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RESPIRATORY FAILURE and Propranolol

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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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Propranolol Side Effects

Completed Suicide (157)
Cardiac Arrest (133)
Bradycardia (109)
Hypotension (104)
Overdose (76)
Dizziness (70)
Respiratory Arrest (69)
Dyspnoea (57)
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Toxicity To Various Agents (47)
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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 Safety and Efficacy of Propranolol Eye Drops in Treating Retinopathy of Premature
Condition: Retinopathy of Prematurity
Intervention: Drug: Propranolol eye drops
Outcome Measures: Incidence rate of progression from stage 2 ROP to more severe stage ROP (stage 2 or 3 with plus, stage 4 and stage 5);   Plasma concentrations of Propranolol at the steady state;   Number of newborns who progress to Stage 3 without plus ROP;   Number of newborns who progress to Stage 4 or 5 ROP with total or partial retinal detachment;   Number of newborns who need laser treatment;   Number of newborns who need rescue treatment with bevacizumab;   Number of newborns who need vitrectomy;   Collection of adverse events due to eye drop Propranolol treatment
2 Not yet recruiting Efficacy of Propranolol Treatment to Prevent Melanoma Progression
Conditions: Stages III Skin Melanoma;   Stages II Skin Melanoma;   Stage IB Skin Melanoma
Interventions: Drug: Propranolol hydrochloride;   Drug: Placebo pill
Outcome Measures: Efficacy of Propranolol on progression free survival for patients suffering from a primary melanoma with a high risk of recurrence;   Use of serum microRNA profile as a predictor for recurrence;   Overall survival
3 Recruiting Propanolol and Red Cell Adhesion Non-asthmatic Children Sickle Cell Disease
Condition: Sickle Cell Disease
Intervention: Drug: Propranolol
Outcome Measures: measurement of the sickle red cell response to epinephrine;   Safety data regarding the use of propanolol in children with sickle cell disease
4 Recruiting Study of Propranolol in Newly Diagnosed Breast Cancer Patients Undergoing Neoadjuvant Chemotherapy
Condition: Locally Advanced Breast Cancer
Interventions: Drug: Propranolol;   Other: Breast imaging - Diffuse Optical Tomography (DOT)
Outcome Measures: Percentage of patients who are compliant with taking > 80% take the drug while on chemotherapy.;   Changes in angiogenesis;   Changes in stress levels;   Number of Patients with Adverse Events;   Change in DOT-derived parameters;   Changes in tumor proliferation
5 Unknown  Propranolol Treatment of Traumatic Memories (PTTM)
Conditions: Traumatic Memory;   Posttraumatic Stress Disorder
Interventions: Drug: Propranolol Hydrochloride;   Drug: Placebo
Outcome Measures: The primary endpoint will be changes between the pretreatment and posttreatment scores in the Clinician Assessment Posttraumatic Scale (CAPS), Impact of Event Scale (IES) and Traumatic Memory Description Measure (TMDM) instruments.;   The secondary endpoint will be changes between the treatment and posttreatment score in the other scales used - MINI, ZAS, ZDS and NIHS.
6 Recruiting Perioperative Propranolol in Patients With Post Traumatic Stress Disorder (PTSD)
Condition: Post-traumatic Stress Disorder
Interventions: Drug: Propranolol Hydrochloride;   Other: Placebo
Outcome Measures: ICU length of stay;   Hospital length of stay;   Postoperative delirium;   Postoperative renal dysfunction;   Perioperative complications;   Pain intensity;   Pain unpleasantness;   Analgesics use;   Length of intubation and mechanical ventilation;   Post Traumatic Stress Disorder symptomatology;   Quality of Life;   Functional status;   Sleep Quality;   Depression symptoms;   Postoperative Neurocognitive Dysfunction Score;   30-day, 3-month, and 1-year mortality;   Postoperative complications
7 Recruiting Efficacy of Clonidine and Propranolol in Dentistry (AAA)
Condition: Anxiety
Interventions: Drug: Clonidine;   Drug: Propranolol;   Drug: Placebo
Outcome Measures: Change from baseline in modified dental anxiety scale(MDAS)and vital signs (blood pressure, heart rate, respiratory rate, oxygen saturation) until four hours post treatment;   Changes in Verbal Numerical Rating Scale (VNRS) at three, six, and twenty-four hours post treatment
8 Unknown  Reducing Reconsolidation of Trauma Memories With Propranolol
Condition: Posttraumatic Stress Disorder
Interventions: Drug: Propranolol;   Drug: Short acting + long acting Propranolol + memory reactivation
Outcome Measures: Electromyogram;   Heart rate;   Skin conductance;   PTSD symptom levels;   Quality of life;   Memory Experience;   Psychophysiological assessments
9 Unknown  Endoscopic Band Ligation (EBL) Versus Propranolol for Primary Prophylaxis of Variceal Bleeding
Conditions: Variceal Bleeding;   Cirrhosis
Interventions: Procedure: Endoscopic band ligation;   Drug: Propranolol;   Procedure: endoscopic band ligation and Propranolol
Outcome Measures: First esophageal variceal bleeding;   Mortality; Significant esophageal variceal bleeding; Upper gastrointestinal bleeding except esophageal bleeding; Adverse events
10 Unknown  A Psychophysiologic Study of Weakening Traumatic Combat Memories With Post-Reactivation Propranolol
Condition: Post-Traumatic Stress Disorder
Intervention: Drug: Propranolol
Outcome Measure: Psychophysiologic responses during script-driven imagery of combat events
11 Unknown  A Novel Treatment For Chronic Posttraumatic Stress Disorder (PTSD) Using Post-Reactivation Propranolol
Condition: Stress Disorders, Post-Traumatic
Intervention: Drug: Propranolol is available in generic form as the Wyeth product under the trade name Inderal.
