China
Africa
Explore chapters and articles related to this topic
Selected topics
Published in Henry J. Woodford, Essential Geriatrics, 2022
Electromyogram (EMG) testing is likely to show muscle denervation with preserved velocities when there is LMN involvement. Brain or spine imaging is likely to appear normal. Genetic testing can be considered for people with a family history. There is no curative treatment. Riluzole, a glutamate antagonist, improves survival at 12 months, but has no benefit on muscle strength. The median survival increase is around three to six months.65 Speech and language therapy can help with dysarthria and dysphagia. Tube feeding may be appropriate for selected people with dysphagia. Non-invasive ventilation can prolong survival in appropriate patients. Analgesia may be necessary for joint pains. Spasticity may be present. Advance care planning and palliative care are important aspects of management.
Thoracic Trauma
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
Pain reduces the patient’s tidal volume, leading to inadequate ventilation of the basal segments, resulting in atelectasis. Pain also inhibits coughing, allowing secretions to obstruct bronchi and cause acute respiratory failure. Effective pain relief is therefore essential and may include the application of intercostal nerve or paravertebral blockade (see later), although these techniques are most appropriately performed in a hospital setting. Even a small flail may be a devastating injury in the frail elderly patient. Splinting is not an effective management as this will reduce respiratory movement and exacerbate the ventilatory compromise. Operative fixation of rib fractures is occasionally indicated, but its place in management has not been definitively established. In severe cases the patient will require intubation and mechanical ventilation. The use of non-invasive ventilation may also be considered.
Respiratory
Published in Faye Hill, Sash Noor, Neel Sharma, Tiago Villanueva, Medical and Surgical Emergencies for Students and Junior Doctors, 2021
Faye Hill, Sash Noor, Neel Sharma
Non-invasive ventilation should be considered for patients who are slow to wean from invasive ventilation and for those with hypercapnic ventilatory failure. Doxapram is an alternative to non-invasive ventilation.
Association of gabapentinoid utilization with postoperative pulmonary complications in gynecologic surgery: a retrospective cohort study
Published in Current Medical Research and Opinion, 2021
Hon Sen Tan, Zach Frere, Vijay Krishnamoorthy, Tetsu Ohnuma, Karthik Raghunathan, Ashraf S. Habib
However, our study has limitations inherent to retrospective trials and the use of billing data. Unmeasured confounding may have influenced our results, as detailed information on factors increasing the risk of pulmonary complications such as history of smoking and pulmonary comorbidities were not available. However, the inclusion of the validated Elixhauser Comorbidity Index in our regression models may mitigate the influence of unmeasured confounding. Furthermore, the increase in postoperative pulmonary complications associated with gabapentinoid use could be affected by the presence of comorbidities such as chronic pain disorders, chronic opioid or gabapentinoid use, or chronic kidney disease, which may not be precisely identified in our database. Finally, we are unable to differentiate between non-invasive ventilation used for acute respiratory failure, and its use for obstructive sleep apnea or chronic obstructive pulmonary disease.
High flow nasal cannula versus non- invasive ventilation in prevention of intubation in immunocompromised patient with acute hypoxemic respiratory failure
Published in Egyptian Journal of Anaesthesia, 2021
Ashraf Elsayed Elagamy, Sameh Salem Taha, Dalia Mohamed Elfawy
Over the last decades, the number of immunocompromised patients have increased due to advances in chemotherapy, bone marrow transplantation and other organ transplantation [1]. Indeed these types of patient have risk of serious complications especially acute hypoxemic respiratory failure [2]. Acute respiratory distress syndrome (ARDS) mortality is high, it ranges from 35% to 46% according to the severity of ARDS and remains high despite recent modalities of treatment [3]. Non-invasive ventilation (NIV) becomes a reliable method in treatment of acute respiratory failure but its role in ARDS is not certain [4]. Acute respiratory failure (ARF) type 1 is considered one of the major indications for ICU admission in immunocompromised patients. Early non-invasive ventilation is considered as a practical, simple and inexpensive technique to prevent deterioration of respiratory functions and complications in this type of patients [5]. A large center study showed that there is no difference between NIV and standard oxygen therapy in ARF [6].
Single clip: An improvement of the filament-perforation mouse subarachnoid haemorrhage model
Published in Brain Injury, 2019
Jianhua Peng, Yue Wu, Jinwei Pang, Xiaochuan Sun, Ligang Chen, Yue Chen, Jiping Tang, John H. Zhang, Yong Jiang
Intraoperative guardianship was performed as previously described with slight modifications (7). The animals were anesthetized with pentobarbital sodium (50 mg/kg) by intraperitoneal injection. Non-invasive ventilation was performed as previously described (8). Afterwards, a 1.5 cm midline incision was made on the scalp (mouse in the prone position), and a small parietal craniotomy was made (3 mm occipital form the right coronary seam and 3 mm lateral from the midline). An intracranial pressure (ICP)-probe (Codman, Raynham, Massachusetts, USA) was introduced between the bone and brain into the epidural space, and enclosed with bone wax. Then, a cerebral blood flow (CBF)-probe (Moor Instruments, Axminster, Devon, UK) was vertically glued on the temporal bone with cyanoacrylate (2 mm occipital form the left coronary seam and 6 mm lateral from the midline). The mean blood pressure (MBP) was measured by a PE-10 pipe within the right femoral artery via an animal functional experiment system (Taimeng Technologies, Chengdu, China). The ICP, CBF and MBP were recorded continuously from 5 min before SAH to 10 min after SAH. Ten min prior and 10 min after SAH, The femoral arterial blood gas was measured 10 min before SAH and 10 min after SAH by a Radiometer Medical ApS (Radiometer, Copenhagen, Denmark). Body temperature was maintained at 37 ± 0.5°C throughout the procedure using a heating pad.