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  • 1
    Electronic Resource
    Electronic Resource
    Long-term management of acute respiratory failure in metabolic myopathy (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1406-1409 
    Details
    ISSN: 1432-1238
    Keywords: Keywords Respiratory failure ; Mitochondrial myopathy ; Acid maltase deficiency ; Intermittent positive pressure ventilation ; Carnitine palmitoyl transferase deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract   Objective: To describe how patients cope with the propos-al of treatment with intermittent artificial ventilation after acute respiratory failure due to progressive respiratory muscle weakness. Design: Case series, follow-up study. Setting: Neurological intensive care unit (ICU). Patients: 7 consecutive patients with metabolic myopathy treated for acute respiratory failure between 1983 and 1992. interventions: Intermittent positive pressure ventilation (IPPV) via tracheostomy. Measurements and results: Symptoms of chronic hypoventilation preceded acute respiratory failure for months. With one exception, patients were mainly disabled from respiratory muscle weakness and sleep-related breathing disorders. IPPV was recommended to prevent recurrent respiratory failure. Two of 28.8nthree patients who accepted home IPPV returned to full-time jobs. One patient, who decided against IPPV, died from CO2 narcosis several months after discharge. All patients adhered to the respiratory regimen once instituted. Conclusions: Acute respiratory failure in chronic myopathy is heralded by daytime drowsiness. IPPV, or at least regular monitoring of waking and sleeping partial pressure of carbon dioxide, is highly recommended even if weaning is successful. IPPV improved quality of life. The treatment strategy at discharge from the ICU should be optimal, as patients are reluctant to modify regimens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709559
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Long-term management of acute respiratory failure in metabolic myopathy (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1406-1409 
    Details
    ISSN: 1432-1238
    Keywords: Respiratory failure ; Mitochondrial myopathy ; Acid maltase deficiency ; Intermittent positive pressure ventilation ; Carnitine palmitoyl transferase deficiency
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To describe how patients cope with the proposal of treatment with intermittent artificial ventilation after acute respiratory failure due to progressive respiratory muscle weakness. Design Case series, follow-up study. Setting Neurological intensive care unit (ICU). Patients 7 consecutive patients with metabolic myopathy treated for acute respiratory failure between 1983 and 1992. Interventions Intermittent positive pressure ventilation (IPPV) via tracheostomy. Measurements and results Symptoms of chronic hypoventilation preceded acute respiratory failure for months. With one exception, patients were mainly disabled from respiratory muscle weakness and sleep-related breathing disorders. IPPV was recommended to prevent recurrent respiratory failure. Two of three patients who accepted home IPPV returned to full-time jobs. One patient, who decided against IPPV, died from CO2 narcosis several months after discharge. All patients adhered to the respiratory regimen once instituted. Conclusions Acute respiratory failure in chronic myopathy is heralded by daytime drowsiness. IPPV, or at least regular monitoring of waking and sleeping partial pressure of carbon dioxide, is highly recommended even if weaning is successful. IPPV improved quality of life. The treatment strategy at discharge from the ICU should be optimal, as patients are reluctant to modify regimens.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709559
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Indicators of dysautonomia in severe Guillain-Barré syndrome (1999)
    Springer
    Journal of neurology 246 (1999), S. 1015-1022 
    Details
    ISSN: 1432-1459
    Keywords: Key words Polyneuritis ; Autonomic dysfunction ; Intensive ; care ; Cardiac arrest ; Blood pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract This study sought to establish quantitative criteria for dysautonomia in artificially ventilated patients with Guillain-Barré syndrome (GBS). Such criteria would help to identify patients at risk for cardiovascular complications. This retrospective controlled clinical study compared hourly cardiovascular monitoring data from 36 successive, artificially ventilated GBS patients with that from 11 artificially ventilated control patients with myasthenia. Tolerance limits for daily means, extremes, and variations in heart rate (HR) and blood pressure (BP) were estimated from the most abnormal subgroups of the treatment days of our control patients. These exceeded previously suggested arbitrary cutoff values for dysautonomia. The range in systolic BP was increased in 27 GBS patients, despite an upper limit of normal (85 mmHg) that was double the value suggested in previous work. All 16 patients with mean systolic BP above 165 mm Hg also had persistent tachycardia (mean HR 〉 125 bpm), or were treated with β-blockers. This pattern of sympathetic hyperactivity was combined with probable vagal hyperactivity (bradycardia 〈 48 bpm) in 6 patients. Hypotension (minimal systolic BP 〈 85 mm Hg) and unprovoked bradycardia indicated sympathetic hypoactivity in 3 patients. Except in one patient who suffered from asystole on his first day on the ICU, all episodes of bradycardia were preceded by increased daily systolic BP variation (〉 85 mm Hg), which thus proved to be a sensitive and prognostically valuable indicator of dysautonomia in GBS.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004150050506
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
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