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https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#1
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte(®) ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg(-1) . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149003/determinants-of-ventilator-withdrawal-among-patients-with-prolonged-mechanical-ventilation
#2
Lavi Oud
No abstract text is available yet for this article.
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29148295/is-naloxone-the-best-antidote-to-reverse-tramadol-induced-neuro-respiratory-toxicity-in-overdose-an-experimental-investigation-in-the-rat
#3
Camille Lagard, Isabelle Malissin, Wassila Indja, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
CONTEXT: Since the banning of dextropropoxyphene from the market, overdoses, and fatalities attributed to tramadol, a WHO step-2 opioid analgesic, have increased markedly. Tramadol overdose results not only in central nervous system (CNS) depression attributed to its opioid properties but also in seizures, possibly related to non-opioidergic pathways, thus questioning the efficiency of naloxone to reverse tramadol-induced CNS toxicity. OBJECTIVE: To investigate the most efficient antidote to reverse tramadol-induced seizures and respiratory depression in overdose...
November 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#4
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29137587/a-lung-model-to-demonstrate-dynamic-gas-trapping-and-intrinsic-positive-end-expiratory-pressure-at-realistic-ventilation-settings
#5
S H Freebairn, R Imlay, E Barrett, Maj Park, R C Freebairn
Intrinsic positive end-expiratory pressure (PEEP) and gas trapping are recognised hazards during ventilation of patients with airflow obstruction. Demonstration of these phenomena on conventional lung models using realistic ventilation settings is difficult. We describe an Intrinsic PEEP Model that is able to demonstrate dynamic gas trapping and intrinsic PEEP at realistic ventilation settings, and demonstrate its ability to develop intrinsic PEEP in a timeframe useful for teaching. The model uses a Heimlich valve to permit a lower resistance on inspiration than expiration...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29135527/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#6
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29134425/quick-reference-tidal-volume-cards-reduce-the-incidence-of-large-tidal-volumes-during-surgery
#7
Chirag K Shah, Angela Moss, William Henderson, Breandan Sullivan, Ana Fernandez-Bustamante
Ventilation with large tidal volumes (V T), greater than 10 ml/kg of predicted body weight (PBW), is associated with worse outcomes in critically ill and surgical patients. We hypothesized that the availability of quick reference cards with proposed V T ranges specific to gender and different heights would reduce the intraoperative use of large V T during prolonged abdominal surgery. We compared retrospectively the incidence of median V T used during prolonged (≥4-h-long) abdominal surgery before ("before") and after ("after") the quick reference V T cards were made available in all anesthesia machines in operating rooms of a single academic US medical center...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29132702/neutrophil-lymphocyte-ratio-prognostic-impact-in-heart-surgery-early-outcomes-and-late-survival
#8
Shuli Silberman, Ulfat Abu-Yunis, Rachel Tauber, Linda Shavit, Tal Grenader, Daniel Fink, Daniel Bitran, Ofer Merin
BACKGROUND: The neutrophil-lymphocyte ratio (NLR) is a recognized marker of inflammation associated with poor outcomes in various clinical situations. We analyzed the prognostic significance of preoperative elevated NLR in patients undergoing cardiac surgery. METHODS: We performed a retrospective review of 3,027 consecutive patients undergoing cardiac surgery. Receiver-operating-characteristic was used to determine the cutoff value for elevated NLR. Multivariate regression was used to determine the predictive value of preoperative NLR on clinical outcomes...
