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https://www.readbyqxmd.com/read/29679377/clinical-characteristics-of-long-term-survival-with-non-invasive-ventilation-and-factors-affecting-the-transition-to-invasive-ventilation-in-als
#1
Takahiko Hirose, Fumiharu Kimura, Hiroki Tani, Shin Ota, Akihiro Tsukahara, Eri Sano, Taro Shigekiyo, Yoshitsugu Nakamura, Kensuke Kakiuchi, Mikiko Motoki, Kiichi Unoda, Simon Ishida, Hideto Nakajima, Shigeki Arawaka
Introduction We evaluated post non-invasive ventilation survival and factors for the transition to tracheostomy in amyotrophic lateral sclerosis. Methods We analyzed 197 patients using a prospectively-collected database, with 114 patients since 2000. Results Of 114 patients, 59 patients underwent non-invasive ventilation (NIV), which prolonged the total median survival time to 43 months compared with 32 months without treatment. The best post-NIV survival was associated with a lack of bulbar symptoms, higher measured pulmonary function, and a slower rate of progression at diagnosis...
April 20, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29678310/grossly-abnormal-ventilation-perfusion-spect-study-in-idiopathic-pulmonary-arterial-hypertension-without-thromboembolism
#2
Kenneth Chan, John G Coghlan, Margaret Hall, Jamanda Haddock, Alan Bates, Benjamin E Schreiber
Pulmonary hypertension is a serious condition with multiple underlying aetiologies which require different treatment strategies. We present a case of severe idiopathic pulmonary arterial hypertension in a 20-year-old patient with ongoing breathlessness. She was initially diagnosed with asthma and panic attacks in community care. As the symptoms became progressively worse, she was referred for pulmonary hypertension clinic assessment. Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) showed grossly abnormal perfusion defects which were mismatched to the ventilation scan, suggestive of chronic thromboembolic disease...
January 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#3
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29674397/massive-haemoptysis-secondary-to-mycotic-pulmonary-artery-aneurysm-in-subacute-invasive-aspergillosis
#4
Shahbaz Piracha, Asad Mahmood, Noman Qayyum, Muhammad Badar Ganaie
A 68-year-old man, presented with 3 week history of infective symptoms and mild haemoptysis. Past medical history included severe emphysema and a chronic right upper lobe (RUL) cavity. He was discharged from follow-up a year ago in view of clinical and radiological stability; previous bronchoscopic examinations yielded no specific diagnosis. CT scan on admission confirmed complex cavitary consolidation of RUL. He developed massive haemoptysis requiring intubation and ventilation. CT pulmonary angiogram (CTPA) revealed 16 mm RUL pulmonary artery (PA) aneurysm which was successfully embolized...
April 19, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29671041/oropharyngeal-and-nasopharyngeal-decontamination-with-chlorhexidine-gluconate-in-lung-cancer-surgery-a-randomized-clinical-trial
#5
Xavier Benoit D'Journo, Pierre-Emmanuel Falcoz, Marco Alifano, Jean-Philippe Le Rochais, Thomas D'Annoville, Gilbert Massard, Jean Francois Regnard, Philippe Icard, Charles Marty-Ane, Delphine Trousse, Christophe Doddoli, Bastien Orsini, Sophie Edouard, Matthieu Million, Nathalie Lesavre, Anderson Loundou, Karine Baumstarck, Florence Peyron, Stephane Honoré, Stéphanie Dizier, Aude Charvet, Marc Leone, Didier Raoult, Laurent Papazian, Pascal Alexandre Thomas
PURPOSE: Respiratory complications are the leading causes of morbidity and mortality after lung cancer surgery. We hypothesized that oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate (CHG) would be an effective method to reduce these complications as reported in cardiac surgery. METHODS: In this multicenter parallel-group randomized double-blind placebo-controlled trial, we enrolled consecutive adults scheduled for anatomical pulmonary resection for lung cancer...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29671035/-prognostic-relevance-of-tissue-oxygen-saturation-in-patients-in-the-early-stage-of-multiple-organ-dysfunction-syndrome
#6
D Huster, F Härtel, S Nuding, J Schroeder, Y Zhang, K Werdan, H Ebelt
BACKGROUND: Patients in circulatory shock exhibit insufficient peripheral perfusion to ensure adequate oxygenation of vital organs such as the heart and brain. Early detection of reduced tissue oxygen saturation (St O2 ) could be used for rapid therapeutic intervention and thus improve the prognosis of patients in the early stage of multiple organ dysfunction syndrome (MODS). MATERIALS AND METHODS: A total of 60 patients in the early stage of MODS (APACHE [Acute Physiology and Chronic Health Evaluation] II score ≥20) were investigated in a monocentric, prospective, randomized phase II study...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29666685/identifying-risk-factors-for-healthcare-associated-infections-caused-by-carbapenem-resistant-acinetobacter-baumannii-in-a-neonatal-intensive-care-unit
#7
Amira M Sultan, Wael A Seliem
Objectives: Acinetobacter baumannii is a causative pathogen of various healthcare-associated infections (HAIs) and is particularly prevalent in high-risk hospital settings. This study aimed to determine risk factors associated with HAIs caused by carbapenem-resistant A. baumannii (CRAB) in a neonatal intensive care unit (NICU). Methods: This prospective study was performed between January 2013 and June 2014 among NICU patients at the Mansoura University Children's Hospital, Mansoura, Egypt...
