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https://www.readbyqxmd.com/read/28440124/perspectives-on-advance-care-planning-among-patients-recently-requiring-non-invasive-ventilation-for-acute-respiratory-failure-a-qualitative-study-using-thematic-analysis
#1
Tracy A Smith, Rebecca T Disler, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
BACKGROUND: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. AIM: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. DESIGN: Qualitative research using thematic analysis...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28436715/controlled-invasive-mechanical-ventilation-strategies-in-obese-patients-undergoing-surgery
#2
Lígia de Albuquerque Maia, Pedro Leme Silva, Paolo Pelosi, Patricia Rieken Macedo Rocco
The obesity prevalence is increasing in surgical population. As the number of obese surgical patients increases, so does the demand for mechanical ventilation. Nevertheless, ventilatory strategies in this population are challenging, since obesity results in pathophysiological changes in respiratory function. Areas covered: We reviewed the impact of obesity on respiratory system and the effects of controlled invasive mechanical ventilation strategies in obese patients undergoing surgery. To date, there is no consensus regarding the optimal invasive mechanical ventilation strategy for obese surgical patients, and no evidence that possible intraoperative beneficial effects on oxygenation and mechanics translate into better postoperative pulmonary function or improved outcomes...
April 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28435031/clinical-outcome-associated-with-the-use-of-different-inhalation-method-with-and-without-humidification-in-asthmatic-mechanically-ventilated-patients
#3
Islam O F Moustafa, Muhammad H E ElHansy, Moataz Al Hallag, James B Fink, Patricia Dailey, Hoda Rabea, Mohamed E A Abdelrahim
BACKGROUND: Inhaled-medication delivered during mechanical-ventilation is affected by type of aerosol-generator and humidity-condition. Despite many in-vitro studies related to aerosol-delivery to mechanically-ventilated patients, little has been reported on clinical effects of these variables. The aim of this study was to determine effect of humidification and type of aerosol-generator on clinical status of mechanically ventilated asthmatics. METHOD: 72 (36 females) asthmatic subjects receiving invasive mechanical ventilation were enrolled and assigned randomly to 6 treatment groups of 12 (6 females) subjects each received, as possible, all inhaled medication using their assigned aerosol generator and humidity condition during delivery...
April 20, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#4
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28431343/measurement-of-physical-activity-levels-in-the-intensive-care-unit-and-functional-outcomes-an-observational-study
#5
Lisa J Beach, Kate Fetterplace, Lara Edbrooke, Selina M Parry, Rachel Curtis, Thomas Rechnitzer, Sue Berney, Linda Denehy
PURPOSE: Primary aims were: (1) objectively quantify levels of physical activity with the sensewear armband mini-fly motion sensor (SWA-MF), (2) evaluate the correlation of SWA-MF measurement of active and resting energy expenditure against the ICU Mobility scale (IMS) and indirect calorimetry respectively. MATERIALS AND METHODS: Adults mechanically ventilated ≥48h and anticipated to remain in ICU≥5days were included. Physical activity (PA) was measured using a SWA-MF (over the first five days); energy expenditure was measured with both the SWA-MF and the Deltatrac II metabolic cart on day three; highest level of mobility was assessed on the IMS...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28429854/application-of-3c-insulin-pump-system-in-combination-with-non-invasive-ventilation-in-the-treatment-of-a-patient-with-type-2-diabetes-and-obstructive-sleep-apnea-syndrome
#6
Peng Dong, Jing Xu, Junhong Wang, Chunhong Zhang
We observed the curative effect of 3C insulin system in combination with non-invasive ventilation in a patient with type 2 diabetes and obstructive sleep apnea syndrome (OSAS). 3C insulin pump is a system of devices that closely monitors and effectively regulates blood glucose levels. Non-invasive ventilation has been shown to be an effective treatment for OSAS. A type 2 diabetic patient with concomitant OSAS was treated with a 3C insulin pump system for real-time continuous glucose monitoring and nocturnal non-invasive ventilation for OSAS...
