scholarly journals Usefulness of chest ultrasonography in the management of acute respiratory failure in the emergency room

Critical Care ◽  
2011 ◽  
Vol 15 (S1) ◽  
Author(s):  
S Silva ◽  
M Dao ◽  
C Biendel ◽  
B Riu ◽  
J Ruiz ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Emergency Room ◽  
Chest Ultrasonography

scholarly journals Use of remdesivir in the presence of elevated LFTs for the treatment of severe COVID-19 infection

2020 ◽  
Vol 13 (10) ◽  
pp. e239210
Author(s):  
Andrew J Sabers ◽  
Amber L Williams ◽  
T Michael Farley
Keyword(s):  
Respiratory Failure ◽  
Liver Function ◽  
Acute Respiratory Failure ◽  
Emergency Room ◽  
Hospital Stay ◽  
Emergency Response ◽  
Liver Function Tests ◽  
Upper Limit ◽  
High Liver ◽  
Comprehensive Metabolic Panel

An 82-year-old man with an extensive medical history presented to the emergency room with complaints of generalised weakness and cough. He tested positive for COVID-19 10 days prior to presenting to the emergency room. Although his symptoms started a week prior to diagnosis, his weakness increased, warranting emergency response. A comprehensive metabolic panel was drawn from the patient on admission, indicating markedly high liver function tests (LFTs) ≥20 times above the upper limit of normal. On day 1 of admission, the decision was still made to start remdesivir (5-day course) due to decompensated acute respiratory failure as well as dexamethasone. The patient’s LFTs significantly improved throughout his hospital stay. The patient made a full recovery and was discharged on day 10 of hospitalisation.

scholarly journals Out-of-hospital helmet CPAP in acute respiratory failure reduces mortality: a study led by nurses

2016 ◽  
Vol 73 (4) ◽  
Author(s):  
G. Garuti ◽  
G. Bandiera ◽  
M.S. Cattaruzza ◽  
L. Gelati ◽  
J.F. Osborn ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Length Of Stay ◽  
Acute Respiratory Failure ◽  
Emergency Room ◽  
Medical Therapy ◽  
Historical Control Group ◽  
Historical Control ◽  
Control Group ◽  
Standard Medical Therapy ◽  
Clinical Conditions

Background and Aim. Acute respiratory failure (ARF) is a condition that must be treated as quickly as possible. Continuous Positive Airway Pressure (CPAP) is a common method used to treat ARF in hospital. The main objective of our study was to investigate the effect of CPAP prior to admission to the emergency room, on the reduction of endotracheal intubation, in-hospital mortality and on the length of stay in hospital (HLOS). Methods. A prospective, observational (non-randomised) study with a historical control group. Data from 3 groups of patients with ARF, irrespective of cause, was collected: pre-hospital CPAP (PHCPAP) group, i.e. 35 patients treated with a helmet CPAP in the ambulance, by trained nurses (mean age, years 80.1±7.9 SD; 14 males); hospital CPAP (HCPAP) group, i.e. 46 patients treated with helmet CPAP in the hospital emergency room (mean age 78.6±6.9 SD; 27 males), and a historical control group of 125 patients treated with medical therapy only (mean age 76.7±5.5 SD; 52 males). CPAP was delivered via a helmet interface. Results. Compared with standard medical therapy, helmet CPAP (pre and in-hospital) reduced mortality by 77 % (p=0.005), while pre-hospital helmet CPAP reduced it by 94% (p=0.011), after adjustment for age, sex, severity of clinical conditions at entry and diagnosis upon admission. HLOS was reduced, compared with standard medical therapy, by 63.5% and by 66% (adjusting for age, sex, severity of clinical conditions at entry and diagnosis at admission) with helmet CPAP (pre and in-hospital) and with helmet CPAP in the ambulance, respectively (p<0.0001). Conclusions. Treating patients with ARF of any cause, with CPAP by trained nurses, before hospital admission, is safe, reduces mortality and the length of stay needed in hospital.

scholarly journals Chest Ultrasonography in Diagnosing Etiology of Acute Respiratory Failure

2020 ◽  
Vol 19 (1) ◽  
pp. 20-25
Author(s):  
Chiranjibi Pant ◽  
Anusmriti Pal ◽  
Manoj Yadav ◽  
Bishow Kumar Shrestha ◽  
Suraj Rana
Keyword(s):  
Critical Care ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Diagnostic Accuracy ◽  
Lung Ultrasound ◽  
Tertiary Care ◽  
Cost Effective ◽  
Final Diagnosis ◽  
Chronic Obstructive ◽  
Chest Ultrasonography

Introduction: Lung ultrasonography (LUS) is a useful diagnostic tool in critical care setting. Lung ultrasound at bed side is relatively easy to perform, cost effective and reproducible. Analysis of various sign and profile, alone or in combination is as accurate as gold standard test like Computed Tomography scan of the chest in detection of etiology of acute respiratory failure. The aim of our study was to perform bed side lung ultrasound in patent with ARF and to find out the diagnostic accuracy of lung ultrasound when compared with diagnosis made by the clinician. Methods: This descriptive observational study was conducted at tertiary care teaching centre in Nepal between February 2019 and July 2019. Consecutive samples of acute respiratory failure patient were included. Lung ultrasound was performed at bed side by fellows of pulmonary critical care medicine. Specific 10 signs of blue protocol were assessed in six different sites of both the chest. Findings of LUS was recorded and analysed to formulate a diagnosis, and finally compared with the final diagnosis. Results: Forty eight patients of acute respiratory failure with median age of 66 years (17 to 89 years) were included with 66.7% being females. 97.9 % of the patient presented with acute shortness of breath of less than one week duration. A total of 13 different diagnosis was made at the end of the treatment for all the patient. LUS accurately diagnosed them in 43 cases, with an overall accuracy of 89.6 %. Chronic obstructive pulmonary disease, pulmonary edema, pneumonia, pleural effusion, pneumothorax were accurately diagnosed with LUS however in acute respiratory distress syndrome and interstitial lung disease, lung ultrasound had poor diagnostic accuracy. Conclusions: Lung ultrasound is useful tool in diagnosing etiology of acute respiratory failure. Diagnosis made by lung ultrasound was 89.6% correct when compared with final diagnosis made by clinician.

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