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RESPIRATORY FAILURE and Norco

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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 Phase III Study of the Safety and Efficacy of Cl-108 in the Treatment of Moderate to Severe Pain
Conditions: Pain;   Nausea;   Vomiting
Interventions: Drug: CL-108;   Drug: Placebo
Outcome Measures: To compare the occurrence and severity of opioid-induced nausea and vomiting (OINV) associated with CL-108 to Norco.;   To demonstrate the efficacy of CL-108 when compared to placebo for the relief of pain following surgical removal of impacted third molar teeth.;   Reduction of the severity of nausea in patients treated with an opioid-containing pain reliever.;   Reduction of vomiting in patients treated with an opioid-containing pain reliever.
2 Not yet recruiting Efficacy and Safety of Amantadine HCl Extended Release Tablets in Parkinson's Disease Subjects With Levodopa-Induced Dyskinesias
Conditions: Parkinson's Disease;   Levodopa Induced Dyskinesia (LID)
Interventions: Drug: Amantadine HCl ER (ALLAY-LID II);   Drug: Placebo
Outcome Measures: Unified Dyskinesia Rating Scale;   Mobility State Self Assessment (Subject Diary Cards);   Mobility State Self-Assessment (Subject Diary Cards);   MDS-Unified Parkinson's Disease Rating Scale;   Fatigue Severity Scale
3 Not yet recruiting Efficacy and Safety of Amantadine ER Tablets to Treat Parkinson's Disease Patients With Levodopa Induced Dyskinesia.
Conditions: Parkinson's Disease;   Levodopa Induced Dyskinesia (LID)
Interventions: Drug: Amantadine ER Tablets;   Drug: Placebo Tablets for Amantadine ER Tablets
Outcome Measures: Unified Dyskinesia Rating Scale (UDysRS);   Mobility State Self-Assessment (Subject Diary Cards);   MDS-UPDRS;   Fatigue Severity Scale
4 Recruiting Edible Plant Exosome Ability to Prevent Oral Mucositis Associated With Chemoradiation Treatment of Head and Neck Cancer
Conditions: Head and Neck Cancer;   Oral Mucositis
Interventions: Dietary Supplement: Grape extract;   Drug: Lortab, Fentanyl patch, mouthwash
Outcome Measures: Pain caused by oral mucositis;   Level of immune biomarkers in blood;   Level of immune biomarkers in mucosal tissue
5 Not yet recruiting Ureteral Stent-related Pain and Mirabegron (SPAM) Trial
Condition: Nephrolithiasis
Interventions: Drug: Mirabegron;   Drug: Tamsulosin;   Drug: Percocet
Outcome Measures: Ureteral stent related pain and lower urinary tract symptoms (LUTS) as measured by the Ureteral Stent Symptom Questionnaire.;   Quality of life impact of mirabegron for stent symptoms as measured with the Ureteral Stent Symptoms Questionnaire.
6 Unknown  Fentanyl Administered Intraorally for Rapid Treatment of Orthopedic Pain
Condition: Pain, Fracture, Sprain
Interventions: Drug: Fentanyl rapid dissolving tablet 100mcg;   Drug: lansoprazole 15mg rapidly dissolving tablet + Percocet PO
Outcome Measures: Time to analgesia;   Occurrence of untoward opioid side effects
7 Not yet recruiting An Open Label, Prospective Study of the Analgesic Efficacy of Oral Xartemis Compared to Generic Oxycodone/APAP( Acetaminophen) in the Treatment of Moderate to Severe Post Operative Pain.
Condition: Post Operative Pain
Interventions: Drug: Percocet;   Drug: Xartemis
Outcome Measures: Non Inferiority;   Patient Global Assessment
8 Recruiting Adductor Canal Nerve Block Following Total Knee Arthroplasty
Condition: Post-op Pain
Interventions: Drug: Morphine PCA started at the end of surgery, 1 Percocet 1/325mg every 4 hours; may receive a second Percocet if needed.;   Drug: For the 30ml ropivacaine the intervention would be the subject can request extra pain medication which would be Percocet and/or morphine PCA.
