yang ◽  
Guillermo Guiterrez
Keyword(s):  
Mechanical Ventilator ◽  
Ventilator Support
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