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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Myotonic dystrophy or Steinert's disease may be discovered during acute respiratory failure, sometimes caused by a general anaesthetic. It complicates chronic respiratory failure which is present in almost all cases, both restrictive and obstructive, the clinical signs of which progress with the myopathy. Apart from myotonic degeneration of the respiratory muscles, a hypoventilation syndrome of central origin has been described, but the etiology of this respiratory failure is dominated by repeated aspiration pneumonia favoured by constant dysphagia and passage of food into the trachea and poor cough reflex. One should attempt to correct this.
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PMID:[Myotonic dystrophy and acute respiratory insufficiency]. 19 96

In a patient with acute respiratory failure due to aspiration pneumonia, PaO2 decrease and Qs/Qt increase were observed during continuous positive pressure ventilation. This paradoxical finding was attributted to vascular collapse in well ventilated upper alveoli associated with blood flow redistribution to dependent hypoventilated areas with low ventilation-perfusion relationships.
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PMID:Unusual response to continuous positive pressure ventilation. 78 39

Cardiopulmonary abnormalities are frequently encountered in myotonic dystrophy. We present five patients with myotonic dystrophy who entered the intensive care unit in acute respiratory failure. The possible etiologic factors of pulmonary complications are reviewed. The most important is probably aspiration pneumonia. The difficulties in the treatment of the respiratory failure are emphasezed. Myotonia of the chest muscles and diaphragm make artificial ventilation difficult. Recovery is delayed chiefly by swallowing disturbances. General anaesthesia is hazardous. Four patients presented cardiac arrhythmias and/or conduction abnormalities which were transient.
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PMID:Respiratory failure and cardiac disturbances in myotonic dystrophy. 96 70

The authors report a 56-year-old woman with Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute respiratory failure. Five days before admission, she experienced right otalgia and right facial pain and consulted an otolaryngologist of our hospital, who diagnosed the illness as acute parotitis and laryngopharyngitis. One day before admission, she experienced mild dyspnea and general fatigue and came to our hospital emergency room. A chest X-ray film revealed no abnormalities but some blisters were observed around her right ear. The next day, her dyspnea became more severe and she was admitted. A chest X-ray film on admission revealed right lower lobe consolidation, and neurological examination disclosed multiple cranial nerve paralysis, i.e., paralysis of the right fifth, seventh, eighth, ninth, tenth, eleventh, twelfth and left tenth cranial nerve. The serum titer of anti-herpes zoster antibody was elevated to 1,024, and the patient was diagnosed as having Ramsey Hunt syndrome with multiple cranial nerve paralysis. Arterial blood gas analysis revealed hypoxemia with hypercapnea, which was considered to be due to aspiration pneumonia and central airway obstruction caused by vocal cord paralysis. Mechanical ventilation was soon instituted and several antibiotics and acyclovir were administered intravenously, with marked effects. Three months after admission, the patient was discharged with no sequelae except mild hoarseness. Patients with herpes zoster oticus, facial nerve paralysis and auditory symptoms are diagnosed as having Ramsey Hunt syndrome. This case was complicated by lower cranial nerve paralysis and acute respiratory failure, which is very rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A case of Ramsey Hunt syndrome with multiple cranial nerve paralysis and acute respiratory failure]. 175 19

A 68-year-old woman with a history of hiatus hernia developed aspiration pneumonia after operation for fractured neck of femur. After 8 days, acute respiratory failure was caused by massive retention of air and food in the oesophagus. This was relieved by aspiration, and treated by balloon dilation of the gastric cardia.
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PMID:Respiratory failure as presentation of achalasia of the oesophagus. 178 29

We studied the need for mechanical ventilation in 265 patients with respiratory failure who came to our medical ICU over the past 3 years. The time required for weaning from mechanical ventilation and the percentage of patients who needed oxygen therapy or mechanical ventilation at home after their condition was no longer acute were also studied. Of the patients treated in the medical ICU, 143 (54%) required mechanical ventilation; 104 (39%) had acute respiratory failure and the others had acute exacerbations of chronic respiratory failure. Some causes of acute respiratory failure were aspiration pneumonia, bronchial asthma, and drug use. Three-fourths of those with chronic respiratory failure had pulmonary emphysema, sequela of pulmonary tuberculosis, or idiopathic interstitial pneumonia. In patients with chronic respiratory failure, success in weaning could be predicted from the respiratory index (PaO2/FIO2), the serum albumin level, and the length of time that they were ventilated with more than 60% oxygen. Thirteen patients with chronic respiratory failure died while receiving mechanical ventilation. Of those who survived, 11 underwent tracheostomies, and 4 of those 11 were mechanically ventilated at home with portable devices. Ten other survivors received home oxygen therapy. Chest physicians bear the greatest responsibility for managing mechanical ventilation in medical emergencies. Moreover, the prognosis for patients with chronic respiratory failure can be improved with a long-term program for respiratory care that includes home mechanical ventilation and home oxygen therapy.
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PMID:[Mechanical ventilation and long-term respiratory care in the intensive care unit of a general hospital]. 875

