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https://www.readbyqxmd.com/read/29785297/determination-of-the-intersegmental-plane-using-the-slip-knot-method
#1
Makoto Endoh, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Kenta Nakahashi, Mitsuaki Sadahiro
Background: Visualization of intersegmental planes in the lung is desirable for precise anatomical lung segmentectomy. We developed the slip-knot method for creating inflation-deflation lines. This study aimed to assess relevant data for thoracoscopic segmentectomy performed using this method. Methods: In the slip-knot method, the objective segmental bronchus is looped with a monofilament thread. One end of the thread is then pulled during temporary bilateral ventilation, causing the knot to slip toward the bronchus...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29779590/pathophysiology-of-neuromuscular-respiratory-diseases
#2
REVIEW
Joshua O Benditt
Gas exchange between the atmosphere and the human body depends on the lungs and the function of the respiratory pump. The respiratory pump consists of the respiratory control center located in the brain, bony rib cage, diaphragm, and intercostal, accessory, and abdominal muscles. A variety of muscles serve to fine-tune adjustments of ventilation to metabolic demands. Appropriate evaluation and interventions can prevent respiratory complications and prolong life in individuals with neuromuscular diseases. This article discusses normal function of the respiratory pump, general pathophysiologic issues, and abnormalities in more common neuromuscular diseases...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29778750/our-modified-technique-of-combined-antegrade-vein-graft-cardioplegia-infusion-versus-conventional-antegrade-method-in-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#3
Mehrzad Sharifi, Seyed Reza Mousavi, Mohammad Rafiei
BACKGROUND: To determine the efficacy of antegrade cardioplegia supplemented with venous graft perfusion in patients scheduled for coronary artery bypass grafting (CABG). METHODS: 223 consecutive patients scheduled for isolated CABG were randomized to receive either continuous crystalloid cardioplegia via vein grafts on completion of each distal anastomosis plus intermittent blood cardioplegia through aortic root (group 1, n = 110) or antegrade blood cardioplegia alone (group 2, n = 113)...
May 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29778333/radiotracer-localization-of-nonpalpable-pulmonary-nodules-a-single-center-experience
#4
Sandra L Starnes, Michael Wolujewicz, Julian Guitron, Valerie Williams, Jennifer Scheler, Ross Ristagno
OBJECTIVE: Multiple localization techniques to facilitate intraoperative identification of small or nonsolid pulmonary nodules have been developed. Radiotracer localization using technetium-labeled macroaggregated albumin has been our preferred localization method since 2009. We report our experience, including technical pitfalls and modifications, of our initial 77 patients who underwent this technique. METHODS: All patients undergoing preoperative radiotracer localization were identified from a prospective database...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29778239/time-dependent-changes-in-cardiorespiratory-functions-of-anesthetized-rats-exposed-to-sustained-hypoxia
#5
Kouki Kato, Ryosuke Morinaga, Seigo Fushuku, Nobuaki Nakamuta, Yoshio Yamamoto
Although cardiovascular responses may be altered by respiratory changes under prolonged hypoxia, the relationship between respiratory and cardiovascular changes remains unknown. The aim of the present study is to clarify cardiorespiratory changes in anesthetized rats during and after hypoxic conditions using simultaneous recordings of cardiorespiratory variables with 20-sec recording intervals. After air breathing for 20 min (pre-exposure period), rats were subjected to 10% O2 for 2 h (hypoxic exposure period) and then air for 30 min (recovery period)...
