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1

Respiratory failure caused by giant thymolipoma.  

PubMed

The authors present the case of a 31-year-old woman with a massive anterior mediastinal tumor who presented with respiratory failure. A thoracic computed tomographic scan suggested a mediastinal lipomatous mass, and an operation was performed. Resection of the tumor resulted in immediate improvement in the patient's pulmonary status, and the histopathologic examination revealed thymolipoma. Because thymolipoma can attain enormous dimensions and compress adjacent structures, it should be immediately resected. PMID:18640359

Ceran, Sami; Tulek, Baykal; Sunam, Guven; Suerdem, Mecit

2008-08-01

2

Neuroborreliosis as a cause of respiratory failure  

Microsoft Academic Search

We report three cases of neuroborreliosis presenting with acute respiratory impairment. All the patients had encephalopathy and focal neurological signs with brain stem abnormalities in two. All three patients had respiratory arrest associated with progressive nocturnal hypoventilation or prolonged central apnoea. Tracheostomy and prolonged periods of ventilatory support were necessary in all cases and weaning was complicated by residual central

Mark T. Silva; Mark Sophar; Robin S. Howard; Geoffrey T. Spencer

1995-01-01

3

Living with Respiratory Failure  

MedlinePLUS

... Share this page from the NHLBI on Twitter. Living With Respiratory Failure One of the main goals ... how to quit smoking. Emotional Issues and Support Living with respiratory failure may cause fear, anxiety, depression, ...

4

[Respiratory failure].  

PubMed

The aged patients are susceptible to respiratory failure, especially acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The mortality rate for ARDS ranges from 40-70% despite of intensive care using currently available drugs. However, its mechanism still remains to be elucidated. Platelet-activating factor (PAF) and metabolites of arachidonic acid, i.e., eicosanoids, are lipid mediators that have various biological effects including cell adhesion, endothelial cell activation and the production of cytokines. Recent studies using genetically-engineered mice have shown that PAF and cytosolic PLA2 (cPLA2) play an important role in the pathogenesis of ALI. The inhibition of these pathways, PAF and cPLA2, might provide a novel therapeutic approach to ALI. PMID:23855209

Nagase, Takahide

2013-06-01

5

A Fatal Case of Acute Respiratory Failure Caused by Mycobacterium massiliense  

PubMed Central

Few recent reports have indicated that Mycobacterium massiliense causes various infections including respiratory infection. However, there is scarce information on the clinical significance, natural history of the infection, and therapeutic strategy. This report describes a case of an immunocompetent old man infected by M. massiliense that causes acute respiratory failure. In light of the general courses of non-tuberculous mycobacterium infections, rapid progression and fatality are very rare and odd. In addition, we discuss the biological and pathological properties of M. massiliense with the review of cases reported previously including our fatal one.

Choi, Kyoung Hwa; Yu, Hae Min; Jeong, Jae Seok; Kim, So Ri

2013-01-01

6

Respiratory failure complicating rubeola.  

PubMed

We reviewed the charts of 19 patients with the diagnosis of measles who were admitted to the pediatric intensive care unit for respiratory failure requiring intubation and mechanical ventilation. Patients studied were admitted during the period June 1989 to June 1990. The mean age was 19 months (range, 3 to 51 months). The cause for respiratory failure fell into two groups: 47 percent developed pneumonitis and refractory hypoxemia. Patients with pneumonitis and hypoxemic respiratory failure had a 56 percent mortality. An oxygenation index of greater than 40 for 4 h separated survivors from nonsurvivors (oxygenation index = [mean airway pressure x FIo2/PaO2 x 100]). Patients with tracheitis alone all survived. In these patients the organism primarily responsible was Staphylococcus aureus (70 percent). Two of the seven patients with S aureus tracheitis had signs and symptoms of toxic shock syndrome and we subsequently demonstrated toxic shock syndrome toxin 1 in both patients. PMID:8252964

Swift, J D; Barruga, M C; Perkin, R M; van Stralen, D

1993-12-01

7

Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs other causes: Effectiveness and predictors of failure in a respiratory ICU in North India  

PubMed Central

Objectives To determine the effectiveness of noninvasive positive pressure ventilation (NIPPV), and the factors predicting failure of NIPPV in acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) versus other causes of ARF. Patients and methods This was a prospective observational study and all patients with ARF requiring NIPPV over a one-and-a-half year period were enrolled in the study. We recorded the etiology of ARF and prospectively collected the data for heart rate, respiratory rate, arterial blood gases (pH, partial pressure of oxygen in the arterial blood [PaO2], partial pressure of carbon dioxide in arterial blood [PaCO2]) at baseline, one and four hours. The patients were further classified into two groups based on the etiology of ARF as COPD–ARF and ARF due to other causes. The primary outcome was the need for endotracheal intubation during the intensive care unit (ICU) stay. Results During the study period, 248 patients were admitted in the ICU and of these 63 (25.4%; 24, COPD–ARF, 39, ARF due to other causes; 40 male and 23 female patients; mean [standard deviation] age of 45.7 [16.6] years) patients were initiated on NIPPV. Patients with ARF secondary to COPD were older, had higher APACHE II scores, lower respiratory rates, levels compared to other causes of ARF. After one hour there was lower pH and higher PaCO2 levels with increase a significant decrease in respiratory rate and heart rate and decline in PaCO2 levels in patients successfully managed with NIPPV. However, there was no in pH and PaO2 difference in improvement of clinical and blood gas parameters between the two groups except at one hour which was significantly the rate of decline of pH at one and four hours and PaCO2 faster in the COPD group. NIPPV failures were significantly higher in ARF due to other causes (15/39) than in ARF–COPD (3/24) (p = 0.03). The mean ICU and hospital stay and the hospital mortality were similar in the two groups. In the multivariate logistic regression model (after and adjusting for gender, APACHE II scores and improvement in respiratory rate, pH, PaO2 at one hour) only the etiology of ARF, ie, ARF–COPD, was associated with a decreased PaCO2 risk of NIPPV failure (odds ratio 0.23; 95% confidence interval, 0.58–0.9). Conclusions NIPPV is more effective in preventing endotracheal intubation in ARF due to COPD than other causes, and the etiology of ARF is an important predictor of NIPPV failure.

Agarwal, Ritesh; Gupta, Rajesh; Aggarwal, Ashutosh N; Gupta, Dheeraj

2008-01-01

8

Dialysis disequilibrium syndrome: an unusual cause of respiratory failure in the medical intensive care unit.  

PubMed

We describe a case of the dialysis disequilibrium syndrome (DDS) that was marked by the rapid onset of cerebral edema and the subsequent development of acute respiratory failure. The patient was treated successfully with a combination of mechanical hyperventilation and mannitol. The clinical presentation, pathogenesis, prevention and treatment of the entity are discussed. PMID:10923740

DiFresco, V; Landman, M; Jaber, B L; White, A C

2000-05-01

9

Clinical assessment for identifying causes of acute respiratory failure in cancer patients.  

PubMed

In cancer patients with acute respiratory failure (ARF), early adequate therapy is associated with better outcomes. We investigated the performance of the DIRECT approach, which uses criteria available at the bedside at admission to the intensive care unit (ICU), to identify causes of ARF in cancer patients. This cohort study included cancer patients with ARF of determined aetiology. Associations of aetiological groups with the selected criteria were evaluated using correspondence analysis. 424 cancer patients were included: 201 (47%) with bacterial pneumonia, 131 (31%) with opportunistic infections and 92 (22%) with noninfectious disorders. Mechanical ventilation (both invasive and noninvasive) was needed in 328 (77%) patients, treatment for shock in 217 (51%) patients and dialysis in 82 (19%) patients. 142 (34%) patients died in the ICU. Correspondence plots showed that bacterial pneumonia was associated with neutropenia, solid tumour, multiple myeloma, <3 days since symptom onset, shock, unilateral crackles and unilateral radiographic pattern. Opportunistic infections were associated with steroids, lymphoproliferative disorders and haematopoietic stem-cell transplantation, whereas noninfectious disorders were associated with acute leukaemia The selected criteria are strongly associated with causes of ARF in cancer patients and could be used to develop an algorithm for selecting first-line diagnostic investigations and empirical treatments. PMID:23143549

Schnell, David; Mayaux, Julien; Lambert, Jérôme; Roux, Antoine; Moreau, Anne-Sophie; Zafrani, Lara; Canet, Emmanuel; Lemiale, Virginie; Darmon, Michael; Azoulay, Elie

2012-11-08

10

Acute respiratory failure. 2: Nursing management.  

PubMed

This is the second in a two-part unit on acute respiratory failure. Part 1 defined this condition, explored the causes of different types of failure and outlined basic respiratory assessment. This part outlines medical and nursing management of patients in acute respiratory failure. PMID:18833716

Higgins, Dan; Guest, John

11

Noninvasive positive pressure ventilation for respiratory failure caused by exacerbations of chronic obstructive pulmonary disease: a standard of care?  

Microsoft Academic Search

This editorial comments on a meta-analysis of the use of noninvasive positive pressure ventilation to treat patients with acute respiratory failure caused by chronic obstructive pulmonary disease (COPD) exacerbations published in the British Medical Journal earlier this year. Based on its analysis of seven randomized controlled trials that met pre-specified criteria, the meta-analysis demonstrated highly significant benefits of noninvasive positive

Nicholas S Hill

2003-01-01

12

Giant cell carcinoma causing rapidly progressive respiratory failure as the presenting feature of AIDS.  

PubMed

The incidence of lung cancer has been increasing among HIV-positive patients. The majority of these cases were in patients previously diagnosed as HIV-positive and treated with highly active antiretroviral therapy (HAART). Here, we report a 56-year-old male patient with lung cancer, who was diagnosed as HIV-positive after the onset of neck pain and lumbago and thus, was not treated with anti-AIDS therapy. The patient developed rapidly progressive and fatal respiratory failure. Autopsy demonstrated giant cell carcinoma of the lung responsible for carcinomatous lymphangitis. This case highlighted the possibility that pulmonary carcinogenesis in HIV-positive patients is not necessarily associated with HAART therapy. PMID:22844020

Sugawara, E; Yamamoto, K; Umeda, S; Suzuki, S; Kurata, M; Endo, Y; Uchibori, K; Akashi, T; Inase, N; Kitagawa, M

2012-07-01

13

Empyema and Respiratory Failure Secondary to Nephropleural Fistula Caused by Chronic Urinary Tract Infection: A Case Report  

PubMed Central

We report a case of nephropleural fistula causing empyema and respiratory failure in a 68-year-old gentleman with a long history of urological problems including recurrent nephrolithiasis and urinary tract infections. He was admitted with sepsis, a productive cough, pyuria, and reduced breath sounds over the left hemithorax. Radiological imaging revealed a fistulous connection between a left-sided perinephric abscess and the pleural space. He was commenced on broad spectrum intravenous antibiotics but developed progressive respiratory failure requiring intensive care admission. Urinary and pleural aspirates cultured facultative anaerobic pathogens with identical resistance patterns. Drainage of thoracic and perinephric collections was carried out, allowing him to be extubated after 24 hours and discharged home after 18 days on an extended course of oral antibiotics. Left nephrectomy is now planned after a period of convalescence. Empyema developing in patients with known urolithiasis should alert the treating physician to the possibility that a pathological communication has formed especially if typical urinary tract pathogens are cultured from respiratory sampling.

Jones, G. H.; Kalaher, H. R.; Misra, N.; Curtis, J.; Parker, R. J.

2012-01-01

14

Central Neurogenic Respiratory Failure: A Challenging Diagnosis  

PubMed Central

Background Central nervous system lesions are rare causes of respiratory failure. Simple observation of the breathing pattern can help localize the lesion, but the examiner needs to be aware of potential pitfalls such as metabolic or pulmonary alterations. Methods We describe 3 cases in which central neurogenic respiratory failure occurred simultaneously with other alterations or in an unusual presentation. Results All patients were diagnosed with central neurogenic respiratory failure and treated for it with good recovery. Conclusion Central neurogenic respiratory failure is a challenging diagnosis and needs to be reminded in difficult-to-wean patients carrying inconclusive evidences of metabolic or pulmonary alterations.

Carvalho, Flavio A.; Bernardino, Tenille; Maciel, Ricardo O.H.; Felizola, Sergio F.A.; Costa, Eduardo L.V.; Silva, Gisele S.

2011-01-01

15

Intensive care adult patients with severe respiratory failure caused by Influenza A (H1N1)v in Spain  

Microsoft Academic Search

INTRODUCTION: Patients with influenza A (H1N1)v infection have developed rapidly progressive lower respiratory tract disease resulting in respiratory failure. We describe the clinical and epidemiologic characteristics of the first 32 persons reported to be admitted to the intensive care unit (ICU) due to influenza A (H1N1)v infection in Spain. METHODS: We used medical chart reviews to collect data on ICU

Jordi Rello; Alejandro Rodríguez; Pedro Ibañez; Lorenzo Socias; Javier Cebrian; Asunción Marques; José Guerrero; Sergio Ruiz-Santana; Enrique Marquez; Frutos Del Nogal-Saez; Francisco Alvarez-Lerma; Sergio Martínez; Miquel Ferrer; Manuel Avellanas; Rosa Granada; Enrique Maraví-Poma; Patricia Albert; Rafael Sierra; Loreto Vidaur; Patricia Ortiz; Isidro Prieto del Portillo; Beatriz Galván; Cristóbal León-Gil

2009-01-01

16

Respiratory management of acute respiratory failure in neuromuscular diseases.  

PubMed

Neuromuscular diseases (NMD) can affect all major respiratory muscles, leading to the development of respiratory failure, which is the most common cause of morbidity and mortality in patients affected by those conditions. Based on the clinical onset of acute respiratory failure (ARF), NMD can be classified into two main categories: 1) slowly progressive NMD with acute exacerbations of chronic respiratory failure, and 2) rapidly progressive NMD with acute episodes of respiratory failure. The most common slowly progressive NMDs, such as motor neuron diseases and inherited myopathies, account for the majority of NMD patients developing chronic neuromuscular respiratory failure at risk of acute exacerbations. Conversely, rapidly progressive NMDs, such as Guillain-Barré syndrome and myasthenic crises, are characterized by a sudden onset of ARF, usually in patients with previously normal respiratory function. The patho-physiological mechanisms responsible for ARF in NMD and the variety and complexity of specific challenges presented by the two main categories of NMD will be analyzed in this review, with the aim of providing clinically relevant suggestions for adequate respiratory management of these patients. PMID:20125073

Racca, F; Del Sorbo, L; Mongini, T; Vianello, A; Ranieri, V M

2009-11-24

17

Acute respiratory failure from abused substances.  

PubMed

Acute respiratory failure is a common complication of drug abuse. It is more likely to develop in the setting of chronic lung disease or debility in those with limited respiratory reserve. Drugs may acutely precipitate respiratory failure by compromising respiratory pump function and/or by causing pulmonary pathology. Polysubstance overdoses are common, and clinicians should anticipate complications related to multiple drugs. Impairment of respiratory pump function may develop from central nervous system (CNS) depression (suppression of the medulla oblongata, stroke or seizures) or respiratory muscle fatigue (increased respiratory workload, metabolic acidosis). Drug-related respiratory pathology may result from parenchymal (aspiration-related events, pulmonary edema, hemorrhage, pneumothorax, infectious and non-infectious pneumonitides), airway (bronchospasm and hemorrhage), or pulmonary vascular insults (endovascular infections, hemorrhage, and vasoconstrictive events). Alcohol, cocaine, amphetamines, opiates, and benzodiazepines are the most commonly abused drugs that may induce events leading to acute respiratory failure. While decontamination and aggressive supportive measures are indicated, specific therapies to correct seizures, metabolic acidosis, pneumothorax, infections, bronchospasm, and agitation should be considered. Drug-related respiratory failure when due to CNS depression alone may portend well, but in patients with drug-related significant pulmonary pathology, a protracted course of illness may be anticipated. PMID:15296619

Wilson, Kevin C; Saukkonen, Jussi J

18

Adiaspiromycosis Causing Respiratory Failure and a Review of Human Infections Due to Emmonsia and Chrysosporium spp.  

PubMed Central

We report a case of a 27-year-old male who presented with respiratory distress that required mechanical ventilation. Transbronchial biopsy revealed adiaspores of the fungus Emmonsia crescens within granulomata, a condition known as adiaspiromycosis. The patient received amphotericin products and corticosteroids, followed by itraconazole, and made a full recovery. Emmonsia crescens is a saprobe with a wide distribution that is primarily a rodent pathogen. The clinical characteristics of the 20 cases of human pulmonary adiaspiromycosis reported since the last comprehensive case review in 1993 are described here, as well as other infections recently reported for the genus Emmonsia. Pulmonary adiaspiromycosis has been reported primarily in persons without underlying host factors and has a mild to severe course. It remains uncertain if the optimal management of severe pulmonary adiaspiromycosis is supportive or if should consist of antifungal treatment, corticosteroids, or a combination of the latter two. The classification of fungi currently in the genus Emmonsia has undergone considerable revision since their original description, including being grouped with the genus Chrysosporium at one time. Molecular genetics has clearly differentiated the genus Emmonsia from the Chrysosporium species. Nevertheless, there has been a persistent confusion in the literature regarding the clinical presentation of infection with fungi of these two genera; to clarify this matter, the reported cases of invasive Chrysosporium infections were reviewed. Invasive Chrysosporium infections typically occur in impaired hosts and can have a fatal course. Based on limited in vitro susceptibility data for Chrysosporium zonatum, amphotericin B is the most active drug, itraconazole susceptibility is strain-dependent, and fluconazole and 5-fluorocytosine are not active.

Sutton, Deanna A.; Graybill, John R.

2012-01-01

19

Is Amiodarone an Underrecognized Cause of Acute Respiratory Failure in the ICU?  

Microsoft Academic Search

Amiodarone is a commonly used anti-arrhythmic agent, with well-recognized chronic toxicity. Less well known is amiodarone's potential to cause acute lung damage, which can be severe or, occasionally, life-threatening. Lungs that have already been exposed to physical insults, such as the lungs of patients undergoing cardiac surgery, are particularly susceptible to acute pulmonary toxicity (APT). Unfortunately, cardiac surgery is one

Houman Ashrafian; Patrick Davey

2001-01-01

20

Chronic graft-versus-host disease-related polymyositis as a cause of respiratory failure following allogeneic bone marrow transplant  

Microsoft Academic Search

An unusual case of respiratory failure and dropped head syndrome as a complication of severe chronic graft-versus-host disease (GVHD)-related polymyositis is described. The patient required tracheostomy and mechanical ventilation but recovered following treatment with aggressive immunosuppression and intensive rehabilitation. The differential diagnoses of muscle weakness in the bone marrow transplant (BMT) patient and the dropped head syndrome are both discussed.

AM Leano; K Miller; AC White

2000-01-01

21

Neurogenic respiratory failure.  

PubMed

It is uncommon for the lungs to be primarily involved in neurological conditions but severe respiratory problems can arise indirectly. These are usually the result of disorders of central ventilatory control, respiratory muscle weakness, or bulbar involvement. The effects of those disorders can be predicted by an understanding of the nervous control mechanisms and mechanical factors that determine effective ventilation. Awareness of these potential complications, and the increased availability of more advanced diagnostic and monitoring techniques in everyday clinical practice, has resulted in the introduction of specific treatments to try to reduce consequent morbidity and mortality. PMID:23312649

Hind, Charles R K

2013-01-01

22

The application of bi-level positive airway pressure in patients with severe pneumonia and acute respiratory failure caused by influenza A (H1N1) virus  

PubMed Central

Objective To evaluate the effect of noninvasive Bi-level Positive Airway Pressure (BiPAP) ventilation on the severe influenza A virus associated with pneumonia and acute respiratory failure (ARF). Methods Based on conventional therapy via face mask using BiPAP ventilator positive airway pressure ventilation in the treatment of severe pneumonia caused by influenza A (H1N1) virus with acute respiratory failure (ARF) in 18 cases, we observed and evaluated the therapeutic effects. Results PaO2 and SaO2 before and after treatment were (48.85 ± 12.15)mmHg, (68.56 ± 16.25) mmHg and (80 ± 6)%, (92 ± 5)%, respectively. The results were significantly different (P<0.05) before and after treatment. Endotracheal intubation rate was 25% (6/24) and case-fatality rate was 8.3% (2/24). Conclusion BiPAP ventilator airway pressure by face mask ventilation can reduce the rate of endotracheal intubation in the treatment of severe pneumonia caused by influenza A (H1N1) virus in acute respiratory failure. It could be an effective approach in the emergency treatment with clinical value.

Liu, Wei; Hua, Shucheng; Peng, Liping

2010-01-01

23

Two different causes of acute respiratory failure in a patient with diffuse idiopathic skeletal hyperostosis and ankylosed cervical spine.  

PubMed

We report a case of 73-year-old man with massive hyperostosis of the cervical spine associated with diffuse idiopathic skeletal hyperostosis (DISH), resulting in dysphagia, hoarseness and acute respiratory insufficiency. An emergency operation was performed, which involved excision of osteophytes at the level of C6-C7, compressing the trachea against enlarged sternoclavicular joints, also affected by DISH. Approximately 3 years later, the patient sustained a whiplash injury in a low impact car accident, resulting in a C3-C4 fracture dislocation, which was not immediately diagnosed because he did not seek medical attention after the accident. For the next 6 months, he had constant cervical pain, which was growing worse and eventually became associated with dysphagia and dyspnoea, ending once again in acute respiratory failure due to bilateral palsy of the vocal cords. The patient underwent a second operation, which comprised partial reduction and combined anteroposterior fixation of the fractured vertebrae. Twenty months after the second operation, mild hoarseness was still present, but all other symptoms had disappeared. The clinical manifestations, diagnosis and treatment of the two unusual complications of DISH are discussed. PMID:19798518

Vengust, Rok; Mihalic, René; Turel, Matjaz

2009-10-02

24

Noninvasive Ventilation for Acute Respiratory Failure  

Microsoft Academic Search

Noninvasive ventilation for acute respiratory failure. L. Brochard, J. Mancebo, M.W. Elliott. #ERS Journals Ltd 2002. ABSTRACT: Noninvasive ventilation (NIV) has emerged as a significant advance in the management of respiratory failure. There is now a wide body of prospective randomized-controlled trial data to support its use, particularly in the management of patients with acute or respiratory failure due to

L. Brochard; J. Mancebo; M. W. Elliott

2002-01-01

25

Depletion of PHF14, a novel histone-binding protein gene, causes neonatal lethality in mice due to respiratory failure.  

PubMed

The plant homeodomain (PHD) finger is identified in many chromatin-binding proteins, and functions as a 'reader' that recognizes specific epigenetic marks on histone tails, bridging transcription factors and their associated complexes to chromatin, and regulating gene expression. PHD finger-containing proteins perform many biological functions and are involved in many human diseases including cancer. PHF14 is predicted to code for a protein with multiple PHD fingers. However, its function is unidentified. The aim of this study is to characterize PHF14 and investigate its biological significance by employing multiple approaches including mouse gene-targeting knockout, and molecular cloning and characterization. Three transcripts of PHF14 in human cell lines were identified by reverse transcriptase polymerase chain reaction. Two isoforms of PHF14 (PHF14? and PHF14?) were cloned in this study. It was found that PHF14 was ubiquitously expressed in mouse tissues and human cell lines. PHF14?, the major isoform of PHF14, was localized in the nucleus and also bound to chromatin during cell division. Interestingly, co-immunoprecipitation results suggested that PHF14? bound to histones via its PHD fingers. Strikingly, gene-targeting knockout of PHF14 in mice resulted in a neonatal lethality due to respiratory failure. Pathological analysis revealed severe disorders of tissue and cell structures in multiple organs, particularly in the lungs. These results indicated that PHF14 might be an epigenetic regulator and play an important role in the development of multiple organs in mouse. PMID:23688586

Huang, Qin; Zhang, Lin; Wang, Yiguo; Zhang, Chenyi; Zhou, Shuhua; Yang, Guang; Li, Zhongqiang; Gao, Xiang; Chen, Zhengjun; Zhang, Zhe

2013-05-20

26

Respiratory failure in chronic obstructive pulmonary disease  

Microsoft Academic Search

Respiratory failure is still an important complication of chronic obstructive pulmonary disease (COPD) and hospitalisation with an acute episode being a poor prognostic marker. However, other comorbid conditions, especially cardiovascular disease, are equally powerful predictors of mortality. The physiological basis of acute respiratory failure in COPD is now clear. Significant ventilation\\/perfusion mismatching with a relative increase in the physiolo- gical

P. M. A. Calverley

2003-01-01

27

Sexual intercourse and respiratory failure.  

PubMed

Sexual activity is an important component of quality of life in patients suffering from chronic illnesses. To our knowledge, the effects of sexual activity on gas exchange in patients with respiratory failure have not been yet studied. To such an extent, we evaluated the oxygen saturation (SaO2), by a pulse oxymeter, during three different sexual performances in a 63-yr-old patient affected by chronic obstructive pulmonary disease (COPD) on long-term oxygen therapy (LTOT). The sexual performances were divided in four periods: basal, sex, 10 min after sex and relax. In each performance during sex, we observed a significant increase of either heart rate (HR) or SaO2, with the highest value of the latter achieved within the 10 min of the post-sex period. SaO2 returned to basal value (pre-sex) by the end of the relax period. We conclude that the observed improvement of SaO2 during sexual activity might be due to a better ventilation/perfusion ratio (V/Q) obtained for either an increase of ventilation (hyperventilation) and perfusion (tachycardia), without significant muscle expenditure. PMID:18394872

Polverino, Francesca; Santoriello, Carlo; De Sio, Vittorio; Andò, Filippo; de Blasio, Francesco; Polverino, Mario

2008-04-03

28

Acute Antiarrhythmic Effects of Bi-Level Positive Airway Pressure Ventilation in Patients with Acute Respiratory Failure Caused by Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial  

Microsoft Academic Search

Background: Cardiac arrhythmias are common in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF) and may be life threatening. Recently, non-invasive positive pressure ventilation has been advanced as a useful tool in COPD patients with ARF. This method can affect global cardiac performance through its effects on many determinants of cardiac function and may be helpful

Maurizio Marvisi; Marco Brianti; Giuseppe Marani; Gabriele Turrini; Paolo Zambrelli; Corrado Ajolfi; Roberto Delsignore

2004-01-01

29

"Smoking wet": respiratory failure related to smoking tainted marijuana cigarettes.  

PubMed

Reports have suggested that the use of a dangerously tainted form of marijuana, referred to in the vernacular as "wet" or "fry," has increased. Marijuana cigarettes are dipped into or laced with other substances, typically formaldehyde, phencyclidine, or both. Inhaling smoke from these cigarettes can cause lung injuries. We report the cases of 2 young adults who presented at our hospital with respiratory failure soon after they had smoked "wet" marijuana cigarettes. In both patients, progressive hypoxemic respiratory failure necessitated rescue therapy with extracorporeal membrane oxygenation. After lengthy hospitalizations, both patients recovered with only mild pulmonary function abnormalities. To our knowledge, this is the first 2-patient report of severe respiratory failure and rescue therapy with extracorporeal oxygenation after the smoking of marijuana cigarettes thus tainted. We believe that, in young adults with an unexplained presentation of severe respiratory failure, the possibility of exposure to tainted marijuana cigarettes should be considered. PMID:23466531

Gilbert, Christopher R; Baram, Michael; Cavarocchi, Nicholas C

2013-01-01

30

Respiratory failure in a patient with dermatomyositis.  

PubMed

Since its original description in 1956 the association between interstitial lung disease and polymyositis (PM) and dermatomyositis (DM) has become well established. Interstitial lung disease (ILD) can be a significant complication in rheumatic diseases (RDs). Although most patients with RD do not develop clinically evident ILD, these systemic autoimmune disorders are estimated to be responsible for approximately 25% of all ILD deaths and 2% of deaths due to all respiratory causes. Radiologic abnormalities in DM are characterized by a high incidence of airspace consolidation. Non-Specific Interstitial Pneumonia (NSIP) is the most common form of lung disease, with a frequency in biopsies 4-fold greater than that of Usual Interstitial Pneumonia (UIP) in PM and a slightly smaller predominance in DM.We report a case of a female patient, 57 years old, no former smoker, whose clinical history was onset in November 2008 with asthenia with muscle and osteoarticular pain especially located in the upper limbs and then also expanded to the lower limbs. The EMG was compatible with dermatomyositis in the acute phase. The patient received therapy with steroids and tacrolimus, also making several rounds of treatment with immunoglobulin. Given the recurrence of myositis in association with signs of poorly controlled interstitial lung disease, immunosuppressive therapy with Rituximab was administered. The Computed Tomography (CT) scans showed "bronchiectasis and traction bronchiolectasis, hypodense areas consistent with the phenomena of air trapping. The pattern of interstitial lung disease with fibrotic evolution seems consistent with NSIP.The arterial blood gas analysis showed a pattern of hypoxic-hypercapnic respiratory failure (pH: 7,34, PaO2: 67 mmHg; PaCO2: 55 mmHg).As a result of an episode of marked desaturation unresponsive to supplemental oxygen at high flows we proceeded to noninvasive mechanical ventilation with Helmet for 24 hours/24. This ventilatory support was maintained for a week, with resolution of the respiratory failure.In this brief case report we want to highlight various pulmonary complications as a result of dermatomyositis. The progression of respiratory complications may also lead to a situation of respiratory failure, as in our patient, and require a noninvasive ventilatory treatment. PMID:23531196

Salimbene, Ivano; Leli, Ilaria; Valente, Salvatore

2013-03-27

31

Respiratory failure in a patient with dermatomyositis  

PubMed Central

Since its original description in 1956 the association between interstitial lung disease and polymyositis (PM) and dermatomyositis (DM) has become well established. Interstitial lung disease (ILD) can be a significant complication in rheumatic diseases (RDs). Although most patients with RD do not develop clinically evident ILD, these systemic autoimmune disorders are estimated to be responsible for approximately 25% of all ILD deaths and 2% of deaths due to all respiratory causes. Radiologic abnormalities in DM are characterized by a high incidence of airspace consolidation. Non-Specific Interstitial Pneumonia (NSIP) is the most common form of lung disease, with a frequency in biopsies 4-fold greater than that of Usual Interstitial Pneumonia (UIP) in PM and a slightly smaller predominance in DM. We report a case of a female patient, 57 years old, no former smoker, whose clinical history was onset in November 2008 with asthenia with muscle and osteoarticular pain especially located in the upper limbs and then also expanded to the lower limbs. The EMG was compatible with dermatomyositis in the acute phase. The patient received therapy with steroids and tacrolimus, also making several rounds of treatment with immunoglobulin. Given the recurrence of myositis in association with signs of poorly controlled interstitial lung disease, immunosuppressive therapy with Rituximab was administered. The Computed Tomography (CT) scans showed "bronchiectasis and traction bronchiolectasis, hypodense areas consistent with the phenomena of air trapping. The pattern of interstitial lung disease with fibrotic evolution seems consistent with NSIP. The arterial blood gas analysis showed a pattern of hypoxic-hypercapnic respiratory failure (pH: 7,34, PaO2: 67 mmHg; PaCO2: 55 mmHg). As a result of an episode of marked desaturation unresponsive to supplemental oxygen at high flows we proceeded to noninvasive mechanical ventilation with Helmet for 24 hours/24. This ventilatory support was maintained for a week, with resolution of the respiratory failure. In this brief case report we want to highlight various pulmonary complications as a result of dermatomyositis. The progression of respiratory complications may also lead to a situation of respiratory failure, as in our patient, and require a noninvasive ventilatory treatment.

2013-01-01

32

Respiratory failure and symptomatic hypercalcaemia complicating pulmonary tuberculosis  

PubMed Central

A 47-year-old Caucasian man was admitted to hospital with respiratory failure due to a severe pneumonia, requiring admission to the Intensive Care Unit (ICU) for respiratory support. Bronchial washings cultured Mycobacterium tuberculosis, a rare cause of respiratory failure, and fortunately he responded to standard antituberculous therapy. However, the patient subsequently developed symptomatic hypercalcaemia; an unusual complication of tuberculosis (TB) in the UK, probably contributed to by a combination of sunbathing and activation of 25-hydroxy vitamin D in the TB granuloma. The majority of patients treated for TB in the UK are probably vitamin D deficient and are therefore unlikely to become hypercalcaemic.

Waller, Michael; Murphy, Stephen; Krishnaraj, Natarajan; Antunes, George

2009-01-01

33

[Acute respiratory failure due to neuromuscular disorders].  

PubMed

Numerous acute and chronic neuromuscular disorders may induce an acute ventilatory failure. The latter is sometimes triggered by a complication like a bronchial aspiration, a pneumonia, or an atelectasis. The acute ventilatory failure often develops insidiously and may be missed until the terminal event. Four different clinical presentations are depicted in this review: slowly progressive (Duchenne muscular dystrophy), rapidly progressive (Guillain-Barré syndrome), chronic with exacerbations (myasthenia gravis), and a form consecutive to critical care (critical care polyneuropathy and myopathy). For each type of ventilatory failure, the review discusses the preventive surveillance, the treatment of acute respiratory failure, and the long-term management. PMID:10549058

Fitting, J W; Chevrolet, J C

1999-09-01

34

Acute respiratory failure in the elderly: diagnosis and prognosis  

Microsoft Academic Search

Acute respiratory failure (ARF) in patients over 65 years is common in emergency departments (EDs) and is one of the key symptoms of congestive heart failure (CHF) and respiratory disorders. Searches were conducted in MEDLINE for published studies in the English language between January 1980 and August 2007, using 'acute dyspnea', 'acute respiratory failure (ARF)', 'heart failure', 'pneumonia', 'pulmonary embolism

SAMUEL DELERME; P ATRICK RAY

2008-01-01

35

H1N1 Influenza Viral Infection in a Postpartum Young Woman Causes Respiratory Failure: What the Care Providers Ought to Know?  

PubMed Central

Pregnant and postpartum women are considered a population at increased risk of hospitalization of H1N1 infection. We report the case of a young postpartum woman, who developed evidence of respiratory failure reaching the point of requiring intubation due to an H1N1 influenza virus infection two days after a caesarean delivery. We emphasize the diagnosis, management, and the outcome focusing on the question “what the care providers, including obstetric health care workers, ought to know?” Diagnostic and management strategy for pregnant or postpartum women with novel influenza A (H1N1) viral infection and increased awareness amongst patients and health care professionals may result in improved survival.

Aloizos, Stavros; Aravosita, Paraskevi; Mystakelli, Christina; Kanna, Efthymia; Gourgiotis, Stavros

2012-01-01

36

Acute respiratory failure as a first manifestation of syringomyelia  

PubMed Central

A 40 year old woman presented with a short history of acute onset of breathlessness to the ER of our hospital and after initial evaluation for acute pulmonary embolism which was ruled out after carrying out the appropriate investigations, she was diagnosed to be afflicted with syringomyelia based on her neurological symptoms and clinical findings, which was confirmed by doing an MRI scan, which was her basic diagnosis that was complicated by acute hypercapnic respiratory failure. This case is being reported to highlight syringomyelia as an unusual cause of acute respiratory failure, which manifested clinically in this patient as its first presentation and the underlying neurological diagnosis has been found to be present in very few reported cases (less than 0.01% of case reports) in the available literature as the basic disease in the absence of its classical presenting features. Problems associated with acute respiratory failure in the setting of syringomyelia are discussed.

Al Bashapshe, Ali; Bhatia, Harsha; Aziz, Shahid

2010-01-01

37

Noninvasive mechanical ventilation in acute respiratory failure  

Microsoft Academic Search

Mechanical ventilation (MV) has been indicated in the treatment of acute respiratory failure (ARF) if conservative treatment fails. Invasive MV is asso- ciated to a variety of complications. The recent innovations of noninvasive methods of MV (NMV) avoid the complications of invasive MV, whilst ensuring a similar degree of efficacy. A review of the literature from 1989 to 1995 shows

N. Ambrosino

1996-01-01

38

Shrinking the room for invasive ventilation in hypercapnic respiratory failure.  

PubMed

Noninvasive ventilation (NIV) was introduced as an alternative to invasive mechanical ventilation for acute respiratory failure caused from exacerbations of chronic obstructive pulmonary disease in the 1980s, and its use gradually rose worldwide. Seventy-eight patients (57 males, mean age 78.3 ± 9.2 years) undergoing NIV were evaluated. Of them, 48 (62.3%) had acute hypercapnic respiratory failure because of a chronic obstructive pulmonary disease exacerbation, and the remaining 30 had acute hypercapnic respiratory failure from other causes, mainly cardiac failure. All patients were treated by NIV using the bi-level positive airway pressure set up at high pressure/high backup rate. NIV was successful in 67 subjects (85.9%) and the patients were discharged, 57 of whom continued NIV at home and ten had spontaneous breathing. NIV was unsuccessful in eleven patients, ten of whom died and one was successfully treated by invasive mechanical ventilation. Significant differences were detected for a higher basal Glasgow Coma Scale score in successfully treated patients (P = 0.007), a higher basal Acute Physiology and Chronic Health Evaluation score in unsuccessfully treated patients (P = 0.004), and a lower pH after 1 hour in unsuccessfully treated patients (P = 0.015). These findings show a very high rate of success of NIV in patients with acute hypercapnic respiratory failure not only from chronic obstructive pulmonary disease but also from cardiac failure. This suggests that the use of invasive mechanical ventilation may be further reduced, with a decrease in its known complications as well. PMID:23516004

Scarpazza, Paolo; Incorvaia, Cristoforo; Melacini, Chiara; Cattaneo, Roberta; Bonacina, Cristiano; Riario-Sforza, Gian Galeazzo; Casali, Walter

2013-03-15

39

Acute exacerbations and respiratory failure in chronic obstructive pulmonary disease.  

PubMed

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) describe the phenomenon of sudden worsening in airway function and respiratory symptoms in patients with COPD. These exacerbations can range from self-limited diseases to episodes of florid respiratory failure requiring mechanical ventilation. The average patient with COPD experiences two such episodes annually, and they account for significant consumption of health care resources. Although bacterial infections are the most common causes of AECOPD, viral infections and environmental stresses are also implicated. AECOPD episodes can be triggered or complicated by other comorbidities, such as heart disease, other lung diseases (e.g., pulmonary emboli, aspiration, pneumothorax), or systemic processes. Pharmacologic management includes bronchodilators, corticosteroids, and antibiotics in most patients. Oxygen, physical therapy, mucolytics, and airway clearance devices may be useful in selected patients. In hypercapneic respiratory failure, noninvasive positive pressure ventilation may allow time for other therapies to work and thus avoid endotracheal intubation. If the patient requires invasive mechanical ventilation, the focus should be on avoiding ventilator-induced lung injury and minimizing intrinsic positive end-expiratory pressure. These may require limiting ventilation and "permissive hypercapnia." Although mild episodes of AECOPD are generally reversible, more severe forms of respiratory failure are associated with a substantial mortality and a prolonged period of disability in survivors. PMID:18453367

MacIntyre, Neil; Huang, Yuh Chin

2008-05-01

40

Teacher Failure: Some Potential Causes.  

ERIC Educational Resources Information Center

|Principals of elementary and secondary schools in Idaho (N=246) responded to a questionnaire that asked them to identify some causes of teacher failure. The major problems leading to teachers being placed on probation or not having contracts renewed appeared to be in the areas of: (1) behavior management and student motivation; (2) personality…

Lerch, Robert D.

41

The use of extracorporeal life support in pediatric burn patients with respiratory failure  

Microsoft Academic Search

Respiratory failure is the most common cause of death after thermal injury and may be caused by inhalation injury, acute respiratory distress syndrome (ARDS) or pneumonia. ARDS is usually associated with sepsis; however, it may also occur during burn shock, especially in patients that have a delayed or inadequate fluid resuscitation.1 During the past 24 months, five pediatric burn patients

Michael J. Goretsky; David G. Greenhalgh; Glenn D. Warden; Frederick C. Ryckman; Brad W. Warner

1995-01-01

42

Motor neuron disease presenting as acute respiratory failure: a clinical and pathological study.  

PubMed Central

Respiratory failure is rarely a presenting symptom of motor neuron disease. Seven patients with motor neuron disease who presented with acute respiratory failure of unknown cause and required mechanical ventilation were studied. They all had symptoms and signs suggestive of diaphragmatic weakness. Respiratory involvement seemed disproportionately severe, as six were ambulatory and only three noted limb weakness. Only one had tongue weakness and none had swallowing difficulty. Electrophysiological studies showed widespread denervation and, in particular, diaphragmatic involvement to explain the severe respiratory failure. Weaning from the ventilator was unsuccessful in all cases. The four patients examined at necropsy showed severe loss of anterior horns cells in the cervical cord, with only minimal upper motor neuron involvement. Motor neuron disease should be recognised as a cause of acute respiratory failure, secondary to diaphragmatic paralysis from involvement of phrenic motor neurons. Images

Chen, R; Grand'Maison, F; Strong, M J; Ramsay, D A; Bolton, C F

1996-01-01

43

Encrusted cystitis causing postrenal failure.  

PubMed

Encrusted cystitis is characterized by chronic inflammation of the bladder with encrustation of the mucosa, induced by urea-splitting bacterial infection. However, encrusted cystitis in itself is not well known. We report a case of encrusted cystitis causing postrenal failure. An 81-year-old man with pneumonia complained of pollakisuria, micturition pain, and gross hematuria. Bladder calculi were found, and transurethral lithotripsy was performed. However, because his symptoms did not improve, he was referred to our hospital. His urine pH was 8.5, and urine culture grew Corynebacterium and Proteus. Computerized tomography and cystoscopy revealed bladder "encrustation," caused by bladder wall calcification, and bilateral hydronephrosis. Hence, he was diagnosed with postrenal failure resulting from encrusted cystitis. Immediate bilateral nephrostomy was constructed, with continuous bladder perfusion with an acid solution for acidification of his urine, followed by intravenous administration of ceftriaxone. After 2 weeks of treatment, the calcification disappeared and his bladder mucosa was normalized. The postrenal failure also improved and thus the nephrostomy tubes were removed. Encrusted cystitis is curable by prompt treatment with acidification of urine. Therefore, precise diagnosis and therapy are critical. PMID:23605319

Tanaka, Takaki; Yamashita, Shinichi; Mitsuzuka, Koji; Yamada, Shigeyuki; Kaiho, Yasuhiro; Nakagawa, Haruo; Arai, Yoichi

2013-04-21

44

Coma blisters with hypoxemic respiratory failure.  

PubMed

A 24-year-old woman with quadriplegia was admitted with respiratory failure because of pneumonia. She was on multiple medications including diazepam, oxycodone, and amitriptyline, known to be associated with coma blisters, though she did not overdose on any of them. On hospital day 2, she developed multiple blisters on both sides of her right forearm and hand. Skin biopsy showed eccrine gland degeneration consistent with coma blisters. It was felt that hypoxemia from her pneumonia contributed to the development of these blisters, which occurred on both pressure and non-pressure bearing areas of the arm. Coma blisters are self-limited skin lesions that occur at sites of maximal pressure, mostly in the setting of drug overdose. However, coma blisters may occur with metabolic and neurological conditions resulting in coma. PMID:22483521

Agarwal, Abhishek; Bansal, Meghana; Conner, Kelly

2012-03-15

45

Acute respiratory distress caused by massive thymolipoma.  

PubMed

The authors present the case of a 40-year-old female with a massive anterior mediastinal tumor who presented with acute respiratory distress. She required emergent intubation and ventilatory support for respiratory compromise caused by lung compression. Preoperative computed tomographic scan results suggested a mediastinal lipomatous mass. Resection of the tumor resulted in immediate improvement in her pulmonary status. Because thymolipomas can attain enormous dimensions and compress adjacent structures, they should be resected at the time of diagnosis. PMID:15586609

Halkos, Michael E; Symbas, John D; Symbas, Panagiotis N

2004-11-01

46

Hereditary myopathy with early respiratory failure: occurrence in various populations.  

PubMed

OBJECTIVE: Several families with characteristic features of hereditary myopathy with early respiratory failure (HMERF) have remained without genetic cause. This international study was initiated to clarify epidemiology and the genetic underlying cause in these families, and to characterise the phenotype in our large cohort. METHODS: DNA samples of all currently known families with HMERF without molecular genetic cause were obtained from 12 families in seven different countries. Clinical, histopathological and muscle imaging data were collected and five biopsy samples made available for further immunohistochemical studies. Genotyping, exome sequencing and Sanger sequencing were used to identify and confirm sequence variations. RESULTS: All patients with clinical diagnosis of HMERF were genetically solved by five different titin mutations identified. One mutation has been reported while four are novel, all located exclusively in the FN3 119 domain (A150) of A-band titin. One of the new mutations showed semirecessive inheritance pattern with subclinical myopathy in the heterozygous parents. Typical clinical features were respiratory failure at mid-adulthood in an ambulant patient with very variable degree of muscle weakness. Cytoplasmic bodies were retrospectively observed in all muscle biopsy samples and these were reactive for myofibrillar proteins but not for titin. CONCLUSIONS: We report an extensive collection of families with HMERF with five different mutations in exon 343 of TTN, which establishes this exon as the primary target for molecular diagnosis of HMERF. Our relatively large number of new families and mutations directly implies that HMERF is not extremely rare, not restricted to Northern Europe and should be considered in undetermined myogenic respiratory failure. PMID:23606733

Palmio, Johanna; Evilä, Anni; Chapon, Françoise; Tasca, Giorgio; Xiang, Fengqing; Brådvik, Björn; Eymard, Bruno; Echaniz-Laguna, Andoni; Laporte, Jocelyn; Kärppä, Mikko; Mahjneh, Ibrahim; Quinlivan, Rosaline; Laforêt, Pascal; Damian, Maxwell; Berardo, Andres; Taratuto, Ana Lia; Bueri, Jose Antonio; Tommiska, Johanna; Raivio, Taneli; Tuerk, Matthias; Gölitz, Philipp; Chevessier, Frederic; Sewry, Caroline; Norwood, Fiona; Hedberg, Carola; Schröder, Rolf; Edström, Lars; Oldfors, Anders; Hackman, Peter; Udd, Bjarne

2013-04-19

47

Rescue high frequency oscillation in neonates with acute respiratory failure.  

PubMed

The aim was to study the efficacy of rescue High Frequency Oscillatory Ventilation (HFOV) in improving the oxygenation and ventilation in neonates with acute respiratory failure after failing Conventional Mechanical Ventilation (CMV). Primary outcome was short term oxygenation, lung recruitment, and ventilation and secondary outcome studied was survival. 675 babies were ventilated and 97 of them received HFOV. HFOV significantly improved oxygenation index, alveolar-arterial oxygen gradient, pH, PCO2, PO2 and caused better lung recruitment within 2 hours. Fifty seven babies (58.77%) survived and the mortality was more in <28 weeks, babies with pulmonary hemorrhage, sepsis and CDH. PMID:21555797

Poddutoor, Preetham Kumar; Chirla, Dinesh Kumar; Sachane, Kapil; Shaik, Farhan A R; Venkatlakshmi, Alla

2011-02-28

48

Respiratory failure secondary to human metapneumovirus requiring extracorporeal membrane oxygenation in a 32-month-old child.  

PubMed

Human metapneumovirus (HMPV) is a common virus that can cause respiratory problems ranging from mild upper respiratory tract disease to respiratory failure requiring mechanical support. Here, we report a case of a 32-month-old male with a previous history of asthma, who developed respiratory failure two weeks after onset of cough and rhinorrhea and required extracorporeal membrane oxygenation (ECMO) for 9 days after failing high-frequency oscillatory ventilation (HFOV). To our knowledge, this is the oldest reported pediatric patient with respiratory failure secondary to human metapneumovirus that did not respond to mechanical ventilation. This case highlights three critical points: the potentially fatal causative role of HMPV in respiratory failure in an older pediatric age group of immunocompetent hosts, the importance of early recognition of impending respiratory failure, and the timely utilization of ECMO. PMID:22675646

Gupta, Abha; Bembea, Melania; Brown, Anna; Robertson, Courtney; Romer, Lewis; Cohn, Ronald D

2012-05-22

49

Respiratory Failure Secondary to Human Metapneumovirus Requiring Extracorporeal Membrane Oxygenation in a 32-Month-Old Child  

PubMed Central

Human metapneumovirus (HMPV) is a common virus that can cause respiratory problems ranging from mild upper respiratory tract disease to respiratory failure requiring mechanical support. Here, we report a case of a 32-month-old male with a previous history of asthma, who developed respiratory failure two weeks after onset of cough and rhinorrhea and required extracorporeal membrane oxygenation (ECMO) for 9 days after failing high-frequency oscillatory ventilation (HFOV). To our knowledge, this is the oldest reported pediatric patient with respiratory failure secondary to human metapneumovirus that did not respond to mechanical ventilation. This case highlights three critical points: the potentially fatal causative role of HMPV in respiratory failure in an older pediatric age group of immunocompetent hosts, the importance of early recognition of impending respiratory failure, and the timely utilization of ECMO.

Gupta, Abha; Bembea, Melania; Brown, Anna; Robertson, Courtney; Romer, Lewis; Cohn, Ronald D.

2012-01-01

50

Noninvasive ventilation for acute respiratory failure: a review of the literature and current guidelines.  

PubMed

Noninvasive ventilation, both continuous positive airway pressure and noninvasive positive pressure ventilation, has been used increasingly for acute respiratory failure over the past several years. Noninvasive ventilation has been proven to be beneficial for some causes of acute respiratory failure, most clearly for acute exacerbations of chronic obstructive pulmonary disease, while its use in other forms of acute respiratory failure remains more controversial. In this article, the evidence for the use of noninvasive ventilation in various kinds of acute respiratory failure will be examined. Particular attention will be paid to the clinical situations commonly encountered by emergency medicine and general internal medicine clinicians. The potential dangers of noninvasive ventilation as well as some guidelines for clinical decision making when treating patients with this mode of ventilator support will also be discussed. PMID:23054404

Berg, Katherine Margaret; Clardy, Peter; Donnino, Michael William

2012-09-28

51

Causes of Power-Related Satellite Failures  

Microsoft Academic Search

Satellite on-orbit failures are rare, but costly. Failures cumulatively account for losses that total many billions of dollars. In order to understand the causes of power- system related failures, publicly-available data sources were analyzed to determine the origin of power-system related failures of spacecraft. Data from reported failures and anomalies of commercial and scientific satellites from the period 1990-2006 were

Geoffrey A. Landis; Sheila G. Bailey; Renee Tischler

2006-01-01

52

Palliative noninvasive ventilation in patients with acute respiratory failure  

Microsoft Academic Search

Over the last two decades, the increasing use of noninvasive ventilation (NIV) has diminished the need for endotracheal ventilation,\\u000a thus decreasing the rate of ventilation-induced complications. Thus, NIV has decreased both intubation rates and mortality\\u000a rates in specific subsets of patients with acute respiratory failure (e.g., patients with hypercapnia, cardiogenic pulmonary\\u000a edema, immune deficiencies, or post-transplantation acute respiratory failure). NIV

Élie Azoulay; Alexandre Demoule; Samir Jaber; Achille Kouatchet; Anne-Pascale Meert; Laurent Papazian; Laurent Brochard

53

Oxygen tolerance in patients with acute respiratory failure  

Microsoft Academic Search

Objective: To search for a threshold of pulmonary oxygen toxicity in patients with acute respiratory failure. Design: Retrospective study over a 10-year period. Setting: Three intensive care units of two university hospitals. Patients and participants: Seventy-four patients with acute respiratory failure ventilated continuously with a FIO2 L 0.9 for at least 48 h were selected. Interventions: Information regarding status, scoring,

G. Capellier; P. Beuret; G. Clement; F. Depardieu; C. Ract; J. Regnard; D. Robert; F. Barale

1998-01-01

54

Cuirass respirator treatment of chronic respiratory failure in scoliotic patients  

Microsoft Academic Search

The results are reported of domiciliary cuirass respirator treatment, using tailor-made shells, in four patients with severe thoracic scoliosis. Three of the patients had suffered from poliomyelitis. All complained of increasing dyspnoea on exertion, ultimately interfering with almost every activity of daily life; three patients had severe acute respiratory failure necessitating urgent admission to the Respiratory Care Unit. Right heart

P W Wiers; R Le Coultre; O T Dallinga; W van Dijl; A F Meinesz; H J Sluiter

1977-01-01

55

Prevention of nosocomial infections in acute respiratory failure patients  

Microsoft Academic Search

Patients with acute respiratory failure are predisposed to acquire nosocomial infection primarily because they may need ventilatory support, usually invasive mechanical ventilation. The presence of an endotracheal tube impairs natural defences of the respiratory tract and favours airways colonisation and lung infection. Cross transmission of microorganisms may also occur via contaminated hands of healthcare workers that manipulate invasive devices. Thus,

E. Girou

2003-01-01

56

Non-invasive positive pressure ventilation in acute hypercapnic respiratory failure: clinical experience of a respiratory ward  

Microsoft Academic Search

Non-invasive positive pressure ventilation in acute hypercapnic respiratory failure: clinical experience of a respiratory ward. R. Scala, M. Naldi, I. Archinucci, G. Coniglio. Background: Although a controlled trial demonstrat- ed that non-invasive positive pressure ventilation (NIV) can be successfully applied to a respiratory ward (RW) for selected cases of acute hypercapnic respiratory failure (AHRF), clinical practice data about NIV use

R. Scala; M. Naldi; G. Coniglio

57

Central respiratory failure during acute organophosphate poisoning.  

