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https://www.readbyqxmd.com/read/29143503/-lung-and-pleural-space-ultrasonography-for-pulmonologist
#1
Leslie Noirez, Laurent P Nicod
In the past twenty years ultrasound has been the subject of renewed interest in lung exploration in the broad sense. The necessity of accessing a means of rapid exploration at the bed of the patient in a critical situation has led to the development of a pleuro-pulmonary ultrasound semiology to make it a diagnostic tool of choice which exceeds the strict framework intensive care units and emergency services. With the diagnosis of thoracic tumors or the exploration of interstitial syndromes, it tends to integrate more into the daily practice of the pulmonologist...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29137886/diesel-exhaust-inhalation-exposure-induces-pulmonary-arterial-hypertension-in-mice
#2
Jing Liu, Xiaoqing Ye, Dapeng Ji, Xiaofei Zhou, Cong Qiu, Weiping Liu, Luyang Yu
Diesel exhaust (DE) is one of the main sources of urban air pollution. An increasing number of evidence showed the association of air pollution with cardiovascular diseases. Pulmonary arterial hypertension (PAH) is one of the most disastrous vascular diseases, which results in right ventricular failure and death. However, the relationship of DE inhalation exposure with PAH is still unknown. In this study, male adult mice were exposed by inhalation to filtered ambient air (negative control), 10% O2 hypoxia (PAH-phenotype positive control), 350 μg/m(3) particulate matter whole DE, or the combination of DE and hypoxic condition...
November 11, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/29136212/neoadjuvant-and-adjuvant-therapy-for-stage-iii-non-small-cell-lung-cancer
#3
Shun-Ichi Watanabe, Kazuo Nakagawa, Kenji Suzuki, Kazuya Takamochi, Hiroyuki Ito, Jiro Okami, Keiju Aokage, Hisashi Saji, Hiroshige Yoshioka, Yoshitaka Zenke, Tadashi Aoki, Yasuhiro Tsutani, Morihito Okada
The treatments for advanced non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the 5-year survival of patients with Stage III NSCLC who underwent surgical resection alone has been dismal. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy...
November 9, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29131347/critical-care-ultrasound-a-national-survey-across-specialties
#4
Jeffrey R Stowell, Ross Kessler, Resa E Lewiss, Igor Barjaktarevic, Bikash Bhattarai, Napatkamon Ayutyanont, John L Kendall
PURPOSE: Management of the critically ill patient requires rapid assessment and differentiation. Point-of-care ultrasound (POCUS) improves diagnostic accuracy and guides resuscitation. This study sought to describe the use of critical care related POCUS amongst different specialties. METHODS: This study was conducted as an online 18-question survey. Survey questions queried respondent demographics, preferences for POCUS use, and barriers to implementation. RESULTS: 2735 recipients received and viewed the survey with 416 (15...
November 13, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/29128035/bedside-identification-of-massive-pulmonary-embolism-with-point-of-care-transesophageal-echocardiography
#5
Tomislav Jelic, Melanie Baimel, Jordan Chenkin
BACKGROUND: Pulmonary embolism can be difficult to diagnose, particularly in those who are hemodynamically unstable and cannot be imaged to confirm the diagnosis. Echocardiography can allow for rapid assessment of patients in shock, but requires adequate transthoracic windows to obtain clinically useful information. Emergency physician-performed transesophageal echocardiography (TEE) may be a useful tool when transthoracic echocardiography fails. CASE REPORT: An 86-year-old woman presented to the emergency department after a fall at home...
November 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29126167/outcome-of-long-term-complications-after-permanent-metallic-left-bronchial-stenting-in-children
#6
Paola Serio, Raffaella Nenna, Marco Di Maurizio, Stefano Avenali, Roberto Leone, Roberto Baggi, Luigi Arcieri, Bruno Murzi, Andrea Quarti, Marco Pozzi, Lorenzo Mirabile, Fabio Midulla
OBJECTIVES: We describe the way we treated 7 children with critical long-term complications after metallic balloon-expandable stenting in the left mainstem bronchus. METHODS: Endoscopic follow-up included a first bronchoscopy 3 weeks after stenting, then monthly for 3 months, every 4-6 months up to 1 year and at scheduled times to calibrate stent diameter up to final calibration. When major complications occurred, patients underwent chest computed tomographic angiography...
