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RESPIRATORY FAILURE and Pradaxa

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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

Check out the latest treatments for RESPIRATORY FAILURE

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Pradaxa Side Effects

Gastrointestinal Haemorrhage (2049)
Anaemia (785)
Cerebrovascular Accident (760)
Haemorrhage (724)
Fall (618)
Rectal Haemorrhage (581)
Renal Failure Acute (471)
Dizziness (465)
Dyspepsia (439)
Haemorrhagic Anaemia (428)
Coagulopathy (420)
Dyspnoea (414)
Ischaemic Stroke (406)
Contusion (388)
Epistaxis (381)
Nausea (379)
Melaena (366)
Haemoglobin Decreased (363)
Asthenia (351)
Death (342)
Cerebral Haemorrhage (303)
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Diarrhoea (283)
Haematuria (281)
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Upper Gastrointestinal Haemorrhage (267)
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Haematochezia (264)
Deep Vein Thrombosis (258)
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Abdominal Pain Upper (213)
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Vomiting (190)
Haematoma (181)
Abdominal Pain (178)
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Pain In Extremity (164)
Oedema Peripheral (164)
Renal Impairment (160)
Haemoptysis (156)

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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 Management of Myocardial Injury After Noncardiac Surgery Trial
Condition: Myocardial Injury After Noncardiac Surgery (MINS)
Interventions: Drug: Dabigatran;   Drug: Placebo (for Dabigatran);   Drug: Omeprazole;   Drug: Placebo (for Omeprazole)
Outcome Measures: Major vascular complication (for Dabigatran);   Major upper gastrointestinal complication (for Omeprazole);   Individual secondary outcomes for Dabigatran;   Upper gastrointestinal complication for Omeprazole;   Major vascular complication for Omeprazole;   Individual secondary outcomes for Omeprazole;   Safety outcomes for Dabigatran;   Safety outcomes for Omeprazole
2 Recruiting Strategy of Continued Versus Interrupted Dabigatran at Time of Device Surgery in Patients With Moderate to High Risk of Arterial Thromboembolic Events
Condition: Hematoma
Intervention: Drug: Dabigatran
Outcome Measures: Clinically significant hematoma;   Composite of major peri-operative bleeding events and thrombo-embolic events
3 Recruiting Dabigatran Versus Warfarin After Mitral and/or Aortic Bioprosthesis Replacement and Atrial Fibrillation Postoperatively
Condition: Primary Disease
Interventions: Drug: Dabigatran;   Drug: Warfarin
Outcome Measures: Embolic Events;   Bleeding
4 Recruiting SPARK: Safety Study of Pradaxa in Atrial Fibrillation Patients by Regulatory Requirement of Korea
Condition: Atrial Fibrillation
Intervention: Drug: Pradaxa (Dabigatran etexilate mesilate)
Outcome Measures: Occurrence of adverse events;   Incidence rate of stroke;   Incidence rate of systemic embolism
5 Recruiting Drug Interaction Study Between Bosutinib And Dabigatran
Condition: Healthy
Interventions: Drug: Dabigatran;   Drug: Bosutinib
Outcome Measures: Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast);   Maximum Observed Plasma Concentration (Cmax);   Time to Reach Maximum Observed Plasma Concentration (Tmax);   Plasma Decay Half-Life (t1/2);   Apparent Oral Clearance (CL/F);   Apparent Volume of Distribution (Vz/F)
6 Recruiting Dabigatran's Effect on Changes in Atrial Fibrosis in Patients With Atrial Fibrillation
Condition: Atrial Fibrillation
Intervention: Drug: Dabigatran etexilate (Pradaxa)
Outcome Measure: Percentage of fibrosis
7 Recruiting Dabigatran Treatment Following Transient Ischemic Attack and Minor Stroke
Conditions: Transient Ischemic Attack;   Minor Ischemic Stroke
Intervention: Drug: Dabigatran 110/150 mg BID
