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RESPIRATORY DISTRESS and Penicillin

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RESPIRATORY DISTRESS Symptoms and Causes

What is respiratory failure?

Respiratory failure is a condition in which your blood doesn't have enough oxygen or has too much carbon dioxide. Sometimes you can have both problems.

When you breathe, your lungs take in oxygen. The oxygen passes into your blood, which carries it to your organs. Your organs, such as your heart and brain, need this oxygen-rich blood to work well.

Another part of breathing is removing the carbon dioxide from the blood and breathing it out. Having too much carbon dioxide in your blood can harm your organs.

What causes respiratory failure?

Conditions that affect your breathing can cause respiratory failure. These conditions may affect the muscles, nerves, bones, or tissues that support breathing. Or they may affect the lungs directly. These conditions include

  • Lung diseases such as COPD (chronic obstructive pulmonary disease), cystic fibrosis, pneumonia, and pulmonary embolism
  • Conditions that affect the nerves and muscles that control breathing, such as amyotrophic lateral sclerosis (ALS), muscular dystrophy, spinal cord injuries, and stroke
  • Problems with the spine, such as scoliosis (a curve in the spine). They can affect the bones and muscles used for breathing.
  • Damage to the tissues and ribs around the lungs. An injury to the chest can cause this damage.
  • Drug or alcohol overdose
  • Inhalation injuries, such as from inhaling smoke (from fires) or harmful fumes
What are the symptoms of respiratory failure?

The symptoms of respiratory failure depend on the cause and the levels of oxygen and carbon dioxide in your blood.

A low oxygen level in the blood can cause shortness of breath and air hunger (the feeling that you can't breathe in enough air). Your skin, lips, and fingernails may also have a bluish color. A high carbon dioxide level can cause rapid breathing and confusion.

Some people who have respiratory failure may become very sleepy or lose consciousness. They also may have arrhythmia (irregular heartbeat). You may have these symptoms if your brain and heart are not getting enough oxygen.

How is respiratory failure diagnosed?

Your health care provider will diagnose respiratory failure based on

  • Your medical history
  • A physical exam, which often includes
    • Listening to your lungs to check for abnormal sounds
    • Listening to your heart to check for arrhythmia
    • Looking for a bluish color on your skin, lips, and fingernails
  • Diagnostic tests, such as
    • Pulse oximetry, a small sensor that uses a light to measure how much oxygen is in your blood. The sensor goes on the end of your finger or on your ear.
    • Arterial blood gas test, a test that measures the oxygen and carbon dioxide levels in your blood. The blood sample is taken from an artery, usually in your wrist.

Once you are diagnosed with respiratory failure, your provider will look for what is causing it. Tests for this often include a chest x-ray. If your provider thinks you may have arrhythmia because of the respiratory failure, you may have an EKG (electrocardiogram). This is simple, painless test that detects and records your heart's electrical activity.

What are the treatments for respiratory failure?

Treatment for respiratory failure depends on

  • Whether it is acute (short-term) or chronic (ongoing)
  • How severe it is
  • What is causing it

Acute respiratory failure can be a medical emergency. You may need treatment in intensive care unit at a hospital. Chronic respiratory failure can often be treated at home. But if your chronic respiratory failure is severe, you might need treatment in a long-term care center.

One of the main goals of treatment is to get oxygen to your lungs and other organs and remove carbon dioxide from your body. Another goal is to treat the cause of the condition. Treatments may include

  • Oxygen therapy, through a nasal cannula (two small plastic tubes that go in your nostrils) or through a mask that fits over your nose and mouth
  • Tracheostomy, a surgically-made hole that goes through the front of your neck and into your windpipe. A breathing tube, also called a tracheostomy, or trach tube, is placed in the hole to help you breathe.
  • Ventilator, a breathing machine that blows air into your lungs. It also carries carbon dioxide out of your lungs.
  • Other breathing treatments, such as noninvasive positive pressure ventilation (NPPV), which uses mild air pressure to keep your airways open while you sleep. Another treatment is a special bed that rocks back and forth, to help you breathe in and out.
  • Fluids, often through an intravenous (IV), to improve blood flow throughout your body. They also provide nutrition.
  • Medicines for discomfort
  • Treatments for the cause of the respiratory failure. These treatments may include medicines and procedures.

If you have respiratory failure, see your health care provider for ongoing medical care. Your provider may suggest pulmonary rehabilitation.

If your respiratory failure is chronic, make sure that you know when and where to get help for your symptoms. You need emergency care if you have severe symptoms, such as trouble catching your breath or talking. You should call your provider if you notice that your symptoms are worsening or if you have new signs and symptoms.