November 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29123889/a-case-of-non-cardiogenic-pulmonary-edema-provoked-by-intravenous-acetazolamide
#7
Yuichiro Ono, Makiko Morifusa, Satoru Ikeda, Chika Kunishige, Yoshiki Tohma
Case: A 61-year-old man was diagnosed with severe chest trauma after a car accident and had had difficulty in weaning from a ventilator because of flail chest and dilated cardiomyopathy. On the 17th day in the intensive care unit, he received i.v. acetazolamide to increase urine output. One hour after the injection, he suddenly developed severe hypoxia. Chest radiography revealed a butterfly shadow. He received other diuretics and a vasodilator, which seemed slowly to resolve the respiratory failure...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29118839/acute-angle-closure-glaucoma-a-potential-blind-spot-in-critical-care
#8
Anna Petsas, George Chapman, Richard Stewart
We report a case of a 69-year-old gentleman who developed an acutely painful eye with loss of visual acuity whilst on the critical care unit. He was admitted three days previously with an infective exacerbation of chronic obstructive pulmonary disease requiring invasive mechanical ventilation. In addition, he received intravenous antibiotics, steroids, nebulised bronchodilators and intravenous aminophylline, together with noradrenaline for blood pressure support. On development of visual symptoms, an emergency ophthalmology review diagnosed acute angle closure glaucoma...
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#9
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#10
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29114008/2017-american-heart-association-focused-update-on-adult-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#11
REVIEW
Monica E Kleinman, Zachary D Goldberger, Thomas Rea, Robert A Swor, Bentley J Bobrow, Erin E Brennan, Mark Terry, Robin Hemphill, Raúl J Gazmuri, Mary Fran Hazinski, Andrew H Travers
Cardiopulmonary resuscitation is a lifesaving technique for victims of sudden cardiac arrest. Despite advances in resuscitation science, basic life support remains a critical factor in determining outcomes. The American Heart Association recommendations for adult basic life support incorporate the most recently published evidence and serve as the basis for education and training for laypeople and healthcare providers who perform cardiopulmonary resuscitation.
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29092970/extracorporeal-membrane-oxygenation-for-post-transplant-hypoxaemia-following-very-severe-hepatopulmonary-syndrome
#12
Lakshmi Kumar, Dinesh Balakrishnan, Rekha Varghese, Sudhindran Surendran
Hepatopulmonary syndrome (HPS) associated with end-stage liver disease has a high morbidity when room air PaO2 is less than 50 mm Hg. Safe levels of oxygenation to facilitate transplantation have not been defined despite advancement in care. Postoperatively, hypoxaemia worsens due to ventilation perfusion mismatch contributed by postoperative pulmonary vasoconstriction and due to decrease in endogenous nitric oxide. A 16-year-old boy with cirrhosis presented with HPS and a PaO2 of 37 mm Hg on room air and underwent living donor liver transplant...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29092868/patients-outcomes-after-acute-respiratory-failure-a-qualitative-study-with-the-promis-framework
#13
Michelle N Eakin, Yashika Patel, Pedro Mendez-Tellez, Victor D Dinglas, Dale M Needham, Alison E Turnbull
BACKGROUND: As mortality rates for patients treated in intensive care units decrease, greater understanding of the impact of critical illness on patients' well-being is needed. OBJECTIVE: To describe the survivorship experience of patients who had acute respiratory failure by using the Patient Reported Outcomes Measurement Information System (PROMIS) framework. METHODS: A total of 48 adult patients who had acute respiratory failure completed at least 1 semistructured telephone-based interview between 5 and 18 months after their stay in the intensive care unit...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#14
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29073361/high-risk-sarcoidosis-current-concepts-and-research-imperatives
#15
William H Sauer, Barney J Stern, Robert Baughman, Daniel A Culver, Walter Royal
Sarcoidosis is a disease with heterogeneous manifestations and outcomes, varying in part based on organ involvement. Specifically, sarcoidosis patients at risk for poor outcomes include individuals with treatment-resistant pulmonary sarcoidosis, including fibrotic pulmonary disease and pulmonary hypertension, as well as those with cardiac, neurologic and multi-organ disease. The limited but available data relating to these high-risk sarcoidosis patients, defined as those patients with presentations requiring medical intervention to avoid progressive disability or premature death, was evaluated as part of the National Heart Lung and Blood Institute's (NHLBI) workshop to improve understanding of these disease manifestations...
