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Acute respiratory distress syndrome: nationwide changes in incidence, treatment and mortality over 23 years.

https://arctichealth.org/en/permalink/ahliterature118376
Source
Acta Anaesthesiol Scand. 2013 Jan;57(1):37-45
Publication Type
Article
Date
Jan-2013
Author
M I Sigurdsson
K. Sigvaldason
T S Gunnarsson
A. Moller
G H Sigurdsson
Author Affiliation
Department of Anaesthesia and Intensive Care Medicine, Landspitali University Hospital, Reykjavik, Iceland. gislihs@landspitali.is
Source
Acta Anaesthesiol Scand. 2013 Jan;57(1):37-45
Date
Jan-2013
Language
English
Publication Type
Article
Keywords
APACHE
Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Child
Child, Preschool
Female
Follow-Up Studies
Hospital Mortality
Humans
Iceland - epidemiology
Infant
Intensive Care
Logistic Models
Male
Middle Aged
Positive-Pressure Respiration
Prognosis
Respiratory Distress Syndrome, Adult - epidemiology - mortality - therapy
Respiratory Function Tests
Respiratory Insufficiency - epidemiology - etiology
Sex Factors
Survival
Survival Analysis
Young Adult
Abstract
The aim of this study was to assess population-based changes in incidence, treatment, and in short- and long-term survival of patients with acute respiratory distress syndrome (ARDS) over 23 years.
Analysis of all patients in Iceland who fulfilled the consensus criteria for ARDS in 1988-2010. Demographic variables, Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and ventilation parameters were collected from hospital charts.
The age-standardised incidence of ARDS during the study period was 7.2 cases per 100,000 person-years and was increased by 0.2 cases per year (P?
Notes
Comment In: Acta Anaesthesiol Scand. 2013 Jan;57(1):1-223216359
PubMed ID
23216361 View in PubMed
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Anaesthetic practice and postoperative pulmonary complications.

https://arctichealth.org/en/permalink/ahliterature222795
Source
Acta Anaesthesiol Scand. 1992 Nov;36(8):812-8
Publication Type
Article
Date
Nov-1992
Author
T. Pedersen
J. Viby-Mogensen
C. Ringsted
Author Affiliation
Department of Anaesthesia, Herlev Hospital, University of Copenhagen, Denmark.
Source
Acta Anaesthesiol Scand. 1992 Nov;36(8):812-8
Date
Nov-1992
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Anesthesia Recovery Period
Anesthesia, Conduction - methods
Anesthesia, General - methods
Atracurium - administration & dosage
Bupivacaine - administration & dosage
Denmark - epidemiology
Humans
Incidence
Lung Diseases - epidemiology
Lung Diseases, Obstructive - physiopathology
Middle Aged
Pancuronium - administration & dosage
Pneumonia - epidemiology
Postoperative Complications - epidemiology
Prospective Studies
Pulmonary Atelectasis - epidemiology
Respiratory Insufficiency - epidemiology
Risk factors
Surgical Procedures, Operative
Time Factors
Abstract
The aim of this study was to identify risk factors associated with postoperative pulmonary complications. The influence of the anaesthetic technique was evaluated (i.e. general contra regional anaesthesia and long contra intermediately acting muscle relaxants (pancuronium and atracurium)) taking into account the patient's age, the presence or absence of chronic obstructive lung disease (preoperative risk factors), the type of surgery and the duration of anaesthesia (perioperative risk factors). Seven thousand and twenty-nine patients undergoing abdominal, urological, gynaecological or orthopaedic surgery were included in the study. A total of 290 patients (4.1%) suffered from one or more postoperative pulmonary complications. Six thousand and sixty-two patients received general anaesthesia and 4.5% of these had postoperative pulmonary complications. Of the patients admitted to major surgery receiving pancuronium, 12.7% (135/1062) developed postoperative pulmonary complications, compared to only 5.1% (23/449) receiving atracurium (P
PubMed ID
1466220 View in PubMed
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The association between tracheostomy and sternal wound infection in postoperative cardiac surgery patients.

