Articles related to RESPIRATORY HEALTH
Oxygen Manifesto, Part 1: Advice from 3 Respiratory Specialists
Uncover vital insights about supplemental oxygen use, demystify misconceptions, and learn best practices for managing respiratory diseases. Good day, physicians. Let’s talk about the controversial issue of supplemental oxygen use, frequently discussed by patients, clinicians, advocacy groups, and even politicians. In this summary, we’ll untangle misconceptions and illuminate best practices. To start with, the body’s oxygen utilization depends on three things: lung function, heart efficiency, and muscle oxygen use. These factors can improve with exercise, but worsen with inactivity. Remember, exercise matters. Why does oxygen matter? For patients with chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF), or pulmonary hypertension (PH), impaired oxygenation can lead to hypoxemia and hypoxia. Hence, supplemental oxygen becomes a necessity. How do we assess oxygen levels? Two tests can be employed: arterial blood gas (ABG) or pulse oximetry. Normal partial pressure of oxygen, as per ABG, is around 75-100 mmHg, and a drop below 60 necessitates supplemental oxygen. Oxygen saturation, measurable via either test, should ideally be 95% or above, and values dropping to 90 or below indicate the need for supplemental oxygen. Now, let’s dispel some myths. Shortness of breath doesn’t always equate to hypoxia. A patient can experience breathlessness even with normal oxygen […]
Family Medicine/General Practice May 24th 2023
The Journal of Clinical Investigation (JCI)
Machine Learning Links Unresolving Secondary Pneumonia to Mortality in Patients with Severe Pneumonia, Including COVID-19
In a recent single-center prospective cohort study, the effect of unsuccessful treatment of ventilator-associated pneumonia (VAP) on mortality rates in patients with severe pneumonia was evaluated. The study involved 585 mechanically ventilated patients with severe pneumonia and respiratory failure, including 190 with severe COVID-19, all of whom underwent at least one bronchoalveolar lavage. A novel machine learning approach, CarpeDiem, was employed to group similar ICU patient-days into clinical states based on electronic health record data. Findings indicated that the lengthy ICU stays experienced by COVID-19 patients were largely due to prolonged periods of respiratory failure. The study discovered that although VAP wasn’t a contributing factor to mortality rates overall, patients with a single episode of unsuccessfully treated VAP demonstrated a significantly higher mortality rate (76.4%) compared to those with successfully treated VAP (17.6%). Furthermore, the CarpeDiem model highlighted that unresolved VAP was linked with transitions to clinical states associated with increased mortality. The study underscores that unsuccessful treatment of VAP is correlated with higher mortality and that patients with COVID-19 are at an elevated risk of VAP due to prolonged respiratory failure.
Internal Medicine May 22nd 2023
Changes in Cardiorespiratory Fitness Accurately Predict Mortality, Study Finds
In a study of nearly 100,000 individuals aged 30 to 95 without any prior evidence of CVD, decline in peak metabolic equivalent of task score (METS) of greater than 1.0 was inversely proportionate to changes in mortality risk. METS were determined using symptom-limited exercise treadmill tests.
Cardiology April 5th 2023
Effect of Regular, Low-Dose, Extended-release Morphine on Chronic Breathlessness in Chronic Obstructive Pulmonary Disease: The BEAMS Randomized Clinical Trial
A double-blind, placebo-controlled randomized clinical trial including people with COPD and chronic breathlessness was conducted at 20 Australian medical centers. One-hundred sixty participants were randomized to oral extended-release morphine versus placebo. The change in the intensity of worst breathlessness at week 1 was not significantly different between the morphine group and the placebo group.
Internal Medicine December 7th 2022
FDA Panel Backs Novel Combination Inhaler for Asthma in Adults Only
Although the panel voted 16:1 for the new budesonide + albuterol inhaler in adults, they said the data does not support use in children and they were split on use in adolescents over the age of 12.
Allergy & Immunology November 29th 2022
FDA Authorizes IL-1 Drug for Hospitalized COVID Patients
Anakinra (Kineret, Sobi) currently approved for rheumatoid arthritis and some rare disorders, was granted an emergency use authorization for a subgroup of COVID-hospitalized patients who are at risk of severe respiratory failure.
Family Medicine/General Practice November 29th 2022