April 21, 2017: Journal of Diabetes Investigation
https://www.readbyqxmd.com/read/28428229/withdrawal-of-invasive-ventilation-in-a-patient-with-motor-neurone-disease-and-total-locked-in-syndrome
#7
Aoife Gleeson, Faye Johnson
Withdrawing invasive ventilation from a person with motor neurone disease who lacks the relevant mental capacity raises ethical issues such as the withdrawal of life-sustaining treatment and establishing best interests. There is little available information on providing optimal symptom management to these patients during the withdrawal process. We describe a man with motor neurone disease who also had total locked-in syndrome at the time of ventilation withdrawal, and we document the legal, ethical, emotional and symptom control issues encountered in supporting him...
April 20, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#8
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28424565/invasive-pneumococcal-disease-still-lots-to-learn-and-a-need-for-standardized-data-collection-instruments
#9
T J Marrie, G J Tyrrell, Sumit R Majumdar, Dean T Eurich
Background. Large studies of invasive pneumococcal disease (IPD) are frequently lacking detailed clinical information. Methods. A population-based 15-year study of IPD in Northern Alberta. Results. 2435 patients with a mean age of 54.2 years formed the study group. Males outnumbered females and Aboriginal and homeless persons were overrepresented. High rates of smoking, excessive alcohol use, and illicit drug use were seen. Almost all (87%) had a major comorbidity and 15% had functional limitations prior to admission...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28421780/intestinal-dysfunction-in-the-critical-trauma-patients-an-early-and-frequent-event
#10
Beatriz Pinto Costa, Paulo Martins, Carla Verissimo, Marta Simões, Marisa Tomé, Manuela Grazina, Jorge Pimentel, Francisco Castro-Sousa
BACKGROUND: Small-bowel dysfunction exerts a relevant prognostic impact in the critically ill patients. Citrullinemia has been used in the evaluation of the intestinal function and it is considered an objective parameter of the functional enterocyte mass. Present study proposes to determine the intestinal dysfunction prevalence and the citrullinemia kinetic profile in severe trauma patients and to investigate its correlation with severity indicators and clinical outcome. METHODS: A prospective study including 23 critical trauma patients was performed...
March 30, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#11
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28417671/the-use-of-noninvasive-positive-pressure-ventilation-following-pediatric-tonsillectomy
#12
Adva Buzi, Orly M Coblens, Michael MacGillivray, Lisa Elden
Objective To determine the risks of bleeding and other complications in pediatric patients who require noninvasive positive pressure ventilation (PPV) in the immediate posttonsillectomy period. Study Design Case series with chart review. Setting Single tertiary pediatric hospital. Subjects and Methods Sixty-nine patients who had undergone tonsillectomy from July 2007 through December 2013 and required postoperative PPV were reviewed. Data collected included age, sex, medical history, preoperative polysomnogram parameters, length of use and type of noninvasive ventilatory support, and postoperative complications...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28412382/use-of-nebulized-antimicrobials-for-the-treatment-of-respiratory-infections-in-invasively-mechanically-ventilated-adults-a-position-paper-from-the-european-society-of-clinical-microbiology-and-infectious-diseases
#13
Jordi Rello, Candela Solé-Lleonart, Jean-Jacques Rouby, Jean Chastre, Stijn Blot, Garyfallia Poulakou, Charles-Edouard Luyt, Jordi Riera, Lucy B Palmer, Jose M Pereira, Tim Felton, Jayesh Dhanani, Matteo Bassetti, Tobias Welte, Jason A Roberts
With an established role in cystic fibrosis and bronchiectasis, nebulized antibiotics are increasingly being used to treat respiratory infections in critically ill invasively mechanically ventilated adult patients. Although there is limited evidence describing their efficacy and safety, in an era of need for new strategies to enhance antibiotic effectiveness because of a shortage of new agents and increases in antibiotic resistance, the potential of nebulization of antibiotics to optimize therapy is considered of high interest, particularly in patients infected with multidrug-resistant (MDR) pathogens...