https://arctichealth.org/en/permalink/ahliterature114185
Source
Can J Anaesth. 2013 Jul;60(7):684-91
Publication Type
Article
Date
Jul-2013
Author
Louise Sun
Munir Boodhwani
Heather Baer
Bernard McDonald
Author Affiliation
Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, K1Y 4W7, Canada.
Source
Can J Anaesth. 2013 Jul;60(7):684-91
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Aged
Cardiac Surgical Procedures - statistics & numerical data
Female
Follow-Up Studies
Humans
Incidence
Intensive Care
Intubation, Intratracheal - statistics & numerical data
Male
Middle Aged
Myocardial Revascularization - statistics & numerical data
Ontario - epidemiology
Operative Time
Patient Admission
Reoperation
Respiration, Artificial - statistics & numerical data
Respiratory Insufficiency - epidemiology
Retrospective Studies
Risk factors
Sternotomy - statistics & numerical data
Surgical Wound Dehiscence - epidemiology
Surgical Wound Infection - epidemiology
Tracheostomy - statistics & numerical data
Abstract
To investigate whether tracheostomy increases the risk of sternal wound infection (SWI) post cardiac surgery.
All patients undergoing cardiac surgery via median sternotomy from September 1997 to October 2010 were included in this retrospective observational study. Primary exposure was tracheostomy performed during admission to the cardiac surgical intensive care unit. The primary outcome was SWI during hospital admission. Multivariable logistic regression was used to determine if tracheostomy was an independent predictor of SWI. Restriction and propensity score analyses were then used to assess if tracheostomy is a causal risk factor for SWI.
Four hundred and eleven of 18,845 patients (2.2%) were treated with tracheostomy. Incidences of SWI in tracheostomy and non-tracheostomy groups were 19.5% (80/411) and 0.8% (154/18,434), respectively. Using multivariable logistic regression analysis, tracheostomy was found to be an independent predictor of SWI (odds ratio [OR] 2.8; 95% confidence interval [CI] 1.9 to 4.2). In an analysis restricted to respiratory failure patients, tracheostomy was associated with sternal wound infection (OR 3.4; 95% CI 2.4 to 4.9). When the analysis was stratified by the risk of receiving tracheostomy as represented by propensity score (PS), 46 patients (12%) in the intermediate risk category (PS 0.2-0.4) had SWIs (adjusted OR 2.97; 95% CI 1.6 to 5.6), and 52 patients (14%) in the highest risk category (PS > 0.4) had SWIs (OR 1.52; 95% CI 0.85 to 2.87).
Our single-centre observational study of cardiac surgery patients found tracheostomy to be an independent risk factor for SWI. Our analysis showed a robust association when restricted to patients with respiratory failure and after the population was stratified by the propensity to have a tracheostomy.
Notes
Comment In: Can J Anaesth. 2013 Jul;60(7):625-923625549
PubMed ID
23640661 View in PubMed
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Chronic airways obstruction leading to chronic hypoxemic respiratory failure: an estimate of the size and trend of the problem in Canada.

