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https://www.readbyqxmd.com/read/29330683/cardiac-function-during-weaning-failure-the-role-of-diastolic-dysfunction
#1
Ferran Roche-Campo, Alexandre Bedet, Emmanuel Vivier, Laurent Brochard, Armand Mekontso Dessap
BACKGROUND: Cardiac dysfunction is a common cause of weaning failure. Weaning shares some similarities with a cardiac stress test and may challenge active phases of the cardiac cycle-like ventricular contractility and relaxation. This study aimed at assessing systolic and diastolic function during the weaning process and scrutinizing their dynamics during weaning trials. METHODS: Echocardiography was performed during baseline ventilator settings to assess cardiac function at the initiation of the weaning process and at the start and the end of consecutive weaning trials (performed at day-1, day-2, and before extubation if applicable) to explore the evolution of left ventricle contractility and relaxation in a subset of patients...
January 9, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29329111/severe-peri-ictal-respiratory-dysfunction-is-common-in-dravet-syndrome
#2
YuJaung Kim, Eduardo Bravo, Caitlin K Thirnbeck, Lori A Smith-Mellecker, Se Hee Kim, Brian K Gehlbach, Linda C Laux, Douglas R Nordli Jr, George B Richerson
Dravet syndrome (DS) is a severe childhood-onset epilepsy commonly due to mutations of the sodium channel gene SCN1A. DS patients have a high risk of sudden unexplained death in epilepsy (SUDEP), believed to be due to cardiac mechanisms. Here we show that DS patients have peri-ictal respiratory dysfunction. One patient who had severe and prolonged postictal hypoventilation later died of SUDEP. Mice with an Scn1aR1407X/+ loss of function mutation died after spontaneous and heat-induced seizures due to central apnea followed by progressive bradycardia...
January 11, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29320801/fatigue-during-chest-compression-using-a-neonatal-patient-simulator
#3
Diego Enriquez, Javier Meritano, Birju A Shah, Clara Song, Edgardo Szyld
OBJECTIVE:  The objective of this study was to evaluate chest compression (CC) quality and operator fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore its association with provider aerobic activity and body mass index. METHODS:  This was a prospective observational experimental study on pediatricians, neonatologists, and neonatal nurses who frequently deliver newborns and who have signed the informed consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for 10 minutes on a neonatal mannequin...
January 10, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29319542/supplemental-oxygen-in-patients-with-stable-chronic-obstructive-pulmonary-disease-evidence-from-nocturnal-oxygen-treatment-trial-to-long-term-oxygen-treatment-trial
#4
Umur Hatipoğlu, James K Stoller
PURPOSE OF REVIEW: Oxygen therapy was the first treatment shown to prolong life in patients with chronic obstructive pulmonary disease (COPD) and has been joined by lung volume reduction surgery in selected patients with emphysema, smoking cessation, and potentially noninvasive ventilation in chronic hypercapneic respiratory failure. Although there is consensus around the survival-enhancing effect of supplemental oxygen (SupplO2) for patients with chronic severe hypoxemia at rest, the impact of SupplO2 for COPD patients with moderate hypoxemia and exertional desaturation had been less clear...
