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https://www.readbyqxmd.com/read/29779927/patent-ductus-arteriosus-the-physiology-of-transition
#1
REVIEW
Poorva Deshpande, Michelle Baczynski, Patrick J McNamara, Amish Jain
The transition from intrauterine to extrauterine life represents a critical phase of physiological adaptation which impacts many organ systems, most notably the heart and the lungs. The majority of term neonates complete this transition without complications; however, dysregulation of normal postnatal adaptation may lead to acute cardiopulmonary instability, necessitating advanced intensive care support. Although not as well appreciated as changes in vascular resistances, the shunt across the DA plays a crucial physiologic role in the adaptive processes related to normal transitional circulation...
May 5, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29774649/end-of-life-trajectory-of-coping-and-self-care-of-patients-with-idiopathic-pulmonary-fibrosis-a-meta-synthesis-using-meta-ethnography
#2
Yasuko Igai
AIM: This study aimed to extract patient narratives regarding the end-of-life trajectory of their self-care and coping experiences as patients with idiopathic pulmonary fibrosis and to use meta-ethnography to discover common metaphors of their experience in order to inform the development of nursing interventions. METHODS: A comprehensive search of qualitative research using electronic databases, in English and Japanese, regarding patients with IPF, identified four articles...
May 17, 2018: Japan Journal of Nursing Science: JJNS
https://www.readbyqxmd.com/read/29755170/patient-education-provided-by-physiotherapists-for-patients-with-chronic-obstructive-pulmonary-disease-results-of-a-scoping-review
#3
REVIEW
Judy King, Sarah Tessier, Marie-Josée Charette, Danica Gaudet
Purpose: Physiotherapists have been acknowledged as playing a vital role in the care of people living with chronic obstructive pulmonary disease (COPD), and this care includes providing patient education (PE). Yet very little is known about the issues critical to providing this PE. The purpose of this scoping review was to identify and map out the current knowledge about the content, processes, and overall effectiveness of the PE provided by physiotherapists for people living with COPD. Method: Using the guidelines developed by Arksey and O'Malley in 2005 and by Levac in 2010, key databases were searched...
2018: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/29750814/one-year-mortality-after-recovery-from-critical-illness-a-retrospective-cohort-study
#4
Sharukh Lokhandwala, Ned McCague, Abdullah Chahin, Braiam Escobar, Mengling Feng, Mohammad M Ghassemi, David J Stone, Leo Anthony Celi
RATIONALE: Factors associated with one-year mortality after recovery from critical illness are not well understood. Clinicians generally lack information regarding post-hospital discharge outcomes of patients from the intensive care unit, which may be important when counseling patients and families. OBJECTIVE: We sought to determine which factors among patients who survived for at least 30 days post-ICU admission are associated with one-year mortality. METHODS: Single-center, longitudinal retrospective cohort study of all ICU patients admitted to a tertiary-care academic medical center from 2001-2012 who survived ≥30 days from ICU admission...
2018: PloS One
https://www.readbyqxmd.com/read/29747662/progressive-mobility-program-and-technology-to-increase-the-level-of-physical-activity-and-its-benefits-in-respiratory-muscular-system-and-functionality-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#5
Debora Stripari Schujmann, Adriana Claudia Lunardi, Carolina Fu
BACKGROUND: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables...
May 10, 2018: Trials
https://www.readbyqxmd.com/read/29742226/influenza-a-non-h1n1-associated-with-acute-respiratory-failure-and-acute-renal-failure-in-a-previously-vaccinated-cystic-fibrosis-patient
#6
Louise Piva Penteado, Cecília Susin Osório, Antônio Balbinotto, Paulo de Tarso Roth Dalcin
In the 2014 - 2015 season, most influenza infections were due to A (H3N2) viruses. More than two-thirds of circulating A (H3N2) viruses are antigenically and genetically different (drifted) from the A (H3N2) vaccine component of 2014 - 2015 northern and southern Hemisphere seasonal influenza vaccines. The purpose of this paper is to report a case of seasonal influenza A non-H1N1 infection that occurred in June 2015 in an adult cystic fibrosis patient with severe lung disease previously vaccinated with the anti-flu trivalent vaccine...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29739630/extracorporeal-life-support-as-salvage-therapy-for-massive-pulmonary-embolus-and-cardiac-arrest-in-pregnancy
#7
Michael E Takacs, Kristina E Damisch
BACKGROUND: Massive pulmonary embolus (PE) with prolonged cardiac arrest in the setting of pregnancy has few treatment options. Selections are further restricted if there are contraindications to the standard therapies of embolectomy and thrombolysis. We report a case of extracorporeal life support (ECLS) used as salvage therapy for a critically ill pregnant patient. CASE REPORT: A 21-year-old woman presented to a small rural hospital with chest pain, dyspnea, hypoxia, and syncope...