https://arctichealth.org/en/permalink/ahliterature226312
Source
Bull Int Union Tuberc Lung Dis. 1991 Jun-Sep;66(2-3):113-23
Publication Type
Article
Author
D A Enarson
S C Newman
R L Fan
C. Macarthur
Author Affiliation
Division of Pulmonary Medicine, University of Alberta, Edmonton, Canada.
Source
Bull Int Union Tuberc Lung Dis. 1991 Jun-Sep;66(2-3):113-23
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cause of Death
Cohort Studies
Cross-Sectional Studies
Humans
Lung Diseases, Obstructive - complications - epidemiology - mortality
Prevalence
Prognosis
Respiratory Insufficiency - epidemiology - etiology - mortality
Risk factors
Abstract
Chronic airways obstruction is a common cause of morbidity and mortality in Canada. It may progress to hypoxic respiratory failure and then to death. Only a few studies of the prevalence of chronic airways obstruction have been reported from Canada, but a number of studies have been reported from the United States and the United Kingdom, countries with similar socioeconomic conditions and ethnic compositions to those in Canada. The prevalence of chronic airflow limitation in these studies averages 9.3%. In each study, tobacco smoke exposure is the most prominent etiologic agent. Other contributing factors identified in the studies are air pollution, occupational exposure, respiratory infections and childhood respiratory illness. Endogenous modifiers of these risk factors demonstrated in the published studies include age, elevated peripheral blood leukocyte count and familial factors. Although epidemiologic studies have been able to identify the prevalence of functional impairment associated with chronic airways obstruction, risk factors associated with its development and modifiers of these risk factors, it is not possible to determine the prevalence of severe chronic airways obstruction resulting in hypoxemic respiratory failure. An estimate of this prevalence has been calculated based on certain assumptions. It was assumed that patients dying of chronic airways obstruction were likely, in a high proportion of cases, to have hypoxemic respiratory failure. It has been demonstrated that only one-half of all patients dying of chronic airways obstruction are correctly designated on death certificates. It was assumed, conservatively, that the median survival of patients with hypoxemic respiratory failure is two years. From these assumptions, it was estimated that the prevalence of hypoxemic respiratory failure in 1986 in Canada was 100 per 100,000 population. This is higher than the present rate of oxygen therapy, indicating that some patients currently eligible for this treatment may not be receiving it.
PubMed ID
1756292 View in PubMed
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Community-acquired pneumonia requiring admission to an intensive care unit: a descriptive study.

https://arctichealth.org/en/permalink/ahliterature164148
Source
Medicine (Baltimore). 2007 Mar;86(2):103-11
Publication Type
Article
Date
Mar-2007
Author
Thomas J Marrie
M Reza Shariatzadeh
Author Affiliation
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada. tom.marrie@ualberta.ca
Source
Medicine (Baltimore). 2007 Mar;86(2):103-11
Date
Mar-2007
Language
English
Publication Type
Article
Keywords
APACHE
Adolescent
Adult
Age Factors
Aged
Anti-Bacterial Agents - therapeutic use
Blood Glucose - analysis
Canada - epidemiology
Community-Acquired Infections - drug therapy - epidemiology - microbiology
Creatinine - blood
Female
Humans
Intensive Care Units
Intubation, Intratracheal
Length of Stay
Male
Middle Aged
Multivariate Analysis
Patient Admission - statistics & numerical data
Pneumonia - drug therapy - epidemiology - microbiology
Prospective Studies
Pulmonary Disease, Chronic Obstructive - epidemiology
Respiration
Respiration, Artificial
Respiratory Insufficiency - epidemiology - etiology - therapy
Severity of Illness Index
Shock - epidemiology
Smoking - epidemiology
Abstract
Severe community-acquired pneumonia (CAP) requiring admission to an intensive care unit (ICU) has been inadequately studied. We compared characteristics and outcomes of patients with CAP who were admitted to the ICU with those of patients managed on the ward. Of the 3675 patients hospitalized with CAP, 374 (10%) were admitted to the ICU. The main reason for ICU admission was respiratory failure requiring intubation and ventilation (n = 303, 81%), although this indication decreased with increasing age (p 24 breaths per minute. Patients with low Pneumonia Severity Index scores and low CURB-65 scores were admitted to the ICU based on clinical judgment that appeared to supersede objective scoring. Severe CAP requiring admission to the ICU is common, and the decision about which patients to admit often requires clinical judgment that in many cases appears at odds with various validated pneumonia severity scoring systems.
PubMed ID
17435590 View in PubMed
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Contributions to the epidemiology of acute respiratory failure.

