ABSTRACT
Legionella-associated respiratory failure has a high mortality, despite modern ventilation modalities. Extracorporeal membrane oxygenation (ECMO) is used to achieve gas exchange independent of pulmonary function in patients with severe respiratory failure. This was a retrospective review of the management and outcome of patients with Legionella-associated respiratory failure treated with ECMO support in a large ECMO center over the past 10 years. A retrospective review of patients with confirmed Legionella-associated severe respiratory failure managed with ECMO support at a single center. Between 2000 and 2010, 19 patients with severe respiratory failure caused by Legionella were managed with ECMO after failure to respond to conventional intensive care management. Median PaO2/FiO2 ratio was 66 and median pCO2 was 60 torr. Sixteen patients (84%) survived to hospital discharge. Extracorporeal membrane oxygenation should be considered in patients with Legionella-associated respiratory failure, who have failed conventional ventilation.
Subject(s)
Extracorporeal Membrane Oxygenation/methods , Legionella , Legionellosis/complications , Respiratory Distress Syndrome/microbiology , Respiratory Distress Syndrome/therapy , Respiratory Insufficiency/therapy , Adult , Extracorporeal Membrane Oxygenation/adverse effects , Female , Humans , Legionellosis/therapy , Male , Middle Aged , Respiratory Insufficiency/etiology , Retrospective Studies , Survival Rate , Treatment OutcomeABSTRACT
Caregiving is an important component in the management of patients with a tracheostomy or laryngectomy. The purpose of this integrative research literature review was to gain a better understanding of the impact of caregiving for adults and children with laryngectomy or tracheostomy on the patient, the family, and the caregiver. Patients who had undergone laryngectomy or tracheostomy included those with and without cancer. This integrated review of the literature on caregiving in this population demonstrates the dearth of studies on this subject. Despite the significance of the caregiving role, few studies have addressed caregiving, and those that have are primarily descriptive. Studies are needed that develop and test interventions to assist caregivers in adaptation to their role, identification of methods of decreasing caregiver burden and strain, and coordination of resources to support patients and caregivers of patients with tracheostomies and laryngectomies.
Subject(s)
Caregivers/psychology , Interpersonal Relations , Laryngectomy/psychology , Marriage/psychology , Spouses/psychology , Activities of Daily Living , Adaptation, Psychological , Adult , Child , Cost of Illness , Family Health , Home Nursing/psychology , Humans , Laryngectomy/adverse effects , Needs Assessment , Research Design , Respiration, Artificial/adverse effects , Respiration, Artificial/psychology , Role , Social Support , Stress, Psychological/psychology , Tracheostomy/adverse effects , Tracheostomy/psychologyABSTRACT
In March, 2002, the Society of Otorhinolaryngology and Head-Neck Nurses, Inc. (SOHN) conducted a web-based survey of members' knowledge of and satisfaction with its portfolio of products and services. This paper reports on the process of developing and conducting the survey, as well as its findings. A new "Volunteer Agreement/Code of Conduct", piloted for this team's work is introduced. General and specific recommendations are put forth for SOHN members and leaders, including useful information to facilitate work for future survey teams.
