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Measuring and monitoring vital signs
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Hypoventilation is the term used for slow and shallow breathing, which could lead to inadequate gaseous exchange. You should also observe whether the chest expands equally on both sides, particularly if there is a history of chest injury.
Dysfunctions of COVID-19
Published in Wenguang Xia, Xiaolin Huang, Rehabilitation from COVID-19, 2021
Hypoventilation can be caused by decreased respiratory power, increased dead space, decreased chest wall and lung compliance, and increased airway resistance. When respiratory muscle power is weakened, the chest expands feebly and the alveoli do not fill normally, resulting in decreased ventilation. The increase of dead space volume is seen in rapid shallow breathing, which leads to the increase of anatomic ineffective air cavity and the decrease of effective air exchange capacity in alveoli. Bronchiectasis increases the airway volume, which also gives rise to the enlargement of the anatomic cavity, leading to hypoventilation.
Pathophysiology
Published in Burkhard Madea, Asphyxiation, Suffocation,and Neck Pressure Deaths, 2020
Wolfgang Keil, Claire Delbridge
Extensive rib fractures are a frequent cause of obstruction of thoracic movements. If the chest wall including the pleura costalis is injured, there is an open pneumothorax. The intrathoracic negative pressure is lost and the lung on the affected side of the chest can collapse to a greater or lesser extent. As a result, hypoventilation of varying intensity occurs, which can even result in death by asphyxiation. A double-sided open pneumothorax is particularly dangerous and can seldom be survived without immediate medical help. Closed pneumothorax can occur as a result of punctures of the lungs by fractured ribs. In this case, the inhaled air penetrates into the affected half of the chest and increases the negative pressure. The consequences are identical to those described for open pneumothorax.
The effect of combined ultrasound-guided transverse thoracic muscle plane block and rectus sheath plane block on the peri-operative consumption of opioids in open heart surgeries with median sternotomy
Published in Egyptian Journal of Anaesthesia, 2023
Fady Medhat Mokhtar Nessim, Alaa Eid Mohamed Hassan, Fahmy Saad Latif Eskander, Riham Fathy Galal Nady
Finally, this study on 50 patients undergoing elective cardiac surgery (after excluding 7 patients) demonstrated the benefit of the TTP block combined with the RSP block as a helpful pain modality rather than the massive amounts of intravenous opioids consumed during the intraoperative period. It has been demonstrated in practice that early extubation reduces the risk of hemodynamic affliction, ventilator-associated pneumonia (VAP), and barotraumas linked with positive-pressure ventilation (PPV). Controlling one of the main factors that raises the failure rates of weaning from mechanical ventilation (MV) and re-intubation is essential for achieving early but safe extubation. This factor is post-sternotomy pain. The latter results in respiratory failure by causing hypoventilation and pulmonary atelectasis. Less opioid use promotes fast-tract extubation, reduces side effects, and generates greater financial gains for cardiac centers.
“Me and ‘that’ machine”: the lived experiences of people with neuromuscular disorders using non-invasive ventilation
Published in Disability and Rehabilitation, 2023
Meredith A. Perry, Matthew Jenkins, Bernadette Jones, Jarrod Bowick, Hannah Shaw, Emma Robinson, Morgan Rowan, Kate Spencer, Alister Neill, Tristram Ingham
Neuromuscular disorders (NMD) encompasses a range of conditions which vary in aetiology and include both acquired and inherited. The global prevalence of NMD is estimated to be 1% of the world’s population [1]. Associated thoracic muscle weakness and chronic respiratory failure often occur with NMD [2]. Respiratory failure symptoms typically develop during sleep when the drive to breathe is lower and the upper airway is more collapsible [3]. This results in nocturnal hypoventilation. However, with disease progression, respiratory failure may also occur during the daytime. Eventually daytime hypercapnia, morning headache, orthopnoea, and dyspnoea ensues [3]. Respiratory failure is the major cause of mortality and reduced quality of life (QoL) in people with NMD who have respiratory complications [4], accounting for 80% of mortality in people with specific neuromuscular disorders [5].
Disorders of sleep and wakefulness in amyotrophic lateral sclerosis (ALS): a systematic review
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2021
Diana Lucia, Pamela A. McCombe, Robert D. Henderson, Shyuan T. Ngo
There is some information that helps to measure the effects of hypoventilation. Among the uncontrolled studies assessing subjective sleep using the PSQI, two assessed sleep quality in ALS patients who were using noninvasive ventilation (NIV). One study (17) reported that 70.3% of patients showed pathological results in the PSQI when sleep quality was assessed the day before the initiation of NIV. After 3 months of NIV, patients still reported poor sleep quality; however, the average PSQI score improved from 6.5 to 6.0. The other study, which followed 13 patients before and after NIV, showed that prior to NIV initiation, all patients were classed as poor sleepers with an average PSQI score of 8 (18). After 12 months of NIV, patients were still defined as poor sleepers, however, there was an overall reduction in the average PSQI score, compared to pre NIV initiation. Another study of ALS patients; who were not on NIV, reported that 57.14% were poor sleepers with an average PSQI score of 7.0 (12).