Potápění na nádech je každému plavci dostupná sportovní aktivita nevyžadující žádné mimořádné technické vybavení. Ve své závodní podobě má potápění na nádech (také apnoické potápění či freediving) řadu disciplín, v nichž potápěči soutěží jednak v bazénu, jednak ve venkovních přírodních vodách. Nejzávažnějším rizikem je náhlá a nepozorovaná ztráta vědomí, tzv. potápěčský blackout. Ten může mít letální následky, pokud se potápěči nedostane okamžité pomoci. Zásadními preventivními opatřeními těchto příhod je nepotápět se nikdy bez dohledu druhé osoby, nehyperventilovat před ponořením pod vodní hladinu a případně absolvovat potápěčský kurz pod dohledem certifikovaného profesionálního instruktora.
Breath-hold diving is a sport activity available to every swimmer, not requiring any special technical equipment. In its competitive form, brath-hold diving (also apnea diving or freediving) has a number of disciplines in which divers compete both in the pool and in the outdoor natural waters. The most serious risk is a sudden and unobserved loss of consciousness, the so-called diving blackout. It can have lethal consequences if the diver does not get immediate help. The basic preventive measures of these events are never to dive without the supervision of another person, never to hyperventilate before immersion below the water surface and possibly complete a diving course under the supervision of a certified professional instructor.
- MeSH
- apnoe etiologie mortalita patofyziologie MeSH
- hypoxie etiologie mortalita patologie MeSH
- lidé MeSH
- poškození plic etiologie patofyziologie prevence a kontrola MeSH
- potápění * škodlivé účinky MeSH
- rizikové faktory MeSH
- zadržování dechu MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
Background: Respiratory parameters are important predictors of prognosis in the COPD population. Global Initiative for Obstructive Lung Disease (GOLD) 2017 Update resulted in a vertical shift of patients across COPD categories, with category B being the most populous and clinically heterogeneous. The aim of our study was to investigate whether respiratory parameters might be associated with increased all-cause mortality within GOLD category B patients. Methods: The data were extracted from the Czech Multicentre Research Database, a prospective, noninterventional multicenter study of COPD patients. Kaplan-Meier survival analyses were performed at different levels of respiratory parameters (partial pressure of oxygen in arterial blood [PaO2], partial pressure of arterial carbon dioxide [PaCO2] and greatest decrease of basal peripheral capillary oxygen saturation during 6-minute walking test [6-MWT]). Univariate analyses using the Cox proportional hazard model and multivariate analyses were used to identify risk factors for mortality in hypoxemic and hypercapnic individuals with COPD. Results: All-cause mortality in the cohort at 3 years of prospective follow-up reached 18.4%. Chronic hypoxemia (PaO2 <7.3 kPa), hypercapnia (PaCO2 >7.0 kPa) and oxygen desaturation during the 6-MWT were predictors of long-term mortality in COPD patients with forced expiratory volume in 1 second ≤60% for the overall cohort and for GOLD B category patients. Univariate analyses confirmed the association among decreased oxemia (<7.3 kPa), increased capnemia (>7.0 kPa), oxygen desaturation during 6-MWT and mortality in the studied groups of COPD subjects. Multivariate analysis identified PaO2 <7.3 kPa as a strong independent risk factor for mortality. Conclusion: Survival analyses showed significantly increased all-cause mortality in hypoxemic and hypercapnic GOLD B subjects. More important, PaO2 <7.3 kPa was the strongest risk factor, especially in category B patients. In contrast, the majority of the tested respiratory parameters did not show a difference in mortality in the GOLD category D cohort.