Living with respiratory failure may cause fear, anxiety, depression, and stress. Talk therapy, medicines, and support groups can help you feel better.

NIH: National Heart, Lung, and Blood Institute

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RESPIRATORY DISTRESS Clinical Trials and Studies

Treatments might be new drugs or new combinations of drugs, new surgical procedures or devices, or new ways to use existing treatments. The goal of clinical trials is to determine if a new test or treatment works and is safe. Clinical trials can also look at other aspects of care, such as improving the quality of life for people with chronic illnesses. People participate in clinical trials for a variety of reasons. Healthy volunteers say they participate to help others and to contribute to moving science forward. Participants with an illness or disease also participate to help others, but also to possibly receive the newest treatment and to have the additional care and attention from the clinical trial staff.
Rank Status Study
1 Recruiting Oral Penicillin and Penicillin Levels in Venous Umbilical Cord Blood
Condition: Group B Streptococcus
Intervention: Drug: oral Penicillin V
Outcome Measures: The level of antibiotics in the umbilical vein cord blood of newborn infants after the administration of Penicillin orally while in labor.;   Compare levels of Penicillin in the umbilical cord blood of women who received oral Penicillin to the levels of women who received intravenous Penicillin in labor. Comparisons will be done through literature only.
2 Recruiting The Diagnosis of Penicillin/AminoPenicillin Allergy in Thailand
Conditions: Penicillin Allergy;   AminoPenicillin Allergy
Intervention:
Outcome Measures: The true prevalence of Penicillin/aminoPenicillin allergy;   The diagnostic values of currently used skin test reagents and drug-specific IgE measurement
3 Recruiting Perioperative Antibiotic Choices for Surgical Prophylaxis in Penicillin-allergic Pediatric Patients
Condition: Penicillin Allergy
Intervention: Drug: Antibiotic
Outcome Measure: Number of subjects with antibiotic related adverse event
4 Not yet recruiting Antibiotic Treatment and Intravenous Immunoglobulin Trial for PANDAS
Condition: Pandas
Interventions: Drug: Sertraline+Antibiotic (Penicillin/azithromycin);   Drug: Sertraline+placebo;   Biological: IVIG
Outcome Measures: The improvement of OC/tic symptoms will be superior in patients treated with SSRI+AB and in case with IVIG, compared with those treated with SSRI+placebo, as assessed by the YBOCS/YGTSS;   The degree of treatment response is expected to correlate with the percentage reduction in antibodies titers following IVIG administration;   The degree of treatment response is also expected to correlate with decreased inflammation in specific regions of the brain, as demonstrated by macroscopic changes and microstructural alterations on MRI and serum and CSF cytokines and chemokines
5 Recruiting A Comparative Evaluation of the Safety and Efficacy of Daptomycin Versus Standard of Care in Pediatric Subjects Two - Seventeen Years of Age With Bacteremia Caused by Staphylococcus Aureus
Condition: Bacteremia
Interventions: Drug: Daptomycin;   Drug: Comparator (Vancomycin, Semi-synthetic Penicillin, First-generation cephalosporins, Clindamycin)
Outcome Measures: Safety of daptomycin measured by the incidence of treatment-emergent adverse events, vital signs, echocardiogram (if performed) and clinical laboratory tests, use of concomitant medications,physical and neurological exam results.;   Efficacy of daptomycin will be based on Investigator's assessment of clinical response (cure, improved, failure or non-evaluable) at the Test of Cure (TOC) visit.
6 Not yet recruiting Patients Response to Early Switch To Oral:Osteomyelitis Study
Condition: Osteomyelitis
Interventions: Drug: oral antibiotics;   Procedure: intravenous antibiotics
Outcome Measures: Clinical Failures;   Evaluation of adverse events related to the use of antibiotics;   Cost of care from the hospital perspective
7 Unknown  Intravenous Immunoglobulins as Effective Treatment in Sydenham's Chorea
Conditions: Sydenham Chorea;   Post Streptococcal Movement Disorder
Interventions: Biological: Intravenous immunoglobulin;   Drug: standard interventions Penicillin VK and haloperidol
Outcome Measures: improved scores on the sydenham chorea assessment charts;   improved quality of life
8 Recruiting Neonatal and Paediatric Pharmacokinetics of Antimicrobials Study
Condition: Paediatric Antimicrobial Pharmacokinetics
Intervention:
Outcome Measure: The pharmacokinetic parameters of drug clearance and volume of distribution for each Penicillin.
9 Recruiting The Amputation Surgical Site Infection Trial (ASSIT)