PubMed

Organophosphate (OP) pesticide poisoning is a global health problem with over 250,000 deaths per year. OPs affect neuronal signaling through acetylcholine (Ach) neurotransmission via inhibition of acetylcholinesterase (AChE), leading to accumulation of Ach at the synaptic cleft and excessive stimulation at post-synaptic receptors. Mortality due to OP agents is attributed to respiratory dysfunction, including central apnea. Cholinergic circuits are integral to many aspects of the central control of respiration, however it is unclear which mechanisms predominate during acute OP intoxication. A more complete understanding of the cholinergic aspects of both respiratory control as well as neural modification of pulmonary function is needed to better understand OP-induced respiratory dysfunction. In this article, we review the physiologic mechanisms of acute OP exposure in the context of the known cholinergic contributions to the central control of respiration. We also discuss the potential central cholinergic contributions to the known peripheral physiologic effects of OP intoxication. PMID:23933009

Carey, Jennifer L; Dunn, Courtney; Gaspari, Romolo J

2013-08-07

58

Large thymolipoma causing primarily respiratory distress.  

PubMed

Thymolipoma, is an anterior mediastinal tumor that is benign in origin. It is often asymptomatic, but can enlarge significantly prior to diagnosis. It consists of thymic and fatty tissue and is surrounded by a capsule. Less than a hundred cases have been reported worldwide. Although rare, it should be considered in the differential diagnosis of mediastinal tumors. In this paper, we report the case of a 44-year-old woman presenting with a giant thymolipoma causing symptoms of severe respiratory distress. The patient underwent surgical resection, which is the main treatment, and remains free of disease. PMID:22919867

Abi Ghanem, Moussa; Habambo, Georges; Bahous, Joudy; Chouairy, Camil; Abu Khalil, Bassam

59

Respiratory failure and sleep in neuromuscular disease  

Microsoft Academic Search

Sleep hypoxaemia in non-rapid eye movement (non-REM) and rapid eye movement (REM) sleep was examined in 20 patients with various neuromuscular disorders with reference to the relation between oxygen desaturation during sleep and daytime lung and respiratory muscle function. All the patients had all night sleep studies performed and maximum inspiratory and expiratory mouth pressures (PI and Pemax), lung volumes,

P T Bye; E R Ellis; F G Issa; P M Donnelly; C E Sullivan

1990-01-01

60

Infectious mononucleosis, diffuse pneumonia and acute respiratory failure in an elderly woman.  

PubMed

Infectious mononucleosis (IM) is a benign disease and is frequently associated with mild respiratory symptoms. The pulmonary manifestations rarely dominate the clinical picture. We report a case of an older adult patient with IM who developed diffuse pneumonia and acute respiratory failure. The diagnosis of IM was confirmed serologically, whereas other possible causes of pneumonia were excluded in this study. Pulmonary manifestations of IM are discussed, and the atypical features that may be seen in older adults are simultaneously reviewed. PMID:14994978

Karachalios, G; Charalabopoulos, A K; Karachaliou, I G; Charalabopoulos, K

2004-01-01

61

Noninvasive positive pressure ventilation for acute respiratory failure in children: a concise review  

Microsoft Academic Search

Noninvasive positive pressure ventilation (NPPV) refers to the delivery of mechanical respiratory support without the use\\u000a of endotracheal intubation (ETI). The present review focused on the effectiveness of NPPV in children > 1 month of age with\\u000a acute respiratory failure (ARF) due to different conditions. ARF is the most common cause of cardiac arrest in children. Therefore,\\u000a prompt recognition and

Abolfazl Najaf-Zadeh; Francis Leclerc

2011-01-01

62

Genetic cardiomyopathies causing heart failure.  

PubMed

Despite the striking advances in medical and surgical therapy, the morbidity, mortality, and economic burden of heart failure (HF) remain unacceptably high. There is increasing evidence that the risk and course of HF depend on genetic predisposition; however, the genetic contribution to HF is heterogeneous and complex. At one end of the spectrum are the familial monogenic HF syndromes in which causative mutations are rare but highly penetrant. At the other, HF susceptibility and course may be influenced by more common, less penetrant genetic variants. As detailed in this review, efforts to unravel the basis of the familial cardiomyopathies at the mendelian end of the spectrum already have begun to deliver on the promise of informative mechanisms, novel gene-based diagnostics, and therapies for distinct subtypes of HF. However, continued progress requires the differentiation of pathogenic mutations, disease modifiers, and rare, benign variants in the deluge of data emerging from increasingly accessible novel sequencing technologies. This represents a significant challenge and demands a sustained effort in analysis of extended family pedigrees, diligent clinical phenotyping, and systematic annotation of human genetic variation. PMID:23989711

Cahill, Thomas J; Ashrafian, Houman; Watkins, Hugh

2013-08-30

63

Sudden Atelectasis and Respiratory Failure in a Neutropenic Patient: Atypical Presentation of Pseudomembranous Necrotizing Bronchial Aspergillosis  

PubMed Central

Pseudomembranous necrotizing bronchial aspergillosis (PNBA) is a rare form of invasive aspergillosis with a very poor prognosis. The symptoms are non-specific, and the necrotizing plugs cause airway obstruction. Atelectasis and respiratory failure can be the initial manifestations. Recently, we treated an immunocompromised patient with PNBA, who presented with a sudden onset of atelectasis and acute respiratory failure. There were no preceding signs except for a mild cough and one febrile episode. Bronchoscopy revealed PNBA, and Aspergillus nidulans was cultured from the bronchial wash.

Noh, Ji Yun; Kang, Eun Hae; Seo, Bo Kyoung; Rho, Kyoung Ho; Chae, Yang-Seok; Kim, Byung Soo

2012-01-01

64

Structures for Common-Cause Failure Analysis.  

National Technical Information Service (NTIS)

Common-cause failure methodology and terminology have been reviewed and structured to provide a systematical basis for addressing and developing models and methods for quantification. The structure is based on (1) a specific set of definitions, (2) catego...

J. K. Vaurio

1981-01-01

65

Acute respiratory failure in the elderly: etiology, emergency diagnosis and prognosis  

Microsoft Academic Search

INTRODUCTION: Our objectives were to determine the causes of acute respiratory failure (ARF) in elderly patients and to assess the accuracy of the initial diagnosis by the emergency physician, and that of the prognosis. METHOD: In this prospective observational study, patients were included if they were admitted to our emergency department, aged 65 years or more with dyspnea, and fulfilled

Patrick Ray; Sophie Birolleau; Yannick Lefort; Marie-Hélène Becquemin; Catherine Beigelman; Richard Isnard; Antonio Teixeira; Martine Arthaud; Bruno Riou; Jacques Boddaert

2006-01-01

66

A cranio-cervical malformation presenting as acute respiratory failure  

Microsoft Academic Search

An 18-year-old, previously healthy male presented with bilateral pneumonia and acute respiratory failure with severe carbon dioxide retention. The presence of mild brainstem signs and hypoventilation led to the discovery of a platybasia, basilar invagination, and kinking of the medulla oblongata with early syrinx. He was operated upon but postoperatively was noted to have a mixed type of sleep apnea.

Mir Mumtaz Ali; Neville Russell; Adnan Awada; Donald Mc Lean

1996-01-01

67

Survival of bronchiectatic patients with respiratory failure in ICU  

Microsoft Academic Search

BACKGROUND: The outcome of patients with bronchiectasis during and after their stay in the intensive care unit (ICU) has seldom been reported in the literature. Managing these patients in the ICU can be challenging because of the complex nature of their disease. This study aims to identify the in-hospital and long-term outcome of patients with bronchiectasis and respiratory failure (RF)

Abdulaziz H Alzeer; Mohammed Masood; Syed Jani Basha; Shaffi A Shaik

2007-01-01

68

Acute respiratory failure secondary to mesalamine-induced interstitial pneumonitis.  

PubMed

Interstitial pneumonitis as an adverse effect of mesalamine therapy is a rare but potentially serious complication. Patients typically have a mild disease course with no documented cases of respiratory failure in published literature. Given its variable latent period and non-specific signs and symptoms, it may be difficult to diagnose. We present the case of a 65-year-old man who presented with symptoms of fever, shortness of breath and a non-productive cough, 2 weeks after initiation of therapy with mesalamine. His hospital course was complicated by acute respiratory failure requiring intubation and mechanical ventilation. Radiographic studies revealed bilateral lower lobe infiltrates and bronchosopy with bronchoalveolar lavage and transbronchial biopsy were consistent with a diagnosis of drug-induced interstitial pneumonitis. The aim of this paper is to highlight the importance of considering a diagnosis of mesalamine-induced lung injury in patients presenting with respiratory symptoms while on mesalamine therapy and to review relevant literature. PMID:23964037

Abraham, Albin; Karakurum, Ali

2013-08-20

69

Genetic causes of spermatogenic failure  

PubMed Central

Approximately 10%–15% of couples are infertile, and a male factor is involved in almost half of these cases. This observation is due in part to defects in spermatogenesis, and the underlying causes, including genetic abnormalities, remain largely unknown. Until recently, the only genetic tests used in the diagnosis of male infertility were aimed at detecting the presence of microdeletions of the long arm of the Y chromosome and/or chromosomal abnormalities. Various other single-gene or polygenic defects have been proposed to be involved in male fertility. However, their causative effects often remain unproven. The recent evolution in the development of whole-genome-based techniques and the large-scale analysis of mouse models might help in this process. Through knockout mouse models, at least 388 genes have been shown to be associated with spermatogenesis in mice. However, problems often arise when translating this information from mice to humans.

Massart, Annelien; Lissens, Willy; Tournaye, Herman; Stouffs, Katrien

2012-01-01

70

Structures for common-cause failure analysis  

SciTech Connect

Common-cause failure methodology and terminology have been reviewed and structured to provide a systematical basis for addressing and developing models and methods for quantification. The structure is based on (1) a specific set of definitions, (2) categories based on the way faults are attributable to a common cause, and (3) classes based on the time of entry and the time of elimination of the faults. The failure events are then characterized by their likelihood or frequency and the average residence time. The structure provides a basis for selecting computational models, collecting and evaluating data and assessing the importance of various failure types, and for developing effective defences against common-cause failure. The relationships of this and several other structures are described.

Vaurio, J.K.

1981-01-01

71

Palliative noninvasive ventilation in patients with acute respiratory failure.  

PubMed

Over the last two decades, the increasing use of noninvasive ventilation (NIV) has diminished the need for endotracheal ventilation, thus decreasing the rate of ventilation-induced complications. Thus, NIV has decreased both intubation rates and mortality rates in specific subsets of patients with acute respiratory failure (e.g., patients with hypercapnia, cardiogenic pulmonary edema, immune deficiencies, or post-transplantation acute respiratory failure). NIV is also increasingly used as a palliative strategy when endotracheal ventilation is deemed inappropriate. In this context, palliative NIV can either be administered to offer a chance for survival, or to alleviate the symptoms of respiratory distress in dying patients. The literature provides information from 10 studies published between 1992 and 2006, in which 458 patients received palliative NIV. The technique was feasible, usually well tolerated, and half of the patients survived. The objectives of this review article are to define palliative NIV, to delineate the place for palliative NIV among overall indications of NIV, and to define the contribution of NIV to the palliative strategies available for patients with acute respiratory failure. Potential benefits and harm from NIV in patients who are not eligible for endotracheal ventilation are discussed. The appropriateness of palliative NIV should be reported in a study that relies on both quantitative criteria (rate of palliative NIV use and mortality) and qualitative criteria (patient comfort, end-of-life process, family burden, and health-care provider satisfaction). PMID:21656292

Azoulay, Elie; Demoule, Alexandre; Jaber, Samir; Kouatchet, Achille; Meert, Anne-Pascale; Papazian, Laurent; Brochard, Laurent

2011-06-09

72

Neonatal paracorporeal lung assist device for respiratory failure.  

PubMed

Neonates who experience respiratory failure despite maximal ventilatory support have only extracorporeal membrane oxygenation as a rescue therapy, but it has very poor outcomes as a bridge to transplantation. A pumpless lung-assist device has been used in adults as a bridge to lung transplantation. An alternative membrane oxygenator, the Quadrox iD, is a suitable size for neonatal blood flow. Here we report the use of the Quadrox iD membrane oxygenator with central cannulation as a paracorporeal respiratory support therapy for a neonate with alveolar capillary dysplasia awaiting lung transplantation. PMID:23336880

Hoganson, David M; Gazit, Avihu Z; Sweet, Stuart C; Grady, R Mark; Huddleston, Charles B; Eghtesady, Pirooz

2013-02-01

73

[Interpretation of ventilator curves in patients with acute respiratory failure].  

PubMed

Mechanical ventilation is a therapeutic intervention involving the temporary replacement of ventilatory function with the purpose of improving symptoms in patients with acute respiratory failure. Technological advances have facilitated the development of sophisticated ventilators for viewing and recording the respiratory waveforms, which are a valuable source of information for the clinician. The correct interpretation of these curves is crucial for the correct diagnosis and early detection of anomalies, and for understanding physiological aspects related to mechanical ventilation and patient-ventilator interaction. The present study offers a guide for the interpretation of the airway pressure and flow and volume curves of the ventilator, through the analysis of different clinical scenarios. PMID:22014424

Correger, E; Murias, G; Chacon, E; Estruga, A; Sales, B; Lopez-Aguilar, J; Montanya, J; Lucangelo, U; Garcia-Esquirol, O; Villagra, A; Villar, J; Kacmarek, R M; Burgueño, M J; Blanch, L

2011-10-19

74

A novel case of transient right ventricular failure in a patient with respiratory distress.  

PubMed

Right ventricular (RV) failure is characterized by an inability to pump blood into the pulmonary circulation and can often lead to hemodynamic instability. Common causes of RV failure include left ventricular (LV) failure, RV infarction, sepsis, cor pulmonale due to acute respiratory distress syndrome, pulmonary emboli, or pulmonary hypertension. We report the case of a 61-year-old woman with no significant pulmonary or cardiac disease who presented with hypoxic respiratory failure in the setting of opioid overdose. She remained obtunded despite naloxone treatment and required endotracheal intubation as well as norepinephrine therapy for persistent hypotension. A transthoracic echocardiogram demonstrated isolated severe RV dysfunction without any LV abnormalities. Cardiac catheterization showed no obstructive coronary artery disease, pulmonary hypertension, or elevated left atrial pressures, and chest imaging only revealed signs of aspiration. Over the next 6 days, the patient's cardiac and respiratory function improved, and a repeat echocardiogram demonstrated complete normalization of RV function. This case demonstrates a novel finding that marked, but transient, RV dysfunction can occur in the setting of acute respiratory failure. PMID:22547558

Liu, Stanley S; Kovell, Lara C; Horne, Aaron; Chang, David; Petronis, John D; Zakaria, Sammy

2012-04-29

75

Clinical Issues and Research in Respiratory Failure from Severe Acute Respiratory Syndrome  

Microsoft Academic Search

The National Heart, Lung, and Blood Institute, along with the Cen- ters for Disease Control and Prevention and the National Institute of Allergy and Infectious Diseases, convened a panel to develop recommendationsfortreatment,prevention,andresearchforrespi- ratory failure from severe acute respiratory syndrome (SARS) and other newly emerging infections. The clinical and pathological fea- tures of acute lung injury (ALI) from SARS appear indistinguishable

Mitchell M. Levy; Melisse S. Baylor; Gordon R. Bernard; Rob Fowler; Teri J. Franks; Frederick G. Hayden; Rita Helfand; Stephen E. Lapinsky; Thomas R. Martin; Michael S. Niederman; Gordon D. Rubenfeld; Arthur S. Slutsky; Thomas E. Stewart; Barbara A. Styrt; B. Taylor Thompson; Andrea L. Harabin

76

Extracorporeal Perfusion for Acute Respiratory Failure. Membrane Lung Perfusion for Acute Respiratory Failure.  

National Technical Information Service (NTIS)

The overall long term extracorporeal perfusion (ECMO) therapy in the treatment of severe acute respiratory distress syndrome (ARDS). Efforts were directed at four components of the overall goal: (1) Which lung diseases improve during ECMO or control thera...

W. M. Zapol

1976-01-01

77

[Non-invasive ventilation: indication for acute respiratory failure].  

PubMed

Mask or Non-invasive ventilation (NIV) is used for critically ill patients with acute respiratory failure (ARF): acute exacerbation of chronic obstructive bronchopulmonary disease and severe cardiogenic pulmonary edema are considered as the best indications for NIV since it improves the outcome of these patients. This technique is also proposed for hypoxemic respiratory failure, with more various results. To be effective here, NIV must be established early enough and should not delay intubation if required. NIV is also proposed after invasive ventilation or in patients in whom endotracheal intubation is not desirable. Its use has increased and its effectiveness seems to have improved, due to a better understanding of the technique but also thanks to technological progress. PMID:23346673

Brunner, Marie-Eve; Lyazidi, Aissam; Richard, Jean-Christophe Marie; Brochard, Laurent

2012-12-12

78

Noninvasive mechanical ventilation in acute hypoxaemic respiratory failure  

Microsoft Academic Search

ABSTRACT: In acute hypoxaemic respiratory failure (HRF), oxygenation, reduction in the work,of breathing and in dyspnoea,may,be achieved by delivering noninvasive mechanical,ventilation (NIMV). Several uncontrolled and 13 randomized,controlled studies (RCS) were,reviewed. Uncontrolled studies confirmed,the feasibility and the possibility to improve,arterial blood oxygenation,with NIMV. The 13 RCS compared,NIMV versus a conventional approach,in a total of 720 patients with HRF. Endotracheal intubation was

M. Wysocki; M. Antonelli

2001-01-01

79

Postoperative respiratory failure due to acute eosinophilic pneumonia  

Microsoft Academic Search

A non-smoking 63-year-old man developed respiratory failure following surgical repair of a thoracoabdominal aortic aneurysm. He had severe hypoxemia and an elevated minute ventilation requiring prolonged mechanical support. Initial postoperative chest radiographs revealed new, transient, migratory infiltrates, and the patient received broad-spectrum antibiotic therapy. Chest radiographs subsequently demonstrated persistent, diffuse infiltrates, and bronchoalveolar lavage (BAL) analysis demonstrated significant eosinophilia (30%)

R. C. St. John; J. N. Allen; E. R. Pacht

1990-01-01

80

Causes of catastrophic failure in complex systems  

Microsoft Academic Search

Root causes of mission critical failures and major cost and schedule overruns in complex systems and programs are studied through the post-mortem analyses compiled for several examples, including the Hubble Space Telescope, the Challenger and Columbia Shuttle accidents, and the Three Mile Island nuclear power plant accident. The roles of organizational complexity, cognitive biases in decision making, the display of

David A. Thomas

2010-01-01

81

Causes of catastrophic failure in complex systems  

NASA Astrophysics Data System (ADS)

Root causes of mission critical failures and major cost and schedule overruns in complex systems and programs are studied through the post-mortem analyses compiled for several examples, including the Hubble Space Telescope, the Challenger and Columbia Shuttle accidents, and the Three Mile Island nuclear power plant accident. The roles of organizational complexity, cognitive biases in decision making, the display of quantitative data, and cost and schedule pressure are all considered. Recommendations for mitigating the risk of similar failures in future programs are also provided.

Thomas, David A.

2010-08-01

82

Alternative modalities of ventilation in acute respiratory failure.  

PubMed

Acute respiratory failure continues to complicate the management of critically ill trauma and surgical patients. Despite an increased understanding of the pathophysiology of this process, there is no golden bullet with which to stop or reverse it. Management remains directed toward maintenance of gas exchange and minimizing complications until such time as the process that initiated the respiratory failure has resolved and the lungs have an opportunity to recover. Continuous positive pressure ventilation with PEEP and oxygen is the conventional modality for achieving this goal. It is apparent that some patients are refractory to this therapy. In addition, there is evidence that alveolar injury may occur as a result of increasing airway pressures and shear forces. These authors have reviewed a number of modalities that seek to address these issues. IRV, whether pressure or volume controlled, appears at least able to provide adequate gas exchange in some patients who are refractory to conventional therapies. The same appears to be true for pressure control ventilation, airway pressure release ventilation, and volume control ventilation with a modified decelerating flow waveform. Whether any of these modalities will prove to alter outcome with respect to mortality remains to be seen. Work continues in the arena of extrapulmonary oxygenation. Results of recent studies are improved compared to the results of the NIH trial reflecting advances in technology, technique, and experience. The IVOX is a fascinating device that has been shown to effectively transfer respiratory gases, as has perfluorocarbon associated gas exchange. Whether these technologies will find a role in the treatment of adult respiratory failure awaits further study. PMID:7597555

Cole, F J; Shouse, B A

1995-01-01

83

Early Use of Noninvasive Mechanical Ventilation in Patients with Acute Hypercapnic Respiratory Failure in a Respiratory Ward: A Prospective Study  

Microsoft Academic Search

BackgroundIn recent years, the optimal location for noninvasive mechanical ventilation (NIMV) has been a matter of debate. Our aim was to detect the effectiveness of NIMV in acute hypercapnic respiratory failure (AHRF) in respiratory ward and factors associated with failure.

Aydin Ciledag; Akin Kaya; Buket Basa Akdogan; Pinar Akin Kabalak; Zeynep P. Onen; Elif Seny Banu Gulbay

2010-01-01

84

Fulminant hepatic failure caused by tuberculosis.  

PubMed Central

A 54 year old Asian woman developed fulminant hepatic failure followed by renal failure. Because of a past history of possible tuberculosis, she was given antituberculous drugs. The chest x ray was normal. A transjugular liver biopsy showed caseating necrosis, granulomas, and acid fast bacilli indicative of miliary tuberculosis. Despite full supportive therapy, her condition deteriorated and she died. Postmortem examination showed widespread miliary tuberculosis; culture confirmed the presence of Mycobacterium tuberculosis. Tuberculosis causes fulminant hepatic failure rarely and only three cases have been described. In this, as with the other cases, hyponatraemia and hepatomegaly were features at presentation. This is the first report of treatment being given before death. Images p793-a

Hussain, W; Mutimer, D; Harrison, R; Hubscher, S; Neuberger, J

1995-01-01

85

Apneic crises: a clue for MECP2 testing in severe neonatal hypotonia-respiratory failure.  

PubMed

Males with methyl-CpG-binding protein 2 (MECP2) mutations may present with neonatal encephalopathy. We report on an infant with a MECP2 mutation who exhibited complex constellation of symptoms, including severe hypotonia, respiratory failure, and apneic episodes. In the neonatal period these symptoms are common to other disorders, including Ondine syndrome. Our observation confirms that the triad of severe hypotonia, apneic episodes, and respiratory failure may be caused by MECP2 mutations. Neonatologist and neuropediatricians must be alert to the presence of these symptoms to exclude this rare but severe disorder. Clinical suspicion and molecular confirmation of MECP2 mutation is of great importance for defining the diagnosis of this rare affection. PMID:22497713

Falsaperla, Raffaele; Pavone, Lorenzo; Fichera, Marco; Striano, Pasquale; Pavone, Piero

2012-04-11

86

Respiratory failure and mechanical ventilation: Pathophysiology and methods of promoting weaning  

Microsoft Academic Search

Respiratory failure may be manifested either by impaired gas exchange or by impaired ventilatory function. The latter results\\u000a in more severe problems in weaning patients from mechanical ventilation. Ventilatory failure may result from inadequate respiratory\\u000a drive, excessive respiratory workload, inadequate respiratory muscle endurance, or a combination of these factors.\\u000a \\u000a Simple bedside tests of ventilatory function are useful for evaluating the

Jill P. Karpel; Thomas K. Aldrich

1986-01-01

87

How to ventilate brain-injured patients in respiratory failure  

Microsoft Academic Search

It is common knowledge that in brain-injured patients the principal morbidity and mortality are most frequently caused by\\u000a the primary disease, i.e. cerebral nervous system injury and its neurological consequences [1]. Nevertheless, extracerebral organ dysfunctions are frequent in brain-injured patients, in creasing morbidity and mortality\\u000a [2, 3]. Among them, the most frequent complication is respiratory dysfunction including pulmonary oedema and

P. Pelosi; P. Severgnini; M. Chiaranda

88

Acute interstitial pneumonia (hamman-rich syndrome) as a cause of idiopathic acute respiratory distress syndrome.  

PubMed

Hamman-Rich syndrome, also known as acute interstitial pneumonia, is a rare and fulminant form of idiopathic interstitial lung disease. It should be considered as a cause of idiopathic acute respiratory distress syndrome. Confirmatory diagnosis requires demonstration of diffuse alveolar damage on lung histopathology. The main treatment is supportive care. It is not clear if glucocorticoid therapy is effective in acute interstitial pneumonia. We report the case of a 77-year-old woman without pre-existing lung disease who initially presented with mild upper respiratory tract infection and then progressed to rapid onset of hypoxic respiratory failure similar to acute respiratory distress syndrome with unknown etiology. Despite glucocorticoid therapy, she did not achieve remission and expired after 35 days of hospitalization. The diagnosis of acute interstitial pneumonia was supported by the histopathologic findings on her lung biopsy. PMID:21687544

Bruminhent, Jackrapong; Yassir, Shahla; Pippim, James

2011-05-29

89

Acute Interstitial Pneumonia (Hamman-Rich Syndrome) as a Cause of Idiopathic Acute Respiratory Distress Syndrome  

PubMed Central

Hamman-Rich syndrome, also known as acute interstitial pneumonia, is a rare and fulminant form of idiopathic interstitial lung disease. It should be considered as a cause of idiopathic acute respiratory distress syndrome. Confirmatory diagnosis requires demonstration of diffuse alveolar damage on lung histopathology. The main treatment is supportive care. It is not clear if glucocorticoid therapy is effective in acute interstitial pneumonia. We report the case of a 77-year-old woman without pre-existing lung disease who initially presented with mild upper respiratory tract infection and then progressed to rapid onset of hypoxic respiratory failure similar to acute respiratory distress syndrome with unknown etiology. Despite glucocorticoid therapy, she did not achieve remission and expired after 35 days of hospitalization. The diagnosis of acute interstitial pneumonia was supported by the histopathologic findings on her lung biopsy.

Bruminhent, Jackrapong; Yassir, Shahla; Pippim, James

2011-01-01

90

Common environmental allergens causing respiratory allergy in india  

Microsoft Academic Search

Respiratory allergy affects all age groups but the children are the worst affected by the respiratory allergy. Bioparticles\\u000a from different biological sources are the main cause of allergy. Pollen grains, fungal spores, insect and other materials\\u000a of biological origin form the most important allergen load in the air. For the efficient diagnosis of the allergy and its\\u000a effective treatment it

A. B. Singh; Pawan Kumar

2002-01-01

91

Titin mutation segregates with hereditary myopathy with early respiratory failure  

PubMed Central

In 2001, we described an autosomal dominant myopathy characterized by neuromuscular ventilatory failure in ambulant patients. Here we describe the underlying genetic basis for the disorder, and we define the neuromuscular, respiratory and radiological phenotype in a study of 31 mutation carriers followed for up to 31 years. A combination of genome-wide linkage and whole exome sequencing revealed the likely causal genetic variant in the titin (TTN) gene (g.274375T>C; p.Cys30071Arg) within a shared haplotype of 2.93 Mbp on chromosome 2. This segregated with the phenotype in 21 individuals from the original family, nine subjects in a second family with the same highly selective pattern of muscle involvement on magnetic resonance imaging and a third familial case with a similar phenotype. Comparing the mutation carriers revealed novel features not apparent in our original report. The clinical presentation included predominant distal, proximal or respiratory muscle weakness. The age of onset was highly variable, from early adulthood, and including a mild phenotype in advanced age. Muscle weakness was earlier onset and more severe in the lower extremities in nearly all patients. Seven patients also had axial muscle weakness. Respiratory function studies demonstrated a gradual deterioration over time, reflecting the progressive nature of this condition. Cardiomyopathy was not present in any of our patients despite up to 31 years of follow-up. Magnetic resonance muscle imaging was performed in 21 affected patients and revealed characteristic abnormalities with semitendinosus involvement in 20 of 21 patients studied, including 3 patients who were presymptomatic. Diagnostic muscle histopathology most frequently revealed eosinophilic inclusions (inclusion bodies) and rimmed vacuoles, but was non-specific in a minority of patients. These findings have important clinical implications. This disease should be considered in patients with adult-onset proximal or distal myopathy and early respiratory failure, even in the presence of non-specific muscle pathology. Muscle magnetic resonance imaging findings are characteristic and should be considered as an initial investigation, and if positive should prompt screening for mutations in TTN. With 363 exons, screening TTN presented a major challenge until recently. However, whole exome sequencing provides a reliable cost-effective approach, providing the gene of interest is adequately captured.

Pfeffer, Gerald; Elliott, Hannah R.; Griffin, Helen; Barresi, Rita; Miller, James; Marsh, Julie; Evila, Anni; Vihola, Anna; Hackman, Peter; Straub, Volker; Dick, David J.; Horvath, Rita; Santibanez-Koref, Mauro; Udd, Bjarne

2012-01-01

92

[Respiratory pump failure. Clinical symptoms, diagnostics and therapy].  

PubMed

The total anatomical and functional apparatus which allows normal ventilation of the lungs is known as the respiratory pump. An insufficiency of this system, which can be caused by a multitude of reasons, primarily affects the inspiratory musculature and especially the diaphragm. One of the essential clinical characteristics is rapid shallow breathing. Exhaustion of the repiratory musculature due to acute respiratory insufficiency is normally clinically registered but can also be functionally determined in particular by the maximum static inspiratory closed mouth pressure. A further option is invasive measurement of the transdiaphragmal pressure, which however is not suitable as a routine procedure. Mechanical ventilation is used as treatment of respiratory pump insufficiency independent of the cause. This is initially a non-invasive procedure but if unsuccessful intubation and invasive ventilation are indicated. The technical developments in the field of extracorporeal gas exchange systems are very promising. However, in view of the insufficient data, ventilation procedures using masks and tubes still remain the first choice methods. PMID:22527662

Pfeifer, M

2012-05-01

93

Non-invasive negative and positive pressure ventilation in the treatment of acute on chronic respiratory failure  

Microsoft Academic Search

Objective: To investigate in clinical practice the role of non- invasive mechanical ventilation in the treatment of acute respiratory failure on chronic respiratory disorders. Design: An 18 months prospective cohort study. Setting: A specialised respiratory intensive care unit in a university-affiliated hospital. Patients: A total of 258 consecutive patients with acute respiratory failure on chronic respiratory disorders. Interventions: Criteria for

Massimo Gorini; Roberta Ginanni; Giuseppe Villella; Donatella Tozzi; Annike Augustynen; Antonio Corrado

2004-01-01

94

Acute respiratory failure revealing a multilocular thymic cyst in an infant: a case report  

PubMed Central

Introduction Multilocular thymic cysts are rare benign lesions of the neck and mediastinum that can occur at any age. In children, multilocular thymic cysts are usually symptomatic after the age of 2 years and produce few symptoms. We present an unusual case of a multilocular thymic cyst diagnosed in a 3-month-old girl and causing severe respiratory failure. Case presentation A 3 month-old-girl, with a medical history of dyspnea and wheezing since the age of 20 days, presented in our pediatric intensive care unit for acute respiratory failure requiring mechanical ventilation. The chest radiograph showed thoracic distension without any other abnormalities. The diagnosis of severe asthma was initially suspected and the patient was treated by intravenous corticosteroids and continuous perfusion of salbutamol without any improvement. A chest tomography scan was performed and demonstrated an anterior mediastinal multiseptated cystic mass extending from the inferior face of the thyroid gland to the left cardiophrenic angle. Sternotomy and excision biopsy were planned urgently. The cystic mass was excised completely. The histopathological examination confirmed the diagnosis of a multilocular thymic cyst. Conclusion The particularities of our observation are the occurrence of a multilocular thymic cyst in a young infant and its presentation by a severe acute respiratory failure mimicking asthma.

2009-01-01

95

Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study  

Microsoft Academic Search

Context: In patients with hypoxemic acute respiratory failure (ARF), randomized studies have shown noninvasive positive pressure ventilation (NPPV) to be associated with lower rates of endotracheal intubation. In these patients, predictors of NPPV failure are not well characterized. Objective: To investigate variables predictive of NPPV failure in patients with hypoxemic ARF. Design: Prospective, multicenter cohort study. Setting: Eight Intensive Care

M. Antonelli; G. Conti; M. Moro; A. Esquinas; G. Gonzalez-Diaz; M. Confalonieri; P. Pelaia; T. Principi; C. Gregoretti; F. Beltrame; M. Pennisi; A. Arcangeli; R. Proietti; M. Passariello; G. Meduri

2001-01-01

96

Extracorporeal membrane oxygenation for severe acute respiratory failure  

PubMed Central

Extracorporeal membrane oxygenation (ECMO) is a technique for providing life support, in case the natural lungs are failing and are not able to maintain a sufficient oxygenation of the body's organ systems. ECMO technique was an adaptation of conventional cardiopulmonary bypass technique and introduced into treatment of severe acute respiratory distress syndrome (ARDS) in the 1970s. The intial reports of the use of ECMO in ARDS patients were quite enthusiastic, however, in the following years it became clear that ECMO was only of benefit in newborns with acute respiratory failure. In neonates treated with ECMO, survival rates of 80% could be achieved. In adult patients with ARDS, two large randomized controlled trials (RCTs) published in 1979 and 1994 failed to show an advantage of ECMO over convential treatment, survival rates were only 10% and 33%, respectively, in the ECMO groups. Since then, ECMO technology as well as conventional treatment of adult ARDS have undergone further improvements. In conventional treatment lung-protective ventilation strategies were introduced and ECMO was made safer by applying heparin-coated equipment, membranes and tubings. Many ECMO centres now use these advanced ECMO technology and report survival rates in excess of 50% in uncontrolled data collections. The question, however, of whether the improved ECMO can really challenge the advanced conventional treatment of adult ARDS is unanswered and will need evaluation by a future RCT.

Lewandowski, Klaus

2000-01-01

97

Acute Respiratory Failure in Patients with Severe Community-acquired Pneumonia A Prospective Randomized Evaluation of Noninvasive Ventilation  

Microsoft Academic Search

In uncontrolled studies, noninvasive positive pressure ventilation (NPPV) was found useful in avoid- ing endotracheal intubation in patients with acute respiratory failure (ARF) caused by severe commu- nity-acquired pneumonia (CAP). We conducted a prospective, randomized study comparing stan- dard treatment plus NPPV delivered through a face mask to standard treatment alone in patients with severe CAP and ARF. Patients fitting

MARCO CONFALONIERI; ALFREDO POTENA; GIORGIO CARBONE; ROSSANA DELLA PORTA; ELIZABETH A. TOLLEY; G. UMBERTO MEDURI

98

Exertional hyperpnea in patients with chronic heart failure is a reversible cause of exercise intolerance  

Microsoft Academic Search

Background: Hyper- pnea in chronic heart failure occurs even in the absence of consider- able impairment of lung function. It is caused by altered respiratory pattern with rapid shallow breathing and ventilation-perfusion mismatch, so far thought to be irreversible. Objectives: To test the underlying pathophysiologic disorders and the reversibility of this hyperpnea, i.e., the increased ventilatory response to exercise and

I. Reindl; F. X. Kleber

1996-01-01

99

Episodic medical home interventions in severe bedridden Chronic Respiratory Failure patients: a 4 year retrospective study  

Microsoft Academic Search

Episodic medical home interventions in severe bedridden Chronic Respiratory Failure patients: a 4 year retrospective study. L. Barbano, E. Bertella, M. Vitacca. Background and Aim. Home care for respiratory pa- tients includes a complex array of services delivered in an uncontrolled setting. The role of a respiratory specialist inside the home healthcare team has been scarcely studied up to now.

L. Barbano; E. Bertella; M. Vitacca

100

Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation  

Microsoft Academic Search

Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation. M. Decramer. #ERS Journals Ltd 2003. ABSTRACT: Several treatment options are available for end-stage chronic obstructive pulmonary disease (COPD). Respiratory rehabilitation and lung volume reduction surgery are reviewed here. Respiratory rehabilitation can now be considered a prime treatment for COPD. Indeed, it has been clearly shown to improve exercise

M. Decramer

2003-01-01

101

Neonatal Respiratory Failure: A 12Month Clinical Epidemiologic Study From 2004 to 2005 in China  

Microsoft Academic Search

OBJECTIVES.In the past decade, neonatal special care services in China have been established, during which time various therapies for neonatal respiratory failure have been introduced. The objective of this study was to investigate the incidence, man- agement, outcome, and cost of neonatal respiratory failure treated by mechanical ventilation in 23 tertiary NICUs of major hospitals in southeastern and midwestern China.

Liling Qian; Cuiqing Liu; Wanzhu Zhuang; Yunxia Guo; Jialin Yu; Hanqiang Chen; Sannan Wang; Zhenlang Lin; Shiwen Xia; Xiaohong Liu; Chao Chen; Bo Sun

2009-01-01

102

Noninvasive mechanical ventilation in a patient with respiratory failure after hematopoietic progenitor transplantation  

Microsoft Academic Search

Respiratory failure requiring orotracheal intubation (OTI) and mechanical ventilation (MV) is almost always a fatal complication in patients who undergo hematopoietic progenitor transplantation (HPT). We present the case of a woman who suffered respiratory failure with bilateral infiltrates on a chest X-ray taken on day +14 following autologous bone marrow transplantation. We managed the patient satisfactorily with noninvasive ventilation, avoiding

D Marín; E González-Barca; E Domingo; J Berlanga; A Grañena

1998-01-01

103

Acute Eosinophilic Pneumonia with respiratory failure: a case likely triggered by cigarette smoking  

Microsoft Academic Search

Acute Eosinophilic Pneumonia with respiratory failure: a case likely triggered by cigarette smoking. E. Grossi, G. Poletti, V. Poletti. The authors report a case of acute respiratory failure that fulfils the diagnostic criteria for acute eosinophilic pneumonia. Bronchoalveolar lavage eosinophilia and eosinophilic lung diseases are also discussed. The pathogenetic events, including the role of IL-5, eotaxin 1 and 2 and

E. Grossi; G. Poletti; V. Poletti

104

Noninvasive ventilation for acute respiratory failure: a prospective randomised placebo-controlled trial  

Microsoft Academic Search

Noninvasive ventilation for acute respiratory failure: a prospective randomised placebo- controlled trial. F. Thys, J. Roeseler, M. Reynaert, G. Liistro, D.O. Rodenstein. #ERS Journals Ltd 2002. ABSTRACT: The aim of the present study was to clarify whether the known effects of noninvasive positive-pressure ventilation (NPPV) in patients with respiratory failure are real or due to placebo effects and whether early

F. Thys; J. Roeseler; M. Reynaert; G. Liistro; D. O. Rodenstein

2002-01-01

105

Non-invasive positive pressure ventilation in acute respiratory failure: providing competent care  

Microsoft Academic Search

Non-invasive positive pressure ventilation (NPPV) has been used as an alternative strategy to provide ventilatory support for patients with acute respiratory failure. Most studies demonstrate that the use of NPPV in acute respiratory failure results in a reduction in the need for endotracheal intubation and an overall survival advantage. However, current evidence, in the form of randomized controlled trials, suggests

Rosa PY Ho; Martin Boyle

2000-01-01

106

Respiratory muscle function and exercise intolerance in heart failure  

Microsoft Academic Search

Inspiratory muscle weakness (IMW) is prevalent in patients with chronic heart failure (CHF) caused by left ventricular systolic\\u000a dysfunction, which contributes to reduced exercise capacity and the presence of dyspnea during daily activities. Inspiratory\\u000a muscle strength (estimated by maximal inspiratory pressure) has independent prognostic value in CHF. Overall, the results\\u000a of trials with inspiratory muscle training (IMT) indicate that this

Jorge P. Ribeiro; Gaspar R. Chiappa; J. Alberto Neder; Lutz Frankenstein

2009-01-01

107

Long-term survival for COPD patients receiving noninvasive ventilation for acute respiratory failure  

PubMed Central

Implementation of noninvasive ventilation (NIV) as an add-on treatment has been routinely used in a non-intensive care setting since 2004 for patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure at a university hospital in Denmark. Although randomized controlled trials show lowered mortality rates in highly selected patients with acute exacerbation and respiratory failure, there are only few reports on long-term survival after receiving NIV. We present long-term all-cause mortality data from patients receiving NIV for the first time. Method Data from medical records were retrospectively retrieved from all patients receiving NIV for the first time after being admitted acutely to an acute medical ward and further transfer to a respiratory ward with respiratory failure and a diagnosis of COPD in the period January 1, 2005 to December 31, 2007; patients were followed until January 2012. Demographic data collected included age, sex, diagnoses at discharge, and, when present, FEV1; a “not-to-intubate” order was also registered when listed. Results In total, 253 patients (143 female, 110 male) received NIV for the first time. The median age was 72 years (range 46–91 years). The 30-day mortality rate was 29.3%. The 5-year survival rate was 23.7%. Women showed a trend towards better survival than men (25.7% vs 19.2%, P = 0.25), and the trend was even more pronounced for patients with COPD. Conclusion The mortality rate of patients receiving NIV is high, as expected in a real-life setting, but with a 5-year survival rate of 23.7% with a trend towards more female than male long-term survivors.

Titlestad, Ingrid L; Lassen, Annmarie T; Vestbo, J?rgen

2013-01-01

108

Primary respiratory failure due to inclusion body myositis: think outside the box.  

PubMed

Inclusion body myositis features a slowly progressive inflammatory myopathy characterized by progressive proximal muscle weakness in the lower extremities, followed by proximal, upper-extremity weakness and later involvement of distal muscles groups. Although the most severely affected muscles are those of the limbs, the disease can also involve the respiratory, cardiovascular and gastrointestinal system muscles as well. We describe a unique patient who presented with acute hypercapnic hypoxic respiratory failure secondary to inclusion body myositis. Our patient required mechanical ventilation but responded to corticosteroid therapy. The diagnosis was delayed in part because of the slowly progressive course of the disease and the fact that an extensive investigation had not disclosed a cause. We postulate that muscle biopsy may be warranted in select patients suffering from a protracted muscle weakness. PMID:23589953

Jethava, Ashif; Ali, Syed; Dasanu, Constantin A

2013-03-01

109

RPGR mutations might cause reduced orientation of respiratory cilia.  

PubMed

RPGR gene encodes retinitis pigmentosa guanosine triphosphatase regulator protein, mutations of which cause 70% of the X-linked retinitis pigmentosa (XLRP) cases. Rarely, RPGR mutations can also cause primary ciliary dyskinesia (PCD), a multisystem disorder characterized by recurrent respiratory tract infections, sinusitis, bronchiectasis, and male subfertility. Two patients with PCD_RP and their relatives were analyzed using DNA sequencing, transmission electron microscopy (TEM), immunofluorescence (IF), photometry, and high-speed videomicroscopy. The Polish patient carried a previously known c.154G>A substitution (p.Gly52Arg) in exon 2 (known to affect splicing); the mutation was co-segregating with the XLRP symptoms in his family. The c.824 G>T mutation (p. Gly275Val) in the Australian patient was a de novo mutation. In both patients, TEM and IF did not reveal any changes in the respiratory cilia structure. However, following ciliogenesis in vitro, in contrast to the ciliary beat frequency, the ciliary beat coordination in the spheroids from the Polish proband and his relatives carrying the c.154G>A mutation was reduced. Analysis of the ciliary alignment indicated severely disturbed orientation of cilia. Therefore, we confirm that defects in the RPGR protein may contribute to syndromic PCD. Lack of ultrastructural defects in respiratory cilia of the probands, the reduced ciliary orientation and the decreased coordination of the ciliary bundles observed in the Polish patient suggested that the RPGR protein may play a role in the establishment of the proper respiratory cilia orientation. PMID:22888088

Bukowy-Biery??o, Zuzanna; Zi?tkiewicz, Ewa; Loges, Niki Tomas; Wittmer, Mariana; Geremek, Maciej; Olbrich, Heike; Fliegauf, Manfred; Voelkel, Katarzyna; Rutkiewicz, Ewa; Rutland, Jonathan; Morgan, Lucy; Pogorzelski, Andrzej; Martin, James; Haan, Eric; Berger, Wolfgang; Omran, Heymut; Witt, Micha?

2012-08-06

110

Surprising cause of respiratory distress in child: laryngeal leech.  

PubMed

Foreign body aspiration is a major problem that can cause respiratory distress and oral bleeding in a child. Leeches are rarely seen foreign bodies in the larynx. Generally, they live in springwater and can be aspirated by drinking. They can cause respiratory distress, oral bleeding, and anemia, if diagnostic process is delayed. When leeches are detected, urgent diagnosis and treatment are necessary. In this case, we present a 7-year-old child examined in the emergency service with these symptoms. A dark green living body in the larynx was detected and removed urgently under sedo-analgesia. The living body was seen as a leech that is 5 cm in length. PMID:22627458

Yazici, Ha?met; Do?an, Sedat; Sunter, Ahmet Volkan; Yilmaz, Engin; Da?kaya, Hayrettin

2012-05-01

111

Acute Pediatric Rhabdomyolysis: Causes and Rates of Renal Failure  

Microsoft Academic Search

OBJECTIVES.The goals were to (1) compare the causes, clinical presentation, and prevalence of acute renal failure in pediatric rhabdomyolysis with the published data for adults; (2) determine predictors of acute renal failure in pediatric patients with rhabdomyolysis; and (3) explore the relationship of acute renal failure with treatment modalities such as fluid and bicarbonate administration. METHODS.We performed a retrospective chart

Rebekah Mannix; Mei Lin Tanb; Robert Wright; Marc Baskin

2010-01-01

112

How faults cause software failures: implications for software reliability engineering  

Microsoft Academic Search

Software systems typically contain design and code defects that manifest themselves as software failures at various points during program execution. These software faults can be viewed as causing failures to occur according to some chance mechanism that is often taken to be a Poisson process. Individual per-fault failure sequences (resulting from delayed fault detection and software correction) during test execution

W. K. Ehrlich; A. Iannino; B. S. Prasanna; J. P. Stampfel; J. R. Wu

1991-01-01

113

Heart failure caused by toxoplasmosis in a fennec fox (Fennecus zerda).  

PubMed

A male fennec fox (Fennecus zerda) kit was examined for lethargy, inappetence, and weight loss. Clinical findings included respiratory distress, a gallop rhythm, and retinochoroiditis. Radiography indicated pleural effusion and cardiomegaly. Echocardiographic findings included left ventricular dilatation, low left ventricular ejection fraction, and atrioventricular valvular regurgitation. Necropsy findings were compatible with a diagnosis of congestive heart failure caused by myocarditis. Histopathology showed a disseminated infection with Toxoplasma gondii causing myocarditis, skeletal polymyositis, gastrointestinal myositis, and panuveitis. Toxoplasma-induced myocarditis should be included in the differential diagnosis of heart failure and retinochoroiditis in the fennec fox. PMID:15533972

Kottwitz, Jack J; Preziosi, Diane E; Miller, Margaret A; Ramos-Vara, Jose A; Maggs, David J; Bonagura, John D

114

Acute phase protein changes in calves during an outbreak of respiratory disease caused by bovine respiratory syncytial virus  

Microsoft Academic Search

Bovine acute phase proteins (APPs), lipopolysaccharide binding protein (LBP), serum amyloid A (SAA), haptoglobin (Hp) and alpha1-acid glycoprotein (AGP) were evaluated as inflammatory markers during an outbreak of bovine respiratory disease (BRD) caused by bovine respiratory syncytial virus (BRSV). Calves (n=10) presented mild to moderate signs of respiratory disease. Secondary bacterial infections, Pasteurella multocida and Mycoplasma dispar as major species,

Toomas Orro; Tarja Pohjanvirta; Ulla Rikula; Anita Huovilainen; Sakari Alasuutari; Liisa Sihvonen; Sinikka Pelkonen; Timo Soveri

2011-01-01

115

Postmortem diagnosis of acute myocardial infarction in patients with acute respiratory failure - demographics, etiologic and pulmonary histologic analysis  

PubMed Central

OBJECTIVES: Acute respiratory failure is present in 5% of patients with acute myocardial infarction and is responsible for 20% to 30% of the fatal post-acute myocardial infarction. The role of inflammation associated with pulmonary edema as a cause of acute respiratory failure post-acute myocardial infarction remains to be determined. We aimed to describe the demographics, etiologic data and histological pulmonary findings obtained through autopsies of patients who died during the period from 1990 to 2008 due to acute respiratory failure with no diagnosis of acute myocardial infarction during life. METHODS: This study considers 4,223 autopsies of patients who died of acute respiratory failure that was not preceded by any particular diagnosis while they were alive. The diagnosis of acute myocardial infarction was given in 218 (4.63%) patients. The age, sex and major associated diseases were recorded for each patient. Pulmonary histopathology was categorized as follows: diffuse alveolar damage, pulmonary edema, alveolar hemorrhage and lymphoplasmacytic interstitial pneumonia. The odds ratio of acute myocardial infarction associated with specific histopathology was determined by logistic regression. RESULTS: In total, 147 men were included in the study. The mean age at the time of death was 64 years. Pulmonary histopathology revealed pulmonary edema as well as the presence of diffuse alveolar damage in 72.9% of patients. Bacterial bronchopneumonia was present in 11.9% of patients, systemic arterial hypertension in 10.1% and dilated cardiomyopathy in 6.9%. A multivariate analysis demonstrated a significant positive association between acute myocardial infarction with diffuse alveolar damage and pulmonary edema. CONCLUSIONS: For the first time, we demonstrated that in autopsies of patients with acute respiratory failure as the cause of death, 5% were diagnosed with acute myocardial infarction. Pulmonary histology revealed a significant inflammatory response, which has not previously been reported.

de Matos Soeiro, Alexandre; Ruppert, Aline D; Canzian, Mauro; Capelozzi, Vera L; Serrano, Carlos V

2012-01-01

116

Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation  

Microsoft Academic Search

Objective: To evaluate non-invasive ventilation (NIV) prospectively in a group of patients developing acute respiratory failure (ARF) after bilateral lung transplantation (BLT). Setting: General intensive care unit (ICU) of Rome \\

M. Rocco; G. Conti; M. Antonelli; M. Bufi; M. Costa; D. Alampi; F. Ruberto; G. Stazi; P. Pietropaoli

2001-01-01

117

Tetraplegia and respiratory failure following mild cervical trauma in a child with Cornelia De Lange syndrome.  

PubMed

Here we report a 6-year-old female patient with Cornelia de Lange syndrome who developed tetraplegia and respiratory failure after a seemingly trivial spinal trauma due to an spinal malformation that has not yet been described. PMID:19221546

Del Gaudio, A; Varano, L; Perrotta, F; Sorrentino, E; Pagano, A

2009-03-01

118

Clinical and electrophysiological predictors of respiratory failure in Guillain-Barré syndrome: a prospective study  

Microsoft Academic Search

Summary Background Respiratory failure is the most serious short-term complication of Guillain-Barré syndrome and can require invasive mechanical ventilation in 20-30% of patients. We sought to identify clinical and electrophysiological predictors of respiratory failure in the disease. Methods We prospectively assessed electrophysiological data and clinical factors, including identifi ed predictors of delay between disease onset and admission, inability to lift

Marie-Christine Durand; Raphaël Porcher; David Orlikowski; Jérôme Aboab; Christian Devaux; Bernard Clair; Djillali Annane; Jean-Louis Gaillard; Frédéric Lofaso; Jean-Claude Raphael; Tarek Sharshar

2006-01-01

119

Total extracorporeal arteriovenous carbon dioxide removal in acute respiratory failure: a phase I clinical study  

Microsoft Academic Search

Objective: To evaluate the safety and efficacy of pumpless extracorporeal arteriovenous carbon dioxide removal (AVCO2R) in subjects with acute respiratory failure and hypercapnia. Design: A phase I within-group time series trial in which subjects underwent up to 72 h of support with AVCO2R in intensive care units of two university hospitals. Patients: Eight patients with acute hypercapnic respiratory failure or

Steven A. Conrad; Joseph B. Zwischenberger; Laurie R. Grier; Scott K. Alpard; Akhil Bidani

2001-01-01

120

Market Failure Caused by Quality Uncertainty  

Microsoft Academic Search

The classical argument used to explain why markets can fail when there is product quality variability (e.g. the used car market) relies heavily on the presence of asymmetric information —i.e. there must exist some reliable quality indicators that can be observed by sellers, but not by buyers. Using computer simulation, this paper illustrates how such market failures can occur even

Segismundo S. Izquierdo; Luis R. Izquierdo; José M. Galán

121

Stress Related Failures Causing Open Metallization.  

