scholarly journals Potential Sedative and Therapeutic Value of Dexmedetomidine in Critical COVID-19 patients

2021 ◽  
Author(s):  
Saeid Safari ◽  
Alireza Jahangirifard ◽  
Alireza Zali ◽  
Alireza Salimi ◽  
Ehsan Bastanhagh ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Multiple Organ ◽  
Analgesic Agent ◽  
Hypoxemic Respiratory Failure ◽  
Therapeutic Benefits ◽  
Therapeutic Value ◽  
Ventilation Support ◽  
Respiratory Treatment ◽  
Organ Dysfunctions ◽  
Selection Of

The coronavirus 2019 disease (COVID-19) is an ongoing outbreak of respiratory disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus can invade various tissues and organs, causing multiple organ dysfunctions. Critically ill COVID-19 patients may develop acute respiratory distress syndrome and pneumonia, which are the major causes of hypoxemic respiratory failure and death due to SARS-CoV-2 infection. Thus, ventilation support (invasive or noninvasive), has become a common practice in respiratory treatment of COVID-19 patients. Patients receiving mechanical ventilation usually require sedation to alleviate anxiety, pain and discomfort. On the other hand, current clinical reports have indicated that a significant number of COVID-19 patients require prolonged intensive care unit (ICU) care and ventilation, which increases the risk of delirium. Thus, selection of appropriate sedative medications during this period is of utmost importance. Dexmedetomidine (DEX) is a sedative, anxiolytic and analgesic agent that acts through the α2-adrenoceptor. Its sedative property is notable due to the lack of respiratory depression. In addition, its cytoprotective, immunoregulatory and anti-inflammatory properties have been well established in preclinical settings. Based on these features, a number of recent studies have proposed DEX as a beneficial sedative agent that simultaneously mitigates the excessive inflammation and protects vital body organs in patients with severe COVID-19. In current brief review, we aimed to discuss the therapeutic benefits of DEX in managing different indications of COVID-19.

scholarly journals Management strategy for hematological malignancy patients with acute respiratory failure

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Li Jiang ◽  
Qunfang Wan ◽  
Hongbing Ma
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Management Strategy ◽  
Distress Syndrome ◽  
Hematological Malignancy ◽  
Invasive Mechanical Ventilation ◽  
Selection Procedure ◽  
Multiple Organ ◽  
Ventilation Support ◽  
Optimal Setting

AbstractAcute respiratory failure (ARF) is still the major cause of intensive care unit (ICU) admission for hematological malignancy (HM) patients although the advance in hematology and supportive care has greatly improved the prognosis. Clinicians have to make decisions whether the HM patients with ARF should be sent to ICU and which ventilation support should be administered. Based on the reported investigations related to management of HM patients with ARF, we propose a selection procedure to manage this population and recommend hematological ICU as the optimal setting to recuse these patients, where hematologists and intensivists can collaborate closely and improve the outcomes. Moreover, noninvasive ventilation (NIV) still has its own place for selected HM patients with ARF who have mild hypoxemia and reversible causes. It is also crucial to monitor the efficacy of NIV closely and switch to invasive mechanical ventilation at appropriate timing when NIV shows no apparent improvement. Otherwise, early IMV should be initiated to HM with ARF who have moderate and severe hypoxemia, adult respiratory distress syndrome, multiple organ dysfunction, and unstable hemodynamic. More studies are needed to elucidate the predictors of ICU mortality and ventilatory mode for HM patients with ARF.

Therapeutic Value of Oral History

1981 ◽  
Vol 12 (1) ◽  
pp. 49-53 ◽  
Author(s):  
Willa Baum
Keyword(s):  
Oral History ◽  
The Elderly ◽  
Exchange Of Information ◽  
Therapeutic Benefits ◽  
Therapeutic Value

There can be a rich exchange of information and techniques between gerontologists and oral historians working with the elderly. Oral history provides a way of making concrete one's experiences and wisdom and of creating from them a heritage to hand down to one's family and communal heirs. There are great therapeutic benefits or enhancement-of-life benefits to the narrators doing an oral history. Benefits are directly in proportion to how rigorous a historical effort it is, and therefore, the less “therapeutic” the goal, the more therapeutic the result will be.

