Articles: mechanical-ventilation.
-
J. Allergy Clin. Immunol. · Jul 2020
Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19.
Coronavirus disease 2019 (COVID-19) can manifest as a viral-induced hyperinflammation with multiorgan involvement. Such patients often experience rapid deterioration and need for mechanical ventilation. Currently, no prospectively validated biomarker of impending respiratory failure is available. ⋯ The maximal level of IL-6, followed by CRP level, was highly predictive of the need for mechanical ventilation. This suggests the possibility of using IL-6 or CRP level to guide escalation of treatment in patients with COVID-19-related hyperinflammatory syndrome.
-
Paediatric anaesthesia · Jul 2020
Association of Tidal Volume during Mechanical Ventilation with Postoperative Pulmonary Complications in Pediatric Patients Undergoing Major Scoliosis Surgery.
The use of lung-protective ventilation strategies with low tidal volumes may reduce the occurrence of postoperative pulmonary complications. However, evidence of the association of intraoperative tidal volume settings with pulmonary complications in pediatric patients undergoing major spinal surgery is insufficient. ⋯ In pediatric patients undergoing major spinal surgery, high tidal volume was associated with an elevated risk of postoperative pulmonary complications. However, the effect of tidal volume on pulmonary outcomes in the young subgroup (≤3 years) differed from that in the old (>3 years). Such information may help to optimize ventilation strategy for children of different ages.
-
We report for the first time therapy-resistant hypernatremia (plasma sodium concentration ≥150 mmol per liter) developing in 6 of 12 critically ill coronavirus disease 2019 (COVID-19) patients age 57-84 years requiring mechanical ventilation. There was no correlation between plasma sodium concentrations and sodium input. ⋯ These findings are consistent with abnormally increased renal sodium reabsorption, possibly caused by increased angiotensin II activity secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced downregulation of angiotensin-converting enzyme 2 (ACE2) receptors. As hypernatremia was associated with increased length of intensive care unit stay, special attention should be paid to the electrolyte status of COVID-19 patients.