Conditions: Wound Infection;   Amputation Wound
Interventions: Drug: Co-amoxiclav;   Drug: Iodine;   Drug: Metronidazole;   Drug: Chlorhexidine;   Drug: Teicoplanin;   Drug: Clindamycin
Outcome Measures: Surgical Site Infection;   Impact of different skin preparations on infection rates;   Rate of re-intervention;   Mortality;   Satisfactory healing rates;   Quality of life;   Resource use;   • Rate of C. Diff., MSSA (Methicillin Sensitive Staphylococcus Aureus), MRSA (Methicillin Resistant Staphylococcus Aureus) infection;   Mobility;   Pain Control
10 Recruiting The Role of Antibiotics in Full Thickness Skin Graft Survival for Facial Reconstructive Surgery
Condition: Facial Defect
Intervention: Drug: cephalexin
Outcome Measures: Graft failure rate;   Percentage surface area of graft failure
11 Unknown  The Effectiveness of Probiotics for the Therapy of Acute Pharyngotonsillitis in Adult Patients
Condition: Throat Pain
Interventions: Drug: Placebo;   Drug: Probiotics
Outcome Measures: period of disease;   analysis
12 Recruiting Extended Open Challenge in Patients With a History of Drug Eruption Following Beta-lactam Treatment
Condition: Beta-lactam Allergy
Intervention: Drug: Beta-lactam oral challenge
Outcome Measure: The safety of a 5-day oral challenge in patients with suspected beta-lactam allergy
13 Not yet recruiting Mortality Reduction After Oral Azithromycin: Morbidity Study
Condition: Childhood Mortality
Interventions: Drug: Azithromycin;   Drug: Placebo
Outcome Measures: Presence of malaria parasites on thick blood smear in children 1-60 months;   Fraction of isolates of pneumococcus exhibiting macrolide resistance by nasopharyngeal swabs in children 1-60 months;   Fraction of isolates of Staphylococcus aureus exhibiting macrolide resistance by nasal swabs in children 1-60 months;   Fraction of isolates of Streptococcus pyogenes exhibiting macrolide resistance by oropharyngeal swabs in children 1-60 months;   Evidence of E. coli macrolide resistance in stool specimens in children 1-60 months;   Fraction of conjunctival swabs yielding ocular chlamydia in children 1-60 months;   Height over time in children aged 1-60 months;   Presence of malaria gametocytes, and density of malaria parasites and gametocytes, in children 1-60 months;   Rates of malaria parasitemia among children 1-59.9 months.;   Hemoglobin concentration and presence of anemia (hemoglobin <11 g/dL) in children 1-60 months;   Nasopharyngeal pneumococcal macrolide resistance in individuals 7-12 years;   Nasopharyngeal pneumococcal macrolide resistance in children aged 1-60 months seen in local health clinics for a respiratory complaint;   Rates of acute respiratory illness among children 1-59.9 months.;   Carriage rates and proportions of S. pneumoniae isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months.;   Carriage rates and proportions of S. pneumoniae isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months hospitalized for pneumonia and diarrhea.;   Presence of the trachoma grades "follicular trachoma" (TF) and "intense inflammatory trachoma" (TI), as defined by the WHO simplified grading system, in children 1-60 months;   Trachoma infection and antibody status in children (1-60 months);   Rates of diarrhea among children 1-59.9 months.;   Carriage rates and proportions E. coli isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months;   Carriage rates and proportions of E. coli isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months hospitalized for pneumonia and diarrhea.;   Studies of intestinal permeability and inflammation, microbial translocation, and immune activation assessed through venous sampling of children 6 months;   Studies of intestinal permeability and inflammation, microbial translocation, and immune activation assessed through urine samples for L:M ratios of children 6 months;   Studies of intestinal permeability and inflammation, microbial translocation, and immune activation assessed through stool (fecal neopterin) of children 6 months;   Nasopharyngeal methicillin-resistant Staphylococcus aureus in children 1-60 months;   Carriage rates and proportions of S. aureus isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months.;   Carriage rates and proportions of S. aureus isolates resistant to macrolides and to antibiotics commonly used to treat pediatric infections among children 1-59.9 months hospitalized for pneumonia and diarrhea.;   Nasopharyngeal pneumococcal resistance to Penicillin and clindamycin in children 1-60 months;   Nasopharyngeal pneumococcal macrolide resistance determinants (ermB and mefA), serotype, and multilocus sequence type in children 1-60 months;   Oropharyngeal Streptococcus pyogenes macrolide resistance to Penicillin and clindamycin in children 1-60 months;   Oropharyngeal Streptococcus pyogenes macrolide resistance determinants (mefA, ermB, ermTR) in children 1-60 months;   Microbial diversity in the conjunctival, nasopharyngeal, nasal, oropharyngeal, and intestinal microbiomes of children aged 1-60 months;   Serology for exposure to exotic pathogens cross sectional sample of children aged 1-60 months;   Knee-heel length and head circumference over time in children aged 1-60 months;   Commensal and diarrheagenic E. coli carriage in stool of children aged 1-60 months
