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https://www.readbyqxmd.com/read/29453639/upper-airway-obstruction-induced-by-non-invasive-ventilation-using-an-oronasal-interface
#1
Valentin Schellhas, Christian Glatz, Ingo Beecken, Angelika Okegwo, Anna Heidbreder, Peter Young, Matthias Boentert
BACKGROUND: On initiation of long-term non-invasive ventilation (NIV), intermittent upper airway obstruction has rarely been described as possibly treatment-induced. Inspiratory pressure effects and the use of an oronasal interface may promote obstructive events in some patients with neuromuscular disease (NMD) and amyotrophic lateral sclerosis (ALS) in particular. METHODS: We evaluated clinical data from 212 patients in whom NIV was initiated using an oronasal mask...
February 17, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29452277/association-between-obesity-and-acute-severity-among-patients-hospitalized-for-asthma-exacerbation
#2
Sarah Kyuragi Luthe, Atsushi Hirayama, Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Although studies have demonstrated relations between obesity and incident asthma, little is known about the association of obesity with acute severity in adults hospitalized for asthma exacerbation. OBJECTIVES: To investigate the association of obesity with acute severity of asthma exacerbation. METHODS: This is a retrospective cohort study using population-based data of 8 geographically diverse US states from 2010 through 2013...
February 13, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29450782/-is-the-refusal-of-invasive-or-noninvasive-ventilation-in-a-child-with-spinal-muscular-atrophy-ethically-justified
#3
Martina Radner, Annette Henry
We report about an infant who was diagnosed with spinal muscular atrophy type 1 (Werdnig-Hoffmann) at the age of 7 weeks. In a detailed discussion with the physicians the parents decided against mechanical ventilation in the event of either acute or chronical respiratory failure. During care at home all palliative actions were taken to optimize the quality of life for the child. The boy died at the age of 7 months at home. Whether continuous mechanical ventilation in a child with spinal muscular atrophy type 1 should be the individual decision of the parents or whether it should never be offered by the physicians is discussed controversially in the present medical literature...
February 15, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29449956/bilateral-bronchial-stent-deployment-for-palliative-treatment-of-a-compressive-intrathoracic-mass-in-a-cat
#4
Kieran Borgeat, Kerry Simpson, David Reese, Helen Wilson, Joanna Potter, Daniel Ogden
Case summary: Bronchial stents may be useful to relieve clinical signs of extraluminal compression. Herein we describe a case which, to our knowledge, is the first cat where bilateral bronchial stents have been used clinically. Respiratory signs of principal bronchial compression were alleviated after the stent procedure. Minor complications occurred, specifically: severe hypoxia during stent deployment; a transient, self-limiting postoperative pneumothorax possibly associated with ventilation-induced lung injury; bronchopneumonia (possibly pre-existing); and transient worsening of cough postoperatively...
January 2018: JFMS Open Reports
https://www.readbyqxmd.com/read/29447297/development-of-a-decision-aid-for-cardiopulmonary-resuscitation-and-invasive-mechanical-ventilation-in-the-intensive-care-unit-employing-user-centered-design-and-a-wiki-platform-for-rapid-prototyping
#5
Ariane Plaisance, Holly O Witteman, Annie LeBlanc, Jennifer Kryworuchko, Daren Keith Heyland, Mark H Ebell, Louisa Blair, Diane Tapp, Audrey Dupuis, Carole-Anne Lavoie-Bérard, Carrie Anna McGinn, France Légaré, Patrick Michel Archambault
BACKGROUND: Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. OBJECTIVES: To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose...
2018: PloS One
https://www.readbyqxmd.com/read/29446066/resource-use-during-the-last-6-months-of-life-of-individuals-dying-with-and-of-alzheimer-s-disease
#6
Kristof Faes, Joachim Cohen, Lieven Annemans
OBJECTIVES: To compare resource use during the last 6 months of life of individuals diagnosed with Alzheimer's disease (AD) but for whom AD was not formally identified as the underlying cause of death (dying with AD) with that of those who had AD as underlying cause of death (dying of AD). DESIGN: Full-population retrospective analysis. SETTING: Belgium. PARTICIPANTS: All Belgian decedents in 2012. MEASUREMENTS: We linked participants' healthcare, population, and death certificate data...