January 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29317824/selection-of-piperacillin-tazobactam-infusion-mode-guided-by-sofa-score-in-cancer-patients-with-hospital-acquired-pneumonia-a-randomized-controlled-study
#5
Yang Lyu, Yang Yang, Xin Li, Min Peng, Xin He, Peng Zhang, Shangwen Dong, Wanhua Wang, Donghao Wang
Background: This study aimed to select piperacillin/tazobactam (TZP) infusion mode guided by Sequential Organ Failure Assessment (SOFA) score in cancer patients with hospital-acquired pneumonia (HAP) postoperation. Patients and methods: A total of 120 cancer patients with postoperative HAP were divided into two groups: improved administration group (L group) and conventional treatment group (Con group). The Con group received traditional infusion of TZP and the L group received it as prolonged infusion...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#6
REVIEW
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29314257/contemporary-management-and-outcomes-of-acute-type-a-aortic-dissection-an-analysis-of-the-sts-adult-cardiac-surgery-database
#7
Teng C Lee, Zachary Kon, Faisal H Cheema, Maria V Grau-Sepulveda, Brian Englum, Sunghee Kim, Paramita S Chaudhuri, Vinod H Thourani, Gorav Ailawadi, G Chad Hughes, Matthew L Williams, J Matthew Brennan, Lars Svensson, James S Gammie
PURPOSE: Management of acute type A aortic dissection (AAAD) is challenging and operative strategies are varied. We used the STS Adult Cardiac Surgery Database (STS ACSD) to describe contemporary surgical strategies and outcomes for AAAD. METHODS: Between July 2011 and September 2012, 2982 patients with AAAD underwent operations at 640 centers in North America. RESULTS: In this cohort, median age was 60 years old, 66% were male, and 80% had hypertension...
January 4, 2018: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29312659/healthcare-associated-infection-and-its-risk-factors-among-patients-admitted-to-a-tertiary-hospital-in-ethiopia-longitudinal-study
#8
Solomon Ali, Melkamu Birhane, Sisay Bekele, Gebre Kibru, Lule Teshager, Yonas Yilma, Yesuf Ahmed, Netsanet Fentahun, Henok Assefa, Mulatu Gashaw, Esayas Kebede Gudina
Background: Healthcare associated infection (HAI) is alarmingly increasing in low income settings. In Ethiopia, the burden of HAI is still not well described. Methods: Longitudinal study was conducted from May to September, 2016. All wards of Jimma University Medical Centre were included. The incidence, prevalence and risk factors of healthcare associated infection were determined. A total of 1015 admitted patients were followed throughout their hospital stay. Biological specimens were collected from all patients suspected to have hospital aquired infection...
2018: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29306493/delivery-room-resuscitation-and-short-term-outcomes-in-moderately-preterm-infants
#9
Monika Bajaj, Girija Natarajan, Seetha Shankaran, Myra Wyckoff, Abbot R Laptook, Edward F Bell, Barbara J Stoll, Waldemar A Carlo, Betty R Vohr, Shampa Saha, Krisa P Van Meurs, Pablo J Sanchez, Carl T D'Angio, Rosemary D Higgins, Abhik Das, Nancy Newman, Michele C Walsh
OBJECTIVES: To describe the frequency and extent of delivery room resuscitation and evaluate the association of delivery room resuscitation with neonatal outcomes in moderately preterm (MPT) infants. STUDY DESIGN: This was an observational cohort study of MPT infants delivered at 290/7 to 336/7 weeks' gestational age (GA) enrolled in the Neonatal Research Network MPT registry. Infants were categorized into 5 groups based on the highest level of delivery room intervention: routine care, oxygen and/or continuous positive airway pressure, bag and mask ventilation, endotracheal intubation, and cardiopulmonary resuscitation including chest compressions and/or epinephrine use...
January 3, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29305431/case-of-nasogastric-tube-dysfunction
#10
Florian Rainer, Guenther Prenner, Lukas Peter Binder, Peter Fickert, Johannes Plank
CLINICAL PRESENTATION: An elderly female patient was admitted to intensive care for prolonged vasopressor therapy and mechanical ventilation after cardiac arrest and acute percutaneous coronary intervention. Antiplatelet, thyroid hormone replacement and statin therapies were administered through a 14-French nasogastric tube (Nestlé Health Science) and enteral feeding was initiated. Correct position of the nasogastric tube was confirmed radiologically. On the seventh day in the intensive care, our patient was seen to regurgitate soft crumbs into her mouth...