February 2018: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29664358/tailored-management-of-stage-iiia-non-small-cell-lung-cancer-in-the-era-of-the-8th-edition-of-the-tnm-classification-for-lung-cancer
#8
Michael R Mueller
Stage IIIA is a very heterogeneous group encompassing locally advanced disease with T3 and T4 tumors without any nodal involvement and very small T1a primary tumors with unilateral mediastinal lymphatic disease. Tailored management defines interdisciplinary management requiring board decisions, which can sometimes be difficult particularly in stage IIIa non-small-cell lung cancer (NSCLC). Lobectomy still is standard of care even for stage I NSCLC, which increasingly is implemented using minimally invasive surgical technique...
March 2018: Future Oncology
https://www.readbyqxmd.com/read/29662873/permissive-hypercapnia-results-in-decreased-functional-vessel-density-in-the-skin-of-extremely-low-birth-weight-infants
#9
Alexandra Francoise Puchwein-Schwepcke, Kristina Schottmayer, Zuzana Mormanová, Jens Dreyhaupt, Orsolya Genzel-Boroviczeny, Ulrich H Thome
Background: Ventilator-induced lung injury with subsequent bronchopulmonary dysplasia remains an important issue in the care of extremely low-birth-weight infants. Permissive hypercapnia has been proposed to reduce lung injury. Hypercapnia changes cerebral perfusion, but its influence on the peripheral microcirculation is unknown. Methods: Data were collected from 12 infants, who were randomized to a permissive high PCO2 target group (HTG) or a control group (CG)...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29658860/pressure-support-breaths-triggered-by-total-artificial-heart-in-invasive-and-non-invasive-mechanical-ventilation
#10
Amit Prasad, Kai Singbartl, Behzad Soleimani, Christoph Brehm, Ali Ghodsizad
Because of the risks associated with extended mechanical ventilation, it is desirable to extubate patients as early as possible. However, weaning patients from mechanical ventilation too early has risks associated with it as well. Thus, it is important to note that in the two cases presented here, pressure-supported breaths were falsely triggered by a patient's a Syncardia® total artificial heart (TAH), influencing decisions about weaning the patient from mechanical ventilation.
March 2, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657729/risk-factors-for-prolonged-mechanical-ventilation-in-patients-with-severe-multiple-injuries-and-blunt-chest-trauma-a-single-center-retrospective-case-control-study
#11
Yasuyuki Okabe
Aim: Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). Methods: Consecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29657373/severe-varicella-pneumonia-in-adults-seven-years-single-center-experience-from-india
#12
Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, R K Soni
Context: Varicella pneumonia is a rare but a serious complication of chickenpox in adults. There is paucity of data on varicella pneumonia from India. Aims: The aim of this study is to describe the clinical manifestations, hospital course, treatment, and outcome of adult patients with severe varicella pneumonia. Settings and Design: This was a retrospective, observational study of patients with severe varicella pneumonia attending a tertiary care teaching hospital...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#13
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29657253/minimally-invasive-mitral-valve-repair-through-right-minithoracotomy-11-year-single-institute-experience
#14
Taichi Sakaguchi, Toshinori Totsugawa, Masahiko Kuinose, Kentaro Tamura, Arudo Hiraoka, Genta Chikazawa, Hidenori Yoshitaka
BACKGROUND: Although minimally invasive mitral valve repair (MIMVR) is increasingly being performed, only a few clinical studies from Japanese institutions have been reported.Methods and Results:From 2006 to 2017, 387 consecutive patients (135 females, mean age 56±13 years) underwent an initial isolated MIMVR through a right minithoracotomy. The mitral etiology was degenerative in 348, functional in 22, and endocarditis in 13 cases. Repair techniques included leaflet resection/plication in 280, chordal reconstruction in 109, and annuloplasty alone in 24 patients, and concomitant procedures included tricuspid valve repair and atrial fibrillation ablation in 70 (18...