We studied 19 patients, all older than 75 years of age, who had isolated coronary artery bypass grafting (CABG) from January 1990 to December 1996. Clinical characteristics, hospital mortality and long-term survival were compared between this elderly group (> or = 75 years) and a younger group (60-74 years) in which 130 consecutive patients underwent the same procedure during the same period. There were no differences of coronary risk factors, renal function, respiratory function and ejection fraction between the two groups. The incidences of left main trunk stenosis (> or = 50%) and three-vessel-disease were more common in the elderly group, but the difference between the groups was not statistically significant. Preoperative use of an intra-aortic balloon pump was more frequent in the elderly group (p < 0.01). The hospital mortality rate of 31.6% for the elderly group was significantly higher than that of 5.4% for the younger group (p < 0.01). However, of particular note is that the 30-day hospital mortality was half (15.8%) and that three of six (50%) hospital deaths occurred between 35 and 148 days. These patients died from acute respiratory failure subsequent to aspiration pneumonia, ruptured dissecting aortic aneurysm, and ischemic enterocolitis. This difference between the 30-day hospital mortality rate (15.8%) and hospital mortality rate (31.6%) emphasizes the influence that postoperative complications can have on subsequent outcome. Of 136 hospital survivors (123 in the younger group and 13 in the elderly), 98% have been followed for a mean of 32 months. The 4-year survival was 60 +/- 22% for hospital survivors of the elderly group. It compares favorably with that for the younger group (85 +/- 5%), and with previously reported data. We conclude that despite a significantly increased hospital mortality, good long-term survival can be realized after CABG, even in patients older than 75 years.
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PMID:[Surgical results of coronary artery bypass grafting in patients older than 75 years]. 925 88

The mortality of the influenza virus pneumonia is on the increase caused by the decline of the vaccination for the influenza virus in Japan. The purpose of our research is to study the clinical feature of severe influenza virus pneumonia that caused acute respiratory failure. This study included 68 patients with adult influenza virus infection who consulted our hospital between October 1997 and May 1999. Six (8.8%) of 68 were diagnosed as having influenza virus pneumonia that caused acute respiratory failure. All patients with influenza virus pneumonia showed severe conditions with respiratory failure and a high-risk group. Two super high age patients had emergency status with unconsciousness. A super high age patient with influenza virus pneumonia died of aspiration pneumonia 118 days after admission. All patients with influenza virus pneumonia were received antibiotics. Although 4 of 6 patients did not respond to antibiotics, adrenocorticosteroids were administered. As the result, 3 of 4 patients, healing was achieved. We concluded that adrenocorticosteroids might be useful for treating severe influenza virus pneumonia under the administration of appropriate antibiotics.
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PMID:Clinical study of severe influenza virus pneumonia that caused acute respiratory failure. 1183 Sep 27

With complex and extensive pharmacological effects, corticosteroids are widely used in many clinical situations. A survey conducted to define the role of corticosteroids in various settings of peri-operative and critical care gave strong evidence to support that the use of corticosteroid is absolutely indicated in patients with adrenal insufficiency, asthma, anaphylaxis, acute spinal cord injury, and increased ICP resulting from brain tumors. As the benefits of corticosteroids are much in evidence, their uses are recommended to extend to postoperative antiemesis, acute respiratory failure (such as ARDS, COPD, and fat embolism), increased ICP associated with brain abscess, thyroid storm, and refractory hypothermia. Beneficial effect could be expected in septic shock with high-dose corticosteroids. Despite extensive reports on their versatile usefulness, evidence-based review did not recommend the use of corticosteroids in increased ICP associated with traumatic head injury and cerebral infarct, cardiac arrest, post-extubation airway edema, and aspiration pneumonia due to poor effectiveness let alone further worsening of the conditions. Great caution must be taken in clinical situations where administration of corticosteroids is considered contraindicated such as systemic fungal infection, hypersensitivity to the drug, intramuscular injection in idiopathic thrombocytopenia purpura, vaccination with live virus.
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PMID:An evidence-based review on the use of corticosteroids in peri-operative and critical care. 1219 90

We report a case of neurogenic pulmonary edema associated with epileptic seizure. A 36-year-old woman had had several episodes of fainting and postictal respiratory failure, and since July 1998 had been admitted to a nearby hospital three times. On October 12, 1999, she was again admitted to a nearby hospital with the same symptom, and was transferred from that hospital to ours for evaluation of the recurrent respiratory disorder. Low-grade fever, mild leukocytosis, hypoxemia and bilateral diffuse opacities were observed as previously on chest radiography, and improved within several days without any specific therapy. The negative C reactive protein level, normal cardiac function and faintly bloody bronchoalveolar lavage fluid were also observed. There was no evidence of aspiration pneumonia, infectious disease, or underlying heart or lung disease. Electroencephalography showed spikes in accord with the left temporal lobe, and the cause of the patient's fainting was thought to be temporal lobe epilepsy. After all other causes had been excluded, this case was diagnosed as neurogenic pulmonary edema associated with epileptic seizure. Only about 40 cases of the postictal pulmonary edema have been reported since 1908, and the pathophysiologic mechanism of this condition is still unknown. Neurogenic pulmonary edema associated with epileptic seizure is rare, but the importance of awareness of this condition needs to be emphasized because it is suspected to be the cause of unexpected sudden death in epileptics. We should consider the disease as important in the differential diagnosis of acute respiratory failure associated with epilepsy.
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PMID:[A case of neurogenic pulmonary edema associated with epileptic seizure]. 1264 14


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