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Mast cell activation syndrome(MCAS) is a systemic autoinflammatory disease in whichmast cells behave erratically. It is unknown whether MCAS recently evolved or if it has been an unrecognized entity for years. Clinically, the patient may present in a constant to near-constant state of allergic reaction. However, the patientmay also present with a variety of nonallergic symptoms. There is currently no curative treatment, and providers must prepare to be persistent in seeking symptom-management strategies. This case study describes the vast array of symptoms a typical MCAS patient may exhibit. There is a need for provider education and awareness of this disease that could affect up to 17% of the population on a spectrum from very mild to debilitating symptoms. MCAS is often eithermisdiagnosed or the diagnosis is greatly delayed due to a lack of provider awareness. Patientsmay approach primary care providers as their first line of treatment for their aberrant, mysterious symptoms, and therefore it is imperative that nurse practitioners are aware of the disease. Nurse practitioners can play a vital role in the management of MCAS using their attention to detail to recognize patterns, validate patients' experiences, and have a voice in diagnostic criteria consensus. [ABSTRACT FROM AUTHOR]

Background Improved recognition of patient-ventilator asynchrony may reduce duration of mechanical ventilation. Objective To evaluate the effects of education about patient-ventilator synchrony on clinicians' level of knowledge and patients' mean duration of mechanical ventilation. Methods A quasi-experimental 1-group pretest-posttest study was performed in a 16-bed intensive care unit. Analysis included 33 clinicians and 97 ventilator patients. The intervention consisted of PowerPoint lectures on patient-ventilator synchrony. Data included test scores before and after the education, scores on the Acute Physiology and Chronic Health Evaluation II, and mean duration of mechanical ventilation. Differences in scores before and after education, mean duration of mechanical ventilation, and mean health evaluation scores before and after education were determined by using t tests. Results Of the 33 clinicians, 17 were registered nurses and 16 were respiratory therapists. Posttest scores were 63% higher than pretest scores (P < .001). Before the lecture, 47 patients had a mean health evaluation score of 21 (SD, 7.8) and mean duration of mechanical ventilation of 5.4 (SD, 4.6) days. After the lecture, 50 patients had a mean health evaluation score of 24.6 (SD, 8.2) and mean duration of mechanical ventilation of 4.8 (SD, 4.3) days. Mean health evaluation score was marginally higher after the lecture (P=.054). Mean duration of mechanical ventilation did not differ (P=.54). Conclusions Clinicians' test scores increased significantly after patient-ventilator synchrony lectures. Mean duration of mechanical ventilation decreased by 0.6 days and health evaluation scores were marginally higher after the lectures. [ABSTRACT FROM AUTHOR]

The occurrence of ventilator-associated pneumonia (VAP) infections in mechanically ventilated patients has significantly affected how medical providers manage the severe acute pulmonary pathology in chronic obstructive pulmonary disease (COPD) and implement medical interventions to prevent infectious transmission to these patients in the intensive care unit. Severe COPD is present in more than 65 million people worldwide, thereby placing these individuals at an increased risk of intensive care unit admission and VAP contraction. Chronic obstructive pulmonary disease is well known as a risk factor for developing VAP and is related to adverse risk factors such as developing multiple drugYresistant bacteria. Evidence shows that COPD immunosuppression continues to be associated with pulmonary infection, but multiple modalities are available to combat and treat acute exacerbations before decompensation begins, thereby preventing prolonged endotracheal mechanical ventilation. [ABSTRACT FROM AUTHOR]