Outcome Measure: Symptomatic Hemorrhagic Transformation
8 Recruiting Use of Dabigatran Etexilate to Prevent Stroke and Thromboembolism
Conditions: Atrial Fibrillation;   Atrial Flutter
Intervention: Drug: dabigatran etexilate mesylate
Outcome Measures: Frequency of major bleeding complications and thrombo-embolic events in patients administered dabigatran following RF ablation.;   Dabigatran serum drug levels in patients experiencing a major bleeding or thrombo-embolic event.;   Frequency of minor bleeding events
9 Recruiting Pradaxa Study in Non-valvular Atrial Fibrillation Patients With Severely Impaired Renal Function
Condition: Atrial Fibrillation
Intervention: Drug: Pradaxa, dabigatran etexilate
Outcome Measures: Pre-dose concentration of the analyte in plasma at steady state immediately before administration of the next dose;   Concentration of analyte in plasma at steady state at 2 hours after administration of the last dose
10 Recruiting Open Label Study Comparing Efficacy and Safety of Dabigatran Etexilate to Standard of Care in Paediatric Patients With Venous Thromboembolism (VTE)
Condition: Venous Thromboembolism
Interventions: Drug: dabigatran etexilate;   Drug: standard of care
Outcome Measures: First component of the co-primary endpoint: A combined efficacy endpoint of complete thrombus resolution plus freedom from recurrent VTE plus freedom from mortality related to VTE;   Second component of the co-primary endpoint: Freedom from major bleeding events (a safety endpoint);   Pharmacokinetic assessments (plasma concentrations of total dabigatran) 3 days after start of treatment (after at least six consecutive dabigatran doses) and after 3 days following any dabigatran dose adjustment;   Frequency of dose adjustments;   Frequency of switch of type of anti-coagulation therapy (including dabigatran to SOC) and a switch from an intended standard of care treatment to another;   Freedom from thrombus progression at baseline and at days 21 and 84 after randomisation;   Assessment of the acceptability of an age-appropriate formulation at end of therapy;   Freedom from recurrence of VTE at 6, 9 and 12 months;   Freedom from occurrence of post-thrombotic syndrome at 6, 9 and 12 months;   All bleeding events;   All-cause mortality;   All components of the primary efficacy endpoints;   Pharmacodynamic assessments (aPTT, ecarin clotting time (ECT) and dTT) 3 days after start of treatment (after at least six consecutive dabigatran doses) and after 3 days following any dabigatran dose adjustment;   Frequency of temporary discontinuation from therapy;   Frequency of permanent discontinuation from therapy;   Number of laboratory monitoring requirements for dose adjustment during the treatment phase
11 Recruiting Safety and Tolerability of Dabigatran Etexilate Solution in Children 1 to < 12 Years of Age
Condition: Venous Thromboembolism
Intervention: Drug: dabigatran etexilate
Outcome Measures: Plasma concentrations of total dabigatran;   Plasma concentrations of free dabigatran;   Plasma concentrations of BIBR 1048 BS (Base);   Plasma concentrations of BIBR 951 BS;   Plasma concentrations of BIBR 1087 SE (Acid);   Activated prothrombin time (aPTT);   Ecarin clotting time (ECT);   Factor IIa inhibition;   Incidence of all bleeding events;   Incidence of all adverse events;   Global assessment of tolerability will be summarized across all patients in the treated set;   Patient assessment of taste will be summarized across all patients in the treated set;   Changes in laboratory and clinical parameters
12 Recruiting Impact of Dabigatran and Phenprocoumon on Clopidogrel Mediated ADP Induced Platelet Aggregation in Patients With Atrial Fibrillation
Conditions: Coronary Heart Disease;   Atrial Fibrillation;   Acute Coronary Syndrome;   Atherosclerosis
