scholarly journals Clinical Value of Bronchoscopy in Acute Respiratory Failure

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1755
Author(s):  
Raffaele Scala ◽  
Luca Guidelli
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Percutaneous Dilatational Tracheostomy ◽  
Severe Pneumonia ◽  
Rigid Bronchoscopy ◽  
Pulmonary Complications ◽  
Added Value ◽  
Clinical Value ◽  
Therapeutic Goals ◽  
Clinical Scenarios

Bronchoscopy may be considered the “added value” in the diagnostic and therapeutic pathway of different clinical scenarios occurring in acute respiratory critically ill patients. Rigid bronchoscopy is mainly employed in emergent clinical situations due to central airways obstruction, haemoptysis, and inhaled foreign body. Flexible bronchoscopy (FBO) has larger fields of acute applications. In intensive care settings, FBO is useful to facilitate intubation in difficult airways, guide percutaneous dilatational tracheostomy, and mucous plugs causing lobar/lung atelectasis. FBO plays a central diagnostic role in acute respiratory failure caused by intra-thoracic tumors, interstitial lung diseases, and suspected severe pneumonia. “Bronchoscopic” sampling has to be considered when “non-invasive” techniques are not diagnostic in suspected ventilator-associated pneumonia and in non-ventilated immunosuppressed patients. The combined use of either noninvasive ventilation (NIV) or High-flow nasal cannula (HFNC) with bronchoscopy is useful in different scenarios; the largest body of proven successful evidence has been found for NIV-supported diagnostic FBO in non-ventilated high risk patients to prevent and avoid intubation. The expected diagnostic/therapeutic goals of acute bronchoscopy should be balanced against the potential severe risks (i.e., cardio-pulmonary complications, bleeding, and pneumothorax). Expertise of the team is fundamental to achieve the best rate of success with the lowest rate of complications of diagnostic and therapeutic bronchoscopic procedures in acute clinical circumstances.

scholarly journals Severe pneumonia with anemic syndrome.

2018 ◽  
Vol 96 (3) ◽  
pp. 267-272
Author(s):  
Dmitry A. Arkhangelsky ◽  
V. P. Butikov ◽  
Yu. N. Zakrevsky ◽  
Yu. E. Barachevsky ◽  
A. G. Shevchenko ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Clinical Case ◽  
Severe Pneumonia ◽  
Medical Evacuation ◽  
Respiratory Index

The question of determining the criteria for medical evacuation of patients with severe pneumonia from remote regions is still poorly understood. Presented a clinical case of successful evacuation of a patient with severe pneumonia with the presence of anemia. The aim of the study was to evaluate anemia as a prediction of the possible development of acute respiratory failure in patients with pneumonia. Statistically significant associations of increased respiratory index (РаО2/FiO2) with hemoglobin levels (r=0,689 p=0.001) and the number of blood erythrocytes (r=0,683 p=0,001).

Acute Respiratory Failure and Pulmonary Complications in End-Stage Liver Disease

2018 ◽  
Vol 39 (05) ◽  
pp. 546-555 ◽  
Author(s):  
Tisha Wang ◽  
Igor Barjaktarevic ◽  
Steven Chang ◽  
Nida Qadir
Keyword(s):  
Liver Disease ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
High Risk Patient ◽  
Volume Overload ◽  
Hepatopulmonary Syndrome ◽  
Pulmonary Complications ◽  
Current Evidence ◽  
End Stage Liver Disease ◽  
End Stage

AbstractAcute respiratory failure has a high mortality in patients with end-stage liver disease (ESLD). These patients may develop acute respiratory failure for reasons specific to advanced liver disease, including hepatopulmonary syndrome, portopulmonary hypertension, and hepatic hydrothorax. They may also develop respiratory complications due to conditions seen in the general intensive care unit population to which ESLD patients are at higher risk, including infection, volume overload, and the acute respiratory distress syndrome. Management of these patients is complicated and multifaceted, and a comprehensive understanding of the etiologies and treatment of acute respiratory failure is critical in this high-risk patient population. This article reviews current evidence surrounding the prevalence, management, and complications of the various etiologies of acute respiratory failure in ESLD patients.

scholarly journals ERS Clinical Practice Guidelines: high-flow nasal cannula in acute respiratory failure

2021 ◽  
pp. 2101574
Author(s):  
Simon Oczkowski ◽  
Begüm Ergan ◽  
Lieuwe Bos ◽  
Michelle Chatwin ◽  
Miguel Ferrer ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
High Risk ◽  
Acute Respiratory Failure ◽  
Task Force ◽  
Extubation Failure ◽  
Pulmonary Complications ◽  
High Flow ◽  
Respiratory Support ◽  
High Flow Nasal Cannula ◽  
Non Invasive