January 5, 2018: Gut
https://www.readbyqxmd.com/read/29304923/potentially-modifiable-risk-factors-for-long-term-cognitive-impairment-after-critical-illness-a-systematic-review
#11
REVIEW
Amra Sakusic, John C O'Horo, Mikhail Dziadzko, Dziadzko Volha, Rashid Ali, Tarun D Singh, Rahul Kashyap, Ann M Farrell, John D Fryer, Ronald Petersen, Ognjen Gajic, Alejandro A Rabinstein
Long-term cognitive impairment is common in survivors of critical illness. Little is known about the etiology of this serious complication. We sought to summarize current scientific knowledge about potentially modifiable risk factors during intensive care unit (ICU) treatment that may play a substantial role in the development of long-term cognitive impairment. All searches were run on October 1, 2017. The search strategy included Ovid MEDLINE, Ovid Embase, Ovid CDR, Cochrane Central Register of Controlled Trials and Database of Abstracts of Reviews of Effect, Scopus, and Web of Science, and included MeSH headings and keywords related to intensive care, critical care, and cognitive disorders...
January 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29303440/predictive-value-of-positive-high-sensitivity-troponin-t-in-intubated-traumatic-brain-injury-patients
#12
Ayman El-Menyar, Mohammad Asim, Rifat Latifi, Shrikant I Bangdiwala, Hassan Al-Thani
OBJECTIVE The clinical relevance of high-sensitivity troponin T (HsTnT) in trauma patients is not well explored. In this study, the authors aimed to study the predictive value of serum HsTnT in intubated patients who had sustained traumatic brain injury (TBI). METHODS A retrospective analysis was conducted for all intubated TBI patients between 2010 and 2014 at a national level 1 trauma center. Data were analyzed and compared based on the HsTnT status on admission (group 1, negative results; and group 2, positive results)...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29301587/foodborne-botulism-due-to-ingestion-of-home-canned-green-beans-two-case-reports
#13
Dorothea Hellmich, Katja E Wartenberg, Stephan Zierz, Tobias J Mueller
BACKGROUND: Foodborne botulism is a life-threatening, rapidly progressive disease. It has an incidence of less than 10 cases per year in Germany and mostly affects several previously healthy people at the same time. The only specific treatment is the administration of botulism antitoxin. According to the German guidelines administration of antitoxin is recommended only in the first 24 hours after oral ingestion of the toxin. CASE PRESENTATION: A 47-year-old white woman and her 51-year-old white husband presented with paralysis of multiple cranial nerves and rapidly descending paralysis approximately 72 hours after ingestion of home-canned beans...
January 4, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29298407/a-hybrid-form-of-telemedicine-a-unique-way-to-extend-intensive-care-service-to-neonates-in-medically-underserved-areas
#14
Abhishek Makkar, Mike McCoy, Gene Hallford, Marilyn Escobedo, Edgardo Szyld
BACKGROUND: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU...
January 3, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29297798/evaluation-of-blood-gas-values-in-anesthetized-southern-white-rhinoceros-ceratotherium-simum-ventilated-with-a-novel-demand-ventilator-in-a-zoological-park-setting
#15
Mark Jeon, Khursheed R Mama, Jeffrey R Zuba, Nadine Lamberski, James E Oosterhuis, Meredith M Clancy, Katie W Delk, Matthew E Kinney, Patrick J Morris, Francisco Olea-Popelka
Rhinoceros conservation efforts are essential to the survival of the species. One such effort is focused on using advanced reproductive technologies to produce viable northern white rhinoceros ( Ceratotherium simum cottoni) embryos for implantation into southern white rhinoceros ( Ceratotherium simum simum) surrogates. Anesthesia may be required to facilitate necessary procedures in these surrogate rhinoceros, but commonly reported side effects including hypercapnia and hypoxemia limit anesthetic recumbency time due to animal safety concerns...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29288612/postintubation-tracheoesophageal-fistula-diagnosis-treatment-and-prognosis
#16
Ciprian Bolca, Valerian Păvăloiu, Georgiana Fotache, Mihai Dumitrescu, Andrei Bobocea, Mihai Alexe, Genoveva Cadar, Radu Stoica, Cristian Paleru, Ioan Cordoş
Introduction: Postintubation tracheoesophageal fistula is a severe complication occurring under certain conditions in patients that require prolonged mechanical ventilation. MATERIAL AND METHODS: This article focuses on a sample of 11 patients with postintubation tracheoesophageal fistula, operated in our department between 2005 and 2015. The anterior approach with tracheal resection was performed in 10 of these patients, while an atypical surgical technique was preferred in a case involving a large-sized fistula...