July 2018: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/29777672/valvectomy-versus-replacement-for-the-surgical-treatment-of-tricuspid-endocarditis
#6
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777668/anterior-pericardiectomy-for-post-infective-constrictive-pericarditis-intermediate-term-outcomes
#7
Anil Acharya, Raamesh Koirala, Nivesh Rajbhandari, Jyotindra Sharma, Bijoy Rajbanshi
BACKGROUND: Post tubercular constrictive pericarditis is prevalent pericardial disease in developing countries. Pericardiectomy is the treatment of choice but considered a procedure of high morbidity and mortality. METHODS: From January 2003 to December 2013 we performed 130 pericardiectomies. Mean age was 22.95±12.55 years with 92 (71%) males. All patients were symptomatic; 118 (91%) were in NYHA class III / IV. Almost all patients were diagnosed to be of tubercular origin; 14 (11 %) histopathologically proven, 77 (59%) with definitive history while 39 (30%) suspected to be of tubercular origin and 91 (70%) received prior antitubercular treatment...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29775603/genetic-and-extracardiac-anomalies-are-associated-with-inferior-single-ventricle-palliation-outcomes
#8
Bahaaldin Alsoufi, Courtney McCracken, Matthew Oster, Subhadra Shashidharan, Kirk Kanter
BACKGROUND: We aim to examine the effect of genetic syndromes and extracardiac anomalies (GS/EC) on single ventricle (SV) palliation with focus on hospital death, interstage mortality, and progression towards subsequent palliation stages. METHODS: 530 neonates with SV underwent first-stage palliation: Norwood (n=284,53%), shunt (n=173,33%), band (n=73,14%). Outcomes were compared between those with GS/EC (n=121,23%) and without GS/EC (n=409,77%). Regression analyses were adjusted for other risk factors (age, gender, prematurity, weight, SV anomaly, first-stage palliation surgery)...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29770192/safety-and-efficacy-of-n-acetyl-cysteine-for-prophylaxis-of-ventilator-associated-pneumonia-a-randomized-double-blind-placebo-controlled-clinical-trial
#9
Mojtaba Sharafkhah, Ali Abdolrazaghnejad, Nader Zarinfar, Abolfazl Mohammadbeigi, Ali Massoudifar, Sahand Abaszadeh
Ventilator-associated-pneumonia (VAP) is characterized by morbidity, mortality, and prolonged length of stay in intensive care unit (ICU). The present study aimed to examine the effect of N-acetyl-cysteine (NAC) in preventing VAP in patients hospitalized in ICU. We performed a prospective, randomized, double-blind, placebo-controlled trial of 60 mechanically ventilated patients at high risk of developing VAP. NAC (600 mg/twice daily) and placebo (twice daily) were administered to NAC group ( n = 30) and control group ( n = 30), respectively, through the nasogastric tube in addition to routine care...
January 2018: Medical Gas Research
https://www.readbyqxmd.com/read/29769438/cytometry-tof-identifies-alveolar-macrophage-subtypes-in-acute-respiratory-distress-syndrome
#10
Eric D Morrell, Alice Wiedeman, S Alice Long, Sina A Gharib, T Eoin West, Shawn J Skerrett, Mark M Wurfel, Carmen Mikacenic
Studies in human peripheral blood monocyte-derived macrophages in vitro have shown clear evidence that multiple macrophage polarization states exist. The extent to which different alveolar macrophage (AM) polarization states exist in homeostasis or in the setting of severe injury such as acute respiratory distress syndrome (ARDS) is largely unknown. We applied single-cell cytometry TOF (CyTOF) to simultaneously measure 36 cell-surface markers on CD45+ cells present in bronchoalveolar lavage from healthy volunteers, as well as mechanically ventilated subjects with and without ARDS...
May 17, 2018: JCI Insight
https://www.readbyqxmd.com/read/29768017/the-signaling-network-resulting-in-ventilator-induced-diaphragm-dysfunction
#11
Huibin Tang, Joseph B Shrager
Mechanical ventilation (MV) is a life-saving measure for those incapable of adequately ventilating or oxygenating without assistance. Unfortunately, even brief periods of MV result in diaphragm weakness (i.e., "ventilator-induced diaphragm dysfunction" - VIDD) that may render it difficult to wean the ventilator. Prolonged MV is associated with cascading complications and is a strong risk factor for death. Thus, prevention of VIDD may have a dramatic impact on mortality rates. Here, we summarized the current understanding of the pathogenic events underlying VIDD...
May 16, 2018: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29765788/early-pulmonary-interstitial-emphysema-in-preterm-neonates-respiratory-management-and-case-report-in-nonventilated-very-low-birth-weight-twins
#12
Judith Gronbach, Harald Ehrhardt, Klaus-Peter Zimmer, Markus Waitz
Early pulmonary interstitial emphysema in extreme preterm neonates is closely linked with respiratory distress syndrome and exposure to mechanical ventilation. In severe cases, maintaining adequate gas exchange aiming to avoid further lung damage and other neonatal morbidities associated with systemic/pulmonary hypoperfusion, prolonged hypoxia, and respiratory acidosis can be challenging and requires in-depth knowledge into the pathophysiology of the disease. Herein, we report on very low birth weight twins who developed early pulmonary interstitial emphysema during noninvasive respiratory support...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#13
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#14
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29760857/retrospective-chart-review-of-synthetic-cannabinoid-intoxication-with-toxicologic-analysis
#15
Payal Sud, Miles Gordon, Laura Tortora, Matthew Stripp, Damon Borg, Adam Berman
Introduction: Use of synthetic cannabinoids (SC) has recently emerged as a new drug epidemic. Our emergency departments (EDs) received a surge of SC users presenting with lethargy and bradycardia, contrasting prior reports of SC-induced tachycardia and agitation. Our goal was to describe these novel presentations and characterize the compounds. Methods: We present a case series of patients with SC intoxication who presented to our toxicology service covering two tertiary care EDs between 2/11/2015 and 6/23/2015...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29758209/bilateral-internal-mammary-artery-utilization-in-diabetics-friend-or-foe
#16
Todd C Crawford, Xun Zhou, Charles D Fraser, J Trent Magruder, Alejandro Suarez-Pierre, Diane Alejo, Jennifer Bobbitt, Clifford E Fonner, Kurt Wehberg, Brad Taylor, Christopher Kwon, Michael Fiocco, John V Conte, Rawn Salenger, Glenn J Whitman
BACKGROUND: Bilateral internal mammary artery (BIMA) grafting in diabetic patients undergoing coronary artery bypass grafting (CABG) remains controversial. Our study compared morbidity and mortality between 1)diabetic and non-diabetic BIMA patients and 2)diabetic BIMA versus diabetic patients who underwent left internal mammary artery (LIMA) grafting only. METHODS: Patients who underwent isolated CABG from July 2011 - June 2016 at any of the 10 centers in Maryland were propensity scored across 16 variables...
