Importance: A sustained inflation (SI) provided at birth might reduce bronchopulmonary dysplasia (BPD).
Objective: This study aims to examine whether an SI-guided exhaled carbon dioxide (ECO) compared with positive pressure ventilation (PPV) alone at birth decreases BPD.
Design: Randomised controlled trial. Infants were randomly allocated to either SI (SI group) or PPV (PPV group).
Participants: Participants of this study include infants between 23 and 32 weeks gestation with a need for PPV at birth.
Intervention: Infants randomised into the SI group received an initial SI with a peak inflation pressure (PIP) of 24 cmHO over 20 s. The second SI was guided by the amount of ECO. If ECO was ≤20 mm Hg, a further SI of 20 s was delivered. If ECO was >20 mm Hg the second SI was 10 s. Infants randomised into the PPV group received mask PPV with an initial PIP of 24 cmHO.
Primary Outcomes: Reduction in BPD defined as the need for respiratory support or supplemental oxygen at corrected gestational age of 36 weeks.
Results: SI (n=76) and PPV (n=86) group had similar rates of BPD (23% vs 33%, p=0.090, not statistically significant). The duration of mechanical ventilation was significantly reduced with SI versus PPV (63 (10-246) hours versus 204 (17-562) hours, respectively (p=0.045)). No short-term harmful effects were identified from two SI lasting up to 40 s (eg, pneumothorax, intraventricular haemorrhage or patent ductus arteriosus).
Conclusion: Preterm infants <33 weeks gestation receiving SI at birth had lower duration of mechanical ventilation and similar incidence of BPD compared with PPV. Using ECO to guide length of SI is feasible.
Trial Registration Number: NCT01739114; Results.
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http://dx.doi.org/10.1136/archdischild-2016-312286 | DOI Listing |
J Glob Health
December 2024
Department of Anesthesiology, Critical Care and Pain Medicine, UTHealth, Houston, Texas, USA.
Background: Previous studies have shown that hypertonic saline nasal irrigation and gargling reduced the duration of symptoms in upper respiratory infections caused by coronavirus. This study aims to investigate the effects of two saline regimens on symptoms associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2).
Methods: Between 2020 and 2022, individuals aged 18-65 years who tested positive for SARS-CoV-2 infection via polymerase chain reaction (PCR) were randomly assigned to either low- or high-saline regimens for 14 days.
Cureus
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Pulmonology/Critical Care, University of Kansas School of Medicine, Wichita, USA.
Empyema, a type of pleural effusion characterized by pus accumulation in the pleural space, is most often caused by bacterial infections, typically as a complication of pneumonia. This case report presents a 70-year-old man with chronic obstructive pulmonary disease (COPD), rheumatoid arthritis, and chronic bilateral hydropneumothoraces, who developed pyopneumothorax due to dual infections with and . The patient presented with worsening dyspnea, hypoxemia, and respiratory acidosis, requiring hospitalization and chest tube thoracostomy.
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Department of Critical Care Medicine, St. Luke's International Hospital, Tokyo, JPN.
Systemic capillary leak syndrome (SCLS) is a rare and life-threatening disorder characterized by acute hypotension, hypoalbuminemia, and hemoconcentration, which often results in severe respiratory complications, such as pulmonary edema. SCLS can be triggered by infections, including COVID-19, and is associated with a high mortality rate. Here, we report a case of COVID-19-associated SCLS in a 68-year-old man.
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December 2024
Pulmonology and Critical Care, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Malignant hyperthermia is a pharmacogenetic disorder that manifests clinically as a hypermetabolic crisis when a patient with a mutation in the ryanodine or dihydropyridine receptor genes is exposed to neuromuscular blocking agents. Depolarizing neuromuscular agents are known to cause malignant hyperthermia, but cases caused by nondepolarizing agents are rarely reported. We present a case consistent with malignant hyperthermia after receipt of cisatracurium, a nondepolarizing anesthetic agent.
View Article and Find Full Text PDFVaccine X
October 2024
WHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region.
We conducted a test negative study from November 2023 to June 2024, enrolling 4,367 children hospitalized with acute respiratory illness in Hong Kong. Among the children who tested negative for influenza virus and SARS-CoV-2, 56.8 % had received influenza vaccination.
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