An Evidence-Based Protocol for Manual Prone Positioning of Patients With ARDS

2021 ◽  
Vol 41 (6) ◽  
pp. 55-60
Author(s):  
Patrick Ryan ◽  
Cynthia Fine ◽  
Christine DeForge
Keyword(s):  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Medical Center ◽  
Academic Medical Center ◽  
Prone Positioning ◽  
Hypoxemic Respiratory Failure ◽  
Unplanned Extubations

Background Manual prone positioning has been shown to reduce mortality among patients with moderate to severe acute respiratory distress syndrome, but it is associated with a high incidence of pressure injuries and unplanned extubations. This study investigated the feasibility of safely implementing a manual prone positioning protocol that uses a dedicated device. Review of Evidence A search of CINAHL and Medline identified multiple randomized controlled trials and meta-analyses that demonstrated both the reduction of mortality when prone positioning is used for more than 12 hours per day in patients with acute respiratory distress syndrome and the most common complications of this treatment. Implementation An existing safe patient-handling device was modified to enable staff to safely perform manual prone positioning with few complications for patients receiving mechanical ventilation. All staff received training on the protocol and use of the device before implementation. Evaluation This study included 36 consecutive patients who were admitted to the medical intensive care unit at a large academic medical center because of hypoxemic respiratory failure/acute respiratory distress syndrome and received mechanical ventilation and prone positioning. Data were collected on clinical presentation, interventions, and complications. Sustainability Using the robust protocol and the low-cost device, staff can safely perform a low-volume, high-risk maneuver. This method provides cost savings compared with other prone positioning methods. Conclusions Implementing a prone positioning protocol with a dedicated device is feasible, with fewer complications and lower costs than anticipated.

scholarly journals How to Control Covid-19 with a Nanobiotherapy?

2020 ◽  
Keyword(s):  
Intensive Care Unit ◽  
Immune Response ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Multiple Organ ◽  
World Health ◽  
Shortness Of Breath ◽  
The World ◽  
Health Organization ◽  
Muscle Ache

The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. In a recent study of Nanshan Chen et al., on patients of Wuhan Jinyintan Hospital, Wuhan, China, from the 99 patients with SARSCoV-2 infection, 51% had chronic diseases and they had symptoms of fever (83%), cough (82%) shortness of breath (31%), muscle ache (11%), fatigue (9%), headache (8%), sore throat (5%), rhinorrhea (4%), chest pain (2%), diarrhea (2%), and nausea and vomiting (1%) [1, 2]. The majority of patients can recover, however, about 25% of patients will progress into severe complications including acute respiratory distress syndrome (ARDS), which may worsen rapidly into respiratory failure, need an intensive care unit (ICU) and even cause multiple organ failure [3]. Depending on the pathophysiological mechanisms supposed to be involved in the development of the various clinical forms of the disease, various types of treatment have been tested with varying degrees of success. We have developed a nanotherapy to block the entry of the virus into the host cell, to reduce its potential for replication and to regulate the immune response against the microbial aggressor [4].

scholarly journals Pranic Healing as a Complimentary Therapy in averting Multiple Organ Failure: A Case Report

2019 ◽  
Author(s):  
ANURADHA NITTUR ◽  
Rajesh Srivastava
Keyword(s):  
Case Report ◽  
Multiple Organ Failure ◽  
Organ Failure ◽  
Distress Syndrome ◽  
Conventional Medicine ◽  
Multiple Organ ◽  
Ventilator Support ◽  
Energy Therapy ◽  
Multiple Diagnosis

The case report has been presented to demonstrate the response to Pranic Healing intervention by a patient with Acute Respiratory Distress Syndrome (ARDS), heading towards multiple organ failure, triggered by secondary haemophagocyticlymphohistiocytosis (HLH)The29 yr old patient had been on ventilator support, immunocompromised and in a critical state with multiple diagnosis and multiple hospitalizations for nearly eight months. He had stopped responding to conventional medicine and acupuncture. Complimentary Therapy in the form of Pranic Healing, a no touch, no drug energy therapy was provided to the patient for three months. Pranic Healing along with standardised medical care helped the patient recover rapidly and he was discharged within six weeks of starting Pranic Healing therapy. The case study provides a promising example of Pranic Healing intervention in averting multiple organ failure and promoting regeneration of vital organs.

scholarly journals Relationships between cardiovascular signs and neurological signs in asphyxiated neonates in Ilorin, North Central Nigeria

2021 ◽  
Vol 21 (2) ◽  
pp. 743-752
Author(s):  
Amudalat Issa ◽  
Mohammed Baba Abdulkadir ◽  
Omotayo Olukemi Adesiyun ◽  
Bilkis Owolabi ◽  
Habibat Suberu ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Multiple Organ ◽  
Cross Sectional ◽  
North Central ◽  
Neurological Outcomes ◽  
The Relationship ◽  
Volume Pulse ◽  
Organ Dysfunctions