Outcome Measures: Total Opiate pain medication;   Patient satisfaction with pain control
9 Not yet recruiting The Effect of NSAIDs After a Rotator Cuff Repair Surgery.
Condition: Rotator Cuff Tear
Interventions: Procedure: Rotator cuff repair;   Drug: Ibuprofen, Hydrocodone/Acetaminophen, Omeprazole;   Drug: Hydrocodone/Acetaminophen
Outcome Measures: American Shoulder and Elbow Surgeons (ASES) Shoulder Score;   Ultrasound evaluation of retear rate
10 Recruiting Liver Fibrosis in Alpha-1 Antitrypsin Deficiency (AATD)
Conditions: Liver Fibrosis;   Alpha-1 Antitrypsin Deficiency;   AAT Deficiency;   AATD
Interventions: Device: Abdominal ultrasound;   Procedure: History and physical;   Procedure: Intravenous catheter;   Procedure: Blood draw;   Other: Liver questionnaire;   Procedure: Liver Biopsy;   Drug: Midazolam;   Drug: Fentanyl;   Drug: Lidocaine;   Drug: Acetaminophen;   Drug: Lorazepam;   Drug: Oxycodone/Acetaminophen;   Drug: Ondansetron
Outcome Measures: To estimate the prevalence and histologic spectrum of liver injury in an adult with Alpha-1 Antitrypsin deficiency and a genotype of ZZ.;   To identify environmental and host risk factors for clinically significant liver fibrosis.;   To define the diagnostic accuracy of non-invasive markers of fibrosis in AAT liver disease.;   To explore epigenetic markers for the development of liver fibrosis.;   To quantify liver fibrosis progression.
11 Recruiting Safety and Efficacy Study of Fentanyl Buccal Tablet Use in the Emergency Department for Isolated Extremity Injury
Condition: Pain
Interventions: Drug: Fentanyl;   Drug: Oxycodone/acetaminophen;   Drug: oxycodone/acetaminophen
Outcome Measures: Pain Level;   Nausea level;   Occurrence of adverse events
12 Recruiting Comparing the Efficacy of Oral Opioids for Outpatient Acute Pain Management After ED Discharge Discharge
Condition: Analgesia After ED Discharge for Extremity Injuries
Intervention: Drug: Oral Opioid Pain Medicine
Outcome Measures: Difference in pain score before and after last dose.;   Overall Satisfaction with the pain medicine;   Side Effects
13 Recruiting Safety and Efficacy of Gabapentin for Neuropathic Pain in Fabry Disease
Conditions: Fabry Disease;   Neuropathic Pain
Interventions: Drug: Gabapentin;   Drug: placebo
Outcome Measures: average reduction in hydrocodone-acetaminophen use;   Number and type of adverse events;   Pain levels;   Define therapeutic level for gabapentin
14 Not yet recruiting Equality Study of Ofirmev vs Oral Acetaminophen
Condition: Pain, Postoperative
Interventions: Drug: IV acetaminophen;   Drug: oral acetaminophen
Outcome Measures: Primary outcome will measure total opioid consumption while the patient is in the PACU;   time from PACU admission to request for first opioid dose
15 Not yet recruiting Local Anesthesia and Analgesics in Endodontic Pain
Condition: Odontalgia
Interventions: Drug: Oral placebo;   Drug: Oral ibuprofen;   Drug: oral naproxen;   Drug: oral acetaminophen/hydrocodone + ibuprofen
Outcome Measures: Effect of long acting anesthesia and analgesics on endodontic pain;   Effect of gender and age on post-operative endodontic pain treatment
16 Not yet recruiting Post-operative Analgesia in Elective, Soft-tissue Hand Surgery
Conditions: Carpal Tunnel;   Ganglion Cyst;   Trigger Finger
Interventions: Drug: Acetaminophen/Hydrocodone;   Drug: Acetaminophen/Ibuprofen
Outcome Measures: Efficacy comparison utilizing Visual Analog Scale (VAS), Likert Pain Score and Mean daily pain values;   Incidence of adverse effects
17 Recruiting Clinical Research of the Prognostic Influence of NSAIDS's Anti-inflammatory Effect on Senior Patients With Hip Fracture
Condition: Hip Fracture
Interventions: Drug: celecoxib;   Drug: Acetaminophen oxycodone
Outcome Measure:
18 Recruiting Tracking & Feedback Registry to Reduce Breast Cancer Treatment Disparities
Condition: Breast Cancer
Intervention: Other: Tracking & Feedback
Outcome Measures: Change in intervention effect of adjuvant treatment;   Organizational Characteristics
19 Recruiting Narcotic vs. Non-narcotic Pain Study Protocol
Condition: Carpal Tunnel
Interventions: Drug: Narcotic;   Drug: non-narcotic
Outcome Measure: Pain relief
20 Not yet recruiting Comprehensive Opioid Management
Condition: Chronic Pain
Interventions: Behavioral: IVR self-management;   Behavioral: Opioid monitoring;   Other: Enhanced usual care
Outcome Measures: Brief Pain Inventory;   Concordance with opioid treatment practice guidelines