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Home ventilation

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https://www.readbyqxmd.com/read/29157220/combined-effects-of-leaks-respiratory-system-properties-and-upper-airway-patency-on-the-performance-of-home-ventilators-a-bench-study
#1
Kaixian Zhu, Claudio Rabec, Jésus Gonzalez-Bermejo, Sébastien Hardy, Sami Aouf, Pierre Escourrou, Gabriel Roisman
BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically "tolerable" leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony ("critical leak") in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA...
November 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29154419/clinical-profiles-and-prognosis-of-acute-heart-failure-in-adult-patients-with-dystrophinopathies-on-home-mechanical-ventilation
#2
Abdallah Fayssoil, Rabah Ben Yaou, Adam Ogna, France Leturcq, Olivier Nardi, Bernard Clair, Karim Wahbi, Frederic Lofaso, Pascal Laforet, Denis Duboc, David Orlikowski, Djillali Annane
AIMS: Duchenne muscular dystrophy (DMD) is characterized by respiratory and heart involvements. In the context of permanently wheelchair bound and on mechanical ventilation (MV) patients, the clinical presentation of acute heart failure (AHF) syndrome may be atypical. We sought to describe clinical and genetic profiles and to determine prognosis of DMD and Becker muscular dystrophy (BMD) patients on home MV (HMV), hospitalized for AHF. METHODS AND RESULTS: We included genetically proven DMD and BMD patients on HMV admitted for AHF...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29152895/survey-of-financial-burden-of-families-in-the-u-s-with-children-using-home-mechanical-ventilation
#3
Jeffrey D Edwards, Howard B Panitch, Andrei Constantinescu, Rachel L Miller, Patricia W Stone
AIM: To describe and quantify the out-of-pocket expenses, employment loss, and other financial impact related to caring for a child using home mechanical ventilation (HMV). METHOD: We conducted a cross-sectional survey of U.S. families with children who used HMV. Eligible participants were invited to complete a questionnaire addressing household and child characteristics, out-of-pocket expenses, employment loss/reduction, and financial stress. Participants were recruited with the help of three national patient registries...
November 20, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#4
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29112540/aeromedical-transport-in-children-a-descriptive-analysis-of-96-cases
#5
Guillaume Mortamet, Karen Harrington, Hervé Raffin, Mehdi Oualha, Sylvain Renolleau
OBJECTIVE: Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS: In this single-center retrospective study, we included air-transported patients less than 18 years old. RESULTS: During the study period, 96 patients, with median age of 120 months (range, 0-204), were air transported...
November 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29112078/survival-outcomes-following-the-use-of-extracorporeal-membrane-oxygenation-as-a-rescue-technology-in-critically-ill-patients-results-from-pennsylvania-2007-2015
#6
Marco D Huesch, Andrew Foy, Christoph Brehm
OBJECTIVE: To examine real-world outcomes of survival, length of stay, and discharge destination, among all adult extracorporeal membrane oxygenation admissions in one state over nearly a decade. DESIGN: Retrospective analysis of administrative discharge data. SETTING: State-wide administrative discharge data from Pennsylvania between 2007 and 2015. PATIENTS: All 2,948 consecutive patients billed under a Diagnosis-Related Grouper 3 grouper and in whom a procedural code for extracorporeal membrane oxygenation was present, admitted between the beginning of 2007 and the end of 2015 to hospitals regulated by the state of Pennsylvania...
November 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29078902/admission-of-elderly-blunt-thoracic-trauma-patients-directly-to-the-intensive-care-unit-improves-outcomes
#7
Owen J Pyke, Jerry A Rubano, James A Vosswinkel, Jane E McCormack, Emily C Huang, Randeep S Jawa
INTRODUCTION: Blunt thoracic trauma in the elderly has been associated with adverse outcomes. As an internal quality improvement initiative, direct intensive care unit (ICU) admission of nonmechanically ventilated elderly patients with clinically important thoracic trauma (primarily multiple rib fractures) was recommended. METHODS: A retrospective review of the trauma registry at a level 1 trauma center was performed for patients aged ≥65 y with blunt thoracic trauma, admitted between the 2 y before (2010-2012) and after (2013-2015) the recommendation...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29066003/clinical-outcomes-after-burns-in-elderly-patients-over-70-years-a-17-year-retrospective-analysis
#8
Gregg Dexter, Sachin Patil, Kanwardeep Singh, Michael A Marano, Robin Lee, Sylvia J Petrone, Ronald S Chamberlain
INTRODUCTION: In the United Stated population >70years is likely to double by the year 2050. Elderly population (>70years) are most vulnerable to burns and outcomes following such injuries in this special group is poorly studied. This study aimed to look at outcomes following burns in patients >70years over a period of 17 years. MATERIALS AND METHODS: Data on 6512 patients admitted to a Level I Burn Center between 1995 and 2011 was analyzed. Age, gender, ethnicity, TBSA, burn etiology, hospital and burn intensive care unit (ICU) length of stay (LOS) and status at discharge were abstracted...
