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Boyko VV, Tkachenko VV, Sochnieva AL, Kritsak VV. Modern view on the problem of acute pleural empyema surgical treatment. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:327-337. [PMID: 38592997 DOI: 10.36740/wlek202402121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Aim: data study on the results of treatment of acute non-specific purulent-destructive pleura diseases with the purpose of further improvement of its results on the basis of improvement of diagnostics, identification of factors of disease prognosis and by implementing differential tactics of surgical treatment with the use of minimally invasive interventions. PATIENTS AND METHODS Materials and Methods: We have studied modern literary sources on the topic of current trends in the treatment of acute pleural empyema and its complications. The studied material is summarized and presented in the form of a literature review in this article. CONCLUSION Conclusions: These issues cannot be considered to be completely solved and require further study. Everything mentioned above dictates the search of new effective methods of the treatment of the mentioned pathology and proves the relevance of the theme. The outlined information highlights the necessity of improvement of surgical tactics in patients with pleural empyema.
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Affiliation(s)
- Valeriy V Boyko
- KHARKIV NATIONAL MEDICAL UNIVERSITY, KHARKIV, UKRAINE; SI "ZAITSEV INSTITUTE OF GENERAL AND EMERGENCY SURGERY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE", KHARKIV, UKRAINE
| | - Vladimir V Tkachenko
- EDUCATIONAL AND SCIENTIFIC MEDICAL INSTITUTE OF THE NATIONAL TECHNICAL UNIVERSITY ≪KHARKIV POLYTECHNIC INSTITUTE≫, KHARKIV, UKRAINE
| | - Anastasiia L Sochnieva
- EDUCATIONAL AND SCIENTIFIC MEDICAL INSTITUTE OF THE NATIONAL TECHNICAL UNIVERSITY ≪KHARKIV POLYTECHNIC INSTITUTE≫, KHARKIV, UKRAINE
| | - Vasyl V Kritsak
- SI "ZAITSEV INSTITUTE OF GENERAL AND EMERGENCY SURGERY OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE", KHARKIV, UKRAINE; EDUCATIONAL AND SCIENTIFIC MEDICAL INSTITUTE OF THE NATIONAL TECHNICAL UNIVERSITY ≪KHARKIV POLYTECHNIC INSTITUTE≫, KHARKIV, UKRAINE
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Kleiven AL, Markussen HØ, Skjønsberg OH, Janssens JP, Aarrestad S. Effect of Respiratory Events on Health-Related Quality of Life in Patients Treated with Long-Term Noninvasive Ventilation. Respiration 2022; 101:1099-1109. [PMID: 36353785 PMCID: PMC9808888 DOI: 10.1159/000527066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-term noninvasive ventilation (NIV) can increase or maintain health-related quality of life (HRQoL) for patients with chronic hypercapnic respiratory failure (CHRF). Evidence from studies systematically assessing how NIV-specific factors influence HRQoL is limited. OBJECTIVES The objective of this study was to describe HRQoL measured by the Severe Respiratory Insufficiency Questionnaire (SRI) in patients with CHRF treated with long-term NIV and to analyze the associations between HRQoL and hypoxemia, hypercapnia, and respiratory events such as apneas, hypopneas (AHI), and patient ventilator asynchrony (PVA) occurring during long-term NIV. METHODS We included sixty-seven stable patients with established long-term NIV due to neuromuscular disease or thoracic cage disorders in a prospective cross-sectional study at Oslo University Hospital. Patients answered the SRI and underwent daytime arterial blood gases, nocturnal pulse oximetry, sleep polygraphy, and nocturnal transcutaneous CO2. RESULTS The mean global SRI for 62 patients was 64.8 ± 14.5, with the highest score in SRI Social Relationships (79.5 ± 15.6). There were no differences in HRQoL between the different patient groups. Compliant patients had a significantly higher score in SRI Attendant and Sleep. Residual nocturnal hypoxemia affected both the subscale SRI "Respiratory Complaints" and SRI "Attendant Symptoms and Sleep." Persisting daytime hypercapnia, nocturnal hypoventilation, and high AHI affected the subscale SRI "Anxiety" negatively, while frequent PVA was associated with a lower score in SRI "Physical Function." CONCLUSION In a group of patients with long-term NIV, undesired respiratory events during NIV are associated with lower HRQoL in several of the SRI subscales. We suggest designing interventional studies to confirm the possible relationship between HRQoL and respiratory events during long-term NIV.
