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Prolonged wean

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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/29316934/physiological-mitochondrial-and-oxidative-stress-differences-in-the-presence-or-absence-of-lactation-in-rats
#2
Hayden W Hyatt, Yufeng Zhang, Wendy R Hood, Andreas N Kavazis
BACKGROUND: Human epidemiological data show that breastfeeding reduces the mother's probability of developing several disease conditions, including obesity and type II diabetes compared to mothers that give birth but do not breastfeed. The goal of this investigation was to characterize how lactation changes a rat's body composition, metabolism, mitochondrial function, and oxidative stress. METHODS: Ten-week old female Sprague-Dawley rats were divided into three groups (n = 8 per group): 1) non-reproductive (NR), 2) those that were allowed to mate and give birth, but were not allowed to suckle their pups (PP), and 3) those that were allowed to mate and give birth, and suckled their young until weaning at 21 days (PL)...
January 9, 2018: Reproductive Biology and Endocrinology: RB&E
https://www.readbyqxmd.com/read/29310404/extracorporeal-membrane-oxygenation-combined-with-continuous-renal-replacement-therapy-in-cutaneous-burn-and-inhalation-injury-caused-by-hydrofluoric-acid-and-nitric-acid
#3
Qinhua Pu, Jinxian Qian, Weiyi Tao, Aixiang Yang, Jian Wu, Yaodong Wang
RATIONALE: Hydrofluoric acid (HF) is a highly corrosive agent and can cause corrosive burns. HF can penetrate deeply into tissues through intact skin and the lipid barrier, leading to painful liquefactive necrosis, and inducing hypocalcemia and hypomagnesemia. In this study, we hypothesize that continuous renal replacement therapy (CRRT) may be beneficial in addressing hemodynamic instability in cases of HF poisoning. PATIENT CONCERNS: A 25-year-old man fell into an electroplating pool containing 10% HF and 50% nitric acid...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29307694/adult-males-buffer-the-cortisol-response-of-young-guinea-pigs-changes-with-age-mediation-by-behavior-and-comparison-with-prefrontal-activity
#4
Michael B Hennessy, W Tang Watanasriyakul, Brittany C Price, Alexander S Bertke, Patricia A Schiml
In the guinea pig, the presence of the mother buffers hypothalamic-pituitary-adrenal (HPA) responses of her young during exposure to a novel environment, and can do so even if she is anesthetized. In contrast, under comparable conditions other conspecifics (siblings, other adult females) are less effective or ineffective in doing so. However, we recently observed that an unfamiliar adult male reduced plasma cortisol elevations and increased Fos in the prefrontal cortex of preweaning pups exposed to a novel enclosure for 120min...
January 4, 2018: Hormones and Behavior
https://www.readbyqxmd.com/read/29290746/prolonged-dexmedetomidine-infusion-and-drug-withdrawal-in-critically-ill-children
#5
Astrid S Haenecour, Winnie Seto, Charline M Urbain, Derek Stephens, Peter C Laussen, Corrine R Balit
OBJECTIVE: To characterise the incidence, symptoms and risk factors for withdrawal associated with prolonged dexmedetomidine infusion in paediatric critically ill patients. METHODS: Retrospective chart review in the paediatric intensive care unit and the cardiac critical care unit of a single tertiary children's hospital. Patients up to 18 years old, who received dexmedetomidine for longer than 48 hours were included. RESULTS: A total of 52 patients accounted for 68 unique dexmedetomidine treatment courses of more than 48 hours...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29288612/postintubation-tracheoesophageal-fistula-diagnosis-treatment-and-prognosis
#6
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/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#7
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#8
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29229263/the-hemodynamic-effects-of-different-pacing-modalities-after-cardiopulmonary-bypass-in-patients-with-reduced-left-ventricular-function
#9
R C W Gielgens, I H F Herold, A H M van Straten, B M van Gelder, F A Bracke, H H M Korsten, M A Soliman Hamad, R A Bouwman
OBJECTIVES: Patients with decreased left ventricular function undergoing cardiac surgery have a greater chance of difficult weaning from cardiopulmonary bypass and a poorer clinical outcome. Directly after weaning, interventricular dyssynchrony, paradoxical septal motion, and even temporary bundle-branch block might be observed. In this study, the authors measured arterial dP/dtmax, mean arterial pressure (MAP), and cardiac index using transpulmonary thermodilution, pulse contour analysis, and femoral artery catheter and compared the effects between right ventricular (A-RV) and biventricular (A-BiV) pacing on these parameters...
July 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#10
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29221982/hypothermic-cardiopulmonary-bypass-weaning-and-prolonged-postoperative-rewarming-in-a-patient-with-intraoperative-oxygenator-thrombosis
#11
Ian Grant, Max Breidenstein, Ana Parsee, Charles Krumholz, Jacob Martin
No abstract text is available yet for this article.