https://arctichealth.org/en/permalink/ahliterature183992
Source
Crit Care. 2003 Aug;7(4):288-90
Publication Type
Article
Date
Aug-2003
Author
Klaus Lewandowski
Author Affiliation
Klinik für Anästhesiologie und operative Intensivmedizin, Charité, Campus Virchow-Klinikum, Medizinische Fakultät der Humboldt-Universität zu Berlin, Berlin, Germany. klaus.lewandowski@charite.de
Source
Crit Care. 2003 Aug;7(4):288-90
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Critical Illness
Germany - epidemiology
Hospital Mortality
Humans
Intensive Care Units
Multiple Organ Failure
Norway
Prospective Studies
Respiratory Insufficiency - epidemiology - mortality - physiopathology
Severity of Illness Index
Treatment Outcome
Notes
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Comment On: Crit Care. 2003 Aug;7(4):R7212930559
PubMed ID
12930552 View in PubMed
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Elective cesarean delivery, neonatal intensive care unit admission, and neonatal respiratory distress.

https://arctichealth.org/en/permalink/ahliterature157981
Source
Obstet Gynecol. 2008 Apr;111(4):823-8
Publication Type
Article
Date
Apr-2008
Author
Wendy Yee
Harish Amin
Stephen Wood
Author Affiliation
Department of Pediatrics, University of Calgary, Calgary Alberta, Canada. wendy.yee@calgaryhealthregion.ca
Source
Obstet Gynecol. 2008 Apr;111(4):823-8
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Cesarean Section - statistics & numerical data
Female
Gestational Age
Humans
Infant, Newborn
Intensive Care Units, Neonatal - statistics & numerical data
Length of Stay
Patient Admission - statistics & numerical data
Pregnancy
Respiratory Insufficiency - epidemiology
Retrospective Studies
Sex Factors
Surgical Procedures, Elective
Abstract
To evaluate the relationship among gestational age at elective cesarean delivery, neonatal intensive care unit (NICU) admission, and whether the presence of pre-cesarean delivery labor or ruptured membranes affected the incidence of neonatal respiratory distress.
A chart review was performed of all elective caesarean deliveries (documented planned in advance) during 1 year, 2004-2005, in the Calgary Health Region; resulting in liveborn infants at or after 36 weeks of gestation and birth weight equal to or greater than 2,500 g. The primary outcomes are relative risk of NICU admission or respiratory distress.
A total of 1,193 paired maternal and infant charts were reviewed. Admission rate to the NICU was 156 of 1,195 (13.1%). The most common admitting diagnosis was respiratory distress, 126 of 156 (80%). Male gender was a significant risk factor for admission to the NICU or respiratory distress (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.27-2.60, and OR 1.98, 95% CI 1.33-2.95, respectively). Elective cesarean delivery beyond 270 days of gestational age (38(4/7) weeks) significantly reduced the risk for NICU admission or respiratory distress (OR 0.62, 95% CI 0.43-0.89, and OR 0.50, 95% CI 0.34-0.74, respectively). The presence of spontaneous contractions or rupture of membranes before elective cesarean delivery did not reduce the risk of NICU admission or respiratory distress (OR 1.05, 95% CI 0.69-1.62, and OR 0.96, 95% CI 0.60-1.55, respectively).
Admission to NICU and development of respiratory distress were associated with gestational age at time of elective cesarean delivery and male gender. Awaiting the onset of labor or ruptured membranes did not appear to reduce the risk of NICU admission or neonatal respiratory distress.
Notes
Comment In: Obstet Gynecol. 2008 Jul;112(1):183-4; author reply 18418591324
Comment In: Obstet Gynecol. 2008 Apr;111(4):810-118378737
PubMed ID
18378740 View in PubMed
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Estimated prevalences of respiratory symptoms, asthma and chronic obstructive pulmonary disease related to detection rate in primary health care.

