scholarly journals Therapeutic benefits of proning to improve pulmonary gas exchange in severe respiratory failure: Focus on fundamentals of physiology

2021 ◽  
Author(s):  
Ronan M. G. Berg ◽  
Jacob Peter Hartmann ◽  
Ulrik Winning Iepsen ◽  
Regitse Højgaard Christensen ◽  
Andreas Ronit ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Gas Exchange ◽  
Pulmonary Gas Exchange ◽  
Severe Respiratory Failure ◽  
Therapeutic Benefits

scholarly journals The Fat Embolism Syndrome Treated with Oxygen, Diuretics, Sodium Restriction and Spontaneous Ventilation

1979 ◽  
Vol 7 (2) ◽  
pp. 136-142 ◽  
Author(s):  
L. I. G. Worthley ◽  
M. McD. Fisher
Keyword(s):  
Respiratory Failure ◽  
Gas Exchange ◽  
Fat Embolism ◽  
Pulmonary Gas Exchange ◽  
Spontaneous Ventilation ◽  
Severe Respiratory Failure ◽  
Sodium Restriction ◽  
Fat Embolism Syndrome ◽  
Failure Treatment ◽  
Embolism Syndrome

The fat embolism syndrome is a self limiting disease with its mortality related to the degree of respiratory failure. Treatment therefore is directed at maintaining satisfactory pulmonary gas exchange throughout the course of the disease. In 28 consecutive patients diagnosed with fat embolism syndrome and severe respiratory failure, therapy consisted of oxygen, diuretics, sodium restriction and a trial of spontaneous ventilation. There was no mortality.

scholarly journals COVID-19 Critical Illness Pathophysiology Driven by Diffuse Pulmonary Thrombi and Pulmonary Endothelial Dysfunction Responsive to Thrombolysis

2020 ◽  
Author(s):  
Hooman D. Poor ◽  
Corey E. Ventetuolo ◽  
Thomas Tolbert ◽  
Glen Chun ◽  
Gregory Serrao ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Respiratory Failure ◽  
Critical Illness ◽  
Endothelial Dysfunction ◽  
Gas Exchange ◽  
Vascular Disease ◽  
Lung Mechanics ◽  
Pulmonary Vascular Disease ◽  
Severe Respiratory Failure ◽  
Icu Management

AbstractCritically ill COVID-19 patients have relatively well-preserved lung mechanics despite severe gas exchange abnormalities, a feature not consistent with classical ARDS but more consistent with pulmonary vascular disease. Patients with severe COVID-19 also demonstrate markedly abnormal coagulation, with elevated D-dimers and higher rates of venous thromboembolism. We present four cases of patients with severe COVID-19 pneumonia with severe respiratory failure and shock who demonstrated immediate improvements in gas exchange and/or hemodynamics with systemic tPA.Subject category4.6 ICU Management and Outcome

Predictors of Failure of High-Frequency Oscillatory Ventilation in Term Infants With Severe Respiratory Failure

PEDIATRICS ◽  
1995 ◽  
Vol 95 (3) ◽  
pp. 400-404
Author(s):  
Michael S. Paranka ◽  
Reese H. Clark ◽  
Bradley A. Yoder ◽  
Donald M. Null
Keyword(s):  
Respiratory Failure ◽  
Gas Exchange ◽  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
High Frequency ◽  
High Frequency Oscillatory Ventilation ◽  
Severe Respiratory Failure ◽  
Sustained Improvement ◽  
Oscillatory Ventilation ◽  
High Frequency Oscillatory

Objective. To identify clinical factors in term neonates with severe respiratory failure that predict which neonates are unlikely to respond to high-frequency oscillatory ventilation (HFOV). Design. This was a retrospective review of patient charts and medical records. Patients. We studied 190 newborns treated with HFOV between July 1985 and December 1992. All patients were at least 35 weeks' estimated gestational age and had severe respiratory failure, defined as arterial to alveolar oxygen ratio (a/A ratio) of less than 0.2 or the need for peak inspiratory pressure greater than 35 cm H2O on conventional ventilation. Results. Of the 190 patients, 111 (58%) responded to HFOV (HFOV responders), and 79 (42%) were placed on extracorporeal membrane oxygenation (ECMO) after HFOV failed to improve gas exchange (nonresponders). The two groups were similar in gender and birth weight. Factors associated with failure of HFOV to produce a sustained improvement in gas exchange were a diagnosis of congenital diaphragmatic hernia and more severe respiratory compromise as assessed by admission blood gas. Stepwise logistic regression analysis showed that a diagnosis of congenital diaphragmatic hernia/lung hypoplasia (CDH/LH) and the a/A ratio at initiation of and after 6 hours of HFOV were the only significant independent predictors of the need for ECMO. Among all the patients, the presence of CDH/LH or an initial a/A ratio of 0.05 or lower yielded a sensitivity of 74% and specificity of 77% in correctly identifying neonates in whom HFOV failed to produce a sustained improvement in oxygenation. When neonates with CDH/LH were excluded from analysis, the most significant predictor of failure of HFOV was the a/A ratio after 6 hours of HFOV. In neonates without CHD/LH, a 6-hour a/A ratio of 0.08 or lower discriminated responders from nonresponders (ie, treatment with ECMO) with a sensitivity of 77% and specificity of 92%. Conclusions. In our patients, the presence of CDH/LH, severe respiratory failure (a/A ratio 0.05 or lower) at initiation of HFOV, and lack of improvement in oxygenation (a/A ratio 0.08 or lower after 6 hours of HFOV) were associated with failure of HFOV and treatment with ECMO. This information should help other centers to identify neonates who are at the greatest risk for requiring ECMO support and thus allow prompt transfer to an ECMO center.

Chronic respiratory failure

2010 ◽  
pp. 3467-3475
Author(s):  
P.M.A. Calverley
Keyword(s):  
Respiratory Failure ◽  
Gas Exchange ◽  
Pulmonary Gas Exchange ◽  
Chronic Respiratory Failure ◽  
Clinical State

Chronic respiratory failure describes a clinical state when the arterial P o 2 breathing air is less than 8.0 kPa, which may or may not be associated with hypercapnia (defined as P co 2 more than 6.0 kPa (45 mmHg)). Four processes cause arterial hypoxaemia due to inefficient pulmonary gas exchange—ventilation–perfusion (...

scholarly journals Pulmonary gas exchange during venoarterial bypass with a membrane lung for acute respiratory failure

1978 ◽  
Vol 75 (6) ◽  
pp. 839-846 ◽  
Author(s):  
F. Lemaire ◽  
F. Jardin ◽  
B. Regnier ◽  
D. Loisance ◽  
B. Goudot ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Gas Exchange ◽  
Acute Respiratory Failure ◽  
Pulmonary Gas Exchange ◽  
Membrane Lung

Favorable Anakinra Responses in COVID-19 Patients with Severe Respiratory Failure

2020 ◽  
Author(s):  
George Dimopoulos ◽  
Quirijn de Mast ◽  
Nikolaos Markou ◽  
Maria Theodorakopoulou ◽  
Apostolos Komnos ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Severe Respiratory Failure
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