- MeSH
- analýza krevních plynů MeSH
- chronická obstrukční plicní nemoc diagnóza mortalita patofyziologie terapie MeSH
- databáze faktografické MeSH
- dýchání * MeSH
- hyperkapnie diagnóza mortalita patofyziologie terapie MeSH
- hypoxie diagnóza mortalita patofyziologie terapie MeSH
- Kaplanův-Meierův odhad MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- plíce patofyziologie MeSH
- prediktivní hodnota testů MeSH
- prognóza MeSH
- proporcionální rizikové modely MeSH
- rizikové faktory MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- test chůzí MeSH
- usilovný výdechový objem MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: In immunocompromised patients with acute hypoxemic respiratory failure (ARF), initial management aims primarily to avoid invasive mechanical ventilation (IMV). METHODS: To assess the impact of initial management on IMV and mortality rates, we performed a multinational observational prospective cohort study in 16 countries (68 centers). RESULTS: A total of 1611 patients were enrolled (hematological malignancies 51.9%, solid tumors 35.2%, systemic diseases 17.3%, and solid organ transplantation 8.8%). The main ARF etiologies were bacterial (29.5%), viral (15.4%), and fungal infections (14.7%), or undetermined (13.2%). On admission, 915 (56.8%) patients were not intubated. They received standard oxygen (N = 496, 53.9%), high-flow oxygen (HFNC, N = 187, 20.3%), noninvasive ventilation (NIV, N = 153, 17.2%), and NIV + HFNC (N = 79, 8.6%). Factors associated with IMV included age (hazard ratio = 0.92/year, 95% CI 0.86-0.99), day-1 SOFA (1.09/point, 1.06-1.13), day-1 PaO2/FiO2 (1.47, 1.05-2.07), ARF etiology (Pneumocystis jirovecii pneumonia (2.11, 1.42-3.14), invasive pulmonary aspergillosis (1.85, 1.21-2.85), and undetermined cause (1.46, 1.09-1.98). After propensity score matching, HFNC, but not NIV, had an effect on IMV rate (HR = 0.77, 95% CI 0.59-1.00, p = 0.05). ICU, hospital, and day-90 mortality rates were 32.4, 44.1, and 56.4%, respectively. Factors independently associated with hospital mortality included age (odds ratio = 1.18/year, 1.09-1.27), direct admission to the ICU (0.69, 0.54-0.87), day-1 SOFA excluding respiratory score (1.12/point, 1.08-1.16), PaO2/FiO2 < 100 (1.60, 1.03-2.48), and undetermined ARF etiology (1.43, 1.04-1.97). Initial oxygenation strategy did not affect mortality; however, IMV was associated with mortality, the odds ratio depending on IMV conditions: NIV + HFNC failure (2.31, 1.09-4.91), first-line IMV (2.55, 1.94-3.29), NIV failure (3.65, 2.05-6.53), standard oxygen failure (4.16, 2.91-5.93), and HFNC failure (5.54, 3.27-9.38). CONCLUSION: HFNC has an effect on intubation but not on mortality rates. Failure to identify ARF etiology is associated with higher rates of both intubation and mortality. This suggests that in addition to selecting the appropriate oxygenation device, clinicians should strive to identify the etiology of ARF.
- MeSH
- hostitel s imunodeficiencí * MeSH
- hypoxie mortalita terapie MeSH
- intratracheální intubace škodlivé účinky MeSH
- komorbidita MeSH
- kritický stav MeSH
- lidé středního věku MeSH
- lidé MeSH
- mortalita v nemocnicích MeSH
- neinvazivní ventilace metody MeSH
- oxygenoterapie metody MeSH
- prospektivní studie MeSH
- respirační insuficience etiologie mortalita terapie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- věkové faktory MeSH
- vyhodnocení orgánové dysfunkce MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- pozorovací studie MeSH
Nicotine has been repeatedly reported as substance possessing neuroprotective properties. This study focused on the possible beneficial effects of nicotine against the high-altitude hypoxia (9000 m for one hour). 15 min prior to hypoxia exposition rats (12- and 35-day-old) were treated with nicotine. Next day electrodes have been implanted and the effects of nicotine and hypoxia (or both factors) on duration of afterdischarges (ADs) were tested. Administration of nicotine declined the hypoxia-induced mortality in 35-day-old animals. Nicotine pretreatment had no effect on ADs duration in 12-day-old pups, therefore brought about suppression of ADs in 35-day-old animals. Taken together, our data show that nicotine exhibits an anticonvulsant effect that is age-dependent. The mechanisms of nicotine neuroprotective properties include probably the influence of calcium homeostasis, increase synthesis of variety of growth factors, inhibition of the caspase cascades and antioxidant capability of nicotine.
- MeSH
- časové faktory MeSH
- elektrody MeSH
- elektrofyziologie metody MeSH
- elektrokardiografie metody MeSH
- epilepsie farmakoterapie MeSH
- hypoxie farmakoterapie mortalita MeSH
- krysa rodu rattus MeSH
- mezibuněčné signální peptidy a proteiny metabolismus MeSH
- mozek účinky léků MeSH
- nadmořská výška MeSH
- neuroprotektivní látky farmakologie MeSH
- nikotin farmakologie MeSH
- potkani Wistar MeSH
- statistické modely MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- mužské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- MeSH
- hypoxie diagnóza mortalita MeSH
- nemoci nedonošenců MeSH
- novorozenec MeSH
- těhotenství MeSH
- Check Tag
- novorozenec MeSH
- těhotenství MeSH