May 5, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29739430/relax-restricted-versus-liberal-positive-end-expiratory-pressure-in-patients-without-ards-protocol-for-a-randomized-controlled-trial
#8
Anna Geke Algera, Luigi Pisani, Dennis C J Bergmans, Sylvia den Boer, Corianne A J de Borgie, Frank H Bosch, Karina Bruin, Thomas G Cherpanath, Rogier M Determann, Arjen M Dondorp, Dave A Dongelmans, Henrik Endeman, Jasper J Haringman, Janneke Horn, Nicole P Juffermans, David M van Meenen, Nardo J van der Meer, Maruschka P Merkus, Hazra S Moeniralam, Ilse Purmer, Pieter Roel Tuinman, Mathilde Slabbekoorn, Peter E Spronk, Alexander P J Vlaar, Marcelo Gama de Abreu, Paolo Pelosi, Ary Serpa Neto, Marcus J Schultz, Frederique Paulus
BACKGROUND: Evidence for benefit of high positive end-expiratory pressure (PEEP) is largely lacking for invasively ventilated, critically ill patients with uninjured lungs. We hypothesize that ventilation with low PEEP is noninferior to ventilation with high PEEP with regard to the number of ventilator-free days and being alive at day 28 in this population.  METHODS/DESIGN: The "REstricted versus Liberal positive end-expiratory pressure in patients without ARDS" trial (RELAx) is a national, multicenter, randomized controlled, noninferiority trial in adult intensive care unit (ICU) patients with uninjured lungs who are expected not to be extubated within 24 h...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29732423/predicting-critical-care-unit-level-complications-after-long-segment-fusion-procedures-for-adult-spinal-deformity
#9
Rafael De la Garza-Ramos, Jonathan Nakhla, Yaroslav Gelfand, Murray Echt, Aleka N Scoco, Merritt D Kinon, Reza Yassari
Background: To identify predictive factors for critical care unit-level complications (CCU complication) after long-segment fusion procedures for adult spinal deformity (ASD). Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database [2010-2014] was reviewed. Only adult patients who underwent fusion of 7 or more spinal levels for ASD were included. CCU complications included intraoperative arrest/infarction, ventilation >48 hours, pulmonary embolism, renal failure requiring dialysis, cardiac arrest, myocardial infarction, unplanned intubation, septic shock, stroke, coma, or new neurological deficit...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29724800/the-importance-of-quality-in-pulmonary-v-q-imaging
#10
April Mann, Mario DiDea, France Fournier, Daniel Tempesta, Jessica Williams, Norman LaFrance
As the healthcare environment continues to change and morph into a system focusing on increased quality and evidence-based outcomes, nuclear medicine technologists must be reminded they play a critical role in achieving high quality interpretable images used to drive patient care, treatments and best possible outcomes. A survey performed by the Quality Committee, Society of Nuclear Medicine and Molecular Imaging-Technologist Section demonstrated a clear knowledge gap exists amongst technologists regarding their understanding of quality, how it is measured, and how it should be achieved throughout all practicing technologists despite role and education level...
