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pulmonary and critical care

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https://www.readbyqxmd.com/read/28719225/association-between-social-support-and-self-care-behaviors-in-adults-with-chronic-obstructive-pulmonary-disease
#1
Zijing Chen, Vincent S Fan, Basia Belza, Kenneth Pike, Huong Q Nguyen
RATIONALE: Higher social support is associated with a better quality of life and functioning in adults with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine the association between structural and functional social support and self-care behaviors in adults with COPD. METHODS: This was a longitudinal study using data from the CASCADE (COPD Activity: Serotonin Transporter, Cytokines, and Depression) study which was focused on depression and functioning in COPD...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28717966/association-between-aspirin-use-and-deep-venous-thrombosis-in-mechanically-ventilated-icu-patients
#2
Ena Gupta, Furqan S Siddiqi, Ryan Kunjal, Muhammad Faisal, Farah Al-Saffar, Abubakr A Bajwa, Lisa M Jones, Vandana Seeram, James D Cury, Adil Shujaat
Deep venous thrombosis (DVT) is common in intensive care unit (ICU) patients. It is often silent and may be complicated by pulmonary embolism and death. Thromboprophylaxis with heparin does not always prevent venous thromboembolism (VTE). Aspirin (ASA) reduces the risk of VTE in surgical and high-risk medical patients but it is unknown if ASA may prevent DVT in mechanically ventilated ICU patients. We performed a retrospective chart review of critically ill patients who received mechanical ventilation for >72 h and underwent venous ultrasonography for suspected DVT between Jan 2012 and Dec 2013...
July 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28708679/transpulmonary-pressure-describes-lung-morphology-during-decremental-positive-end-expiratory-pressure-trials-in-obesity
#3
Jacopo Fumagalli, Lorenzo Berra, Changsheng Zhang, Massimiliano Pirrone, Roberta R De Santis Santiago, Susimeire Gomes, Federico Magni, Glaucia A B Dos Santos, Desmond Bennett, Vinicius Torsani, Daniel Fisher, Caio Morais, Marcelo B P Amato, Robert M Kacmarek
OBJECTIVES: Atelectasis develops in critically ill obese patients when undergoing mechanical ventilation due to increased pleural pressure. The current study aimed to determine the relationship between transpulmonary pressure, lung mechanics, and lung morphology and to quantify the benefits of a decremental positive end-expiratory pressure trial preceded by a recruitment maneuver. DESIGN: Prospective, crossover, nonrandomized interventional study. SETTING: Medical and Surgical Intensive Care Units at Massachusetts General Hospital (Boston, MA) and University Animal Research Laboratory (São Paulo, Brazil)...
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28700476/peripheral-monocytosis-as-a-predictive-factor-for-adverse-outcome-in-the-emergency-department-survey-based-on-a-register-study
#4
Mathias Hensel, Lena Grädel, Alexander Kutz, Sebastian Haubitz, Andreas Huber, Beat Mueller, Philipp Schuetz, Thomas Hügle
Monocytosis is associated with chronic infections such as tuberculosis or endocarditis as well as rheumatic and myeloproliferative disorders. Monocytes are also involved in the pathogenesis of atherosclerosis, coronary artery disease, and stroke. The value of monocytosis as a prognostic marker in different diagnostic groups in the emergency setting, however, has not been investigated so far.The aim of the article is to study monocytosis as an outcome factor in the emergency setting.In a Swiss register study, we analyzed monocyte counts in 4238 patients aged >18 years who were admitted to the emergency department of a regional tertiary care hospital...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28694197/feasibility-safety-and-utility-of-advanced-critical-care-transesophageal-echocardiography-performed-by-pulmonary-critical-care-fellows-in-a-medical-intensive-care-unit
#5
Yunuen Aguilera Garcia, Luis Quintero, Karan Singh, Viera Lakticova, AnnaMaria Iakovou, Seth Koenig, Mangala Narasimhan, Paul H Mayo
BACKGROUND: Competence in advanced critical care transesophageal echocardiography allows the intensivist to diagnose and manage cardiopulmonary failure when transthoracic echocardiography is not sufficient to answer the clinical question. This report describes the feasibility, safety, and utility of transesophageal echocardiography in mechanically ventilated critically ill patients performed by pulmonary and critical care fellows in a medical intensive care unit. METHODS: This is a longitudinal descriptive study of advanced transesophageal echocardiography performed in mechanically ventilated patients...