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Affiliation(s)
- Anne Louise Kleiven
- Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway,*Anne Louise Kleiven,
| | - Heidi Øksnes Markussen
- Western Norway University of Applied Sciences, Bergen, Norway,Department of Thoracic Medicine, Haukeland University Hospital, Bergen, Norway
| | - Ole Henning Skjønsberg
- Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jean-Paul Janssens
- Division of Pulmonary Diseases, Geneva University Hospital, Genève, Switzerland
| | - Sigurd Aarrestad
- Department of Pulmonary Medicine, Oslo University Hospital, Oslo, Norway
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Ribeiro C, Jácome C, Oliveira P, Conde S, Windisch W, Nunes R. Patients experience regarding home mechanical ventilation in an outpatient setting. Chron Respir Dis 2022; 19:14799731221137082. [PMID: 36417310 PMCID: PMC9706049 DOI: 10.1177/14799731221137082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The patient's experience of treatment is a cornerstone of high-quality healthcare, along with clinical safety and effectiveness. We aimed to evaluate the patients' perspectives regarding home mechanical ventilation (HMV) follow up in an outpatient setting and ascertain differences between patients that started HMV in the outpatient setting compared to other settings. METHODS This cross-sectional study was conducted with patients with chronic respiratory failure under HMV in the Outpatient Ventilation Clinic. Patients filled in a patient experience questionnaire and the S3-NIV questionnaire. RESULTS The study included 235 patients (127, 54% male), median 70 [25-75 percentiles 64-76] years) and about half were adapted to HMV in the outpatient setting (117, 49.8%). Patients had a daily ventilator usage of 8.0 [6.0-10.0] hours and have been on ventilator for a median of 35.0 [12.0-66.0] months. Patients reported an overall good experience regarding education at initiation (209 [88.9%] considered the information given was enough), short time to adaptation [104 (44.3%) felt adapted after some hours], with perceived benefits (171 [72.8%] reported less shortness of breath, 158 (67.2%) improved quality of life and 150 (63.8%) less tiredness). Benefits overcame the treatment side-effects (158 [67.2%] reported mucosal dryness, 109 (46.4%) mask sores and 96 (40.9%) leaks). There was no difference in terms of reported health gains, side effects or time to adaptation between adaptation settings, but patients starting HMV in the outpatient setting reported better communication and education at adaptation. CONCLUSIONS Outpatient setting was perceived as a positive experience, both in HMV initiation and follow up, with good patient-physician communication leading to significant health reported gains, improvement of health status and well-being and good treatment adherence.
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Affiliation(s)
- Carla Ribeiro
- Pulmonology Department,
Centro
Hospitalar de Vila Nova de
Gaia/Espinho, Vila Nova de Gaia, Portugal,Carla Ribeiro, Pulmonology Department,
Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes s/n,
Vila Nova de Gaia 4434-502, Portugal.
| | - Cristina Jácome
- CINTESIS@RISE, MEDCIDS,
Faculty of
Medicine of the University of Porto,
Porto, Portugal
| | - Pedro Oliveira
- ISPUP-EPI Unit, Instituto de
Ciências Biomédicas de Abel Salazar, Universidade do
Porto, Portugal
| | - Sara Conde
- Pulmonology Department,
Centro
Hospitalar de Vila Nova de
Gaia/Espinho, Vila Nova de Gaia, Portugal
| | - Wolfram Windisch
- Faculty of Health/School of
Medicine, Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt
Köln gGmbH, Witten/Herdecke University, Cologne,
Germany
| | - Rui Nunes
- Faculty of Medicine,
University
of Porto, Porto, Portugal
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Ribeiro C, Jácome C, Castro L, Conde S, Windisch W, Nunes R. Long-term health-related quality of life in patients on home mechanical ventilation. BMC Pulm Med 2022; 22:433. [DOI: 10.1186/s12890-022-02236-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022] Open
Abstract
Abstract
Background
It is fundamental to optimize and retain health-related quality of life (HRQoL) in the long term in patients with home mechanical ventilation (HMV). Therefore, this study aimed to evaluate the evolution of the HRQoL in patients already established on HMV across a period of 5 years and whether the HRQoL is associated with mortality.
