Acute respiratory failure

Nickel carbonyl Carbonylation of acetylene and alcohols to produce acrylic and methacrylic acids Acute respiratory failure carcinogenic... 

Age >40 yr, previous venous thromboembolism, chronic heart failure, acute respiratory failure, recent major surgery (within 2 wk), confined air/ground travel (>6 h duration within 1 wk of admission), inflammatory bowel disease, myocardial infarction, nephrotic syndrome, and ischemic stroke... 

In the critical care setting, hypophosphatemia can result in impaired diaphragmatic contractility and acute respiratory failure. 

AC Before meals (ante cibos) ARF Acute renal failure acute respiratory failure acute... 

Relatively few data are available on the response of ANP to endotoxemia or septic shock. In an ovine model, a 13-fold increase in blood ANP concentration has been found 2 hours after endotoxin administration in a dose of 1.5 pg/kg body weight (LI7). The ANP level remained elevated during the first 6 hours and was associated with marked diuresis and natriuresis and with decreased cardiac output and increased peripheral resistence (LI7). In human studies, a significantly higher ANP blood level was observed in ARDS (E4) and in patients with acute respiratory failure associated with sepsis (M30). In a longitudinal study, we found that plasma ANP levels were increased in patients with sepsis, but the ANP levels showed no relation to the severity of disease or to the presence of shock (B8). 

K8. Kietzmann, D., Kahl, R., Miiller, M., Burchardi, H., and Kettler, D., Hydrogens peroxide in expired breath condensate of patients with acute respiratory failure and with ARDS. Intensive Care Med. 19,78-81 (1993). 

M30. Mitaka, C., Nagura, T., Sakanishi, N Tsunoda, Y., and Toyooka, H., Plasma a-atrial natriuretic peptide concentrations in acute respiratory failure associated with sepsis Preliminary study. Crit. Care Med. 18, 1201-1203 (1990). 

Skeletal muscle dysfunction can cause myalgia, bone pain, weakness, and potentially fatal rhabdomyolysis. Respiratory muscle weakness and diaphragmatic contractile dysfunction can cause acute respiratory failure. 

DIAGNOSIS OF ACUTE RESPIRATORY FAILURE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE ... 

The diagnosis of acute respiratory failure in COPD is made on the basis of an acute drop in Pa02 of 10 to 15 mm Hg or any acute increase in PaC02 that decreases the serum pH to 7.3 or less. 

The most common cause of acute respiratory failure in COPD is acute exacerbation of bronchitis with an increase in sputum volume and viscosity. This serves to worsen obstruction and further impair alveolar ventilation, resulting in worsening hypoxemia and hypercapnia. Additional causes are pneumonia, pulmonary embolism, left ventricular failure, pneumothorax, and CNS depressants. 

The goals of therapy for patients experiencing exacerbations of COPD are prevention of hospitalization or reduction in length of hospital stay, prevention of acute respiratory failure and death, resolution of symptoms, and a return to baseline clinical status and quality of life. 

Noninvasive positive-pressure ventilation (NPPV) provides ventilatory support with oxygen and pressurized airflow using a face or nasal mask with a tight seal but without endotracheal intubation. In patients with acute respiratory failure due to COPD exacerbations, NPPV was associated with lower mortality, lower intubation rates, shorter hospital stays, and greater improvements in serum pH in 1 hour compared with usual care. Use of NPPV reduces the complications that often arise with invasive mechanical ventilation. NPPV is not appropriate for patients with altered mental status, severe acidosis, respiratory arrest, or cardiovascular instability. 

The first group persons in grave condition threatening their life (acute respiratory failure and cardiovascular collapse, coma, convulsions, paralytic manifestations). Upon first aid provided, these persons are to be evacuated to specialized medical institutions as soon as possible, preferably by ambulance cars, equipped with reanimation facilities. 

Myasthenia gravis Exacerbations of myasthenia gravis have been reported in patients with myasthenia gravis treated with telithromycin. This has sometimes occurred within a few hours after intake of the first dose of telithromycin. Reports have included life-threatening acute respiratory failure with a rapid onset. Telithromycin is not recommended in patients with myasthenia gravis unless no other therapeutic alternatives are available. 

In patients with borderline respiratory reserve, the depressant properties of the opioid analgesics may lead to acute respiratory failure. 

All of the above-mentioned blood oxygenators are used outside the body, and hence are referred to as extracorporeal oxygenators. They are mainly used for heart surgery, which can last for up to several hours. However, blood oxygenators are occasionally used extracorporeally to assist the pulmonary function of the patients in acute respiratory failure (ARF) for extended periods of up to a few weeks. This use of extracorporeal oxygenators is known as extracorporeal membrane oxygenation (ECMO). 