National Technical Information Service (NTIS)

Non-linear Finite Element Analysis has been used to model stresses and infer stress induced void formation in narrow Al-S; metal lines. Observed failures correlate well with calculated stresses determined by varying intrinsic stress of the passivation, to...

S. K. Groothuis

1988-01-01

122

Outside force causes most natural gas pipeline failures  

Microsoft Academic Search

Damage from a force outside the pipeline is the primary cause of natural-gas pipeline service failures in the U.S. The second and third main causes of line service failures are material failure and corrosion. These are the major conclusions of an analysis of reports of line service incidents filed with the U.S. Department and Transportation (DOT). The study, covering incident

R. J. Eiber; D. J. Jones; G. S. Kramer

1987-01-01

123

Dexmedetomidine for sedation in the parturient with respiratory failure requiring noninvasive ventilation.  

PubMed

Dexmedetomidine is a selective alpha-2 receptor agonist that possesses both sedative and analgesic properties, with minimal respiratory depression. We report the successful administration of dexmedetomidine on a 16-year-old primigravida woman that allowed the patient to tolerate application of bi-level positive airway pressure ventilation in treatment of acute hypoxemic respiratory failure. PMID:22709960

Duan, Melissa; Lee, Jarone; Bittner, Edward A

2012-06-15

124

Noninvasive positive pressure ventilation in the management of acute respiratory failure due to osteogenesis imperfecta  

Microsoft Academic Search

The development of acute respiratory failure (ARF) secondary to respiratory tract infection is a common event in patients affected with osteogenesis imperfecta type III. Noninvasive positive pressure ventilation (NPPV) is increasingly administered to treat severe ARF of various origin. The use of NPPV in two patients with severe ARF secondary to osteogenesis imperfecta type III is presented.

Giovanna Arcaro; Fausto Braccioni; Federico Gallan; Maria Rita Marchi; Andrea Vianello

125

Noninvasive Positive Pressure Ventilation Treatment for Acute Respiratory Failure in SARS  

Microsoft Academic Search

This study describes the blood gases features and short-term outcomes with noninvasive positive pressure ventilation (NPPV) treatment in the management of acute respiratory failure (ARF) during a severe acute respiratory syndrome (SARS) epidemic. Between April 22 and May 1, 2003, 120 patients meeting clinical criteria for SARS were admitted to a hospital for infectious diseases in Beijing, China. At 6

Fang Han; Yu Y. Jiang; Jian H. Zheng; Zhan C. Gao; Quan Y. He

2004-01-01

126

Inhaled prostacyclin and high-frequency oscillatory ventilation in a premature infant with respiratory syncytial virus-associated respiratory failure.  

PubMed

In a 29-day-old premature infant with respiratory syncytial virus (RSV) pneumonia, we have shown an additive effect of high-frequency oscillatory ventilation (HFOV) and continuous inhalation of prostacyclin (iPGI(2)) with improvement of ventilation and oxygenation. The addition of continuous inhaled iPGI(2) to HFOV was beneficial in the treatment of hypoxemic respiratory failure owing to RSV-associated pneumonia. The improvement in alveolar recruitment by increasing lung expansion by HFOV along with less ventilation-perfusion mismatch by iPGI(2) appears to be responsible for the synergistic effect and favorable clinical outcome. We conclude that the combined therapy of HFOV and continuous inhaled iPGI(2) may be considered in RSV-associated hypoxemic respiratory failure in pediatric patients. PMID:22753555

Gupta, Manoj; Guertin, Stephen; Martin, Steve; Omar, Said

2012-07-02

127

RESPIRATORY SYNCYTIAL VIRUS: AN IMPORTANT CAUSE OF ACUTE RESPIRATORY ILLNESS AMONG YOUNG ADULTS UNDERGOING MILITARY TRAINING  

PubMed Central

SUMMARY Background Military recruits receiving training are vulnerable to acute respiratory disease and a significant proportion of illness is due to unidentified pathogens. While some countries use surveillance programs to monitor such illness, few data exist for recruits of the British Armed Forces. Objectives Through active surveillance of approximately 1000 Royal Navy trainees during 2001, we sought to describe and determine the aetiology of acute respiratory illness. Methods Standard viral culture was used together with serology and a novel highly sensitive real-time PCR and molecular beacon probe assay for RSV detection. Results Among 54 Royal Navy recruits with respiratory symptoms adenovirus was identified in 35%, influenza viruses in 19% and RSV in 14% of this group. All of the recruits were absent from training for almost a week, most of whom were confined to the sickbay. Conclusions This study is the first to document adenovirus and RSV as important causes of acute respiratory illness among Royal Navy trainees. The study findings demonstrate the clinical significance and challenges of diagnosing RSV infection in young adults.

O'Shea, Matthew K.; Pipkin, Christopher; Cane, Patricia A.; Gray, Gregory C.

2008-01-01

128

Common-Cause Failure Analysis in Event Assessment  

SciTech Connect

This paper describes the approach taken by the U. S. Nuclear Regulatory Commission to the treatment of common-cause failure in probabilistic risk assessment of operational events. The approach is based upon the Basic Parameter Model for common-cause failure, and examples are illustrated using the alpha-factor parameterization, the approach adopted by the NRC in their Standardized Plant Analysis Risk (SPAR) models. The cases of a failed component (with and without shared common-cause failure potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g., failure to start and failure to run) is a new feature of this paper. These methods are being applied by the NRC in assessing the risk significance of operational events for the Significance Determination Process (SDP) and the Accident Sequence Precursor (ASP) program.

Dana L. Kelly; Dale M. Rasmuson

2008-09-01

129

Failure Causes of a Polymer Resettable Circuit Protection Device  

NASA Astrophysics Data System (ADS)

As a circuit protection device, failure or abnormal behavior of polymer positive-temperature-coefficient resettable devices can cause damage to circuits. Identification of failure modes and determination of failure causes are necessary to improve the reliability of resettable circuit protection devices and understand their limitations. In this study, a series of experiments was conducted to identify the failure modes of polymer positive-temperature- coefficient resettable circuit protection devices. The causes of failures of a polymer positive-temperature-coefficient resettable circuit protection device were determined by failure analyses, including analysis of the increase in surface temperature using an infrared camera, interconnection analysis using cross-sectioning and environmental scanning electron microscopy, analysis of the microstructures of carbon-black-filled polymer composite, thermal property analysis of the polymer composite, and coefficient of thermal expansion analysis of different parts of the resettable circuit protection device.

Cheng, Shunfeng; Tom, Kwok; Pecht, Michael

2012-09-01

130

Partial 3-methylcrotonyl-CoA carboxylase deficiency in an infant with fatal outcome due to progressive respiratory failure  

Microsoft Academic Search

Isolated partial 3-methylcrotonyl-CoA carboxylase (MCC) deficiency has been described to be the cause for a distinct relatively\\u000a mild clinical picture in a single patient. We describe another patient with isolated partial MCC deficiency who suffered from\\u000a failure to thrive, muscular hypotonia and progressive respiratory insufficiency with fatal outcome at the age of 6.5 months.\\u000a MCC deficiency was suspected at 3

U. N. Wiesmann; T. Suormala; J. Pfenninger; E. R. Baumgartner

1998-01-01

131

Common-Cause Failure Analysis in Event Assessment  

SciTech Connect

This paper reviews the basic concepts of modelling common-cause failures (CCFs) in reliability and risk studies and then applies these concepts to the treatment of CCF in event assessment. The cases of a failed component (with and without shared CCF potential) and a component being unavailable due to preventive maintenance or testing are addressed. The treatment of two related failure modes (e.g. failure to start and failure to run) is a new feature of this paper, as is the treatment of asymmetry within a common-cause component group.

D. M. Rasmuson; D. L. Kelly

2008-06-01

132

Failure of automobile seat belts caused by polymer degradation  

Microsoft Academic Search

This paper analyzes the failure of a particular brand of automobile seat belts. The failures described were part of what nearly became the most expensive and widespread automobile recall in U.S. history, affecting about 8.8 x 106 vehicles and with a potential total cost of U.S. $109 . The failures were caused by the degradation and fracture of the seat

J. M. Henshaw; V. Wood; A. C. Hall

1999-01-01

133

Bilateral posterior ischaemic optic neuropathy after severe diabetic ketoacidosis, cardiopulmonary resuscitation and respiratory failure.  

PubMed

A 44-year-old male European with type I diabetes mellitus fell into diabetic ketoacidosis. In the emergency room, he developed an episode of asystole and respiratory failure requiring one cycle of cardiopulmonary resuscitation and extracorporeal membrane oxygenation (ECMO). Waking up 7 days later, he presented a bilateral complete loss of vision. Ophthalmological examination including funduscopy on days 1 and 10, after extubation, showed bilateral large round pupils non-reactive to light and a normal fundus. Neuroimaging studies, including MRI and MRA of the brain, were all within normal limits. A lumbar puncture and comprehensive serological testing excluded an infectious or rheumatic cause. An empirical high-dose intravenous steroid treatment administered for 5 days had no effect on his vision. His eye examination at 1.5 months follow-up showed a normal fundus except for progressive bilateral optic nerve disc pallor, which pointed towards the diagnosis of a posterior ischaemic optic neuropathy. PMID:23417383

Wirth, Christina Doris; Leitner, Christoph; Perrig, Martin

2013-02-14

134

Gorham syndrome with postoperative respiratory failure and requiring prolonged mechanical ventilation.  

PubMed

Gorham syndrome is a rare disease that presents as progressive osteolysis, and may affect any part of the skeleton. The pathologic process involves the replacement of normal bone by aggressively expanding but non-neoplastic vascular tissue, resulting in massive osteolysis of the adjacent bone. If the spine and ribs are affected, the subsequent kyphosis and chest wall deformity may cause severe restrictive ventilatory impairment. We report a 34-year-old male with Gorham syndrome presenting as progressive kyphosis, severe back pain, unstable gait, and exertional dyspnea. Pulmonary function testing revealed severe restrictive ventilatory impairment. He underwent spinal surgery but could not be extubated after surgery. Postoperative left lower lung pneumonia and respiratory failure required prolonged mechanical ventilation. After a weaning program of pressure support ventilation and T-piece spontaneous breathing trials, he was successfully weaned from mechanical ventilation. PMID:23550170

Huang, Shiang-Yu; Lee, Ying-Min; Tzeng, Shiau-Tzu; Su, Chiu-Ping; Huang, Shiu-Feng; Wu, Yao-Kuang; Lan, Chou-Chin

2013-04-02

135

[Hypocalcemic dilated cardiomyopathy: rare cause of heart failure].  

PubMed

Hypocalcemic dilated cardiomyopathy is a rare cause of heart failure in adults. We report a case in a 19-year-old woman who developed congestive heart failure induced by severe chronic hypocalcemia disclosing primary hypoparathyroidism. Complete regression of the clinical signs was achieved with vitamin-calcium treatment, but left ventricular systolic dysfunction persisted eight months after treatment. PMID:11965090

Chraibi, S; Drighl, A; Nafidi, S; Zahraoui, M; Tahiri, A; Chraibi, N

2001-11-01

136

Early malperfusion, ischemia reperfusion injury, and respiratory failure in acute complicated type B aortic dissection after thoracic endovascular repair  

PubMed Central

Background The aim of this study was to determine the early mortality and major complications of acute complicated type B aortic dissection (ACBD) after thoracic endovascular aortic repair (TEVAR). Methods Twenty-six consecutive patients with ACBD who underwent TEVAR were included. Clinical indications before TEVAR and in-hospital mortality and major complications after TEVAR were analyzed and compared with similar reports. Results TEVAR was technically successful in all cases. In-hospital mortality occurred in four patients (15%), and major complications occurred in an additional four patients (15%). Three of the four (75%) of the deaths were associated with malperfusion and ischemia reperfusion injury (IRI), and 3/4 (75%) of the major complications were caused by respiratory failure (RF). Conclusions In-hospital mortality associated strongly with severe end-organ malperfusion and IRI, while major complications associated with RF, during TEVAR. Our results indicate that malperfusion, IRI and respiratory failure during TEVAR should be carefully monitored and aggressively treated.

2013-01-01

137

Failure Caused by Breaching in Subaqueous Sand  

Microsoft Academic Search

Breaching can generate sustained turbidity flows in submarine canyon heads or delta mouths; it is caused by shear dilation. We conduct flume experiments and analyze pore pressure changes due to shear dilation during breaching. We deposit and consolidate fine-grained sand 9cm deep and 6cm long at one end of a 29cm long water-filled tank placed on flat surface. Breaching is

Y. You; P. B. Flemings; D. C. Mohrig

2009-01-01

138

Peri-operative respiratory failure in a cirrhotic patient: a misleading diagnosis.  

PubMed

Patients with chronic liver disease may present with different degrees of respiratory dysfunction whose differential diagnosis is important before elective surgery. We report the case of a misleading diagnosis of peri-operative respiratory failure in a cirrhotic patient who underwent mastectomy. Intra-operative respiratory failure was ascribed by the anaesthetic team to pulmonary embolism and after the operation this diagnosis was still suspected. Despite postoperative heparin treatment, pulmonary gas exchange remained severely impaired. On the hypothesis of a right to left shunt, we performed transoesophageal echocardiography with a bubble test and confirmed hepatopulmonary syndrome. We administered anticoagulant therapy to the patient following surgery, increasing the risk of haemorrhage. We also continued orotracheal intubation and mechanical ventilation longer than was needed. Respiratory symptoms in a patient with liver disease should not be underestimated and up to 20% of these patients may have hepatopulmonary syndrome. PMID:17697229

Busani, S; Rinaldi, L; Barbieri, E; Drago, A; Barbieri, A; Girardis, M

2007-09-01

139

Hypercapnic respiratory failure due to L-tryptophan-induced eosinophilic polymyositis.  

PubMed

A 24-year-old man presenting with fever, rash, and myalgias subsequently developed hypercapnic respiratory failure and severe limb muscle weakness. Muscle biopsy revealed eosinophilic myositis, due to the ingestion of large quantities of L-tryptophan as a dietary supplement. Complete recovery occurred with corticosteroid administration. Significant involvement of the respiratory muscles can be a predominant feature of this newly described disease entity. PMID:1995239

Ivey, M; Eichenhorn, M S; Glasberg, M R; Hyzy, R C

1991-03-01

140

Noninvasive Positive Pressure Ventilation in Acute Respiratory Failure of Chronic Obstructive Pulmonary Disease  

Microsoft Academic Search

.   Noninvasive positive pressure ventilation (NPPV) has reemerged as an effective strategy for reducing morbidity and mortality\\u000a associated with acute exacerbations of chronic obstructive pulmonary disease (COPD). During acute respiratory failure, dynamic\\u000a hyperinflation, intrinsic PEEP, and increased airway resistance result in a mechanical workload that exceeds inspiratory muscle\\u000a capacity. NPPV provides augmentation of alveolar ventilation and respiratory muscle rest. Observational,

H. E. Clark; P. G. Wilcox

1997-01-01

141

Emerging indications for extracorporeal membrane oxygenation in adults with respiratory failure.  

PubMed

Recent advances in technology have spurred the increasing use of extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure. However, this accounts for only a small percentage of patients with respiratory failure. We envision the application of ECMO in many other forms of respiratory failure in the coming years. Patients with less severe forms of acute respiratory distress syndrome, for instance, may benefit from enhanced lung-protective ventilation with the very low tidal volumes made possible by direct carbon dioxide removal from the blood. For those in whom hypercapnia predominates, extracorporeal support will allow for the elimination of invasive mechanical ventilation in some cases. The potential benefits of ECMO may be further enhanced by improved techniques, which facilitate active mobilization. Although ECMO for these and other expanded applications is under active investigation, it has yet to be proven beneficial in these settings in rigorous controlled trials. Ultimately, with upcoming and future technological advances, there is the promise of true destination therapy, which could lead to a major paradigm shift in the management of respiratory failure. PMID:23952860

Abrams, Darryl; Brodie, Daniel

2013-08-01

142

[Frontotemporal dementia with motor neuron disease diagnosed after the development of type II respiratory failure].  

PubMed

A 79-year-old woman attended the Center for Comprehensive Care of Memory Disorders at the Kyorin University Hospital in 2006 due to forgetfulness. Her initial diagnosis was vascular dementia. In 2007, her cognition declined gradually. Then, impaired verbal fluency and stuttering, the symptoms of non-fluent aphasia, were presented. Thereafter, 5 mg/day donepezil hydrochloride was prescribed. She later suffered type II respiratory failure. Needle electromyography revealed denervation of lower motor neurons. This led to the diagnosis of frontotemporal dementia with motor neuron disease. Interestingly, before developing type II respiratory failure, cognitive decline and non-fluent aphasia occurred in this case. PMID:20139654

Satomura, Hajime; Kobayashi, Yoshio; Kozaki, Koichi; Hattanmaru, Mikiko; Tanaka, Masamichi; Sato, Michiko; Moriya, Yukiko; Inoue, Shinichiro; Hasegawa, Hiroshi; Toba, Kenji

2009-01-01

143

Comparison of High Frequency Positive Pressure Mechanical Ventilation (HFPPV) With Conventional Method in the Treatment of Neonatal Respiratory Failure  

PubMed Central

Background Respiratory failure is a major problem in neonatal medicine in all over the world and has different causes. Using mechanical ventilation is one of its major treatments. Objectives Different strategies have been expressed in this context, including high frequency mechanical ventilation. Patients and Methods This study is a prospective randomized clinical trial conducted on all newborns with respiratory failure hospitalized in the NICU of Tehran vali-asr Hospital during 2009.These patients were divided in to two groups through block Randomization method; conventional mechanical ventilation group and high frequency ventilation group. Results Intraventricular hemorrhage (IVH) and air leak (e.g. pneumothorax) were less in HFPPV group than conventional group (P = 0.012 and P = 0.038). The mean time needed for mechanical ventilation was lower in HFPPV group, but this difference was not statistically significant (P = 0.922). Needing to O2 in 28 days of age was almost equal in both groups (P = 0. 99). Mortality, and refractory hypoxia and PVL were lower in HFPPV group, but the difference was not statistically significant (P = 0.301, P = 0. 508, P = 0. 113). Conclusions Treatment of neonatal respiratory failure with high rate mechanical ventilation may reduce some complications.

Amini, Elahe; Nayeri, Fatemeh Sadat; Hemati, Arezu; Esmaeilinia, Tahere; Nili, Firuzeh; Dalili, Hossein; Aminnejad, Majid

2013-01-01

144

Common-Cause Failure Analysis in Event Assessment.  

National Technical Information Service (NTIS)

This paper describes the approach taken by the U. S. Nuclear Regulatory Commission to the treatment of common-cause failure in probabilistic risk assessment of operational events. The approach is based upon the Basic Parameter Model for common-cause failu...

D. L. Kelly D. M. Rasmuson

2008-01-01

145

Noninvasive Positive-Pressure Ventilation for Respiratory Failure after Extubation  

Microsoft Academic Search

background The need for reintubation after extubation and discontinuation of mechanical ventilation is not uncommon and is associated with increased mortality. Noninvasive positive- pressure ventilation has been suggested as a promising therapy for patients with respi- ratory failure after extubation, but a single-center, randomized trial recently found no benefit. We conducted a multicenter, randomized trial to evaluate the effect of

Andrés Esteban; Fernando Frutos-Vivar; Niall D. Ferguson; Yaseen Arabi; Carlos Apezteguía; Marco González; Scott K. Epstein; Nicholas S. Hill; Stefano Nava; Marco-Antonio Soares; Gabriel D'Empaire; Inmaculada Alía; Antonio Anzueto

2004-01-01

146

Inhaled nitric oxide in acute respiratory failure: Dose-response curves  

Microsoft Academic Search

Objective: To determine the dose-response curve of inhaled nitric oxide (NO) in terms of pulmonary vasodilation and improvement in PaO2 in adults with severe acute respiratory failure. Design: Prospective randomized study. Setting: A 14-bed ICU in a teaching hospital. Patients: 6 critically ill patients with severe acute respira- tory failure (lung injury severity score >__ 2.5) and pulmo- nary hypertension.

L. Puybasset; J. J. Rouby; E. Mourgeon; T. E. Stewart; P. Cluzel; M. Arthaud; P. Poète; L. Bodin; A. M. Korinek; P. Viars

1994-01-01

147

Respiratory chain complex I deficiency caused by mitochondrial DNA mutations  

PubMed Central

Defects of the mitochondrial respiratory chain are associated with a diverse spectrum of clinical phenotypes, and may be caused by mutations in either the nuclear or the mitochondrial genome (mitochondrial DNA (mtDNA)). Isolated complex I deficiency is the most common enzyme defect in mitochondrial disorders, particularly in children in whom family history is often consistent with sporadic or autosomal recessive inheritance, implicating a nuclear genetic cause. In contrast, although a number of recurrent, pathogenic mtDNA mutations have been described, historically, these have been perceived as rare causes of paediatric complex I deficiency. We reviewed the clinical and genetic findings in a large cohort of 109 paediatric patients with isolated complex I deficiency from 101 families. Pathogenic mtDNA mutations were found in 29 of 101 probands (29%), 21 in MTND subunit genes and 8 in mtDNA tRNA genes. Nuclear gene defects were inferred in 38 of 101 (38%) probands based on cell hybrid studies, mtDNA sequencing or mutation analysis (nuclear gene mutations were identified in 22 probands). Leigh or Leigh-like disease was the most common clinical presentation in both mtDNA and nuclear genetic defects. The median age at onset was higher in mtDNA patients (12 months) than in patients with a nuclear gene defect (3 months). However, considerable overlap existed, with onset varying from 0 to >60 months in both groups. Our findings confirm that pathogenic mtDNA mutations are a significant cause of complex I deficiency in children. In the absence of parental consanguinity, we recommend whole mitochondrial genome sequencing as a key approach to elucidate the underlying molecular genetic abnormality.

Swalwell, Helen; Kirby, Denise M; Blakely, Emma L; Mitchell, Anna; Salemi, Renato; Sugiana, Canny; Compton, Alison G; Tucker, Elena J; Ke, Bi-Xia; Lamont, Phillipa J; Turnbull, Douglass M; McFarland, Robert; Taylor, Robert W; Thorburn, David R

2011-01-01

148

Respiratory chain complex I deficiency caused by mitochondrial DNA mutations.  

PubMed

Defects of the mitochondrial respiratory chain are associated with a diverse spectrum of clinical phenotypes, and may be caused by mutations in either the nuclear or the mitochondrial genome (mitochondrial DNA (mtDNA)). Isolated complex I deficiency is the most common enzyme defect in mitochondrial disorders, particularly in children in whom family history is often consistent with sporadic or autosomal recessive inheritance, implicating a nuclear genetic cause. In contrast, although a number of recurrent, pathogenic mtDNA mutations have been described, historically, these have been perceived as rare causes of paediatric complex I deficiency. We reviewed the clinical and genetic findings in a large cohort of 109 paediatric patients with isolated complex I deficiency from 101 families. Pathogenic mtDNA mutations were found in 29 of 101 probands (29%), 21 in MTND subunit genes and 8 in mtDNA tRNA genes. Nuclear gene defects were inferred in 38 of 101 (38%) probands based on cell hybrid studies, mtDNA sequencing or mutation analysis (nuclear gene mutations were identified in 22 probands). Leigh or Leigh-like disease was the most common clinical presentation in both mtDNA and nuclear genetic defects. The median age at onset was higher in mtDNA patients (12 months) than in patients with a nuclear gene defect (3 months). However, considerable overlap existed, with onset varying from 0 to >60 months in both groups. Our findings confirm that pathogenic mtDNA mutations are a significant cause of complex I deficiency in children. In the absence of parental consanguinity, we recommend whole mitochondrial genome sequencing as a key approach to elucidate the underlying molecular genetic abnormality. PMID:21364701

Swalwell, Helen; Kirby, Denise M; Blakely, Emma L; Mitchell, Anna; Salemi, Renato; Sugiana, Canny; Compton, Alison G; Tucker, Elena J; Ke, Bi-Xia; Lamont, Phillipa J; Turnbull, Douglass M; McFarland, Robert; Taylor, Robert W; Thorburn, David R

2011-03-02

149

Lung Transplantation for Respiratory Failure Resulting From Systemic Disease  

Microsoft Academic Search

Background. Lung transplantation for pulmonary failure resulting from systemic disease is controversial. We reviewed our transplant experience in patients with sarcoidosis, scleroderma, lymphangioleiomyomatosis, and graft-versus-host disease.Methods. This retrospective review examined the outcome of 23 patients who underwent pulmonary transplantation for these systemic diseases. Group 1 included 15 patients with pulmonary hypertension who underwent transplantation (9 for sarcoidosis, 6 for scleroderma),

Frank A. Pigula; Bartley P. Griffith; Marco A. Zenati; James H. Dauber; Samuel A. Yousem; Robert J. Keenan

1997-01-01

150

Fiberoptic Bronchoscopy during Nasal Non-Invasive Ventilation in Acute Respiratory Failure  

Microsoft Academic Search

Background: Various methods have been described for safely performing fiberoptic bronchoscopy (FB) while applying non-invasive positive pressure ventilation (NIPPV) in patients with acute respiratory failure (ARF). Objectives: To evaluate the safety of a new method to perform FB in patients with ARF. Methods: Patients with ARF in whom FB was indicated were studied. The primary end-point was a mean drop

E. Chiner; J. N. Sancho-Chust; M. Llombart; C. Senent; A. Camarasa; J. Signes-Costa

2010-01-01

151

Early exercise rehabilitation of muscle weakness in acute respiratory failure patients.  

PubMed

Acute respiratory failure patients experience significant muscle weakness, which contributes to prolonged hospitalization and functional impairments after hospital discharge. Based on our previous work, we hypothesize that an exercise intervention initiated early in the intensive care unit aimed at improving skeletal muscle strength could decrease hospital stay and attenuate the deconditioning and skeletal muscle weakness experienced by these patients. PMID:23873130

Berry, Michael J; Morris, Peter E

2013-10-01

152

SUMMARY Can impairments of thyroid function test affect prognosis in patients with respiratory failure?  

Microsoft Academic Search

Thyroid function test (TFT) impairments can be detected in extrathyroidal dysfunction, primarily in chronic obstructive pul- monary disease (COPD) with acute respiratory failure (RF). The aims of this study were to: (i) evaluate TFT impairments in patients with RF, (ii) compare TFT results to a control group without RF and (iii) assess the effects of thyroid dysfuncti- on on clinical

Özen K. BA?O?LU; Alev GÜRGÜN; Firat BAYRAKTAR; Birgül KIRAN; Mustafa Hikmet ÖZHAN

153

Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure due to Severe Acute Pancreatitis  

Microsoft Academic Search

Background:Patients with acute pancreatitis (AP) who require mechanical ventilation have high morbidity and mortality rates. Noninvasive positive pressure ventilation (NPPV) delivered through a mask has become increasingly popular for the treatment of acute respiratory failure (ARF) and may limit some mechanical ventilation complications. Objectives: The purpose of this retrospective, observational study was to evaluate our clinical experience with the use

Samir Jaber; Gérald Chanques; Mustapha Sebbane; Farida Salhi; Jean-Marc Delay; Pierre-François Perrigault; Jean-Jacques Eledjam

2006-01-01

154

Efficacy of Noninvasive Positive Pressure Ventilation in Elderly Patients with Acute Hypercapnic Respiratory Failure  

Microsoft Academic Search

Background: There have been no reports on the efficacy of noninvasive positive pressure ventilation (NPPV) in elderly patients. Objectives: The purpose of this study was to clarify the efficacy and identify the predictors of a successful outcome of NPPV in patients over the age of 75 years with acute hypercapnic respiratory failure (AHRF). Methods: We retrospectively evaluated the data of

Yohei Kida; Yoshiaki Minakata; Yoichi Yamada; Masakazu Ichinose

2012-01-01

155

Management of respiratory failure with ventilation via intranasal stents in cystic fibrosis  

PubMed Central

The case history is presented of a patient with acute respiratory failure complicated by nasal obstruction resulting in intolerance of nasal ventilation. Urgent insertion of nasal stents permitted restoration of ventilation with resolution of breathlessness and stabilisation of arterial blood gases.??

Edenborough, F; Wildman, M; Morgan, D

2000-01-01

156

Oxygenation Index Predicts Outcome in Children with Acute Hypoxemic Respiratory Failure  

Microsoft Academic Search

To define outcome and time dependence of predictors of outcome in pediatric acute hypoxemic respiratory failure, 131 patients (age range, 1 month to 18 years) were prospectively followed. Paramet- ric models were used to describe time-related events, and compet- ing risks analysis was performed for mortality estimates. Multiple logistic analysis was applied to describe time-related predictors of ventilation time and

Daniel Trachsel; Brian W. McCrindle; Satoshi Nakagawa; Desmond Bohn

157

ECMO in acute and chronic adult respiratory failure: recent trends and future directions.  

PubMed

Extracorporeal membrane oxygenation (ECMO) can be used to preserve or enhance systemic oxygen delivery in patients with refractory cardiac or respiratory failure. Although widely accepted as a standard of care for many indications in children and for adult cardiogenic shock, ECMO for adult respiratory failure is more controversial. This controversy arose over thirty years ago after the disappointing results of the first flawed, randomized study and is fueled by a group of non-ECMO clinicians who repeatedly criticize the methodology of more recent studies which show probable benefit. In spite of this, there is probably now more evidence to support the use of ECMO in refractory acute respiratory distress syndrome than for any other form of rescue therapy. The purpose of this review is to update clinicians regarding trends in ECMO research over the last 12 months and speculate on how the clinical use of ECMO and associated technology will evolve. PMID:23752720

Maclaren, G; Brain, M J; Butt, W W

2013-06-10

158

Acute Stridor and Respiratory Failure due to Retrosternal Subglottic Stenosis of Unknown Origin.  

PubMed

Respiratory failure due to subglottic stenosis is a rare but serious condition. A 22-year-old male presented to the emergency department (ED) with shortness of breath, stridor, and change in tone of voice. The patient did not complain of B-symptoms (fever, weight loss, and night sweats). In the week before this presentation, he was diagnosed with an upper respiratory tract infection with associated bronchospasm and discharged on oral antibiotics and inhaled salbutamol without effect. He developed hypercapnic respiratory failure in the ED after a coughing episode. A normal nasopharyngoscopic examination and a subtle mediastinal abnormality on chest radiograph lead to a working diagnosis of retrosternal subglottic obstruction. The complexities of his airway management and suggestions for multidisciplinary approach are discussed. PMID:23956890

Vithanage, Tharindu; Keijzers, Gerben; Willis, Nicola Jane; Cochrane, Tara; Smith, Linda

2013-07-15

159

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

Microsoft Academic Search

Background  Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is a rare autosomal recessive neuromuscular disease of unknown prevalence characterized by degeneration of anterior horn ?-motoneurons and manifesting in the first 6?months of life as life-threatening irreversible diaphragmatic paralysis associated with progressive symmetrical muscular weakness (distal lower limbs mainly involved), muscle atrophy, and peripheral sensory neuropathy.Setting  Pediatric intensive care unit of tertiary

Alberto Giannini; Anna Maria Pinto; Giordano Rossetti; Edi Prandi; Danilo Tiziano; Christina Brahe; Nardo Nardocci

2006-01-01

160

[Learning from failure - implications for respiratory and intensive care medicine: a conceptual review].  

PubMed

The clinical, social and economical impact of failure in medicine [i. e., adverse health care events (AHCE)] is overwhelming. Respiratory and intensive care medicine are strongly relevant to AHCE, particularly in cases associated with respiratory failure, mechanical ventilation and pharmacotherapy. In spite of the obvious necessity to learn from AHCE, its realisation in health-care organisations is still rare. This conceptual review therefore aims to (i) clarify the most relevant terminology, (ii) identify obstacles related to this health-care topic, and (iii) present possible strategies for solving the problems, thereby enabling respiratory and intensive care medicine to systematically and effectively learn from failure. A review of the literature (effective as of June 2013) derived from the electronic databases Medline via PubMed, EMBASE, ERIC and Google Scholar identified the following relevant obstacles (ii): a so-called blame culture associated with concealing failure, missing system analyses (vs. individual breakdown), and (economically) misdirected incentives. Possible strategies to overcome these obstacles (iii) include acknowledging the importance of leadership, a safe environment, open reporting, an effective feedback culture, and detection (e. g., trigger-tools), analysis and discussion (e. g., double loop learning) of failure. The underlying reasons for the occurrence of AHCE are based on structural, organisational and human shortcomings, and affect all categories of caregivers. Approaches to solving the problem should therefore focus primarily on the entire system, rather than on the individual alone. PMID:23846430

Kabitz, H-J

2013-07-11

161

Causes of growth failure in growth failure in a model of neonatal zinc (Zn) deficiency  

Technology Transfer Automated Retrieval System (TEKTRAN)

Zn deficiency is a common cause of growth failure in children in developing countrie,s and Zn supplementation can significantly improve growth of at-risk populations. Although Zn deficiency leads to anorexia and poor growth, it is unclear whether anorexia is the sole cause of poor growth. Our object...

162

Occupational respiratory and skin sensitization caused by polyfunctional aziridine hardener.  

PubMed

Polyfunctional aziridine (PFA) is increasingly used as a water-based crosslinker in two-component paints, paint primers, lacquers, topcoats and other protective coatings. The crosslinker is made by reacting multifunctional acrylic monomer with a highly reactive aziridine compound. Respiratory allergy or hypersensitivity from PFA has not been reported previously. During 1978-1991 we came across nine cases with hypersensitivity from PFA: two had allergic contact dermatitis (ACD), four had occupational asthma and three had both of them. Five of the patients were parquet layers, two were fibreboard painters, one was a spray painter and one was a salesman of PFA products. ACD was diagnosed by positive allergic patch test reactions with PFA in a dilution series in petrolatum: 0.32%-0.5% gave a 2(+)-3+ allergic reaction in the five cases with ACD but 0.1% gave only a weak reaction in one case, whereas the methacrylate patch test series was negative. The diagnosis of seven cases of occupational asthma due to PFA hardener was based on symptoms related to exposure to PFA hardener at work, and on positive provocation tests with PFA hardener. One had an immediate type reaction, one a had a dual reaction, and the others had late reactions. The positive reactions with the PFA hardener and the negative reactions with the acrylate compounds indicate that PFA caused ACD which is different from the previous reports in which acrylates present as impurities in the PFA hardener caused the sensitization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7553246

Kanerva, L; Keskinen, H; Autio, P; Estlander, T; Tuppurainen, M; Jolanki, R

1995-05-01

163

Acute respiratory failure induced by bleomycin and hyperoxia  

SciTech Connect

Bleomycin, a chemotherapeutic agent, and oxygen at concentrations greater than 20%, induce acute pulmonary damage separately and when administered together. The interaction of 5 U/kg intratracheal bleomycin and 24 hours of exposure to 80% oxygen in hamsters produces delayed onset acute respiratory distress syndrome three days after treatment. As little as 12 hours of 80% O/sub 2/ exposure, after intratracheal bleomycin, induces severe pulmonary damage. Lung lesions are characterized as diffuse alveolar damage. Significantly pulmonary edema, measured by iodine-125-bovine serum albumin and technetium-99m-diethylenetriaminepentaacetate, occurs 72 hours after treatment. Lesions progress from focal mild alveolar interstitial and air-space macrophage and granulocyte infiltrates at 24 hours to marked infiltrates and severe interstitial and air space edema with hemorrhages and hyaline membranes at 96 hours. Significant changes measured by electron microscopy morphometry are increases in volume fractions of neutrophils, alveolar tissue and mononuclear leukocytes. Surfactant assay of bronchoalveolar lavage fluid shows a marked decrease in the lecithin/sphingomyelin ratio at 72 hours. Proposed mechanisms of bleomycin and hyperoxia synergism include enhanced production of superoxide radicals either directly or indirectly by increasing neutrophil activity or numbers, or by alteration of cell mediators. The pulmonary edema, without evidence of severe morphological changes, may be secondary to alterations of transalveolar transport mechanisms.

Goad, M.E.P.

1985-01-01

164

Ventilatory strategies in patients with sepsis and respiratory failure.  

PubMed

Patients with sepsis may require mechanical ventilation due to the acute respiratory distress syndrome (ARDS). It has become increasingly accepted that mechanical ventilation can contribute to lung injury in these patients. The modern concept of ventilator-induced lung injury is described in the context of alveolar over-distention (volutrauma), alveolar de-recruitment (atelectrauma), and biochemical injury and inflammation to the lung parenchyma (biotrauma). To avoid over-distention lung injury, the tidal volume should be set at 6 mL/kg predicted body weight and plateau pressure should be limited to 30 cm H2O. This has been shown to afford a survival benefit. Although setting positive end-expiratory pressure (PEEP) to zero is likely harmful during mechanical ventilation of patients with ARDS, evidence is lacking for a survival benefit if a high PEEP level is set compared with a modest level of PEEP. Although adjunctive measures such as recruitment maneuvers, prone position, and inhaled nitric oxide may improve oxygenation, evidence is lacking that these measures improve survival. PMID:16107230

Hess, Dean R; Thompson, B Taylor

2005-09-01

165

Causes and prevention of rehabilitation technology prescription failures  

Microsoft Academic Search

Rehabilitation technology is the application of science and engineering to the solution of human problems and limitations caused by impairments, disabilities and handicaps. Many devices are currently available for the rehabilitation population that reduce or eliminate these limitations. Unfortunately, prescriptions often fail for many reasons. Risk prescription failure can be minimized if the rehabilitation engineer and the rehabilitation physician enter

R. Brown; K. Zimmermann; T. Monga

1995-01-01

166

Hepatic failure caused by plasma cell infiltration in multiple myeloma  

Microsoft Academic Search

Although plasma cell infiltration is not rare in autopsy of patients with multiple myeloma (MM), it is very rarely detected in living patients. This is because MM rarely causes significant liver dysfunction that requires further evaluation. A 49-year-old man presented with acute renal failure and was diagnosed with kappa light chain MM stage ?B. Thalidomide and dexamethasone were initiated. The

Fadi E Rahhal; Robert R Schade; Asha Nayak; Teresa A Coleman

167

Boiler tube failure root cause analysis advisory system  

Microsoft Academic Search

Boiler tube failures are conditions that utilities have been battling since the day boilers were invented. They amount to millions of dollars of lost generation and anything done in this field to aid root cause and solution determination would be of great benefit to the utility industry. A computer software advisory system is being developed through a systematic approach to

H. Gonzalez; P. S. Chang

1997-01-01

168

Noninvasive ventilation for acute hypercapnic respiratory failure: intubation rate in an experienced unit.  

PubMed

BACKGROUND: Failure of noninvasive ventilation (NIV) is common in patients with chronic obstructive pulmonary disease (COPD) admitted to the intensive care unit (ICU) for acute hypercapnic respiratory failure (AHRF). We aimed to assess the rate of NIV failure and to identify early predictors of intubation under NIV in patients admitted for AHRF of all origins in an experienced unit. METHODS: Observational cohort study using data prospectively collected over a 3-year period after the implementation of a nurse-driven NIV protocol in a 24-bed medical ICU of a French university hospital. RESULTS: Among 242 patients receiving NIV for AHRF (PaCO2 > 45mmHg), 67 had cardiogenic pulmonary edema (CPE), 146 had acute-on-chronic respiratory failure (AOCRF) - including patients with COPD (n=99) or another chronic respiratory disease (n=47) - and 29 had non-AOCRF (mostly pneumonia). Overall, the rates of intubation and ICU mortality were respectively 15% and 5%. Intubation rates were 4% in CPE, 15% in AOCRF and 38% in non-AOCRF (p<0.001). After adjustment, non-AOCRF was independently associated with NIV failure, as well as acidosis (pH <7.30) and severe hypoxemia (PaO2/FiO2 ? 200) after 1 hour of NIV initiation, whereas altered consciousness on admission and ventilatory settings had no influence on outcome. CONCLUSION: Intubation rate could be reduced to 15% in patients receiving NIV for AHRF, with a mortality rate of only 5%. Whereas the risk of NIV failure is associated with hypoxemia and acidosis after initiation of NIV, it is also markedly influenced by the presence or absence of an underlying chronic respiratory disease. PMID:23737546

Contou, Damien; Fragnoli, Chiara; Córdoba-Izquierdo, Ana; Boissier, Florence; Brun-Buisson, Christian; Thille, Arnaud W

2013-06-01

169

Respiratory infection of mice with mammalian reoviruses causes systemic infection with age and strain dependent pneumonia and encephalitis  

PubMed Central

Background Because mammalian reoviruses are isolated from the respiratory tract we modeled the natural history of respiratory infection of adult and suckling mice with T1 Lang (T1L) and T3 Dearing (T3D) reoviruses. Methods Adult and suckling Balb/c mice were infected by the intranasal route and were assessed for dose response of disease as well as viral replication in the lung and other organs. Viral antigen was assessed by immunofluorescence and HRP staining of tissue sections and histopathology was assessed on formalin fixed, H?+?E stained tissue sections. Results Intranasal infection of adult mice resulted in fatal respiratory distress for high doses (107 pfu) of T1L but not T3D. In contrast both T1L and T3D killed suckling mice at moderate viral dosages (105 pfu) but differed in clinical symptoms where T1L induced respiratory failure and T3D caused encephalitis. Infections caused transient viremia that resulted in spread to peripheral tissues where disease correlated with virus replication, and pathology. Immunofluorescent staining of viral antigens in the lung showed reovirus infection was primarily associated with alveoli with lesser involvement of bronchiolar epithelium. Immunofluorescent and HRP staining of viral antigens in brain showed infection of neurons by T3D and glial cells by T1L. Conclusions These mouse models of reovirus respiratory infection demonstrated age and strain dependent disease that are expected to be relevant to understanding and modulating natural and therapeutic reovirus infections in humans.

2013-01-01

170

Fiber optic bronchoscopy in patients with acute hypoxemic respiratory failure requiring noninvasive ventilation - a feasibility study  

PubMed Central

Introduction Noninvasive ventilation (NIV) is a standard procedure in selected patients with acute respiratory failure. Previous studies have used noninvasive ventilation to ensure adequate gas exchange during fiberoptic bronchoscopy in spontaneously breathing hypoxemic patients, thus avoiding endotracheal intubation. However, it is unknown whether bronchoscopy can be performed safely in patients with acute hypoxemic respiratory failure already in need of NIV prior to the decision for bronchoscopy. Methods We prospectively investigated 40 consecutive, critically ill, adult patients with acute hypoxemic respiratory failure (14 women, 26 men, age 61 ± 15 years, partial pressure for oxygen/fraction of inspired oxygen (PaO2/FiO2) < 300 under noninvasive ventilation, Simplified Acute Physiology scores (SAPS II) 47 ± 9.9 points). All patients required noninvasive ventilation prior to the decision to perform bronchoscopy (median 10.5 h; range 2.2 to 114). Blood gases, heart rate, blood pressure and ventilation were monitored before, during and up to 120 minutes after bronchoscopy. Results Bronchoscopy could be completed in all patients without subsequent complications. Oxygen saturation fell to < 90% in two patients (5%), and the lowest value during the procedure was 84%. The mean PaO2/FiO2 ratio improved from 176 ± 54 at baseline to 240 ± 130 (P < 0.001) at the end of bronchoscopy and 210 ± 79 after 120 minutes. The transient mean partial pressure of carbon dioxide in the arterial blood (PaCO2) increase was 9.4 ± 8.1 mm Hg. Four patients (10%) required endotracheal intubation during the first eight hours after the procedure. Bronchoalveolar lavage yielded diagnostic information in 26 of 38 (68%) patients. Conclusions In critically ill patients with acute hypoxemic respiratory failure requiring noninvasive ventilation, bronchoscopy can be performed with an acceptable risk. Since these patients per se have a high likelihood of subsequent endotracheal intubation due to failure of NIV, bronchoscopy should only be performed by experienced clinicians.

2011-01-01

171

Extracorporeal life support for 100 adult patients with severe respiratory failure.  

PubMed Central

OBJECTIVE: The authors retrospectively reviewed their experience with extracorporeal life support (ECLS) in 100 adult patients with severe respiratory failure (ARF) to define techniques, characterize its efficacy and utilization, and determine predictors of outcome. SUMMARY BACKGROUND DATA: Extracorporeal life support maintains gas exchange during ARF, providing diseased lungs an optimal environment in which to heal. Extracorporeal life support has been successful in the treatment of respiratory failure in infants and children. In 1990, the authors instituted a standardized protocol for treatment of severe ARF in adults, which included ECLS when less invasive methods failed. METHODS: From January 1990 to July 1996, the authors used ECLS for 100 adults with severe acute hypoxemic respiratory failure (n = 94): paO2/FiO2 ratio of 55.7+/-15.9, transpulmonary shunt (Qs/Qt) of 52+/-22%, or acute hypercarbic respiratory failure (n = 6): paCO2 84.0+/-31.5 mmHg, despite and after maximal conventional ventilation. The technique included venovenous percutaneous access, lung "rest," transport on ECLS, minimal anticoagulation, hemofiltration, and optimal systemic oxygen delivery. RESULTS: Overall hospital survival was 54%. The duration of ECLS was 271.9+/-248.6 hours. Primary diagnoses included pneumonia (49 cases, 53% survived), adult respiratory distress syndrome (45 cases, 51 % survived), and airway support (6 cases, 83% survived). Multivariate logistic regression modeling identified the following pre-ECLS variables significant independent predictors of outcome: 1) pre-ECLS days of mechanical ventilation (p = 0.0003), 2) pre-ECLS paO2/FiO2 ratio (p = 0.002), and 3) age (years) (p = 0.005). Modeling of variables during ECLS showed that no mechanical complications were independent predictors of outcome, and the only patient-related complications associated with outcome were the presence of renal failure (p < 0.0001) and significant surgical site bleeding (p = 0.0005). CONCLUSIONS: Extracorporeal life support provides life support for ARF in adults, allowing time for injured lungs to recover. In 100 patients selected for high mortality risk despite and after optimal conventional treatment, 54% survived. Extracorporeal life support is extraordinary but reasonable treatment in severe adult respiratory failure. Predictors of survival exist that may be useful for patient prognostication and design of future prospective studies. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5.

Kolla, S; Awad, S S; Rich, P B; Schreiner, R J; Hirschl, R B; Bartlett, R H

1997-01-01

172

Distempter Vaccination of Dogs: Factors Which Could Cause Vaccine Failure  

PubMed Central

Distemper vaccination failures are uncommon. A number of factors which could cause such failure are discussed. The blocking effect of maternal antibody can be expected in 50% of pups at six weeks but is not important after 12 weeks. Among intercurrent infections, the immunosuppressive effect of parvovirus has the potential to precipitate vaccine-induced distemper. Corticosteroids at levels up to 10 mg/kg do not interfere with successful distemper vaccination. Anesthesia or surgery has little effect but use of chloramphenicol or tetracyclines should be avoided. High environmental temperatures can lead to vaccine failure, as can vitamin E deficiency. Excessive environmental exposure to virulent distemper virus can overcome levels of protection which would be adequate under normal circumstances.

Povey, R. Charles

1986-01-01

173

Anesthesia for cesarean section in a patient with respiratory failure -A case report-  

PubMed Central

We present successful epidural anesthesia and assisted mechanical ventilation in a parturient woman with respiratory failure. A 41-year-old woman at 35 weeks' of gestation was entering labor. She was pneumonectomized on the left, had bronchiectasis on the remnant lung, and was under assisted mechanical ventilation by continuous positive airway pressure (CPAP) because of severely restricted lung function and superimposed pneumonia. We administered continuous epidural analgesia for vaginal delivery, and extended it for cesarean section after failure of vaginal delivery. During the procedure, her ventilation was continuously assisted by CPAP. The maternal and fetal outcomes were successful.

Lee, Hae Jin; Chon, Jin Young; Koh, Hyun-Jung; Park, Noh-Su

2013-01-01

174

Insights About Emergency Diesel Generator Failures from the USNRC's Common Cause Failure Database  

SciTech Connect

The US Nuclear Regulatory Commission has sponsored development of a database of common cause failure events for use in commercial nuclear power plant risk and reliability analyses. This paper presents a summary of the results from analysis of the emergency diesel generator data from the database. The presentation is limited to the overall insights, the design and manufacturing cause and the instrumentation and control sub-system.

Mosleh, A. [Univ. of Maryland, MD (US); Rasmuson, D. [USNRC (US); Marshall, F.; Wierman, T. [INEEL (US)

1999-08-01

175

Timing of recovery of lung function after severe hypoxemic respiratory failure in children  

Microsoft Academic Search

Objective: To describe the timing of recovery of lung function after severe acute hypoxemic respiratory failure (AHRF) in children.\\u000a Design: A serial observational follow-up study of clinical and lung function measurements up to 53 months after acute illness. Setting: University pediatric intensive care unit in a national children's hospital. Patients: Five critically ill children aged 5–14 years. Interventions: None Results:

N. D. B. Golder; R. C. Tasker

1998-01-01

176

Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure  

Microsoft Academic Search

Home respiratory polygraphy for diagnosis of sleep-disordered breathing in heart failure. E. Quintana-Gallego, M. Villa-Gil, C. Carmona-Bernal, G. Botebol-Benhamou, A ´. Martõ´nez-Martõ´nez, A ´ .S anchez-Armengol, J. Polo-Padillo, F. Capote. #ERS Journals Ltd 2004. ABSTRACT: The present study assessed the usefulness of home cardiorespiratory polygraphy as an alternative to overnight polysomnography for the diagnosis of sleep- disordered breathing in heart

E. Quintana-Gallego

2004-01-01

177

Control of breathing, respiratory patterns and dyspnoea in patients with congestive heart failure  

Microsoft Academic Search

The aim of this paper was the evaluation of the control of breathing and respiratory patterns in patients with congestive heart failure (CHF) and its relation with the genesis of dyspnoea. Forty seven patients were studied with CHF, with a mean age of 60.9±12.5 years and compared them with 35 age-matched controls, free of cardiopulmonary diseases. The evaluation included: (a)

Miguel Mota Carmo; Teresa Ferreira; Cristina Bárbara; Nuno Lousada; A. Bensabat Rendas

1999-01-01

178

Maternal and fetal recovery after severe respiratory failure due to influenza: a case report  

PubMed Central

Background During pregnancy women are at increased risk of severe complications to influenza infection, including death of mother or fetus, especially if chronic comorbid medical conditions such as diabetes mellitus are present. Case presentation A 36 years old Caucasian pregnant woman with type 1 diabetes underwent mechanical ventilation in gestation week 27 for severe respiratory failure due to influenza and pneumonia. For three weeks during and following her most severe illness, fetal growth could not be detected and the umbilical flows and amniotic fluid volumes were affected too. The possibility of preterm delivery and extracorporeal membrane oxygenation (ECMO) treatment were considered, however the patient and her fetus recovered gradually on conservative treatment. Under close surveillance the pregnancy continued until term, with delivery of an infant with appropriate weight for gestational age. Conclusion Preterm delivery and decreased birth weight were reported for women with antepartum pneumonia. Mechanical ventilation and ECMO treatment for severe respiratory failure in pregnancy are life threatening conditions and have been associated with preterm delivery. It remains uncertain if delivery improves the respiratory status of a critically ill woman, and the fetal condition is likely to improve, if the maternal condition is stabilized. Severe respiratory insufficiency requiring mechanical ventilation in a diabetic pregnant woman with influenza was successfully treated conservatively. Despite clear signs of impaired fetal condition in the acute phase, watchful waiting resulted in delivery of a normal weight infant at term.

2013-01-01

179

Bilateral congenital lobar emphysema: A rare cause for respiratory distress in infancy  

PubMed Central

We report a rare case of bilateral congenital lobar emphysema in a 2-month-old male infant who presented with severe respiratory distress leading to respiratory failure. Plain chest X-ray and later high-resolution CT scan of the chest revealed that both the right middle and the left upper lobes were emphysematous. Surgical excision of the affected lobes has been done successfully in two sequential operations of right middle lobectomy followed by left upper lobectomy which resulted in significant improvement of respiratory status. In this report, the presentation, diagnosis, and surgical management of this rare condition are discussed.

Abushahin, Ahmad M; Tuffaha, Amjad S.; Khalil, Najeh K.; Ismeal, Adel M.