July 7, 2017: Chest
https://www.readbyqxmd.com/read/28693521/predictors-of-intensive-care-unit-admission-and-mortality-in-patients-with-ischemic-stroke-investigating-the-effects-of-a-pulmonary-rehabilitation-program
#6
Belma Doğan Güngen, Abdulkadir Tunç, Yeşim Güzey Aras, Aslı Aksoy Gündoğdu, Adil Can Güngen, Serdar Bal
BACKGROUND: The aim of this study was to investigate the predictors of intensive care unit (ICU) admission and mortality among stroke patients and the effects of a pulmonary rehabilitation program on stroke patients. METHODS: This prospective study enrolled 181 acute ischemic stroke patients aged between 40 and 90 years. Demographical characteristics, laboratory tests, diffusion-weighed magnetic resonance imaging (DWI-MRI) time, nutritional status, vascular risk factors, National Institute of Health Stroke Scale (NIHSS) scores and modified Rankin scale (MRS) scores were recorded for all patients...
July 11, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28666290/-venous-paravasation-after-augmentation-of-pedicle-screws-an-underestimated-risk
#7
Axel Prokop, Manuela Sagerer, Wolfgang Rupp, Marc Chmielnicki
Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures. Average age was 77.5 years. During the six month observation period, no patients died. There were no neurological deficits. On VAS, average pain decreased from 8.5 to 4...
June 30, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28648009/-diagnostic-performance-of-t-spot-tb-on-peripheral-blood-in-combination-with-adenosine-deaminase-on-pleural-fluid-for-the-diagnosis-of-tuberculous-pleurisy-within-different-age-group
#8
H Y Xu, D Q Zhang, J R Ye, S S Su, Y P Xie, C S Chen, Y P Li
Objective: To evaluate the performance of T cell enzyme-linked immuno-spot assay (T-SPOT) on peripheral blood in combination with adenosine deaminase (ADA) on pleural fluid for diagnosis of tuberculous (TB) pleurisy within different age groups. Methods: The data of patients with pleural effusion from the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from April 2012 to November 2016 were retrospectively analyzed, and the diagnoses of these patients were histopathologically confirmed through medical thoracoscopy...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28645011/transient-portal-venous-gas-associated-with-reversible-non-occlusive-mesenteric-ischemia-a-case-report
#9
Gaël Piton, Brice Paquette, Eric Delabrousse, Gilles Capellier
OBJECTIVES: To report the utility of abdominal ultrasonography (US) to identify the presence of portal venous gas (PVG) during non-occlusive mesenteric ischemia (NOMI), and to follow the disappearance of portal venous gas after resolution of the NOMI. DATA SOURCES: This was a clinical observation of a patient, with images of abdominal computed tomography (CT), and a video of portal venous gas identified by ultrasonography. DATA SYNTHESIS: We describe the case of an adult patient admitted to our ICU for NOMI developing 48h after cardiac surgery...
June 16, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28642012/evaluation-of-a-device-combining-an-inferior-vena-cava-filter-and-a-central-venous-catheter-for-preventing-pulmonary-embolism-among-critically-ill-trauma-patients
#10
Victor F Tapson, Joshua P Hazelton, John Myers, Claudia Robertson, Ramyar Gilani, Julie A Dunn, Marko Bukur, Martin A Croce, Ann Peick, Sonlee West, Lawrence Lottenberg, Jay Doucet, Preston R Miller, Bruce Crookes, Rajesh R Gandhi, Chasen A Croft, Anthony Manasia, Brian A Hoey, Howard Lieberman, Oscar D Guillamondegui, Victor Novack, Gregory Piazza, Samuel Z Goldhaber
PURPOSE: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients. MATERIALS AND METHODS: In a multicenter, prospective, single-arm clinical trial, the device was inserted at the bedside without fluoroscopy and subsequently retrieved before transfer from the intensive care unit (ICU). The primary efficacy endpoint was freedom from clinically significant PE or fatal PE 72 hours after device removal or discharge, whichever occurred first...