Background: Perinatal asphyxia is a condition associated with multiple organ dysfunctions inclusive of cardiovascular dys- function. Neurologic predictors of survival have been studied, but little has been reported regarding cardiovascular signs and their role in determining outcome in asphyxia. Objective: The study aimed to determine the relationship between cardiovascular signs and outcomes in asphyxiated new- borns with hypoxic ischaemic encephalopathy. Methods: This was a cross sectional study involving asphyxiated new-born babies recruited within the first 24 hours of life. Hypoxic ischaemic encephalopathy staging was done using Sarnat and Sarnat staging. All patients had a detailed cardi- ovascular examination on admission, after initial resuscitation (30 – 60 minutes) into admission, and were followed till final outcome: discharge or death. Results: Eighty-five asphyxiated new-borns with HIE were studied over seven months. Abnormal cardiovascular-related signs identified in the patients included respiratory distress (64.7%), small volume pulse (57.6%), hypotension (52.9%), hy- poxemia (48.2%) and shock (32.9%). Five babies died. None of the clinical signs had a significant relationship with mortality. Conclusion: Abnormal cardiovascular signs increased with the progression of HIE staging but had no relationship with mortality. Keywords: Cardiovascular signs; Neurological outcomes; Mortality; Perinatal asphyxia.

Otorhinolaryngological manifestations of COVID-19

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Jarosław Wysocki
Keyword(s):  
Respiratory Tract ◽  
Distress Syndrome ◽  
Clinical Symptoms ◽  
Wide Spectrum ◽  
Multiple Organ ◽  
Upper Respiratory Tract ◽  
Equilibrium System ◽  
Similar Frequency ◽  
Upper Respiratory ◽  
Loss Of Strength

COVID-19 manifests itself in a wide spectrum of clinical symptoms, both in terms of their variety and severity. It can be asymptomatic or abortive, mild, moderate, severe and lightning, as septic with multiple organ failure and shock Typical leading symptoms of COVID-19 are: high fever poorly responding to drugs, severe loss of strength, chest pain, dyspnoea, pain headaches, bone and joint pain and muscle pain, until the onset of acute respiratory distress syndrome (ARDS). However, many publications mention among the possible symptoms also others, not related to the involvement of the lower respiratory tract. These are gastrointestinal disorders, damage to the central and peripheral nervous system, catarrh of the upper respiratory tract and dysfunctions of the sensory organs. The aim of this literature review was to determine the frequency of various head and neck dysfunctions that are part of COVID-19. Symptoms of conjunctivitis, nasal mucosa, pharynx and larynx are reported by about of patients, but they do not always occur at the same time, as in infections caused, for example, by rhinoviruses. Anosmi / hyposmia or ageusia / hypogeusia occur with a similar frequency. Symptoms of damage to the equilibrium system, such as dizziness, are reported by approx. 1/3, vertigo and hearing loss approx. 5-6%, tinnitus approx. 10% of patients. Reports of coexistence with COVID-19 of peripheral paresis of the facial nerve are so far relatively few and often included in the neurological disorders, the frequency of which is also about 1/3 of COVID-19 cases. Importantly, both catarrhal symptoms and the others listed here may precede, co-occur or follow the appearance of the leading symptoms of COVID-19. They can also be the only symptoms of this disease. This should prompt otorhinolaryngologists to be particularly vigilant in this regard

Acute Respiratory Distress Syndrome: Etiology, Pathogenesis, and Summary on Management

2019 ◽  
Vol 35 (8) ◽  
pp. 723-737 ◽  
Author(s):  
Shawn Kaku ◽  
Christopher D. Nguyen ◽  
Natalie N. Htet ◽  
Dominic Tutera ◽  
Juliana Barr ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Management Strategies ◽  
Treatment Strategies ◽  
Acute Lung Inflammation ◽  
Hypoxemic Respiratory Failure ◽  
Pulmonary Vascular Permeability ◽  
Current State

The acute respiratory distress syndrome (ARDS) has multiple causes and is characterized by acute lung inflammation and increased pulmonary vascular permeability, leading to hypoxemic respiratory failure and bilateral pulmonary radiographic opacities. The acute respiratory distress syndrome is associated with substantial morbidity and mortality, and effective treatment strategies are limited. This review presents the current state of the literature regarding the etiology, pathogenesis, and management strategies for ARDS.

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