2012-01-01

180

OUTCOMES USING EXTRACORPOREAL LIFE SUPPORT FOR ADULT RESPIRATORY FAILURE DUE TO STATUS ASTHMATICUS  

PubMed Central

Our objective was to describe the outcomes for extracorporeal life support (ECLS) use in adult respiratory failure due to status asthmaticus and to determine whether ECLS use in status asthmaticus is associated with greater survival than other indications for ECLS. This retrospective cohort study used the multi-center, international extracorporeal life support organization registry. The study population included 1257 adults with respiratory failure requiring ECLS. Status asthmaticus was the primary indication for ECLS in 24 patients. 83.3% of asthmatics survived to hospital discharge, compared to 50.8% of non-asthmatics (n=1233) (OR favoring survival for asthmatics = 4.86, 95%CI 1.65–14.31, p=0.004). The survival advantage for asthmatics remained significant after adjustment for potential confounders. Complications were noted in 19 of 24 asthmatics (79.2%). In conclusion, we found that status asthmaticus, as an indication for ECLS in adult respiratory failure, appeared to be associated with greater survival than other indications for ECLS. However, complications are common and whether ECLS confers a survival advantage compared to other salvage treatment options remains unknown. More detailed information and complete reporting of ECLS use for status asthmaticus are needed to determine whether and when the potentially life-saving intervention of ECLS should be initiated in the asthmatic failing conventional therapy.

Mikkelsen, Mark E.; Woo, Y. Joseph; Sager, Jeffrey S.; Fuchs, Barry D.; Christie, Jason D.

2009-01-01

181

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment  

PubMed Central

Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children's hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group (N = 7). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4–4.2] versus 4.3 [2.8–7.4]?cm/cm2; P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.

Top, Anke P. C.; Buijs, Erik A. B.; Schouwenberg, Patrick H. M.; van Dijk, Monique; Tibboel, Dick; Ince, Can

2012-01-01

182

A rare cause of pacemaker failure: interatrial block.  

PubMed

Pacemaker and implantable cardioverter defibrillators (ICD) systems are useful in detection and differentiation of many symptomatic and asymptomatic arrhythmias. In this report, we described a rare condition that caused by failure in detection of a clinical tachyarrhythmia by a dual chamber pacemaker that implanted because of intermittent atrioventricular (AV) block and sinus node disease in a 46-year-old patient. In our case, bidirectional interatrial block was demonstrated; and the symptoms associated with high ventricular rate caused by left atrial tachyarrhythmias relieved after AV node ablation. PMID:24047493

Demircan, Sabri; Yuksel, Serkan; Gulel, Okan

2013-01-20

183

Chest Wall Abnormalities which Cause Neonatal Respiratory Distress  

Microsoft Academic Search

\\u000a Thoracic cage abnormalities may produce respiratory problems in the neonatal period. Particularly disorders of bone growth\\u000a and formation, such as in skeletal dysplasias, may restrict pulmonary development and expansion, or may distort the airways.\\u000a The radiographic features of these disorders are diverse, but generally include short ribs.

Georg F. Eich

184

Immotile cilia syndrome: a new cause of neonatal respiratory distress  

Microsoft Academic Search

Kartagener's syndrome is a condition that consists of situs inversus, bronchiectasis, and sinusitis. Some patients have respiratory symptoms that date from early infancy, and electron microscopical examination has shown that adults with this condition lack dynein arms in ciliary microtubules. It has been suggested that an inherited defect in ciliary ultrastructure, the immotile cilia, is the basis for the syndrome.

A Whitelaw; A Evans; B Corrin

1981-01-01

185

Successful pregnancy with epidermal growth factor receptor tyrosine kinase inhibitor treatment of metastatic lung adenocarcinoma presenting with respiratory failure  

Microsoft Academic Search

We report a woman presenting with respiratory failure due to a right-sided pleural effusion, lung metastases and lymphangitis carcinomatosis from advanced lung adenocarcinoma in the third trimester of pregnancy, who showed good response to EGFR tyrosine kinase inhibitor.

Chee-Hong Lee; Chong-Kin Liam; Yong-Kek Pang; Keong-Tiong Chua; Boon-Khaw Lim; Nai-Lang Lai

2011-01-01

186

Porcine reproductive and respiratory syndrome virus (PRRSV) causes apoptosis during its replication in fetal implantation sites  

Microsoft Academic Search

Reproductive failure due to porcine reproductive and respiratory syndrome virus (PRRSV) is characterized by late-term abortions, early farrowing and an increase of dead and mummified fetuses and weak-born piglets. The mechanism of PRRSV-induced reproductive failure is poorly understood. Human pregnancies, complicated by some pathogens leading to reproductive disorders exhibit increased apoptosis in the fetal membranes. Because PRRSV-target cells are present

Uladzimir U. Karniychuk; Dipongkor Saha; Marc Geldhof; Merijn Vanhee; Pieter Cornillie; Wim Van den Broeck; Hans J. Nauwynck

2011-01-01

187

Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure  

Microsoft Academic Search

Objective: This study compared the effectiveness of non- invasive ventilation (NIV) and the risk factors for NIV failure in hyper- capnic acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) vs. non- COPD conditions. Design and set- ting: Prospective cohort study in the medical intensive care unit of a uni- versity hospital. Patients and partic- ipants: 111 patients

Jason Phua; Kien Kong; Kang Hoe Lee; Liang Shen; T. K. Lim

2005-01-01

188

Mitochondrial disorders caused by mutations in respiratory chain assembly factors  

PubMed Central

Summary Mitochondrial diseases involve the dysfunction of the oxidative phosphorylation (OXPHOS) system. This group of diseases presents with heterogeneous clinical symptoms affecting mainly organs with high energy demands. Defects in the multimeric complexes comprising the OXPHOS system have a dual genetic origin, mitochondrial or nuclear DNA. Although many nuclear DNA mutations involve genes coding for subunits of the respiratory complexes, the majority of mutations found to date affect factors that do not form part of the final complexes. These assembly factors or chaperones have multiple functions ranging from cofactor insertion to proper assembly/stability of the complexes. Although significant progress has been made in the last few years in the discovery of new assembly factors, the function of many remains elusive. Here, we describe assembly factors or chaperones that are required for respiratory chain complex assembly and their clinical relevance.

Diaz, Francisca; Kotarsky, Heike; Fellman, Vineta; Moraes, Carlos T.

2011-01-01

189

Impact of Positive End-expiratory Pressure on Chest Wall and Lung Pressure-Volume Curve in Acute Respiratory Failure  

Microsoft Academic Search

To investigate whether chest-wall mechanics could affect the total respiratory system pressure-vol- ume (P-V) curve in patients with acute respiratory failure (ARF), and particularly the lower inflection point (LIP) of the curve, we drew the total respiratory system, lung, and chest-wall P-V curves (P-Vrs, P-V L , and P-Vw, respectively) for 13 patients with ARF, using the supersyringe method together

MARIO MERGONI; ALESSANDRA MARTELLI; ANNALISA VOLPI; STEFANIA PRIMAVERA; PAOLO ZUCCOLI; ANDREA ROSSI

190

Electrophysiological correlates of respiratory failure in acute organophosphate poisoning: Evidence for differential roles of muscarinic and nicotinic stimulation  

PubMed Central

Background. Respiratory failure in acute organophosphate (OP) poisoning can occur early and also relatively late in the clinical course, and the pathophysiology of respiratory failure at these different phases may have important clinical implications. Objective. To compare the electrophysiological findings in patients with early and late respiratory failure following acute OP poisoning. Methods. A prospective observational case series of consenting symptomatic patients with acute OP poisoning were assessed with daily physical examinations and repetitive nerve stimulation (RNS) studies. RNS was done on right and left median and ulnar nerves at 1, 3, 10, 15, 20, and 30 Hz. Outcomes such as need for ventilation and development of intermediate syndrome (IMS) were noted. Early respiratory failure was defined as occurring within 24 hours of ingestion. Results. Seventy-eight patients were recruited for the clinical and electrophysiological study and of those 59 (75.6%) patients had ingested chlorpyrifos. Seven patients developed respiratory failure within 24 hours of ingestion with overt muscarinic signs. They had no electrophysiological abnormalities at median and ulnar nerves before intubation. Three of them later developed “forme fruste” IMS. Five other patients developed late respiratory failure after 24 hours of ingestion, and all of them showed progressive RNS changes indicating severe IMS prior to intubation. Conclusion. The normal RNS in all patients developing early respiratory failure suggests that it is due to a central nervous system (CNS) and muscarinic effect. This emphasizes the need for early rapid atropinisation as a priority, combating the nicotinic effects being less urgent. This is in contrast with the late respiratory failure, which has been shown to be associated with neuromuscular dysfunction. Further studies are needed to quantify CNS and muscarinic dysfunction to assist in the development of better treatments for the severe and early OP poisoning.

Jayawardane, Pradeepa; Senanayake, Nimal; Buckley, Nick A; Dawson, Andrew H

2012-01-01

191

Prothrombotic state in senile patients with acute exacerbations of chronic obstructive pulmonary disease combined with respiratory failure  

PubMed Central

The aim of this study was to study the clinical value of prethrombotic state and treatment with low molecular weight heparin (LMWH) in senile patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) combined with respiratory failure. Hemorheological markers (hematocrit, blood viscosity and plasma viscosity), fibrinogen (FIB), D-dimer and gas analysis were evaluated in 30 senile patients with AECOPD combined with respiratory failure and compared with those in 30 cases without respiratory failure. A total of 30 cases with AECOPD combined with respiratory failure were randomly divided into treatment and control groups. The two groups received conventional treatment. The treatment group also received LMWH injections every 12 h for 6 days and the clinical effect was observed. The levels of FIB, D-dimer, hematocrit, blood viscosity and plasma viscosity were significantly higher in the patients with AECOPD combined with respiratory failure compared with those in the patients without respiratory failure. The plasma D-dimer and FIB levels had significantly positive correlations with the partial pressure of CO2 (PaCO2) and negative correlations with the partial pressure of O2 (PaO2) in the patients with AECOPD combined with respiratory failure. The curative effect was improved in the treatment group, compared with that in the control group without side-effects. However, no significant changes in activated partial thromboplastin time (APTT) and international normalized ratio (INR) were observed between the treatment and control groups. The senile patients with AECOPD combined with respiratory failure suffered from hypercoagulation. Early detection and diagnosis of the prethrombotic state and timely treatment with LMWH may benefit these patients without side-effects.

SONG, YA-JUN; ZHOU, ZHE-HUI; LIU, YAO-KANG; RAO, SHI-MING; HUANG, YING-JUN

2013-01-01

192

Combined high-frequency ventilation for management of terminal respiratory failure: a new technique.  

PubMed

Seven patients with severe adult respiratory distress syndrome (ARDS) developed terminal respiratory failure and severe hypoxemia (PaO2 below 50 mm Hg) with death imminent despite maximal ventilatory support with intermittent positive-pressure ventilation (IPPV) and positive end-expiratory pressure (PEEP). High-frequency positive-pressure ventilation (HFPPV) was used in these patients for one day at a rate of 250 breaths/min, with slight improvement of PaO2 to a mean of 80 mm Hg. High-frequency oscillatory (HFO) ventilation was used during the second day at a rate of 2000 breaths/min; this provided adequate oxygenation with a mean PaO2 of 244 mm Hg. Nonetheless, during HFO there was progressive CO2 retention and respiratory acidosis (mean PCO2 67 mm Hg). On the third study day, all seven patients were ventilated with combined high-frequency ventilation (CHFV) for a period from 5-21 days. CHFV is based on the administration of HFPPV simultaneously with HFO and provided adequate oxygenation by accelerated gas diffusion and CO2 elimination by convection. PaO2 was maintained during CHFV at a mean of 280 mm Hg. CO2 elimination was adequate with a mean PaCO2 of 32 mm Hg. Cardiac output also was adequately maintained during CHFV. Moreover, CHFV was well tolerated in our patients, allowing them to communicate with their families and nurses. CHFV successfully treated the hypoxemia of respiratory failure in all the patients. However, five patients (71%) died of cardiac arrest as a result of multisystem failure despite adequate oxygenation (PaO2 above 80 mm Hg). PMID:6401413

El-Baz, N; Faber, L P; Doolas, A

1983-01-01

193

Non-Invasive Pressure Support Ventilation in Patients with Respiratory Failure due to Severe Acute Cardiogenic Pulmonary Edema  

Microsoft Academic Search

Background: Recent studies suggest the use of non-invasive pressure support ventilation (NIPSV) in patients with acute cardiogenic pulmonary edema (ACPE). However, it remains unclear whether all patients with ACPE benefit from NIPSV. Objectives: To investigate short-term effects of NIPSV on respiratory, hemodynamic and oxygenation parameters in patients with respiratory failure due to severe ACPE and to identify factors predicting the

Arschang Valipour; Wolfgang Cozzarini; Otto C. Burghuber

2004-01-01

194

Predictive Significance of the Six-Minute Walk Distance for Long-Term Survival in Chronic Hypercapnic Respiratory Failure  

Microsoft Academic Search

Background: The 6-min walk distance (6-MWD) is a global marker of functional capacity and prognosis in chronic obstructive pulmonary disease (COPD), but less explored in other chronic respiratory diseases. Objective: To study the role of 6-MWD in chronic hypercapnic respiratory failure (CHRF). Methods: In 424 stable patients with CHRF and non-invasive ventilation (NIV) comprising COPD (n = 197), restrictive diseases

Stephan Budweiser; Felix Heidtkamp; Rudolf A. Jörres; Frank Heinemann; Michael Arzt; Stephan Schroll; Kathrin Schmidbauer; Andre P. Hitzl; Michael Pfeifer

2008-01-01

195

[Effectiveness analysis of high-frequency oscillatory ventilation in pediatrics patients with acute respiratory failure in a tertiary hospital].  

PubMed

Introduction. High frequency oscillatory ventilation (HFOV) is a rescue therapy for hypoxemic patients who deteriorate in conventional mechanical ventilation and/or for the air-leak syndrome treatment. A recent meta analysis showed that HFOV might have reduced mortality in pediatric and adult patients compared with conventional ventilation. In this context it's important to evaluate the effectiveness of this method in everyday use. Objectives. Main: To analize the effectiveness of HFOV in everyday practice in a center without extra corporeal membrane oxygenation (ECMO) capabilities. Secondary: To describe demographics and causes of severe respiratory failure of patients requiring HFOV. To assess the relationship between potential predictors and the occurrence of mortality. Population and methods. Retrospective study analyzing medical records of all patients that required HFOV in a tertiary care pediatric hospital pediatric intensive care units between march 1st 2008 and july 1st 2010. Results. Sixty-nine patients received 76 HFOV treatments. Eighty percent were diagnosed with acute lower respiratory infection or sepsis and 62.3% (n= 43) had preexisting chronic co-morbidities. The majority of HFOV treatments were because refractory hypoxemia (93.4%). Non survivors patients had worse clinical status at PICU admission, higher multiorgan failure, worse oxygenation and pulmonary condition. Conclusions. Everyday use of HFOV in a population with high incidence of chronic, oncologic and/or immunocompromised patients was associated with a survival of 33.4%. More prognostic studies are needed for a more effective selection of HFOV candidates. PMID:22760747

Taffarel, Pedro; Bonetto, Germán; Jorro Barón, Facundo; Selandari, Jorge; Sasbón, Jorge

196

Middle East respiratory syndrome coronavirus (MERS-CoV) causes transient lower respiratory tract infection in rhesus macaques.  

PubMed

In 2012, a novel betacoronavirus, designated Middle East respiratory syndrome coronavirus or MERS-CoV and associated with severe respiratory disease in humans, emerged in the Arabian Peninsula. To date, 108 human cases have been reported, including cases of human-to-human transmission. The availability of an animal disease model is essential for understanding pathogenesis and developing effective countermeasures. Upon a combination of intratracheal, ocular, oral, and intranasal inoculation with 7 × 10(6) 50% tissue culture infectious dose of the MERS-CoV isolate HCoV-EMC/2012, rhesus macaques developed a transient lower respiratory tract infection. Clinical signs, virus shedding, virus replication in respiratory tissues, gene expression, and cytokine and chemokine profiles peaked early in infection and decreased over time. MERS-CoV caused a multifocal, mild to marked interstitial pneumonia, with virus replication occurring mainly in alveolar pneumocytes. This tropism of MERS-CoV for the lower respiratory tract may explain the severity of the disease observed in humans and the, up to now, limited human-to-human transmission. PMID:24062443

de Wit, Emmie; Rasmussen, Angela L; Falzarano, Darryl; Bushmaker, Trenton; Feldmann, Friederike; Brining, Douglas L; Fischer, Elizabeth R; Martellaro, Cynthia; Okumura, Atsushi; Chang, Jean; Scott, Dana; Benecke, Arndt G; Katze, Michael G; Feldmann, Heinz; Munster, Vincent J

2013-09-23

197

CubeSats failures caused by space environment  

NASA Astrophysics Data System (ADS)

When a satellite is in orbit, it remains in direct contact with a hostile environment. An analyzes of possible failures that have occurred with CubeSat class satellites due to this exposure is presented. These small satellites have 10cm cubic form and about 1.33 kilograms, they have all subsystems integrated on a single module that fits in the available intern volume, using high technology of miniaturization. Generally, this satellites are launched at a 650km (LEO) altitude orbits. At this range, one of the biggest problems that may affect satellites is the precipitation of charged particles, and this may cause the failure of subsystems and magnetic interference in equipments, with emphasis to natural causes as the impact of solar activity (the solar cycle, solar flares, coronal mass ejection, etc.) and the interference of the South Atlantic Magnetic Anomaly, knowing that the majority of CubeSat's orbits intersect at some point the acting anomaly region. The analysis consist of a statistical survey of thirty nine CubeSats already launched, taking into account their actual conditions, giving results of the most common causes and issues that have occurred with them, including the relationship with larger satellites of all kinds, thus contributing for the success and optimization of future CubeSats missions.

Lourencena Caldas Franke, Lucas; Schuch, Nelson Jorge; Santos Cupertino Durao, Otavio; Lopes Costa, Lucas; Escobar Burger, Eduardo; Zolar Gehlen Bohrer, Rubens; Ronan Coelho Stekel, Tardelli

198

Mortality of neonatal respiratory failure related to socioeconomic factors in Hebei province of China.  

PubMed

Dramatic progress has occurred in neonatal intensive care in tertiary centers in mid-eastern China. We investigated the characteristics of neonatal respiratory failure (NRF) including the incidence, management, outcomes and costs in 14 neonatal intensive care units (NICUs) of Hebei, a province at an intermediate economic level in China. Over a period of 12 consecutive months in 2007-2008, perinatal data were collected prospectively from all NICU admissions (n = 11,100). NRF was defined as severe hypoxemia requiring respiratory support for more than 24 h, and was diagnosed in 1,875 newborns (16.9%). The average birth weight of newborns with NRF was 2,200 g (range 600-5,500 g), with 60.9% <2,500 g, and 2% <1,000 g. The male:female ratio was 2.6:1. The leading diagnosis was respiratory distress syndrome; 58.3% of newborns with respiratory distress syndrome received surfactant. Continuous positive airway pressure was used more than ventilation (73.3 vs. 49.1%,p < 0.001). Overall, the mortality rate until discharge was 31.4% (583/1,859). Most deaths (432, 74.1%) followed a parental decision to withdraw care. NRF mortality varied in association with different gross domestic product levels, family annual income and nurse-to-bed ratios. The median cost of a hospital stay was 10,169 CNY (interquartile range: 6,745-16,386) for NRF survivors. We conclude that, despite the available respiratory support in these emerging NICUs, the mortality of NRF remains. This was associated with prematurity, standard of care but also with socioeconomic factors affecting treatment decisions. Assessment of efficacy of respiratory support for NRF in such emerging neonatal services should account for both standard of care and socioeconomic conditions. PMID:21150226

Ma, Li; Liu, Cuiqing; Wang, Yuqi; Li, Shufang; Zhai, Shufen; Gu, Xiaofeng; Liu, Fang; Yan, Aixia; Guo, Wei; Li, Yingyu; Xiao, Min; Yin, Jianying; Li, Yanzhi; Liu, Xia; Wang, Rong; Kirpalani, Haresh; Sun, Bo

2010-12-10

199

Neuromuscular blockade with acute respiratory failure in a patient receiving cibenzoline  

PubMed Central

Cibenzoline is a class Ic antiarrhythmic agent that can be used to treat supraventricular arrhythmias. A case is reported of cibenzoline overdose in a patient with impaired renal function, leading not only to the usual cardiac and metabolic symptoms (bradycardia and hypoglycaemia), but also to a myastheniform syndrome with acute respiratory failure. Neuromuscular blockade was demonstrated by repetitive supramaximal stimulation of the median nerve, and diaphragmatic involvement was evidenced by applying the same protocol to the phrenic nerve. Muscle strength recovered as serum cibenzoline levels decreased, allowing the patient to be weaned from the ventilator. This observation suggests that cibenzoline, like other antiarrhythmic agents, can be responsible for neuromuscular blockade, and should therefore be used with caution in patients with neuromuscular and respiratory diseases or with impaired renal function. ???

Similowski, T.; Straus, C.; Attali, V.; Girard, F.; Philippe, F.; Deray, G.; Thomas, D.; Derenne, J. P.

1997-01-01

200

Active cycle of breathing techniques in non-invasive ventilation for acute hypercapnic respiratory failure.  

PubMed

We hypothesised that applying the active cycle of breathing techniques (ACBT) in patients with acute hypercapnic respiratory failure undergoing non-invasive ventilation would improve patient outcome. Thirty-four patients were randomised so that 17 patients with acute hypercapnic respiratory failure received the ACBT and non-invasive ventilation (ACBT group), and 17 patients received non-invasive ventilation alone (control group). The primary outcome measure was length of time requiring non-invasive ventilation, and secondary outcome measures were change in acute physiology score, change in arterial blood gas values, total duration of non-invasive ventilation, and length of stay in the intensive care unit. Although not significant, there was a greater decrease in arterial carbon dioxide pressure in the ACBT group compared to the control group (-21.41 mmHg vs -17.45 mmHg, p = 0.27). Total duration of ventilation tended to be shorter in the ACBT group than in the control group (64.9 hours vs 84.1 hours, p = 0.15). Length of time in need of non-invasive ventilation was significantly lower in the ACBT group than in the control group (5.0 days vs 6.7 days, p = 0.03). There was no significant difference in length of stay in the intensive care unit between the two groups (8.0 vs 9.4 days, p = 0.31). The use of ACBT may have positive effects in the treatment of patients with acute hypercapnic respiratory failure, resulting in a shorter length of time requiring non-invasive ventilation. PMID:15151490

Inal-Ince, Deniz; Savci, Sema; Topeli, Arzu; Arikan, Hulya

2004-01-01

201

Changes in the spectrum of organisms causing respiratory tract infections: a review.  

PubMed

Over the last decade, the spectrum of organisms causing community-acquired acute lower respiratory tract infections has changed. Streptococcus pneumoniae now causes approximately 30% of outpatient acute pneumonia-less than in former decades-whereas Mycoplasma pneumoniae is found in both young and elderly patients. The Enterobacteriaceae and Staphylococcus aureus are now seen more frequently as respiratory tract pathogens in community-acquired pneumonia patients, and they are the major organisms causing pneumonia in residents of homes for the elderly or nursing homes, and in immuno-compromised patients. Agents that were previously considered non-pathogenic for the respiratory tract include serotypes of Haemophilus influenzae other than type b, H. parainfluenzae and Moraxella (Branhamella) catarrhalis; these organisms affect mainly patients with underlying cardiopulmonary disease. Legionella species can cause sporadic as well as epidemic disease of the lower respiratory tract. Chlamydia pneumoniae is a newly recognized pathogen responsible for mild to severe upper and lower respiratory tract infections. In 60-80% of cases, hospital-acquired pneumonias are caused by Gram-negative bacilli and S. aureus. These organisms colonize the mucosal membranes of the upper respiratory tract and penetrate into the lower tract by aspiration or intubation. PMID:1287613

Kayser, F H

1992-01-01

202

Effect of Controlled Oxygen Therapy on Arterial Blood Gases in Acute Respiratory Failure  

PubMed Central

Seven patients in acute exacerbation of chronic respiratory failure were given 24·5% and later 28% oxygen through Ventimasks. The mean increases in arterial PO2 were 11 and 21 mm. Hg while breathing 24·5% and 28% oxygen respectively compared with control values while breathing air. Associated increases in arterial PCO2 were 4 and 8 mm. Hg, respectively. In five of the patients these increases in inspired oxygen concentration resulted in useful increases in tissue oxygen supply without significant deterioration in ventilation, but in two patients arterial PCO2 rose excessively and artificial ventilation was required.

Warrell, D. A.; Edwards, R. H. T.; Godfrey, S.; Jones, N. L.

1970-01-01

203

Protocol-based noninvasive positive pressure ventilation for acute respiratory failure  

Microsoft Academic Search

Purpose  Noninvasive positive pressure ventilation (NPPV) has been suggested to be associated with adverse outcomes in emergency patients\\u000a with acute respiratory failure (ARF), possibly because of a delay in tracheal intubation (TI). We hypothesized that protocol-based\\u000a NPPV (pNPPV) might improve the outcomes, compared with individual physician-directed NPPV (iNPPV).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  To guide decision making regarding the use of NPPV, we developed an NPPV

Tadashi Kikuchi; Satoshi Toba; Yukio Sekiguchi; Tomomi Iwashita; Hiroshi Imamura; Masatomo Kitamura; Kenichi Nitta; Katsunori Mochizuki; Kazufumi Okamoto

2011-01-01

204

Nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis with diaphragmatic involvement in a patient with respiratory failure.  

PubMed

Nephrogenic fibrosing dermopathy/nephrogenic systemic fibrosis (NFD/NSF) is a disorder occurring exclusively in patients with renal disease. Until recently, it has been considered a fibrosing disorder essentially confined to the skin and underlying superficial soft tissue. Recent reports, however, have described patients with involvement of other organ systems, suggesting that this disorder is actually a systemic disease with preferential cutaneous manifestations. We describe a patient with end-stage renal disease with diagnosed NFD/NSF who subsequently developed respiratory failure leading to his death. Autopsy findings showed NFD/NSF involving the skin of all extremities, as well as diffuse diaphragm involvement. PMID:16427988

Kucher, Cynthia; Steere, Joanna; Elenitsas, Rosalie; Siegel, Don L; Xu, Xiaowei

2006-02-01

205

Extracorporeal membrane oxygenation in adults with severe respiratory failure: a multi-center database  

Microsoft Academic Search

Objective  To evaluate clinical and treatment factors for patients recorded in the Extracorporeal Life Support Organization (ELSO) registry\\u000a and survival of adult extracorporeal membrane oxygenation (ECMO) respiratory failure patients.\\u000a \\u000a \\u000a \\u000a Design and patients  Retrospective case review of the ELSO registry from 1986–2006. Data were analyzed separately for the entire time period and\\u000a the most recent years (2002–2006).\\u000a \\u000a \\u000a \\u000a Results  Of 1,473 patients, 50% survived to

Thomas V. Brogan; Ravi R. Thiagarajan; Peter T. Rycus; Robert H. Bartlett; Susan L. Bratton

2009-01-01

206

Multiple organ failure with the adult respiratory distress syndrome in homicidal arsenic poisoning.  

PubMed

A 30-year-old man and a 39-year-old woman, who was 28 weeks pregnant, were simultaneously poisoned by eating chocolate containing arsenic trioxide. They developed a picture of multiple organ failure peaking around the 8th to 10th day after ingestion, with the development of life-threatening adult respiratory distress syndrome (ARDS) in both patients. This rarely reported complication of arsenic poisoning was managed successfully by intubation and mechanical ventilation with positive end expiratory pressure in both patients. Hemodynamic and laboratory data are presented supporting the clinical course. Arsenic toxicity further resulted in intrauterine fetal death. The effects of severe arsenic poisoning leading to early multiple organ failure with ARDS as well as to protracted, debilitating polyneuropathy are discussed. PMID:1315982

Bolliger, C T; van Zijl, P; Louw, J A

1992-01-01

207

Syringomyelia and chronic respiratory failure in a term infant delivered by Caesarean section.  

PubMed

The case of a term, male neonate (birthweight 3785g) with cephalic presentation, Caesarean-section (C-section) delivery, and failure to thrive is reported. The infant presented with generalized hypotonia and respiratory failure immediately following birth. An initial diagnosis of hypoxic-ischemic encephalopathy was made. However, ventilator dependency and slow recovery of generalized tonus over the following weeks could not be explained. Late cervical magnetic resonance imaging showed extensive syringomyelia from C2 to C7. To the authors' knowledge, this is the first report of syringomyelia after a C-section delivery following cephalic presentation without any associated abnormalities. Follow-up at 2 years of age revealed no improvement on neurological examination: poor head control, difficulty swallowing, flaccid paralysis of upper limbs, and spasticity of lower limbs with exacerbated deep reflexes and spontaneous clonus. Difficulties in establishing the diagnosis and managing the case are discussed. PMID:17593128

Sant'Anna, G M; Azevedo, C T; Simas, A; Castro, B P; Bhering, C A

2007-07-01

208

Higher Education Students' Beliefs about the Causes of Examination Failure: A Network Approach  

Microsoft Academic Search

Examination failure is of paramount importance in higher education, affecting educational institutions, teaching staff and students alike. In spite of this, little quantitative research has attempted to examine the perceived causes of exam failure. In the present study, 73 participants completed a questionnaire in which they rated the importance of various predetermined causes of exam failure. These 11 causes were

Jonathan Ling; Thomas M. Heffernan; Steven J. Muncer

2003-01-01

209

Phrenic nerve palsy: A rare cause of respiratory distress in newborn.  

PubMed

Birth injury is defined as an impairment of a newborn's body function or structure due to adverse influences that occurred at birth. Phrenic nerve palsy may result from birth trauma during a traumatic neonatal delivery from a stretch injury due to lateral hyperextension of the neck at birth. This could be a rare cause of respiratory distress in the newborn period with irregular respiration. Respiratory distress due to phrenic nerve damage leading to paralysis of the ipsilateral diaphragm may require continuous positive airway pressure or mechanical ventilation and if unresponsive, surgical plication of diaphragm. Herein, we report a case of phrenic nerve palsy in a newborn presenting with respiratory distress. PMID:23560016

Murty, V S S Yerramilli; Ram, K Dinedra

2012-09-01

210

Phrenic nerve palsy: A rare cause of respiratory distress in newborn  

PubMed Central

Birth injury is defined as an impairment of a newborn's body function or structure due to adverse influences that occurred at birth. Phrenic nerve palsy may result from birth trauma during a traumatic neonatal delivery from a stretch injury due to lateral hyperextension of the neck at birth. This could be a rare cause of respiratory distress in the newborn period with irregular respiration. Respiratory distress due to phrenic nerve damage leading to paralysis of the ipsilateral diaphragm may require continuous positive airway pressure or mechanical ventilation and if unresponsive, surgical plication of diaphragm. Herein, we report a case of phrenic nerve palsy in a newborn presenting with respiratory distress.

Murty, V. S. S. Yerramilli; Ram, K. Dinedra

2012-01-01

211

Diversity Strategies to Mitigate Postulated Common Cause Failure Vulnerabilities  

SciTech Connect

This paper describes an approach to establish effective mitigating strategies that can resolve potential common-cause failure (CCF) vulnerabilities in instrumentation and control (I&C) systems at nuclear power plants. A particular objective in the development of these strategies, which consist of combinations of diversity attributes and their associated criteria, is to address the unique characteristics of digital technology that can contribute to CCF concerns. The research approach employed to establish diversity strategies involves investigation of available documentation on diversity usage and experience from nuclear power and non-nuclear industries, capture of expert knowledge and lessons learned, determination of common practices, and assessment of the nature of CCFs and compensating diversity attributes. The resulting diversity strategies address considerations such as the effect of technology choices, the nature of CCF vulnerabilities, and the prospective impact of each diversity type. In particular, the impact of each attribute and criterion on the purpose, process, product, and performance aspects of diverse systems are considered.

Wood, Richard Thomas [ORNL

2010-01-01

212

[Effectiveness of the HighFO novel oxygen nebulizer for respiratory failure patients with severe hypoxia].  

PubMed

Optimal oxygen delivery is an essential component of therapy for patients with respiratory failure. Reservoir masks or air entrainment nebulizers have often been used for patients who require highly concentrated oxygen, but these may not actually deliver a sufficient fraction of inspired oxygen if there is a marked increase in the patient's ventilatory demands, or if oxygen flow becomes limited due to high resistance in the nebulizer nozzles. The HighFO nebulizer is a novel air entrainment nebulizer equipped with unique structures which reduce nozzle resistance, and as a result, it is possible to supply a sufficient flow of highly concentrated-oxygen. The purpose of this study was to evaluate the effectiveness and usefulness of the HighFO nebulizer in 10 respiratory failure patients with severe hypoxemia who used a reservoir mask and required more than 10 L/min of oxygen supply. In each case, the reservoir mask was replaced with the HighFO nebulizer, and changes in percutaneous oxygen saturation (SpO2) were monitored using pulse oximetry. Oxygenation improved promptly after the reservoir mask was substituted for the HighFO nebulizer (SpO2 : 83.7% +/- 8.5%-94.2% +/- 3.2%, p = 0.007). This finding suggests that the HighFO nebulizer was reasonably effective in delivering highly concentrated oxygen, sufficient for patient demands. The HighFO nebulizer may be the beginning of a new strategy for oxygen therapy. PMID:21591451

Takamatsu, Kazufumi; Sakuramoto, Minoru; Inoue, Daiki; Ishitoko, Manabu; Itotani, Ryo; Suzuki, Shinko; Matsumoto, Masataka; Takemura, Masaya; Fukui, Motonari

2011-04-01

213

Short term effect of intermittent negative pressure ventilation in COPD patients with respiratory failure.  

PubMed

Ten patients with stable chronic obstructive pulmonary disease (COPD) and hypercapnic respiratory failure were randomly submitted to intermittent negative pressure ventilation (INPV) 6 h per day for 5 consecutive days by either a cuirass or pneumo wrap ventilator. The effects were assessed by measurements of spirometry, blood gases, maximal inspiratory (MIP) and expiratory (MEP) pressures, 12 minutes walking distance test (12 mwd), sensation of dyspnoea by a visual analogue scale (VAS) and diaphragmatic electromyographic activity (Edi). Edi was recorded during INPV sessions in only 7 patients. The same measurements apart from Edi were also performed in 8 matched control patients randomly submitted to conventional physiotherapy. During INPV, Edi activity was reduced, at least temporarily down to 50% of baseline values. Comparison of baseline with post INPV values showed no changes in thoracic gas volume (TGV), forced expiratory volume in one second (FEV1), FEV1/forced vital capacity (FVC), arterial oxygen partial pressure (Pao2) and MEP; significant improvements were seen in MIP, vital capacity (VC), VAS, and 12 mwd only in patients submitted to INPV. A significant improvement in PaCO2 was observed in both groups of patients. We conclude that INPV may be effective in improving the functional reserve of the inspiratory muscles in selected COPD patients with hypercapnic respiratory failure and signs of inspiratory muscle dysfunction. PMID:2376246

Ambrosino, N; Montagna, T; Nava, S; Negri, A; Brega, S; Fracchia, C; Zocchi, L; Rampulla, C

1990-05-01

214

Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial.  

PubMed

INTRODUCTION: Noninvasive ventilation (NIV), as a weaning-facilitating strategy in predominantly chronic obstructive pulmonary disease (COPD) mechanically ventilated patients, is associated with reduced ventilator-associated pneumonia, total duration of mechanical ventilation, length of intensive care unit (ICU) and hospital stay, and mortality. However, this benefit after planned extubation in patients with acute respiratory failure of various etiologies remains to be elucidated. The aim of this study was to determine the efficacy of NIV applied immediately after planned extubation in contrast to oxygen mask (OM) in patients with acute respiratory failure (ARF). METHODS: A randomized, prospective, controlled, unblinded clinical study in a single center of a 24-bed adult general ICU in a university hospital was carried out in a 12-month period. Included patients met extubation criteria with at least 72 hours of mechanical ventilation due to acute respiratory failure, after following the ICU weaning protocol. Patients were randomized immediately before elective extubation, being randomly allocated to one of the study groups: NIV or OM. We compared both groups regarding gas exchange 15 minutes, 2 hours, and 24 hours after extubation, reintubation rate after 48 hours, duration of mechanical ventilation, ICU length of stay, and hospital mortality. RESULTS: Forty patients were randomized to receive NIV (20 patients) or OM (20 patients) after the following extubation criteria were met: pressure support (PSV) of 7 cm H2O, positive end-expiratory pressure (PEEP) of 5 cm H2O, oxygen inspiratory fraction (FiO2) ? 40%, arterial oxygen saturation (SaO2) ? 90%, and ratio of respiratory rate and tidal volume in liters (f/TV) < 105. Comparing the 20 patients (NIV) with the 18 patients (OM) that finished the study 48 hours after extubation, the rate of reintubation in NIV group was 5% and 39% in OM group (P = 0.016). Relative risk for reintubation was 0.13 (CI = 0.017 to 0.946). Absolute risk reduction for reintubation showed a decrease of 33.9%, and analysis of the number needed to treat was three. No difference was found in the length of ICU stay (P = 0.681). Hospital mortality was zero in NIV group and 22.2% in OM group (P = 0.041). CONCLUSIONS: In this study population, NIV prevented 48 hours reintubation if applied immediately after elective extubation in patients with more than 3 days of ARF when compared with the OM group. TRIAL REGISTRATION NUMBER: ISRCTN: 41524441. PMID:23497557

Ornico, Susana R; Lobo, Suzana M; Sanches, Helder S; Deberaldini, Maristela; Tófoli, Luciane T; Vidal, Ana M; Schettino, Guilherme P; Amato, Marcelo B; Carvalho, Carlos R; Barbas, Carmen S

2013-03-01

215

Integrated heart failure management in the patient with heart failure caused by left ventricular systolic dysfunction  

Microsoft Academic Search

1. The increasing burden of heart failure is a result of the aging population and improvements in cardiac care. It is estimated that 660,000 new cases of heart failure are diagnosed every year in the United States. 2. Heart failure with normal ejection fraction (HFNEF) is part of a single entity of heart failure that includes also heart failure with

Marco Metra; Valerio Zaca; Savina Nodari; Livio Dei Cas

216

Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD)  

PubMed Central

Executive Summary In July 2010, the Medical Advisory Secretariat (MAS) began work on a Chronic Obstructive Pulmonary Disease (COPD) evidentiary framework, an evidence-based review of the literature surrounding treatment strategies for patients with COPD. This project emerged from a request by the Health System Strategy Division of the Ministry of Health and Long-Term Care that MAS provide them with an evidentiary platform on the effectiveness and cost-effectiveness of COPD interventions. After an initial review of health technology assessments and systematic reviews of COPD literature, and consultation with experts, MAS identified the following topics for analysis: vaccinations (influenza and pneumococcal), smoking cessation, multidisciplinary care, pulmonary rehabilitation, long-term oxygen therapy, noninvasive positive pressure ventilation for acute and chronic respiratory failure, hospital-at-home for acute exacerbations of COPD, and telehealth (including telemonitoring and telephone support). Evidence-based analyses were prepared for each of these topics. For each technology, an economic analysis was also completed where appropriate. In addition, a review of the qualitative literature on patient, caregiver, and provider perspectives on living and dying with COPD was conducted, as were reviews of the qualitative literature on each of the technologies included in these analyses. The Chronic Obstructive Pulmonary Disease Mega-Analysis series is made up of the following reports, which can be publicly accessed at the MAS website at: http://www.hqontario.ca/en/mas/mas_ohtas_mn.html. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework Influenza and Pneumococcal Vaccinations for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Smoking Cessation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Community-Based Multidisciplinary Care for Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Long-term Oxygen Therapy for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Acute Respiratory Failure Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Noninvasive Positive Pressure Ventilation for Chronic Respiratory Failure Patients With Stable Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Hospital-at-Home Programs for Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Home Telehealth for Patients With Chronic Obstructive Pulmonary Disease (COPD): An Evidence-Based Analysis Cost-Effectiveness of Interventions for Chronic Obstructive Pulmonary Disease Using an Ontario Policy Model Experiences of Living and Dying With COPD: A Systematic Review and Synthesis of the Qualitative Empirical Literature For more information on the qualitative review, please contact Mita Giacomini at: http://fhs.mcmaster.ca/ceb/faculty_member_giacomini.htm. For more information on the economic analysis, please visit the PATH website: http://www.path-hta.ca/About-Us/Contact-Us.aspx. The Toronto Health Economics and Technology Assessment (THETA) collaborative has produced an associated report on patient preference for mechanical ventilation. For more information, please visit the THETA website: http://theta.utoronto.ca/static/contact. Objective The objective of this evidence-based analysis was to examine the effectiveness, safety, and cost-effectiveness of noninvasive positive pressure ventilation (NPPV) in the following patient populations: patients with acute respiratory failure (ARF) due to acute exacerbations of chronic obstructive pulmonary disease (COPD); weaning of COPD patients from invasive mechanical ventilation (IMV); and prevention of or treatment of recurrent respiratory failure in COPD patients after ex

McCurdy, BR

2012-01-01

217

Sudden failure of implantable pulse generators: cause of failure and examination.  

PubMed

A sudden failure of implantable pulse generators used for spinal cord stimulation occurred in two patients. To identify the cause of this failure, an intensive destructive analysis of the explanted devices was carried out. A functional diagnosis was carried out by inspecting amplitude, pulse width and frequency on each output channel of the implantable pulse generators. Later, the titanium case of the pulse generators was opened by laser cutting to minimise any additional mechanical stress during the opening procedure. The functional test for both pulse generators showed faultless behaviour. Using light and electron microscopy, hairline cracks could be identified in the electrical connection between battery and electronic circuit. In both devices, the cracks spread through the whole bond wire in the connection to the plus pole of the battery and partially also to the minus pole. The analysis showed that both devices failed by broken bond wires. The electrical connection to the battery exists just by the spring characteristic of the wires. A push to the implant causes a short-term disconnection, resulting in a power on reset of the device. Manufacturing or design issues, allowing micromotion between battery and the hybrid part, may be the reason for this problem. PMID:17915998

Lanmüller, Hermann; Buchroithner, Johanna; Wernisch, Johann; Alesch, François

2007-10-01

218

Epidemiology of noninvasive mechanical ventilation in acute respiratory failure - a retrospective population-based study  

PubMed Central

Background Noninvasive mechanical ventilation (NIV) is a front-line therapy for the management of acute respiratory failure (ARF) in the intensive care units. However, the data on factors and outcomes associated with the use of NIV in ARF patients is lacking. Therefore, we aimed to determine the utilization of NIV for ARF in a population-based study. Methods We conducted a populated-based retrospective cohort study, where in all consecutively admitted adults (?18?years) with ARF from Olmsted County, Rochester, MN, at the Mayo Clinic medical and surgical ICUs, during 2006 were included. Patients without research authorization or on chronic NIV use for sleep apnea were excluded. Results Out of 1461 Olmsted County adult residents admitted to the ICUs in 2006, 364 patients developed ARF, of which 146 patients were initiated on NIV. The median age in years was 75 (interquartile range, 60–84), 48% females and 88.7% Caucasians. Eighteen patients (12%) were on Continuous Positive Airway Pressure (CPAP) mode and 128 (88%) were on noninvasive intermittent positive-pressure ventilation (NIPPV) mode. Forty-six (10%) ARF patients were put on NIV for palliative strategy to alleviate dyspnea. Seventy-six ARF patients without treatment limitation were given a trial of NIV and 49 patients succeeded, while 27 had to be intubated. Mortality was similar between the patients initially supported with NIV versus invasive mechanical ventilation (33% vs 22%, P=0.289). In the multivariate analysis, the development of acute respiratory distress syndrome (ARDS) and higher APACHE III scores were associated with the failure of initial NIV treatment. Conclusions Our results have important implications for a future planning of NIV in a suburban US community with high access to critical care services. The higher APACHE III scores and the development of ARDS are associated with the failure of initial NIV treatment.

2013-01-01

219

Early tracheal stenosis causing extubation failure and prolonged ventilator dependency.  

PubMed

Postintubation stenosis is the most frequent cause of benign tracheal stenosis and may cause reintubation and delay in weaning of intensive care unit patients. This case study describes typical patients with tracheal stenosis and the management of these patients. Five patients requiring reintubation and mechanical ventilation due to early intubation-related stenosis are discussed. Stridor developed in three cases after extubation. In these cases, bronchoscopy revealed tracheal stenosis. Dilatation and silicone stent placement were performed using rigid bronchoscopy. The other two patients were on ventilators when they were admitted to the intensive care unit and their stenoses were also treated by rigid bronchoscopy. Hypercapnia and hypoxia resolved after intervention in three cases. Of the remaining two patients, one had the tracheostomy closed and in the other patient ventilation was stopped but the tracheostomy was maintained. Tracheal stenosis developing in the subglottic region after extubation, especially after exposure to cuff pressure, may lead to reintubation. A tracheostomy may hinder the diagnosis of progressive stenosis and may lead to unnecessary maintenance of ventilator treatment. Early intubation-related tracheal stenosis should therefore be considered in cases of weaning or extubation failure and prompt appropriate investigation and treatment. PMID:23362899

Dalar, L; Schuurmans, M M; Eryuksel, E; Karasulu, L; Kosar, A F; Altin, S

2013-01-01

220

Targeted inactivation of the murine Abca3 gene leads to respiratory failure in newborns with defective lamellar bodies  

SciTech Connect

Mutations in the human ABCA3 gene, encoding an ABC-transporter, are associated with respiratory failure in newborns and pediatric interstitial lung disease. In order to study disease mechanisms, a transgenic mouse model with a disrupted Abca3 gene was generated by targeting embryonic stem cells. While heterozygous animals developed normally and were fertile, individuals homozygous for the altered allele (Abca3-/-) died within one hour after birth from respiratory failure, ABCA3 protein being undetectable. Abca3-/- newborns showed atelectasis of the lung in comparison to a normal gas content in unaffected or heterozygous littermates. Electron microscopy demonstrated the absence of normal lamellar bodies in type II pneumocytes. Instead, condensed structures with apparent absence of lipid content were found. We conclude that ABCA3 is required for the formation of lamellar bodies and lung surfactant function. The phenotype of respiratory failure immediately after birth corresponds to the clinical course of severe ABCA3 mutations in human newborns.

Hammel, Markus [Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Lindwurmstrasse 4, 80337 Munich (Germany); Michel, Geert [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Hoefer, Christina [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Klaften, Matthias [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Mueller-Hoecker, Josef [Institute of Pathology, Ludwig-Maximilians-University Munich, Thalkirchner Strasse 36, 80337 Munich (Germany); Angelis, Martin Hrabe de [GSF-National Research Center for Environment and Health, Institute of Experimental Genetics, Ingolstaedter Landstrasse 1, 85764 Neuherberg (Germany); Holzinger, Andreas [Dr. von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Lindwurmstrasse 4, 80337 Munich (Germany)]. E-mail: andreas.holzinger@med.uni-muenchen.de

2007-08-10

221

Physiological effects and optimisation of nasal assist-control ventilation for patients with chronic obstructive pulmonary disease in respiratory failure  

Microsoft Academic Search

BACKGROUND: A study was undertaken to investigate the effects of non-invasive assist-control ventilation (ACV) by nasal mask on respiratory physiological parameters and comfort in acute on chronic respiratory failure (ACRF). METHODS: Fifteen patients with chronic obstructive pulmonary disease (COPD) were prospectively and randomly assigned to two non-invasive ventilation (NIV) sequences in spontaneous breathing (SB) and ACV mode. ACV settings were

C. Girault; V. Chevron; J. C. Richard; I. Daudenthun; P. Pasquis; J. Leroy; G. Bonmarchand

1997-01-01

222

Negative pressure ventilation versus conventional mechanical ventilation in the treatment of acute respiratory failure in COPD patients  

Microsoft Academic Search

This case-control study was aimed to evaluate the effectiveness of nega- tive pressure ventilation (NPV) versus conventional mechanical ventilation (CMV) for the treatment of acute respiratory failure (ARF) in patients with chronic obstructive pulmonary disease (COPD) admitted to a respiratory intermediate intensive care unit (RIICU) and four general intensive care units (ICU). Twenty-six COPD patients in ARF admitted in 1994-95

A. Corrado; M. Gorini; R. Ginanni; C. Pelagatti; G. Villella; U. Buoncristiano; F. Guidi; E. Pagni; A. Peris; E. De Paola

1998-01-01

223

Efficacy of high-flow oxygen and active humidification in a patient with acute respiratory failure of neuromuscular origin.  

PubMed

The treatment of choice for patients with respiratory failure of neuromuscular origin, especially in situations of hypercapnic respiratory acidosis, is noninvasive ventilation (NIV). Endotracheal intubation and invasive ventilation are indicated for patients with severe respiratory compromise or failure of NIV. In recent years high-flow oxygen therapy and active humidification devices have been introduced in the medical practice. They are emerging evidence that high-flow may be effective in different clinical settings: such as acute respiratory failure, after cardiac surgery, during sedation and analgesia, in acute heart failure, in hypoxemic respiratory distress, in Do-Not-Intubate patients, in the case of patients with chronic cough and copious secretions, pulmonary fibrosis or cancer, both in critical areas or in the emergency department. We have studied a patient suffering from amyotrophic lateral sclerosis (ALS) who arrived at the emergency department with acute hypercapnic respiratory failure, which was treated successfully with a heated, humidified high-flow oxygen therapy device (HFNC). The patient did not tolerate NIV and we decided to try the HFNC as an alternative to intubation, since the patient had also rejected the application of invasive measures. An ABG performed after an hour of treatment showed a trend for improvement of both the pH, and the PCO2, and also improved the level of awareness of the patient. Respiratory acidosis was corrected and the patient could be discharged after 5 days of hospitalization. The response to HFNC was similar to that expected with NIV. We discuss the mechanisms of action of heated, humidified high-flow oxygen therapy and the need for research on this in the future. PMID:23650430

Díaz-Lobato, S; Folgado, Ma; Chapa, A; Mayoralas, S

2013-04-30

224

Effect of Laser Arytenoidectomy on Respiratory Stridor Caused by Multiple System Atrophy  

PubMed Central

Respiratory stridor in patients with multiple system atrophy is a complication that occasionally causes nocturnal sudden death. Continuous positive airway pressure (CPAP) therapy has been proposed as an alternative to tracheostomy to treat nocturnal stridor associated with multiple system atrophy. However, some patients cannot tolerate CPAP therapy and experience sleep disturbances, even if the pressure is controlled; also, CPAP therapy can be less effective in patients with a narrow glottic opening during sleep. This report describes the effect of laser arytenoidectomy on respiratory stridor caused by multiple system atrophy. Citation: Chitose S; Kikuchi A; Ikezono K; Umeno H; Nakashima T. Effect of laser arytenoidectomy on respiratory stridor caused by multiple system atrophy. J Clin Sleep Med 2012;8(6):713-715.

Chitose, Shun-ichi; Kikuchi, Atsushi; Ikezono, Keiko; Umeno, Hirohito; Nakashima, Tadashi

2012-01-01

225

Hygrometric properties of inspired gas and oral dryness in patients with acute respiratory failure during noninvasive ventilation.  