May 11, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29754983/cognitive-impairment-in-intensive-care-unit-patients-a-pilot-mixed-methods-feasibility-study-exploring-incidence-and-experiences-for-recovering-patients
#17
Rosalind Elliott, Elizabeth Yarad, Sarah Webb, Katherine Cheung, Frances Bass, Naomi Hammond, Doug Elliott
BACKGROUND: Despite improvements in survival after critical illness and intensive care unit (ICU) treatment, some recovering patients still face ongoing challenges. There are few investigations exploring the incidence, risk factors, and trajectory for cognitive impairment (CI) in former ICU patients in Australia. OBJECTIVES: To test the feasibility of a study protocol designed to ascertain the incidence and impact of CI during recovery from a critical illness. METHODS: We conducted a mixed-methods longitudinal single-centre pilot study...
May 10, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29749670/influence-of-water-depth-on-energy-expenditure-during-aquatic-walking-in-people-post-stroke
#18
Hyosok Lim, Daniel Azurdia, Brenda Jeng, Taeyou Jung
BACKGROUND AND PURPOSE: This study aimed to investigate the metabolic cost during aquatic walking at various depths in people post stroke. The secondary purpose was to examine the differences in metabolic cost between aquatic walking and land walking among individuals post stroke. DESIGN: A cross-sectional research design is used. METHODS: Twelve participants post stroke (aged 55.5 ± 13.3 years) completed 6 min of walking in 4 different conditions: chest-depth, waist-depth, and thigh-depth water, and land...
May 11, 2018: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/29742591/duration-of-respiratory-failure-after-trauma-is-not-associated-with-increased-long-term-mortality
#19
Mackenzie R Cook, Kathleen O'Connell, Qian Qiu, Andrew J Riggle, Thomas H Shoultz, Rebecca G Maine, Saman Arbabi, Grant E O'Keefe, Joseph Cuschieri, Ronald V Maier, Bryce R H Robinson
OBJECTIVES: Although 1-year survival in medically critically ill patients with prolonged mechanical ventilation is less than 50%, the relationship between respiratory failure after trauma and 1-year mortality is unknown. We hypothesize that respiratory failure duration in trauma patients is associated with decreased 1-year survival. DESIGN: Retrospective cohort of trauma patients. SETTING: Single center, level 1 trauma center. PATIENTS: Trauma patients admitted from 2011 to 2014; respiratory failure is defined as mechanical ventilation greater than or equal to 48 hours, excluded head Abbreviated Injury Score greater than or equal to 4...
May 7, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29741919/efficacy-of-acupuncture-treatment-for-improving-the-respiratory-status-in-patients-receiving-prolonged-mechanical-ventilation-in-intensive-care-units-a-retrospective-observational-study
#20
Jun Matsumoto-Miyazaki, Hiroaki Ushikoshi, Kodai Suzuki, Nagisa Miyazaki, Takahide Nawa, Hideshi Okada, Shozo Yoshida, Ichijiro Murata, Shinji Ogura, Shinya Minatoguchi
BACKGROUND AND OBJECTIVE: Patients in critical care settings often require prolonged mechanical ventilation (MV) therapy and, occasionally, they cannot be weaned from MV. The authors evaluated the efficacy of acupuncture treatment for improving the respiratory status and promoting successful weaning from prolonged MV in patients at intensive care units (ICUs). DESIGN: Retrospective observational study. SETTING: Gifu University Hospital, Gifu, Japan...
May 9, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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