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Capillary pCO 2 helps distinguishing idiopathic pulmonary arterial hypertension from pulmonary hypertension due to heart failure with preserved ejection fraction

RationaleThe demographics of patients with idiopathic pulmonary arterial hypertension (IPAH) are changing and this diagnosis is increasingly being made in older patients. However, diagnostic misclassifications are common as it may be difficult to differentiate between IPAH and pulmonary hypertension due to heart failure with preserved ejection fraction (PH-HFpEF). We investigated the hypothesis that the capillary pCO2 (pcCO2) may help distinguishing between idiopathic pulmonary arterial hypertension (IPAH) and pulmonary hypertension due to heart failure with preserved ejection fraction (PH-HFpEF). Methods: In a cross-sectional study, we retrospectively assessed pcCO2 levels (obtained from arterialized capillary blood at the time of diagnosis) from patients with IPAH or PH-HFpEF, respective...

Heated humidified high-flow nasal oxygen in adults: mechanisms of action and clinical implications.

HEATED HUMIDIFIED HIGH-FLOW NASAL OXYGEN IN ADULTS: MECHANISMS OF ACTION AND CLINICAL IMPLICATIONS. Chest. 2015 Mar 5; Authors: Spoletini G, Alotaibi M, Blasi F, Hill NS Abstract Abstract: Traditionally, nasal oxygen therapy has been delivered at low flows via nasal cannulae. In recent years, nasal cannulae designed to administer heated and humidified air/oxygen mixtures at high flows (up to 60 L/min) have been gaining popularity. These high-flow nasal cannula (HFNC) systems enhance patients' comfort and tolerance compared to traditional high flow oxygenation systems, such as nasal masks and nonrebreathing systems. By delivering higher flow rates, HFNC is less apt than traditional oxygenation systems to permit entrainment of room air during patient inspiration. Combine...

Indications for and management of tracheostomies

There has been documented evidence of tracheostomies for over two millennia, the majority being descriptions of relieving acute upper airway obstructions in an emergency. Refinement of anaesthetic and surgical techniques resulted in the increased frequency and success of the procedure and in the latter half of the 20th century they were being used increasingly as adjuncts to long-term respiratory support for patients who had either lost their upper airway or who had limited bulbar function and reduced ability to clear secretions via coughing and expectorating. (Source: Surgery (Medicine Publishing))

Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications

Conclusions: After controlling for potential confounders, this propensity-adjusted analysis demonstrates an increased odds of a composite complication with intubation following failed NIPPV. Further, the presence of a composite complication during intubation is associated with an increased odds of death in the ICU. (Source: Annals of Intensive Care)

Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis in the WHO European Region 2011 – 2015: cost-effectiveness analysis

Drug-resistant tuberculosis (TB) has increased at an alarming rate in the WHO European Region. Of the 27 countries worldwide with a high burden of multidrug resistant-TB (MDR-TB), 15 are in the European Region. An estimated 78,000 new cases of MDR-TB occur annually in the Region, of which approximately 10% are extensively drug-resistant (XDR)-TB. In response, the WHO Regional Office for Europe developed a Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis (2011–2015). (Source: Tuberculosis)

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