https://arctichealth.org/en/permalink/ahliterature15499
Source
Scand J Prim Health Care. 2001 Mar;19(1):54-7
Publication Type
Article
Date
Mar-2001
Author
M. Hasselgren
M. Arne
A. Lindahl
S. Janson
B. Lundbäck
Author Affiliation
Centre for Public Health Research, University of Karlstad, Sweden. mikael.hasselgren@swipnet.se
Source
Scand J Prim Health Care. 2001 Mar;19(1):54-7
Date
Mar-2001
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Asthma - epidemiology - physiopathology
Cross-Sectional Studies
Female
Humans
Lung Diseases, Obstructive - epidemiology - physiopathology
Male
Middle Aged
Population Surveillance
Prevalence
Primary Health Care - standards - statistics & numerical data
Research Support, Non-U.S. Gov't
Respiratory Insufficiency - epidemiology
Sweden - epidemiology
Abstract
OBJECTIVE: To assess the prevalence of respiratory symptoms, asthma and chronic obstructive pulmonary disease (COPD), and to relate it to an estimated detection rate in primary health care. DESIGN: A two-staged study with a cross-sectional survey and a clinical validation. SETTING: The adult population of Värmland, a county in Sweden. SUBJECTS: 4814 persons completed the survey and 206 the confirmative validation study. MAIN OUTCOME MEASURES: Prevalence of respiratory symptoms, of asthma and COPD. RESULTS: More than 40% reported respiratory symptoms. Wheeze was reported by 8.0%, shortness of breath by 11.4% and sputum production by 14.1%. Smoking was more common among women than among men. The prevalence of asthma was 8.2% and COPD 2.1%. Of persons with asthma, 33% were estimated to be undiagnosed, 67% used medication and nearly 60% attended primary health care services. CONCLUSION: Respiratory symptoms as well as asthma were common in this study and equivalent to earlier findings. The difference between the epidemiologically estimated prevalence of asthma and the lower detection rate in primary health care can be explained by at least three factors: persons who did not seek any care, were underdiagnosed or attended other health care providers.
PubMed ID
11303549 View in PubMed
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Gene expression analysis in induced sputum from welders with and without airway-related symptoms.

https://arctichealth.org/en/permalink/ahliterature140568
Source
Int Arch Occup Environ Health. 2011 Jan;84(1):105-13
Publication Type
Article
Date
Jan-2011
Author
Lena S Jönsson
Jørn Nielsen
Karin Broberg
Author Affiliation
Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University Hospital, 221 85, Lund, Sweden.
Source
Int Arch Occup Environ Health. 2011 Jan;84(1):105-13
Date
Jan-2011
Language
English
Publication Type
Article
Keywords
Adult
Gene Expression - genetics
Humans
Inflammation - genetics
Male
Microarray Analysis
Middle Aged
Occupational Exposure - adverse effects
Oxidative Stress
Polymerase Chain Reaction
Respiratory Insufficiency - epidemiology - etiology - genetics
Sputum
Sweden
Welding
Young Adult
Abstract
To identify changes in gene expression in the airways among welders, with and without lower airway symptoms, working in black steel.
Included were 25 male, non-smoking welders. Each welder was sampled twice; before exposure (after vacation), and after 1 month of exposure. From the welders (14 symptomatic, of whom 7 had asthma-like symptoms), RNA from induced sputum was obtained for gene expression analysis. Messenger RNA from a subset of the samples (n = 7) was analysed with microarray technology to identify genes of interest. These genes were further analysed using quantitative PCR (qPCR; n = 22).
By comparing samples before and after exposure, the microarray analysis resulted in several functional annotation clusters: the one with the highest enrichment score contained "response to wounding", "inflammatory response" and "defence response". Seven genes were analysed by qPCR: granulocyte colony-stimulating factor 3 receptor (CSF3R), superoxide dismutase 2, interleukin 8, glutathione S-transferase pi 1, tumour necrosis factor alpha-induced protein 6 (TNFAIP6), interleukin 1 receptor type II and matrix metallopeptidase 25 (MMP25). Increased levels of CSF3R, TNFAIP6 and MMP25 were indicated among asthmatic subjects compared to non-symptomatic subjects, although the differences did not reach significance.
Workers' exposure to welding fumes changed gene expression in the lower airways in genes involved in inflammatory and defence response. Thus, microarray and qPCR technique can demonstrate markers of exposure to welding fumes and possible disease-related markers. However, further studies are needed to verify genes involved and to further characterise the mechanism for welding fumes-associated lower airway symptoms.
PubMed ID
20862590 View in PubMed
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33 records – page 1 of 4.