Outcome Measures: Clinician-Administered PTSD Scale (CAPS) for DSM-IV;   Mini International Neuropsychiatric Interview (MINI);   Peritraumatic Distress Inventory (PDI);   The Peritraumatic Dissociative Experiences Questionnaire;   PTSD Check List (PCL) civilian version;   Script-driven imagery psychophysiological measurement
12 Recruiting Propranolol in Severely Burned Children
Condition: Burn
Interventions: Drug: Propranolol;   Drug: Placebo
Outcome Measures: Resting heart rate multiplied by the systolic blood pressure measurement= rate pressure product;   Number of deaths
13 Recruiting Propranolol Versus Prednisolone for Treatment of Symptomatic Hemangiomas
Condition: Hemangioma of Infancy
Interventions: Drug: Propranolol;   Drug: Prednisolone
Outcome Measures: reduction in size of hemangioma;   Tolerability of medication
14 Recruiting The Safety and Efficiency of Propranolol as an Initial Treatment for Pediatric Hemangioma
Condition: Hemangioma
Interventions: Drug: Prednisolone;   Drug: Propranolol
Outcome Measures: Hemangioma volume measured by MRI or SONO;   Size changes from baseline;   Heart rate change from Baseline at 16 weeks;   Change from Baseline in color;   Changes in Size of Ulceration;   Whether or not Re-epithelized in 16weeks;   Stop time of proliferation;   Time of regression;   Drug compliance within 16 weeks;   Change from Baseline in systolic blood pressure at 16 weeks;   Changes from baseline in Glucose level at 16 weeks;   Whether the facial edema occurs within 16 weeks;   Whether growth retardation occurs within 16 weeks;   Whether the Gastroesophageal reflux occurs within 16 weeks;   Number of Participants with Adverse drug reaction
15 Recruiting Protective Effects of Propranolol in Adults
Condition: Burn
Interventions: Drug: Propranolol;   Drug: Placebo
Outcome Measures: Cardiac rate pressure product;   Mortality rates
16 Recruiting Rifaximin and Propranolol Combination Therapy Versus Propranolol Monotherapy in Cirrhotic Patients
Conditions: Liver Cirrhosis;   Portal Hypertension
Interventions: Drug: Rifaximin + Propranolol;   Drug: Propranolol + Placebo
Outcome Measures: Hepatic vein pressure gradient(HVPG);   occurence of gastrointestinal bleeding
17 Recruiting Efficacy and Safety of Propranolol Versus Acebutolol on the Proliferative Phase of Infantile Hemangioma
Condition: Hemangioma
Interventions: Drug: Acebutolol;   Drug: Propanolol
Outcome Measures: Hemangioma size;   Tolerance of treatment;   Proportion of patients requiring treatment with corticosteroids because of the evolution of a 'serious' hemangioma
18 Recruiting Early Propranolol After Traumatic Brain Injury: Phase II
Condition: Traumatic Brain Injury
Intervention: Drug: Propranolol
Outcome Measure: Determine in patients with traumatic brain injury (TBI) the safe dosing of early Propranolol.
19 Unknown  Propranolol for Diabetic Retinopathy
Condition: Proliferative Diabetic Retinopathy
Intervention: Drug: Propranolol
Outcome Measures: Area of retinal neovascularization on fundus photography;   Retinopathy level in contralateral eye;   Optical coherence tomography macular thickness of treated and fellow eye;   Amount of fluorescein leakage on angiography;   Early Treatment Diabetic Retinopathy Study visual acuity in study and fellow eye
20 Recruiting Treatment of PTSD by Reduction of Traumatic Memory Reconsolidation by Propranolol : a Multisite Trial
Condition: Post-traumatic Stress Disorder
Interventions: Drug: Propranolol;   Other: Trauma reactivation;   Drug: placebo
Outcome Measure: PTCD CheckList (PCL) total score.