November 10, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29125270/alternative-incision-sutureless-aortic-valve-replacement-propensity-matched-comparison-between-partial-sternotomy-and-right-anterior-minithoracotomy
#9
Daniyar Gilmanov, Marco Solinas, Giuseppe Santarpino, Pier A Farneti, Michele Murzi, Theodor Fischlein, Steffen Pfeiffer
BACKGROUND: Sutureless aortic valve prostheses have the potential to augment the adoption of alternative incision approaches for aortic valve replacement (AVR). Still, we lack the evidence on which surgical approach is best associated with sutureless AVR. METHODS: Data on 483 patients undergoing sutureless small incision AVR between 2010-2014 in two European institutions (207 with partial sternotomy (MS) and 276 via right anterior minithoracotomy (RAMT)) have been retrospectively analyzed...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29121283/postoperative-pulmonary-complications-pulmonary-and-systemic-inflammatory-responses-after-lung-resection-surgery-with-prolonged-one-lung-ventilation-randomized-controlled-trial-comparing-intravenous-and-inhalational-anaesthesia
#10
F de la Gala, P Piñeiro, A Reyes, E Vara, L Olmedilla, P Cruz, I Garutti
Background: Recent studies report the immunomodulatory lung-protective role of halogenated anaesthetics during lung resection surgery (LRS) but have not investigated differences in clinical postoperative pulmonary complications (PPCs). The main goal of the present study was to compare the effect of sevoflurane and propofol on the incidence of PPCs in patients undergoing LRS. The second aim was to compare pulmonary and systemic inflammatory responses to LRS. Methods: Of 180 patients undergoing LRS recruited, data from 174 patients were analysed...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121081/intraoperative-ventilatory-leak-predicts-prolonged-air-leak-after-lung-resection-a-retrospective-observational-study
#11
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Hyun-Kyu Yoon, Chul-Woo Jung
Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volume data were retrieved from the electronic anesthesia records. Ventilatory leak (%) was calculated as [(inspiratory tidal volume-expiratory tidal volume)/ inspiratory tidal volume × 100] and was measured after restart of two-lung ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/29118830/a-multicentre-prospective-evaluation-of-alcohol-related-admissions-to-intensive-care-units-in-wales
#12
Ceri Lynch, Richard Pugh, Ceri Battle
Purpose: We conducted a prospective multicentre study in 13 Welsh intensive care units to assess what proportion of intensive care admissions relate to alcohol, and how outcomes among these patients compare with non-alcohol related admissions. Materials and methods: Data were prospectively collected for one month between June and July 2015. Every intensive care admission was screened for alcohol associations based on ICD-10 criteria, using a pre-designed pro-forma...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29116572/admission-of-tetanus-patients-to-the-icu-a-retrospective-multicentre-study
#13
Rafael Mahieu, Thomas Reydel, Adel Maamar, Jean-Marc Tadié, Angeline Jamet, Arnaud W Thille, Nicolas Chudeau, Julien Huntzinger, Steven Grangé, Gaetan Beduneau, Anne Courte, Stephane Ehrmann, Jérémie Lemarié, Sébastien Gibot, Michael Darmon, Christophe Guitton, Julia Champey, Carole Schwebel, Jean Dellamonica, Thibaut Wipf, Ferhat Meziani, Damien Du Cheyron, Achille Kouatchet, Nicolas Lerolle
BACKGROUND: An extended course of tetanus (up to 6 weeks) requiring ICU admission and protracted mechanical ventilation (MV) may have a significant impact on short- and long-term survival. The subject is noteworthy and deserves to be discussed. METHODS: Twenty-two ICUs in France performed tetanus screenings on patients admitted between January 2000 and December 2014. Retrospective data were collected from hospital databases and through the registers of the town hall of the patients...
