Influenza and Other Respiratory Virus Weekly Activity Report, October 18, 2008, Week 43

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, October 18, 2008, Week 42

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, October 11, 2008, Week 41

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, May 29, 2009, revised Week 20

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, May 30, 2009, revised Week 21

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, June 13, 2009, revised Week 23

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, June 6, 2009, Week 22

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, June 27, 2009, Week 25

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, June 20, 2009, Week 24

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, July 4, 2009, Week 26

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Influenza and Other Respiratory Virus Weekly Activity Report, July 11, 2009, Week 27

Weekly report of the Iowa Influenza Surveillance Network produced by the Iowa Department of Public Health.

Interactions between respiration and systemic hemodynamics. Part II: practical implications in critical care.

In Part I of this review, we have covered basic concepts regarding cardiorespiratory interactions. Here, we put this theoretical framework to practical use. We describe mechanisms underlying Kussmaul's sign and pulsus paradoxus. We review the literature on the use of respiratory variations of blood pressure to evaluate volume status. We show the possibilities of attaining the latter aim by investigating with ultrasonography how the geometry of great veins fluctuates with respiration. We provide a Guytonian analysis of the effects of PEEP on cardiac output. We terminate with some remarks on the potential of positive pressure breathing to induce acute cor pulmonale, and on the cardiovascular mechanisms that at times may underly the failure to wean a patient from the ventilator.

Décubitus ventral et syndrome de détresse respiratoire aiguë de l'adulte: de la théorie à la pratique [Prone position mechanical ventilation in the Acute Respiratory Distress syndrome: theoretical and practical considerations].

Mortality of the acute respiratory distress syndrome (ARDS) remains extremely high and only few evidence-based specific treatments are currently available. Protective mechanical ventilation has emerged as the comer stone of the management of ARDS to avoid the occurrence of ventilation-induced lung injuries (VILI). Mechanical ventilation in the prone position has often been considered as a rescue therapy reserved to refractory hypoxemia. Since the publication of the PROSEVA study in 2013, early prone positioning for mechanical ventilation should be recommended to improve survival of patients with severe ARDS. In this article, both the theoretical and practical aspects of mechanical ventilation in prone position are reviewed.

Which clinical signs predict hypoxaemia in young Senegalese children with acute lower respiratory tract disease?

BACKGROUND: Acute lower respiratory tract diseases are an important cause of mortality in children in resource-limited settings. In the absence of pulse oximetry, clinicians rely on clinical signs to detect hypoxaemia. OBJECTIVE: To assess the diagnostic value of clinical signs of hypoxaemia in children aged 2 months to 5 years with acute lower respiratory tract disease. METHODS: Seventy children with a history of cough and signs of respiratory distress were enrolled. Three experienced physicians recorded clinical signs and oxygen saturation by pulse oximetry. Hypoxaemia was defined as oxygen saturation <90%. Clinical predictors of hypoxaemia were evaluated using adjusted diagnostic odds ratios (aDOR). RESULTS: There was a 43% prevalence of hypoxaemia. An initial visual impression of poor general status [aDOR 20·0, 95% CI 3·8-106], severe chest-indrawing (aDOR 9·8, 95% CI 1·5-65), audible grunting (aDOR 6·9, 95% CI 1·4-25) and cyanosis (aDOR 26·5, 95% CI 1·1-677) were significant predictors of hypoxaemia. CONCLUSION: In children under 5 years of age, several simple clinical signs are reliable predictors of hypoxaemia. These should be included in diagnostic guidelines.