April 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28410811/long-term-non-invasive-ventilation-therapies-in-children-a-scoping-review
#14
REVIEW
Maria L Castro-Codesal, Kristie Dehaan, Robin Featherstone, Prabhjot K Bedi, Carmen Martinez Carrasco, Sherri L Katz, Elaine Y Chan, Glenda N Bendiak, Fernanda R Almeida, Deborah L Olmstead, Rochelle Young, Vicki Woolf, Karen A Waters, Colin Sullivan, Lisa Hartling, Joanna E MacLean
Long-term non-invasive ventilation (NIV) is a common modality of breathing support used for a range of sleep and respiratory disorders. The aim of this scoping review was to provide a summary of the literature relevant to long-term NIV use in children. We used systematic methodology to identify 11,581 studies with final inclusion of 289. We identified 76 terms referring to NIV; the most common term was NIV (22%). Study design characteristics were most often single center (84%), observational (63%), and retrospective (54%)...
March 2, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28410001/respiratory-pattern-and-tidal-volumes-differ-for-pressure-support-and-volume-assured-pressure-support-in-amyotrophic-lateral-sclerosis
#15
Trevor T Nicholson, Sean B Smith, Teepu Siddique, Robert Sufit, Senda Ajroud-Driss, John M Coleman, Lisa F Wolfe
RATIONALE: Amyotrophic Lateral Sclerosis is a progressive neuromuscular disease resulting in respiratory failure and death. Use of non-invasive ventilation (NIV) improves survival. However, use of Volume-Assured Pressure Support (VAPS) has not been extensively studied in ALS. OBJECTIVES: To explore the clinical utility of a detailed evaluation of device-recorded NIV data in the management of chronic respiratory failure in ALS. To determine if there are differences in efficacy between patients using VAPS or PS...
April 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28408814/non-invasive-ventilation-with-intelligent-volume-assured-pressure-support-versus-pressure-controlled-ventilation-effects-on-the-respiratory-event-rate-and-sleep-quality-in-copd-with-chronic-hypercapnia
#16
Georg Nilius, Nato Katamadze, Ulrike Domanski, Maik Schroeder, Karl-Josef Franke
BACKGROUND: COPD patients who develop chronic hypercapnic respiratory failure have a poor prognosis. Treatment of choice, especially the best form of ventilation, is not well known. OBJECTIVES: This study compared the effects of pressure-controlled (spontaneous timed [ST]) non-invasive ventilation (NIV) and NIV with intelligent volume-assured pressure support (IVAPS) in chronic hypercapnic COPD patients regarding the effects on alveolar ventilation, adverse patient/ventilator interactions and sleep quality...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28408618/national-policies-fostering-hospice-care-increased-hospice-utilization-and-reduced-the-invasiveness-of-end-of-life-care-for-cancer-patients
#17
Yu-Yun Shao, Emily Han-Chung Hsiue, Chih-Hung Hsu, Chien-An Yao, Ho-Min Chen, Mei-Shu Lai, Ann-Lii Cheng
BACKGROUND: In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies. METHODS: A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28406813/effects-of-hypercapnia-and-hypercapnic-acidosis-on-hospital-mortality-in-mechanically-ventilated-patients
#18
Ravindranath Tiruvoipati, David Pilcher, Hergen Buscher, John Botha, Michael Bailey
OBJECTIVES: Lung-protective ventilation is used to prevent further lung injury in patients on invasive mechanical ventilation. However, lung-protective ventilation can cause hypercapnia and hypercapnic acidosis. There are no large clinical studies evaluating the effects of hypercapnia and hypercapnic acidosis in patients requiring mechanical ventilation. DESIGN: Multicenter, binational, retrospective study aimed to assess the impact of compensated hypercapnia and hypercapnic acidosis in patients receiving mechanical ventilation...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#19
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28401600/involvement-of-patients-perspectives-on-treatment-with-non-invasive-ventilation-in-patients-with-copd-a-qualitative-study
#20
Helle Marie Christensen, Lotte Huniche, Ingrid L Titlestad
AIMS AND OBJECTIVES: To clarify COPD patients' perspectives on treatment with non-invasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating COPD patients with non-invasive ventilation is well documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with COPD experience and evaluate treatment with non-invasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine...
April 12, 2017: Journal of Clinical Nursing
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