Five patients with metformin-associated severe lactic acidosis, seen between 1 September 1998 and 31 May 2001, have been reported (58). Two had attempted suicide. All had severe metabolic acidosis with a high anion gap and raised blood lactate concentrations. Four developed profound hypotension and three had acute respiratory failure. Three had normal preceding renal function. Three required conventional hemodialysis and two continuous renal replacement therapy. 

Acute Respiratory Failure, edited by W. M. Zapol and K. J. Falke... 

Acute Respiratory Failure in Chronic Obstructive Pulmonary Disease, edited by J.-P. Derenne, W. A. Whitelaw,... 

Acute respiratory failure, which can be complicated by pneumonia, has been reported in psychiatric patients receiving long-term neuroleptic drugs (SED-11, 107) (157). 

The value of spotting the unusual has been demonstrated by a number of infectious disease outbreaks in the United States. A classic example is the initial reports of the human immunodeficiency virus epidemic. Alert clinicians in California and New York City noted clusters of rare illnesses, Kaposi s sarcoma and Pneumocystis carinii pneumonia, among homosexual male clients in their practices (CDC, 1981a, 1981b). In May 1993, a New Mexico medical examiner reported two deaths from acute respiratory failure 5 days apart (CDC, 1993). 

How should hospitals increase their capacity to provide mechanical ventilation for a surge of patients with acute respiratory failure during a mass casualty event or influenza pandemic Rubinson and colleagues address this issue in a recently published article (Rubinson, Branson, Pesik, Talmor, 2006). Their report is based on an evaluation and assessment of a wide range of positive pressure ventilation (PPV) equipment, with the goal of determining the suitability of each device for mass casualty care. The article provides information useful for determining which types of PPV equipment would be the best choice for hospitals in need of a serviceable alternative to full feature ventilators, which will be in short supply and are too expensive for hospitals to stockpile. 

Chlorine is considered a direct-acting irritant to the target tissues, the eyes and respiratory tract. Death is due to acute respiratory failure. Chlorine gas reacts at the site of contact and very little of the chemical is absorbed into the bloodstream (Eaton and Klaassen, 2001). Any chlorine that is absorbed becomes part of the body pool of chlorine, and toxicokinetics is not involved in the mechanism of action. 

Acetazolamide should be avoided in patients with severe COPD. These patients may be unable to increase their alveolar ventilation enough to compensate for the acid-base alterations induced by acetazolamide. In some patients, especially those with severe pulmonary disease, increased CO2 gradients or acidosis may lead to acute respiratory failure. Acetazolamide should be used cautiously in such patients, and the practitioner should use the lowest effective dose to reduce lOP... 

A 73-year-old man with acute respiratory failure, presumed to be secondary to amiodarone toxicity, developed sepsis and acute renal insufficiency, and required intermittent hemodialysis. Following a Herpes simplex labialis infection he was treated with oral aciclovir (400 mg tds). The next day he became sleepy, disoriented, and agitated. Over the next 48 hours his neurological condition deteriorated and he responded to pain... 

The commonest form of lung damage is an interstitial alveolitis, although pneumonitis and bronchiolitis obhter-ans have also been reported, as have sohtary localized fibrotic lesions, non-cardiac pulmonary edema, pleural effusions, acute respiratory failure, acute pleuritic chest pain, and adult respiratory distress syndrome (SEDA-17, 220) (SEDA-18, 201) (66-68). Amiodarone has also been reported to cause impairment of lung function, even in patients who do not develop pneumonitis (69), and preexisting impairment of lung function may constitute a contraindication to amiodarone. 

In acute promyelocytic leukemia arsenic trioxide can cause a syndrome similar to the retinoic acid syndrome (15), with fever, skin rash, edema, pleural effusion, pericardial effusion, and acute respiratory failure. 

Zalman F, Perloff JK, Durant NN, Campion DS. Acute respiratory failure following intravenous verapamil in Duchenne s muscular dystrophy. Am Heart J 1983 105(3) 510-11. 

Acute respiratory failure predominated in patients under 30 years of age whilst cardiotoxic effects predominated in the elderly. 

Interstitial pneumonitis with acute respiratory failure was attributed to flecainide in a 59-year-old man with congenital heart disease related to the LEOPARD sjmdrome, in which there are multiple freckles (Lentigines), Electrocardiographic abnormalities. 

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