Download or read book Ventilation non invasive chez des patients insuffisants respiratoires d tiologie neuromusculaire written by Lucie Griffon and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : L'efficacité de la ventilation non invasive est établie pour contrôler l'hypoventilation alvéolaire dans l'insuffisance respiratoire chronique des patients neuromusculaires. Les critères de mise en route de la ventilation non invasive ont été définis pour chaque maladie neuromusculaire par l'HAS. Ils reposent sur des paramètres cliniques et fonctionnels.Objectifs : Décrire les caractéristiques des patients neuromusculaires bénéficiant d'une mise en route de ventilation non invasive (VNI) dans notre service pendant une période de 15 ans, évaluer le respect des recommandations dans nos pratiques, évaluer l'efficacité et l'observance à 3 et 6 mois de la VNI et l'influence de nos pratiques sur la survie.Méthodes : Dans une étude de cohorte rétrospective de janvier 2001 à décembre 2015, nous avons recueilli les anomalies cliniques et fonctionnelles présentes à la mise en route de la ventilation non invasive ainsi que ses modalités, son efficacité et la survie chez 173 patients neuromusculaires au stade de l'insuffisance respiratoire. Résultats : Dans notre cohorte, 115 patients avaient une maladie neuromusculaire rapidement progressive de l'adulte, 38 une maladie lentement progressive de l'adulte et 20 une maladie lentement progressive de l'enfant. La mise en route de ventilation s'est faite en situation aigue chez 33 patients (19%) et l'indication a été posée sur la présence d'une hypercapnie aux gaz du sang à l'état stable chez 63 patients (37%). Les critères de mise en route étaient conformes aux recommandations de l'HAS de 2006 chez 118 patients (68,2%). L'évolution de nos pratiques au cours des années montre une tendance à une installation plus précoce de la ventilation non invasive en tenant davantage compte des anomalies de la fonction respiratoire (CVF à 39,5% [28,8-46,8] avant 2007 contre une CVF à 55% [42-71] après 2007; p

Download or read book Ventilation non invasive VNI au long cours chez les patients insuffisants respiratoires chroniques written by Jean Morin (Pneumologue).) and published by . This book was released on 2016 with total page 96 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction Le nombre de patients traités par ventilation non invasive (VNI) à domicile pour une insuffisance respiratoire chronique (IRC) ne cesse de progresser. Les indications historiques de mise sous VNI au long cours (IRC restrictives et pathologies neuromusculaires NM) ont été largement supplantées par le syndrome obésité hypoventilation (SOH) et par la bronchopneumopathie chronique obstructive (BPCO), avec des résultats controversés. Dix ans après les dernières grandes études de cohorte, nous avons évalué la qualité de vie et la survie de ces patients ventilés à domicile. Méthodes : Cette étude de cohorte prospective multicentrique a étudié l’efficacité de la VNI au long cours sur la survie et la qualité de vie, évaluée par le questionnaire Medical Outcome Study 36-item Short-Form Health Survey (SF-36) administré à l'initiation de la VNI puis au 4e et au 12e mois. Résultats : Entre septembre 2009 et décembre 2015, 451 patients traités par VNI au long cours ont été inclus et classés selon 9 diagnostics d’IRC hyercapnique : BPCO (n=56), BPCO obèses (n=107), SOH (n=161), NM (n=35), scléroses latérales amyotrophiques (SLA) (n=41), déformations de la paroi thoracique (n=20), séquelles de tuberculose ou de chirurgie (n=7), paralysies phréniques (n=15), bronchectasies (n= 9). Le taux de survie global à 4 ans est de 66% dans cette cohorte. Les patients NM ont eu la meilleure survie. Aucune différence de survie n’a été décelée entre les groupes BPCO, BPCO obèses et SOH. Les patients porteurs d’une SLA ont eu une mortalité supérieure aux autres. La VNI n’a pas eu d'influence significative sur la qualité de vie des patients BPCO durant la 1ère année. Elle a amélioré les 8 dimensions du SF-36 et le score moyen mental chez les patients SOH, 5 dimensions du SF-36 chez les patients BPCO obèses (p

