Cardiopulmonary extracorporeal assistance is a high complexity procedure for patients with acute respiratory failure, who have failed conventional ventilatory support. A 30 years old female patient with bacterial endocarditis and congestive cardiac failure subjected to cardiac surgery presented severe hypoxemia, right heart failure and pulmonary hypertension, and failed conventional treatment. Cardiopulmonary support with extracorporeal membrane oxygenation (ECMO) reverted the pathophysiologic alterations allowing a successful recovery.
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Med Care
February 2025
RTI International, Research Triangle Park, NC.
Background: There is a lack of consensus on the effectiveness of audio-based care to manage chronic conditions. This knowledge gap has implications for health policy decisions and for health equity, as underserved populations are more likely to access care by telephone.
Objectives: We compared the effectiveness of audio-based care to usual care for managing chronic conditions (except diabetes).
Healthcare (Basel)
December 2024
Respiratory Failure Clinic and Sleep Laboratory, General Hospital of Thessaloniki "G. Papanikolaou", Aristotle's University of Thessaloniki, 541 24 Thessaloniki, Greece.
There are many aspects in the relationship between smoking and sleep that have not been investigated thoroughly yet, especially in regards to obstructive sleep apnea-hypopnea syndrome (OSAHS). In this cross-sectional study, 2359 participants, who have visited the sleep clinic of our hospital during a 13-year period and were former or current smokers, were included. Their smoking history, measured in packyears of smoking, and their nicotine dependence, measured with the Fagerström scale, were correlated with various epidemiological and sleep-related variables.
View Article and Find Full Text PDFEClinicalMedicine
January 2025
Department of Anesthesia and Intensive Care Unit, Regional University Hospital of Montpellier, St-Eloi Hospital, University of Montpellier, Montpellier, CEDEX 5, France.
Background: Patients with obesity are at high-risk of extubation failure. Discrepancies were found in the results of recent randomized controlled trials (RCTs) regarding the roles of noninvasive ventilation (NIV), high flow nasal cannula (HFNC) and conventional oxygen therapy (COT) to prevent extubation failure in critically ill patients with obesity.
Methods: In this systematic review and network meta-analysis, we searched MEDLINE, Cochrane Center Register of Controlled Trials and Web of Science from 1 January 1998 to 1 July 2024 for RCTs evaluating noninvasive respiratory support therapies (NIV, HFNC, COT, NIV + HFNC) after extubation in critically ill adults with obesity.
Cureus
December 2024
Critical Care Medicine, Star Care Multispeciality Hospital, Kozhikode, IND.
Background: Fluid management is a crucial critical care component, influencing outcomes such as organ function, renal integrity, and survival in critically ill patients. Recent evidence suggests that balanced crystalloids may offer advantages over isotonic saline, particularly in reducing the risk of acute kidney injury (AKI) and other complications. This study aimed to evaluate the impact of balanced crystalloids versus isotonic saline on clinical outcomes in the intensive care unit (ICU), focusing on AKI, renal replacement therapy (RRT), and mortality.
View Article and Find Full Text PDFEur J Case Rep Intern Med
November 2024
Department of Lung Diseases and Thoracic Surgery, Pauls Stradins Clinical University Hospital, Riga, Latvia.
Background: Clinically amyopathic dermatomyositis (CADM) is a rare subtype of idiopathic inflammatory myositis often linked with the presence of autoantibodies targeting melanoma differentiation-associated protein 5 (MDA5). Patients with CADM are at increased risk of developing rapidly progressing interstitial lung disease, which significantly increases both morbidity and mortality compared to other forms of inflammatory myopathies. While there is no standardized treatment regimen, current therapeutic strategies are generally focused on combination immunosuppressive therapies.
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