PubMed

PURPOSE:: Because noninvasive ventilation (NIV) delivers medical gas at high flow, inadequate humidification may cause oral dryness and patient discomfort. A heated humidifier (HH) is often used to humidify inspired gas during NIV but little has been reported about its effects on hygrometric conditions inside of full face masks and oral dryness for a 24 hrs use. METHODS:: Using a hygrometer, we measured absolute humidity (AH) of inside full face masks applied to patients with acute respiratory failure who were receiving NIV for 24 hrs. A single limb turbine ventilator and a facemask with an exhalation port were used for NIV. Oral moistness was evaluated using an oral moisture-checking device and, three times during the study, patients subjectively scored feeling of dryness on a 0-10 numerical rating scale (NRS; 10 was the most severe dryness). RESULTS:: Sixteen patients with acute respiratory failure were enrolled. Full face mask internal AH was 30.0±2.6 mgH2O/L (range 23.1-33.3 mgH2O/L). The median value of oral moistness was 19.2% (inter-quartile range: IQR 4.4%-24.0%) and the median value of NRS was 5.5 (IQR 4-7). AH and inspired gas leak correlated inversely within the patients (correlation coefficient: r = -0.56, p < .001) and between the patients (r = -0.58, p = .02). AH and oral moistness correlated within the patients (r = 0.39, p = .04) Oral breathing was associated with reduced oral moistness (p = .001) and increased NRS (p = .002). CONCLUSIONS:: AH varied among patients and some complained of oral dryness even with HH. Oral breathing decreased oral moistness and worsened feelings of dryness. PMID:23764857

Oto, Jun; Nakataki, Emiko; Okuda, Nao; Onodera, Mutsuo; Imanaka, Hideaki; Nishimura, Masaji

2013-06-13

226

Etiology and Outcome of Patients with HIV Infection and Respiratory Failure Admitted to the Intensive Care Unit  

PubMed Central

Background. Although access to HAART has prolonged survival and improved quality of life, HIV-infected patients with severe immunosuppression or comorbidities may develop complications that require critical care support. Our objective is to evaluate the etiology of respiratory failure in patients with HIV infection admitted to the ICU, its relationship with the T-lymphocytes cell count as well as the use of HAART, and its impact on outcome. Methods. A single-center, prospective, and observational study among all patients with HIV-infection and respiratory failure admitted to the ICU from December 1, 2011, to February 28, 2013, was conducted. Results. A total of 42 patients were admitted during the study period. Their median CD4 cell count was 123 cells/?L (mean 205.7, range 2.0–694.0), with a median HIV viral load of 203.5 copies/mL (mean 58,676, range <20–367,649). At the time of admission, 23 patients (54.8%) were receiving HAART. Use of antiretroviral therapy at ICU admission was not associated with survival, but it was associated with higher CD4 cell counts and lower HIV viral loads. Twenty-five patients (59.5%) had respiratory failure secondary to non-HIV-related diseases. Mechanical ventilation was required in 36 patients (85.1%). Thirteen patients (31.0%) died. Conclusions. Noninfectious etiologies of respiratory failure account for majority of HIV-infected patients admitted to ICU. Increased mortality was observed among patients with sepsis as etiology of respiratory failure (HIV related and non-AIDS related), in those receiving mechanical ventilation, and in patients with decreased CD4 cell count. Survival was not associated with the use of HAART. Complementary studies are warranted to address the impact of HAART on outcomes of HIV-infected patients with respiratory failure admitted to ICU.

Ahmad, Noeen; Butala, Ashvin; Flores, Rosemarie; Tran, Truc; Llosa, Alfonso; Fishkin, Edward

2013-01-01

227

Cutter roof failure: an overview of the causes and methods for control. Information Circular\\/1986  

Microsoft Academic Search

The Bureau of Mines is conducting research on the causes and methods for control of cutter roof failure in underground coal mines. The hazardous ground-control problem exposes miners to the danger of falling roof rock and frequently results in massive roof failure. The report outlines the probable causes of cutter roof failure, which are based on field investigations, numerical model

Hill

1986-01-01

228

[Role of biomarkers in the differential diagnosis of acute respiratory failure in the immediate postoperative period of lung transplantation].  

PubMed

Lung transplant recipients are at high risk of suffering many complications during the immediate postoperative period, such as primary graft dysfunction, acute graft rejection or infection. The most common symptom is the presence of acute respiratory failure, and the use of biomarkers could be useful for establishing an early diagnosis of these conditions. Different biomarkers have been studied, but none have proven to be the gold standard in the differential diagnosis of acute respiratory failure. This paper offers a review of the different biomarkers that have been studied in this field. PMID:23462428

Ruano, L; Sacanell, J; Roman, A; Rello, J

2013-02-22

229

CITED2 mutations potentially cause idiopathic premature ovarian failure.  

PubMed

Anomalies in gonadal development in a mouse knockout model of Cited2 have been recently described. In Cited2(-/-) female gonads, an ectopic cell migration was observed and the female program of sex determination was transiently delayed. We hypothesize that, in humans, this temporary inhibition of genes should be sufficient to provoke a developmental impairment of the female gonads, conducive to premature ovarian failure (POF). To establish whether CITED2 mutations are a common cause of the disease, we performed a mutational analysis of this gene in a panel of patients with POF and in a group of control women with normal fertility. We amplified and directly sequenced the complete open reading frame of CITED2 in 139 patients with POF and 290 controls. This study revealed 5 synonymous and 3 nonsynonymous variants. Among these, 7 are novel. The nonsynonymous variant c.604C>A (p.Pro202Thr) was found uniquely in 1 woman from the POF group. In silico analysis of this mutation indicated a potential deleterious effect. We conclude that mutations in CITED2 may be involved in POF pathogenesis. PMID:22709740

Fonseca, Dora Janeth; Ojeda, Diego; Lakhal, Besma; Braham, Rim; Eggers, Stefanie; Turbitt, Erin; White, Stefan; Grover, Sonia; Warne, Garry; Zacharin, Margaret; Nevin Lam, Alexandra; Landolsi, Hanène; Elghezal, Hatem; Saâd, Ali; Restrepo, Carlos Martín; Fellous, Marc; Sinclair, Andrew; Koopman, Peter; Laissue, Paul

2012-06-16

230

Noninvasive assessment of right and left ventricular function in acute and chronic respiratory failure  

SciTech Connect

This review evaluates noninvasive techniques for assessing cardiovascular performance in acute and chronic respiratory failure. Radiographic, radionuclide, and echocardiographic methods for determining ventricular volumes, right (RV) and left ventricular (LV) ejection fractions, and pulmonary artery pressure (PAP) are emphasized. These methods include plain chest radiography, radionuclide angiocardiography, thallium-201 myocardial imaging, and M mode and 2-dimensional echocardiography, which have recently been applied in patients to detect pulmonary artery hypertension (PAH), right ventricular enlargement, and occult ventricular performance abnormalities at rest or exercise. Moreover, radionuclide angiocardiography has proven useful in combination with hemodynamic measurements, for evaluating the short-and long-term cardiovascular effects of therapeutic agents, such as oxygen, digitalis, theophylline, beta-adrenergic agents, and vasodilators.

Matthay, R.A.; Berger, H.J.

1983-05-01

231

Role of noninvasive ventilation in elderly patients with hypercapnic respiratory failure.  

PubMed

The effectiveness of non-invasive ventilation (NIV) in treating patients with acute respiratory failure (ARF) is showed by its ability to diminish the recurrence to endotracheal intubation (ETI), the occurrence of ETI-associated lung infections as well as related mortality. A specific issue is the outcome of NIV in patients referring to Emergency Department for ARF who receive a do-not-intubate (DNI) order because of too critical conditions or advanced age. Recent data show that elderly patients (mean age 81 years) with ARF who have a DNI order can be successfully treated by NIV, as demonstrated by a survival rate of 83%. The positive outcome was confirmed by a subsequent 3-year observation, that demonstrated an overall survival rate of 54%. These findings clearly suggest to treat by NIV elderly patients also in presence of a DNI order. PMID:22362244

Riario-Sforza, G G; Scarpazza, P; Incorvaia, C; Casali, W

2012-01-01

232

Use of functional independence measure in rehabilitation of inpatients with respiratory failure.  

PubMed

Most outcomes do not deeply express the degree of disability in patients with respiratory failure (RF) following inpatient pulmonary rehabilitation (IPR). The aim of our study was to evaluate the efficacy of an IPR in patients with confirmed COPD and RF using functional independence measure (FIM) that determines the degree of disability experienced by patients and the progress they make during rehabilitation. This scale includes several items: self care, mobility, locomotion, communication and social recognition. Twenty-two patients (age 70+/-2 years, PO(2) 58.18+/-7.63mmHg, PCO(2) 46.82+/-9.11mmHg) were prospectively observed and studied. IPR included respiratory and peripheral muscle training, mucus evacuation techniques, and energy conservation techniques. FIM, Medical Research Council dyspnoea scale (MRC), St. George's Respiratory Questionnaire (SGRQ), and 6-min walking distance (6-MWD) were assessed on admission (pre) and discharge (post) from IPR. After IPR there was a statistically significant improvement (p<0.01) in all the FIM items (total score in self care, mobility, locomotion, social recognition) except for communication. Changes of MRC (pre 4.32+/-0.84; post 3.00+/-1.15, p<0.001), SGRQ (%) (pre 69.86+/-4.62; post 46.50+/-11.94, p<0.001), and 6-MWD (pre 164.54+/-98.63; post 214.32+/-97.64, p<0.001) paralleled those improvements. An inverse correlation between MRC and FIM (r=-0.5042, p=0.016) was observed. Our preliminary study has shown that the benefits of IPR in COPD with RF do not only translate in dyspnoea, exercise capacity and quality of life but also within neuromotor disabilities as assessed by FIM. Our results warrant future studies in pulmonary rehabilitation using FIM as an outcome measure. PMID:18977645

Pasqua, Franco; Biscione, Gian Luca; Crigna, Girolmina; Gargano, Romana; Cardaci, Vittorio; Ferri, Luigi; Cesario, Alfredo; Clini, Enrico

2008-11-01

233

[Diagnosis and management of exacerbations and acute respiratory failure in patients with chronic obstructive pulmonary disease].  

PubMed

Acute episode of chronic obstructive pulmonary disease occurs in almost all patients, during which cough, expectoration and dyspnea increase. When the underlying disease is not severe and the acute episode not life-threatening, the term "exacerbation" is appropriate, and the patients can be managed at home. When the underlying disease is advanced and the acute episode possibly life-threatening, the terms of "acute respiratory failure" or "decompensation" can be used. These patients are most often admitted to the hospital, and at times to the intensive care unit. Bronchodilators and respiratory physiotherapy form the basis of the management of acute episodes of COPD. In severe cases, oxygen must be administered, and the decision of an hospitalisation considered. Antibiotics and corticosteroids shoud not be prescribed in a systematic manner. In the most severe cases, non-invasive ventilation must be accessible. The prevention of acute episodes of COPD is best achieved through tobacco cessation and influenza vaccine. Finally, an acute episode may be an opportunity to make a diagnosis of COPD if this has not been done before. PMID:15497798

Similowski, Thomas; Cracco, Christophe; Duguet, Alexandre; Derenne, Jean-Philippe

2004-09-15

234

Pentraxin-3 in late-preterm newborns with hypoxic respiratory failure.  

PubMed

The aim of this study was: echocardiographical assessment of cardiac alterations in late-preterm newborns with hypoxic respiratory failure (HRF), and, study serum pentraxin-3 (PTX-3) in relation to the severity of respiratory impairment and to some echocardiographic parameters (i.e. ejection fraction (EF), stroke volume (SV) and cardiac output (CO). We enrolled in this study 40 newborn infants whose 22 (group I) with moderate HRF and 18 (group II) with severe HRF. In group I the mean values of EF, SV and CO were significantly higher than in the group II. Our results showed a significant increase of PTX-3 in group II patients at 24h of life when compared to group I. Taking patients all together (n=40), we found a significant (R=-73) reverse correlation between EF and serum values of PTX-3. PTX-3 in our patients with HRF is affected by the severity of the hypoxic insult and correlate with the cardio-vascular impairment. PMID:20515753

Sciacca, Pietro; Betta, Pasqua; Mattia, Carmine; Li Volti, Giovanni; Frigiola, Alessandro; Curreri, Sergio; Amato, Maurizio; Distefano, Giuseppe

2010-06-01

235

Effect of Dichlorphenamide on Gas Exchange and CSF Acid-Base State in Chronic Respiratory Failure  

PubMed Central

Dichlorphenamide was administered to 13 patients with chronic respiratory failure, and the effects on gas exchange at rest and during exercise and on the acid-base state of CSF were observed. The ventilation for a given level of CO2 production was increased both at rest and during exercise, resulting in an increased arterial Po2 and decreased Pco2. The ventilatory stimulation paralleled the development of a metabolic acidosis but was not associated with tissue CO2 accumulation. Indeed, CSF Pco2 and the oxygenated mixed venous (rebreathing) Pco2 fell by the same amount as arterial Pco2. The level of CO2 elimination after two minutes of exercise was as great for a given work load after dichlorphenamide as before. These findings do not support the view that the drug impairs CO2 transport from tissues either at rest or during exercise. They are most consistent with the view that the primary locus of action of dichlorphenamide in therapeutic doses is the kidney. The metabolic acidosis which results is likely the basis of the respiratory stimulatin, perhaps by its effects on the CSF H2CO3-HCO3 - system. Inhibition of carbonic anhydrase in the red cell and choroid plexus are probably unimportant effects. ImagesFig. 4

Naimark, Arnold; Cherniack, Reuben M.

1966-01-01

236

Role of extracorporeal lung assist in the treatment of acute respiratory failure.  

PubMed

For patients with most severe acute respiratory distress syndrome (ARDS) conservative treatment with lung protective ventilation is often not sufficient to prevent life-threatening hypoxemia and additional strategies are necessary. Extracorporeal lung assist (ECLA) or extracorporeal membrane oxygenation (ECMO) using capillary membrane oxygenators can provide sufficient gas exchange and lung rest. In 2 randomized trials mortality was unchanged for ECMO. Today an technically enhanced ECMO is used for most severe ARDS using clinical algorithm and different case studies demonstrated a survival rate about 56%. Today miniaturized ECMO with optimized blood pumps and oxygenators are available and could enhance safety and clinical management. Another approach is an arterio-venous pumpless interventional lung assist (ILA) with a low resistance oxygenator. Advantages seem a simplified clinical management and less blood trauma. At present new devices are developed for chronic respiratory failure or bridge to lung transplant. Oxygenators with even less flow resistance could be implanted paracorporeal using the right ventricle as driving force. An intravascular oxygenator has been developed using the combination of a miniaturized blood pump and an oxygenator for implantation in the vena cava. Well designed clinical trials are necessary to demonstrate a clinical benefit for these experimental devices. PMID:16682933

Kopp, R; Dembinski, R; Kuhlen, R

2006-06-01

237

Respiratory failure presenting in H1N1 influenza with Legionnaires disease: two case reports  

PubMed Central

Introduction Media sensationalism on the H1N1 outbreak may have influenced decisional processes and clinical diagnosis. Case Presentation We report two cases of patients who presented in 2009 with coexisting H1N1 virus and Legionella infections: a 69-year-old Caucasian man and a 71-year-old Caucasian woman. In our cases all the signs and symptoms, including vomiting, progressive respiratory disease leading to respiratory failure, refractory hypoxemia, leukopenia, lymphopenia, thrombocytopenia, and elevated levels of creatine kinase and hepatic aminotransferases, were consistent with critical illness due to 2009 H1N1 virus infection. Other infectious disorders may mimic H1N1 viral infection especially Legionnaires' disease. Because the swine flu H1N1 pandemic occurred in Autumn in Italy, Legionnaires disease was to be highly suspected since the peak incidence usually occurs in early fall. We do think that our immediate suspicion of Legionella infection based on clinical history and X-ray abnormalities was fundamental for a successful resolution. Conclusion Our two case reports suggest that patients with H1N1 should be screened for Legionella, which is not currently common practice. This is particularly important since the signs and symptoms of both infections are similar.

2011-01-01

238

Functional and histopathological identification of the respiratory failure in a DMSXL transgenic mouse model of myotonic dystrophy  

PubMed Central

SUMMARY Acute and chronic respiratory failure is one of the major and potentially life-threatening features in individuals with myotonic dystrophy type 1 (DM1). Despite several clinical demonstrations showing respiratory problems in DM1 patients, the mechanisms are still not completely understood. This study was designed to investigate whether the DMSXL transgenic mouse model for DM1 exhibits respiratory disorders and, if so, to identify the pathological changes underlying these respiratory problems. Using pressure plethysmography, we assessed the breathing function in control mice and DMSXL mice generated after large expansions of the CTG repeat in successive generations of DM1 transgenic mice. Statistical analysis of breathing function measurements revealed a significant decrease in the most relevant respiratory parameters in DMSXL mice, indicating impaired respiratory function. Histological and morphometric analysis showed pathological changes in diaphragmatic muscle of DMSXL mice, characterized by an increase in the percentage of type I muscle fibers, the presence of central nuclei, partial denervation of end-plates (EPs) and a significant reduction in their size, shape complexity and density of acetylcholine receptors, all of which reflect a possible breakdown in communication between the diaphragmatic muscles fibers and the nerve terminals. Diaphragm muscle abnormalities were accompanied by an accumulation of mutant DMPK RNA foci in muscle fiber nuclei. Moreover, in DMSXL mice, the unmyelinated phrenic afferents are significantly lower. Also in these mice, significant neuronopathy was not detected in either cervical phrenic motor neurons or brainstem respiratory neurons. Because EPs are involved in the transmission of action potentials and the unmyelinated phrenic afferents exert a modulating influence on the respiratory drive, the pathological alterations affecting these structures might underlie the respiratory impairment detected in DMSXL mice. Understanding mechanisms of respiratory deficiency should guide pharmaceutical and clinical research towards better therapy for the respiratory deficits associated with DM1.

Panaite, Petrica-Adrian; Kuntzer, Thierry; Gourdon, Genevieve; Lobrinus, Johannes Alexander; Barakat-Walter, Ibtissam

2013-01-01

239

Intranasal caseous fibrinous plug causing upper respiratory distress in two African grey parrots (Psittacus erithacus).  

PubMed

Two cases of intranasal caseous fibrinous plugs causing upper respiratory distress in two African grey parrots are described. The causal bacterial agents in one case were Klebsiella spp., Bacillus mycoides, Staphylococcus epidermitis, and Pasteurella multocida. Both cases produced pressure necrosis and obstruction of the naris. PMID:7259689

Burr, E W

240

[Acute respiratory distress syndrome caused by tropical eosinophilic lung disease: a case in Gabon].  

PubMed

The purpose of this report is to describe the case of a 28-year-old woman in whom acute respiratory distress syndrome (ARDS) following cholecystectomy led to the discovery of eosinophilic lung disease. Outcome was favorable after oxygenotherapy and medical treatment using ivermectin and corticosteroids. The case shows that hypereosinophilic syndrome can be the underlying cause of ARDS. PMID:21695880

Chani, M; Iken, M; Eljahiri, Y; Nzenze, J R; Mion, G

2011-04-01

241

WORLD TRADE CENTER FINE PARTICULATE MATTER CAUSES RESPIRATORY TRACT HYPERRESPONSIVENESS IN MICE  

EPA Science Inventory

World Trade Center Fine Particulate Matter Causes Respiratory Tract Hyperresponsiveness in Mice Stephen H. Gavett1, Najwa Haykal-Coates1, Jerry W. Highfill1, Allen D. Ledbetter1, Lung Chi Chen2, Mitchell D. Cohen2, Jack R. Harkema3, James G. Wagner3, and Daniel L. Costa1....

242

Failure of aerosolised 99mTc DTPA clearance to predict outcome in patients with adult respiratory distress syndrome.  

PubMed Central

The rate of clearance of technetium-99m labelled diethylene triamine pentacetic acid (99mTc DTPA) was measured in 32 patients with adult respiratory distress syndrome to determine if a more rapid clearance rate, possibly reflecting a more severe abnormality of pulmonary function, was associated with a reduced likelihood of recovery from pulmonary failure. Although the mean rate of clearance from lung to blood (T1/2LB) of 99mTc DTPA was more rapid in the patients (T1/2LB = 29 (SEM 3.2) min than in 42 normal subjects (T1/2LB = 59 (1.8)min), there was no difference between the clearance rate in the 18 patients who recovered from respiratory failure (T1/2LB = 31 (5) min) and the 14 who died (T1/2LB = 27 (4) min). Additionally, not all patients studied had abnormally rapid clearance rates. In 12 of the 32 patients the T1/2 fell within the range for normal individuals; this was found more commonly in patients who were predisposed to develop adult respiratory distress syndrome by pancreatitis or massive blood transfusion. These data suggest that a single measurement of 99mTc DTPA clearance in patients with established respiratory failure and adult respiratory distress syndrome is of no value in assessing the likelihood of recovery from this condition.

Royston, D; Braude, S; Nolop, K B

1987-01-01

243

Noninvasive vs invasive ventilation in COPD patients with severe acute respiratory failure deemed to require ventilatory assistance  

Microsoft Academic Search

Objective To determine whether non-invasive ventilation (NIV) may be an effective and safe alternative to invasive mechanical ventilation in chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF) meeting criteria for mechanical ventilation. Design and setting Matched case-control study conducted in ICU. Patients and intervention NIV was prospectively applied to 64 COPD patients with advanced ARF. Their outcomes

Enzo Squadrone; Pamela Frigerio; Claudio Fogliati; Cesare Gregoretti; Giorgio Conti; Massimo Antonelli; Roberta Costa; Paola Baiardi; Paolo Navalesi

2004-01-01

244

Noninvasive mechanical ventilation as a palliative treatment of acute respiratory failure in patients with end-stage solid cancer  

Microsoft Academic Search

Noninvasive ventilation (NIV) is widely used in the treatment of acute respiratory failure (ARF), but not in patients with end-stage solid cancer in whom any form of mechanical ventilation tends to be avoided. In a prospective study, we investigated the use of NIV in 23 patients with solid malignancies receiving palliative care and who were affected by severe hypoxic or

Annamaria Cuomo; Monica Delmastro; Piero Ceriana; Stefano Nava; Giorgio Conti; Massimo Antonelli; Emanuele Iacobone

2004-01-01

245

Compariso of two different modes for noninvasive mechanical ventilation in chronic respiratory failure: volume versus pressure controlled device  

Microsoft Academic Search

Comparison of two different modes for noninvasive mechanical ventilation in chronic respiratory failure: volume versus pressure controlled device. B. Schönhofer, M. Sonneborn, P. Haidl, H. Böhrer, D. Köhler. ©ERS Journals Ltd 1997. ABSTRACT: The most commonly used mode of noninvasive mechanical ventila- tion (NMV) is volume-controlled intermittent positive pressure ventilation (IPPV). Pressure support ventilation has recently become increasingly popular, but

B. Schönhofer; M. Sonneborn; P. Haidl; H. Böhrer; D. Köhler

1997-01-01

246

The Effect of Body Mass Index on Outcomes of Patients Receiving Noninvasive Positive-Pressure Ventilation in Acute Respiratory Failure  

Microsoft Academic Search

BACKGROUND: A study was undertaken to determine factors present in adult patients, newly admitted to the hospital, that predict the inability of noninvasive positive-pressure ventilation (NPPV) to sustain the work of breathing and avoid endotracheal intubation. METHODS: Data were collected prospectively from patients with acute respiratory failure who were admitted to Hackensack University Medical Center from August 2001 to August

Deborah A Hutter; Bart K Holland; Hormoz Ashtyani

247

Successful pregnancy with epidermal growth factor receptor tyrosine kinase inhibitor treatment of metastatic lung adenocarcinoma presenting with respiratory failure.  

PubMed

We report a woman presenting with respiratory failure due to a right-sided pleural effusion, lung metastases and lymphangitis carcinomatosis from advanced lung adenocarcinoma in the third trimester of pregnancy, who showed good response to EGFR tyrosine kinase inhibitor. PMID:21920622

Lee, Chee-Hong; Liam, Chong-Kin; Pang, Yong-Kek; Chua, Keong-Tiong; Lim, Boon-Khaw; Lai, Nai-Lang

2011-09-13

248

Severe murine typhus with shock and acute respiratory failure in a Japanese traveler after returning from Thailand.  

PubMed

We treated a case of severe murine typhus in a Japanese traveler after returning from Thailand. Although the disease is typically self-limited or mild, the patient showed shock and multiple organ failure including acute respiratory distress syndrome. Then the patient fully recovered following intensive care and administration of antirickettsial medicines. PMID:23279232

Sakamoto, Naoya; Nakamura-Uchiyama, Fukumi; Kobayashi, Ken-Ichiro; Takasaki, Tomohiko; Ogasawara, Yumiko; Ando, Shuji; Iwabuchi, Sentaro; Ohnishi, Kenji

2012-11-30

249

Delayed intrathyroidal hematoma causing respiratory distress after a seemingly benign fall: a case report  

Microsoft Academic Search

A rare event of a fall causing delayed intrathyroidal hematoma and respiratory distress is reported here. A 75-year-old woman\\u000a with symptoms of vertigo causing syncope and fall 24 h earlier was seen and discharged from our emergency department after\\u000a an unremarkable physical exam and 6-h observation period. Within 3 h of discharge, the patient was transported back by Emergency\\u000a Medical

Lucas B. Chartier; Joel P. Turner

2010-01-01

250

Six minute walking distance in kyphoscoliosis patients with chronic respiratory failure  

PubMed Central

Aim To evaluate kyphoscoliosis patients with chronic hypercapnic respiratory failure (CHRF) using the six minute walk test (6MWT) distance (6MWD) and cardio-pulmonary function tests. Method This prospective cross-sectional study was carried out in a tertiary training and research hospital in Turkey. Kyphoscoliosis patients with CHRF on home mechanical ventilation (HMV) followed in a respiratory intensive care unit (RICU) out-patient clinic were enrolled. Patients' demographics were recorded as well as transthoracic echocardiography (ECHO), 6MWD, spirometry, arterial blood gas (ABG) values and high resolution chest computed tomography. 6MWT results were compared with other parameters. Results Thirty four patients with kyphoscoliosis and chronic respiratory insufficiency admitted to our outpatient clinic were included in the study but 25 (17 M) patients underwent 6MWT (8 patients walked with oxygen supplement due to PaO2 < 60 mm Hg). The mean 6MWD was 274.4 ± 76.2 (median 270) m and median 6MWD predicted rate was 43.7% (inter quartile ratio, IQR, 37.6% to 47.7%). Median HMV use was 3 years (IQR 2-4). 6MWD predicted rate, body mass index (BMI), HMV duration were similar in male and female patients. 6MWD correlated well with age, BMI, dyspnea score for baseline 6MWT (r: - 0.59, p < 0.002, r: - 0.58, p < 0.003, r: - 0.55, p < 0.005 respectively) but modestly with forced expiratory volume in one second, pulse rate for baseline 6MWT, pulse saturation rate, fatigue and dyspnea score at end of 6MWT (r: - 0.44, p < 0.048; r: 0.44, p < 0.027; r: - 0.43, p < 0.031; r: - 0.42, p < 0.036; r: - 0.42, p < 0.034 respectively). 6MWD predicted rate was only correlated with dyspnea score at baseline (r: - 0.46, p < 0.022). The systolic pulmonary arterial pressure (PAPs) in 6 (24%) cases was more than 40 mmHg, in whom mean PaO2/FiO2 was 301.4 ± 55.4 compared to 280.9 ± 50.2 in those with normal PAPs (p > 0.40). Conclusion The 6MWT is an easy way to evaluate physical performance limitation in kyphoscoliosis patients with chronic hypercapnic respiratory failure using home mechanical ventilation. Nearly 275 m was the mean distance walked in the 6MWT, but rather than distance in meters, the 6MWD predicted rate according to gender and body mass index equation might be a better way for deciding about physical performance of these patients. Dyspnea score at baseline before the 6MWT may be the most important point that affects 6MWD in this patient population.

2010-01-01

251

Efficacy of noninvasive mechanical ventilation in obese patients with chronic respiratory failure.  

PubMed

Chronic respiratory failure (CRF) develops in a minority of obese patients. Noninvasive mechanical ventilation (NIMV) is a new optional treatment for such patients. The aim of this study was to evaluate the effectiveness of NIMV in obese patients with CRF. The material of the study consisted of 34 obese patients (body mass index 47.3 ± 7.9 kg/m(2)) with CRF (PaO2 = 6.40 ± 0.93 kPa and PaCO2 = 8.67 ± 2.13 kPa) who were hypoxemic despite an optimal therapy. Thirteen patients had an overlap syndrome (OS) - chronic obstructive pulmonary disease (COPD) coexisting with obstructive sleep apnea syndrome (OSAS) and 21 patients had obesity-hypoventilation syndrome (OHS). Ventilation parameters were determined during polysomnography. The efficacy of NIMV was evaluated on the fifth day and after 1 year's home treatment. We observed a significant increase in the mean blood oxygen saturation during sleep in all patients; the increase was greater in patients with OHS (92.6 ± 1.4 %) than in patients with OS (90.4 ± 1.8 %). There was a significant improvement of diurnal PaO2 and PaCO2 on the fifth day of NIMV (mean PaO2 increase 2.1 kPa and PaCO2 decrease 0.9 kPa) and also after 1 year of home NIMV (mean PaO2 increase 1.9 kPa and PaCO2 decrease 2.4 kPa). Only one patient stopped treatment because of lack of tolerance during the observation period (1-3 years). In conclusion, NIMV is an effective and well tolerated treatment option in obese patients with CRF resulting in a rapid relief of respiratory disorders during sleep and a gradual, long-term improvement of gas exchange during the day, particularly in patients with OHS. PMID:23835975

Piesiak, P; Brzecka, A; Kosacka, M; Jankowska, R

2013-01-01

252

High frequency jet ventilation in acute respiratory failure: which ventilator settings?  

PubMed

Seven hypoxaemic patients with acute respiratory failure were ventilated with HFJV (Ventilator VS 600). Arterial oxygenation was improved in each patient by the increases induced in mean airway pressure (PAW) (to 20 cm H2O) using three different ventilatory settings applied in a random order: technique A: I:E ratio 0.43, driving pressure 2.9 bar, no PEEP; technique B: I:E ratio 1.0, driving pressure 1.9 bar, no PEEP; technique C: I:E ratio 0.43, driving pressure 1.8 bar, PEEP 11 cm H2O. Respiratory frequency was maintained at 250 b.p.m. throughout the study. There were no significant differences in PaO2 (FlO2 = 1) or Qs/Qt between the three techniques. In contrast, carbon dioxide elimination was markedly affected by the method used to increase PAW:PaCO2 was significantly higher during technique C (8.5 +/- 3.6 kPa) and technique B (6.6 +/- 2.1 kPa) than during technique A (4.8 +/- 0.9 kPa). Significant increases in cardiac index, heartrate, mean pulmonary arterial pressure and a decrease in the arterio-venous oxygen content difference were observed when PaCO2 increased. We conclude that, to obtain the PAW necessary to improve pulmonary oxygen exchange, more effective carbon dioxide elimination is achieved by increasing the driving pressure, rather than by increasing the I:E ratio, or using a PEEP valve. PMID:3942665

Mal, H; Rouby, J J; Benhamou, D; Viars, P

1986-01-01

253

Evaluation of a transcutaneous carbon dioxide monitor in patients with acute respiratory failure  

PubMed Central

BACKGROUND: Non-invasive measurement of oxygenation is a routine procedure in clinical practice, but transcutaneous monitoring of PCO2(PtCO2) is used much less than expected. METHODS: The aim of our study was to analyze the value of a commercially available combined SpO2/PtCO2 monitor (TOSCA-Linde Medical System, Basel, Switzerland) in adult non-invasive ventilated patients with acute respiratory failure. Eighty critically ill adult patients, requiring arterial blood sample gas analyses, underwent SpO2 and PtCO2 measurements (10 min after the probe was attached to an earlobe) simultaneously with arterial blood sampling. The level of agreement between PaCO2 - PtCO2 and SaO2 - SpO2was assessed by Bland-Altman analyses. RESULTS: Both, SaO2 from blood gas analysis and SpO2 from the transcutaneous monitor, and PaCO2 and PtCO2 were equally useful. No measurements were outside of the acceptable clinical range of agreement of ± 7.5 mmHg. CONCLUSIONS: The accuracy of estimation of the TOSCA transcutaneous electrode (compared with the “gold standard” blood sample gas analysis) was generally good. Moreover, TOSCA presents the advantage of the possibility of continuous non-invasive measurement. The level of agreement of the two methods of measurement allows us to state that the TOSCA sensor is useful in routine monitoring of adults admitted to an intermediate respiratory unit and undergoing non-invasive ventilation.

Nicolini, Antonello; Ferrari, Maura Bravo

2011-01-01

254

Senile cardiac amyloidosis: an underappreciated cause of heart failure.  

PubMed

This case presents a patient with biopsy-proven, wild-type transthyretin (TTR) senile amyloidosis. The case was that of a man in his early 70s who presented with gradually progressive symptoms and signs of heart failure. The recent history included an episode of severe pancreatitis secondary to cholelithiasis and subsequently (and incidentally) noted hepatomegaly and marked ascites. Further evaluation of the aetiology of the heart failure, through echocardiography, coronary angiography and endomyocardial biopsy, led to an exact diagnosis of SSA. The patient is being treated with conventional heart failure medications while consideration is given to the use of diflusinal as an antiamyloidogenic small molecular stabiliser of TTR. Monitoring and further management advice are being coordinated by the National Amyloidosis Centre. PMID:23391947

Shah, Shreena; Dungu, Jason; Dubrey, Simon William

2013-02-06

255

Analysis of lightning-caused distribution transformer failures  

Microsoft Academic Search

This paper investigates the effects of direct strokes to medium-voltage (MV) lines by analyzing the surges at the primary and secondary sides of a single-phase distribution transformer installed in a typical rural network of the state of Rio Grande do Sul, located in the South of Brazil. The distribution transformers of AES Sul, the electric utility, present a high failure

T. O. de Carvalho; A. Piantini; P. F. Obase; J. M. Janiszewski; E. L. Batista

2011-01-01

256

Causes of Breathing Inefficiency During Exercise in Heart Failure  

Microsoft Academic Search

BackgroundPatients with heart failure (HF) develop abnormal pulmonary gas exchange; specifically, they have abnormal ventilation relative to metabolic demand (ventilatory efficiency\\/minute ventilation in relation to carbon dioxide production [VE\\/VCO2]) during exercise. The purpose of this investigation was to examine the factors that underlie the abnormal breathing efficiency in this population.

Paul R. Woods; Thomas P. Olson; Robert P. Frantz; Bruce D. Johnson

2010-01-01

257

Delayed intrathyroidal hematoma causing respiratory distress after a seemingly benign fall: a case report  

PubMed Central

A rare event of a fall causing delayed intrathyroidal hematoma and respiratory distress is reported here. A 75-year-old woman with symptoms of vertigo causing syncope and fall 24 h earlier was seen and discharged from our emergency department after an unremarkable physical exam and 6-h observation period. Within 3 h of discharge, the patient was transported back by Emergency Medical Services with an enlarging neck mass and subjective respiratory distress. CT scan demonstrated a large, expanding hematoma, and the patient underwent an emergency hemithyroidectomy. Hürtle cell adenoma was found on pathologic specimen examination. A review of the literature of similar cases is presented, emphasizing the notion that concurrent thyroid pathology is a risk factor for airway compromise after seemingly benign trauma and that airway compromise can present in a delayed fashion.

Turner, Joel P.

2010-01-01

258

Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome  

Microsoft Academic Search

Summary Background The worldwide outbreak of severe acute respiratory syndrome (SARS) is associated with a newly discovered coronavirus, SARS-associated coronavirus (SARS- CoV). We did clinical and experimental studies to assess the role of this virus in the cause of SARS. Methods We tested clinical and postmortem samples from 436 SARS patients in six countries for infection with SARS- CoV, human

Thijs Kuiken; Ron A M Fouchier; Martin Schutten; Guus F Rimmelzwaan; Geert van Amerongen; Debby van Riel; Jon D Laman; Ton de Jong; Gerard van Doornum; Wilina Lim; Ai Ee Ling; Paul K S Chan; John S Tam; Maria C Zambon; Robin Gopal; Christian Drosten; Sylvie van der Werf; Nicolas Escriou; Jean-Claude Manuguerra; Klaus Stöhr; J S Malik Peiris; Albert D M E Osterhaus

259

Structure–Activity Model of Chemicals That Cause Human Respiratory Sensitization  

Microsoft Academic Search

We report a structure–activity model of chemicals with the potential to cause respiratory allergy developed through the CASE\\/MultiCASE systems. Chemicals documented to elicit a decrease in FEV1of ?20% within 24 h of inhalation provocation challenge were used to form a learning set. Additional requirements for inclusion in the learning set were that chemicals had at least two contiguous nonhydrogen atoms

Cynthia Graham; Herbert S. Rosenkranz; Meryl H. Karol

1997-01-01

260

Acute Respiratory Distress Syndrome Caused by Mycoplasma Pneumoniae Diagnosed by Polymerase Chain Reaction  

PubMed Central

Mycoplasma pneumoniae (M. pneumoniae) is a common pathogen in cases of atypical pneumonia. Most individuals with Mycoplasma pneumonia run a benign course, with non-specific symptoms of malaise, fever and non-productive cough that usually resolve with no long-term sequelae. Acute lung injury is not commonly seen in Mycoplasma pneumonia. We report a case of acute respiratory distress syndrome cause by M. pneumoniae diagnosed by quantitative real-time polymerase chain reaction (RT-PCR).

Yew, Peter; Farren, David; Curran, Tanya; Coyle, Peter V; McCaughey, Conall; McGarvey, Lorcan

2012-01-01

261

Bilateral cystic pulmonary glial heterotopia and palatinal teratoma causing respiratory distress in an infant.  

PubMed

We report on a male infant with extensive, bilateral cystic and solid lung lesions who presented postnatally with respiratory distress caused by bilateral cystic lung lesions. Parenchyma-sparing resections were performed. Histology revealed the presence of neuroglial cell-lined cysts and glial nodules. In addition, a neural element containing palatinal teratoma was detected and excised. Based on previously published cases, the pathogenesis and clinical features of pulmonary neuroglial heterotopia are discussed. PMID:19944234

Dettmer, Petra; Beck, Maria; Eufinger, Harald; Rossler, Leon; Tannapfel, Andrea; Coerdt, Wiltrud; Tröbs, Ralf-Bodo

2009-11-01

262

Respiratory sound energy and its distribution patterns following clinical improvement of congestive heart failure: a pilot study  

PubMed Central

Background Although congestive heart failure (CHF) patients typically present with abnormal auscultatory findings on lung examination, respiratory sounds are not normally subjected to additional analysis. The aim of this pilot study was to examine respiratory sound patterns of CHF patients using acoustic-based imaging technology. Lung vibration energy was examined during acute exacerbation and after clinical improvement. Methods Respiratory sounds throughout the respiratory cycle were captured using an acoustic-based imaging technique. Twenty-three consecutive CHF patients were imaged at the time of presentation to the emergency department and after clinical improvement. Digital images were created (a larger image represents more homogeneously distributed vibration energy of respiratory sound). Geographical area of the images and respiratory sound patterns were quantitatively analyzed. Data from the CHF patients were also compared to healthy volunteers. Results The median (interquartile range) geographical areas of the vibration energy image of acute CHF patients without and with radiographically evident pulmonary edema were 66.9 (9.0) and 64.1(9.0) kilo-pixels, respectively (p < 0.05). After clinical improvement, the geographical area of the vibration energy image of CHF patients without and with radiographically evident pulmonary edema were increased by 18 ± 15% (p < 0.05) and 25 ± 16% (p < 0.05), respectively. Conclusions With clinical improvement of acute CHF exacerbations, there was more homogenous distribution of lung vibration energy, as demonstrated by the increased geographical area of the vibration energy image.

2010-01-01

263

[Non-invasive ventilation in treatment of adults with chronic respiratory failure].  

PubMed

Non-invasive mechanical ventilation (NIV) is a modern method of chronic respiratory failure (CRF) treatment. With the development of medicine and society known as "western", the number of elderly people, in whom there is overlapping of chronic diseases such as COPD, is growing. In adult population NIV is used in the treatment of neuromuscular diseases such as amyotrophic lateral sclerosis (ALS) or spinal muscular atrophy. The other main indications include restrictive diseases such as kyphoscoliosis, pulmonary diseases with COPD which is the primary indication, and various forms of central apnea syndrome with epidemiologically essential role of obesity hypoventilation syndrome (OHS). In each of those indications, and in different patients, the mode and ventilation intensity may significantly differ. The aim of this review is to disseminate knowledge on the potential role of NIV in adults with CRF. This paper attempts to analyze the available knowledge concerning NIV in adults with CRF. Special attention is paid to the potential pathomechanisms which should become the subject of future research. PMID:23744169

Skoczy?ski, Szymon; Ta?birek, Maciej; Pierzcha?a, W?adys?aw

2013-01-01

264

[Artificial lung ventilation using separate intubation of two main bronchi in patients with acute respiratory failure].  

PubMed

Two-luminal endotracheal tubes are used for one-lung or selective ventilation. However, in some cases there is a need for not only to isolate the lung, but also to exclude the trachea from ventilation, for example, in injuries of its distal portions. The use of a two-luminal endobronchial tube under these conditions does not always permit isolation of an affected area since the tracheal cuff is frequently above the site of an injury. For the treatment of such complications and for selective ventilation, it is proposed to use separate intubation of two main bronchi under guidance of fibrobronchoscopy. For this, two single-luminal bronchial tubes having different inlet openings are simultaneously used; one tube is inserted translaryngeally, the other is placed through the tracheostomic opening. The tube having a cut in the bronchial cuff with an opening for ventilation of the right upper lobar bronchus is employed for the right main bronchus. There are examples how to use separate intubation of the main bronchi in patients with acute respiratory failure. This procedure may be the method of choice for treating tracheal distal injuries and, if required, for performing selective artificial ventilation. The effects of the latter are analyzed. PMID:16076042

Galstian, G M; Shulutko, E M; Riazanova, I B; Iatskov, K V; Makhinia, V A; Togonidze, D K

265

Increased left ventricular stiffness impairs filling in dogs with pulmonary emphysema in respiratory failure.  

PubMed Central

In a chronic canine model of pulmonary emphysema, we studied the interaction between left ventricular (LV) mechanics and pulmonary disease during severe hypoxemia. The hypoxemia was similar to that which may occur during a severe exacerbation of chronic obstructive lung disease. In six dogs with papain-induced emphysema and in seven dogs without emphysema, LV mechanics were examined when a hypoxic gas mixture was inspired to reduce PO2 to about 35 mmHg (hypoxic study) and during nonhypoxic conditions (room air study). In both groups, LV diastolic compliance was reduced during the hypoxic study by a similar amount. This finding could not be explained in terms of ventricular interdependence. Our analysis suggested that hypoxia decreased diastolic compliance (i.e., increased LV diastolic stiffness) by impairing LV relaxation. The primary effect of hypoxia was to decrease the extent to which LV relaxation occurred for a given end-diastolic pressure, while the rate of LV relaxation was decreased just slightly. This study indicates that severe hypoxemia because of respiratory failure may impair myocardial relaxation leading to a decrease in LV filling.

Gomez, A; Mink, S

1986-01-01

266

[Subacute necrotizing lymphadenitis showing lymphatic blockade-mediated acute respiratory failure].  

PubMed

A 24-year-old woman was referred to our hospital with fever and cervical lymphadenopathy. On admission, her serum concentration of soluble IL-2 receptor had increased to 1,740 IU/ml, LDH was 2,889 IU/l, and ferritin was 2,389 ng/ml. Dyspnea became evident (PaO2 60 Torr) with a further increase of serum ferritin to 96,552 mg/ml on day 11. Chest CT findings showed the thickening of the interlobular septa, bilateral pleural effusion, and swelling of mediastinal lymph nodes, symptoms which were very similar to those associated with lymphangitis carcinomatosis. She received steroid pulse therapy (methylprednisolone, 1,000 mg/day for three days). This resulted in a rapid improvement of her dyspnea and disappearance of the lymphatic blockade-mediated pulmonary findings in two days. A cervical lymph node biopsy was performed on day 12, and revealed that she had subacute lymphadenitis (Kikuchi disease). This case suggests that acute respiratory failure should be considered in cases of Kikuchi disease when associated with a lymphatic blockade. PMID:16784097

Aota, Yasuo; Iguchi, Tomotaka; Sasaki, Yuko; Yokoyama, Tomohisa; Shoji, Nahoko; Itoh, Yoshikazu; Miyazawa, Keisuke; Matubayashi, Jun; Mukai, Kiyosi; Ohyashiki, Kazuma

2006-05-01

267

Leptospirosis: An ignored cause of acute renal failure in Taiwan  

Microsoft Academic Search

Leptospirosis, caused by a spirochete, is the most common zoonosis in domestic or wild animals. Animals excrete infected urine in soil or water and may cause human infections through abrased wound, mucosa, conjunctiva, or by swallowing contaminated water. Clinical presentations of leptospirosis are mostly subclinical. Five to ten percent of leptospirosis are fatal, causing fever, hemorrhage, jaundice, and acute renal

Chih-Wei Yang; Ming-Jeng Pan; Mai-Szu Wu; Yu-Ming Chen; Yu-Tang Tsen; Chun-Liang Lin; Cheng-Hung Wu; Chiu-Ching Huang

1997-01-01

268

Spinal anaesthesia for caesarean section in the presence of respiratory failure and spinal metastases from a soft tissue clear cell sarcoma.  

PubMed

Spinal metastases occur in up to 70% of all patients with cancer. However, only 10% are symptomatic. Before considering central neuraxial blockade in patients with malignancy, a history of back pain should be excluded. Anaesthetists should be aware that intrathecal and epidural injections could cause paraplegia if metastases are impinging on the spinal cord. Failure to achieve adequate sensory anaesthesia after central neuraxial blockade or presentation with postoperative paraplegia may indicate the presence of asymptomatic vertebral canal metastases. In this report, the anaesthetic management of a patient with respiratory failure and spinal metastases from a soft tissue sarcoma, requiring caesarean section is described. Sensory anaesthesia extending above a level of imminent cord compression was achieved despite loss of cerebrospinal fluid signal on magnetic resonance imaging. PMID:23809016

Miskovic, A M; Dob, D P

2013-05-09

269

CubeSats failures caused by space environment  

Microsoft Academic Search

When a satellite is in orbit, it remains in direct contact with a hostile environment. An analyzes of possible failures that have occurred with CubeSat class satellites due to this exposure is presented. These small satellites have 10cm cubic form and about 1.33 kilograms, they have all subsystems integrated on a single module that fits in the available intern volume,

Lucas Lourencena Caldas Franke; Nelson Jorge Schuch; Otavio Santos Cupertino Durao; Lucas Lopes Costa; Eduardo Escobar Burger; Rubens Zolar Gehlen Bohrer; Tardelli Ronan Coelho Stekel

2010-01-01

270

Causes and prevention of structural materials failures in naval environments  

Microsoft Academic Search

An analysis is made of most corrosion-related, naval aircraft, structural materials failure problems. The phenomena of stress corrosion cracking, hydrogen or environmental cracking, corrosion fatigue, and exfoliation corrosion are discussed. Methods of determining hydrogen embrittling effects and hydrogen concentration are related to sustained-load tolerances of cadmium plated high strength steels. An electromechanical test is described to illustrate the hydrogen-induced elastic

V. S. Agarwala; D. A. Berman; G. Kohlhaas

1985-01-01

271

Successful use of extracorporeal membrane oxygenation for acute respiratory failure in a patient with chronic granulomatous disease.  

PubMed

A 9-year-old boy presented with pneumonia, bilateral pulmonary lesions, and fulminant respiratory failure requiring support with extracorporeal membrane oxygenation (ECMO). Open lung biopsy and subsequent bronchoscopy identified Nocardia cyriacigeorgica and Burkholderia cepacia pneumonia. Chronic granulomatous disease (CGD) was diagnosed by an abnormal neutrophil oxidative burst assay. An aggressive diagnostic and therapeutic strategy, which included ECMO, allowed for patient survival and return to baseline function. No ECMO survivors with CGD have previously been reported. It is now recognized that several forms of CGD exist, and some forms may be compatible with long-term survival. Therefore, the diagnosis of CGD should not necessarily be considered a contraindication to ECMO. This is the first known survivor of CGD-related acute respiratory failure supported by ECMO. PMID:22595605

Madden, Jesse L; Schober, Michelle E; Meyers, Rebecka L; Bratton, Susan L; Holland, Steven M; Hill, Harry R; Rollins, Michael D

2012-05-01

272

Cutter roof failure: an overview of the causes and methods for control. Information Circular/1986  

SciTech Connect

The Bureau of Mines is conducting research on the causes and methods for control of cutter roof failure in underground coal mines. The hazardous ground-control problem exposes miners to the danger of falling roof rock and frequently results in massive roof failure. The report outlines the probable causes of cutter roof failure, which are based on field investigations, numerical model analysis, and in-mine observations. Traditional methods of control are presented, as well as innovative methods based on mining concepts developed during earlier years of coal-mining history. The report can be useful to a mine operator for assessing the causes of cutter roof failure on a site-by-site basis and for predicting the probability of its occurrence. A process is presented for selecting an optimum control method that includes both traditional and innovative control techniques for each of the various causes of cutter roof failure.

Hill, J.L.

1986-01-01

273

Noninvasive ventilation for the treatment of acute respiratory failure in patients with hematologic malignancies: a pilot study  

Microsoft Academic Search

Objective: To evaluate treatment with noninvasive ventilation (NIV) by nasal mask as an alternative to endotracheal intubation and\\u000a conventional mechanical ventilation in patients with hematologic malignancies complicated by acute respiratory failure to\\u000a decrease the risk of hemorrhagic complications and increase clinical tolerance. Design: Prospective clinical study. Setting: Hematologic and general intensive care unit (ICU), University of Rome “La Sapienza”. Patients:

G. Conti; P. Marino; A. Cogliati; A. Lappa; G. Rosa; A. Gasparetto

1998-01-01

274

Ventilator management for hypoxemic respiratory failure attributable to H1N1 novel swine origin influenza virus  

Microsoft Academic Search

Novel H1N1 swine origin influenza virus has led to a worldwide pandemic. During the pandemic, a significant number of patients became critically ill primarily because of respiratory failure. Most of these patients required intubation and mechanical ventilation and were treated with conventional modes of mechanical venti- lation using a lung-protective strategy with low tidal volumes, plateau pressures <30 to 35

Clare D. Ramsey; Duane Funk; Russell R. Miller III; Anand Kumar

2010-01-01

275

Dexmedetomidine facilitates induction of noninvasive positive pressure ventilation for acute respiratory failure in patients with severe asthma  

Microsoft Academic Search

Noninvasive positive pressure ventilation (NPPV) has been reported to be effective for acute respiratory failure in patients\\u000a with severe asthma. Although NPPV requires less sedative than invasive mechanical ventilation, agitated patients with severe\\u000a asthma should be given the minimum sedation necessary to facilitate the induction of NPPV. Two asthmatic patients (a 65-year-old\\u000a man and a 32-year-old woman) separately presented to

Yasushi Takasaki; Takanori Kido; Kazunori Semba

2009-01-01

276

Application of non-invasive mechanical ventilation in an asthmatic pregnant woman in respiratory failure: a case report  

PubMed Central

The use of non-invasive mechanical ventilation (NIV) during an asthma attack is controversial. We report a case of a 28-year-old female patient in her 16th week of pregnancy with community-acquired pneumonia who presented during an asthma attack, which led to hypoxic respiratory failure. She was successfully treated using NIV. This case is worth discussing as it includes two clinical conditions in which NIV is often considered contraindicated.

Caner, Hanife; Eryuksel, Emel; Kosar, Filiz

2013-01-01

277

Health-related quality of life and long-term prognosis in chronic hypercapnic respiratory failure: a prospective survival analysis  

Microsoft Academic Search

BACKGROUND: Health-related quality of life (HRQL) is considered as an important outcome parameter in patients with chronic diseases. This study aimed to assess the role of disease-specific HRQL for long-term survival in patients of different diagnoses with chronic hypercapnic respiratory failure (CHRF). METHODS: In a cohort of 231 stable patients (chronic obstructive pulmonary disease (COPD), n = 98; non-COPD (obesity-hypoventilation

Stephan Budweiser; Andre P Hitzl; Rudolf A Jörres; Kathrin Schmidbauer; Frank Heinemann; Michael Pfeifer

2007-01-01

278

Management of kyphoscoliosis patients with respiratory failure in the intensive care unit and during long term follow up  

PubMed Central

Background We aimed to evaluate the ICU management and long-term outcomes of kyphoscoliosis patients with respiratory failure. Methods A retrospective observational cohort study was performed in a respiratory ICU and outpatient clinic from 2002–2011. We enrolled all kyphoscoliosis patients admitted to the ICU and followed-up at regular intervals after discharge. Reasons for acute respiratory failure (ARF), ICU data, mortality, length of ICU stay and outpatient clinic data, non-invasive ventilation (NIV) device settings, and compliance were recorded. NIV failure in the ICU and the long term effect of NIV on pulmonary performance were analyzed. Results Sixty-two consecutive ICU kyphoscoliosis patients with ARF were enrolled in the study. NIV was initially applied to 55 patients, 11 (20%) patients were intubated, and the majority had sepsis and septic shock (p?

2012-01-01

279

Inhaled ?-agonist therapy and respiratory muscle fatigue as under-recognised causes of lactic acidosis.  