14 Recruiting A Trial Comparing Two Modalities of Prophylactic Nutritional Support During Treatment for Head and Neck Cancer
Condition: Head and Neck Neoplasms
Interventions: Procedure: percutaneous endoscopic gastrostomy tube placement;   Procedure: nasogastric tube placement
Outcome Measures: Nutritional Status;   Quality of Life + Mental/Emotional health;   Cost of care;   Clinical Complications;   Nutritional status
15 Unknown  Study to Proof the Clinical and Bacteriological Non-inferiority of Ampicillin/Amoxicillin Versus Moxifloxacin in Hospitalized Patients With Non-severe Community-acquired Pneumonia
Condition: Community Acquired Pneumonia
Interventions: Drug: Moxifloxacin;   Drug: Ampicillin;Amoxicillin
Outcome Measures: Proof of the clinical non inferiority by the cure rate at the treatment of a Pneumonia at the therapy end (round 3: Day 7 to 10) with a standard Penicillin in a high dosage;   clinical cure rate;   bacteriological effectiveness on patients and seed level;   bacteriological sensitivity into-vitro;   time up to the drug-switch;   time until the dismissal of the patients necessity of the gift of additional antibacterial drug;   cost reduction of the antibiotic-therapy and the complete treatment;   assessment of the effectiveness by the investigator
16 Recruiting Levofloxacin in Preventing Infection in Young Patients With Acute Leukemia Receiving Chemotherapy or Undergoing Stem Cell Transplantation
Conditions: Acute Leukemias of Ambiguous Lineage;   Bacterial Infection;   Diarrhea;   Fungal Infection;   Musculoskeletal Complications;   Neutropenia;   Recurrent Childhood Acute Lymphoblastic Leukemia;   Recurrent Childhood Acute Myeloid Leukemia;   Secondary Acute Myeloid Leukemia;   Untreated Childhood Acute Myeloid Leukemia and Other Myeloid Malignancies
Intervention: Drug: levofloxacin
Outcome Measures: Occurrence of at least 1 episode of true bacteremia among AL and HSCT subjects, respectively;   Susceptibility of E. coli, K. pneumoniae, and P. aeruginosa to cefepime, imipenem, and levofloxacin;   Susceptibility of S. mitis to cefepime, levofloxacin, and Penicillin;   Presence of carbapenem-resistant Enterobacteriaceae;   Duration of parenteral antibiotic administration;   Incidence of febrile neutropenia, severe infection, and death from bacterial infection;   Incidence of severe infection;   Incidence of death from bacterial infection;   Incidence of CDAD, defined as a positive C. difficile toxin assay result and diarrhea, CTCAE version 4, grade 2 and higher
17 Recruiting The Effects of Modified Ultrafiltration on Vancomycin Levels During Cardiopulmonary Bypass in Cardiac Surgery
Condition: Vancomycin Concentration
Intervention: Other: Vancomycin concentrations
Outcome Measure: Circulating vancomycin concentration
18 Recruiting Multicenter Pilot Study Evaluating the Immunogenicity of an Innovative Pneumococcal Vaccination Strategy in Splenectomized Adults
Condition: Splenectomized Patients
Intervention: Biological: Prime-boost pneumococcal immunization
Outcome Measures: Proportion of subjects responsive to 9 of the 13 serotypes common (serotypes 1, 3, 6A, 7F, 9V, 14, 19A, 19F, 23F).;   IgG dosage;   ELISA dosages;   Identification of predictive factors for immunogenicity;   Percentage of patients presenting local or systemic reactions post-immunization;   Evaluation of severe infectious episode;   OPA dosages
19 Not yet recruiting Prophylactic Antibiotics for Manual Removal of Retained Placenta in Vaginal Birth: a Randomized Controlled Trial
Condition: Endometritis
Interventions: Drug: Antibiotic prophylaxis;   Drug: Ampicillin;   Drug: Gentamycin;   Drug: Clindamycin
Outcome Measures: Endometritis rate;   Puerperal fever
20 Recruiting Assessment of the Optimal Dosing of Piperacillin-tazobactam in Intensive Care Unit Patients: Extended Versus Continuous Infusion
Condition: Infectious Disease
Interventions: Drug: piperacillin continuous infusion;   Drug: piperacillin extended infusion
Outcome Measures: pharmacokinetics of piperacillin continuous infusion compared to piperacillin extended infusion;   95% probability of target attainment (PTA95) versus MIC of different organisms.