October 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29065161/critical-illness-among-adults-with-cystic-fibrosis-in-texas-2004-2013-patterns-of-icu-utilization-characteristics-and-outcomes
#9
Lavi Oud
OBJECTIVE: Available reports on critically ill adults with cystic fibrosis (CF) suggest improving short-term outcomes. However, there is marked heterogeneity in reported findings, with studies mostly based on single-centered data, limiting generalizability. We sought to examine population-level patterns of demand for critical care resources, and the characteristics, resource utilization, and outcomes of ICU-managed adults with CF. METHODS: We used the Texas Inpatient Public Use Data File to identify ICU admissions with CF aged ≥18 years in Texas between 2004-2013...
2017: PloS One
https://www.readbyqxmd.com/read/29064179/a-case-of-hypothermia-on-crrt
#10
Gurwant Kaur, Prameela Banoth, Preethi Yerram, Madhukar Misra
A 64-year-old Asian man, with past medical history of hypertension, hypothyroidism, and hyperlipidemia, presented with 3 days history of fever associated with cough and worsening shortness of breath. Subsequent clinical course was complicated by acute lung injury leading to acute respiratory distress syndrome requiring positive pressure ventilation, septic shock requiring inotropic support, and acute kidney injury requiring continuous renal replacement therapy (CRRT). On day 3 of CRRT, the patient developed significant hypothermia (temporal temperature 27...
October 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29063594/late-7-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#11
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Many preterm infants who survive go on to develop bronchopulmonary dysplasia, probably as the result of persistent inflammation in the lungs. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established bronchopulmonary dysplasia. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs. OBJECTIVES: To examine the relative benefits and adverse effects of late systemic postnatal corticosteroid treatment (> 7 days) for preterm infants with evolving or established bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29046009/-experiences-of-patients-with-invasive-and-non-invasive-home-mechanical-ventilation-a-systematic-review-of-qualitative-research
#12
V Nelißen, S Metzing, W Schnepp
Aim of the study Human beings can be ventilated outside of a hospital after a lung failure or due to a neurodegenerative disease. This can be done in different living conditions. This article examines the question of what experiences such patients have made with invasive home mechanical ventilation, and how they have adapted their new lives. Methodology On the basis of a systematic literature research, qualitative studies were analyzed that depict the social reality of patients with invasive and non-invasive home mechanical ventilation...
October 18, 2017: Pneumologie
https://www.readbyqxmd.com/read/29037301/asthma-symptoms-among-chinese-children-the-role-of-ventilation-and-pm10-exposure-at-school-and-home
#13
X-J Fan, C Yang, L Zhang, Q Fan, T Li, X Bai, Z-H Zhao, X Zhang, D Norback
SETTING: Respiratory symptoms in relation to environment in Taiyuan, China. OBJECTIVE: To study associations between school/home exposure and prevalence of respiratory symptoms and self-reported respiratory infections (RIs) among students. DESIGN: A total of 2134 pupils from 10 schools answered a questionnaire; air pollution at school was measured. RESULTS: The prevalence of current wheeze, daytime attacks of breathlessness, nocturnal cough, nocturnal respiratory symptoms and RI was respectively 4...
November 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29025957/admissions-to-acute-care-within-30-and-90-days-of-discharge-home-from-a-pediatric-post-acute-care-hospital
#14
Jane E O'Brien, Helene M Dumas, Maria A Fragala-Pinkham, Jay G Berry
OBJECTIVES: Of all hospitalized children, those with medical complexity have the highest likelihood of hospital readmission. Post-acute hospital care could potentially help stabilize the health of these children. We examined the frequency of acute care hospital admissions after discharge home from a post-acute care hospital (PACH). METHODS: A retrospective cohort analysis of 448 children with medical complexity discharged from a PACH from January 1, 2010, to December 31, 2015, with the main outcomes of acute care hospital readmissions 0 to 30 and 31 to 90 days after discharge home from a PACH...
