Inflammatory Markers in Patients Using Domiciliary Non-invasive Mechanical Ventilation: C Reactive Protein, Procalcitonin, Neutrophil Lymphocyte Ratio

Aim: Early identification and treatment of infections in patients using domiciliary non-invasive mechanical ventilation (NIMV) due to chronic respiratory failure (CRF) can reduce hospital admissions. We assessed C-reactive protein (CRP), procalcitonin, and neutrophil lymphocyte ratio (NLR) as indicators of infection/inflammation.Methods: The study was designed as a retrospective, observational, cross-sectional study, and was performed in 2016 in an intensive care unit outpatient clinic in patients using NIMV. Patients who came to the outpatient clinic with dyspnea, increased sputum, increased prothrombin, and who had hemogram, procalcitonin, and serum CRP, NLR, and PLT/MPV levels assessed, were enrolled into the study. Demographic characteristics, co-morbid diseases, respiratory symptoms, hemogram, biochemistry, CRP, and procalcitonin values in stable and acute attack patients were recorded from patient files. The descriptive statistics and CRP, NLR, and procalcitonin values were assessed.Results: During the study period, 49 patients (24 female) with chronic obstructive pulmonary disease (COPD, n = 24), obesity hypoventilation syndrome (OHS, n = 15), or interstitial lung disease, n = 10), and having had three inflammatory markers assessed, were included in the study. Their mean age was 67 (SD ± 12). Stable patients vs. those who had an acute attack was 41 vs. eight, and within 7 days of outpatient admission four patients were hospitalized. CRP, NLR, and PLT/MPV values were similar in patients' who had sputum purulence, and an increase in dyspnea and sputum, but procalcitonin was significantly higher in patients who had an acute attack. Procalcitonin was not correlated with CRP, NLR, and PLT/MPV.Conclusions: Patients with CRF had similar levels of CRP and NLR during a stable and acute attack state. Procalcitonin may be a better marker for therapeutic decisions in advanced chronic inflammatory diseases

Hiperkarbik Solunum Yetmezliğinde Noninvaziv Mekanik Ventilasyon Başarısızlığı ve Başarısızlığın Uzun Dönem Takip Sonuçları

Amaç: Akut solunum yetmezliğinde noninvaziv mekanik ventilasyon (NIMV) kullanımı önemli bir seçenek haline gelmiştir. Bu çalışmanın amacı hiperkarbik solunum yetmezliği (HSY)’nde NIMV başarısızlık sebepleri ve takip sonuçlarının değerlendirilmesidir.Gereç ve Yöntemler: Geriye dönük gözlemsel kohort çalışma üçüncü basamak göğüs hastalıkları hastanesinin yoğun bakım ünitesinde yapıldı. HSY ile NIMV başarısızlığı olan Ocak-Aralık 2016 arasındaki tüm hastalar çalışmaya alındı. Erken ve geç NIMV başarısızlığı olan gruplarda demografik özellikler, yoğun bakım verileri ve mortalite incelendi. Verilerin analizinde uygun istatistiksel test ve analizler kullanıldı.Bulgular: Çalışmaya alınan 218 hastanın büyük çoğunluğu (n=158, %72,5) kronik obstrüktif akciğer hastalığı idi. Olguların %56’sında erken dönem NIMV başarısızlığı görülmekteydi. En sık görülen başarısızlık nedenleri asidozun devam etmesi veya derinleşmesi ve parsiyel karbondioksit basıncında artış olmasıydı. Mortalite, yoğun bakımda %20, taburculuk sonrası 28 günde ise %9 olarak saptandı. NIMV başarısızlığını asidozun devam etmesinin 4,1 kat (%95 güven aralığı (GA) 1,711-9,882; p=0,002), hava yolunu koruyamamanın 10,4 kat (%95 GA 1,224-89,264; p=0,032), bilinç bulanıklığının ise 2,3 kat (%95 GA 1,023-5,295; p=0,044) artırdığı bulundu.Sonuç: Bu çalışmada olguların yarısında erken NIMV başarısızlığı görülmüş olup en sık başarısızlık sebeplerinin ise asidozun devam etmesi ve parsiyel karbondioksit basıncında artma olduğu bulundu. Yoğun bakım ve 28 günlük mortaliteler değerlendirildiğinde, NIMV başarısızlığı olan hastaların yoğun bakımdan taburcu olduktan sonra da yakın takip edilmesi gerektiği düşünülmektedir

