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RESPIRATORY FAILURE and Abilify

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RESPIRATORY FAILURE 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 FAILURE 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 Aripiprazole (Abilify®) as an Adjunctive Treatment for Inadequate Response in Major Depressive Disorder
Condition: Major Depressive Disorder
Interventions: Drug: Aripiprazole 6-week group;   Drug: Aripiprazole 8-week group
Outcome Measures: Quality of Life Scale (QOLS);   Montgomery-Åsberg Depression Rating Scale
2 Unknown  Aripiprazole and Topiramate on Free-Choice Alcohol Use
Condition: Alcohol Dependence
Interventions: Drug: Double Placebo;   Drug: Aripiprazole 15, placebo;   Drug: Aripiprazole 7.5, Placebo;   Drug: Topiramate 100, Placebo;   Drug: Topiramate 200, Placebo;   Drug: Topiramate 100, Aripiprazole 15;   Drug: Topiramate 100, Aripiprazole 7.5;   Drug: Topiramate 100, Aripiprazole 15mg;   Drug: Topiramate 200, Aripiprazole 7.5mg;   Drug: Topiramate 200, Aripiprazole 15
Outcome Measures: Number of alcoholic drinks consumed in a laboratory setting;   Safety and tolerability of the medications singly and in combination, compared to placebo;   Drinks consumed during the medication titration period
3 Recruiting Double-Blind Placebo Controlled Study of Adjunctive Aripiprazole for Symptomatic Hyperprolactinemia In Premenopausal Women With Schizophrenia
Condition: Hyperprolactinemia
Interventions: Drug: Aripiprazole;   Drug: Placebo
Outcome Measures: To determine if adjunct aripiprazole will resolve or improve prolactin related hormonal side effects (amenorrhea, oligomenorrhea, galactorrhea).;   To test whether adjunctive aripiprazole will improve quality/perceived quality of life.;   To identify if adjunct aripiprazole will improve bone turnover as measured by assays of osteoblastic and osteoclastic activity.;   To examine side effects associated with adjunctive aripiprazole versus placebo and conduct a cost analysis of adjunctive aripiprazole use.;   To evaluate the mediator effects of estrogen, progesterone, prolactin effects on quality of life, bone turnover and sexual functioning.
4 Unknown  The New Strategy for Pharmacological Treatment in People With Schizophrenia
Condition: Schizophrenia
Interventions: Drug: Rispridoen and Aripiprazole;   Drug: Risperidne;   Drug: Abilify
Outcome Measures: SANS(Scale for the Assessment of Negative Symptoms);   SARS(Simpson-Angus Rating Scale);   Drug Attitude Inventory;   Side effect checklist
5 Recruiting Study to Evaluate the Efficacy and Safety of Aripiprazole
Condition: Autism
Intervention: Drug: Aripiprazole
Outcome Measures: irritability subscale of the aberrant behavior checklist;   Change from baseline in ABC-subscale of lethargy/social withdrawal, stereotypic behavior, hyperactivity, inappropriate speech;   Change of CGI-S, CGI-I from baseline;   Change of Behavioral problems from baseline;   Change of Adaptive Skills from baseline;   Change of Parental stress from baseline
6 Recruiting Efficacy, Safety, and Tolerability of an Intramuscular Formulation of Aripiprazole (OPC-14597) as Maintenance Treatment in Bipolar I Patients
Condition: Bipolar I Disorder
Interventions: Drug: Intramuscular (IM) Depot Aripiprazole;   Drug: Intramuscular (IM) Depot Placebo
Outcome Measures: Time from randomization to recurrence of any mood episode during Double-Bind Placebo Controlled phase;   Proportion of subjects meeting criteria for recurrence of any mood episode(manic, mixed, depressive);   Mean change from randomization to endpoint in the CGI-BP-S (mania) score;   Time from randomization to recurrence defined by hospitalization for a mood episode.
7 Unknown  Neuroimaging Of Treatment Effects in Treatment-Resistant Depression
Condition: Major Depressive Disorder
Intervention: Drug: escitalopram and adjunctive aripiprazole and placebo
Outcome Measures: Use of PET and fMRI to demonstrate the differential pattern of dopaminergic activity, dopamine receptor binding in the putamen and caudate and correlation these findings to MADRS in MDD subjects treated with escitalopram and aripiprazole.;   Correlation of D2binding before and after adjunctive aripiprazole with emergence of extrapyramidal symptoms and akathisia.