June 20, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#11
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
June 22, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28638515/use-of-fellow-as-clinical-teacher-fact-curriculum-for-teaching-during-consultation-effect-on-subspecialty-fellow-teaching-skills
#12
Eli M Miloslavsky, Kathleen Degnan, Jenna McNeill, Jakob I McSparron
BACKGROUND: Subspecialty consultation in inpatient care is increasing. Teaching by subspecialty fellows in a consultation setting may be an important source of work-based learning for students and residents. However, teaching and evaluation of learners in this context may be challenging due to personal and systems-based barriers. OBJECTIVE: We developed and evaluated a framework designed to overcome barriers to teaching and to improve fellow teaching skills during inpatient consultation...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28630565/efficacy-of-various-scoring-systems-for-predicting-the-28-day-survival-rate-among-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-requiring-emergency-intensive-care
#13
Zhihong Feng, Tao Wang, Ping Liu, Sipeng Chen, Han Xiao, Ning Xia, Zhiming Luo, Bing Wei, Xiuhong Nie
We aimed to investigate the efficacy of four severity-of-disease scoring systems in predicting the 28-day survival rate among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) requiring emergency care. Clinical data of patients with AECOPD who required emergency care were recorded over 2 years. APACHE II, SAPS II, SOFA, and MEDS scores were calculated from severity-of-disease indicators recorded at admission and compared between patients who died within 28 days of admission (death group; 46 patients) and those who did not (survival group; 336 patients)...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28629636/nasal-high-flow-oxygen-therapy-in-the-ward-setting-a-prospective-observational-study
#14
Alison M Pirret, Susan F Takerei, Claire L Matheson, Meghan Kelly, Wharewaina Strickland, Joanne Harford, Nicola E Jepsen, Lisa J Welsh, Chloe P A Allan
BACKGROUND: Whilst research demonstrates the benefits of nasal high flow oxygen in the intensive care setting, limited literature exists on its benefits in ward patients. OBJECTIVES: This study evaluated the use of nasal high flow oxygen in adult ward patients with respiratory failure or at risk of respiratory deterioration. Primary outcome was an improvement in pulmonary function as indicated by decreases in respiratory and heart rates and an increase in arterial oxygen saturation via pulse oximetry...
June 16, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28625165/transpulmonary-thermodilution-advantages-and-limits
#15
REVIEW
Xavier Monnet, Jean-Louis Teboul
BACKGROUND: For complex patients in the intensive care unit or in the operating room, many questions regarding their haemodynamic management cannot be answered with simple clinical examination. In particular, arterial pressure allows only a rough estimation of cardiac output. Transpulmonary thermodilution is a technique that provides a full haemodynamic assessment through cardiac output and other indices. MAIN BODY: Through the analysis of the thermodilution curve recorded at the tip of an arterial catheter after the injection of a cold bolus in the venous circulation, transpulmonary thermodilution intermittently measures cardiac output...
June 19, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28622013/acetazolamide-use-in-severe-chronic-obstructive-pulmonary-disease-pros-and-cons
#16
Rosemary Adamson, Erik R Swenson
Acetazolamide is a carbonic anhydrase (CA) inhibitor sometimes used as a respiratory stimulant for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving oxygenation, reducing carbon dioxide retention, and aiding liberation from mechanical ventilation and/or attempting to correct a metabolic alkalosis. However, the net effect of CA inhibition is multifactorial and complex, because CA is inhibited in many tissues that may negatively affect the patient with lung disease. The full impact of acetazolamide and other CA inhibitors depends critically on dosing, age, and pulmonary, renal, hepatic, hematological, and respiratory muscle function and reserves...
July 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28620467/recent-advances-in-understanding-lung-function-development
#17
REVIEW
Erik Melén, Stefano Guerra
Recent years have witnessed critical contributions to our understanding of the determinants and long-term implications of lung function development. In this article, we review studies that have contributed to advances in understanding lung function development and its critical importance for lung health into adult life. In particular, we have focused on early life determinants that include genetic factors, perinatal events, environmental exposures, lifestyle, infancy lower respiratory tract infections, and persistent asthma phenotypes...
2017: F1000Research
https://www.readbyqxmd.com/read/28612657/improving-care-for-advanced-copd-through-practice-change-experiences-of-participation-in-a-canadian-spread-collaborative
#18
Jennifer Y Verma, Claudia Amar, Shannon Sibbald, Graeme M Rocker
Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care system. With direct investment of <$1-million CAD, a pan-Canadian quality improvement collaborative (QIC) supported the spread of INSPIRED to 19 teams in the 10 Canadian provinces contingent upon participation in evaluation. The collaborative evaluation followed a mixed-methods summative approach relying on collated quantitative data, team documents, and surveys sent to core members of the 19 teams...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28611969/anastomotic-strictures-after-esophageal-atresia-repair-incidence-investigations-and-management-including-treatment-of-refractory-and-recurrent-strictures
#19
REVIEW
Renato Tambucci, Giulia Angelino, Paola De Angelis, Filippo Torroni, Tamara Caldaro, Valerio Balassone, Anna Chiara Contini, Erminia Romeo, Francesca Rea, Simona Faraci, Giovanni Federici di Abriola, Luigi Dall'Oglio
Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA) over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS) is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28608755/recommended-reading-from-the-university-of-arizona-pulmonary-and-critical-care-program-fellows
#20
Kareem Ahmad, Luke Gabe, Elaine Cristan, Phillip Factor
No abstract text is available yet for this article.
June 13, 2017: American Journal of Respiratory and Critical Care Medicine
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