Determination of Attitudes of Turkish Thoracic Society Members on Exposure to Sexist Approach and Sexism in Business Life

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEWOS: 000455567104196European Respiratory So

Respiratory symptoms and pulmonary functions before and after pesticide application in cotton farming

Ojective To investigate respiratory health problems related to pesticide exposure in the inhabitants of agricultural areas. Material and methods This study included 252 participants prior to pesticide application and 66 participants from the first group after pesticide application across four cotton farms. Symptom questionnaires were filled out by participants and respiratory function tests were measured before and after pesticide exposure. In addition, PM 10 , PM 2.5 , air temperature, and humidity were measured in all four farming villages before and after pesticide administration. Results PM 10 and PM 2.5 levels were significantly increased after pesticide application. After pesticide application, all participants’ nose, throat, eye, and respiratory complaints increased significantly. Expected forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) percentage values decreased significantly. The rates of FVC and FEV1 values lower than 80% were 23.5% and 22%, espectively, before pesticide application, and this rate increased to 42.4% and 43.1%, respectively, after pesticide application. There was a significant negative correlation between PM 10 levels and FVC, FEV1, and PEF values. After PM 2.5 pesticide application, the risk of experiencing burning in the mouth, nose, and throat increased by 2.3-fold (OR: 2.316), 2.6-fold for burning symptoms in the eyes (OR: 2.593), 2.1-fold for wheezing (OR: 2.153), and 2.2-fold for chest tightness (OR: 2.211). With increased PM 10 levels, the risk of chest tightness increased 1.1-fold (OR: 1.123). Conclusions After pesticide administration, the respiratory health of the participants deteriorated. Performing pesticide applications in agriculture with harmless methods is the most important measure to be taken to protect public healt

The relationship between particulate matter and childhood respiratory complaints and peak expiratory flows in Harran agricultural area

Background. In recent years, many studies have evaluated the increasing incidence of asthma and chronic respiratory diseases among children living close to rural areas with pesticide application. Pesticide exposure in 266 children (126 girls and 140 boys) in Sanliurfa, a cotton-producing province in Turkey, was explored in this work. Four different villages spread over 40 km(2) were included. Methods. Measurements of peak expiratory flow (PEF) in 266 children were conducted in late June, before intensive pesticide applications in the cotton-producing fields. The measurements were repeated for 72 of 266 children after pesticide application in late August. PEF, particulate matter with diameter less than 2.5 mu m (PM2.5), particulate matter with diameter less than 10 mu m (PM10), temperature, humidity, and wind speed were measured. Results. After pesticide application, mean PM2.5 and PM10 values were significantly increased compared to before pesticide application (p < 0.001 for both parameters). After pesticide exposure, nasal discharge, sneezing, burning and itching in the eyes, cough, sputum production, wheezing, shortness of breath and chest tightness were significantly increased (p < 0.001). The mean PEF value was demonstrated to decrease significantly after pesticide application (p < 0.001). Moreover, significant negative correlations were noted between PEF and PM10 and between PEF and PM2.5 (p < 0.001). Conclusions. Intensive pesticide application causes respiratory dysfunction and increased respiratory complaints in children living near the affected agricultural areas, and impacts quality of life adversely. The results of this work can be used to develop an early warning system and methods to prevent respiratory disorders in children residing in the study area.Turkish Thoracic SocietyThe authors wish to express their thanks to the Turkish Thoracic Society for providing financial support for this work.WOS:0006461794000102-s2.0-85105220171PubMed: 3392911

A multicenter randomized trial for the effectiveness of structured discharge and follow-up protocol on readmission rate in COPD patients receiving LTOT/NIV: one-year interim analysis.

28th International Congress of the European-Respiratory-Society (ERS) -- SEP 15-19, 2018 -- Paris, FRANCEWOS: 000455567101063European Respiratory So