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Prolonged wean

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https://www.readbyqxmd.com/read/28933231/temporary-tracheal-stenting-after-pulmonary-artery-sling-repair-in-a-newborn
#1
Sabrina Lueck, Michael Mohr, Claudius Werner, Christoph Schmidt, Edward Malec, Katarzyna Januszewska
Pulmonary artery sling (PAS) is a rare disease frequently associated with severe malacia and stenosis of the trachea. We present a two-day-old newborn that underwent urgent surgery for PAS and needed prolonged respiratory support afterward. Temporary airway stenting above the level of the tracheal bifurcation was performed five days after surgery to overcome severe airway obstruction caused by tracheomalacia and laceration of the tracheal mucosa after diagnostic bronchoscopy. Two days after the procedure, the child could be extubated and after two weeks the stent was removed without complications...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28917004/critical-illness-associated-diaphragm-weakness
#2
REVIEW
Martin Dres, Ewan C Goligher, Leo M A Heunks, Laurent J Brochard
Diaphragm weakness is highly prevalent in critically ill patients. It may exist prior to ICU admission and may precipitate the need for mechanical ventilation but it also frequently develops during the ICU stay. Several risk factors for diaphragm weakness have been identified; among them sepsis and mechanical ventilation play central roles. We employ the term critical illness-associated diaphragm weakness to refer to the collective effects of all mechanisms of diaphragm injury and weakness occurring in critically ill patients...
September 15, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28904980/enterovirus-human-rhinovirus-a-rare-cause-of-acute-respiratory-distress-syndrome
#3
Parita Soni, Anand Rai, Nidhi Aggarwal, Stephan Kamholz, Taek Yoon, Yizhak Kupfer
A 22-year-old Asian woman presented with respiratory distress, cough, and wheezing for 1 week. Prior history included asthma and Turner syndrome. On presentation to the emergency department, the patient was hypotensive, tachycardic, tachypneic, with an oxyhemoglobin saturation in the mid 80% range while breathing ambient air. Chest radiograph revealed pulmonary vascular congestion and a left lower lobe infiltrate. Endotracheal intubation, mechanical ventilation, and vasopressors were initiated. Empiric therapy for community-acquired pneumonia was administered utilizing broad-spectrum intravenous antibiotics...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28904477/studying-the-power-of-the-integrative-weaning-index-in-predicting-the-success-rate-of-the-spontaneous-breathing-trial-in-patients-under-mechanical-ventilation
#4
Sahar Ebrahimabadi, Ahmad Bagheri Moghadam, Mohammadali Vakili, Mahnaz Modanloo, Homeira Khoddam
BACKGROUND AND AIMS: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation. MATERIALS AND METHODS: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28887914/curcumin-attenuates-the-scurfy-induced-immune-disorder-a-model-of-ipex-syndrome-with-inhibiting-th1-th2-th17-responses-in-mice
#5
Gihyun Lee, Hwan-Suck Chung, Kyeseok Lee, Hyeonhoon Lee, Minhwan Kim, Hyunsu Bae
BACKGROUND: Immunodysregulation polyendocrinopathy enteropathy X-linked syndrome (IPEX) is a lethal autoimmune disease caused by mutations in the Foxp3 gene scurfin (scurfy). Immunosuppressive therapy for IPEX patients has been generally ineffective and has caused severe side effects, however curcumin has shown immune regulation properties for inflammatory diseases, such as rheumatoid arthritis, psoriasis, and inflammatory bowel diseases without side effects. OBJECTIVE: The aim of this study was to investigate whether curcumin would attenuate symptoms of IPEX in mouse model and would prolong its survival period...
September 15, 2017: Phytomedicine: International Journal of Phytotherapy and Phytopharmacology
https://www.readbyqxmd.com/read/28886988/perinatal-ciclosporin-a-exposure-elicits-sex-related-cardiac-dysfunction-and-inflammation-in-the-rat-progeny
#6
Hany M El-Bassossy, Zuheir Awan, Mahmoud M El-Mas
Ciclosporin A (CSA) has been identified with harmful cardiotoxicity but little, if any, is known about the influence of perinatal exposure upon the cardiac function of the progeny. The present work examines the premise that perinatal contact with CSA undermines the cardiac function of sexually mature rats. Administration of CSA (15mg/kg/day sc) to pregnant rats from day 6 of conception till weaning led to a decrease in gradient of the end-systolic pressure-volume relationship by a factor of ten for male progeny and a factor of two for female progeny...
September 5, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/28882474/postpartum-inhibition-of-ovarian-steroid-action-increases-aspects-of-maternal-caregiving-and-reduces-medial-preoptic-area-progesterone-receptor-expression-in-female-rats
#7
Z A Grieb, S M Tierney, J S Lonstein
The rapid peripartum onset of maternal caregiving involves progesterone synergizing with estradiol, but prolonging progesterone exposure past this time can prevent the emergence of mothering. Interestingly, there is a 7-10day-long rise in progesterone during mid-lactation, but its effects on mothering are unknown. Given progesterone's potential to inhibit mothering onset, this mid-lactational rise may contribute to the normal attenuation of caregiving behaviors across lactation. To evaluate this, recently-parturient rats were ovariectomized and caregiving observed from postpartum days (PPD) 7-18...
