Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Monaldi Arch Chest Dis · Dec 2010
Out-of-hospital helmet CPAP in acute respiratory failure reduces mortality: a study led by nurses.
Acute respiratory failure (ARF) is a condition that must be treated as quickly as possible. Continuous Positive Airway Pressure (CPAP) is a common method used to treat ARF in hospital. The main objective of our study was to investigate the effect of CPAP prior to admission to the emergency room, on the reduction of endotracheal intubation, in-hospital mortality and on the length of stay in hospital (HLOS). ⋯ Treating patients with ARF of any cause, with CPAP by trained nurses, before hospital admission, is safe, reduces mortality and the length of stay needed in hospital.
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Monaldi Arch Chest Dis · Dec 2010
Comparative StudyAcute myocardial infarction in non-cardiac critically ill patients: a clinical-pathological study.
In patients admitted to the Intensive Care Unit (ICU) for non cardiac disease, the diagnosis of acute coronary syndromes can be challenging. The aim of the study was to define the rate of discrepancies concerning the diagnosis of acute myocardial infarction and to evaluate the presence of risk factors that could be helpful in identifying patients at higher risk of missed diagnosis. ⋯ Our experience strengthens the role of post-mortem examination as a source of feed-back of the overall diagnostic and therapeutic approach especially in septic patients, where the diagnostic error is more frequent.
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Monaldi Arch Chest Dis · Dec 2010
Case ReportsInfluenza A triggered status asthmaticus requiring emergency ECMO.
We describe a case of acute respiratory failure due to severe pneumonia triggered by the influenza A virus, rapidly evolving into a refractory status asthmaticus requiring emergent ECMO assistance, in order to facilitate the clinical management of patients suffering from this rare but life-threatening condition. This case report demonstrates that infection with influenza A virus can present with severe pneumonia and status asthmaticus refractory to medical and ventilatory treatment. When medical treatment and mechanical ventilation fail, extracorporeal membrane oxygenation therapy should not be delayed as it will avoid injury resulting from inadequate mechanical ventilation and lung hyperinflation.