November 7, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29114700/invasive-candidiasis-in-pediatric-patients-at-king-fahad-medical-city-in-central-saudi-arabia-a-5-year-retrospective-study
#14
Zainab Almooosa, Gasmelseed Y Ahmed, Abeer Omran, Ayah AlSarheed, Afnan Alturki, Abdulaziz Alaqeel, Mohammed Alshehri, Tariq Alfawaz, Dayel AlShahrani
To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29110790/long-term-management-of-patients-with-end-stage-lung-diseases
#15
REVIEW
Domenica Federica Briganti, Frank D'Ovidio
Long-term management of end-stage lung disease differs from interstitial lung disease to chronic obstructive pulmonary disease to cystic fibrosis to pulmonary vascular disease. The management includes pharmacological therapy that is disease specific such as antibiotic therapy for cystic fibrosis, antifibrotic drugs in idiopathic pulmonary fibrosis; long-acting beta-agonists, long-acting muscarinic antagonist, and inhaled corticosteroids in chronic obstructive pulmonary disease; and vasodilators in pulmonary arterial hypertension...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29109401/smad3-initiates-oxidative-stress-and-proteolysis-that-underlies-diaphragm-dysfunction-during-mechanical-ventilation
#16
Huibin Tang, Catherine L Kennedy, Myung Lee, Yang Gao, Hui Xia, Francesca Olguin, Danielle A Fraga, Kelsey Ayers, Sehoon Choi, Michael Kim, Amir Tehrani, Yasser A Sowb, Thomas A Rando, Joseph B Shrager
Prolonged use of mechanical ventilation (MV) leads to atrophy and dysfunction of the major inspiratory muscle, the diaphragm, contributing to ventilator dependence. Numerous studies have shown that proteolysis and oxidative stress are among the major effectors of ventilator-induced diaphragm muscle dysfunction (VIDD), but the upstream initiator(s) of this process remain to be elucidated. We report here that periodic diaphragm contraction via phrenic nerve stimulation (PNS) substantially reduces MV-induced proteolytic activity and oxidative stress in the diaphragm...
November 6, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29104127/incidence-risk-factors-and-prognostic-impact-of-re-exploration-for-bleeding-after-cardiac-surgery-a-retrospective-cohort-study
#17
Lucas B Ohmes, Antonino Di Franco, T Sloane Guy, Christopher Lau, Monica Munjal, William Debois, Zhongyi Li, Karl H Krieger, Alexandra N Schwann, Jeremy R Leonard, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative re-exploration for bleeding (RB) is a frequent complication following cardiac surgery. We aim to assess incidence, risk factors, and prognostic significance of RB in a large cohort of cardiac patients. MATERIALS AND METHODS: We reviewed prospectively collected data for all patients who underwent cardiac surgery at our institution from 2007 to 2015. Logistic regression analysis was used to identify independent predictors of RB and specific outcomes...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29104017/neurodevelopmental-outcome-and-health-related-quality-of-life-in-children-with-single-ventricle-heart-disease-before-fontan-procedure
#18
Bettina Reich, Kristina Heye, Ruth Tuura, Ingrid Beck, Kristina Wetterling, Andreas Hahn, Karoline Hofmann, Dietmar Schranz, Hakan Akintürk, Beatrice Latal, Walter Knirsch
OBJECTIVE: Neurodevelopmental impairment and impaired quality of life constitute a major source of morbidity among children with complex congenital heart disease (CHD), in particular for single ventricle morphologies. Risk factors and quality of life determining clinical and neurodevelopmental outcome at two years of age are examined. METHODS: In a two-center cohort study, 48 patients with SV-morphology (26 HLHS, 22 other types of univentricular heart defect) have been examined prior Fontan procedure between 2010 and 2015...
November 2, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29097614/two-year-neurodevelopmental-outcome-of-an-infant-born-at-21-weeks-4-days-gestation
#19
Kaashif A Ahmad, Charlotte S Frey, Mario A Fierro, Alexander B Kenton, Frank X Placencia
Recent literature confirms that, at the lower limit of extrauterine survival, substantial intercenter variability exists in resuscitation practice. The reasons for this variability are unclear, but may be related to disagreement on how to apply the best interests standard to extremely premature infants. Currently, both obstetric and pediatric societies recommend against assessing for viability or attempting resuscitation before 22 weeks' gestation. In this context, we report the unimpaired 2-year outcome of a female infant resuscitated after delivery at 21 weeks' 4 days' gestation and 410 g birth weight...
November 2, 2017: Pediatrics
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#20
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
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