BackgroundHigh-flow nasal cannula (HFNC) has become a frequently used non-invasive form of respiratory support in acute settings, however evidence supporting its use has only recently emerged. These guidelines provide evidence-based recommendations for the use of HFNC alongside other noninvasive forms of respiratory support in adults with acute respiratory failure (ARF).Materials and methodologyThe European Respiratory Society Task Force panel included expert clinicians and methodologists in pulmonology and intensive care medicine. The Task Force used the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methods to summarise evidence and develop clinical recommendations for the use of HFNC alongside conventional oxygen therapy (COT) and non-invasive ventilation (NIV) for the management of adults in acute settings with ARF.ResultsThe Task Force developed 8 conditional recommendations, suggesting using: 1) HFNC over COT in hypoxemic ARF, 2) HFNC over NIV in hypoxemic ARF, 3)HFNC over COT during breaks from NIV, 4) either HFNC or COT in post-operative patients at low risk of pulmonary complications, 5) either HFNC or NIV in post-operative patients at high risk of pulmonary complications, 6) HFNC over COT in non-surgical patients at low risk of extubation failure, 7) NIV over HFNC for patients at high risk of extubation failure unless there are relative or absolute contraindications to NIV, 8) trialling NIV prior to use of HFNC in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic ARF.ConclusionsHFNC is a valuable intervention in adults with ARF. These conditional recommendations can assist clinicians in choosing the most appropriate form of non-invasive respiratory support to provide to patients in different acute settings.

Pulmonary Complications in Measles 2016-2018

2019 ◽  
Vol 70 (10) ◽  
pp. 3722-3726
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Viral Disease ◽  
Pulmonary Complications ◽  
Point Of View ◽  
Personal History ◽  
Age Group ◽  
Respiratory Complications ◽  
Measles Vaccination ◽  
Group Sex

Measles is a viral disease that we have chosen to talk about because of the progressively increasing number of cases, the respiratory complications that progress toward respiratory failure in children and because of the costs that could be lowerd if vaccinations were carried out according to the proposed Schedule by the Ministry of Health. Our research was conducted during 05.2016-31.12.2018 analyzed according to several criteria (age group, sex, personal history, complications, evolution, treatment, etc.). There are 3 particular clinical cases. From the pathophysiological point of view, we consider the focus on respiratory complications to be useful, most complications being alveolar pneumonia in children under 2 years of age, reaching to acute respiratory failure. Can we prevent this? Keywords: Measles, vaccination, respiratory complications, children

scholarly journals Pulmonary Complications in Measles 2016-2018

2019 ◽  
Vol 70 (10) ◽  
pp. 3722-3726
Author(s):  
Narcisa Daniela Nicolescu ◽  
Virgil Filaret Musta ◽  
Ruxandra Laza ◽  
Adelina Raluca Marinescu ◽  
Andreea Mihaela Birlad ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Viral Disease ◽  
Pulmonary Complications ◽  
Point Of View ◽  
Personal History ◽  
Age Group ◽  
Respiratory Complications ◽  
Ministry Of Health ◽  
Group Sex

Measles is a viral disease that we have chosen to talk about because of the progressively increasing number of cases, the respiratory complications that progress toward respiratory failure in children and because of the costs that could be lowerd if vaccinations were carried out according to the proposed Schedule by the Ministry of Health. Our research was conducted during 05.2016-31.12.2018 analyzed according to several criteria (age group, sex, personal history, complications, evolution, treatment, etc.). There are 3 particular clinical cases. From the pathophysiological point of view, we consider the focus on respiratory complications to be useful, most complications being alveolar pneumonia in children under 2 years of age, reaching to acute respiratory failure. Can we prevent this?

scholarly journals HELLP! The Novel Use of Continuous Renal Replacement Therapy and Nitric Oxide in the Treatment of Acute Respiratory Failure in HELLP Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Obteene Azimi-Ghomi ◽  
Glenn Miller ◽  
Carlos Guida ◽  
Adrian Marimon ◽  
Dessislava Boneva ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Hellp Syndrome ◽  
Liver Enzymes ◽  
Pulmonary Complications ◽  
The Novel ◽  
Novel Treatment ◽  
Elevated Liver Enzymes ◽  
Nitric Oxide Therapy

HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome is a rare but serious complication of pregnancy characterized by hemolytic anemia, elevated liver enzymes, and thrombocytopenia. It occurs in <1% of all pregnancies with 70% of cases developing before delivery, the majority occurring between the 27th and 37th weeks of gestation. Respiratory failure seen in HELLP syndrome clinically and radiographically appears similar to acute respiratory distress syndrome (ARDS), with presence of bilateral pulmonary opacities on imaging as well as persistent hypoxemia requiring elevated ventilator requirements. It is seen to complicate 3-10% of cases of HELLP syndrome. Pulmonary complications are theorized to occur as sequelae of the proinflammatory state induced by HELLP syndrome with endothelial dysfunction and subsequent microangiopathic hemolysis and thrombocytopenia. A robust cytokine inflammatory response similar to ARDS is seen, resulting in noncardiogenic pulmonary edema due to vasoplegia and capillary leak syndrome. We present a case of a 27-year-old uniparous female with a term pregnancy complicated by HELLP syndrome who developed respiratory failure requiring mechanical ventilation. Early CRRT and nitric oxide therapy were initiated, with the patient experiencing clinical and radiological improvement of respiratory function within 48 hours. We document the novel treatment of our patient’s acute respiratory failure with CRRT and nitric oxide and delve into the literature regarding its use in acute respiratory failure and ARDS in association with HELLP syndrome.

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