February 15, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29445537/neural-respiratory-drive-and-cardiac-function-in-patients-with-obesity-hypoventilation-syndrome-following-initiation-of-non-invasive-ventilation
#7
Angelo Onofri, Maxime Patout, Georgios Kaltsakas, Elodie Lhuillier, Sitali Mushemi-Blake, Gill Arbane, Martino F Pengo, Philip Marino, Joerg Steier
Background: Chronic hypercapnic respiratory failure (HRF) in obesity hypoventilation syndrome (OHS) is commonly treated using non-invasive ventilation (NIV). We hypothesised that treatment of OHS would improve neural respiratory drive index (NRDI) and cardiac function. Methods: Fourteen patients (8 females) with OHS, who were admitted for initiation of domiciliary NIV, were prospectively studied. Patients had (mean ± SD): age (53±10 years), body mass index (BMI) (50...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445532/sleep-disordered-breathing-in-motor-neurone-disease
#8
REVIEW
Rebecca F D'Cruz, Patrick B Murphy, Georgios Kaltsakas
Motor neurone disease (MND) is a neurodegenerative disease defined by axonal loss and gliosis of upper and lower motor neurones in the motor cortex, lower brainstem nuclei and ventral horn of the spinal cord. MND is currently incurable and has a poor prognosis, with death typically occurring 3 to 5 years after disease onset. The disease is characterised by rapidly progressive weakness leading to paralysis, fasciculations, bulbar symptoms (including dysarthria and dysphagia) and respiratory compromise. Respiratory complications arise as a result of weakness of upper airway (pharyngeal and laryngeal) muscles and respiratory muscles (diaphragm, intercostal and accessory muscles) leading to respiratory failure...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445531/patient-ventilator-asynchrony-and-sleep-disruption-during-non-invasive-ventilation
#9
REVIEW
Michelle Ramsay
Patient-ventilator asynchrony (PVA) are a common phenomenon affecting all patients receiving long-term domiciliary ventilation. The interruption of synchrony between the patient and the ventilator has been reported to be a possible cause of nocturnal sleep disruption leaking to arousals, awakenings and reduced periods of stage 3 and REM sleep overnight. The cause of PVA is multi-factorial driven frequently by leak at the interface, changing respiratory breathing patterns and changes in sleep stages. It currently remains unclear as to whether the PVA is the cause of sleep fragmentation or if PVA is purely a marker of unsuccessful ventilatory control, patient discomfort and underlying sleep disruption...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445530/update-non-invasive-ventilation-in-chronic-obstructive-pulmonary-disease
#10
REVIEW
Neeraj Mukesh Shah, Rebecca Francesca D'Cruz, Patrick B Murphy
Chronic obstructive pulmonary disease (COPD) remains a common cause of morbidity and mortality worldwide. Patients with COPD and respiratory failure, whether acute or chronic have a poorer prognosis than patients without respiratory failure. Non-invasive ventilation (NIV) has been shown to be a useful tool in both the acute hospital and chronic home care setting. NIV has been well established as the gold standard therapy for acute decompensated respiratory failure complicating an acute exacerbation of COPD with reduced mortality and intubation rates compared to standard therapy...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29441279/externally-applied-compression-therapy-for-fontan-patients
#11
Joseph Hernandez, Steven G Chopski, Sam Lee, William B Moskowitz, Amy L Throckmorton
Background: Limited therapeutic options are available for Fontan patients with dysfunctional or failing single ventricle physiology. This study describes the evaluation of an alternative, non-invasive, at-home therapeutic compression treatment for Fontan patients. Our hypothesis is that routinely administered, externally applied compression treatments to the lower extremities will augment systemic venous return, improve ventricular preload, and thus enhance cardiac output in Fontan patients...
January 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29436560/the-role-of-non-invasive-ventilation-used-immediately-after-planned-extubation-for-adults-with-chronic-respiratory-disorders
#12
Jinnan Ou, Huaying Chen, Lezhi Li, Liping Zhao, Na Nie
OBJECTIVE:  To estimate the benefits of non-invasive ventilation (NIV) used immediately after planned postextubation in patients with chronic respiratory disorders. METHODS:  Cochrane Library, PubMed, the Chinese BioMedical Literature Database of clinical trials (CBD) and Embase were searched for pertinent studies by 2 trained investigators. Pooled odds ratios and 95% confidence intervals (CIs) were calculated by employing both fixed-effects and random-effects models...
