![]() ![]() Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act). Our Data: Information on is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.Review Challenges and controversies in COVID-19 respiratory failureĬOVID-19 pneumonia presents distinctive questions and challenges traditional conventions of management of respiratory failure. The trajectory of recommendations on customary intubation practices has undertaken significant paradigm shifts. This review will discuss the role of high flow nasal cannula oxygenation in mitigating respiratory distress in SARS-COV2 pneumonia and will explore the indices that can aid in the timely recognition of failure of non-invasive respiratory support modalities and escalation to mechanical ventilation. The work of breathing is a valuable yardstick for understanding increasing lung elastance. Quantifying work of breathing, though, has its own unique challenges. This article also discusses the emerging controversial proposals of employing high tidal volumes and low PEEP in mechanical ventilation of COVID-19 pneumonia and will review the key concepts of lung stress and strain and the implications of “static” versus “dynamic” strain in ventilator induced lung injury. It considers the established facts of inducing lung strain with larger dynamic deformations caused by high tidal volumes and the benefit of high PEEP in homogenizing the strain distribution. The review suggests that the isolated ground glass opacities could pose as “stress raisers.” The effects of these regional lung homogeneities in amplifying local and global lung stress are also discussed as well as the benefits of PEEP beyond its effect as a pressure barrier against alveolar filling and its utility in lungs with near normal compliance. A physiologic approach is presented to counter the non-uniform and heterogeneous presentations of this unique disease rather than conforming to rigid protocols. Keywords: Covid-19, early intubation, patient self-induced lung injury (P-SILI), pendelluft, lung stress/strain, H and L phenotypes, high tidal volume, low PEEPĪrticle citation: Matta SK. The Southwest Respiratory and Critical Care Chronicles 2020 8(35):29–35 From: Bayhealth Hospital, Milford, Delaware Submitted: Accepted: Reviewer: Gilbert Berdine MD, Victor Test MD Conflicts of interest: none Challenges and controversies in COVID-19 respiratory failure. Matta graduated from the Maharashtra Institute of Medical Education & Research (Mimer) in 2008. This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. Simran MATTA Cited by 3 of University of Nevada School of Medicine, Reno Read 1 publication Contact Simran MATTA. ![]() * COLLECT THE CUTEST OF SLUG CHARACTERS With your evolution stones you can build and level up a team of Elemental Slugs who are the ancestors of all slugs found in the world of Slugterra.She works in Las Vegas, NV and 1 other location and specializes in Critical Care Medicine and Internal Medicine. * EXPLORE MULTIPLE MAGICAL WORLDS From story mode caverns to the Slug Hideout, where your slugs can hang out and interact through various activities with one another – and you! * SOLVE HUNDREDS OF FUN PUZZLES BASED ON one of the best TV series ever - Slugterra! Once you become an experienced Slugslinger, you’ll be able to control the power of Elementals, the legendary ancestors of all Slugs! Will you discover new friends, new rivals, or simply new information to piece together the history of Slugterra? Make sure to befriend as many slugs among the way, they all have a special talent where they can transform into powerful magical beasts! Harness the power of your slug friends, train them and evolve them to their epic Megamorph form! Come beneath the surface to meet the creatures that inhabit Slugterra, Slugs! In this luminous, high-tech, underground world, explore every nook and cranny of the 99 caverns to see what awaits you. ![]()
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