October 12, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29024878/impact-of-outlier-status-on-critical-care-patient-outcomes-does-boarding-medical-intensive-care-unit-patients-make-a-difference
#15
Danish Ahmad, Katherine Moeller, Jared Chowdhury, Vishal Patel, Erika J Yoo
PURPOSE: To evaluate the impact of outlier status, or the practice of boarding ICU patients in distant critical care units, on clinical and utilization outcomes. MATERIALS AND METHODS: Retrospective observational study of all consecutive admissions to the MICU service between April 1, 2014-January 3, 2016, at an urban university hospital. RESULTS: Of 1931 patients, 117 were outliers (6.1%) for the entire duration of their ICU stay. In adjusted analyses, there was no association between outlier status and hospital (OR 1...
October 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29019851/outcomes-of-icu-patients-with-a-discharge-diagnosis-of-critical-illness-polyneuromyopathy-a-propensity-matched-analysis
#16
Daniel A Kelmenson, Natalie Held, Richard R Allen, Dianna Quan, Ellen L Burnham, Brendan J Clark, P Michael Ho, Tyree H Kiser, R William Vandivier, Marc Moss
OBJECTIVES: To assess the impact of a discharge diagnosis of critical illness polyneuromyopathy on health-related outcomes in a large cohort of patients requiring ICU admission. DESIGN: Retrospective cohort with propensity score-matched analysis. SETTING: Analysis of a large multihospital database. PATIENTS: Adult ICU patients without preexisting neuromuscular abnormalities and a discharge diagnosis of critical illness polyneuropathy and/or myopathy along with adult ICU propensity-matched control patients...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29019630/prolonged-hospital-discharge-for-children-with-technology-dependency-a-source-of-health-care-disparities
#17
Sarah A Sobotka, Rishi K Agrawal, Michael E Msall
Children with ventilator assistance have been supported in living at home since 1981 when parental advocacy ushered in a change to Medicaid policy. As the population of children who use medical technology such as long-term ventilation increases, we must critically evaluate our systems for preparing families for home life. Discharge delays persist in the modern era because of fragmentation between hospital and home systems. These discharge delays result in children spending time in less developmentally rich environments, further exacerbating the health and development disparities of children with complex disabilities...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28984426/caregiver-knowledge-and-skills-to-safely-care-for-pediatric-tracheostomy-ventilation-at-home
#18
Reshma Amin, Chris Parshuram, Jeannie Kelso, Audrey Lim, Dimas Mateos, Ian Mitchell, Hema Patel, Madan Roy, Faiza Syed, Rita Troini, David Wensley, Louise Rose
OBJECTIVE: Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers. METHODS: We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada...
October 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28983961/developing-a-predictive-model-for-fine-particulate-matter-concentrations-in-low-socio-economic-households-in-durban-south-africa
#19
B Shezi, N Jafta, B Sartorius, R N Naidoo
In low-resource settings, there is a need to develop models that can address contributions of household and outdoor sources to population exposures. The aim of the study was to model indoor PM2.5 using household characteristics, activities, and outdoor sources. Households belonging to participants in the Mother and Child in the Environment (MACE) birth cohort, in Durban, South Africa, were randomly selected. A structured walk-through identified variables likely to generate PM2.5 . MiniVol samplers were used to monitor PM2...
October 6, 2017: Indoor Air
https://www.readbyqxmd.com/read/28977304/children-with-multiple-congenital-defects-what-are-the-limits-between-therapeutic-obstinacy-and-the-treatment-of-uncertain-benefit
#20
Patricia Souza Valle Cardoso Pastura, Marcelo Gerardin Poirot Land
OBJECTIVE: Therapeutic approach of children with multiple malformations poses many dilemmas, making it difficult to build a line between the treatment of uncertain benefit and therapeutic obstinacy. The aim of this paper was to highlight possible sources of uncertainty in the decision-making process, for this group of children. CASE DESCRIPTION: An 11-month-old boy, born with multiple birth defects and abandoned by his parents, has never been discharged home. He has complex congenital heart disease, main left bronchus stenosis and imperforate anus...
January 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
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