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Epidural morphine in COVID ARDS patients with high respiratory drive: a structured summary of a study protocol for a randomised controlled trial.

OBJECTIVES: We aim to study the effect of epidural morphine as a means to reduce high respiratory drive in COVID 19 patients on non-invasive … dural space. The doses will be escalated daily (5-10 mg), titrated to effect: escalation limited by hypoventilation resulting in respiratory acidosis (pH < 7.2). The intervention will continue for a minimum of 2 doses and a maximum of 5 doses (96 h) of morphine. It will be stopped if the epidural catheter gets dislodged before the second dose or the patient is we …

Acute viral respiratory infections in children before and during the COVID-19 pandemic in a Peruvian reference hospital.

INTRODUCTION AND BACKGROUND: Invasive home mechanical ventilation is used for patients with chronic respiratory insufficiency. This elaborat … d in the analysis. RESULTS AND DISCUSSION: Invasive mechanical ventilation may improve symptoms of hypoventilation, as the analysis of the literature shows. An increase in life expectancy is likely, but for ethical reasons it is not confirmed by premium-quality studies. Complications (e. g. pneumonia) are rare. Mobile home ventilators are available for the imple …

[Hypercapnia and mixed acidosis as the only sign of malignant hyperthermia (MH)?].

CASE REPORT: A 34-year-old male (190 cm/100 kg) was scheduled for surgery of the nasal septum. He had had uneventful anaesthesia for appendi … ase five main reasons for the hypercarbia and mixed acidosis must be considered (Table 1). Firstly, hypoventilation does not seem to be reasonable as the patient was ventilated with 8 to 12 l/min, which is within the range of 80-120 ml/kg.min. Secondly, we can exclude shock and hypoperfusion because the patient had a normal blood pressure and heart rate (within 6 …

[Cardiopulmonary effects of CPPV (continuous positive pressure ventilation) and IRV (inverse ratio ventilation) in experimental myocardial ischemia].

Continuous positive pressure ventilation (CPPV) is an established therapy for treatment of acute respiratory failure (ARF). However, cardiac performance may be severely disturbed due to elevated intrathoracic pressure, inducing a decrease in cardiac output (CO) and oxygen delivery (DO2). Alternatively, mechanical ventilation with prolonged inspiratory to expiratory duration ratio (inversed ratio ventilation IRV) has been successfully used in ARF. No data are available about IRV in acute haemodynamic oedema. Thus, the cardiopulmonary effects of CPPV (positive end-expiratory pressure [PEEP] = 10

[Guidelines for the diagnosis and treatment of obstructive sleep apnea in adults (2025)].

Obstructive sleep apnea (OSA) is a highly prevalent sleep-related breathing disorder with a considerable healthcare burden. Previously, the … sures≥15 cmH2O (1 cmH2O=0.098 kPa), for intolerance to high CPAP pressures, or for OSA with chronic hypoventilation disorders such as COPD, neuromuscular diseases, or obesity hypoventilation syndrome (1, A).Question 10: What are the principles and procedures for PAP titration?Recommendation 10: PAP pressure titration is recommended before initiating therapy (1, A …

Emergency Care

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Pulmonary Hypertension in an Oncologic Intensive Care Unit

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Совпадение в полном тексте источника
… disorders such as obesity hypoventilation syndrome, and neuromuscular weakness. … For example, obesity and awake alveolar hypoventilation may indicate obesity hypoventilation syndrome, inspiratory crackles and clubbing may point toward interstitial lung disease, while sclerodactyly and digital ulcers may suggest systemic sclerosis. Fig. 2 Transthoracic echocardiogram. …

Частота, характеристики и иммунологические композиции атаксии в антиNMDAR, связанной с антителным энцефалитом.

ВВЕДЕНИЕ: Очень редко взрослый антителный энцефалит NMDAR (NMDAR-E) приводит к стойкой атрофии мозга и атаксии. В педиатрии НМДАР-Е широко распространена трансгенитальная атаксия мозга. Атаксия церебельного типа может быть связана с mielin oligodendrocyte glycoprotein (MOG), аквапорин-4 (AQP-4), членом семьи 11 (KLHL11), похожим на келч, и субъектом рецептора 2 (GluK2) глютаматного кайната, все из которых могут быть совместно окуны в NMDAR-E. Здесь мы стремились изучить частоту, долгосрочные результаты и иммунологические сопутствующие атаксии в НМДАР-Е.МЕТОДЫ: В ходе этого наблюдения пациенты

Совпадение в полном тексте источника
… of NMDAR-E follows a characteristic pattern: after a flu-like prodromal phase, psychotic symptoms develop, followed by speech disturbances and epileptic seizures, then—interpreted as generalized encephalitis—loss of consciousness, stereotypic movements, and autonomic dysfunction as well as central hypoventilation … The clinical picture of NMDAR-E varies with age: in infants and young children, movement disorders might predominate, and autonomic dysfunction and hypoventilation are less common ( 5 ). …

Myxedema Coma as the Initial Presentation of Undiagnosed Hypothyroidism: A Rare but Reversible Emergency.