September 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29213205/hypercapnic-ventilatory-response-in-the-weaning-of-patients-with-prolonged-mechanical-ventilation
#12
Chung-Shu Lee, Ning-Hung Chen, Li-Pang Chuang, Chih-Hao Chang, Li-Fu Li, Shih-Wei Lin, Hsiung-Ying Huang
Objective: To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [[Formula: see text]] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2 ]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods: A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29173775/comparison-of-early-versus-delayed-strategies-for-repair-of-congenital-diaphragmatic-hernia-on-extracorporeal-membrane-oxygenation
#13
Jason O Robertson, Cory N Criss, Lily B Hsieh, Niki Matsuko, Josh S Gish, Rodrigo A Mon, Kevin N Johnson, Ronald B Hirschl, George B Mychaliska, Samir K Gadepalli
PURPOSE: For the last seven years, our institution has repaired infants with CDH that require ECMO early after cannulation. Prior to that, we attempted to decannulate before repair, but repaired on ECMO if we were unable to wean after two weeks. This study compares those strategies. METHODS: From 2002 to 2016, 65 infants with CDH required ECMO. 67.7% were repaired on ECMO, and 27.7% were repaired after decannulation. Data were compared between patients repaired ≤5days after cannulation ("early protocol", n=30) and >5days after cannulation or after de-cannulation ("late protocol", n=35)...
November 22, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29170469/rapid-changes-in-atlantic-grey-seal-milk-from-birth-to-weaning-immune-factors-and-indicators-of-metabolic-strain
#14
Amanda D Lowe, Sami Bawazeer, David G Watson, Suzanne McGill, Richard J S Burchmore, P P Paddy Pomeroy, Malcolm W Kennedy
True seals have the shortest lactation periods of any group of placental mammal. Most are capital breeders that undergo short, intense lactations, during which they fast while transferring substantial proportions of their body reserves to their pups, which they then abruptly wean. Milk was collected from Atlantic grey seals (Halichoerus grypus) periodically from birth until near weaning. Milk protein profiles matured within 24 hours or less, indicating the most rapid transition from colostrum to mature phase lactation yet observed...
November 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29164081/delayed-development-of-feeding-skills-in-children-with-feeding-difficulties-cross-sectional-study-in-a-brazilian-reference-center
#15
Cláudia C Ramos, Priscila Maximino, Rachel H V Machado, Ana Beatriz Bozzini, Letícia W Ribeiro, Mauro Fisberg
Background: Delays in gross motor development, sensory processing issues, and organic and behavioral problems are known to interfere in the development of feeding skills (FS); and-therefore-in the success of the process of feeding a child. Children with feeding difficulties (FD) commonly present inadequacy of FS. Objectives: Assessment of five FS in Brazilian children with FD, and search of associations with types of FD. Methods: Cross-sectional study with 70 children below 10 years old...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29152312/a-4-year-study-of-the-proportional-distribution-of-male-reproductive-organ-abnormalities-in-cattle-slaughtered-at-nyagatare-abattoir-eastern-rwanda
#16
Erick Kandiwa, Leoncie Nyirakunzimana, Gervais Habarugira, Borden Mushonga, Alaster Samkange
Male reproductive performance has more impact on overall herd productivity than in the female. In order to assess herd productivity in cattle in Nyagatare, Eastern Rwanda, the proportional distribution of male reproductive organ abnormalities was investigated in 3087 bulls slaughtered over a 4-year period. The aim of the study was to investigate the proportional distribution of male reproductive organ abnormalities in exotic and indigenous bulls slaughtered over a 4-year period at Nyagatare abattoir in Eastern Rwanda...
November 2017: Veterinary Medicine and Science
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#17
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/29135527/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#18
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/29125799/body-growth-and-rapid-hematological-development-support-breath-hold-of-baby-belugas-delphinapterus-leucas-during-subice-transit
#19
Shawn R Noren, Caryn P Poll, Matthew S Edwards
Body size and oxygen stores in the blood and muscle set breath-hold limits in marine mammals, yet these characteristics are understudied in immature cetaceans. We examined body mass and hematology from birth through adulthood in beluga whales (Delphinapterus leucas). At birth, body mass was 8% and 6% of the maximum mass recorded for adult females and males, respectively. Body mass then increased rapidly, approaching an asymptote around 12 yr for females and 18 yr for males. Interestingly, red blood cell counts, hemoglobin content, and hematocrit levels decreased after birth; this neonatal anemia was reversed as levels increased after 2 mo postpartum...
January 2018: Physiological and Biochemical Zoology: PBZ
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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