PubMed

A 49-year-old man with chronic obstructive pulmonary disease (COPD) presented with significant tachypnoea, fevers, productive cough and increased work of breathing for the previous 4 days. Laboratory data showed elevated lactate of 3.2 mEq/L. Continuous inhaled ipratropium and albuterol nebuliser treatments were administered. Lactate levels increased to 5.5 and 3.9 mEq/L, at 6 and 12 h, respectively. No infectious source was found and the lactic acidosis cleared as the patient improved. The lactic acidosis was determined to be secondary to respiratory muscle fatigue and inhaled ?-agonist therapy, two under-recognised causes of lactic acidosis in patients presenting with respiratory distress. Lactic acidosis is commonly used as a clinical marker for sepsis and shock, but in the absence of tissue hypoperfusion and severe hypoxia, alternative aetiologies for elevated levels should be sought to avoid unnecessary and potentially harmful medical interventions. PMID:24127377

Lau, Emily; Mazer, Jeffrey; Carino, Gerardo

2013-10-14

280

Effect of Selected Antiasthmatic Plant Constituents Against Micro Organism Causing Upper Respiratory Tract Infection  

PubMed Central

Most exacerbations of asthma can be proven to be associated with bacterial infections and there is scientific evidence that frequent respiratory infections particularly bacterial infections provoke asthma attack. Considering these facts different plant extracts and phytoconstituents with proven anti asthmatic property had been selected for screening anti microbial activity in in-vitro models. In the present study, Coleus forskohlii Willd. extract (10% Forskolin), Piper Longum L. Extract (20% Piperine), Adathoda vasica Nees. extract (30% Vasicinone), Curcuma longa L. extract (60% Curcumin) were screened for the antibacterial activity against human pathogens causing upper respiratory infection namely Haemophilus influenzae , Streptococcus pneumoniae , Streptococcus pyrogene and Staphylococcus aureus, by taking Gentamycin, Optochin, Bacitracin and Amoxicillin as reference standards. Except for Adathoda vasica Nees. extract, all the other selected plant extracts exhibited a moderate activity antibacterial activity against selected strains.

Nilani, P.; Duraisamy, B.; Dhamodaran, P.; Ravichandran, S.; Elango, K.

2010-01-01

281

Bilateral botryoid nephroblastoma: a rare cause of renal failure.  

PubMed

The authors describe the case of a 16-month-old girl who presented with bilateral hydronephrosis and renal failure secondary to bilateral renal pelvic botryoid Wilms' tumour (nephroblastoma). The term 'botryoid' describes an intrapelvic polypoid renal Wilms tumour, either extending from the renal parenchyma or primarily pelvis-based tumour. Both tumours filled the renal pelvis and extended down the proximal ureter, with no intraparenchymal tumour seen. Bilateral intralobar nephrogenic rests were present. Histological examination demonstrated triphasic nephroblastoma, with focal rhabdomyomatous differentiation of the stromal element bilaterally. Postchemotherapy, the patient underwent bilateral nephrectomy. Post complete resection of her bilateral disease, this patient has had an excellent outcome. This is only the third reported case of bilateral botryoid Wilms' tumour. While the condition is extremely rare, it should be included in the differential diagnosis of a young child with bilateral renal pelvic masses. PMID:22962373

Conlon, Niamh; Teoh, Chia Wei; Pears, Jane; O'Sullivan, Maureen

2012-09-07

282

Failure to detect antibody to bovine respiratory syncytial virus in bovine fetal serum.  

PubMed Central

Sera obtained from 147 bovine fetuses estimated to be between 120 and 270 days of gestation at an abattoir were tested for antibody to bovine respiratory syncytial virus. Antibody to bovine respiratory syncytial virus was not detected in any of the sera examined. Based on the results of this study and a review of the literature, it appears that transplacental infection by bovine respiratory syncytial virus does not occur, or is uncommon.

Baker, J C; Ciszewski, D K; Kirk, J H

1989-01-01

283

World Trade Center fine particulate matter causes respiratory tract hyperresponsiveness in mice.  

PubMed

Pollutants originating from the destruction of the World Trade Center (WTC) in New York City on 11 September 2001 have been reported to cause adverse respiratory responses in rescue workers and nearby residents. We examined whether WTC-derived fine particulate matter [particulate matter with a mass median aerodynamic diameter < 2.5 microm (PM2.5)] has detrimental respiratory effects in mice to contribute to the risk assessment of WTC-derived pollutants. Samples of WTC PM2.5 were derived from settled dust collected at several locations around Ground Zero on 12 and 13 September 2001. Aspirated samples of WTC PM2.5 induced mild to moderate degrees of pulmonary inflammation 1 day after exposure but only at a relatively high dose (100 microg). This response was not as great as that caused by 100 microg PM2.5 derived from residual oil fly ash (ROFA) or Washington, DC, ambient air PM [National Institute of Standards and Technology, Standard Reference Material (SRM) 1649a]. However, this same dose of WTC PM2.5 caused airway hyperresponsiveness to methacholine aerosol comparable to that from SRM 1649a and to a greater degree than that from ROFA. Mice exposed to lower doses by aspiration or inhalation exposure did not develop significant inflammation or hyperresponsiveness. These results show that exposure to high levels of WTC PM2.5 can promote mechanisms of airflow obstruction in mice. Airborne concentrations of WTC PM2.5 that would cause comparable doses in people are high (approximately 425 microg/m3 for 8 hr) but conceivable in the aftermath of the collapse of the towers when rescue and salvage efforts were in effect. We conclude that a high-level exposure to WTC PM2.5 could cause pulmonary inflammation and airway hyperresponsiveness in people. The effects of chronic exposures to lower levels of WTC PM2.5, the persistence of any respiratory effects, and the effects of coarser WTC PM are unknown and were not examined in these studies. Degree of exposure and respiratory protection, individual differences in sensitivity to WTC PM2.5, and species differences in responses must be considered in assessing the risks of exposure to WTC PM2.5. PMID:12782502

Gavett, Stephen H; Haykal-Coates, Najwa; Highfill, Jerry W; Ledbetter, Allen D; Chen, Lung Chi; Cohen, Mitchell D; Harkema, Jack R; Wagner, James G; Costa, Daniel L

2003-06-01

284

World Trade Center fine particulate matter causes respiratory tract hyperresponsiveness in mice.  

PubMed Central

Pollutants originating from the destruction of the World Trade Center (WTC) in New York City on 11 September 2001 have been reported to cause adverse respiratory responses in rescue workers and nearby residents. We examined whether WTC-derived fine particulate matter [particulate matter with a mass median aerodynamic diameter < 2.5 microm (PM2.5)] has detrimental respiratory effects in mice to contribute to the risk assessment of WTC-derived pollutants. Samples of WTC PM2.5 were derived from settled dust collected at several locations around Ground Zero on 12 and 13 September 2001. Aspirated samples of WTC PM2.5 induced mild to moderate degrees of pulmonary inflammation 1 day after exposure but only at a relatively high dose (100 microg). This response was not as great as that caused by 100 microg PM2.5 derived from residual oil fly ash (ROFA) or Washington, DC, ambient air PM [National Institute of Standards and Technology, Standard Reference Material (SRM) 1649a]. However, this same dose of WTC PM2.5 caused airway hyperresponsiveness to methacholine aerosol comparable to that from SRM 1649a and to a greater degree than that from ROFA. Mice exposed to lower doses by aspiration or inhalation exposure did not develop significant inflammation or hyperresponsiveness. These results show that exposure to high levels of WTC PM2.5 can promote mechanisms of airflow obstruction in mice. Airborne concentrations of WTC PM2.5 that would cause comparable doses in people are high (approximately 425 microg/m3 for 8 hr) but conceivable in the aftermath of the collapse of the towers when rescue and salvage efforts were in effect. We conclude that a high-level exposure to WTC PM2.5 could cause pulmonary inflammation and airway hyperresponsiveness in people. The effects of chronic exposures to lower levels of WTC PM2.5, the persistence of any respiratory effects, and the effects of coarser WTC PM are unknown and were not examined in these studies. Degree of exposure and respiratory protection, individual differences in sensitivity to WTC PM2.5, and species differences in responses must be considered in assessing the risks of exposure to WTC PM2.5.

Gavett, Stephen H; Haykal-Coates, Najwa; Highfill, Jerry W; Ledbetter, Allen D; Chen, Lung Chi; Cohen, Mitchell D; Harkema, Jack R; Wagner, James G; Costa, Daniel L

2003-01-01

285

Reliability-based failure cause assessment of collapsed bridge during construction  

Microsoft Academic Search

Until now, in many forensic reports, the failure cause assessments are usually carried out by a deterministic approach so far. However, it may be possible for the forensic investigation to lead to unreasonable results far from the real collapse scenario, because the deterministic approach does not systematically take into account any information on the uncertainties involved in the failures of

Hyun-Ho Choi; Sang-Yoon Lee; Il-Yoon Choi; Hyo-Nam Cho; Sankaran Mahadevan

2006-01-01

286

RETROPERITONEAL LEAKAGE AS A CAUSE OF ACUTE ULTRAFILTRATION FAILURE: ITS ASSOCIATED RISK FACTORS IN PERITONEAL DIALYSIS  

Microsoft Academic Search

? ? ? ? ? Background: Ultrafiltration failure is an important clini- cal problem in patients on maintenance peritoneal dialysis (PD) and is associated with high morbidity and mortality. Acute ultrafiltration failure (AUFF) is usually secondary to mechanical problems with the peritoneal catheter or peri- toneal leakage. Retroperitoneal leakage (RPL) is an impor- tant cause of AUFF and often poses

Man Fai Lam; Wai Kei; Kai Chung Tse; Terrence P. S. Yip

287

Cardiomegaly as a possible cause of lung dysfunction in patients with heart failure  

Microsoft Academic Search

Background Our hypothesis is that an enlarged heart may compete for space with the lungs, causing a restrictive pattern that is often seen in patients with chronic heart failure. Methods Eighty patients with stable congestive heart failure in New York Heart Association classes II and III participated in the study. We measured cardiothoracic index (chest radiography), FEV1, vital capacity, alveolar

PierGiuseppe Agostoni; Gaia Cattadori; Marco Guazzi; Pietro Palermo; Maurizio Bussotti; Giancarlo Marenzi

2000-01-01

288

Spontaneous mode non-invasive ventilation fails to treat respiratory failure in a patient with Multi-mincore disease: a case report  

Microsoft Academic Search

The increased morbidity and mortality resulting from respiratory failure in patients with neuromuscular disorders and\\/or kyphoscoliosis can be reversed with non-invasive ventilation. Spontaneous mode bilevel pressure ventilation is preferred to other modes of ventilation, due to relative ease of use, but may not be suitable for all patients. We report a 27-year old woman with Multi-minicore disease whose respiratory failure

Krishna B Sriram; Andrew Thornton; Ral Antic

2008-01-01

289

[Bullectomy as emergency intervention in a mechanically ventilated patient with refractory type II respiratory failure due to chronic obstructive lung disease (COPD)].  

PubMed

A 44-year-old female patient presented with an extensive exacerbation of severe chronic obstructive lung disease (COPD) and bullous emphysema. Because of a severe type II respiratory failure, the patient was intubated and mechanically ventilated. Respiratory failure was refractory despite appropriate ventilation regimes and pCO2 values ranged from 110 mm Hg to 180 mm Hg. Chest radiography revealed hyperinflation of two giant bullae with mediastinal shifting to the left lung. We describe a successful rescue bullectomy. PMID:18264895

Bastian, A; Khanavkar, B; Scherff, A; Witte, K; Behn, M; Schulte, E; Linder, A; Bollow, M; Ewig, S

2008-02-11

290

Surfactant therapy for maternal blood aspiration: an unusual cause of neonatal respiratory distress syndrome.  

PubMed

Surfactant replacement therapy is the main treatment of neonatal respiratory distress syndrome. However, surfactant therapy has been shown to be effective in the treatment of other diseases causing neonatal respiratory diseases such as pulmonary hemorrhage, meconium aspiration syndrome, pneumonia/sepsis, pulmonary edema or acute lung injury resulting a secondary surfactant deficiency (SSD). Rarely, as like as in the present patient, exogenous blood aspiration such as breast milk or formula aspiration may lead to SSD. Blood in alveolus leads to a significant biochemical and functional disturbance of the surfactant system and inhibits surfactant production. Here, the authors report a preterm infant of 33 wk gestational age with secondary surfactant deficiency due to maternal blood aspiration because of abruptio placentae. She was received two courses of beractant, a natural bovine surfactant, therapy in 24 h. She was extubated on second day and did not require oxygen on 4(th) day. To the authors' knowledge, this is the first reported case of SSD due to maternal blood aspiration treated with surfactant. In conditions such as abruptio placentae, infant should be protected from blood aspiration and if respiratory distress occurs, surfactant inhibition and need for surfactant administration should be considered. PMID:22120615

Celik, Istemi Han; Demirel, Gamze; Canpolat, Fuat Emre; Erdeve, Omer; Dilmen, Ugur

2011-11-26

291

What Causes Failure and Success? Students' Perceptions of Their Academic Outcomes  

ERIC Educational Resources Information Center

How do students' conceptualize the causes of their own academic successes and failures? Taking a phenomenological approach, students identified the causes of their performance immediately following return of a graded examination. We then used factor and item analyses to organize causes that were identified by a substantial number of students into…

Forsyth, Donelson R.; Story, Paul A.; Kelley, Karl N.; McMillan, James H.

2009-01-01

292

Pellagra: A clue as to why energy failure causes diseases?  

PubMed

Pellagra is a curable dietary illness that unchecked leads to dementia, diarrhoea, dermatitis and death due to lack of the precursors for NAD(H). In addition it caused a wide range of monosyndromic degenerative and functional neurological disorders as well as profound developmental, premature aging and metabolic syndromes. Pellagrins harbour many chronic infections including tuberculosis, yeasts and malaria, that may be symbionts supplying nicotinamide adenine dinucleotide {NAD(H)} when the diet is poor. Many common diseases and aging may be caused by electrogenic energy mismatches from lack of a timely supply of NAD(H) creating disturbed metabolic fields and "protonopathies". Initially these may present in compartments fronted by homeostatic corrections from chronic symbiotic infections to inflammatory disease, cancer and degenerative/autophagic diseases that can all release NAD(H). PMID:17349750

Williams, Adrian C; Ramsden, David B

2007-03-08

293

Causes for the failure of water-heater pipes in ammonia production  

Microsoft Academic Search

The causes for the failure of subassemblies and components of apparatus used for chemical production should be diagnosed using modern methods of investigation for the complex study of the properties of the damaged metal and the character of the fracture. We investigated the character and causes of the failure of type 12KhlSNIOT steel pipes 21.7  3.5 mm in diameter,

M. B. Shapiro; Yu. P. Surkov; M. B. Chizhmakov; A. L. Belinkii; O. M. Sokolova; V. G. Rybalko

1987-01-01

294

[Renal failure in a couple caused by Puumala hantavirus].  

PubMed

In Scandinavia Puumala hantavirus causes nephropathia epidemica (NE), characterised by an acute debut of fever, headache, increasing back and abdominal pain, thrombocytopenia, increasing azotemia parameters, as well as microscopic haematuria and mild proteinuria. In some cases transitory myopia can be found. The diagnosis is made with a relevant clinical history and serology, and in most cases a kidney biopsy is not necessary. There is a risk of missing cases of NE as in this case, where a couple became infected by Puumala Hantavirus in a high-risk area but became ill in an area with a low prevalence. PMID:23121909

Redal-Baigorri, Belén; Thiesson, Helle C; Skarphedinsson, Sigurdur

2012-10-29

295

Tracheostomy timing and the duration of weaning in patients with acute respiratory failure  

PubMed Central

Introduction The effect of various airway management strategies, such as the timing of tracheostomy, on liberation from mechanical ventilation (MV) is uncertain. We tested the hypothesis that tracheostomy, when performed prior to active weaning, does not influence the duration of weaning or of MV in comparison with a more selective use of tracheostomy. Patients and methods In this observational prospective cohort study, surgical patients requiring ? 72 hours of MV were followed prospectively. Patients undergoing tracheostomy prior to any active weaning attempts (early tracheostomy [ET]) were compared with patients in whom initial weaning attempts were made with the endotracheal tube in place (selective tracheostomy [ST]). Results We compared the duration of weaning, the total duration of MV and the frequency of fatigue and pneumonia. Seventy-four patients met inclusion criteria. Twenty-one patients in the ET group were compared with 53 patients in the ST group (47% of whom ultimately underwent tracheostomy). The median duration of weaning was shorter (3 days versus 6 days, P = 0.05) in patients in the ET group than in the ST group, but the duration of MV was not (median [interquartile range], 11 days [9–26 days] in the ET group versus 13 days [8–21 days] in the ST group). The frequencies of fatigue and pneumonia were lower in the ET group patients. Discussion Determining the ideal timing of tracheostomy in critically ill patients has been difficult and often subjective. To standardize this process, it is important to identify objective criteria to identify patients most likely to benefit from the procedure. Our data suggest that in surgical patients with resolving respiratory failure, a patient who meets typical criteria for a trial of spontaneous breathing but is not successfully extubated within 24 hours may benefit from a tracheostomy. Our data provide a framework for the conduct of a clinical trial in which tracheostomy timing can be assessed for its impact on the duration of weaning. Conclusion Tracheostomy prior to active weaning may hasten liberation from ventilation and reduce complications. However, this does not reduce the overall duration of MV.

Boynton, Jackie H; Hawkins, Kenneth; Eastridge, Brian J; O'Keefe, Grant E

2004-01-01

296

Heart rate fluctuations of lower frequencies than the respiratory rhythm but caused by it  

Microsoft Academic Search

In conscious adult rabbits,“classical” respiratory sinus arrhythmia does not occur because the respiratory frequency (RF) always exceeds half the heart rate (HR). However, slow HR fluctuations, not synchronous with the respiratory rhythm but affected by it, occur systematically. We have shown that these can be calculated by using aliasing rules. During general anaesthesia, when the RF decreases so that respiratory

Ulrich Zwiener; Bodo Lüthke; Reinhard Bauer; Dirk Hoyer; Annette Richter; Hans Wagner

1995-01-01

297

A huge bladder calculus causing acute renal failure.  

PubMed

We present a 39-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) and IVU film showed a huge 450-g elliptical pelvic calculus that was surgically removed with excellent results. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. PMID:20033143

Wei, Wuran; Wang, Jia

2009-12-22

298

Equipment: Causes of refinery equipment failure and means for eliminating failures  

SciTech Connect

The petroleum refining and petrochemical industry, both here and abroad, incurs major losses due to corrosion damage, amounting to 10-12% of the production cost in refineries. About 60% of all premature failures of equipment are due to corrosion of various elements of the equipment. Of the various types of condensing and cooling equipment in atmospheric-vacuum tubestill units, the condenser/coolers on the overhead line from the atmospheric tower are the most susceptible to corrosion damage. The head fractions of the crude that are condensed in the tubes contain hydrogen sulfide and hydrogen chloride (formed as a result of conversion of organic sulfur and chlorine compounds present in the original crude), along with moisture. This combination produces acids and sharply increases the corrosivity of the working medium in the equipment. From our analysis we have been able to relate the failures to the very marked increases of hydrogen sulfide and hydrogen chloride contents in the head fraction, obviously as a consequence of the high contents of these corrosive components in the condensate from the barometric box (most of the hydrogen sulfide and hydrogen chloride enters the condensate when the head fraction is condensed and the hydrocarbon part of the condensate is separated from the water).

Medvedeva, M.L.

1995-01-01

299

Failure-cause analysis: air preheaters. Final report  

SciTech Connect

This final report under RP1265-8 is one of several surveys being conducted through the Fossil Plant Performance and Reliability Program to define more clearly the major generic equipment and/or operating problems responsible for utility power plant outages. This survey includes input from 40 US utilities encompassing 118 generating units with an average size over 500 MW and using 236 air heaters. Data analysis resulting from this study clearly demonstrates problems with air preheater systems and their components that contribute to loss in performance and unavailability of generating units. Nine major problem areas are identified: corrosion, fouling, plugging, soot blowers, water wash system, seals, fires, and drive and bearing systems. The indicated causes and effects are discussed. Recommendations are made to improve the reliability of existing air preheaters, and generic problems requiring future research and application of existing technologies are identified. It is also recommended that users place more emphasis on the initial procurement phase to specify those design features that improve reliability. Another recommendation is to encourage manufacturers to accelerate their efforts to improve the technology and correct critical problems by upgrading their designs. Implementation of the recommendations included in this report by users and manufacturers can substantially improve the availability of air preheaters.

Maloney, K.L.; Benson, R.C.

1981-07-01

300

An Achondroplasic Case with Foramen Magnum Stenosis, Hydrocephaly, Cortical Atrophy, Respiratory Failure and Sympathetic Dysfunction  

PubMed Central

Background Achondroplasia is a relatively frequent genetic disorder that may lead to limb weakness, motor-mental retardation, hydrocephaly, and respiratory disorders. In this pathology, foramen magnum stenosis and accompanying disorders like respiratory depression is well documented. Case Presentation A 2.5 year-old child with the diagnosis of achondroplasia admitted to our clinic with severe respiratory depression, limb weakness, and motor mental retardation as well as sympathetic dysfunction. In radiologic evaluations, severe foramen magnum stenosis was detected. The patient was operated and posterior fossa decompression was accomplished to prevent compression of respiratory centers and neurons. Conclusion This case is unique with the narrowest foramen magnum reported up to date and the sympathetic dysfunction which is not reported as a complication in achondroplasic patients. The authors review the relevant literature, focusing on the indications for cervicomedullary decompression in infants with achondroplasia.

Ozcetin, Mustafa; Arslan, Mehmet Tayip; Karapinar, Bulent

2012-01-01

301

Lemierre's syndrome and rapidly deteriorating respiratory failure in the emergency department.  

PubMed

Rapidly progressive acute respiratory distress along with life-threatening gram-negative anaerobic sepsis in a young, immunocompetent individual should always raise concern for Lemierre's syndrome. Although still rare, the incidence of Lemierre's syndrome has been increasing over the past 20 years. Lemierre's syndrome is characterized by postanginal septicemia and secondary internal jugular vein suppurative thrombophlebitis. In the emergency department (ED), patients often present with evidence of sepsis and secondary septic emboli to different organs, primarily the lungs.We report a case of a 24-year-old patient who presented to the ED with acute respiratory distress with an atypical and rapidly deteriorating course. She was later diagnosed with Lemierre's syndrome and recovered well after antibiotic treatment, respiratory support, and a lengthy intensive care unit stay. This case report represents an atypical presentation of acute respiratory distress and pharyngitis but is classic for Lemierre's syndrome. PMID:22033390

Dorfman, Annette; Shokoohi, Hamid; Taheri, M Reza

2011-10-26

302

Mechanisms of improvement of respiratory failure in patients with restrictive thoracic disease treated with non-invasive ventilation  

PubMed Central

Background: Nocturnal non-invasive ventilation (NIV) is an effective treatment for hypercapnic respiratory failure in patients with restrictive thoracic disease. We hypothesised that NIV may reverse respiratory failure by increasing the ventilatory response to carbon dioxide, reducing inspiratory muscle fatigue, or enhancing pulmonary mechanics. Methods: Twenty patients with restrictive disease were studied at baseline (D0) and at 5–8 days (D5) and 3 months (3M). Results: Mean (SD) daytime arterial carbon dioxide tension (PaCO2) was reduced from 7.1 (0.9) kPa to 6.6 (0.8) kPa at D5 and 6.3 (0.9) kPa at 3M (p = 0.004), with the mean (SD) hypercapnic ventilatory response increasing from 2.8 (2.3) l/min/kPa to 3.6 (2.4) l/min/kPa at D5 and 4.3 (3.3) l/min/kPa at 3M (p = 0.044). No increase was observed in measures of inspiratory muscle strength including twitch transdiaphragmatic pressure, nor in lung function or respiratory system compliance. Conclusions: These findings suggest that increased ventilatory response to carbon dioxide is the principal mechanism underlying the long term improvement in gas exchange following NIV in patients with restrictive thoracic disease. Increases in respiratory muscle strength (sniff oesophageal pressure and sniff nasal pressure) correlated with reductions in the Epworth sleepiness score, possibly indicating an increase in the ability of patients to activate inspiratory muscles rather than an improvement in contractility.

Nickol, A; Hart, N; Hopkinson, N; Moxham, J; Simonds, A; Polkey, M

2005-01-01

303

Non-invasive ventilatory approach to treatment of acute respiratory failure in neuromuscular disorders. A comparison with endotracheal intubation  

Microsoft Academic Search

Objective: Prospectively to investigate the efficacy of non-invasive positive pressure ventilation (NPPV) combined with cricothyroid\\u000a “mini-tracheostomy” (CM) as a first-line intervention in patients with acute respiratory failure (ARF) of neuromuscular origin,\\u000a in comparison with positive pressure ventilation (PPV) via endotracheal intubation (ETI).¶Design: Prospective analysis of the short-term outcomes of 14 non-consecutive patients suffering from ARF of neuromuscular origin\\u000a who were

A. Vianello; M. Bevilacqua; G. Arcaro; F. Gallan; E. Serra

2000-01-01

304

Accuracy of a transcutaneous carbon dioxide pressure monitoring device in emergency room patients with acute respiratory failure  

Microsoft Academic Search

Purpose  Transcutaneous CO2 monitors are widely used in neonatal ICUs. Until recently, these devices performed poorly in adults. Recent technical modifications\\u000a have produced transcutaneous CO2 monitors that have performed well in adults with chronic illnesses. We evaluated the accuracy of one of these devices, the\\u000a TOSCA® 500, in adults admitted to an emergency department for acute respiratory failure.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We prospectively collected

P.-E. Gancel; E. Roupie; L. Guittet; S. Laplume; N. Terzi

2011-01-01

305

Respiratory failure associated with the lipodystrophy syndrome in an HIV-positive patient with compromised lung function.  

PubMed

Protease inhibitors, used as treatment in human immunodeficiency virus (HIV) infection, are associated with a syndrome of peripheral lipodystrophy, central adiposity, hyperlipidemia and insulin resistance. An HIV-positive patient with chronic obstructive pulmonary disease is presented who developed the lipodystrophy syndrome that is associated with the use of protease inhibitors. It is postulated that the lipodystrophy syndrome further compromised his lung function, leading to respiratory failure. Patients who have pulmonary disease and are taking protease inhibitors require monitoring of clinical status and pulmonary function tests. PMID:11521144

Press, N; Montessori, V; Bai, T R; Montaner, J

306

Improved Outcomes of Patients with End-stage Cystic Fibrosis Requiring Invasive Mechanical Ventilation for Acute Respiratory Failure  

Microsoft Academic Search

Study Objectives  The aim of this study was to determine the effects of an antibiotic strategy with intravenous (IV) continuous infusion of\\u000a a ?-lactam (CIBL) antibiotic and high-dose extended-interval (HDEI) tobramycin upon outcomes in patients with cystic fibrosis\\u000a (CF) requiring invasive mechanical ventilation (IMV) for acute respiratory failure.\\u000a \\u000a \\u000a \\u000a \\u000a Design  The study was a retrospective review from June 1, 2006, to December 1,

Don Hayes Jr; Heidi M. Mansour

307

Gas gangrene: An unusual cause of graft failure in an orthotopic pediatric liver transplant  

Microsoft Academic Search

Gas gangrene of the liver is a very unusual cause of graft failure, and gas gangrene caused byEnterobacter cloacae is also exceedingly rare. Although Clostridial infection could not be excluded in this case, the literature and our case show thatEnterobacter cloacae can be present in gas gangrene tissue whether or not it is the only infecting organism.

T. R. Hall; A. Poon; H. Yaghsczian; M. I. Boechat

1992-01-01

308

Differential Ability of Occupational Chemical Contact and Respiratory Allergens to Cause Immediate and Delayed Dermal Hypersensitivity Reactions in Mice  

Microsoft Academic Search

Trimellitic anhydride (TMA) is known to cause occupational respiratory allergy associated with the presence of specific IgE antibody. Other chemicals, such as 2,4-dinitrochlorobenzene (DNCB), while exhibiting a clear potential for contact sensitization, apparently lack the ability to induce respiratory allergy in man. It has been shown previously that although both chemicals are immunogenic in mice, each provoking contact sensitization, exposure

R. J. Dearman; J. A. Mitchell; D. A. Basketter; I. Kimber

1992-01-01

309

Reproductive success and causes of nest failures for Mississippi Kites: A sink population in eastern Arkansas?  

Microsoft Academic Search

In the White River National Wildlife Refuge, we located and monitored 39 Mississippi Kite (Ictinia mississippiensis) nests during the 2004 and 2005 breeding seasons to examine reproductive success and causes of nesting failures. Nest failures\\u000a were documented using five video recording systems. All kite nests not monitored with a video recording system were observed\\u000a every 3 or 4 d. The

Troy J. Bader; James C. Bednarz

2009-01-01

310

An implicit method for incorporating common-cause failures in system analysis  

Microsoft Academic Search

A general procedure incorporates common-cause (CC) failures into system analysis by an implicit method; i.e., after first solving the system probability equation without CC failures. Components of subsets are assumed to be equally vulnerable to CC of any particular multiplicity. The method allows for age-dependent hazard rates, repairable and nonrepairable components, systems with multiple CC groups, and systems where not

Jussi K. Vaurio

1998-01-01

311

Multiple, Bilateral Fibroepithelial Polyps Causing Acute Renal Failure in a Gastric Cancer Patient  

PubMed Central

We report a case of primary fibroepithelial polyps (FEPs) in the middle of both ureters in a patient with advanced gastric cancer and acute renal failure. Ureteral FEPs are rare benign lesions, and multiple, bilateral lesions are extremely rare. To our knowledge, this report is the seventh case of bilateral FEPs in the literature. Our case has clinical implications because FEPs should be considered as a cause of ureteral obstruction inducing acute renal failure in advanced gastric cancer.

Kim, Sun-Ouck; Youn, Chul Woong; Im, Chang Min; Jung, Sung Il; Oh, Kyung Jin; Kwon, Dongdeuk; Park, Kwangsung; Ryu, Soo Bang

2010-01-01

312

Failure-cause analysis: fossil-fired boilers, pressure parts. Final report  

Microsoft Academic Search

Root-cause failure analyses were conducted to determine the reason for high forced-outage rates attributed to boiler-pressure-part failures in four medium-sized fossil-fired electricity generating units. Those analyses were conducted not only to identify the reasons for the high forced-outage rates in the four boilers selected for study, which are discussed in detail in this report, but also to identify areas where

R. A. Wood; D. N. Williams; W. E. Berry; J. H. Payer

1981-01-01

313

Thrombotic microangiopathy: an atypical cause of acute renal failure in patients with acute pancreatitis  

Microsoft Academic Search

ObjectiveTo report on the development and treatment of thrombotic microangiopathy, an atypical cause of acute renal failure in patients with acute pancreatitis.DesignCase reports.SettingA 21-bed medical intensive care unit at an university hospital.PatientsTwo men with acute pancreatitis presented with acute renal failure, neurological manifestations, haemolytic anaemia and thrombocytopenia. Both patients required intensive care.MeasurementsFragmented red cell count; levels of haptoglobin, amylase and

Alexandre Boyer; Karim Chadda; Amar Salah; Guy Bonmarchand

2004-01-01

314

Antimicrobial Treatment Failures in Patients with Community-acquired Pneumonia Causes and Prognostic Implications  

Microsoft Academic Search

The aim of the study was to determine the causes and prognostic implications of antimicrobial treatment failures in patients with non- responding and progressive life-threatening, community-acquired pneumonia. Forty-nine patients hospitalized with a presumptive diagnosis of community-acquired pneumonia during a 16-mo pe- riod, failure to respond to antimicrobial treatment, and docu- mented repeated microbial investigation > 72 h after initiation of

FRANCISCO ARANCIBIA; SANTIAGO EWIG; JOSE ANTONIO MARTINEZ; MAURICIO RUIZ; TORSTEN BAUER; MARIA ANGELES MARCOS; JOSEP MENSA; ANTONI TORRES

315

[Secondary amyloidosis with irreversible acute renal failure caused by visceral leishmaniasis in a patient with AIDS].  

PubMed

We report a case of visceral leishmaniasis and acute renal failure in a white male patient, 28 years of age, infected with the human immunodeficiency virus (HIV). The clinical presentation of the patient was diarrheic syndrome of long evolution, fever, hepatosplenomegaly and pancytopenia, accompanied by nephrotic syndrome and irreversible acute renal failure. Renal biopsy showed glomerular AA amyloid deposits. This is the first case described in humans of secondary amyloidosis caused by visceral leishmaniasis. PMID:17227255

Navarro, M; Bonet, J; Bonal, J; Romero, R

2006-01-01

316

Acute Failure of Catheter Ablation for Ventricular Tachycardia Due to Structural Heart Disease: Causes and Significance  

PubMed Central

Background Acute end points of catheter ablation for ventricular tachycardia (VT) remain incompletely defined. The aim of this study is to identify causes for failure in patients with structural heart disease and to assess the relation of this acute outcome to longer?term management and outcomes. Methods and Results From 2002 to 2010, 518 consecutive patients (84% male, 62±14 years) with structural heart disease underwent a first ablation procedure for sustained VT at our institution. Acute ablation failure was defined as persistent inducibility of a clinical VT. Acute ablation failure was seen in 52 (10%) patients. Causes for failure were: intramural free wall VT in 13 (25%), deep septal VT in 9 (17%), decision not to ablate due to proximity to the bundle of His, left phrenic nerve, or a coronary artery in 3 (6%), and endocardial ablation failure with inability or decision not to attempt to access the epicardium in 27 (52%) patients. In multivariable analysis, ablation failure was an independent predictor of mortality (hazard ratio 2.010, 95% CI 1.147 to 3.239, P=0.004) and VT recurrence (hazard ratio 2.385, 95% CI 1.642 to 3.466, P<0.001). Conclusions With endocardial or epicardial ablation, or both, acute ablation failure was seen in 10% of patients, largely due to anatomic factors. Persistence of a clinical VT is associated with recurrence and comparatively higher mortality.

Tokuda, Michifumi; Kojodjojo, Pipin; Tung, Stanley; Tedrow, Usha B.; Nof, Eyal; Inada, Keiichi; Koplan, Bruce A.; Michaud, Gregory F.; John, Roy M.; Epstein, Laurence M.; Stevenson, William G.

2013-01-01

317

Cause and analysis of stator and rotor failures in three-phase squirrel-cage induction motors  

Microsoft Academic Search

The squirrel cage induction motor has limitations, which, if exceeded, will result in premature failure of the stator or rotor. The authors identify the various causes of stator and rotor failures. A specific methodology is proposed to facilitate an accurate analysis of these failures. Failures of the bearings and lubrication systems are excluded

Austin H. Bonnett; George C. Soukup

1992-01-01

318

Liver transplantation for acute liver failure caused by macrophage activation syndrome.  

PubMed

Macrophage activation syndrome (MAS) is a rare, potentially fatal condition, which most frequently complicates rheumatological conditions and is often associated with liver dysfunction. In this case report of a patient with MAS, acute liver failure developed despite conventional immunosuppressive therapy. Liver transplantation resulted in rapid recovery and the patient has remained well for six years. A recent diagnosis of Adult Onset Still's Disease (AOSD) provides additional supporting evidence that the initial presentation was caused by MAS. While transplantation in the context of systemic disease remains controversial, this first reported case of successful adult liver transplantation for acute liver failure caused by MAS raises an interesting clinical dilemma. PMID:23981123

Orr, James; Bury, Yvonne; Hudson, Mark; Masson, Steven

2013-08-24

319

Heart failure caused by hookworm infection possibly associated with organic food consumption.  

PubMed

An 87-year-old man with heart failure caused by severe anemia was referred to our hospital. Gastroenteroscopy revealed the existence of several parasites in the duodenum. Examination of the stool by a formalin-ethyl acetate concentration technique detected hookworm eggs. After a single dose of pyrantel pamoate, his symptoms including dyspnea on exertion and edema diminished. And also hemoglobin and B-type natriuretic peptide (BNP) had improved dramatically. Hookworm infection is an extremely rare cause of heart failure, and furthermore this parasitic infection is not common in advanced countries. We suggest the possible relationship between parasite infection and organic foods. PMID:16880709

Kajiya, Takashi; Kuroda, Atsushi; Hokonohara, Daisuke; Tei, Chuwa

2006-08-01

320

Analysis of the causes of failure in high chrome oxide refractory materials from slagging gasifiers  

SciTech Connect

High Cr2O3 refractory materials are used to line the hot face of slagging gasifiers. Gasifiers are reaction chambers that convert water, oxygen, and a carbon feedstock into CO, H2, and methane at temperatures as high as 1575oC and pressures up to 1000 psi. Ash in the carbon feedstock liquefies, erodes and corrodes the gasifier’s refractory liner, contributing to liner failure within a few months to two years. The failure of a refractory liner decreases a gasifier’s on-line availability and causes costly system downtime and repairs. Many factors contribute to refractory lining failure, including slag penetration and corrosion, thermal cycling, gasifier environment, and mechanical loads. The results of refractory post-mortem failure analysis and how observations relate to gasifier service life will be discussed.

Bennett, J.P.; Kwong, K.-S.; Powell, C.A.; Thomas, H.; Krabbe, R.A.

2006-03-01

321

Respiratory failure in lambert-eaton myasthenic syndrome precipitated by calcium-channel blockers: report of a case and literature review.  

PubMed

There have been a few reports in the literature documenting the effects of calcium-channel blockers in Lambert-Eaton myasthenic syndrome (LEMS). We report a case of a patient with LEMS who developed respiratory failure after administration of diltiazem and verapamil. A patient with LEMS, associated with small-cell carcinoma in remission, developed multifocal atrial tachycardia, necessitating the use of diltiazem and verapamil, which led to respiratory failure and intubation 5 days after admission. The patient was taken off all calcium-channel blockers and weaned off the respirator after 6 days. Oral time-release diltiazem was restarted without further exacerbation of LEMS. Most likely the combined use of two different calcium-channel blockers, verapamil and diltiazem, was responsible for this patient's respiratory failure. To date, 5 cases (2 patients with LEMS and 3 with myasthenia gravis) in which cardiac calcium-channel blockers had a definite detrimental effect have been reported. PMID:19078691

Tseng, Anna; Claussen, Gwen C; Oh, Shin J

2002-12-01

322

Two-unit repairable systems with common-cause shock failures and fuzzy parameters: parametric programming approach  

Microsoft Academic Search

This article, proposes a procedure to construct the membership functions of the system characteristics of a two-unit repairable system in series and parallel, which is subject to individual failures and common-cause shock failures. Time to individual failure and common-cause shock failure of the operating units are assumed to follow fuzzified exponential distributions. In addition, time to repair of the failed

Hsin-I. Huang; Chuen-Horng Lin; Jau-Chuan Ke

2008-01-01

323

Pneumocystis carinii infection causes lung lesions historically attributed to rat respiratory virus.  

PubMed

Idiopathic lung lesions characterized by dense perivascular cuffs of lymphocytes and a lymphohistiocytic interstitial pneumonia have been noted in research rats since the 1990s. Although the etiology of this disease has remained elusive, a putative viral etiology was suspected and the term 'rat respiratory virus' (RRV) has been used in reference to this disease agent. The purpose of this study was to determine whether Pneumocystis carinii infection in immunocompetent rats can cause idiopathic lung lesions previously attributed to RRV. In archived paraffin-embedded lungs (n = 43), a significant association was seen between idiopathic lung lesions and Pneumocystis DNA detected by PCR. In experimental studies, lung lesions of RRV developed in 9 of 10 CD rats 5 wk after intratracheal inoculation with P. carinii. No lung lesions developed in CD rats (n = 10) dosed with a 0.22-?m filtrate of the P. carinii inoculum, thus ruling out viral etiologies, or in sham-inoculated rats (n = 6). Moreover, 13 of 16 CD rats cohoused with immunosuppressed rats inoculated with P. carinii developed characteristic lung lesions from 3 to 7 wk after cohousing, whereas no lesions developed in rats cohoused with immunosuppressed sham-inoculated rats (n = 7). Both experimental infection studies revealed a statistically significant association between lung lesion development and exposure to P. carinii. These data strongly support the conclusion that P. carinii infection in rats causes lung lesions that previously have been attributed to RRV. PMID:21819681

Livingston, Robert S; Besch-Williford, Cynthia L; Myles, Matthew H; Franklin, Craig L; Crim, Marcus J; Riley, Lela K

2011-02-01

324

Pneumocystis carinii Infection Causes Lung Lesions Historically Attributed to Rat Respiratory Virus  

PubMed Central

Idiopathic lung lesions characterized by dense perivascular cuffs of lymphocytes and a lymphohistiocytic interstitial pneumonia have been noted in research rats since the 1990s. Although the etiology of this disease has remained elusive, a putative viral etiology was suspected and the term ‘rat respiratory virus’ (RRV) has been used in reference to this disease agent. The purpose of this study was to determine whether Pneumocystis carinii infection in immunocompetent rats can cause idiopathic lung lesions previously attributed to RRV. In archived paraffin-embedded lungs (n = 43), a significant association was seen between idiopathic lung lesions and Pneumocystis DNA detected by PCR. In experimental studies, lung lesions of RRV developed in 9 of 10 CD rats 5 wk after intratracheal inoculation with P. carinii. No lung lesions developed in CD rats (n = 10) dosed with a 0.22-µm filtrate of the P. carinii inoculum, thus ruling out viral etiologies, or in sham-inoculated rats (n = 6). Moreover, 13 of 16 CD rats cohoused with immunosuppressed rats inoculated with P. carinii developed characteristic lung lesions from 3 to 7 wk after cohousing, whereas no lesions developed in rats cohoused with immunosuppressed sham-inoculated rats (n = 7). Both experimental infection studies revealed a statistically significant association between lung lesion development and exposure to P. carinii. These data strongly support the conclusion that P. carinii infection in rats causes lung lesions that previously have been attributed to RRV.

Livingston, Robert S; Besch-Williford, Cynthia L; Myles, Matthew H; Franklin, Craig L; Crim, Marcus J; Riley, Lela K

2011-01-01

325

Noninvasive ventilatory support does not facilitate recovery from acute respiratory failure in chronic obstructive pulmonary disease  

Microsoft Academic Search

Noninvasive ventilatory support does not facilitate recovery from acute respiratory fail- ure in chronic obstructive pulmonary disease. F. Barbé, B. Togores, M. Rubí, S. Pons, A. Maimó, A.G.N. Agustí. ©ERS Journals Ltd 1996. ABSTRACT: This investigation evaluates, in a prospective, randomized and con- trolled manner, whether noninvasive ventilatory support (NIVS) with bilevel posi- tive airway pressure (BiPAP) facilitates recovery from

F. Barbé; B. Togores; M. Rubí; S. Pons; A. Maimó; A. G. N. Agustí

1996-01-01

326

An evaluation of the safety and efficacy of an anti-inflammatory, pulmonary enteral formula in the treatment of pediatric burn patients with respiratory failure.  

PubMed

Respiratory failure is associated with a high mortality rate in burned children. Recently, a specialized pulmonary enteral formula (SPEF) was commercially introduced as an adjunct intervention in acute lung injury management. SPEF contains condition-specific nutrients to modulate the inflammatory response. The study examined SPEF impact in critically ill, pediatric burn patients with respiratory failure. Medical records of acute burn patients admitted December 1997 to October 2006 were reviewed for SPEF treatment. Respiratory and renal indices were compared on the first and final days of SPEF use. Nineteen patients with respiratory failure received SPEF for a mean of 10.8 +/- 0.9 days during their acute burn course. Mean age was 5.3 +/- 1.5 years. Mean total body surface area burn was 44.3 +/- 5.4% with 32.5 +/- 6.4% full thickness. Patients were admitted 2.3 +/- 0.9 days postburn. Significant improvements in peak pressure, PEEP, FiO2, P:F ratio, Pco2, Po2, and ETco2 were noted. Seventeen of the 19 patients survived despite the fact that 9 of the 19 patients developed severe barotrauma requiring multiple tube thoracotomies, and all 19 had extremely poor prognoses at SPEF initiation. Adult SPEF formula for critically ill, pediatric burn patients with respiratory failure is safe and well tolerated. SPEF seems to facilitate recovery from acute lung injury as evidenced by improvements in oxygenation and pulmonary compliance. PMID:18182902

Mayes, Theresa; Gottschlich, Michele M; Kagan, Richard J

327

Perceiving the Causes of Success and Failure: A Cross-Cultural Examination of Attributional Concepts.  

ERIC Educational Resources Information Center

Studies perceptions of causal attributions pertinent to success and failure in two social class groups from Belgium, West Germany, India, South Korea, and England. Found high agreement among the two social classes as well as among four of the nations, but Indians rated all causes as more external, variable, and uncontrollable. (FMW)

Schuster, Beate; And Others

1989-01-01

328

103 Senile systemic amyloidosis: a common cause of heart failure in the elderly?  

Microsoft Academic Search

Senile systemic amyloidosis (SSA) is a rare cause of heart failure due to the deposition of wildtype transthyretin. The clinical features and outcome are ill defined; our aim was to evaluate the natural history of the disease in the UK in a group of thoroughly characterised patients. The series included all cases of biopsy proven transthyretin (TTR) amyloidosis with wildtype

J H Pinney; H J Lachmann; J D Gillmore; A Wechalekar; S D J Gibbs; P Sattianayagam; S M Banypersad; J Dungu; N Wassef; C A McCarthy; P N Hawkins; C J Whelan

2011-01-01

329

Empirical Investigation into the Causes of the Failure of the Monetary Model of the Exchange Rate.  

National Technical Information Service (NTIS)

The main purpose of this paper is to attempt to provide measures of the relative importance of the likely principal causes of the failure of one of the most prominent asset market models, the rational expectations monetary model associated with Frenkel (1...

P. N. Smith M. R. Wickens

1984-01-01

330

Substernal goitre: a rare cause of pulmonary hypertension and heart failure.  

PubMed

Benign substernal goitres usually extend into the upper anterior mediastinum and are easily extractable through a cervical approach. Very infrequently these tumours extend into the thoracic cavity causing compression of mediastinal structures. The authors report a case of pulmonary hypertension and severe cardiac failure secondary to a long-standing substernal goitre, and support the surgical management of this disease. PMID:11091841

Abboud, B; Badaoui, G; Aoun, Z; Tabet, G; Jebara, V A

2000-09-01

331

Failure of Quintech Tx pacemaker caused by loss of stimulus-T interval shortening during exercise  

Microsoft Academic Search

A 74 year old man with a Quintech Tx pacemaker experienced a reduction in his exercise capacity because his heart rate failed to increase with effort. This was shown to be caused by the failure of the interval between the delivered stimulus and evoked T wave to decrease during effort where previously it had done so. Although the stimulus-T interval

T Fyfe; J F Robinson

1986-01-01

332

Unusual Cause of Pulmonary Hypertension and Congestive Heart Failure in a Newborn  

Microsoft Academic Search

Anomalous systemic arterial supply to a lobe of the lung is a rare cause of pulmonary hypertension and congestive heart failure in the newborn period. We report the presentation and successful treatment of a neonate with this unusual anatomy. Proper diagnosis required both echocardiography and aortography, and surgical resection of the involved lobe was curative.

Eric N Mendeloff; Charles B Huddleston; Mark Payne

1997-01-01

333

Nursing care in the prevention of renal failure caused by post-catheterism contrast  

Microsoft Academic Search

The purpose of this study was to identify the nursing scientific production on acute renal failure caused by post-catheterism iodized cardiac contrast, from 2002 to 2007, by analyzing its practical application. A critical analysis was further performed of the selected scientific production outlining nursing care. This study is a literature review of nursing articles, found through computerized search. Out of

Flavia Giron Camerini; Isabel Cruz

2008-01-01

334

Calculating an appropriate multiplier for ß? when modeling common cause failure in triplex systems  

Microsoft Academic Search

The Beta Model for common cause failure (CCF) is well accepted and has proven appropriate for dual architecture Safety Instrumented Systems (SIS). However, it is not directly applicable to a triplex architecture SIS. It has been suggested that CCF for a triplex architecture is appropriately modeled by ???. This paper derives ?, the multiplier for ??, required in the evaluation

Julia V. Bukowski; R. Chalupa

2010-01-01

335

No early respiratory benefit with CVVHDF in patients with acute renal failure and acute lung injury  

Microsoft Academic Search

Background. There is debate as to whether, in patients with acute lung injury, continuous renal replacement therapy has beneficial effects on pulmonary gas exchange by mechanisms other than fluid removal. Because continuous renal replacement therapy is associated with potential morbidity and mortality, it seems unethical to perform a randomized trial in patients with acute lung injury without renal failure. Therefore,

Eric A. J. Hoste; Raymond C. Vanholder; Norbert H. Lameire; Carl D. V. K. Roosens; Johan M. A. Decruyenaere; Stijn I. Blot; Francis A. Colardyn

2002-01-01

336

Disseminated Rhizomucor pusillus causing early multiorgan failure during hematopoietic stem cell transplantation for severe aplastic anemia.  

PubMed

Matched sibling donor hematopoietic stem cell transplantation is the standard of care for severe aplastic anemia, with an overall survival of 80% to 90%. Only 60% to 70% of patients respond to treatment with immunosuppressive therapy. The main life threatening complications are infections, graft failure, and graft versus host disease. A 10-year-old patient with severe aplastic anemia underwent matched sibling donor hematopoietic stem cell transplantation, but developed sudden onset of fatal multiorgan failure on day +12. The cause of death was found only after autopsy. PMID:21358340

Rawlinson, Neil J; Fung, Bonita; Gross, Thomas G; Termuhlen, Amanda M; Skeens, Micah; Garee, Amy; Soni, Sandeep; Pietryga, Daniel; Bajwa, Rajinder P S

2011-04-01

337

Failure of a mine waste dump in Zimbabwe: Causes and consequences  

NASA Astrophysics Data System (ADS)

A combination of factors are considered important in causing the failure and subsequent development of a flowslide of a gold mine waste dump (or tailings dam) at Arcturus, near Harare, Zimbabwe. These factors comprise poor basal drainage, steep perimeter walls, saturation of the walls and basal sediments through continued spigoting of slurry during a period of heavy rainfall, and the effect of this saturation on the tailings. Properties of the tailings, eyewitness accounts, documentary evidence, and site characteristics are discussed. The failure and subsequent development of a fatal 300-m flowslide are reconstructed in a five-phase developmental model. The general applicability of the results is discussed.

Shakesby, Richard A.; Whitlow, J. Richard

1991-09-01

338

Anemia and performance status as prognostic markers in acute hypercapnic respiratory failure due to chronic obstructive pulmonary disease  

PubMed Central

Background In patients with acute hypercapnic respiratory failure (AHRF) during exacerbations of COPD, mortality can be high despite noninvasive ventilation (NIV). For some, AHRF is terminal and NIV is inappropriate. However there is no definitive method of identifying patients who are unlikely to survive. The aim of this study was to identify factors associated with inpatient mortality from AHRF with respiratory acidosis due to COPD. Methods COPD patients presenting with AHRF and who were treated with NIV were studied prospectively. The forced expiratory volume in 1 second (FEV1), World Health Organization performance status (WHO-PS), clinical observations, a composite physiological score (Early Warning Score), routine hematology and biochemistry, and arterial blood gases prior to commencing NIV, were recorded. Results In total, 65 patients were included for study, 29 males and 36 females, with a mean age of 71 ± 10.5 years. Inpatient mortality in the group was 33.8%. Mortality at 30 days and 12 months after admission were 38.5% and 58.5%, respectively. On univariate analysis, the variables associated with inpatient death were: WHO-PS ? 3, long-term oxygen therapy, anemia, diastolic blood pressure < 70 mmHg, Early Warning Score ? 3, severe acidosis (pH < 7.20), and serum albumin < 35 g/L. On multivariate analysis, only anemia and WHO-PS ? 3 were significant. The presence of both predicted 68% of inpatient deaths, with a specificity of 98%. Conclusion WHO-PS ? 3 and anemia are prognostic factors in AHRF with respiratory acidosis due to COPD. A combination of the two provides a simple method of identifying patients unlikely to benefit from NIV.

Mydin, Helmy Haja; Murphy, Stephen; Clague, Howell; Sridharan, Kishore; Taylor, Ian K

2013-01-01

339

Type I Arnold-Chiari malformation with bronchiectasis, respiratory failure, and sleep disordered breathing: a case report  

PubMed Central

Arnold Chiari Malformation (ACM) is defined as a condition where part of the cerebellar tissue herniates into the cervical canal toward the medulla and spinal cord resulting in a number of clinical manifestations. Type I ACM consists of variable displacement of the medulla throughout the formamen magnum into the cervical canal, with prominent cerebellar herniation. Type I ACM is characterized by symptoms related to the compression of craniovertebral junction, including ataxia, dysphagia, nistagmus, headache, dizziness, and sleep disordered breathing. We report a case of a life-long non-smoker, 54 years old woman who presented these symptoms associated with bronchiectasis secondary to recurrent inhalation pneumonia, hypercapnic respiratory failure, and central sleep apnea (CSA). CSA was first unsuccessfully treated with nocturnal c-PAP. The subsequent treatment with low flow oxygen led to breathing pattern stabilization with resolution of CSA and related clinical symptoms during sleep. We suggest that in patients with type I ACM the presence of pulmonary manifestations aggravating other respiratory disturbances including sleep disordered breathing (SDB) should be actively investigated. The early diagnosis is desirable in order to avoid serious and/or poorly reversible damages.

