China
Africa
Explore chapters and articles related to this topic
Health Effects
Published in Wayne T. Davis, Joshua S. Fu, Thad Godish, Air Quality, 2021
Wayne T. Davis, Joshua S. Fu, Thad Godish
Pollutants such as carbon monoxide (CO) and lead (Pb) are absorbed into the bloodstream and may have both direct and indirect effects on the cardiovascular system. These effects will be discussed in subsequent sections. Cardiovascular disease may also result from the indirect effects of other air pollution-incited disease. For example, some individuals die of cor pulmonale, heart failure resulting from the stress of severe chronic respiratory disease. Recent epidemiological studies have shown that premature cardiovascular system-related mortality is strongly associated with exposures to small (≤2.5 μm) particles.
Mortality in mechanically ventilated patients with COVID-19: a systematic review
Published in Expert Review of Medical Devices, 2021
Maria Tsikala Vafea, Raina Zhang, Markos Kalligeros, Evangelia K. Mylona, Fadi Shehadeh, Eleftherios Mylonakis
Apart from anticoagulation, thrombolysis has been reported as a potential beneficial treatment in mechanically ventilated COVID-19 patients with shock and acute cor pulmonale. Poor et al. reported rapid improvement in 4 patients with IMV with severe respiratory failure and shock and markedly elevated dead-space ventilation, who were treated with tissue plasminogen activator [174]. However, clinical guidance cannot rely on case reports and thus further studies are imperative in order to determine the efficacy of thrombolysis in severe COVID-19.
Device profile of the Zephyr endobronchial valve in heterogenous emphysema: overview of its safety and efficacy
Published in Expert Review of Medical Devices, 2021
Steven R. Verga, Gerard J. Criner
Patient inclusion criteria for Zephyr® endobronchial valve placement [15]. Heterogenous Emphysema with FEV1 between 15 and 45% predicted (there have been several smaller studies where the focus was on patients with a FEV1 ≤ 20% predicted, demonstrating clinical improvement without an increased risk of morbidity/mortality) [18].Significant hyperinflation with post-bronchodilator targeted lung capacity (TLC) >100% of predicted and residual volume (RV) of ≥175% predicted (or ≥200% predicted in homogenous emphysema).Between the age of 40–75 years old as per the LIBERATE Trial enrollmentDLCO ≥ 20% predicted (small 20 patient single center study showed patients with DLCO ≤ 20% predicted have statistically significant outcomes without increase risk of respiratory failure) [19].6-min walk distance (6MWD) between 100–450 m after completing supervised pulmonary rehabilitation program.Eligible patients require smoking cessation for at least 4 months and inclusion criteria [20].Patients needed to be optimized medically with controlled COPD with two or fewer exacerbations requiring hospitalizations and fewer than two episodes of pneumonia in past year with clinically insignificant sputum (less than 4 tablespoons daily).In the EMPROVE Trial inclusion criteria for air trapping for Spiration Valve System® is slightly more lenient with RV of ≥150% predicted [21].Exclusion criteria are:Arterial blood gas (ABG) the pCO2 > 50 mm Hg and pO2 < 45 mm Hg.Significant comorbidities: Pulmonary HTN (systolic pulmonary artery pressure ≥ 45 mm Hg) or Cor Pulmonale where they were referred for lung transplant evaluation.Patients were excluded if had recent myocardial infarction or congestive heart failure within 6 months of evaluation [15].