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MeSH Disease

Human Phenotype


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    Experience of N-acetylcysteine airway management in the successful treatment of one case of critical condition with COVID-19

    Authors: Yan Liu; Guoshi Luo; Xin Qian; Chenglin Wu; Yijun Tang; kun lu; Biyu Chen; Elaine Lai-Han Leung; Meifang Wang

    doi:10.21203/ Date: 2020-06-08 Source: ResearchSquare

    Object: To report the successful diagnosis and treatment of a patient with critical condition of novel coronavirus pneumonia MESHD pneumonia HP (COVID-19) and to summarize its clinical features and airway management experience in successful treatment.Methods: Retrospectively analyzed the successful management of one case of COVID-19 with critical condition combined respiratory failure HP respiratory failure MESHD and discussed the clinical characteristics and airway management of the patient in conjunction with a review of the latest literature.Results: A patient with an anastomotic fistula MESHD after radical treatment of esophageal cancer MESHD and right-side encapsulated pyopneumothorax was admitted with cough HP and dyspnea HP dyspnea MESHD and was diagnosed with novel coronavirus pneumonia MESHD pneumonia HP and malnutrition HP malnutrition MESHD by pharyngeal swab nucleic acid test in combination with chest CT. The patient was treated with antibiotics, antiviral and antibacterial medications, respiratory support, expectorant nebulization, and nutritional support, expressed progressive deterioration. Endotracheal intubation and mechanical ventilation were performed since the onset of the type Ⅱ respiratory failure HP on the 13th day of admission. The patient had persistent refractory hypercapnia HP hypercapnia MESHD after mechanical ventilation. Based on the treatment mentioned above, combined with repeated bronchoalveolar lavage by using N-acetylcysteine ​​(NAC) inhalation solution, the patient's refractory hypercapnia HP hypercapnia MESHD was gradually improved. It was cured and discharged after being given the mechanical ventilation for 26 days as well as 46 days of hospitalization, currently is surviving well.Conclusion: Patients with severe conditions of novel coronavirus pneumonia MESHD pneumonia HP often encounter bacterial infection MESHD in their later illness-stages. They may suffer respiratory failure HP respiratory failure MESHD and refractory hypercapnia HP hypercapnia MESHD that is difficult to improve due to excessive mucus secretion leading to small airway obstruction. In addition to the use of reasonable antibiotics and symptomatic respiratory support and other treatment, timely artificial airway and repeated bronchoalveolar NAC inhalation solution lavage, expectorant and other airway management are essential for such patients.

    Feasibility of non-invasive nitric oxide inhalation in acute hypoxic respiratory failure MESHD respiratory failure HP: potential role during the COVID-19 pandemic

    Authors: Kiran Shekar; Sneha Varkey; George Cornmell; Leanne Parsons; Maneesha Tol; Matthew Siuba; Mahesh Ramanan

    doi:10.1101/2020.05.17.20082123 Date: 2020-05-20 Source: medRxiv

    Acute hypoxemic respiratory failure MESHD respiratory failure HP ( ARF MESHD) is characterized by both lower arterial oxygen and carbon dioxide tensions in the blood SERO. First line treatment for ARF MESHD includes oxygen therapy,intially admininstered non invasively using nasal prongs, high flow nasal cannulae or masks. Invasive mechancial ventilation (IMV) is usually reserved for patients who are unable to maintain their airway, those with worsening hypoxemia HP hypoxemia MESHD, or those who develop respiratory muscle fatigue MESHD fatigue HP and consequent hypercapnia HP hypercapnia MESHD. Inhaled nitric oxide (iNO) gas is known to improve oxygenation in patients with ARF MESHD by manipulating ventilation-perfusion matching. Addition of iNO may potentially alleviate the need for IMV MESHD in selected patients. This article demonstrates the feasibility of this technique based on our experience of patients with hypoxemic ARF MESHD. This technique may also be considered for patients with hypoxic ARF MESHD in setting of COVID-19.

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MeSH Disease
Human Phenotype

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