October 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29030027/comparison-of-right-ventricular-measurements-by-perioperative-transesophageal-echocardiography-as-a-predictor-of-hemodynamic-instability-following-cardiac-surgery
#16
Pei-Chi Ting, An-Hsun Chou, Chia-Chih Liao, Victor Chien-Chia Wu, Feng-Chun Tsai, Jaw-Ji Chu, Min-Wen Yang, Shi-Chuan Chang
BACKGROUND: The relationship between perioperative right ventricular (RV) performance and hemodynamic instability after cardiac surgery seemed less portrayed. Therefore, we sought to elucidate this relationship and compare the accuracy of different RV systolic indices in predicting outcome of cardiac surgery. METHODS: This study enrolled consecutive patients referred for cardiac surgeries. Exclusion criteria were non-sinus rhythm or contraindications to transesophageal echocardiography (TEE)...
October 10, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29029712/advanced-cardiopulmonary-support-for-pulmonary-embolism
#17
REVIEW
Oren Friedman, James M Horowitz, Danny Ramzy
Management of high-risk pulmonary embolism (PE) requires an understanding of the pathophysiology of PE, options for rapid clot reduction, critical care interventions, and advanced cardiopulmonary support. PE can lead to rapid respiratory and hemodynamic collapse via a complex sequence of events leading to acute right ventricular failure. Importantly, reduction in pulmonary vascular resistance must be accomplished either by systemic thrombolytics, catheter directed thrombolytics, endovascular clot extraction, or surgical embolectomy...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029709/medical-management-of-pulmonary-embolism-beyond-anticoagulation
#18
REVIEW
Nancy Hsu, Tisha Wang, Oren Friedman, Igor Barjaktarevic
Pulmonary embolism (PE) is a common medical condition that carries significant morbidity and mortality. Although diagnosis, anticoagulation, and interventional clot-burden reduction strategies represent the focus of clinical research and care in PE, appropriate risk stratification and supportive care are crucial to ensure good outcomes. In this chapter, we will discuss the medical management of PE from the time of presentation to discharge, focusing on the critical care of acute right ventricular failure, anticoagulation of special patient populations, and appropriate follow-up testing after acute PE...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29028375/health-disparities-in-patients-with-pulmonary-arterial-hypertension-a-blueprint-for-action-an-official-american-thoracic-society-statement
#19
REVIEW
Arunabh Talwar, Joe G N Garcia, Halley Tsai, Matthew Moreno, Tim Lahm, Roham T Zamanian, Roberto Machado, Steven M Kawut, Mona Selej, Stephen Mathai, Laura Hoyt D'Anna, Sonu Sahni, Erik J Rodriquez, Richard Channick, Karen Fagan, Michael Gray, Jessica Armstrong, Josanna Rodriguez Lopez, Vinicio de Jesus Perez
BACKGROUND: Health disparities have a major impact in the quality of life and clinical care received by minorities in the United States. Pulmonary arterial hypertension (PAH) is a rare cardiopulmonary disorder that affects children and adults and that, if untreated, results in premature death. The impact of health disparities in the diagnosis, treatment, and clinical outcome of patients with PAH has not been systematically investigated. OBJECTIVES: The specific goals of this research statement were to conduct a critical review of the literature concerning health disparities in PAH, identify major research gaps and prioritize direction for future research...
October 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28993038/capnography-in-the-emergency-department-a-review-of-uses-waveforms-and-limitations
#20
Brit Long, Alex Koyfman, Michael A Vivirito
BACKGROUND: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. OBJECTIVE OF THE REVIEW: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. DISCUSSION: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients...
October 6, 2017: Journal of Emergency Medicine
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