8 Recruiting Aripiprazole Once-monthly Versus Paliperidone Palmitate in Adult Patients With Schizophrenia
Condition: Schizophrenia
Interventions: Drug: Aripiprazole and aripiprazole once-monthly;   Drug: Paliperidone and paliperidone palmitate
Outcome Measures: Mean change from Baseline in quality of life;   Investigator's assessment of overall effectiveness;   Mean change from Baseline in clinical global impression;   Mean change from Baseline in quality of life using QLS;   Mean change from Baseline in subjective well-being using SWN-S;   Mean change from Baseline in tolerability and quality of life using TooL;   Safety and tolerability;   Risk of suicidality
9 Recruiting Aripiprazole and Prolactin Study
Condition: Hyperprolactinemia
Intervention: Drug: Aripiprazole
Outcome Measures: Normalization or reduction in prolactin sufficient to restore gonadal function;   Normalization or improvement in bone mineral density
10 Recruiting A Long-term, Extended Treatment Study of Aripiprazole in Pediatric Patients With Schizophrenia
Condition: Schizophrenia
Intervention: Drug: Aripiprazole
Outcome Measures: Adverse events;   Positive and Negative Syndrome Scale (PANSS);   Clinical golobal impression (CGI);   Children's Global Assessment Scale (CGAS)
11 Unknown  Aripiprazole Augmentation Therapy in Treatment-resistant Depression
Condition: Therapy-resistant Depression
Intervention: Drug: Aripiprazole
Outcome Measure: rate of response as defined by a more or equal 50 % reduction of baseline HAM-D (Hamilton Depression Rating scale)
12 Recruiting Adjunctive Aripiprazole in the Treatment of Risperidone-Induced Hyperprolactinemia
Condition: Schizophrenia
Intervention: Drug: Aripiprazole
Outcome Measures: Prolactin level;   PANSS (positive and negative syndrome scale) score
13 Recruiting A Short Treatment Study of Aripiprazole in Pediatric Patients With Schizophrenia
Condition: Schizophrenia
Interventions: Drug: Aripiprazole Low (2 mg/day);   Drug: Aripiprazole Mid (6 - 12 mg/day);   Drug: Aripiprazole High (24 - 30 mg/day)
Outcome Measures: Positive and Negative Syndrome Scale (PANSS) total sore;   PANSS score;   Clinical Global Impression (CGI);   Children's Global Assessment Scale (CGAS);   Adverse events;   Electrocardiogram
14 Unknown  Remediation of Schizophrenia Sensory Gating Deficit With Aripiprazole
Conditions: Schizophrenia;   Sensory Gating
Intervention: Drug: Aripiprzole
Outcome Measure: MEG/EEG and MRI data will be compared with the results of a neuropsych battery and symptom rating scales prior to initiation with aripiprazole and after subject has been on a stable dose of aripiprazole for three month.
15 Unknown  Aripiprazole and Resistant Postpartum Depression
Condition: Postpartum Depression
Intervention: Drug: aripiprazole
Outcome Measures: Montgomery Asberg Depression Rating Scale;   Udvalg for Kliniske Undersogelser Scale
16 Recruiting Open-label Study to Evaluate the Effectiveness of an Intramuscular Formulation of Aripiprazole (OPC-14597) as Maintenance Treatment in Patients With Bipolar I Disorder
Condition: Bipolar I
Intervention: Drug: Aripiprazole
Outcome Measures: Number and percentage of subjects with adverse events;   Injection Site Pain measured by the Visual Analog Scale (VAS);   Number and percentage of subjects with clinically significant abnormal laboratory test results, vitals, ECGs;   Extrapyramidal Symptoms (EPS) will be assessed by change from baseline on Abnormal Involuntary Movement Scale (AIMS), Simpson-Angus Scale (SAS), Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS used in Japan), and Barnes Akathisia Rating Scale (BARS);   Percentage of subjects who remain stable at endpoint
17 Unknown  Evaluating the Effectiveness of Aripiprazole and D-Cycloserine to Treat Symptoms Associated With Autism
Condition: Autistic Disorder
Interventions: Drug: Aripiprazole;   Drug: Placebo;   Drug: D-cycloserine;   Other: fMRI
Outcome Measures: Aberrant Behavior Checklist (ABC) Irritability Subscale;   Clinical Global Impression (CGI) Scale;   ABC Subscales;   Vineland Maladaptive Behavior Subscales;   A modified version of the Compulsion Subscale of the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS);   Autism Diagnostic Observation Schedule (ADOS);   Social Reciprocity Scale (SRS)
18 Recruiting Biomarkers in Autism of Aripiprazole and Risperidone Treatment (BAART)
Condition: Autistic Disorder
Interventions: Drug: Aripiprazole;   Drug: Risperidone
Outcome Measure: To identify phenotypic and genetic traits that predict response to aripiprazole and risperidone in Autistic Disorder
19 Recruiting Low-Dose Adjunctive Aripiprazole in the Treatment of Bipolar Depression: Double-Blind Placebo-Controlled Pilot Study
Conditions: Bipolar Disorder;   Depressive Episode
Interventions: Drug: Low dose Adjunctive Aripiprazole;   Drug: placebo
Outcome Measure: Response rate
20 Recruiting A Double-Blind, Controlled Study of Aripiprazole in Co-Morbid Schizophrenia and Cocaine Dependence
Conditions: Schizophrenia;   Cocaine Dependence
Interventions: Drug: Aripiprazole;   Drug: Perphenazine
Outcome Measures: The proportion of negative urine drug screen results will be significantly greater in the subjects treated with aripiprazole than in those treated with perphenazine.;   The mean total self-report cocaine use days will be significantly fewer in subjects treated with aripiprazole than in those treated with perphenazine.;   The mean cocaine craving scores will be lower in subjects treated with aripiprazole than in those treated with perphenazine.