China
Africa
Explore chapters and articles related to this topic
Sensorineural Hearing Loss
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Linnea Cheung, David M. Baguley, Andrew McCombe
Hyperbaric oxygen therapy (HBOT) delivers 100% oxygen at >1 atm pressure resulting in increased tissue oxygenation and aids the response to infection and ischaemia. Complications of treatment are rare but include barotrauma to ears, sinuses, and lungs; temporary worsening of short-sightedness; claustrophobia; and oxygen poisoning. It is an expensive and time-consuming treatment given over days or weeks and is not widely available. However, some benefit has been shown when initiated within 3 months of the onset of HL; the benefit is potentially greater in cases of severe to profound HL. Studies have shown some benefit of both IT steroids and HBOT as salvage therapies for refractory SSNHL.
Case 31
Published in Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta, Clinical Cases, 2021
Andrew Solomon, Julia Anstey, Liora Wittner, Priti Dutta
In general terms, hyperbaric chambers have a range of clinical roles. Across the world there are multiple registers of hyperbaric chambers that can be single- or multi-occupancy. A general contraindication is pneumothorax. In terms of side effects, barotrauma to the ear has been reported with other adverse effects much less common. In the UK there are several regional hyperbaric centres, often associated with coastal/nautical organisations. The frequently considered indications for hyperbaric oxygen include carbon monoxide excess; decompression illness (deep sea diving–related); gas/air embolism; necrotising soft tissue infection; acute traumatic/thermic/radiation injury.
Diagnostic Imaging in Inhalation Lung Injury
Published in Jacob Loke, Pathophysiology and Treatment of Inhalation Injuries, 2020
Caroline Chiles, Laurence W. Hedlund, Charles E. Putman
During the first 24 hr following the acute event, complications related to therapeutic intervention may also be apparent on chest radiographs. The placement and optimal positioning of central venous lines and endotracheal and nasogastric tubes can be monitored on chest radiographs. The rapid appearance of pleural or mediastinal fluid after venous line placement should raise the possibility of arterial injury or aberrant line placement with subsequent infusion of fluid (Fig. 4). Positioning of the endotracheal tube in a mainstem bronchus can result in collapse of the opposite lung, a potentially life-threatening complication in a patient with pre-existing lung injury. In addition, barotrauma related to mechanical ventilation may first be detected by chest radiographs (Fig. 3a). Chest radiographs in critically ill patients are often obtained using a portable unit with the patient supine. Attention should be directed to the highest portions of the thorax, the anterior costophrenic sulci in the supine patient, when pneumothorax is suspected.
Low tidal volume ventilation alleviates ventilator-induced lung injury by regulating the NLRP3 inflammasome
Published in Experimental Lung Research, 2022
Lixia Wang, Jun Li, Yan Zhu, Binshan Zha
Alveolar barotrauma is a major mechanism underlying VILI.23 Excessive tidal volume is the main cause of barotrauma.24 In our study, high-tidal-volume ventilation (Vt = 10 mL/kg IBW) was chosen during one lung ventilation in patients. Correspondingly, we found that high-tidal-volume ventilation during OLV increased Ppeak, Pplat, and ΔP significantly. However, LTTV (Vt = 5 mL/kg and 5 cm of H2O PEEP) decreased Ppeak, Pplat, and ΔP notably during OLV, indicating that alveolar overdistention was avoided and barotrauma may be reduced. In addition, we also found that LTTV increased Paw during OLV. Paw could be used to safeguard oxygenation when titrating ventilation, because Paw and oxygenation demonstrate a predictable and quantifiable direct relationship.25 Here, our present study found that oxygenation index in patients of LTTV group showed an increasing trend, although there was no significant difference compared with the control group. Therefore, our results suggested that LTTV may exert its lung protective capacity mainly by reducing alveolar barotrauma.
Firefighters during training as divers: physiologic and psychomental stresses
Published in International Journal of Occupational Safety and Ergonomics, 2022
Thomas Muth, Ingo Hansen, Clark Pepper, Jochen D Schipke
An easy 20-min scuba dive at a depth of only 10 m was already perceived to be stressful because the cortisol level after the dive was significantly increased [27]. Many stressors are responsible: after submersion, the hydrostatic pressure increases and compresses the gas-filled spaces outside and inside the diver’s body, causing barotrauma if not adequately responded to [28]. Other stressors possibly arising are impaired visibility, time pressure while searching, strenuous work and complex tasks. Finally, cold needs mentioning, because it impairs underwater performance [29], in particular for higher-order tasks [30]. Apart from these stressors, additional psychological stress was present, because the participants of this study were in demanding training situations with evaluations and group pressure.
Ventilator-induced barotrauma in critically ill patients with COVID-19: a retrospective observational study
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Anuraag Sah, Emilio J. Fabian, Carlos Remolina
This retrospective study done in a Community Hospital ICU in New Jersey early in the pandemic beginning in April through June of 2020 included all patients positive for SARS-CoV-2 infection who were ventilator-dependent for respiratory failure and severe acute respiratory syndrome. IRB approval was obtained by the Chair of Institutional Review Board at the Hospital with study number TRMC2020-12. Informed Consent was not required as this was a retrospective observational analysis with no patient identifiers published. All participants’ age, sex and BMI were all recorded at admission. Patients who were on non-invasive mechanical ventilation including CPAP or BiPAP at any time during their hospital stay were excluded. However, patients who received other forms of supplemental oxygen such as via Nasal Cannula, Non-Rebreather Mask and High-Flow therapy were included. The incidence of barotrauma was defined by the presence of subcutaneous emphysema, pneumothorax or pneumomediastinum in all intubated patients. Incidence of barotrauma was identified based on radiographic findings alone, either chest X-rays or CT scans. Total time in days on the ventilator was also documented, and end time was defined by either the day of tracheostomy tube placement, extubation or death.