Download or read book Variation du volume courant estim au cours de la ventilation non invasive au long cours chez les patients insuffisants respiratoires chroniques written by Marie Gauvrit and published by . This book was released on 2020 with total page 144 pages. Available in PDF, EPUB and Kindle. Book excerpt: Il n'existe pas à ce jour de consensus quant à l'adaptation des niveaux de pressions à utiliser en VNI au long cours. Les sociétés savantes préconisent de cibler un volume courant de 8 à 10 ml/kg de poids idéal théorique, sans que cette cible n'ait été confirmée par des essais randomisés. Dans la cohorte nantaise des patients insuffisants respiratoires chroniques ventilés en non invasif au long cours, avec pour objectif une normalisation du bilan gazeux artériel et de l'oxymétrie nocturne, le volume courant estimé obtenu est variable selon les étiologies. Dans le cadre d'une ventilation non invasive avec pour objectif l'obtention d'un volume courant cible, il semble pertinent d'adapter cet objectif selon l'étiologie de l'insuffisance respiratoire : 8 ml/kg pour les patients neuromusculaires, 9 ml/kg pour les patients BPCO, >10 ml/kg pour les patients SOH et les patients BPCO obèses.

Download or read book Ventilation domicile chez les patients atteints d une maladie neuromusculaire tude des patients suivis pendant 10 ans dans les cantons de Gen ve et Vaud written by and published by . This book was released on with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Les patients atteints de maladies neuromusculaires impliquant les muscles respiratoires décèdent le plus souvent d'une insuffisance respiratoire aiguë précipitée par une infection, faisant très souvent suite à une insuffisance respiratoire chronique le plus fréquemment symptomatique. La ventilation mécanique à domicile est une technique qui a connu un essor important au cours des années 80 et qui permet d'augmenter de manière importante la survie de la plupart de ces patients, de soulager les symptômes liés à l'insuffisance respiratoire et d'améliorer ainsi significativement la qualité de vie. Ce travail rapporte l'expérience de 10 ans de ventilation à domicile chez des patients atteints de maladies neuromusculaires dans les cantons de Genève et Vaud. Il décrit les caractéristiques fonctionnelles des patients au moment de l'introduction de la ventilation, et leur devenir. Il aborde les buts et les implications éthiques de la ventilation dans ce groupe de malades.

Download or read book Pocket Book of Hospital Care for Children written by World Health Organization and published by World Health Organization. This book was released on 2013 with total page 442 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Pocket Book is for use by doctors nurses and other health workers who are responsible for the care of young children at the first level referral hospitals. This second edition is based on evidence from several WHO updated and published clinical guidelines. It is for use in both inpatient and outpatient care in small hospitals with basic laboratory facilities and essential medicines. In some settings these guidelines can be used in any facilities where sick children are admitted for inpatient care. The Pocket Book is one of a series of documents and tools that support the Integrated Managem.

Download or read book Oxygen Therapy for Children written by World Health Organization and published by . This book was released on 2016 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Hypoxaemia is a major contributor to child deaths that occur worldwide each year; for a child with pneumonia hypoxaemia increases the risk of death by up to 5 times. Despite its importance in virtually all types of acute severe illness, hypoxaemia is often not well recognized or well managed, more so in settings where resources are limited. Oxygen therapy remains an inaccessible luxury for a large proportion of severely ill children admitted to hospitals in developing countries. This is particularly true for patients in small district hospitals, where, even if some facility for delivering oxygen is available, supplies are often unreliable and the benefits of treatment may be diminished by poorly maintained, inappropriate equipment or poorly trained staff with inadequate guidelines. Increasing awareness of these problems is likely to have considerable clinical and public health benefits in the care of severely ill children. Health workers should be able to know the clinical signs that suggest the presence of hypoxaemia and have more reliable means of detection of hypoxeamia. This can be achieved through more widespread use of pulse oximetry, which is a non-invasive measure of arterial oxygen saturation. At the same time oxygen therapy must be more widely available; in many remote settings, this can be achieved by use of oxygen concentrators, which can run on regular or alternative sources of power. Having effective systems for the detection and management of hypoxaemia are vital in reducing mortality from pneumonia and other severe acute illnesses. Oxygen therapy is essential to counter hypoxaemia and many times is the difference between life and death. This manual focuses on the availability and clinical use of oxygen therapy in children in health facilities by providing the practical aspects for health workers, biomedical engineers, and administrators. It addresses the need for appropriate detection of hypoxaemia, use of pulse oximetry, clinical use of oxygen and delivery systems and monitoring of patients on oxygen therapy. In addition, the manual addresses practical use of pulse oximetry, and oxygen concentrators and cylinders in an effort to improve oxygen systems worldwide."--Publisher's description.