November 2017: Chirurgia
https://www.readbyqxmd.com/read/29285622/effects-of-the-intensity-of-prehospital-treatment-on-short-term-outcomes-in-patients-with-acute-heart-failure-the-semica-2-study
#17
Òscar Miró, Melissa Hazlitt, Xavier Escalada, Pere Llorens, Víctor Gil, Francisco Javier Martín-Sánchez, Pia Harjola, Verónica Rico, Pablo Herrero-Puente, Javier Jacob, David C Cone, Martin Möckel, Michael Christ, Yonathan Freund, Salvatore di Somma, Said Laribi, Alexandre Mebazaa, Veli-Pekka Harjola
OBJECTIVE: Little is known about treatments provided by advanced life support (ALS) ambulance teams to patients with acute heart failure (AHF) during the prehospital phase, and their influence on short-term outcome. We evaluated the effect of prehospital care in consecutive patients diagnosed with AHF in Spanish emergency departments (EDs). METHODS: We selected patients from the EAHFE registry arriving at the ED by ALS ambulances with available follow-up data. We recorded specific prehospital ALS treatments (supplemental oxygen, diuretics, nitroglycerin, non-invasive ventilation) and patients were grouped according to whether they received low- (LIPHT; 0/1 treatments) or high-intensity prehospital therapy (HIPHT; > 1 treatment) for AHF...
December 28, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29282039/plasma-levels-of-alarmin-hnps-1-3-associate-with-lung-dysfunction-after-cardiac-surgery-in-children
#18
XiWang Liu, QiXing Chen, YuJia Luo, YaoQin Hu, DengMing Lai, XiaoLe Zhang, XiangHong Zhang, JianGen Yu, XiangMing Fang, Qiang Shu
BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether elevated plasma levels of human neutrophil peptides (HNPs) 1-3 herald impaired lung function in infants and young children after cardiac surgery necessitating cardiopulmonary bypass (CPB). METHODS: Consecutive children younger than 3 years old who underwent cardiac surgery were prospectively enrolled...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29279777/ornithine-transcarbamylase-deficiency-if-at-first-you-do-not-diagnose-try-and-try-again
#19
Christan D Santos, Robert A Ratzlaff, Jennifer C Meder, Paldeep S Atwal, Nicole E Joyce
Ornithine transcarbamylase (OTC) deficiency is well known for its diagnosis in the neonatal period. Presentation often occurs after protein feeding and manifests as poor oral intake, vomiting, lethargy progressing to seizure, respiratory difficulty, and eventually coma. Presentation at adulthood is rare (and likely underdiagnosed); however, OTC deficiency can be life-threatening and requires prompt investigation and treatment. Reports and guidelines are scarce due to its rarity. Here, we present a 59-year-old woman with a past history of irritable bowel syndrome who underwent a reparative operation for rectal prolapse and enterocele...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29273200/long-term-survival-prediction-for-cabg-validation-of-the-ascert-model-with-comparison-to-sts-prom
#20
Timothy S Lancaster, Matthew R Schill, Jason W Greenberg, Chawannuch Ruaengsri, Richard B Schuessler, Jennifer S Lawton, Hersh S Maniar, Michael K Pasque, Marc R Moon, Ralph J Damiano, Spencer J Melby
BACKGROUND: The recently developed STS/ACC ASCERT Long-Term Survival Probability Calculator is a valuable addition to existing short-term risk prediction tools for cardiac surgical procedures, but has yet to be externally validated. METHODS: Institutional data were reviewed on 654 patients ≥65 yr of age undergoing isolated CABG between 2005-2010. Predicted survival probabilities were calculated using the ASCERT model. Survival data were collected using the Social Security Death Index and institutional medical records...
December 19, 2017: Annals of Thoracic Surgery
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