Myxedema coma is a rare, life-threatening endocrine emergency representing the extreme manifestation of untreated hypothyroidism. It usually presents with nonspecific symptoms such as confusion, hypothermia, and bradycardia, which can lead to delayed recognition, particularly in elderly patients with multiple comorbidities. We report the case of a 77-year-old man with hypertension, stage 4 chronic kidney disease, anemia of chronic disease, myeloma, and prostate cancer who presented with reduced consciousness following a period of increasing lethargy and confusion. On arrival, he was hypotensiv

Совпадение в полном тексте источника
… Features can include hypothermia, bradycardia, hypotension, hyponatremia, hypoventilation with carbon dioxide (CO₂) retention, and generalized non-pitting edema [ 4 ]. …

Towards an adiposity-related disease framework for the diagnosis and management of obesities.

Obesity is a complex disease that relapses frequently and associates with multiple complications that comprise a worldwide health priority because of its rising prevalence and association with numerous complications, including metabolic disorders, mechanic pathologies, and cancer, among others. Noteworthy, excess adiposity is accompanied by chronic inflammation, oxidative stress, insulin resistance, and subsequent organ dysfunction. This dysfunctional adipose tissue is initially stored in the visceral depot, overflowing subsequently to produce lipotoxicity in ectopic depots like liver, heart,

Совпадение в полном тексте источника
… Common pathophysiology in obesity-related diseases Obesity-related diseases are predominantly determined by physical (i.e. hypoventilation, osteoarthritis) and metabolic features [ 1 ]. … The coexistence of excess weight, daytime hypercapnia (pCO2 > 6 kPa) together with disrupted sleep breathing pattern characterizes the obesity hypoventilation syndrome (OHS) [ 24 ]. …

Patient characteristics in sepsis-related deaths: prevalence of advanced frailty, comorbidity, and age in a Norwegian hospital trust.

ObjectiveTo examine the prevalence of advanced frailty, comorbidity, and age among sepsis-related deaths in an adult hospital population.MethodsRetrospective chart reviews of deceased adults within a Norwegian hospital trust, with a diagnosis of infection, over 2 years (2018-2019). The likelihood of sepsis-related death was evaluated by clinicians as sepsis-related, possibly sepsis-related, or not sepsis-related.ResultsOf 633 hospital deaths, 179 (28%) were sepsis-related, and 136 (21%) were possibly sepsis-related. Among these 315 patients whose deaths were sepsis-related or possibly sepsis-r

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… ileus, ultimately ineligible for addtional surgery 70–79 4 AAA, AF, HT, mitral insufficiency Operated AAA, 5th day post operative rapid onset multiple organ faliure, intubated, heart arrest, unsuccessful resuscitation, long CPR-time 70–79 4 CAD, COPD with chronic respiratory failure, diabetes, obesity-hypoventilation … ultimately ineligible for addtional surgery 70–79 | 4 | AAA, AF, HT, mitral insufficiency | Operated AAA, 5th day post operative rapid onset multiple organ faliure, intubated, heart arrest, unsuccessful resuscitation, long CPR-time 70–79 | 4 | CAD, COPD with chronic respiratory failure, diabetes, obesity-hypoventilation …

Treatments for the prevention of Sudden Unexpected Death in Epilepsy (SUDEP).