April 13, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29656287/respiratory-management-of-extremely-preterm-infants-an-international-survey
#15
Marc Beltempo, Tetsuya Isayama, Máximo Vento, Kei Lui, Satoshi Kusuda, Liisa Lehtonen, Gunnar Sjörs, Stellan Håkansson, Mark Adams, Akihiko Noguchi, Brian Reichman, Brian A Darlow, Naho Morisaki, Dirk Bassler, Simone Pratesi, Shoo K Lee, Abhay Lodha, Neena Modi, Kjell Helenius, Prakesh S Shah
BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration...
April 13, 2018: Neonatology
https://www.readbyqxmd.com/read/29652870/surveillance-for-the-identification-of-cases-of-acute-respiratory-infection-by-enterovirus-d68-in-children-in-a-tertiary-level-care-hospital-during-2014-2016
#16
Ana Estela Gamiño-Arroyo, José Luis Sánchez-Huerta, Alicia Elhaín de la Garza-López, Israel Parra-Ortega, Noé Escobar-Escamilla, Edgar Mendieta-Condado, Fabiola Garcés-Ayala, Gisela Barrera-Badillo, José Ernesto Ramírez-González, José Alberto Díaz-Quiñonez, Daniela de la Rosa-Zamboni
Background: The reemergence of enterovirus D68 (EV-D68) infections in the United States was reported from August-October 2014 (691 cases). In Mexico, an outbreak at the National Institute of Respiratory Diseases was reported (24 cases). The results of epidemiological surveillance of Enterovirus sp. (EV) and other respiratory viruses in a national pediatric tertiary care level hospital are presented. Methods: Following the alert issued by the reemergence of EV-D68 in 2014, epidemiological surveillance -which only detected respiratory viruses by PCR in patients with influenza-like illness using nasopharyngeal swabs- expanded to include children with asthma exacerbation or acute respiratory distress...
2018: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29650284/-home-non-invasive-ventilation-for-chronic-obstructive-pulmonary-disease
#17
S Toujani, S Dabboussi, H Snene, M Mjid, S Kamoun, A Hedhli, S Cheikh Rouhou, R Cheikh, M Beji, Y Ouahchi, J Cherif
INTRODUCTION: The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial. AIM: To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population. METHODS: We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital...
April 9, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29649849/-copd-importance-of-lung-function-testing-for-diagnosis-and-treatment
#18
Wolfram Windisch, Carl Peter Criée
Pulmonary function testing is essential for diagnosis and treatment-guidance of chronic obstructive pulmonary disease (COPD). Airway obstruction as assessed by spirometry should follow the reference-values provided by the Global Lung Initiative (GLI) of the European Respiratory Society (ERS). In addition, lung function testing should also include the assessment of lung hyperinflation and pulmonary emphysema by full-body plethysmography and determination of diffusion capacity. This is important since both, lung hyperinflation and pulmonary emphysema, can present without existing airway obstruction...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29648486/physicians-attitudes-when-faced-with-life-threatening-events-in-children-with-severe-neurological-disabilities
#19
Benjy Wosinski, Christopher J Newman
PURPOSE: Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians' attitudes when making decisions in these situations. METHODS: We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants' attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I...
April 12, 2018: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/29644893/activation-of-the-nfkb-pathway-alters-the-phenotype-of-mscs-in-the-tracheal-aspirates-of-preterm-infants-with-severe-bpd
#20
Tobias Reicherzer, Susanne Häffner, Tayyab Shahzad, Judith Gronbach, Josef Mysliwietz, Christoph Huebener, Uwe Hasbargen, Jan Gertheiss, Andreas Schulze, Saverio Bellusci, Rory E Morty, Anne Hilgendorff, Harald Ehrhardt
Mesenchymal stromal cells (MSCs) are released into the airways of preterm infants following lung injury. These cells display a pro-inflammatory phenotype and are associated with development of severe bronchopulmonary dysplasia (BPD). We aimed to characterize the functional properties of MSCs obtained from tracheal aspirates of 50 preterm infants who required invasive ventilation. Samples were separated by disease severity. The increased proliferative capacity of MSCs was associated with longer duration of mechanical ventilation and higher severity of BPD...
April 12, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
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