2013-01-01

340

[Extracorporeal lung assist in severe respiratory failure and ARDS. Current situation and clinical applications].  

PubMed

Despite improvements in ventilation support techniques, lung protection strategies, and the application of new support treatment, acute respiratory distress syndrome continues to have a high mortality rate. Many strategies and treatments for this syndrome have been investigated over the last few year. However, the only therapeutic measure that has systematically shown to be able to improve survival is that of low volume lung protective ventilation. Thus, using a low tidal volume prevents added lung damage by the same mechanical ventilation that is essential for life support. In this context, the use of extracorporeal lung assist systems is considered an exceptional use rescue treatment in extreme cases. On the other hand, it could be a potentially useful complementary method for an ultra-protective ventilation strategy, that is, by using even lower tidal volumes. The currently available extracorporeal lung assist systems are described in this article, including high flow systems such as traditional extracorporeal membrane oxygenation, CO? removal systems (interventional lung assist or iLA, with or without associated centrifugal pumps), and the new low flow and less invasive systems under development. The aim of this review is to update the latest available clinical and experimental data, the indications for these devices in adult respiratory distress syndrome (ARDS), and their potential indications in other clinical situations, such as the bridge to lung transplantation, multiple organ dysfunction syndrome, or COPD. PMID:20937437

Gómez-Caro, Abel; Badia, Joan Ramon; Ausin, Pilar

2010-06-17

341

Sequential Oxygenation Index and Organ Dysfunction Assessment within the First 3 Days of Mechanical Ventilation Predict the Outcome of Adult Patients with Severe Acute Respiratory Failure  

PubMed Central

Objective. To determine early predictors of outcomes of adult patients with severe acute respiratory failure. Method. 100 consecutive adult patients with severe acute respiratory failure were evaluated in this retrospective study. Data including comorbidities, Sequential Organ Failure Assessment (SOFA) score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) score, PaO2, FiO2, PaO2/FiO2, PEEP, mean airway pressure (mPaw), and oxygenation index (OI) on the 1st and the 3rd day of mechanical ventilation, and change in OI within 3 days were recorded. Primary outcome was hospital mortality; secondary outcome measure was ventilator weaning failure. Results. 38 out of 100 (38%) patients died within the study period. 48 patients (48%) failed to wean from ventilator. Multivariate analysis showed day 3 OI (P = 0.004) and SOFA (P = 0.02) score were independent predictors of hospital mortality. Preexisting cerebrovascular accident (CVA) (P = 0.002) was the predictor of weaning failure. Results from Kaplan-Meier method demonstrated that higher day 3 OI was associated with shorter survival time (log-Rank test, P < 0.001). Conclusion. Early OI (within 3 days) and SOFA score were predictors of mortality in severe acute respiratory failure. In the future, prospective studies measuring serial OIs in a larger scale of study cohort is required to further consolidate our findings.

Lai, Ting-Yu; Hung, Heui-Ling; Chen, Yu-Mu; Chou, Po-An; Wang, Chin-Chou; Lin, Meng-Chih; Fang, Wen-Feng

2013-01-01

342

Recombinant human acid alpha-glucosidase (rhGAA) in adult patients with severe respiratory failure due to Pompe disease.  

PubMed

Pompe disease is a rare metabolic myopathy caused by lysosomal ?-glucosidase deficiency. Pompe disease ranges from a rapidly progressive course when symptoms present in infancy to a more slowly progressive rate when symptoms present in childhood or adulthood. This open-label prospective exploratory study investigated the effect of 12 months of recombinant enzyme replacement therapy in 5 adult patients who had already advanced to a very severe stage of Pompe disease. Muscular and respiratory function, quantitative muscle testing and spirometry were assessed. Four patients were tracheostomized. Respiratory parameters did not deteriorate. A moderate improvement in sitting/supine slow vital capacity in 2 patients (from 7% to 11% and 28% to 32% of predicted) and reductions of ventilation support in 2 patients was observed. Three patients, wheelchair bound at baseline, improved sitting and proximal motor function; 2 patients improved in their ability to stand and transfer. The treatment was well tolerated. Alglucosidase alfa may stabilize or even slightly improve muscle strength and respiratory function among patients with severe Pompe disease. PMID:21550241

Orlikowski, David; Pellegrini, Nadine; Prigent, Hélène; Laforêt, Pascal; Carlier, Robert; Carlier, Pierre; Eymard, Bruno; Lofaso, Frédéric; Annane, Djillali

2011-05-06

343

Reduced Ventilator Pressure and Improved P/F Ratio During Percutaneous Arteriovenous Carbon Dioxide Removal for Severe Respiratory Failure  

PubMed Central

Objective To evaluate the effect of percutaneous arteriovenous carbon dioxide removal (AVCO2R) on ventilator pressures and P/F ratio in a clinically relevant large-animal model of severe respiratory failure. Summary Background Data AVCO2R was developed as a simple arteriovenous shunt with a commercially available low-resistance gas exchange device of sufficient surface area for near-total CO2 removal. With an AV shunt 10% to 15% of cardiac output, AVCO2R allows a reduction in ventilator airway pressures without hypercapnia or the complex circuitry and monitoring required for conventional ECMO. Methods AVCO2R was applied to a new, clinically relevant large-animal model of severe respiratory failure created by smoke inhalation and cutaneous flame burn injury. Adult sheep (n = 9, 38 ± 6 kg) received a 40% total body surface area, third-degree cutaneous flame burn and 36 breaths of cotton smoke insufflation. After injury, all animals were placed on volume-controlled mechanical ventilation to achieve PaO2 > 60 mmHg and PaCO2 < 40 mmHg. Animals were placed on AVCO2R within 40 to 48 hours of injury when the PaO2/FiO2 was <200. Animals underwent cannulation of the carotid artery and jugular vein with percutaneous 10F arterial and 14F venous cannulas. Shunt flow was continuously monitored using an ultrasonic flow probe and calculated as a percentage of cardiac output. Results AVCO2R flows of 800 to 900 ml/min (11% to 13% cardiac output) achieved 77 to 104 ml/min of CO2 removal (95% to 97% total CO2 production) while maintaining normocapnia. Significant reductions in ventilator settings were tidal volume, 421.3 ± 39.8 to 270.0 ± 6.3 ml; peak inspiratory pressure, 24.8 ± 2.4 to 13.7 ± 0.7 cm H2O; minute ventilation, 12.7 ± 1.4 to 6.2 ± 0.8 L/min; respiratory rate, 25.4 ± 1.3 to 18.4 ± 1.8 breaths/min; and FiO2, 0.88 ± 0.1 to 0.39 ± 0.1. The P/F ratio increased from 151.5 ± 40.0 at baseline to 320.0 ± 17.8 after 72 hours. Conclusions Percutaneous AVCO2R allows near-total CO2 removal and significant reductions in ventilator pressures with improvement in the P/F ratio.

Alpard, Scott K.; Zwischenberger, Joseph B.; Tao, Weike; Deyo, Donald J.; Bidani, Akhil

1999-01-01

344

Poor outcome from peritonitis is caused by disease acuity and organ failure, not recurrent peritoneal infection.  

PubMed Central

OBJECTIVE: The purpose of the study is to determine whether organ failure develops in patients despite control of peritoneal infection and whether the process is, in part, neutrophil (polymorphonuclear leukocyte [PMN]) mediated. SUMMARY BACKGROUND DATA: Peritonitis generally responds to prompt surgical intervention and systemic antibiotics; however, some patients continue a septic course and progress to organ failure and death. METHODS: One hundred five consecutive patients with peritonitis between 1988 and 1996 who required operation and a postoperative hospital stay greater than 10 days were studied. Mice were injected with a monoclonal anti-PMN antibody 24 hours before cecal ligation and puncture (CLP) to deplete PMNs. RESULTS: Thirty-eight patients died, and all but 1 had identified organ failure. Seventy-seven patients had either pulmonary failure alone (25 patients) or as a component of multisystem organ failure (52 patients). All but one of these patients showed resolution of their intraperitoneal infection as evident by clinical course, abdominal computed tomographic scan, second-look laparotomy, or autopsy. Recurrent intra-abdominal infection developed in 15 patients, but only 1 had organ failure, and 2 died. At 18 hours after CLP, lung injury, PMN content, interleukin-1 mRNA expression, and liver injury were significantly reduced by anti-PMN treatment, whereas serum endotoxin levels actually increased. CONCLUSIONS: Disease acuity and organ failure, and not recurrent peritoneal infection, are the major causes of adverse outcome in patients with peritonitis. The authors' experimental data indicate that such organ injury is, in part, PMN mediated but not endotoxin mediated. Attraction of PMNs toward the site of primary infection, and thereby away from remote organs, is a logical future therapeutic approach in such patients who are critically ill with peritonitis.

Wickel, D J; Cheadle, W G; Mercer-Jones, M A; Garrison, R N

1997-01-01

345

Respiratory dysfunction in guillain-barré syndrome  

Microsoft Academic Search

Guillain-Barré Syndrome is the leading cause of nontraumatic acute paralysis in industrialized countries. About 30% of patients\\u000a have respiratory failure requiring intensive care unit (ICU) admission and invasive mechanical ventilation. Progressive weakness\\u000a of both the inspiratory and the expiratory muscles is the mechanism leading to respiratory failure. Aspiration pneumonia and\\u000a atelectasis are common consequences of the bulbar muscle weakness and

David Orlikowski; Hélène Prigent; Tarek Sharshar; Frédéric Lofaso; Jean Claude Raphael

2004-01-01

346

Right ventricular failure in acute lung injury and acute respiratory distress syndrome.  

PubMed

Acute respiratory distress syndrome (ARDS) is a clinical entity involving not only alveolar lesions but also capillary lesions, both of which have deleterious effects on the pulmonary circulation, leading to constant pulmonary hypertension and to acute cor pulmonale (ACP) in 20-25% of patients ventilated with a limited plateau pressure (Pplat). Considering the poor prognosis of patients suffering from such acute right ventricular (RV) dysfunction, RV protection by appropriate ventilatory settings has become a crucial issue in ARDS management. The goal of this review is to emphasize the importance of analyzing RV function in ARDS, using echocardiography, in order to limit RV afterload. Any observed acute RV dysfunction should lead physicians to consider a strategy for RV protection, including strict limitation of Pplat, diminution of positive end-expiratory pressure (PEEP) and control of hypercapnia, all goals achieved by prone positioning. PMID:22672932

Repessé, X; Charron, C; Vieillard-Baron, A

2012-06-07

347

Randomized comparison of enoxaparin with unfractionated heparin for the prevention of venous thromboembolism in medical patients with heart failure or severe respiratory disease  

Microsoft Academic Search

Background We compared the efficacy and safety of the low-molecular weight heparin enoxaparin with unfractionated heparin (UFH) for the prevention of venous thromboembolic disease in patients with heart failure or severe respiratory disease. Methods This was a multicenter, controlled, randomized, open study in which patients received either enoxaparin (40 mg once daily) or UFH (5000 IU 3 times daily) for

Franz-Xaver Kleber; Christian Witt; Günter Vogel; Klaus Koppenhagen; Ulrike Schomaker; Curt Werner Flosbach

2003-01-01

348

Expiratory Flow-Volume Loop Profile and Patient Outcome in Chronic Obstructive Pulmonary Disease in Acute Respiratory Failure: A Prospective Observational Study in a Single Intensive Care Unit  

Microsoft Academic Search

Background: Expiratory flow-volume (EFV) loops are continuously displayed on the screen of intensive care unit (ICU) ventilators. Objectives: It was the aim of this study to investigate the relationships of EFV to chronic obstructive pulmonary disease (COPD) patient outcome. Methods: This is a prospective study on COPD patients who received invasive mechanical ventilation for acute respiratory failure in the ICU.

Véronique Porot; Sylvie Ernesto; Véronique Leray; Bertrand Delannoy; Gael Bourdin; Frédérique Bayle; Jean-Christophe Richard; Claude Guérin

2012-01-01

349

Noninvasive Ventilation as a Systematic Extubation and Weaning Technique in Acute-on-Chronic Respiratory Failure A Prospective, Randomized Controlled Study  

Microsoft Academic Search

Prolonged duration of endotracheal mechanical ventilation (ETMV) is associated with an increased morbidity and mortality in intensive care unit (ICU) patients. The aim of this study was to assess the usefulness of noninvasive ventilation (NIV) as a systematic extubation and weaning technique to re- duce the duration of ETMV in acute-on-chronic respiratory failure (ACRF). Among 53 consecutively intubated patients admitted

CHRISTOPHE GIRAULT; ISABELLE DAUDENTHUN; VIRGINIE CHEVRON; FABIENNE TAMION; JACQUES LEROY; GUY BONMARCHAND

350

Noninvasive Mechanical Ventilation in the Weaning of Patients with Respiratory Failure Due to Chronic Obstructive Pulmonary Disease A Randomized, Controlled Trial  

Microsoft Academic Search

Background: In patients with acute exacerbations of chronic obstructive pulmonary disease, mechanical venti­ lation is often needed. The rate of weaning failure is high in these patients, and prolonged mechanical ventilation increases intubation-associated complications. Objective: To determine whether noninvasive ventila­ tion improves the outcome of weaning from invasive me­ chanical ventilation. Design: Multicenter, randomized trial. Setting: Three respiratory intensive care

Stefano Nava; Nicolino Ambrosino; Enrico Clini; Maurizio Prato; Giacomo Orlando; Michele Vitacca; Paolo Brigada; Claudio Fracchia; Fiorenzo Rubini

351

A comparative study of the cardiorespiratory effects of continuous positive airway pressure breathing and continuous positive pressure ventilation in acute respiratory failure  

Microsoft Academic Search

Positive end expiratory pressure (PEEP) produces cardiopulmonary effects whether administered by controlled positive pressure ventilation (CPPV) or continuous positive airway pressure (CPAP). In eight patients with acute respiratory failure, the effects of 20 cm PEEP administered via CPPV and CPAP were compared. An esophageal balloon was used to calculate the transmural vascular pressures. The control values under mechanical ventilation with

G. Simonneau; F. Lemaire; A. Harf; J. Carlet; B. Teisseire

1982-01-01

352

Scale amplification of natural debris flows caused by cascading landslide dam failures  

NASA Astrophysics Data System (ADS)

Debris flows are typically caused by natural terrain landslides triggered by intense rainfalls. If an incoming mountain torrent collapses a series of landslide dams, large debris flows can form in a very short period. Moreover, the torrent can amplify the scale of the debris flow in the flow direction. The catastrophic debris flows that occurred in Zhouqu, China, on 8 August 2010 were caused by intense rainfall and the upstream cascading failure of landslide dams along the gullies. In the wake of the incident, a field study was conducted to better understand the process of cascading landslide dam failures and the formation of debris flows. This paper looks at the geomorphic properties of the debris-flow gullies, estimates the peak flow discharges at different locations using three different methods, and analyzes the key modes (i.e., different landslide dam types and their combinations) of cascading landslide dam failures and their effect on the scale amplification of debris flows. The results show that five key modes in Luojiayu gully and two modes in Sanyanyu gully accounted for the scale amplification of downstream debris flows in the Zhouqu event. This study illustrates how the hazardous process of natural debris flows can begin several kilometers upstream as a complex cascade of geomorphic events (failure of landslide dams and erosion of the sloping bed) can scale to become catastrophic discharges. Neglecting recognition of these hazardous geomorphic and hydrodynamic processes may result in a high cost.

Cui, P.; Zhou, Gordon G. D.; Zhu, X. H.; Zhang, J. Q.

2013-01-01

353

The hypermetabolism organ failure complex  

Microsoft Academic Search

Multisystem organ failure remains the predominant cause of death in the surgical intensive care unit. What used to be thought of as isolated organ failure, such as adult respiratory distress syndrome, is now seen as part of the systemic response to injury and of a systemic injury and repair process. Sepsis has become the systemic inflammatory response to invading microorganisms;

Frank B. Cerra

1987-01-01

354

Reliability-based fatigue failure analysis for causes assessment of a collapsed steel truss bridge  

Microsoft Academic Search

This paper is intended to demonstrate conventional and reliability-based approaches to the collapse cause assessment in order to identify the effects of mis-installed bracket and H-beam members on the collapse of a steel truss bridge over the Han river in Korea only 15 years after opening to traffic. Based on extensive numerical investigations with parametric studies on various possible failure

Hyo-Nam Cho; Jong-Kwon Lim; Hyun-Ho Choi

2001-01-01

355

Does renal failure cause an atherosclerotic milieu in patients with end-stage renal disease?  

Microsoft Academic Search

PURPOSE: Atherosclerotic vascular disease is the main cause of morbidity and mortality in patients with end-stage renal disease, but the independent contribution of renal failure rather than associated risk factors is unclear. We sought to examine the relative contribution of these factors to the severity of atherosclerosis by measuring intima-medial thickness and brachial artery reactivity in uremic patients and controls.SUBJECTS

Robert Kennedy; Colin Case; Robert Fathi; David Johnson; Nicole Isbel; Thomas H Marwick

2001-01-01

356

Clinical failures of endovascular abdominal aortic aneurysm repair: Incidence, causes, and management  

Microsoft Academic Search

Objective: Despite well-documented good early results and benefits of endoluminal stent graft repair of abdominal aortic aneurysm (J Vasc Surg 2002;35:1137-44.)(AAA), the long-term outcome of this method of treatment remains uncertain. In particular, concern exists that late effectiveness and durability are inferior to that of open repair. To determine the incidence and causes of clinical failures of endovascular AAA repair,

Jeffery B. Dattilo; David C. Brewster; Chien-Min Fan; Stuart C. Geller; Richard P. Cambria; Glenn M. LaMuraglia; Alan J. Greenfield; Stephen R. Lauterbach; William M. Abbott

2002-01-01

357

Risk Analysis of Sewer System Operational Failures Caused By Unstable Subsoil  

Microsoft Academic Search

In unstable subsoil areas, all constructions including sewer systems are threatened by non-uniform surface downthrown. Conditions\\u000a of constructing and operating of sewer systems in these localities differ significantly from standard conditions. Therefore,\\u000a it is necessary to distinguish criteria applicable to the designs and reconstruction of sewer systems in these types of areas.\\u000a Ground subsidence causes failures on the sewerage and

Karel K?íž; Vojt?ch Bareš; Jaroslav Pollert; David Stránský

358

Failure cause identification of tribo-mechanical systems using fault tree—a digraph approach  

Microsoft Academic Search

A procedure for the failure cause identification of tribo-mechanical systems is presented based on fault-tree using a digraph approach. A variable-event system digraph for a tribo-mechanical system is suggested which takes into account structure of the system. A top event or undesirable event for the system is then defined and the fault-tree for this top event is deduced from the

Rakesh Sehgal; O. P. Gandhi; S. Angra

2003-01-01

359

Efficacy of tulathromycin in the treatment of respiratory disease in pigs caused by Actinobacillus pleuropneumoniae  

Microsoft Academic Search

The efficacy of a single dose of tulathromycin, a novel triamilide antimicrobial of the macrolide class, given at 2·5 mg\\/kg or 5 mg\\/kg bodyweight, or three daily doses of ceftiofur, given at 3 mg\\/kg bodyweight, was evaluated in pigs with respiratory disease induced experimentally with Actinobacillus pleuropneumoniae. On day 0, 100 pigs with clinical signs of respiratory disease were randomly

F. J. Hart; R. W. Kilgore; T. R. Meinert; R. G. Nutsch; S. J. Sunderland; K. F. Lechtenberg

2006-01-01

360

Common cause failure probabilities in standby safety system fault tree analysis with testing—scheme and timing dependencies  

Microsoft Academic Search

Modelling and quantification of common cause failures (CCFs) in redundant standby safety systems can be implemented by implicit or explicit fault tree techniques. Common cause event probabilities are derived for both methods for systems with time-related CCFs modelled by general multiple failure rates. The probabilities are determined so that the correct time-average risk can be obtained by a single computation.

J. K. Vaurio

2003-01-01

361

Proportional hazards model for competing risks data with missing cause of failure  

PubMed Central

We consider the semiparametric proportional hazards model for the cause-specific hazard function in analysis of competing risks data with missing cause of failure. The inverse probability weighted equation and augmented inverse probability weighted equation are proposed for estimating the regression parameters in the model, and their theoretical properties are established for inference. Simulation studies demonstrate that the augmented inverse probability weighted estimator is doubly robust and the proposed method is appropriate for practical use. The simulations also compare the proposed estimators with the multiple imputation estimator of Lu and Tsiatis (2001). The application of the proposed method is illustrated using data from a bone marrow transplant study.

Hyun, Seunggeun; Sun, Yanqing

2012-01-01

362

Haemodynamic and endocrinological effects of noninvasive mechanical ventilation in respiratory failure.  

PubMed

The aim of this study was to investigate the haemodynamic and endocrinological effects of noninvasive positive pressure ventilation (NIPPV). Eleven patients with oedema and recent hypercapnic and hypoxaemic worsening of a chronic respiratory insufficiency were included. Echocardiography, cardiac radionuclide assessment, blood catecholamines, salt and water handling hormones were measured at admission and discharge (long study (LS)). To discriminate between the action of NIPPV and other treatments, measurements were performed on the fourth day, for 4 h without NIPPV and 4 h with NIPPV (short study (SS)). NIPPV entailed a correction of P(a,CO2) and an increase of P(a,O2) in LS and SS. Oedema disappeared. Body weight decreased (from 85+/-42 to 81+/-40 kg) during LS. Systolic and mean pulmonary arterial pressure decreased in LS and SS. Right ventricular ejection fraction increased in LS. Left ventricular ejection fraction did not change. Cardiac index was normal on admission and then decreased. Natriuretic peptides and catecholamines were increased on admission, whereas plasma renin activity, aldosterone and vasopressin were normal. We suggest that in these patients, oedema can occur independently of renin-angiotensin-aldosterone-vasopressin and with a normal cardiac output. Noninvasive positive pressure ventilation allowed a correction of blood gases, associated with the resolution of oedema, a decrease in pulmonary arterial pressures and an increase in right ventricular ejection fraction. PMID:9426094

Thorens, J B; Ritz, M; Reynard, C; Righetti, A; Vallotton, M; Favre, H; Kyle, U; Jolliet, P; Chevrolet, J C

1997-11-01

363

Effects of mechanical insufflation-exsufflation in preventing respiratory failure after extubation: a randomized controlled trial  

PubMed Central

Introduction Weaning protocols that include noninvasive ventilation (NIV) decrease re-intubation rates and ICU length of stay. However, impaired airway clearance is associated with NIV failure. Mechanical insufflation-exsufflation (MI-E) has been proven to be very effective in patients receiving NIV. We aimed to assess the efficacy of MI-E as part of an extubation protocol. Method Patients with mechanical ventilation (MV) for more than 48 hours with specific inclusion criteria, who successfully tolerated a spontaneous breathing trial (SBT), were randomly allocated before extubation, either for (A) a conventional extubation protocol (control group), or (B) the MI-E extubation protocol (study group). During the postextubation period (48 hours), group A patients received standard medical treatment (SMT), including NIV in case of specific indications, whereas group B received the same postextubation approach plus three daily sessions of mechanical in-exsufflation (MI-E). Reintubation rates, ICU length of stay, and NIV failure rates were analyzed. Results Seventy-five patients (26 women) with a mean age of 61.8 ± 17.3 years were randomized to a control group (n = 40; mean SAPS II, 47.8 ± 17.7) and to a study group (n = 35; mean SAPS II, 45.0 ± 15.0). MV time before enrollment was 9.4 ± 4.8 and 10.5 ± 4.1 days for the control and the study group, respectively. In the 48 hours after extubation, 20 control patients (50%) and 14 study patients (40%) used NIV. Study group patients had a significant lower reintubation rate than did controls; six patients (17%) versus 19 patients (48%), P < 0.05; respectively, and a significantly lower time under MV; 17.8 ± 6.4 versus 11.7 ± 3.5 days; P < 0.05; respectively. Considering only the subgroup of patients that used NIV, the reintubation rates related to NIV failure were significantly lower in the study group when compared with controls; two patients (6%) versus 13 (33%); P < 0.05, respectively. Mean ICU length of stay after extubation was significantly lower in the study group when compared with controls (3.1 ± 2.5 versus 9.8 ± 6.7 days; P < 0.05). No differences were found in the total ICU length of stay. Conclusion Inclusion of MI-E may reduce reintubation rates with consequent reduction in postextubation ICU length of stay. This technique seems to be efficient in improving the efficacy of NIV in this patient population.

2012-01-01

364

Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure  

PubMed Central

Background: Non-invasive ventilation (NIV) has been shown to reduce intubation and in-hospital mortality in patients with chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure (AHRF). However, little information exists on the outcomes following discharge. A study was undertaken to examine the rates of readmission, recurrent AHRF, and death following discharge and the risk factors associated with them. Methods: A cohort of COPD patients with AHRF who survived after treatment with NIV in a respiratory high dependency unit was prospectively followed from July 2001 to October 2002. The times to readmission, first recurrent AHRF, and death were recorded and analysed against potential risk factors collected during the index admission. Results: One hundred and ten patients (87 men) of mean (SD) age 73.2 (7.6) years survived AHRF after NIV during the study period. One year after discharge 79.9% had been readmitted, 63.3% had another life threatening event, and 49.1% had died. Survivors spent a median of 12% of the subsequent year in hospital. The number of days in hospital in the previous year (p = 0.016) and a low Katz score (p = 0.018) predicted early readmission; home oxygen use (p = 0.002), APACHE II score (p = 0.006), and a lower body mass index (p = 0.041) predicted early recurrent AHRF or death; the MRC dyspnoea score (p<0.001) predicted early death. Conclusions: COPD patients with AHRF who survive following treatment with NIV have a high risk of readmission and life threatening events. Further studies are urgently needed to devise strategies to reduce readmission and life threatening events in this group of patients.

Chu, C; Chan, V; Lin, A; Wong, I; Leung, W; Lai, C

2004-01-01

365

Extracorporeal life support for management of refractory cardiac or respiratory failure: initial experience in a tertiary centre  

PubMed Central

Introduction Extracorporeal Life Support (ECLS) and extracorporeal membrane oxygenation (ECMO) have been indicated as treatment for acute respiratory and/or cardiac failure. Here we describe our first year experience of in-hospital ECLS activity, the operative algorithm and the protocol for centralization of adult patients from district hospitals. Methods At a tertiary referral trauma center (Careggi Teaching Hospital, Florence, Italy), an ECLS program was developed from 2008 by the Emergency Department and Heart and Vessel Department ICUs. The ECLS team consists of an intensivist, a cardiac surgeon, a cardiologist and a perfusionist, all trained in ECLS technique. ECMO support was applied in case of severe acute respiratory distress syndrome (ARDS) not responsive to conventional treatments. The use of veno-arterial (V-A) ECLS for cardiac support was reserved for cases of cardiac shock refractory to standard treatment and cardiac arrests not responding to conventional resuscitation. Results A total of 21 patients were treated with ECLS during the first year of activity. Among them, 13 received ECMO for ARDS (5 H1N1-virus related), with a 62% survival. In one case of post-traumatic ARDS, V-A ECLS support permitted multiple organ donation after cerebral death was confirmed. Patients treated with V-A ECLS due to cardiogenic shock (N = 4) had a survival rate of 50%. No patients on V-A ECLS support after cardiac arrest survived (N = 4). Conclusions In our centre, an ECLS Service was instituted over a relatively limited period of time. A strict collaboration between different specialists can be regarded as a key feature to efficiently implement the process.

2010-01-01

366

[A case of acute chronic respiratory failure due to fat embolism syndrome after the left femoral neck fracture].  

PubMed

A 78 year old Japanese woman was transferred to our hospital for the treatment of a fracture of the left femoral neck in April, 2010. She had been taking oral corticosteroid (prednisolone 5 mg/day) for the treatment of idiopathic interstitial pneumonia since 2003, and had been treated by home oxygen therapy since 2007. She fell in the restroom at home and hurt herself, and was transferred to our hospital for treatment of a left femoral neck fracture in April, 2010. Her respiratory status was stable just after the transfer; however, she was transferred to the intensive care unit and started to receive mechanical ventilation due to rapidly progressive respiratory failure on the fourth day after admission. Chest X-ray and computed tomography revealed rapid progression of bilateral ground-glass attenuations, and acute exacerbation of interstitial pneumonia was clinically suspected. However, the elevation of D-dimer over time and characteristic findings of petechial hemorrhagic lesions on her palpebral conjunctivae and neck with microscopic findings of phagocytized lipid in alveolar macrophages in her endobronchial secretion led to the diagnosis of fat embolism syndrome. She was successfully treated with high-dose corticosteroid and sivelestat sodium, and she was discharged on the 21st day after admission. Although a differential diagnosis of acute exacerbation of interstitial pneumonia and fat embolism syndrome was necessary and difficult in the present case, characteristic findings of petechial hemorrhagic lesions of skin, palpebral conjunctiva and lipid-laden alveolar macrophages in endotracheal aspirate were useful for the accurate and prompt diagnosis of fat embolism syndrome. PMID:21913383

Oda, Keishi; Kawanami, Toshinori; Yatera, Kazuhiro; Ogoshi, Takaaki; Kozaki, Minako; Nagata, Shuya; Nishida, Chinatsu; Yamasaki, Kei; Ishimoto, Hiroshi; Mukae, Hiroshi

2011-09-01

367

Retroperitoneal hematoma compressing a single functioning kidney: an unusual cause of obstructive renal failure.  

PubMed

We report a case of a retroperitoneal hematoma occurring in a patient under anticoagulation therapy for deep-venous thrombosis and presenting as an anuric acute renal failure. A coexisting polycythemia vera led to misdiagnosis that could have been life-threatening. A woman, known for polycythemia vera and a single functioning right kidney, was admitted with mild abdominal pain in a context of recent deep venous thrombosis under low-molecular weight heparin. Clinical examination revealed hepatomegaly associated with polycythemia vera. Biochemical evaluation disclosed an acute renal failure, and renal ultrasonography showed no dilation of the renal pelvis. Retroperitoneal hematoma resulted in shock, progressive anemia and obstructive renal failure, related to renal pelvic compression. A right renal indwelling catheter was introduced to restore urine flow after one hemodialysis session, and an inferior vena cava filter was placed because of anti-coagulation contra-indication. However, pulmonary embolism occurred, so that oral anticoagulants were introduced. The hematoma resorbed spontaneously, and a year after this episode, the patient is still alive and well. Retroperitoneal hematoma is a rare cause of obstructive acute renal failure and a life-threatening complication of anti-coagulation therapy. PMID:17542341

Monge, M; Vaida, I; Modeliar, S S; Solanilla, A; Airapetian, N; Presne, C; Makdassi, R; Fournier, A; Choukroun, G

2007-05-01

368

Alveolar Type II Cells Escape Stress Failure Caused by Tonic Stretch through Transient Focal Adhesion Disassembly  

PubMed Central

Mechanical ventilation-induced excessive stretch of alveoli is reported to induce cellular stress failure and subsequent lung injury, and is therefore an injurious factor to the lung. Avoiding cellular stress failure is crucial to ventilator-induced lung injury (VILI) treatment. In the present study, primary rat alveolar type II (ATII) cells were isolated to evaluate their viability and the mechanism of their survival under tonic stretch. By the annexin V/ PI staining and flow cytometry assay, we demonstrated that tonic stretch-induced cell death is an immediate injury of mechanical stress. In addition, immunofluorescence and immunoblots assay showed that the cells experienced an expansion-contraction-reexpansion process, accompanied by partial focal adhesion (FA) disassembly during contraction. Manipulation of integrin adherent affinity by altering bivalent cation levels in the culture medium and applying an integrin neutralizing antibody showed that facilitated adhesion affinity promoted cell death under tonic stretch, while lower level of adhesion protected the cells from stretch-induced stress failure. Finally, a simplified numerical model was established to reveal that adequate disassembly of FAs reduced the forces transmitting throughout the cell. Taken together, these results indicate that ATII cells escape stress failure caused by tonic stretch via active cell morphological remodeling, during which cells transiently disassemble FAs to unload mechanical forces.

Liu, Xiao-Yang; Chen, Xiao-Fei; Ren, Yan-Hong; Zhan, Qing-Yuan; Wang, Chen; Yang, Chun

2011-01-01

369

Intrapleural steroid instillation for multiple organ failure with acute respiratory distress syndrome.  

PubMed

Acute respiratory distress syndrome (ARDS) increases mortality in patients with multiorgan dysfunction syndrome (MODS). This study evaluates the feasibility of intrapleural steroid instillation (IPSI) in patients with ARDS and MODS unresponsive to conventional extracorporeal membrane oxygenation (ECMO). Ninety-two of 467 patients who underwent ECMO between 2005 and 2009 had ARDS, and 30 consecutive adult patients of these 92 patients with severe ARDS and MODS were retrospectively analyzed in this study. Nine of these 30 patients, who did not respond to therapy and whose condition deteriorated, were managed with IPSI. All patients met the inclusion criteria of hemodynamic instability with high catecholamine infusion requirement and 100% oxygen demand in ventilation and ECMO flow. On initial diagnosis of ARDS, no differences in prognostic scorings were observed in patients who underwent conventional treatment (n = 21) and those who underwent IPSI (n = 9). Blood oxygenation, tidal volume, changing in chest radiographic findings, and survival rates were analyzed. The primary outcome was survival until discharge from the hospital. Pulmonary radiographic appearance improved after 3 days of IPSI treatment (P = 0.008); the ratio of arterial partial pressure of oxygen to fraction of inspired oxygen also increased significantly after 5 days of IPSI treatment (P = 0.028). Moreover, the 28-day mortality rate (P = 0.017), 60-day mortality rate (P = 0.003), and survival rate (78% vs. 19%; P = 0.003) significantly improved in patients undergoing IPSI, which therefore appears to be an easily implemented and highly effective treatment for patients with severe ARDS in combination with MODS, particularly in patients who fail to respond to conventional treatment. PMID:24088995

Huang, Pei-Ming; Lin, Tzu-Hsin; Tsai, Pi-Ru; Ko, Wen-Je

2013-11-01

370

Case of an infant with hepatic cirrhosis caused by mitochondrial respiratory chain disorder.  

PubMed

The patient had hepatomegaly with liver dysfunction at the age of 1 month. Magnetic resonance imaging performed at the age of 1 year showed multiple nodules of varying size in his liver. We were able to examine the mitochondrial respiratory chain function in the liver biopsy samples because all other differential diagnoses for hepatic cirrhosis had been ruled out. Complex I and IV activities were below the normal level (<30%) of the citrate synthase (CS) ratio. Liver blue native polyacrylamide gel electrophoresis showed an extremely weak complex I and IV band. Liver respiratory chain complexes I and IV were found to be deficient in this patient. The histologic findings were highly suggestive of mitochondrial respiratory chain disorder. Findings of progressive liver cirrhosis changes were observed in magnetic resonance imaging at the age of 5 years. An examination of the mitochondrial respiratory chain function should be performed along with a liver biopsy if mitochondrial respiratory chain disorder is suspected as a possible differential diagnosis of idiopathic hepatitis. PMID:23910810

Enkai, Shigehiro; Koinuma, Sachi; Ito, Reiko; Igaki, Junko; Hasegawa, Yukihiro; Murayama, Kei; Ohtake, Akira

2013-08-01

371

Semi-fluorinated alkanes as carriers for drug targeting in acute respiratory failure.  

PubMed

Partial liquid ventilation (PLV) with perfluorocarbons may cause pulmonary recruitment in acute lung injury (ALI). Semi-fluorinated alkanes (SFAs) provide biochemical properties similar to perfluorocarbons. Additionally, SFAs are characterized by increased lipophilicity. Therefore, SFA-PLV may be considered for deposition of certain therapeutic drugs into atelectatic lung areas. In this experimental study SFA-PLV was evaluated to demonstrate feasibility, pulmonary recruitment, and efficacy of drug deposition. Feasibility of SFA-PLV was determined in pigs with and without experimental ALI. Animals were randomized to PLV with SFAs up to a cumulative amount of 30 mL x kg?¹ or to conventional mechanical ventilation. Pulmonary recruitment effects were determined by analyzing ventilation-perfusion distributions. Efficacy of intrapulmonary drug deposition was evaluated in further experiments by measuring drug serum concentrations in the course of PLV with SFA-dissolved ?-tocopherol and ibuprofen. Increasing SFA doses caused progressive reduction of intrapulmonary shunt in animals with ALI, indicating pulmonary recruitment. PLV with SFA-dissolved ?-tocopherol had no effect on serum levels of ?-tocopherol, whereas PLV with SFA-dissolved ibuprofen caused a rapid increase of serum levels of ibuprofen. The authors conclude that SFA-PLV is feasible and causes pulmonary recruitment in ALI. Effectiveness of drug deposition in the lung obviously depends on the partitioning drugs out of the SFA phase into blood. PMID:20939753

Dembinski, Rolf; Bensberg, Ralf; Marx, Gernot; Rossaint, Rolf; Quintel, Michael; Kuhlen, Ralf

2010-10-01

372

Cardiomyocyte Expression of a Polyglutamine Pre-amyloid Oligomer Causes Heart Failure  

PubMed Central

Background To determine if soluble pre-amyloid oligomers (PAOs) are toxic when expressed internally in the cardiomyocyte, we tested the hypothesis that cardiomyocyte-restricted expression and accumulation of a known PAO is cytotoxic and sufficient to cause heart failure. Methods and Results Intracellular PAOs, the entities believed to cause toxicity in many neurodegenerative diseases, have been observed in cardiomyocytes derived from mouse and human heart failure samples. Long (>50) polyglutamine (PQ) repeats form PAOs and cause neurotoxicity in Huntington’s and other neurodegenerative diseases, while shorter PQ peptides are benign. We created transgenic mice in which cardiomyocyte-autonomous expression of an 83 residue-long PQ repeat (PQ83), or a non-amyloid forming peptide of 19 PQ repeats (PQ19) as a non-pathological control, were expressed. A PQ83 line with relatively low levels of expression was generated, along with a PQ19 line that expressed approximately 9-fold the levels observed in the PQ83 line. Hearts expressing PQ83 exhibit reduced cardiac function and dilation by five months and all mice died by eight months, whereas PQ19 mice had normal cardiac function, morphology, and lifespan. PQ83 protein accumulates within aggresomes with PAO-specific staining. The PQ83 hearts showed increased autophagosomal and lysosomal content, but also showed markers of necrotic death, including inflammatory cell infiltration and increased sarcolemmal permeability. Conclusions The data confirm the hypothesis that expression of an exogenous PAO forming peptide is toxic to cardiomyocytes and is sufficient to cause cardiomyocyte loss and heart failure.

Pattison, J. Scott; Sanbe, Atsushi; Maloyan, Alina; Osinska, Hanna; Klevitsky, Raisa; Robbins, Jeffrey

2008-01-01

373

The regenerative capacity of zebrafish reverses cardiac failure caused by genetic cardiomyocyte depletion  

PubMed Central

Natural models of heart regeneration in lower vertebrates such as zebrafish are based on invasive surgeries causing mechanical injuries that are limited in size. Here, we created a genetic cell ablation model in zebrafish that facilitates inducible destruction of a high percentage of cardiomyocytes. Cell-specific depletion of over 60% of the ventricular myocardium triggered signs of cardiac failure that were not observed after partial ventricular resection, including reduced animal exercise tolerance and sudden death in the setting of stressors. Massive myocardial loss activated robust cellular and molecular responses by endocardial, immune, epicardial and vascular cells. Destroyed cardiomyocytes fully regenerated within several days, restoring cardiac anatomy, physiology and performance. Regenerated muscle originated from spared cardiomyocytes that acquired ultrastructural and electrophysiological characteristics of de-differentiation and underwent vigorous proliferation. Our study indicates that genetic depletion of cardiomyocytes, even at levels so extreme as to elicit signs of cardiac failure, can be reversed by natural regenerative capacity in lower vertebrates such as zebrafish.

Wang, Jinhu; Panakova, Daniela; Kikuchi, Kazu; Holdway, Jennifer E.; Gemberling, Matthew; Burris, James S.; Singh, Sumeet Pal; Dickson, Amy L.; Lin, Yi-Fan; Sabeh, M. Khaled; Werdich, Andreas A.; Yelon, Deborah; MacRae, Calum A.; Poss, Kenneth D.

2011-01-01

374

Unrecognized Acetaminophen Toxicity as a Cause of 'Indeterminate' Acute Liver Failure  

PubMed Central

Background Despite extensive investigation, the cause of liver injury in 14% of acute liver failure patients remains unknown (indeterminate). In a pilot study, using a novel assay, highly specific acetaminophen-cysteine adducts were detected in 7 of 36 (19%) indeterminate patients. Methods To extend these observations, sera from 110 subjects enrolled in the Acute Liver Failure Study Group registry with indeterminate acute liver failure were analyzed using a similar but more efficient and sensitive adduct assay. As positive controls, an additional 199 patients with known or presumed acetaminophen-induced liver failure were assessed for the presence and quantity of adducts. Clinical, laboratory and outcome data were compared for the two groups. Results Based on previous data from known therapeutic exposures and acetaminophen overdoses, an adduct concentration of ?1.0 nmol/mL serum indicated a definite acetaminophen overdose. Among the 110 indeterminate cases, 18% had assay values ?1.0, with a median level of 9.2 nmol/mL; 94.5 % of the positive control (known APAP) cases had values ?1.0 nmol/mL. Regardless of initial diagnosis, subjects with elevated adduct levels demonstrated the clinical profile and hyperacute biochemical injury pattern associated with acetaminophen overdose: predominance of female gender, very high aminotransferase levels and low bilirubin levels. Conclusions These data confirm and extend previous observations regarding the high (18%) prevalence of unrecognized or uncertain acetaminophen toxicity among subjects with indeterminate acute liver failure. N-acetylcysteine use was limited in this group, presumably because of the lack of a specific diagnosis of acetaminophen toxicity.

Khandelwal, Niraj; James, Laura P.; Sanders, Corron; Larson, Anne M.; Lee, William M.

2011-01-01

375

[Quality of results of therapy of acute respiratory failure : changes over a period of two decades].  

PubMed

Progress in intensive care (ICU) treatment of acute respiratory distress syndrome (ARDS) over the last 20 years includes the introduction of extracorporeal membrane oxygenation (ECMO) for CO2 removal and the widespread use of evidence-based lung-protective ventilatory strategies. Little is known, however, about whether these changes have resulted in improvements in short-term and long-term outcome of acute respiratory distress syndrome (ARDS) within the two decades after introduction. In a retrospective study 167 long-term survivors of severe ARDS who were transferred to the clinic for anesthesiology of the University of Munich, Campus Großhadern by means of specialized intensive care unit (ICU) transport teams and treated over a period of 20 years (1985-2005) were evaluated to investigate whether significant improvements in outcome as a consequence of the above mentioned progress in ARDS therapy have occurred. The ARDS patient cohort studied was characterized with regard to demographic variables, initial acute physiology and chronic health evaluation (APACHE) II score, duration of ICU treatment, the duration of mechanical ventilation and mortality. Data on long-term outcome were collected in a subcohort (n = 125) of patients who responded to mailed questionnaires and included health-related quality of life (HRQL, SF-36 questionnaire), symptoms of post-traumatic stress disorder (PTSD), traumatic memories from ICU treatment (PTSS-10 instrument) and current state of employment. During the observation period no significant changes regarding patient age (39 ± 16 years, mean ± SD), disease severity on admission to the ICU (APACHE II scores 22 ± 5), duration of ICU treatment (47 ± 39 days) or duration of mechanical ventilation (39 ± 38 days) were found. Overall ICU mortality during the two decades was 37.3 % (range 25.0 %-38.1 %) between 1995 and 2001 and a non-significant increase in values between 36.8 % and 58.3 % during the time interval from 2002 und 2005. The paO2/FIO2-ratio on ICU admittance improved significantly between 1990 and 2000 (69 ± 5 between 1990 and 1994 versus 101 ± 12 between 1995 and 2000, p < 0.01) and remained nearly unchanged thereafter. Long-term outcome was evaluated on average 5.0 ± 3.1 years after discharge from the ICU. During the time period between 1985 and 1994 survivors of ARDS showed significant impairments in all 8 categories of the SF-36 HRQL instrument when compared to an age and sex-matched normal population with maximal differences regarding physical function (z = -1.01), general health perception (z = -1.17) and mental health (z = -1.3). Patients who were treated from 1995 to 2005 were still impaired in 7 out of 8 categories of HRQL but reported significantly better mental health (49.6 ± 16.5 vs. 68.6 ± 17.8, p < 0,01) and better physical function than individuals from the previous decade (49.6 ± 16.5 vs. 73.4 ± 27.5, p = 0,03). The difference of mental health was no longer significant when compared to a healthy age and sex matched control group (p = 0.14) but the difference in physical function still was (z = -0.48, p < 0.01). The incidence of severe post-traumatic stress defined as a PTSS-10 score ? 35 was 20.4 % and remained unchanged throughout the 2 decades of observation. The PTSS-10 scores correlated with the number of traumatic memories present (r = 0.43, p < 0.01, n = 125). More than 50 % of long-term survivors were able to return to full time work with no significant changes during the 2 decades of observation. The introduction of new modalities of ARDS treatment were associated with higher paO2/FIO2-ratios on ICU admittance but had no effect on short-term outcomes including duration of ICU therapy, mechanical ventilation or mortality. The ARDS patients are still at risk for post-traumatic stress and persistent impairments in HRQL. Apart from some improvements in HRQL, the outcome of ARDS therapy remained largely unchanged during two decades. PMID:23558717

Briegel, I; Dolch, M; Irlbeck, M; Hauer, D; Kaufmann, I; Schelling, G

2013-04-06

376

Respiratory insufficiency in desminopathy patients caused by introduction of proline residues in desmin c-terminal alpha-helical segment.  

PubMed

Mutations in desmin gene have been identified in patients with cardiac and skeletal myopathy characterized by intracytoplasmic accumulation of desmin-reactive deposits and electron-dense granular aggregates. We characterized two new desminopathy families with unusual features of adult-onset, slowly progressive, diffuse skeletal myopathy and respiratory insufficiency. Progressive reduction of respiratory muscle strength became clinically detectable between the 3rd and the 8th years of illness and led to recurrent chest infections and death in one of the patients. Novel mutations, A357P and L370P, predicted to introduce proline residue into a highly conserved alpha-helical region of desmin, were identified. Proline is known to disrupt the alpha-helix. In addition, the A357P mutation distorts a unique stutter sequence that is considered to be critically important for proper filament assembly. Functional assessment in two cell-lines, one of which does and the other of which does not constitutively produce type III intermediate filaments, demonstrated the inability of mutant desmin carrying either the A357P or the L370P mutation to polymerize and form an intracellular filamentous network. The results of this study indicate that respiratory insufficiency is an intrinsic feature of disease associated with specific desmin mutations; in some patients, respiratory weakness may present as a dominant clinical manifestation and a major cause of disability and death. PMID:12766977

Dagvadorj, Ayush; Goudeau, Bertrand; Hilton-Jones, David; Blancato, Jan K; Shatunov, Alexey; Simon-Casteras, Monique; Squier, Waney; Nagle, James W; Goldfarb, Lev G; Vicart, Patrick

2003-06-01

377

Primary Ciliary Dyskinesia as a Cause of Neonatal Respiratory Distress: Implications for the Neonatologist  

Microsoft Academic Search

We report two cases of term infants who presented with prolonged respiratory distress, rhinitis, and situs inversus. A high index of suspicion led to the diagnosis of Kartagener Syndrome, which is a subgroup of primary ciliary dyskinesia, in the immediate neonatal period.

Tanzeema Hossain; Michael D Kappelman; Antonio R Perez-Atayde; Gregory J Young; Kenneth M Huttner; Helen Christou

2003-01-01

378

Efficacy of tulathromycin in the treatment of respiratory disease in pigs caused by Actinobacillus pleuropneumoniae.  

PubMed

The efficacy of a single dose of tulathromycin, a novel triamilide antimicrobial of the macrolide class, given at 2.5 mg/kg or 5 mg/kg bodyweight, or three daily doses of ceftiofur, given at 3 mg/kg bodyweight, was evaluated in pigs with respiratory disease induced experimentally with Actinobacillus pleuropneumoniae. On day 0, 100 pigs with clinical signs of respiratory disease were randomly assigned to groups of 25 pigs, which were treated with either saline, one of the doses of tulathromycin, or ceftiofur. The pigs' rectal temperatures and clinical scores for respiratory signs and general attitude were recorded daily until day 10. Animals withdrawn from the study for welfare reasons were recorded. On day 10, the animals remaining in the study were weighed, euthanased and examined postmortem. Three of the animals treated with saline and one of those treated with 2.5 mg/kg tulathromycin were withdrawn from the study, but none of those treated with 5 mg/kg tulathromycin or ceftiofur were withdrawn. The least squares mean bodyweight gains of the pigs treated with the antimicrobial agents were significantly (P<0.05) higher than that of the saline-treated group, and the least squares mean percentages of the total lung involvement and incidence of respiratory disease associated with A. pleuropneumoniae were significantly (P<0.05) lower, but there were no significant differences between the three groups of pigs treated with the antimicrobial agents. PMID:16581993

Hart, F J; Kilgore, R W; Meinert, T R; Nutsch, R G; Sunderland, S J; Lechtenberg, K F

2006-04-01

379

Upper Respiratory Tract Disease in the Gopher Tortoise Is Caused by Mycoplasma agassizii  

Microsoft Academic Search

Upper respiratory tract disease (URTD) has been observed in a number of tortoise species, including the desert tortoise (Gopherus agassizii) and the gopher tortoise (Gopherus polyphemus). Clinical signs of URTD in gopher tortoises are similar to those in desert tortoises and include serous, mucoid, or purulent discharge from the nares, excessive tearing to purulent ocular discharge, conjunctivitis, and edema of

M. B. BROWN; G. S. M CLAUGHLIN; P. A. KLEIN; B. C. CRENSHAW

1999-01-01

380

Death Through Respiratory Failure of a Fraction of Ultraviolet-Irradiated Escherichia coli B/r Cells  

PubMed Central

Escherichia coli B/r cells grown on a glycerol-containing medium and ultraviolet (UV)-irradiated to about 0.5% survival respire for about 1 hr and then cease for several hours. The cells that have completed repair and recovery processes begin to divide about 120 min after UV treatment, but this division is completely inhibited in liquid medium by caffeine, which delays repair of the irradiated deoxyribonucleic acid (DNA). When 5-fluorouracil (FU) is used to maintain respiration, the number of cells which form colonies when plated increases about 60-fold within 1 hr after irradiation. At least part of this increase does not involve repair while the cells are in the liquid medium because when caffeine is present there is still a 20-fold increase in colony formation. We conclude that many irradiated cells, although capable of carrying out complete and accurate repair of their DNA, die of respiratory failure; only when continuance of respiration is favored by FU treatment is their colony-forming potential realized. After an early increase, the number of cells able to form colonies in medium that contains FU remains constant while the completion of repair and recovery occurs. After these processes are completed, the number of cells able to form colonies increases slowly, except in the presence of caffeine, presumably because the late increase requires that repair steps take place while the cells are in liquid medium prior to cell division.

Swenson, P. A.; Schenley, R. L.

1972-01-01

381

NEURODEVELOPMENTAL OUTCOMES OF PREMATURE INFANTS WITH SEVERE RESPIRATORY FAILURE enrolled in a RANDOMIZED CONTROLLED TRIAL OF INHALED NITRIC OXIDE  

PubMed Central

Objectives We hypothesized that inhaled nitric oxide (iNO) would not decrease death or neurodevelopmental impairment (NDI) in infants enrolled in the NICHD Preemie iNO Trial (PiNO) trial, nor improve neurodevelopmental outcomes among the follow-up group. Study design Infants <34 weeks, <1500 g with severe respiratory failure were enrolled in the multicenter, randomized, controlled trial. NDI at 18–22 months corrected age was defined as: moderate to severe cerebral palsy (CP), MDI or PDI score<70, blindness, or deafness. Results Of 420 patients enrolled, 109 receiving iNO (52%) and 98 receiving placebo (47%) died. The follow-up rate among survivors was 90%. iNO did not reduce death or NDI (78% vs. 73%; [RR (95%CI) 1.07 (0.95–1.19)], or NDI or MDI<70 among the follow-up group. Moderate-severe CP was slightly higher with iNO [2.41 (1.01–5.75)], as was death or CP among infants ?1000 g BW [1.22 (1.05–1.43)]. Conclusions In this extremely ill cohort, iNO did not reduce death or NDI, or improve neurodevelopmental outcomes. Routine iNO use among premature infants should be limited to research settings until further data are available.