BACKGROUND: Sudden Unexpected Death in Epilepsy (SUDEP) is defined as sudden, unexpected, witnessed or unwitnessed, non-traumatic or non-dro … s; preventing airway obstruction through nocturnal supervision and safety pillows; reducing central hypoventilation through physical stimulation and enhancing serotonergic mechanisms of respiratory regulation using selective serotonin reuptake inhibitors (SSRIs); reducing adenosine and endogenous opioid-induced brain and brainstem depression. OBJECTIVES: To asse …

Acute and Chronic Respiratory Failure in Cancer Patients

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… The diaphragm may also be affected resulting in hypoventilation [ 126 ]. Fibrosis tends to occur on the margins of the radiation field. Fibrosis may cause distortion of the interstitium or traction of the airways. … While a 2011 study identified that opioid related death is less common in cancer patients than in those taking narcotics for other reasons [ 31 ], the high doses of opioid often required to control malignant pain may subject one to hypoventilation and subsequent respiratory failure. …

Chest and Mediastinum

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… However, not every perfusion defect is due to pulmonary embolism, as hypoventilation also leads to reduced perfusion. Therefore, perfusion and ventilation scintigraphy are often combined. … Hypoventilated areas show reduced or absent tracer uptake. For the diagnosis of pulmonary embolism, the findings of the ventilation and the perfusion scintigraphy are evaluated together in addition to the chest radiograph. …

Coexistence of Autoantibodies against the Golgi Complex and Ro52 Antigen in a Patient with Nonspecific Interstitial Pneumonia.

Nonspecific interstitial pneumonia (NSIP) is often associated with connective tissue diseases (CTD). The diagnosis of NSIP was confirmed in a 63-year-old man by high-resolution computed tomography and an open lung biopsy. Anti-Golgi complex autoantibodies (AGA) and anti-Ro52 antibodies were simultaneously detected at high concentrations. Autoantibodies to aminoacyl-tRNA synthetases (ARS) were negative. The patient was treated with corticosteroids for six months. During the seven-year follow-up, NSIP had a slow progression and patient had not developed the clinical features of CTD. The present

ISCCM Guidelines for the Use of Non-invasive Ventilation in Acute Respiratory Failure in Adult ICUs.

UNLABELLED: A. ACUTE HYPERCAPNIC RESPIRATORY FAILURE A1. Acute Exacerbation of COPD: Recommendations: NIV should be used in management of ac … ue to chest wall deformity/Neuromuscular diseases. (PaCO2 ≥ 45) (UPP) A3. NIV in ARF due to Obesity hypoventilation syndrome (OHS): Recommendations: NIV may be used in AHRF in OHS patients when they present with acute hypercapnic or acute on chronic respiratory failure (pH 45). (3B) NIV/CPAP may be used in obese, hypercapnic patients with OHS and/or right heart f …

Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone).

SUMMARY OF CONSENSUS: 1. The use of opioids in cancer pain: The criteria for selecting analgesics for pain treatment in the elderly include, … ing pulmonary condition or receiving concomitant central nervous system (CNS) drugs associated with hypoventilation. Not all opioids show equal effects on respiratory depression: buprenorphine is the only opioid demonstrating a ceiling for respiratory depression when used without other CNS depressants. The different features of opioids regarding respiratory effec …

Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home.

OBJECTIVE: The growing shift toward home care services assumes that "being home is good" and that this is the most desirable option. Althoug … n the study population fell into 4 diagnostic groups: (1) abnormal ventilatory control (eg, central hypoventilation syndrome), (2) neuromuscular disorders, (3) spina bifida, and (4) craniofacial or airway abnormalities resulting in upper airway obstruction. All 4 of these diagnostic groups were included in this study. Among the 12 children recruited, 4 received v …

SUBJECT INDEX Volume 125 (JANUARY–JUNE, 2004)

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После полиомиелита в Австралии: наблюдательное исследование и анализ тенденций за 10-летний период по месяцам, местоположению и сопоставимым состояниям

БАКGROUND: На данный момент нет точной оценки пост-полио-ситуаций в Австралии. Настоящее наблюдательное исследование направлено на предоставление обобщения госпитализаций за 10-летний период в Австралии с акцентом на ежегодные, ежемесячные и региональные тенденции, а также сравнение с четырьмя подобными нейрологическими состояниями. МЕТОДЫ: Ретроспективное исследование поздних эффектов полио и пост-полио-синдрома с 2011 по 2021 год. Основные данные были получены через процесс запроса данных в 2022 году через Австралийский институт здравоохранения и благополучия. Анализ проводился с использова

Совпадение в полном тексте источника
… increased risk of hospitalisation for pulmonary, heart, gastrointestinal disorders, or paralysis of different severities affecting one or more limb. 6 Literature also suggests that polio survivors have a higher rate of comorbid conditions such as depression, 7 , 8 falls, 7 dyslipidaemia, 9 sleep apnoea, hypoventilation …