Methods
This was a 5-year longitudinal cohort study conducted in an Outpatient Ventilation Clinic. Consecutive patients on HMV for at least 30 days responded to the Severe Respiratory Insufficiency (SRI) questionnaire at inclusion and again at 5 years.
Results
A total of 104 patients were included (male 56.7%, median age 69 [P25;P75] [61;77] years). Almost half of the patients had COPD (49.0%). Patients were on HMV for a median of 43.5 [22;85.5] months, with overall good adherence (median 8 [6;9] daily hours). Fifty-seven (54.8%) patients were alive at 5 years. In surviving patients, the only difference with statistical significance was in the attendant symptoms and sleep subscale, with patients scoring 7.1 [-4.5;25] points higher in the final questionnaire (p = 0.002). Survivors had significantly better scores in the SRI at inclusion than deceased patients (median 59.6 [49.2;71.7] vs 48.7 [38.4;63.2]; p = 0.004).
Conclusions
These results shows that HRQoL remains stable in surviving patients with HMV at five years. It also suggests that SRI can be of important prognostic value and help predict the terminal phase of the disease course in patients with long-term HMV.
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Jacobs JM, Marcus EL, Stessman J. Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life. J Am Med Dir Assoc 2021; 22:1242-1247. [PMID: 32907755 PMCID: PMC7474963 DOI: 10.1016/j.jamda.2020.07.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Although prolonged mechanical ventilation (PMV) is increasingly common, little is known concerning patient symptom burden or attitudes toward PMV. This study aims to describe the mood, well-being, distressing symptoms, and attitudes toward prolonged ventilation among PMV patients treated either at home or long-term acute care (LTAC). DESIGN An observational study. SETTING AND PARTICIPANTS 62 communicative participants treated with PMV, aged ≥18 years, insurees of a single HMO, treated at home hospital or LTAC specializing in ventilation in Jerusalem. MEASURES Sociodemographic characteristics; chronic conditions; functional status; symptom burden measured by revised Edmonton Symptomatic Assessment System (r-ESAS); attitudes toward PVM. RESULTS Participants were aged 61.7 ± 20.7 years, commonly suffered progressive neuromuscular disease (43.5%) or chronic lung disease (29%), were functionally dependent, treated at home (64.5%) or LTAC (35.5%), and had a mean PMV duration of 36.6 months (interquartile range 10.8-114.1). The 5-item, short Geriatric Depression Scale identified depression among 38% of participants, and was less at home vs LTAC (34% vs 44%, P < .001). Mean revised Edmonton Symptom Assessment System score was 24.5 ± 14.8 (maximum severity = 100), and participants reported severe or distressing symptoms for tiredness (27%/20%), pain (10%/25%), anxiety (16%/14%), depression (9%/21%), drowsiness (12%/17%), shortness of breath (9%/15%), poor appetite (7%/9%), and nausea (0%/10%). Impaired general well-being was reported as severe, moderate, mild, or none among 15%, 40%, 30%, and 15%, respectively. Only 1 patient had advance directives concerning ventilation prior to intubation, and when asked if they had to choose again today, 85% of patients would again opt for ventilation. CONCLUSIONS AND IMPLICATIONS Few PMV patients reported distressing symptoms, and 85% would choose ventilation if asked again. These findings might be useful in clinical practice to assist in decision making concerning prolonged ventilation.
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Affiliation(s)
- Jeremy M Jacobs
- Institute of Geriatric Medicine, Clalit Health Services, Jerusalem, Israel; Department of Geriatrics and Geriatric Rehabilitation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Institute for Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Esther-Lee Marcus
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Chronic Ventilator-Dependent Division, Herzog Medical Center, Jerusalem, Israel
| | - Jochanan Stessman
- Institute of Geriatric Medicine, Clalit Health Services, Jerusalem, Israel; Department of Geriatrics and Geriatric Rehabilitation, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Institute for Aging Research, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Laxe S, Miangolarra Page JC, Chaler J, Gil Fraguas L, Gómez A, Luna F, Llavona R, Del Pino-Algarrada R, Salaverría Izaguirre N, Sanchez Tarifa P, Santandreu ME, Garreta R. [Rehabilitation in the time of COVID-19]. Rehabilitacion (Madr) 2020; 54:149-153. [PMID: 32441268 PMCID: PMC7151338 DOI: 10.1016/j.rh.2020.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022]
Affiliation(s)
- S Laxe
- Servicio de Rehabilitación, Hospital Clínic de Barcelona, Barcelona, España.
| | - J C Miangolarra Page
- Departamento de Medicina Física y Rehabilitación, Universidad Rey Juan Carlos, Madrid, España; Servicio de Rehabilitación y Medicina Física del Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - J Chaler
- Servicio de Rehabilitación, Egarsat, Terrassa, Barcelona, España; Physiotherapy Barcelona, Universitat de Girona-Universitat de Barcelona, Campus de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - L Gil Fraguas
- Rehabilitación, Gerencia de Atención Integrada de Guadalajara, Universidad de Alcalá de Henares (UAH), Alcalá de Henares, Madrid, España
| | - A Gómez
- Servicio Rehabilitación, Hospital Dr. Negrín de Gran Canaria, Las Palmas de Gran Canaria, España
| | - F Luna
- Área de Musculoesquelético, Dolor e Intervencionismo UGC Interniveles de Rehabilitación, Hospital Regional Universitario de Málaga, Málaga, España
| | - R Llavona
- Instituto Médico Ramón y Cajal, Gijón, Asturias, España
| | - R Del Pino-Algarrada
- Servicio de Rehabilitación, Hospital Universitario Puerta del Mar, Cádiz, España
| | - N Salaverría Izaguirre
- Servicio de Medicina física y rehabilitación, Hospital Universitario Donostia, Donostia, Guipúzcoa, España
| | - P Sanchez Tarifa
- Servicio de Rehabilitación, Hospital Universitario Puerta del Mar, Cádiz, España
| | - M E Santandreu
- Servicio de Rehabilitación del Complejo Hospitalario Insular y Materno Infantil, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, España
| | - R Garreta
- Servicio de Medicina física y rehabilitación, Hospital Mútua de Terrassa, Servicio de Medicina física y rehabilitación, Egarsat, Terrassa, Barcelona, España
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Réveillère C. Clinique : Qualité de vie. Med Sci (Paris) 2019; 35 Hors série n° 2:49. [DOI: 10.1051/medsci/2019186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Psychosocial Interventions for Patients with Severe COPD-An Up-to-Date Literature Review. ACTA ACUST UNITED AC 2019; 55:medicina55090597. [PMID: 31527553 PMCID: PMC6780939 DOI: 10.3390/medicina55090597] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/31/2019] [Accepted: 09/09/2019] [Indexed: 12/26/2022]
Abstract
Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a life limiting condition with a long list of serious psychosocial consequences, aggravating with illness progression. In advanced stages, chronic respiratory failure often develops, which might undermine mental health and reduce activity. The study objective was to review the recent studies concerning psychosocial interventions dedicated to patients with severe COPD. Materials and Methods: The PubMed database was searched for terms, such as ‘COPD and long-term oxygen therapy, non-invasive ventilation, severe or respiratory failure’ and ‘psychological or psychosocial or mental health and intervention.’ Studies were included that described patients with stable, severe COPD and the outcomes of psychosocial interventions. Results and Conclusions: Thirty-four studies were identified and divided into four thematic groups: home medical support, exercise, self-management and mental health. The number of studies that focused on mental health preservation in severe COPD was very limited; i.e., none refer directly to those treated with respiratory failure. Improving patients’ self-efficacy gave promising effects to the acceptance of palliative care, pulmonary rehabilitation completion and mental health. Physical activity might be recommended to be included in interventions for mental health enhancement, although little is known about the role of the particular forms of exercise. An increasing beneficial use of new technologies for psychosocial interventions was noted. Psychosocial interventions applied in advanced COPD underline the roles of self-efficacy, telehealth and physical activity in physical and mental health preservation. However, all of the above elements need to be independently tested on more homogenous groups of patients and have the possible modes of their treatment analysed.
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