May 3, 2018: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/29720052/high-density-lipoprotein-mean-platelet-volume-and-uric-acid-as-biomarkers-for-outcomes-in-patients-with-sepsis-an-observational-study
#11
Luis Bolívar Montero-Chacón, Juan Ignacio Padilla-Cuadra, Sy Han Chiou, Gabriel Torrealba-Acosta
BACKGROUND: We conducted an observational study evaluating the association between uric acid, mean platelet volume (MPV), and high-density lipoprotein (HDL) with complications and outcomes of patients with sepsis in a critical care setting. METHODS: We followed patients with a diagnosis of severe sepsis and septic shock for a maximum of 28 days. Main outcomes assessed included length of stay (LOS), the need for renal replacement therapy (RRT), assisted mechanical ventilation (AMV), and vasopressor support as well as in-unit mortality...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29712611/the-development-of-extracorporeal-membrane-oxygenation
#12
Don K Nakayama
Evolving from the development of heart-lung machines for open-heart surgery, extracorporeal membrane oxygenation has reemerged as a rescue modality for patients with acute respiratory failure that cannot be supported by conventional modes of ventilation. The history of extracorporeal membrane oxygenation begins with the discovery of heparin, fundamental to the success of extracorporeal circulation and membrane lungs. Engineers and scientists created suitable artificial membranes that allowed gas exchange while keeping gas and blood phases separate...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29705765/practice-of-ventilation-in-middle-income-countries-provent-imic-rationale-and-protocol-for-a-prospective-international-multicentre-observational-study-in-intensive-care-units-in-asia
#13
Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Reza Hashemian, Madiha Hashmi, Hisham Ahmed Imad, Kanishka Indraratna, Shivakumar Iyer, Gyan Kayastha, Bhuvana Krishna, Hassan Moosa, Behzad Nadjm, Rajyabardhan Pattnaik, Sriram Sampath, Louise Thwaites, Ni Ni Tun, Nor'azim Mohd Yunos, Salvatore Grasso, Frederique Paulus, Marcelo Gama de Abreu, Paolo Pelosi, Arjen M Dondorp, Marcus J Schultz
INTRODUCTION: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#14
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29701421/rapid-pacing-for-thoracic-endovascular-aortic-repair-a-case-report
#15
Hugo Silva, Andreia Fernandes, João Rodrigues, Daniel Brandão, Manuela Vieira, Catarina Celestino
INTRODUCTION: Endovascular aortic interventions are suitable alternatives to open surgery, being less invasive and having lower mortality and complications. Accurate positioning of the stent graft is a critical point because of systolic thrush. Techniques used to prevent it include pharmacological (antihypertensive drugs, nitroglycerin, adenosine) and mechanical methods (temporary caval occlusion by balloon). Rapid Right Ventricular Pacing (RRVP) is an emerging alternative with good patient tolerance and low level of complications...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29692932/intensive-care-unit-rotations-and-predictors-of-career-choice-in-pulmonary-critical-care-medicine-a-survey-of-internal-medicine-residency-directors
#16
Daniel J Minter, Sean D Levy, Sowmya R Rao, Paul F Currier
Background: The United States (US) is experiencing a growing shortage of critical care medicine (CCM) trained physicians. Little is known about the exposures to CCM experienced by internal medicine (IM) residents or factors that may influence their decision to pursue a career in pulmonary/critical care medicine (PCCM). Methods: We conducted a survey of US IM residency program directors (PDs) and then used multivariable logistic regression to identify factors that were predictive of residency programs with a higher percentage of graduates pursuing careers in PCCM...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29691284/a-modified-algorithm-for-critical-congenital-heart-disease-screening-using-pulse-oximetry
#17
Christina L Diller, Michael S Kelleman, Kenneth G Kupke, Sharon C Quary, Lazaros K Kochilas, Matthew E Oster
: media-1vid110.1542/5727212367001PEDS-VA_2017-4065 Video Abstract OBJECTIVES: Determine the performance of the American Academy of Pediatrics (AAP) critical congenital heart disease (CCHD) newborn screening algorithm and the impact of an alternative algorithm. METHODS: Screening was performed on term infants without a known CCHD diagnosis at or near 24 hours of age at a tertiary birth hospital by using the AAP algorithm from 2013 to 2016. Retrospective review from the birth hospital and the area's sole pediatric cardiac center identified true- and false-positives and true- and false-negatives...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29690686/-impaired-hypoxic-ventilatory-response-and-related-factors-in-han-and-uygur-patients-with-obstructive-sleep-apnea-hypopnea-syndrome
#18
Z M He, H Guo, X L Jiang, J P Li, Q L Zhang, Y P Yang, X S Dong, Piliqing Da, J Shi, M Li, M C Shi, F Han
Objective: To investigate the respiratory central hypoxia response and its related factors in Han and Uygur patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: One hundred and sixty six OSAHS patients were selected from Jan. 2016 to Dec. 2016 in Department of Respiratory and Critical Care Medicine, Kelamayi Central Hospital, including 69 cases of Han nationality and 97 cases of Uygur nationality. Seventy-three healthy subjects of Uygur nationality were enrolled as the control group. All of them under went sleep monitoring, nocturnal oxygen saturation (SaO(2)), pulmonary function and respiratory central hypoxia response...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29687438/sleep-in-critically-ill-mechanically-ventilated-patients-with-severe-sepsis-or-copd
#19
Y Boyko, P Jennum, H Oerding, J T Lauridsen, M Nikolic, P Toft
BACKGROUND: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses' sleep evaluation...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#20
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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