Management of Respiratory Failure

Lamba, Tejpreet; Sharara, Rihab; Leap, Jennifer; Singh, Anil

doi:10.1097/cnq.0000000000000103

Cited by 5 publications

(3 citation statements)

References 57 publications

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“…The causes of ARF can be categorized into lung parenchymal disease, airway obstruction, and neuromuscular dysfunction ( Friedman and Nitu, 2018 ). In the ICU, impaired gas exchange following pulmonary infection has been found to be the most common cause of ARF ( Singh Lamba et al., 2016 ). Patients with ARF tend to experience infections caused by several organisms at the same time ( Zarrinfar et al., 2013 ).…”

Section: Introductionmentioning

confidence: 99%

A Microbial World: Could Metagenomic Next-Generation Sequencing Be Involved in Acute Respiratory Failure?

Huang

Chen

Ding

et al. 2021

Front. Cell. Infect. Microbiol.

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BackgroundThe usefulness of metagenomic next-generation sequencing (mNGS) in identifying pathogens is being investigated. We aimed to compare the power of microbial identification between mNGS and various methods in patients with acute respiratory failure.MethodsWe reviewed 130 patients with respiratory failure, and 184 specimens including blood, bronchoalveolar lavage fluid (BALF), sputum, pleural effusion, ascitic fluid, and urine were tested by mNGS and conventional methods (culture, PCR). We also enrolled 13 patients to evaluate the power of mNGS and pathogen targets NGS (ptNGS) in microbial identifications. Clinical features and microbes detected were analyzed.ResultsmNGS outperformed the conventional method in the positive detection rate of Mycobacterium tuberculosis (MTB) (OR, ∞; 95% CI, 1–∞; P < 0.05), bacteria (OR, 3.7; 95% CI, 2.4–5.8; P < 0.0001), fungi (OR, 4.37; 95% CI, 2.7–7.2; P < 0.0001), mycoplasma (OR, 10.5; 95% CI, 31.8–115; P = 0.005), and virus (OR, ∞; 95% CI, 180.7–∞; P < 0.0001). We showed that 20 patients (28 samples) were detected with Pneumocystis jirovecii (P. jirovecii) by mNGS, but not by the conventional method, and most of those patients were immunocompromised. Read numbers of Klebsiella pneumoniae (K. pneumoniae), Acinetobacter baumannii (A. baumannii), Pseudomonas aeruginosa (P. aeruginosa), P. jirovecii, cytomegalovirus (CMV), and Herpes simplex virus 1 (HSV1) in BALF were higher than those in other sample types, and the read number of Candida albicans (C. albicans) in blood was higher than that in BALF. We found that orotracheal intubation and type 2 diabetes mellitus (T2DM) were associated with a higher detection rate of bacteria and virus by mNGS, immunosuppression was associated with a higher detection rate of fungi and virus by mNGS, and inflammatory markers were associated with mNGS-positive detection rate of bacteria. In addition, we observed preliminary results of ptNGS.ConclusionmNGS outperformed the conventional method in the detection of MTB, bacteria, fungi, mycoplasma, and virus. Orotracheal intubation, T2DM, immunosuppression, and inflammatory markers were associated with a higher detection rate of bacteria, fungi, and virus by mNGS. In addition, ptNGS results were consistent with the detection of abundant bacteria, fungi, and mycoplasma in our specimens.

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Section: Introductionmentioning

confidence: 99%

A Microbial World: Could Metagenomic Next-Generation Sequencing Be Involved in Acute Respiratory Failure?

Huang

Chen

Ding

et al. 2021

Front. Cell. Infect. Microbiol.

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“…Se manifiesta por insuficiencia respiratoria aguda (IRA) definida como la incapacidad aguda del pulmón para mantener una adecuada oxigenación de la sangre con o sin trastorno concomitante en la eliminación de C0 2 . En la mayoría de casos, los niveles arteriales de 0 2 y C0 2 se mantienen bajos, por lo que es necesario instaurar una adecuada ventilación con oxígeno suministrado por una mascarilla o bigotera [14][15][16] . Por lo anterior, el paciente cursa con hipoxemia, hipercapnia, aumento del trabajo respiratorio, cambios hemodinámicos y eventuales trastornos de conciencia y signos de una disfunción respiratoria crítica.…”

Section: Atención Al Paciente Crítico Cardiovascularunclassified

Certificación y especialización en enfermería crítica

Castrillón¹,

Padilla²,

Armijos³

et al. 2018

Rev Fac Cien Med (Quito)

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“…Acute respiratory failure (ARF) is a commonly distressing condition in critically ill patients with increased incidence ( 1 ). The common causes of ARF include pneumonia, sepsis, heart failure, and chronic obstructive pulmonary disease (COPD) ( 1 , 2 ). In most cases, patients with ARF present in conditions not suitable for the establishment of accurate diagnosis at the early stage of illness, which may compromise the outcomes ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis Accuracy of Lung Ultrasound for ARF in Critically Ill Patients: A Systematic Review and Meta-Analysis

et al. 2021

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Background: Acute respiratory failure (ARF) is a commonly distressing condition in critically ill patients. Its early recognition and treatment may improve clinical outcomes. Mounting evidence suggests that lung ultrasound (LUS) could be an alternative to chest X-ray (CXR) or computed tomography (CT) for the diagnosis of ARF in critically ill patients. This meta-analysis aimed to determine whether LUS can be an alternative tool used to investigate the cause of ARF or thoracic pathologies associated with the diagnosis of ARF in critically ill patients.Method: A systematic literature search of the PubMed, Web of Science, Embase, and Cochrane Library databases was conducted from inception to March 2020. Two researchers independently screened studies investigating the accuracy of LUS with CXR or CT for adult critically ill patients with ARF. Data with baseline, true positives, false positives, false negatives, and true negatives were extracted. The study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The pooled sensitivity and specificity were obtained using a bivariate model.Results: Eleven studies, including 1,232 patients, were included in the meta-analysis. Most studies were of low quality. LUS had a pooled sensitivity of 92% (95% confidence interval [CI]: 85–96) and a pooled specificity of 98% (95% CI: 94–99). The area under the summary receiver operating characteristic curve was 98% (95% CI: 97–99). The sensitivity and specificity of LUS to identify different pathological types of ARF were investigated. For consolidation (1,040 patients), LUS had a sensitivity of 89% and a specificity of 97%. For pleural effusion (279 patients), LUS had a pooled sensitivity of 95% and a specificity of 99%. For acute interstitial syndrome (174 patients), LUS had a pooled sensitivity of 95% and a specificity of 91%.Conclusions: LUS is an adjuvant tool that has a moderate sensitivity and high specificity for the diagnosis of ARF in critically ill patients.Systematic Review Registration: The study protocol was registered with PROSPERO (CRD42020211493).

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Management of Respiratory Failure

Cited by 5 publications

References 57 publications

A Microbial World: Could Metagenomic Next-Generation Sequencing Be Involved in Acute Respiratory Failure?

A Microbial World: Could Metagenomic Next-Generation Sequencing Be Involved in Acute Respiratory Failure?

Certificación y especialización en enfermería crítica

Diagnosis Accuracy of Lung Ultrasound for ARF in Critically Ill Patients: A Systematic Review and Meta-Analysis

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