Download or read book Lung Development written by Claude Gaultier and published by Springer. This book was released on 2013-05-27 with total page 464 pages. Available in PDF, EPUB and Kindle. Book excerpt: Knowledge about the mechanisms of lung development has been growing rapidly, especially with regard to cellular and molecular aspects of growth and differentiation. This authoritative international volume reviews key aspects of lung development in health and disease by providing a comprehensive review of the complex series of cellular and molecular interactions required for lung development. It covers such topics as pulmonary hypoplasia, effects of malnutrition, and pulmaonary angiogenesis. An indispensable reference for all those involved in studying or treating lung disease in neonates and children, the book offers a unique view of the development of this essential organ.

Download or read book Chest Physical Therapy and Pulmonary Rehabilitation written by Donna L. Frownfelter and published by . This book was released on 1987 with total page 860 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Operative Surgery written by Paul F. Nora and published by W B Saunders Company. This book was released on 1990 with total page 1412 pages. Available in PDF, EPUB and Kindle. Book excerpt: A comprehensive discussion of the principles and techniques of clinical surgery in a text/atlas combination. Major sections on thoracic surgery, paediatric surgery, and lower alimentary tract and para-alimentary tract surgery are included.

Download or read book Pulmonary Physiology written by Emile M. Scarpelli and published by . This book was released on 1990 with total page 520 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Handbook of ICU EEG Monitoring written by Suzette LaRoche and published by Demos Medical Publishing. This book was released on 2012-12-20 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pearls and take-home points highlighted in every chapter.

Download or read book Primary Pediatric Care written by Robert A. Hoekelman and published by Mosby Incorporated. This book was released on 2000-10-01 with total page 1936 pages. Available in PDF, EPUB and Kindle. Book excerpt: -- An outstanding offer, both the New Hoekelman book & CD! -- Important new information at your fingertips, whether at the office or home.

Download or read book Introduction to Clinical Examination written by Michael J. Ford and published by Elsevier Health Sciences. This book was released on 2005-01-01 with total page 190 pages. Available in PDF, EPUB and Kindle. Book excerpt: The most important core skills for medical students to master are history taking and clinical examination. This extensively revised, eighth edition has been written with the philosophy that the acquisition of clinical skills is most effectively undertaken at the bedside. This pocketbook should be used as a companion, to be taken onto the wards and into consulting rooms where the information is most needed. The book begins with a system of history taking followed by a new chapter on the analysis of key symptoms. The remaining chapters cover physical examination of each of the major systems. Each stage of the examination starts with a detailed, step-by-step description of the examination method complemented by relevant illustrations, diagrams and tables on the facing page. This book is intended primarily for use at the outset of clinical training; once students have achieved proficiency in the basic skills of interviewing and examining, the book should also prove useful for revision. An invaluable starter book concentrating purely on the fundamentals of performing a patient examination. Covers each body system and outlines the principles of: - taking a history - how to conduct a physical examination - specific examination points as appropriate Concentrates only on the main symptoms of disease and then the normal and abnormal physical findings. Mention of specific diseases is confined to those most commonly encountered. Compact and pocket-sized to be carried around easily. · Now in full colour double-page format · Clear simple colour line drawings covering the essentials of a clinical examination. · Published simultaneously with the Eleventh Edition of Macleod's Clinical Examination

Download or read book The Brompton Hospital Guide to Chest Physiotherapy written by and published by Wiley-Blackwell. This book was released on 1977 with total page 112 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Interventional Pulmonology written by J.. Strausz and published by . This book was released on 2010 with total page 317 pages. Available in PDF, EPUB and Kindle. Book excerpt: