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In cases of overdose leading to respiratory arrest, the recommended treatment according to the 2015 American Heart Association guidelines is to administer intramuscular or intranasal naloxone at an initial dose of 0.04-0.4 mg. Dosing may be repeated up to 2 mg if initial dose is ineffective.
The treatment of acute respiratory failure may involve medication such as bronchodilators (for airways disease), [7] [8] antibiotics (for infections), glucocorticoids (for numerous causes), diuretics (for pulmonary oedema), amongst others. [1] [9] [10] Respiratory failure resulting from an overdose of opioids may be treated with the antidote ...
The permissive hypercapnia leads to respiratory acidosis which might have negative side effects, but given that the patient is in ARDS, improving ventilatory function is more important. Since hypoxemia is a major life-threatening condition and hypercapnia is not, one might choose to accept the latter. Hence the term, "permissive hypercapnia."
Acute respiratory distress syndrome (ARDS) is a type of respiratory failure characterized by rapid onset of widespread inflammation in the lungs. [1] Symptoms include shortness of breath (dyspnea), rapid breathing (tachypnea), and bluish skin coloration (cyanosis). [1] For those who survive, a decreased quality of life is common. [4]
Treatment is focused on three aspects: improving respiratory function, treating the underlying cause, and; preventing further damage and allow full recovery to the lung. Pulmonary edema can cause permanent organ damage, and when sudden (acute), can lead to respiratory failure or cardiac arrest due to hypoxia. [7]
In the past, the drug doxapram (a respiratory stimulant), was used for hypercapnia in acute exacerbation of chronic obstructive pulmonary disease but there is little evidence to support its use compared to NIV, [24] and it does not feature in recent professional guidelines. [12] Very severe respiratory failure, in which hypercapnia may also be ...
In these instances, oxygen therapy may decrease respiratory drive, leading to accumulation of carbon dioxide (hypercapnia), acidemia, and increased mortality secondary to respiratory failure. [25] Improved outcomes have been observed with titrated oxygen treatment largely due to gradual improvement of the ventilation/perfusion ratio. [26]
This registry based, multi-center, multi-country data provide provisional support for the use of ECMO for COVID-19 associated acute hypoxemic respiratory failure. Given that this is a complex technology that can be resource intense, guidelines exist for the use of ECMO during the COVID-19 pandemic. [85] [86] [87]
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