For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re...sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
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WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly ...results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
We recommend prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
WHO suggests that patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) over standard oxygen therapy.
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For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur...e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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The document is a handbook on implementing the mBreatheFreely program, an mHealth initiative by the World Health Organization (WHO) and the International Telecommunication Union (ITU) aimed at improving the management of asthma and COPD through mobile technology. It provides a framework for governme...nts and policymakers to develop, launch, and evaluate national mHealth programs. The guide covers areas such as operations management, content development, promotion strategies, technology infrastructure, and monitoring and evaluation. It emphasizes the importance of mHealth in enhancing self-management, prevention, and treatment of chronic respiratory diseases, particularly in low- and middle-income countries. The handbook also includes examples of successful programs and practical tools for adaptation and implementation.
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Paediatric Respiratory Reserch: meet the experts
Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt...h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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Brindar recomendaciones sobre la atención inicial de personas con enfermedad respiratoria aguda (ERA) en el contexto de la infección por coronavirus (COVID-19) en establecimientos de salud basado en flujograma de toma de decisiones. Estas recomendaciones son preliminares y están sujetas a revisi...n a medida que se tengan nuevas evidencias.* Las recomendaciones proporcionadas en este documento se aplican a adultos mayores de 18 años. Audiencias específicas, como los bebés, los niños y las mujeres embarazadas, se abordarán en un documento separado.
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These guidelines provide recommendations for the non-pharmacological aspects of infection prevention and control for acute respiratory diseases (ARD) in health care. Administrative and infection controls, including early detection, isolation and reporting, and establishment of infection control infr...astructure, are key components for containment and mitigation of the impact of pathogens that may constitute a major public health threat. In these guidelines, the options of using natural ventilation and/or exhaust fan assisted ventilation in health-care facilities (HCF) are considered.
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This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management of TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018 ...TB NSP) and on the 2014-2018 Rwanda Leprosy national strategic plan (2014-2018 Leprosy NSP).
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Many critical questions remain about the effectiveness of COVID-19 vaccines in real-world settings. These questions can only be answered in post-introduction vaccine effectiveness studies.This guidance document outlines an approach to leverage existing surveillance systems for Severe Acute Respirato...ry Infection (SARI) to estimate COVID-19 vaccine effectiveness (VE) in preventing SARI associated with laboratory-confirmed SARS-CoV-2 using existing SARI surveillance systems. The approach uses the test-negative design to evaluate VE; cases are SARI patients who tested positive for SARS-CoV-2, and controls are SARI patients who tested negative for SARS-CoV-2.
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It is impossible to address the many complex needs of respiratory virus surveillance with a single surveillance system. Multiple systems, investigations and studies must each be fit-for-purpose to specific priority surveillance objectives, and only together can they provide essential information to ...policy-makers. In essence, each surveillance approach fit together as “tiles in a mosaic” that provides a complete picture of respiratory viruses and the impact of associated illnesses and interventions at the country level. This mosaic framework demonstrates how surveillance approaches may be implemented as coordinated and collaborative systems, well-matched to specific priority objectives.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Recomendaciones para la eleboració de protocolos en países de bajos ingresos