Hintz, SR; Van Meurs, KP; Perritt, R; Poole, WK; Das, A; Stevenson, DK; Ehrenkranz, RA; Lemons, J; Vohr, BR; Heyne, R; Childers, DO; Peralta-Carcelen, M; Dusick, A; Johnson, YR; Morris, B; Dillard, R; Vaucher, Y; Steichen, J; Adams-Chapman, I; Konduri, G; Myers, GJ; de Ungria, M; Tyson, JE; Higgins, RD

2009-01-01

382

The causes, consequences, and treatment of left or right heart failure  

PubMed Central

Chronic heart failure (HF) is a cardiovascular disease of cardinal importance because of several factors: a) an increasing occurrence due to the aging of the population, primary and secondary prevention of cardiovascular events, and modern advances in therapy, b) a bad prognosis: around 65% of patients are dead within 5 years of diagnosis, c) a high economic cost: HF accounts for 1% to 2% of total health care expenditure. This review focuses on the main causes, consequences in terms of morbidity, mortality and costs and treatment of HF.

Pazos-Lopez, Pablo; Peteiro-Vazquez, Jesus; Carcia-Campos, Ana; Garcia-Bueno, Lourdes; de Torres, Juan Pablo Abugattas; Castro-Beiras, Alfonso

2011-01-01

383

Vertical atlantoaxial dislocation as a cause of failure of midline fixation.  

PubMed

We report an 11-year-old girl who had previously undergone an operation for basilar invagination involving a foramen magnum decompression and midline wire fixation. After improving initially, her neurological condition worsened again. Repeated investigations showed a firm midline craniovertebral fixation and bone fusion. However, she was found to have a vertical mobile and reducible atlantoaxial dislocation. Treatment of the vertical dislocation by lateral mass fixation resulted in lasting relief from her symptoms. Vertical instability at the atlantoaxial joints needs to be identified and appropriately treated as it may be a cause of failure of midline fixation. PMID:20678940

Goel, Atul; Shah, Abhidha

2010-08-03

384

[Methodological problems in the search for the causes of school failure at the elementary teaching level].  

PubMed

In France, these failures are massively found in children from the working class. For a better understanding of the causes of failures, and their genesis, the studies of Cresas are essentially based on maternal school (2-6 years). The research is directed in three concordant directions : analysis of the institution, analysis of the various social milieu of children, psychological evolution of the children facing school. The team of the working group "cognition and school adaptation" focuses on the relationship between cognitive development, socio-cultural background and school adaptation. During five years of work, the team has recognised various methodological problems such as : questioning of comparative studies, attempt to approach children predisposed to group active learning failures, implication of researchers in a school, difficulties on the pedagogic organisational and institutional levels. The conclusions insist on questioning the concept of social handicap by considering the examination situation relating factors regarding the children's background, school action and the researchers position itself. Finally, there is an important comment to situate the problem : the notion of social handicap is related to the political and economic organisation. PMID:1232780

Marion-Mignon, A; Breauté, M

1975-01-01

385

[Respiratory management in muscular dystrophies].  

PubMed

Respiratory failure is a major contributor to immobility and mortality in progressive muscular dystrophies. The severity of pulmonary impairment and the stage at which it develops differ according to the type of muscular dystrophy. Appropriate respiratory management for each type should be considered. In Duchenne muscular dystrophy (DMD), respiratory impairment manifests in the late teens, and assisted mechanical ventilation is administered. Noninvasive positive-pressure ventilation (NIPPV) has increased the median survival of patients with DMD by 10 year and improved quality of life. In myotonic dystrophy (MyD), the causes of respiratory failure can involve both the central and the peripheral nervous systems in addition to respiratory muscles. Nocturnal desaturation is more severe in MyD than in other muscular dystrophies with similar degrees of respiratory muscle weakness. Cognitive impairment should be taken into account in the management of MyD patients. NIPPV does not appear to improve survival of MyD. Guidelines for DMD have been published. Respiratory function should be assessed serially by measuring forced vital capacity, oxyhemoglobin saturation, peak cough flow, and end-tidal CO2 level. A respiratory action plan should be enacted with increasing disease severity. Therapeutic measures comprise airway clearance, respiratory muscle training, noninvasive nocturnal ventilation, daytime noninvasive ventilation, and continuous invasive ventilation. At the advanced stage of respiratory failure, attention should be paid to complications related to long-term mechanical ventilation, such as pneumothorax and tracheal hemorrhage. Discussing about end-of-life care among the patient, family, and physician is important before mechanical ventilatory support is required. PMID:22068475

Kuru, Satoshi

2011-11-01

386

Isolated Left Ventricular Noncompaction as a Cause for Heart Failure and Heart Transplantation: A Single Center Experience  

Microsoft Academic Search

Objectives: To determine the prevalence of isolated left ventricular noncompaction (IVNC) as a cause of heart failure and heart transplantation. Methods: There were 960 patients seen in the heart failure clinic from 1987 to 2005, with a complete evaluation including echocardiography at our center (study population, 82% men, mean age 52 years). The following data were collected: type of heart

T. Kovacevic-Preradovic; R. Jenni; E. N. Oechslin; G. Noll; B. Seifert; C. H. Attenhofer Jost

2009-01-01

387

Antiviral activity in vitro of two preparations of the herbal medicinal product Sinupret® against viruses causing respiratory infections.  

PubMed

Sinupret(®), a herbal medicinal product made from Gentian root, Primula flower, Elder flower, Sorrel herb, and Verbena herb is frequently used in the treatment of acute and chronic rhinosinusitis and respiratory viral infections such as common cold. To date little is known about its potential antiviral activity. Therefore experiments have been performed to measure the antiviral activity of Sinupret(®) oral drops (hereinafter referred to as "oral drops") and Sinupret(®) dry extract (hereinafter referred to as "dry extract"), in vitro against a broad panel of both enveloped and non-enveloped human pathogenic RNA and DNA viruses known to cause infections of the upper respiratory tract: influenza A, Chile 1/83 (H1N1) virus (FluA), Porcine Influenza A/California/07/2009 (H1N1) virus (pFluA), parainfluenza type 3 virus (Para 3), respiratory syncytial virus, strain Long (RSV), human rhinovirus B subtype 14 (HRV 14), coxsackievirus subtype A9 (CA9), and adenovirus C subtype 5 (Adeno 5). Concentration-dependent antiviral activity (EC(50) between 13.8 and 124.8 ?g/ml) of Sinupret(®) was observed against RNA as well as DNA viruses independent of a viral envelope. Remarkable antiviral activity was shown against Adeno 5, HRV 14 and RSV in which dry extract was significantly superior to oral drops. This could be ascertained with different assays as plaque-reduction assays in plaque forming units (PFU), the analyses of a cytopathogenic effect (CPE) and with enzyme immunoassays (ELISA) to determine the amount of newly synthesised virus. Our results demonstrate that Sinupret(®) shows a broad spectrum of antiviral activity in vitro against viruses commonly known to cause respiratory infections. PMID:22112724

Glatthaar-Saalmüller, B; Rauchhaus, U; Rode, S; Haunschild, J; Saalmüller, A

2011-11-22

388

Bordetella pertussis as a cause of chronic respiratory infection in an AIDS patient  

Microsoft Academic Search

A 60-year-old heterosexual man with AIDS was admitted to hospital with dyspnea, a severe paroxysmal non-productive cough of two months' duration, low-grade fever and exhaustion.Bordetella pertussis was cultured from a bronchoalveolar lavage specimen. After erythromycin therapy (500 mg q.i.d. for two weeks) all respiratory symptoms resolved progressively over a four-week period.Bordetella pertussis should be added to the long list of

R. Colebunders; C. Vael; K. Blot; J. Van Meerbeeck; J. Van den Ende; M. Ieven

1994-01-01

389

Prevention of otitis media caused by viral upper respiratory tract infection: Vaccines, antivirals, and other approaches  

Microsoft Academic Search

Otitis media (OM) imposes significant morbidity on the pediatric age group and a large financial burden on the general population.\\u000a Because standard medical treatments are not highly efficacious in resolving the accompanying middle ear (ME) inflammation,\\u000a a goal of current research is OM prevention. Past studies show that new episodes of OM are usually a complication of viral\\u000a upper respiratory

William J. Doyle; Cuneyt M. Alper

2003-01-01

390

[Secondary sclerosing cholangitis following liver transplantation: a rare cause for graft failure].  

PubMed

We report on a 25-year-old female patient who presented with recurrent cholestasis following liver transplantation due to primary sclerosing cholangitis. Abdominal ultrasound and computed tomography showed intrahepatic bile duct dilatation and stenosis of the common hepatic artery with flow acceleration and decreased resistance index. The patient developed a severe secondary sclerosing cholangitis (SSC) with biliary casts - despite interventional stent placement of the common hepatic artery - thus requiring retransplantation. After prolonged intensive care unit treatment the patient was discharged in a good general condition. This case report describes SSC as a rare cause for graft failure. In unclear cholestasis after liver transplantation SSC has to be considered as the underlying cause. PMID:23487359

Voigtländer, T; Alten, T; Lehner, F; Strassburg, C P; Manns, M P; Lankisch, T O

2013-03-13

391

Treatment of acute respiratory failure by helmet-delivered non-invasive pressure support ventilation in children with acute leukemia: a pilot study  

Microsoft Academic Search

Objective To evaluate the feasibility of non-invasive ventilation (NIV) through a new interface—the helmet—in the treatment of acute respiratory failure (ARF) in hematologic children. Design and setting Observational, non-randomized report of four consecutive cases. Pediatric Intensive Care Unit in a university hospital. Patients and methods Four consecutive females (aged 9–17 years) affected by acute leukemia (3 acute lymphocytic leukemia [ALL], 1

Marco Piastra; Massimo Antonelli; Antonio Chiaretti; Giancarlo Polidori; Lorenzo Polidori; Giorgio Conti

2004-01-01

392

The prognostic value of cardiopulmonary exercise testing with a peak respiratory exchange ratio of < 1.0 in patients with chronic heart failure  

Microsoft Academic Search

BackgroundPeak oxygen consumption derived from a maximal cardiopulmonary exercise test (CPET) is a standard prognostic indicator in patients with chronic heart failure (CHF). Tests with a peak respiratory exchange ratio (pRER)<1.0 are often taken to be submaximal, and data from such tests are treated as less helpful. The aim of the current study was to compare the prognostic value of

Lee Ingle; Klaus K. Witte; John G. J. F. Cleland; Andrew L. Clark

2008-01-01

393

Comparison of two non-bronchoscopic methods for evaluating inflammation in patients with acute hypoxaemic respiratory failure  

PubMed Central

Introduction The simple bedside method for sampling undiluted distal pulmonary edema fluid through a normal suction catheter (s-Cath) has been experimentally and clinically validated. However, there are no data comparing non-bronchoscopic bronchoalveolar lavage (mini-BAL) and s-Cath for assessing lung inflammation in acute hypoxaemic respiratory failure. We designed a prospective study in two groups of patients, those with acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and those with acute cardiogenic lung edema (ACLE), designed to investigate the clinical feasibility of these techniques and to evaluate inflammation in both groups using undiluted sampling obtained by s-Cath. To test the interchangeability of the two methods in the same patient for studying the inflammation response, we further compared mini-BAL and s-Cath for agreement of protein concentration and percentage of polymorphonuclear cells (PMNs). Methods Mini-BAL and s-Cath sampling was assessed in 30 mechanically ventilated patients, 21 with ALI/ARDS and 9 with ACLE. To analyse agreement between the two sampling techniques, we considered only simultaneously collected mini-BAL and s-Cath paired samples. The protein concentration and polymorphonuclear cell (PMN) count comparisons were performed using undiluted sampling. Bland-Altman plots were used for assessing the mean bias and the limits of agreement between the two sampling techniques; comparison between groups was performed by using the non-parametric Mann-Whitney-U test; continuous variables were compared by using the Student t-test, Wilcoxon signed rank test, analysis of variance or Student-Newman-Keuls test; and categorical variables were compared by using chi-square analysis or Fisher exact test. Results Using protein content and PMN percentage as parameters, we identified substantial variations between the two sampling techniques. When the protein concentration in the lung was high, the s-Cath was a more sensitive method; by contrast, as inflammation increased, both methods provided similar estimates of neutrophil percentages in the lung. The patients with ACLE showed an increased PMN count, suggesting that hydrostatic lung edema can be associated with a concomitant inflammatory process. Conclusions There are significant differences between the s-Cath and mini-BAL sampling techniques, indicating that these procedures cannot be used interchangeably for studying the lung inflammatory response in patients with acute hypoxaemic lung injury.

2009-01-01

394

Mitochondrial DNA That Escapes from Autophagy Causes Inflammation and Heart Failure  

PubMed Central

Heart failure is a leading cause of morbidity and mortality in industrialized countries. Although infection with microorganisms is not involved in the development of heart failure in most cases, inflammation has been implicated in the pathogenesis of heart failure1. However, the mechanisms responsible for initiating and integrating inflammatory responses within the heart remain poorly defined. Mitochondria are evolutionary endosymbionts derived from bacteria and contain DNA similar to bacterial DNA2,3,4. Mitochondria damaged by external hemodynamic stress are degraded by the autophagy/lysosome system in cardiomyocytes5. Here, we show that mitochondrial DNA that escapes from autophagy cell-autonomously leads to Toll-like receptor (TLR) 9-mediated inflammatory responses in cardiomyocytes and is capable of inducing myocarditis, and dilated cardiomyopathy. Cardiac-specific deletion of lysosomal deoxyribonuclease (DNase) II showed no cardiac phenotypes under baseline conditions, but increased mortality and caused severe myocarditis and dilated cardiomyopathy 10 days after treatment with pressure overload. Early in the pathogenesis, DNase II-deficient hearts exhibited infiltration of inflammatory cells and increased mRNA expression of inflammatory cytokines, with accumulation of mitochondrial DNA deposits in autolysosomes in the myocardium. Administration of the inhibitory oligodeoxynucleotides against TLR9, which is known to be activated by bacterial DNA6, or ablation of Tlr9 attenuated the development of cardiomyopathy in DNase II-deficient mice. Furthermore, Tlr9-ablation improved pressure overload-induced cardiac dysfunction and inflammation even in mice with wild-type Dnase2a alleles. These data provide new perspectives on the mechanism of genesis of chronic inflammation in failing hearts.

Oka, Takafumi; Hikoso, Shungo; Yamaguchi, Osamu; Taneike, Manabu; Takeda, Toshihiro; Tamai, Takahito; Oyabu, Jota; Murakawa, Tomokazu; Nakayama, Hiroyuki; Nishida, Kazuhiko; Akira, Shizuo; Yamamoto, Akitsugu; Komuro, Issei; Otsu, Kinya

2012-01-01

395

26 CFR 301.7432-1 - Civil cause of action for failure to release a lien.  

Code of Federal Regulations, 2013 CFR

...officer's or an employee's failure to release a lien...for relief from the failure to release a lien...Cost of any study, analysis, engineering report, test, or project...administrative relief from the failure to release a...

2013-04-01

396

Urea-induced ROS generation causes insulin resistance in mice with chronic renal failure  

PubMed Central

Although supraphysiological concentrations of urea are known to increase oxidative stress in cultured cells, it is generally thought that the elevated levels of urea in chronic renal failure patients have negligible toxicity. We previously demonstrated that ROS increase intracellular protein modification by O-linked ?-N-acetylglucosamine (O-GlcNAc), and others showed that increased modification of insulin signaling molecules by O-GlcNAc reduces insulin signal transduction. Because both oxidative stress and insulin resistance have been observed in patients with end-stage renal disease, we sought to determine the role of urea in these phenotypes. Treatment of 3T3-L1 adipocytes with urea at disease-relevant concentrations induced ROS production, caused insulin resistance, increased expression of adipokines retinol binding protein 4 (RBP4) and resistin, and increased O-GlcNAc–modified insulin signaling molecules. Investigation of a mouse model of surgically induced renal failure (uremic mice) revealed increased ROS production, modification of insulin signaling molecules by O-GlcNAc, and increased expression of RBP4 and resistin in visceral adipose tissue. Uremic mice also displayed insulin resistance and glucose intolerance, and treatment with an antioxidant SOD/catalase mimetic normalized these defects. The SOD/catalase mimetic treatment also prevented the development of insulin resistance in normal mice after urea infusion. These data suggest that therapeutic targeting of urea-induced ROS may help reduce the high morbidity and mortality caused by end-stage renal disease.

D'Apolito, Maria; Du, Xueliang; Zong, Haihong; Catucci, Alessandra; Maiuri, Luigi; Trivisano, Tiziana; Pettoello-Mantovani, Massimo; Campanozzi, Angelo; Raia, Valeria; Pessin, Jeffrey E.; Brownlee, Michael; Giardino, Ida

2009-01-01

397

HIV Reservoirs and Immune Surveillance Evasion Cause the Failure of Structured Treatment Interruptions: A Computational Study  

PubMed Central

Continuous antiretroviral therapy is currently the most effective way to treat HIV infection. Unstructured interruptions are quite common due to side effects and toxicity, among others, and cannot be prevented. Several attempts to structure these interruptions failed due to an increased morbidity compared to continuous treatment. The cause of this failure is poorly understood and often attributed to drug resistance. Here we show that structured treatment interruptions would fail regardless of the emergence of drug resistance. Our computational model of the HIV infection dynamics in lymphoid tissue inside lymph nodes, demonstrates that HIV reservoirs and evasion from immune surveillance themselves are sufficient to cause the failure of structured interruptions. We validate our model with data from a clinical trial and show that it is possible to optimize the schedule of interruptions to perform as well as the continuous treatment in the absence of drug resistance. Our methodology enables studying the problem of treatment optimization without having impact on human beings. We anticipate that it is feasible to steer new clinical trials using computational models.

Mancini, Emiliano; Castiglione, Filippo; Bernaschi, Massimo; de Luca, Andrea; Sloot, Peter M. A.

2012-01-01

398

Weight loss and germination failure caused by psocids in different wheat varieties.  

PubMed

We investigated weight loss caused by Liposcelis entomophila (Enderlein) feeding in damaged (cracked) and intact kernels of 'Jagger' variety of hard red winter wheat over a 90-d period at 30 +/- 1 degrees C and 75 +/- 5% relative humidity. L. entomophila caused 8.5% weight loss in damaged wheat kernels, which was significantly greater than the weight loss found in intact wheat kernels (0.2%). We also evaluated the suitability of six wheat varieties commonly grown in Oklahoma, namely, Jagger, 'Endurance,' 'Overley,' 'Jagalene,' 'OK Bullet,' and 'Deliver' to support populations of four psocid species, namely, Liposcelis bostrychophila Badonnel, L. decolor (Pearman), L. entomophila, and L. paeta Pearman over a 30-d period. The greatest population increase was observed in L. bostrychophila followed by L. paeta. Subsequently, weight loss of damaged and intact wheat kernels and germination of intact kernels infested by L. paeta over a 45-d period were assessed in OK Bullet variety. L. paeta caused weight loss of 3.3% in damaged kernels, which was significantly greater than the weight loss found in intact kernels (0.4%). Based on our data, 40% of infested intact kernels failed to germinate after 45 d of infestation by L. paeta, but this decreased to 32% when adjusted using germination failure of uninfested kernels. Our data show that psocid infestations do not only cause considerable loss in weight of wheat, but also result in significant germination failure. These data call for the formulation of effective integrated psocid management strategies for stored wheat to mitigate the negative impacts of psocid pests. PMID:23448066

Gautam, S G; Opit, G P; Giles, K L; Adam, B

2013-02-01

399

Lymphangitic metastasis of recurrent renal cell carcinoma to the contralateral lung causing lymphangitic carcinomatosis and respiratory symptoms  

PubMed Central

Renal cell carcinoma comprises 80%–85% of kidney malignancies. For early presentations, nephrectomy provides a high cure rate, but patients usually present at advanced stages, leading to poor outcomes. Even for patients without metastatic spread who undergo nephrectomy, metastatic recurrence is frequent. We report the case of a patient who underwent nephrectomy for stage iii renal cell carcinoma and who presented 20 months later with respiratory symptoms consistent with pneumonia, influenza, or (less likely) congestive heart failure or a cardiac event. Persistent right pleural effusion on serial chest radiographs despite treatment prompted computed tomography evaluation, which revealed lymphangitic carcinomatosis, a very rare form of renal cell carcinoma metastasis to the lung. This preliminary finding was confirmed by right middle lobe tissue biopsy through bronchoscopy and cytopathology examination.

Wallach, J.B.; McGarry, T.; Torres, J.

2011-01-01

400

Evaluation of an "in vivo" PaO2 and PaCO2 monitor in the management of respiratory failure.  

PubMed

A commercially available gas-chromatograph (Sentorr Gas Analyzer, Ohio Medical Products, Madison, WI) was tested, featuring continuous measurement of in vivo PaO2 and PaCO2 by means of a thin, heparin-coated catheter, inserted through an indwelling arterial line. Gas tensions are displayed every 4 min. The probes had a tendency to break rather easily, and a considerable proportion of them was faulty. We measured 105 paired determinations of blood gases obtained from patients in respiratory failure requiring mechanical ventilation with a Corning IL 175 Analyzer and displayed by the Sentorr Gas Analyzer. A high correlation (p < 0.01) existed between the two sets of values, but an estimated error of 10-20% was found in the Sentorr data. After modifications of the respirator, changes of displayed values were already notable after 4 min and 90% completed by 8-12 min. The use of this device enabled us to considerably accelerate decision-making in the management of respiratory failure. Although techology still necessitates improvements, before widespread use of in vivo monitoring of PaO2 and PaCO2 is advisable, the concept has significant clinical potential and may represent a major advance in the management of respiratory failure. PMID:6773720

Carlon, G C; Kahn, R C; Ray, C; Howland, W S

1980-07-01

401

Combined noninvasive ventilation and mechanical in-exsufflator in the treatment of pediatric acute neuromuscular respiratory failure.  

PubMed

OBJECTIVES: The present study aims to evaluate the efficacy and complications of combined noninvasive ventilation (NIV) and assisted coughing by mechanical in-exsufflator (MIE) for acute respiratory failure (ARF) in children with neuromuscular disease (NMD). METHODS: A prospective study was conducted in the pediatric intensive care unit. Children with NMD and ARF treated by combined NIV and MIE were included. Treatment success was defined as freedom from tracheal intubation during the hospital stay. Physiologic indices including PaO2 , PaCO2 , pH, and PaO2 /FiO2 were recorded before and 12, 24?hr after the use of NIV/MIE. RESULTS: Combined NIV/MIE was used in 15 NMD children (mean: 8.1 years, range: 3 months to 18 years) with 16 cases of ARF. There was no mortality in this cohort. Treatment success was achieved in 12 cases (75%), including six cases (38%) demanding "Do Not Intubate." ARF was due to pneumonia, with a mean baseline PaCO2 of 73.2?±?19.0?mmHg. In the success group, hypercarbia and acidosis improved after use of NIV/MIE for 24?hr (PaCO2 : 71.7?±?18.6?mmHg vs. 55.8?±?11.6?mmHg, P?

Chen, Tai-Heng; Hsu, Jong-Hau; Wu, Jiunn-Ren; Dai, Zen-Kong; Chen, I-Chen; Liang, Wen-Chen; Yang, San-Nan; Jong, Yuh-Jyh

2013-06-18

402

Clinical Features of Patients on Home Oxygen Therapy Due to Chronic Respiratory Failure at One University Hospital  

PubMed Central

Background/Aims Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions. Methods Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively. Results Regarding the initial indications for HOT, their mean PaO2 was 49.8 mmHg and mean SpO2 was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%). Conclusions Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of cost-effectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.

Kim, Kyoung Hee; Park, Tae Yun; Kim, Eun Sun; Chung, Keun Bum; Lee, Sang-Min; Yim, Jae-Joon; Yoo, Chul-Gyu; Kim, Young Whan; Han, Sung Koo

2012-01-01

403

Acute respiratory distress caused by a giant mediastinal lipoblastoma in a 16-month-old boy.  

PubMed

Lipoblastoma is a rare benign tumor arising from embryonic fat; it occurs mainly in the extremities and almost exclusively in infants and children younger than 3 years. We present a case of giant mediastinal lipoblastoma in a 16-month-old boy who presented with acute respiratory distress. The mass was completely excised through a left posterolateral thoracotomy. The postoperative course was uneventful, and the pathologic final diagnosis was lipoblastoma. Although extremely rare, mediastinal lipoblastoma can be life threatening; therefore, it should be included in the differential diagnosis of mediastinal mass in younger subjects. PMID:22115267

Benato, Cristiano; Falezza, Giovanni; Lonardoni, Alessandro; Magnanelli, Giovanni; Ricci, Michela; Gilioli, Eliana; Calabrò, Francesco

2011-12-01

404

Rapidly grown congenital fetal immature gastric teratoma causing severe neonatal respiratory distress.  

PubMed

A pregnant woman in the mid-third trimester developed complications with enlarged fetal abdomen and polyhydramnios. Prenatal ultrasound visualized dilated bowel, intraperitoneal calcifications, ascites, hydroceles and polyhydramnios, giving the impression of meconium peritonitis. The fetal abdomen continued to increased in size, and maternal dyspnea due to polyhydramnios was aggravated. She underwent a cesarean section at 36 + 1 weeks' gestation. The delivery was followed by severe neonatal respiratory distress due to the huge mass in the abdomen. The tumor was successfully removed by emergency surgery and diagnosed as immature gastric teratoma. No other associated anomaly was found. The infant made a good progress after the operation. PMID:22229956

Jeong, Hyun Chul; Cha, Seong Jae; Kim, Gwang Jun

2012-01-10

405

Relative biological effectiveness of carbon ions for causing fatal liver failure after partial hepatectomy in mice.  

PubMed

To evaluate the acute phase damage to liver by carbon ions, BALB/c mice were irradiated with carbon ions or X-rays after two-thirds partial hepatectomy, and their survival was followed. The 50% lethal dose within 60 days (LD50/60) was 42.2 +/- 0.25 Gy (standard error) for X-rays, and 22.7 +/- 0.25 Gy for carbon ions. The relative biological effectiveness (RBE) of carbon ions was 1.86 (95% confident limits: 1.69-2.04) as calculated from the LD50/60. Mice irradiated at much higher doses, 60 Gy of X-rays or 24 Gy of carbon ions, showed significantly higher serum ammonia levels and lower serum albumin levels than normal, suggesting hepatic failure as a cause of death. Hepatocytes showed karyorrhexis and karyolysis in carbon ion irradiated and spotty necrosis in X-ray irradiated mice, suggesting nuclear damage. Mice irradiated with LD50 of X-rays or carbon ions had a remarkably lower bromodeoxyuridine (BrdU) labeling index and mitotic index than control. Treatments with both BrdU and vincristine showed that none of the hepatocytes that synthesized DNA after irradiation completed mitosis, indicating G2 arrest. The liver weight of irradiated mice significantly decreased depending on the dose. Carbon ions as well as X-rays damaged hepatocytes directly and suppressed liver regeneration leading to fatal liver failure. PMID:11037582

Tomizawa, M; Miyamoto, T; Kato, H; Otsu, H

2000-06-01

406

Procedure for analysis of common-cause failures in probabilistic safety analysis  

SciTech Connect

This report provides practical guidelines for treatment of common-cause failures (CCF) in risk and reliability studies. The procedures outlined in this report are organized according to three phases of analysis, screening analysis, detailed qualitative analysis, and detailed quantitative analysis. The results of the screening analysis phase include conservative identification of potential common-cause vulnerabilities and determination of the scope and focus for more detailed analysis in Phases II and III. Phase II, the detailed qualitative analysis, provides a better understanding of the plant-specific susceptibilities of the systems and components to causes and coupling mechanisms of CCF. The information from this phase can then be used as a basis for a plant-specific quantitative assessment of CCF frequencies. Detailed guidelines are provided for Phase III to aid the analyst in using this qualitative information and generic data in developing a plant-specific CCF base. Depending on the overall objective of the study, CCF analysis can stop at the end of any of the three phases.

Mosleh, A. [Maryland Univ., College Park, MD (United States). Dept. of Materials and Nuclear Engineering

1993-04-01

407

Stratgies for Diversity Usage to Mitigate Postulated Common Cause Failure Vulnerabilities  

SciTech Connect

This paper describes an approach to establish effective mitigating strategies that can resolve potential common-cause failure (CCF) vulnerabilities in instrumentation and control systems at nuclear power plants. A particular objective in the development of these strategies, which consist of combinations of diversity attributes and their associated criteria, is to address the unique characteristics of digital technology that can contribute to CCF concerns. The research approach employed to establish diversity strategies involves investigation of available documentation on diversity usage and experience from nuclear power and non-nuclear industries, capture of expert knowledge and lessons learned, determination of common practices, and assessment of the nature of CCFs and compensating diversity attributes. The resulting diversity strategies address considerations such as the effect of technology choices, the nature of CCF vulnerabilities, and the prospective impact of each diversity type. In particular, the impact of each attribute and criterion on the purpose, process, product, and performance aspects of diverse systems are considered.

Wood, Richard Thomas [ORNL; Waterman, Michael E. [U.S. Nuclear Regulatory Commission

2011-01-01

408

[Miliary tuberculosis of the liver as a cause of septic shock with multi-organ failure].  

PubMed

A woman aged 63 presented with septic fever, followed by hepatocellular jaundice. Viral hepatitis was ruled out by serologic tests, but no definite diagnosis could be made. Due to severe disturbance of the plasmatic coagulatory system and a serum bilirubin level above 4 mg/dl, a liver biopsy was not performed. The patient had a persistent septicemia refractory to Imipenem. In spite of intensive care measures, the patient died of disseminated intravascular coagulation and multiorgan failure caused by septic shock. The correct diagnosis of miliary tuberculosis was made only post mortem by histopathological examination of liver specimens and confirmed by detection of Mycobacterium tuberculosis DNA in the patient's liver by polymerase chain reaction. PMID:8165813

Mandak, M; Kerbl, U; Kleinert, R; Höfler, G; Zeichen, R; Denk, H

1994-01-01

409

A case of cutaneous infection caused by mycobacterium szulgai with progression to acute respiratory distress syndrome.  

PubMed

A 59-year-old man presented with a skin eruption and bilateral swelling of the legs. Soon after the initial presentation, he developed acute respiratory distress syndrome (ARDS) with miliary lung nodules. Culture of samples from the skin ulcers, sputum, and bronchoalveolar lavage fluid all revealed Mycobacterium szulgai infection. The patient was successfully treated with antituberculosis drugs. M. szulgai infection is very rarely reported worldwide, and disseminated infection usually occurs in immunocompromised patients. However, the present patient was a non-immunocompromised case, although he was a hepatitis B virus carrier. While the progression to ARDS from M. tuberculosis infection is well known, this is the first case of M. szulgai infection progressing to ARDS. PMID:22084610

Ohta, Hiromitsu; Miyauchi, Eisaku; Ebina, Masahito; Nukiwa, Toshihiro

2011-06-13

410

A Case of Cutaneous Infection Caused by Mycobacterium Szulgai with Progression to Acute Respiratory Distress Syndrome  

PubMed Central

A 59-year-old man presented with a skin eruption and bilateral swelling of the legs. Soon after the initial presentation, he developed acute respiratory distress syndrome (ARDS) with miliary lung nodules. Culture of samples from the skin ulcers, sputum, and bronchoalveolar lavage fluid all revealed Mycobacterium szulgai infection. The patient was successfully treated with antituberculosis drugs. M. szulgai infection is very rarely reported worldwide, and disseminated infection usually occurs in immunocompromised patients. However, the present patient was a non-immunocompromised case, although he was a hepatitis B virus carrier. While the progression to ARDS from M. tuberculosis infection is well known, this is the first case of M. szulgai infection progressing to ARDS.

Ohta, Hiromitsu; Miyauchi, Eisaku; Ebina, Masahito; Nukiwa, Toshihiro

2011-01-01

411

[Efficacy of injectable carbapenems for respiratory infections caused by Streptococcus pneumoniae and Haemophilus influenzae with Monte Carlo simulation].  

PubMed

Streptococcus pneumoniae and Haemophilus influenzae are two major pathogens for respiratory tract infections, and those infections might cause critically ill patients. We performed the analysis with Monte Carlo Simulation for 253 strains of S. pneumoniae and 309 strains of H. influenzae isolated in the Gifu prefecture in 2002 and 2003. As for the pneumococcal infection in patient with good immunological response, good clinical effect might be obtained by panipenem/betamipron (PAPM/BP) 500 mg, imipenem/cilastatin (IPM/CS) 500 mg, meropenem (MEPM) 500 mg and biapenem (BIPM) 300 mg, b.i.d., while for immunocompromised hosts or infections by penicillin-resistant Streptococcus pneumoniae (PRSP), PAPM/BP, 500 mg, b.i.d., or IPM/CS 500 mg, MEPM 500 mg, t.i.d. or BIPM 600 mg, b.i.d. would be recommended. As for the infections caused by H. influenzae, in patient with good immunological response, good clinical effect might be obtained by MEPM 500 mg, b.i.d or PAPM/BP 1000 mg, b.i.d., while for immunocompromised hosts, MEPM 500 mg, t.i.d. would be recommended. Monte Carlo Simulation would be one of the useful tools for appropriate antimicrobial chemotherapy also against respiratory infections. PMID:17436862

Mikamo, Hiroshige; Tanaka, Kaori; Watanabe, Kunitomo

2007-02-01

412

Acute Lung Failure  

PubMed Central

Lung failure is the most common organ failure seen in the intensive care unit. The pathogenesis of acute respiratory failure (ARF) can be classified as (1) neuromuscular in origin, (2) secondary to acute and chronic obstructive airway diseases, (3) alveolar processes such as cardiogenic and noncardiogenic pulmonary edema and pneumonia, and (4) vascular diseases such as acute or chronic pulmonary embolism. This article reviews the more common causes of ARF from each group, including the pathological mechanisms and the principles of critical care management, focusing on the supportive, specific, and adjunctive therapies for each condition.

Mac Sweeney, Rob; McAuley, Daniel F.; Matthay, Michael A.

2013-01-01

413

Respiratory function monitoring during mechanical ventilation in pediatric intensive care unit  

Microsoft Academic Search

Noninvasive monitoring of lung function during mechanical ventilation has been used to study disease processes causing respiratory\\u000a failure. Pediatric pulmonary function monitoring during mechanical ventilation in the pediatric intensive care unit in patient\\u000a with respiratory failure is becoming more common in western countries. The article describes a review of principles and methods\\u000a of respiratory function monitoring in the pediatric age

Praveen Khilnani

1998-01-01

414

Rescue From Respiratory Dysfunction by Transduction of Full-length Dystrophin to Diaphragm via the Peritoneal Cavity in Utrophin\\/Dystrophin Double Knockout Mice  

Microsoft Academic Search

Duchenne muscular dystrophy (DMD) is an inherited severe muscle wasting disorder with, thus far, no effective therapy. DMD causes respiratory and cardiac failure as well as muscle wastage. Among the various symptoms, respiratory insufficiency is a major cause of death in DMD patients at about 20 years of age. So, naturally, the improvement of respiratory function will extend the patient's

Masatoshi Ishizaki; Yasushi Maeda; Ryoko Kawano; Tomohiro Suga; Yuji Uchida; Katsuhisa Uchino; Satoshi Yamashita; En Kimura; Makoto Uchino

2011-01-01

415

Treatment with Embolization of Cobb' ' ' ' s Syndrome Causing High-output Heart Failure  

Microsoft Academic Search

High-output heart failure may occur in anemia, thyrotoxicosis, Beriberi heart disease, arteriovenous fistula, congenital arteriovenous malformation, Paget's disease of the bone, fibrous dysplasia, polycythemia vera, multiple myeloma, and renal diseases such as glomerulonephritis, carcinoid syndrome, pregnancy and obesity. Among these conditions, reports on heart failure resulting from an arteriovenous malformation are rare. We report a case of high-output heart failure

Hae-Rim Kim; Hyeon-Seong Kim; Kwan-Woo Nam; Ji-Sung Chung; Seung-Ki Kwok; Hye-Jung Lee; Byung-Sik Cho; Kye-Won Lee; Yong-Bum Park; Chul-Soo Park; Jong-Min Lee; Yong-Seok Oh; Ho-Joong Youn; Wook-Sung Chung; Soon-Jo Hong

2002-01-01

416

Quantification of unavailability caused by random failures and maintenance human errors in nuclear power plants  

Microsoft Academic Search

Risk analysis of any equipment or system estimates the unavailability of redundant components due to hardware failure, periodic test and repair work, and human errors in maintenance tasks. A model has been developed in this study to estimate the unavailability of a periodically repairable component of a system that considers hardware failure and maintenance errors due to human failure, and

M. Khalaquzzaman; Hyun Gook Kang; Man Cheol Kim; Poong Hyun Seong

2010-01-01

417

Perry syndrome due to the DCTN1 G71R mutation: a distinctive levodopa responsive disorder with behavioral syndrome, vertical gaze palsy, and respiratory failure.  

PubMed

Perry syndrome is a rare form of autosomal dominant Parkinsonism with respiratory failure recently defined as being due to mutations in the DCTN1 gene. We describe a new family carrying a G71R mutation in the DCTN1 gene. The proband displayed a series of distinctive features not previously described in Perry syndrome: a disorder of vertical downward saccades accompanied by progressive midbrain atrophy, predominant nonmotor symptoms responsive to levodopa, distinctive craniocervical levodopa induced dyskinesias, and a good response to high-dose levodopa therapy and respiratory support. The family was initially thought to have autosomal dominant behavioral variant frontotemporal dementia with Parkinsonism. This report expands the clinical definition of this distinctive syndrome. PMID:20437543

Newsway, Victoria; Fish, Mark; Rohrer, Jonathan D; Majounie, Elisa; Williams, Nigel; Hack, Melissa; Warren, Jason D; Morris, Huw R

2010-04-30

418

Failure to maintain luteal function: a possible cause of early embryonic loss in a cow.  

PubMed Central

The effect of early pregnancy failure on the release of prostaglandin F2 alpha (PGF2 alpha) in response to oxytocin (Ot) was examined in an abnormal breeder (AB) heifer that was not able to maintain a pregnancy beyond 21 days. This animal was used in three experiments: 1) She received one intravenous injection of 100 IU Ot 17 days after the onset of oestrus (Day 0). Frequent blood samples were taken for the measurement of 15-keto-13,14-dihydro-PGF2 alpha (PGFM) by radioimmunoassay. Daily samples for progesterone (P4) determinations were taken to monitor luteal function. This was then repeated using the same animal at either day 17 or 18 or 19 (day 17-19) of pregnancy. 2) Embryos from superovulated normal breeder (NB) donors were transferred at day 7 to the AB heifer as well as to NB control animals. 3) Seven day old embryos from the superovulated AB heifer were transferred to NB recipient animals. At day 17-19 of pregnancy all the recipient heifers (experiments 2 and 3) were subjected to the same protocol as in experiment 1. The results showed that the ability of Ot to stimulate PGF2 alpha release was reduced in the NB recipients bearing viable embryos when compared to cyclic animals. However, for the AB heifer, Ot stimulated PGF2 alpha release to the same extent whether the animal was cyclic or pregnant. Furthermore, the AB animal did not have the extended luteal function associated with removal of viable embryos on day 17-19. The data suggest that the embryonic loss might have been caused by failure of the embryos to prevent the luteolytic release of PGF2 alpha.

Lafrance, M; Goff, A K; Guay, P; Harvey, D

1989-01-01

419

Multiple respiratory gas monitoring causes changes of inspired oxygen concentration in closed anesthesia system.  

PubMed

Effect of multiple respiratory gas monitoring (MRGM) on inspired concentration of oxygen in circuit system during closed anesthesia was studied in 51 adult patients scheduled for abdominal surgery. Required flow rate of fresh oxygen (OFR), inspired oxygen concentration (FiO2) and oxygen saturation of pulse oximeter (SpO2) were measured continuously. Patients were equally divided into three groups at random, group C (no MRGN used), group M1 (using MRGM with its tail gas returned to circuit system), group M2 (using MRGM without tail gas returned). The results revealed that during 180 min of closed anesthesia, OFR required in group C and M1 were about 200-230 ml/min, and in group M2 it was about 400 ml/min. In group C FiO2 decreased by about 10% after 60 min of closed anesthesia (P < 0.01, 60 min vs 0 min) and then stayed stable at this level. In group M1, FiO2 decreased by 16% at 60 min and 34% at 180 min and the decrease was significantly greater than that in group C (P < 0.01). In group M2, FiO2 remained constant during closed anesthesia, which was much higher than those in group C and M1. The tail gas of Capnomac Ultima MRGM contained less oxygen than its sample gas drawn from circuit system simultaneously. PMID:9639787

Li, S; Wang, Z; Zeng, B; Liu, J

1997-01-01

420

Deficiency of Lamellar Bodies in Alveolar Type II Cells Associated with Fatal Respiratory Disease in a Full-term Infant  

Microsoft Academic Search

We report a case of a full-term female infant who presented with severe respiratory distress shortly after birth and died at 23 d of age with unremitting respiratory failure. Infectious and other known causes of respiratory disease in this clinical setting were excluded. Examination of a lung biopsy showed abnormal lung parenchyma with features reminiscent of desquamative interstitial pneu- monitis.

ERNEST CUTZ; SUSAN E. WERT; LAWRENCE M. NOGEE; AIDEEN M. MOORE

2000-01-01

421

Pathophysiological model of chronic heart failure complicated with renal failure caused by three-quarter nephrectomy and subcutaneous injection of isoprenaline.  

PubMed

This study aimed to investigate the pathophysiological changes in a rat chronic heart failure complicated with renal failure model, caused by three-quarters nephrectomy and subcutaneous injection of isoproterenol (ISO). Sprague-Dawley (SD) rats in the model group received three-quarters nephrectomy after twice undergoing surgical resections and subcutaneous injection of ISO (100 mg/kg body weight, injected twice, with a 24 h interval) after one week, while rats in the control group received sham surgery and injection of normal saline. Survival rate, heart failure and renal failure were compared between the two groups after 4 weeks. Serum creatinine (Cr), blood urea nitrogen (BUN), B-type natriuretic protein (BNP), aldolase (ALD), angiotensin II (Ang II) and C-reactive protein (CRP) were determined by kit assay. Urine protein at 24 h was determined by the Bradford method and left ventricular systolic pressure (LVSP), left ventricular diastolic pressure (LVDP) and left ventricular end-diastolic pressure (LVEDP), as well as the maximum rates of increased and decreased left ventricular pressure (±dP/dt(max)) were determined by left ventricular intubation. Heart weight indices were determined and the myocardial pathological conditions were observed by hematoxylin and eosin (HE) staining. There was no death in the control group, while the survival rate of the model group was 73%. Compared with the control group, each index of serum and urine protein in the model group was significantly increased. Additionally, LVSP was decreased, LVDP and LVEDP were increased and heart weight index was increased, with a significant difference. The serum Cr was positively correlated to BNP levels in the model group. Three-quarters nephrectomy and subcutaneous injection of ISO induces left ventricular heart failure and renal failure at the same time, which is characterized in pathophysiology by left ventricular diastolic and systolic function failure, left ventricular myocardial hypertrophy and reconstruction complicated with renal insufficiency. PMID:23403929

Peng, Ding-Feng; Tang, Shao-Yong; Hu, Yong-Jun; Chen, Jiao; Yang, Li

2012-12-19

422

Unusual cause of rapidly progressive right-sided heart failure: aortic sinus of Valsalva aneurysm causing ball valve obstruction of the tricuspid valve.  

PubMed

A rare presentation with rapidly progressive right heart failure due to tricuspid inflow obstruction (simulating right-sided valvular heart disease) caused by a non-coronary cusp sinus of Valsalva aneurysm with small perforation is reported. The aneurysm was causing ball valve obstruction at the tricuspid valve, leading to dilated right atrium and back pressure changes which were relieved after successful aneurysectomy. PMID:19443467

Bagga, Shiv; Mohite, Prashant N; Reddy, Sreenivas; Thingnam, Shyam K; Talwar, Kewal K

2009-05-13

423

Duration of immunity of a quadrivalent vaccine against respiratory diseases caused by BHV-1, PI 3V, BVDV, and BRSV in experimentally infected calves  

Microsoft Academic Search

Several laboratory studies assessed the duration of immunity of a quadrivalent vaccine (Rispoval™4, Pfizer Animal Health) against bovine respiratory diseases (BRD) caused by bovine herpes-virus type-1 (BHV-1), parainfluenza type-3 virus (PI3V), bovine viral-diarrhoea virus type 1 (BVDV), or bovine respiratory syncytial virus (BRSV). Calves between 7 weeks and 6 months of age were allocated to treatment and then were injected

A. R. Peters; S. J. Thevasagayam; A. Wiseman; J. S. Salt

2004-01-01

424

Other viral pneumonias: coronavirus, respiratory syncytial virus, adenovirus, hantavirus.  

PubMed

Severe viral pneumonia is an increasing problem among adults. The incidence and number of viruses known to cause pneumonia and respiratory failure have also expanded in recent years. This article provides an overview of severe respiratory disease caused by coronavirus, respiratory syncytial virus, adenovirus, and hantavirus. These emerging pathogens are easily overlooked and timely diagnosis requires a high index of suspicion and confirmation by molecular testing. Management of individual cases is mainly supportive and requires institution of appropriate infection control measures. Vaccines and effective therapeutics for these potentially devastating respiratory viruses are urgently required. PMID:24094390

Lee, Nelson; Qureshi, Salman T

2013-08-09

425

Anastomoses of the Ovarian and Uterine Arteries: A Potential Pitfall and Cause of Failure of Uterine Embolization  

SciTech Connect

Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure.

Matson, Matthew [Department of Radiology, St. George's Hospital, Blackshaw Road, London, SW17 OQT (United Kingdom); Nicholson, Anthony [Department of Radiology, Hull Royal Infirmary, Anlaby Road, Hull HU3 2JZ (United Kingdom); Belli, Anna-Maria [Department of Radiology, St. George's Hospital, Blackshaw Road, London, SW17 OQT (United Kingdom)

2000-09-15

426

Lung microvascular transport properties measured by multiple indicator dilution methods in patients with adult respiratory distress syndrome. A comparison between patients reversing respiratory failure and those failing to reverse  

SciTech Connect

We conducted indicator dilution studies on the lungs of patients in the early phases of adult respiratory distress syndrome (ARDS) to test the hypothesis that capillary permeability was increased in patients with respiratory failure. Indicator dilution studies were performed using 51Cr-erythrocytes, 125I-albumin, 14C-urea, and 3H-water as tracers. The injectate was infused as a bolus into a central venous line. Peripheral arterial blood was collected and counted for radioactivity. Mathematical analysis of the indicator curves yielded cardiac output, measures of the product of capillary permeability and surface area for urea (PS and D1/2S), the intravascular lung volume (Vv), and the extravascular lung water volume (Ve). Permeability was separated from surface area by normalizing PS and D1/2S to Vv. Patients could be divided into 16 in whom blood gas determinations and radiologic criteria for ARDS were reversed and 23 in whom they were not. We examined indicator dilution and other measures of lung function in the two groups to determine whether significant differences in microvascular function existed. PS and PS/Vv were significantly higher in the nonreversal patients. Ve was above normal, but not different between groups. Linear regression analysis showed significant correlations for all of the following in the nonreversal group: Ve and all measures of permeability, pulmonary vascular resistance (PVR), and the inverse of permeability-surface area measures and AaDO2 and PVR. Only measures of Ve and PS correlated in the reversal group. These results support the hypothesis that capillary permeability is increased in patients with early ARDS and continuing respiratory failure.

Harris, T.R.; Bernard, G.R.; Brigham, K.L.; Higgins, S.B.; Rinaldo, J.E.; Borovetz, H.S.; Sibbald, W.J.; Kariman, K.; Sprung, C.L. (Vanderbilt Univ., Nashville, TN (USA))

1990-02-01

427

A novel mitochondrial MTND5 frameshift mutation causing isolated complex I deficiency, renal failure and myopathy.  

PubMed

Isolated complex I deficiency is the most commonly reported enzyme defect in paediatric mitochondrial disorders, and may arise due to mutations in nuclear-encoded structural or assembly genes, or the mitochondrial genome. We present the clinical, biochemical and molecular genetic data in a young girl whose clinical picture is dominated by chronic renal failure, myopathy and persistent lactic acidosis. An isolated complex I deficiency in muscle was identified due to a novel mutation (m.12425delA) in the MTND5 gene. This single nucleotide deletion is heteroplasmic and detectable in several tissues from the proband but not her mother, suggesting a de novo mutation event. The description of the first frameshift mutation in a mitochondrial complex I gene affirms mitochondrial DNA mutations as an important cause of isolated complex I deficiency in children and the importance of whole mitochondrial genome sequencing in the diagnostic work-up to elucidate the underlying molecular genetic abnormality and provide important genetic advice. PMID:20018511

Alston, Charlotte L; Morak, Monika; Reid, Christopher; Hargreaves, Iain P; Pope, Simon A S; Land, John M; Heales, Simon J; Horvath, Rita; Mundy, Helen; Taylor, Robert W

2009-12-16

428

'Ryanopathy': causes and manifestations of RyR2 dysfunction in heart failure.  

PubMed

The cardiac ryanodine receptor (RyR2), a Ca(2+) release channel on the membrane of the sarcoplasmic reticulum (SR), plays a key role in determining the strength of the heartbeat by supplying Ca(2+) required for contractile activation. Abnormal RyR2 function is recognized as an important part of the pathophysiology of heart failure (HF). While in the normal heart, the balance between the cytosolic and intra-SR Ca(2+) regulation of RyR2 function maintains the contraction-relaxation cycle, in HF, this behaviour is compromised by excessive post-translational modifications of the RyR2. Such modification of the Ca(2+) release channel impairs the ability of the RyR2 to properly deactivate leading to a spectrum of Ca(2+)-dependent pathologies that include cardiac systolic and diastolic dysfunction, arrhythmias, and structural remodelling. In this article, we present an overview of recent advances in our understanding of the underlying causes and pathological consequences of abnormal RyR2 function in the failing heart. We also discuss the implications of these findings for HF therapy. PMID:23408344

Belevych, Andriy E; Radwa?ski, Przemys?aw B; Carnes, Cynthia A; Györke, Sandor

2013-02-12

429

Circulatory failure caused by a fungicide containing iminoctadine and a surfactant: a pharmacological analysis in rats.  

PubMed

The fungicide Befran (BFR), containing iminoctadine as an active ingredient and polyoxyethylene alkylether (POEAE) as a surfactant, has been known to cause circulatory failure in human acute oral poisoning. We investigated separately the effects of iminoctadine, POEAE, and BFR on heart rate and blood pressure of rats and also on isolated atria and aortas. In isolated rat atria, iminoctadine produced positive chronotropic and inotropic responses. In contrast, POEAE produced negative chronotropic and inotropic responses. BFR produced no effects at low concentrations, but significant negative chronotropic and inotropic responses at high concentrations. In isolated rat aortas, iminoctadine produced remarkable vasodilative responses, but POEAE produced vasoconstrictive responses. BFR produced both vasodilative and vasoconstrictive responses. When intravenously administered to anesthetized rats, iminoctadine produced hypotension and tachycardia in a dose-dependent manner. POEAE produced significant hypotension and slight bradycardia. BFR, at low doses, produced hypotension without elevation of heart rate. At high doses, it produced significant hypotension and tachycardia. From these results, it can be concluded that severe hypotension induced by BFR is due mainly to the vasodilative effect of iminoctadine and partly to the cardio-suppressive effect of POEAE. PMID:8209373

Koyama, K; Goto, K; Yamashita, M

1994-06-01

430

Gunshot wounds: causing myocardial infarction, delayed ventricular septal defect, and congestive heart failure.  

PubMed

Penetrating chest trauma can cause a wide variety of cardiac injuries, including myocardial contusion, damage to the interventricular septum, laceration of the coronary arteries, and free-wall rupture. Herein, we describe the case of a 21-year-old man who presented with congestive heart failure, which was secondary to an old myocardial infarction and complicated by the delayed formation of a ventricular septal defect. All of these conditions were attributable to multiple gunshot wounds that the patient had sustained 6 months earlier. Left ventricular angiography showed an apical aneurysm; a large, muscular, ventricular septal defect; and 19 gunshot pellets in the chest wall. Three months after aneurysmectomy and surgical closure of the septal defect, the patient had recovered fully and was asymptomatic.This case reaffirms the fact that substantial cardiac injuries can appear months after chest trauma. The possibility of traumatic ventricular septal defect should be considered in all multiple-trauma patients who develop a new heart murmur, even when overt chest-wall injury is absent. PMID:22412248

Kumar, Sudeep; Moorthy, Nagaraja; Kapoor, Aditya; Sinha, Nakul

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