1.Critical illness polyneuropathy in a patient with Parkinson disease: a case report and review of the literature.
Sheng TAN ; Jian CHEN ; Rui-qing CHEN ; Hui LIU ; Yang GUO ; Can LI ; Ma-hui ZHANG ; Zhen-zhou CHEN
Journal of Southern Medical University 2011;31(10):1792-1794
OBJECTIVETo report a case of critical illness polyneuropathy (CIP) with Parkinson disease and discuss the development, clinical features and early diagnosis of this condition.
METHODSThe clinical data of a patient with CIP and Parkinson's disease and the relevant literature were reviewed.
RESULTSThis case showed no typical disease course of sepsis, and the condition exacerbated rapidly. The patient presented initially with abnormal homeostasis, followed by rapid onset of respiratory muscle weakness to require mechanical ventilation, but no limb weaknesses were detected. Intravenous antibiotics and aggressive treatment of sepsis did not produce any positive responses to wean from mechanical ventilation. Examinations of creatine kinase and cerebrospinal fluid showed no abnormalities. Electromyography and nerve conduction studies demonstrated declined nerve conduction velocity and decreased sensory and motor muscle action potentials, suggesting the possibility of CIP.
CONCLUSIONIn patients with Parkinson disease, the occurrence of sepsis with prolonged mechanical ventilation and limb weakness indicates the necessity of neurophysiological examination, muscle biopsies and laboratory tests, which may help detect CIP in the early phase. Proper interventions of sepsis may reduce the likeliness of CIP. Elimination of the risk factors and aggressive management of sepsis can be effective measures for preventing CIP.
Aged ; Humans ; Male ; Parkinson Disease ; complications ; Polyneuropathies ; complications ; diagnosis ; Respiration, Artificial ; Respiratory Insufficiency ; complications ; Sepsis ; complications
5.Relationship between the result of preoperative pulmonary function test and postoperative pulmonary complications.
Sung Kyu KIM ; Joon CHANG ; Chul Min AHN ; Hee Young SOHN ; Kiho KIM
Journal of Korean Medical Science 1987;2(1):71-74
Good preoperative screening and evaluation of patients undergoing surgery is necessary because it serves to identify the individual who is at risk of increased intra-operative and postoperative morbidity and mortality. The retrospective study was done in an attempt to determine if abnormalities in preoperative pulmonary function, detected by routine pulmonary function tests, would predict which patients would suffer from pulmonary complications following surgery. Pulmonary complications in the postoperative period included fever, atelectasis and respiratory failure. The overall incidence of pulmonary complications from our 78 patients undergoing surgery was 37 percent based on clinical criteria. This incidence was high in patients with FEV1 less than 1.0 L/sec, MVV less than 40% of predicted value and PCO2 more than 45 mmHg.
Fever/etiology
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Humans
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Lung Diseases/*etiology
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*Postoperative Complications
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Pulmonary Atelectasis/diagnosis
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*Respiratory Function Tests
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Respiratory Insufficiency/etiology
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Retrospective Studies
6.Clinical value of noninvasive intermittent positive-pressure ventilation in pneumoconiosis combined with respiratory failure.
Zu-Ying HU ; Jing-Yin HAN ; Shu-Juan WANG ; Ting YU
Chinese Journal of Industrial Hygiene and Occupational Diseases 2011;29(4):311-313
OBJECTIVETo evaluate the value of noninvasive intermittent positive-pressure ventilation (NIPPV) in treatment of patients with pneumoconiosis combined with respiratory failure.
METHODThree were 46 inpatients with pneumoconiosis combined with respiratory failure. Twenty-six inpatients treated with conventional therapy and NIPPV were categorized as treatment group; Twenty inpatients just treated by conventional therapy served as control group. Compared with the changes of HR, RR and arterial blood gas index (PH, PaCO2, PaO2) in two groups after treatment.