Interventions: Drug: Dabigatran;   Drug: Phenprocoumon
Outcome Measures: ADP induced platelet aggregation;   Platelet function tests;   Coagulation parameters
13 Not yet recruiting Validation of a Novel Dabigatran Based Peri-Operative Bridging Anticoagulation Protocol for Patients on Chronic Warfarin Therapy
Condition: Venous Thrombembolic Events.
Intervention: Drug: Dabigatran.
Outcome Measure: Validation of a novel Dabigatran Based Peri-Operative Bridging Anticoagulation Protocol for Patients on Chronic Warfarin Therapy
14 Not yet recruiting Management of Major Bleeding Events in Atrial Fibrillation Patients Using Pradaxa
Conditions: Atrial Fibrillation;   Hemorrhage
Interventions: Drug: Dabigatran 75 mg;   Drug: Dabigatran 150 mg
Outcome Measures: Number of patients with index event safety outcomes (ongoing/resolved/deceased);   Number of patients receiving different types of interventions to stop the index events;   Frequencies of bleeding types and anatomic locations of the index event
15 Recruiting Pharmacokinetics, Safety and Tolerability of Dabigatran Etexilate Solution in Children 1 to < 2 Years of Age
Condition: Venous Thromboembolism
Intervention: Drug: dabigatran etexilate
Outcome Measures: Ecarin clotting time (ECT);   Factor IIa inhibition;   Incidence of all bleeding events;   Incidence of all adverse events;   Plasma concentrations of total dabigatran;   Plasma concentrations of free dabigatran;   Plasma concentrations of BIBR 1048 BS (Base);   Plasma concentrations of BIBR 951 BS;   Plasma concentrations of BIBR 1087 SE (Acid);   Activated prothrombin time (aPTT);   Global assessment of tolerability will be summarized across all patients in the treated set;   Patient assessment of taste will be summarized across all patients in the treated set;   Changes in laboratory and clinical parameters
16 Recruiting Safety Study of Dabigatran in CADASIL
Condition: CADASIL
Interventions: Drug: Dabigatran;   Drug: Antiplatelets
Outcome Measures: Number of microbleeds on MRI;   Major bleeding
17 Not yet recruiting Cognitive Impairment Related to Atrial Fibrillation Prevention Trial
Condition: Atrial Fibrillation
Interventions: Drug: Warfarin;   Drug: Dabigatran
Outcome Measures: Cognitive impairment;   Number of Participants with less important alteration in coagulation test as a Measure of Safety
18 Recruiting Reversal of Dabigatran Anticoagulant Effect With Idarucizumab
Condition: Hemorrhage
Intervention: Drug: idarucizumab
Outcome Measures: Reversal of anticoagulant effect of dabigatran;   Reversal of Activated Partial Thromboplastin Time (aPTT);   Reversal of Thrombin Time (TT);   Duration of reversal;   Occurrence of major bleeding post-surgery (for Group B only);   Time to cessation of bleeding (for Group A only);   Minimum unbound sum (free) dabigatran;   Reversal of diluted Thrombin Time (dTT) or Ecarin Clotting Time (ECT) after the first infusion and before the start of the second
19 Recruiting Pharmacogenomic Study on PKD/PKC of Dabigatran Etexilate and Rivaroxaban
Condition: Healthy Volunteers
Interventions: Drug: D->R->C+R;   Drug: D->R->C+D;   Drug: R->D->C+D;   Drug: R->D->C+R
Outcome Measures: AUC of plasma concentrations of the drugs;   PKD of the drugs
20 Recruiting Pradaxa (Dabigatran Etexilate) 150 mg/q.d. in Patients With Moderate Renal Impairment After Hip or Knee Replacement Surgery
Conditions: Arthroplasty, Replacement;   Thromboembolism
Intervention:
Outcome Measures: Safety: Major bleeding events. Efficacy: composite of all death and documented symptomatic VTE (i.e documented symptomatic DVT and documented symptomatic nonfatal pulmonary embolism).;   Major extra surgical site bleedings,volume of wound drainage, documented symptomatic proximal DVT, documented symptomatic distal DVT, documented symptomatic nonfatal pulmonary embolism and all-cause mortality