September 16, 2017: Hormones and Behavior
https://www.readbyqxmd.com/read/28866754/opioid-associated-iatrogenic-withdrawal-in-critically-ill-adult-patients-a-multicenter-prospective-observational-study
#8
Pan Pan Wang, Elaine Huang, Xue Feng, Charles-André Bray, Marc M Perreault, Philippe Rico, Patrick Bellemare, Paul Murgoi, Céline Gélinas, Annie Lecavalier, Dev Jayaraman, Anne Julie Frenette, David Williamson
BACKGROUND: Opioids and benzodiazepines are frequently used in the intensive care unit (ICU). Regular use and prolonged exposure to opioids in ICU patients followed by abrupt tapering or cessation may lead to iatrogenic withdrawal syndrome (IWS). IWS is well described in pediatrics, but no prospective study has evaluated this syndrome in adult ICU patients. The objective of this study was to determine the incidence of IWS caused by opioids in a critically ill adult population. This multicenter prospective cohort study was conducted at two level-1 trauma ICUs between February 2015 and September 2015 and included 54 critically ill patients...
September 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28832898/spontaneous-breathing-trials-after-prolonged-mechanical-ventilation-monitored-by-electrical-impedance-tomography-an-observational-study
#9
Z Zhao, S-Y Peng, M-Y Chang, Y-L Hsu, I Frerichs, H-T Chang, K Möller
BACKGROUND: The study objective was to examine the correlation between regional ventilation distribution measured with electrical impedance tomography (EIT) and weaning outcomes during spontaneous breathing trial (SBT). METHODS: Fifteen patients received 100% automatic tube compensation (ATC) during the first and 70% during the second hour. Another 15 patients received external continuous positive airway pressure (CPAP) of 5 and 7.5 cmH2 O during the first and second hours, respectively...
August 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#10
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28820029/ninety-two-days-of-extracorporeal-membrane-oxygenation-support-following-congenital-heart-surgery
#11
Mehmet Salih Bilal, Mustafa Kemal Avsar, Özgür Yıldırım, İbrahim Özgür Önsel, Cenap Zeybek, Can Yerebakan
We report on a case involving a 10-month-old infant who received prolonged ECMO therapy following cardiac surgery for multiple ventricular septal defects (VSD). The patient was successfully weaned from 92 days of ECMO support without any long-term deficits.
September 2017: Perfusion
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#12
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28805904/higher-dominance-position-does-not-result-in-higher-reproductive-success-in-female-beef-cattle
#13
R Šárová, M Špinka, F Ceacero
The aim of this study was to investigate whether beef cows that achieve higher dominance status than their age-mates have prolonged reproductive life, increased number of offspring born and weaned, and/or heavier BW of the offspring. We also assessed whether maternal dominance rank affects the offspring sex ratio. We recorded data on 309 potential deliveries of female beef cows with known dominance status in a seasonally pastured herd over a 14-yr period and linked them with yearly records of dominance status of the cows assessed around feeding...
August 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28794867/rapid-onset-of-amiodarone-induced-pulmonary-toxicity-after-lung-lobe-resection-a-case-report-and-review-of-recent-literature
#14
Heiko Baumann, Phillip Fichtenkamm, Thomas Schneider, Jürgen Biscoping, Michael Henrich
Amiodarone-induced pulmonary toxicity (APT) is a severe side effect that can lead to lung fibrosis or fatal respiratory failure. Usually APT occurs during long term therapy after administration of prolonged loading doses or high cumulative doses. We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection. She developed atrial fibrillation with hemodynamic-instability on the first post-operative day. We initiated amiodarone therapy and four days later she developed respiratory failure...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28774721/ontogenetic-and-functional-modularity-in-the-rodent-mandible
#15
Rachel A Menegaz, Matthew J Ravosa
The material properties of diets consumed by juvenile individuals are known to affect adult morphological outcomes. However, much of the current experimental knowledge regarding dietary effects on masticatory form is derived from studies in which individuals are fed a non-variable diet for the duration of their postweaning growth period. Thus, it remains unclear how intra-individual variation in diet, due to ontogenetic variation in feeding behaviors or seasonal resource fluctuations, affects the resulting adult morphology...
June 8, 2017: Zoology: Analysis of Complex Systems, ZACS
https://www.readbyqxmd.com/read/28774204/apache-ii-score-cannot-predict-successful-weaning-from-prolonged-mechanical-ventilation
#16
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62-77) years), hospitalized between 1 January 2012, and 31 December 2013...
August 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28767478/a-case-report-on-ultrasound-guided-serratus-plane-block-and-fast-track-tracheal-extubation-in-the-operating-room-for-thoracic-trauma-patients-is-it-possible
#17
Pierfrancesco Fusco, Paolo Scimia, Stefano Di Carlo, Ambra Testa, Antonio Luciani, Emiliano Petrucci, Franco Marinangeli
Painful rib fractures may be a factor in trauma patients remaining intubated and being given postoperative mechanical ventilation after emergency surgery. Regional techniques could provide sufficient analgesia in these patients to enable weaning and extubation and thus prevent or minimize complications related to prolonged ventilatory support. We describe a trauma patient with multiple rib fractures requiring an emergency splenectomy for whom an ultrasound-guided serratus plane block provided good quality pain relief for his rib fractures and enabled fast-track extubation in the operating room...
August 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#18
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28720157/the-influence-of-azaperone-treatment-at-weaning-on-reproductive-performance-of-sows-altering-effects-of-season-and-parity
#19
T Schwarz, J Nowicki, R Tuz, P M Bartlewski
Azaperone treatment can control aggression and decrease stress due to weaning, re-grouping and hierarchical fighting of gilts and sows. However, the effects of this butyrophenone neuroleptic and sedative administered at weaning on pig reproductive function are poorly characterized. In this year-long study, a total of 619 cross-bred sows (Polish Large White×Polish Landrace) kept on a commercial farm received an i.m. injection of azaperone (Stresnil®; 2 mg/kg BW) just before weaning and were artificially inseminated during the ensuing estrus with 3×109 spermatozoa per dose of an inseminate; 1180 sows served as untreated controls...
July 19, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#20
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
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