RESULTSThe effective ratio of treatment group was 88.5%, control group was 60%, which had significant difference (P < 0.05); The HR in treatment group after treatment was (95.38 +/- 10.75) beats per minute, control group was [(103.00 +/- 12.56) beats per minute; The RR in treatment group was (21.69 +/- 1.37) breaths per minute, control group was [(22.60 +/- 1.57) breaths per minute]; The PaCO2 in treatment group was (52.88 +/- 10.75)mm Hg, control group was [(59.66 +/- 11.49)mm Hg]; All of those were significantly decreased than those in control group (P < 0.05). The PaO2 in treatment group was (100.77 +/- 25.3) mm Hg, control group was [(71.82 +/- 17.94) mmHg]; Compared with the control group, PaO2 in the treatment group increased significantly (P < 0.05).
CONCLUSIONNIPPV is beneficial to pneumoconiosis combined with respiratory failure in different degrees.
Adult ; Aged ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; therapy ; Positive-Pressure Respiration ; Respiratory Insufficiency ; etiology ; therapy
8.Successful treatment of a child with respiratory failure occurred after lime inhalation.
Jie WANG ; Da-bo LIU ; Zhen-yun HUANG
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2008;43(10):792-793
Calcium Compounds
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Foreign Bodies
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complications
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etiology
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Humans
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Infant
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Male
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Oxides
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Respiratory Insufficiency
;
etiology
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therapy
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Treatment Outcome
9.Pulmonary Rehabilitation in Patients with Neuromuscular Disease.
Yonsei Medical Journal 2006;47(3):307-314
In neuromuscular disease (NMD) patients with progressive muscle weakness, respiratory muscles are also affected and hypercapnia can increase gradually as the disease progresses. The fundamental respiratory problems NMD patients experience are decreased alveolar ventilation and coughing ability. For these reasons, it is necessary to precisely evaluate pulmonary function to provide the proper inspiratory and expiratory muscle aids in order to maintain adequate respiratory function. As inspiratory muscle weakening progresses, NMD patients experience hypoventilation. At this point, respiratory support by mechanical ventilator should be initiated to relieve respiratory distress symptoms. Patients with adequate bulbar muscle strength and cognitive function who use a non-invasive ventilation aid, via a mouthpiece or a nasal mask, may have their hypercapnia and associated symptoms resolved. For a proper cough assist, it is necessary to provide additional insufflation to patients with inspiratory muscle weakness before using abdominal thrust. Another effective method for managing airway secretions is a device that performs mechanical insufflation-exsufflation. In conclusion, application of non-invasive respiratory aids, taking into consideration characterization of respiratory pathophysiology, have made it possible to maintain a better quality of life in addition to prolonging the life span of patients with NMD.
Respiratory Insufficiency/etiology/*rehabilitation/*therapy
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Respiration, Artificial
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Neuromuscular Diseases/complications/*rehabilitation
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Humans
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Breathing Exercises
10.Pulmonary Rehabilitation in Patients with Neuromuscular Disease.
Yonsei Medical Journal 2006;47(3):307-314
In neuromuscular disease (NMD) patients with progressive muscle weakness, respiratory muscles are also affected and hypercapnia can increase gradually as the disease progresses. The fundamental respiratory problems NMD patients experience are decreased alveolar ventilation and coughing ability. For these reasons, it is necessary to precisely evaluate pulmonary function to provide the proper inspiratory and expiratory muscle aids in order to maintain adequate respiratory function. As inspiratory muscle weakening progresses, NMD patients experience hypoventilation. At this point, respiratory support by mechanical ventilator should be initiated to relieve respiratory distress symptoms. Patients with adequate bulbar muscle strength and cognitive function who use a non-invasive ventilation aid, via a mouthpiece or a nasal mask, may have their hypercapnia and associated symptoms resolved. For a proper cough assist, it is necessary to provide additional insufflation to patients with inspiratory muscle weakness before using abdominal thrust. Another effective method for managing airway secretions is a device that performs mechanical insufflation-exsufflation. In conclusion, application of non-invasive respiratory aids, taking into consideration characterization of respiratory pathophysiology, have made it possible to maintain a better quality of life in addition to prolonging the life span of patients with NMD.
Respiratory Insufficiency/etiology/*rehabilitation/*therapy
;
Respiration, Artificial
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Neuromuscular Diseases/complications/*rehabilitation
;
Humans
;
Breathing Exercises