February 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29435739/multiparametric-magnetic-resonance-imaging-in-the-assessment-of-pulmonary-hypertension-initial-experience-of-a-one-stop-study
#13
Gisela M B Meyer, Fernanda B Spilimbergo, Stephan Atmayer, Gabriel S Pacini, Matheus Zanon, Guilherme Watte, Edson Marchiori, Bruno Hochhegger
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29434147/what-is-the-impact-of-mildly-altered-consciousness-on-acute-hypoxemic-respiratory-failure-with-non-invasive-ventilation
#14
Mariko Kogo, Kazuma Nagata, Takeshi Morimoto, Jiro Ito, Daichi Fujimoto, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
Objective A severely altered level of consciousness (ALC) is considered to be a possible contraindication to non-invasive ventilation (NIV). We investigated the association between mild ALC and NIV failure in patients with hypoxemic respiratory failure. Methods A retrospective study was conducted by reviewing the medical charts of patients with de novo hypoxemic respiratory failure who received NIV treatment. The clinical background and the outcomes of patients with and without ALC were compared. Patients or Materials Patients who were admitted to our hospital for acute hypoxemic respiratory failure between July 2011 and May 2015 were included in the present study...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29434048/hospital-end-of-life-care-in-haematological-malignancies
#15
Yvan Beaussant, Etienne Daguindau, Adrien Chauchet, Philippe Rochigneux, Christophe Tournigand, Régis Aubry, Lucas Morin
OBJECTIVE: To investigate patterns of care during the last months of life of hospitalised patients who died from different haematological malignancies. METHODS: Nationwide register-based study, including all hospitalised adults ≥20 years who died from haematological malignancies in France in 2010-2013. Outcomes included use of invasive cancer treatments and referral to palliative care. Percentages are adjusted for sex and age using direct standardisation. RESULTS: Of 46 629 inpatients who died with haematological malignancies, 24...
February 6, 2018: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/29432361/single-port-thoracoscopic-pericardial-window-under-local-anesthesia
#16
Chang Y Park, Niall C McGonigle
There are numerous surgical approaches for the treatment of pericardial effusions but no clear consensus of best management. We present a 44-year-old woman with metastatic breast cancer presenting with a new 2-cm pericardial effusion on ultrasound. In light of the patient's palliative condition and the urgent need for chemotherapy, careful consideration was made for her surgical drainage of the pericardial effusion. Because of the patient's medical comorbidities, a general anesthetic was deemed not to be in the patient's best interest...
February 9, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29431543/high-flow-nasal-oxygen-therapy-utilization-7-year-experience-at-a-community-teaching-hospital
#17
Mihaela S Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K Lindenauer, Jay S Steingrub
OBJECTIVE: To examine the use of high flow nasal cannula oxygen therapy (HFNC) between 2008 and 2014 in patients 18 years or older at a community teaching hospital. METHODS: Yearly utilization rates of HFNC, noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were calculated among admissions with a set of cardiopulmonary diagnoses (heart failure, COPD, asthma or pneumonia). RESULTS: Among the 41,711 admissions with at least one of the above cardiopulmonary condition, HFNC was utilized in 1,128 or 27...
February 15, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29430448/extracorporeal-carbon-dioxide-removal-in-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#18
REVIEW
Tommaso Pettenuzzo, Eddy Fan, Lorenzo Del Sorbo
Extracorporeal carbon dioxide removal (ECCO 2 R) has been proposed as an adjunctive intervention to avoid worsening respiratory acidosis, thereby preventing or shortening the duration of invasive mechanical ventilation (IMV) in patients with exacerbation of chronic obstructive pulmonary disease (COPD). This review will present a comprehensive summary of the pathophysiological rationale and clinical evidence of ECCO 2 R in patients suffering from severe COPD exacerbations.
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29428567/clinical-features-of-fatal-severe-fever-with-thrombocytopenia-syndrome-that-is-complicated-by-invasive-pulmonary-aspergillosis
#19
Xiancheng Chen, Zhuxi Yu, Yajun Qian, Danjiang Dong, Yingying Hao, Ning Liu, Qin Gu
INTRODUCTION: Severe fever with thrombocytopenia syndrome (SFTS) has been prevalent in parts of Asia during recent years. However, SFTS with invasive pulmonary aspergillosis (IPA) is rare, and it is important to understand its clinical features. MATERIALS AND METHODS: Total four cases of SFTS with IPA are reviewed and detailing the disease progression, treatment options, and prognosis were summarized and analyzed. RESULTS: The patients with SFTS-associated IPA first presented with fever, gastrointestinal symptoms, thrombocytopenia, leukopenia, and multiple organ failure...
February 7, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29428185/lack-of-correlation-between-left-ventricular-outflow-tract-velocity-time-integral-and-stroke-volume-index-in-mechanically-ventilated-patients
#20
R Blancas, Ó Martínez-González, D Ballesteros, A Núñez, J Luján, D Rodríguez-Serrano, A Hernández, C Martínez-Díaz, C M Parra, B L Matamala, M A Alonso, M Chana
OBJECTIVE: To assess the correlation between left ventricular outflow tract velocity time integral (LVOT VTI) and stroke volume index (SVI) calculated by thermodilution methods in ventilated critically ill patients. DESIGN: A prospective, descriptive, multicenter study was performed. SETTING: Five intensive care units from university hospitals. PATIENTS: Patients older than 17 years needing mechanical ventilation and invasive hemodynamic monitoring were included...
February 7, 2018: Medicina Intensiva
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