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pulmonary and critical care

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https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#1
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#2
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#3
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28323673/clinical-pearls-of-maternal-critical-care-part-2-sickle-cell-disease-in-pregnancy
#4
Vinod Patil, Gamunu Ratnayake, Galina Fastovets
PURPOSE OF REVIEW: The current review outlines the challenges in managing pregnant women with sickle-cell anemia, who are at risk of becoming critically ill during pregnancy. RECENT FINDINGS: Sickle obstetric patients pose unique challenges to the anesthetist and intensivist. We discuss the role of prophylactic transfusions for specific indications like acute anemia and twin pregnancies. The management and prevention of vaso-occlusive crises and chest crisis are also outlined...
March 18, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28306323/a-feasibility-assessment-of-behavioral-based-interviewing-to-improve-candidate-selection-for-a-pulmonary-and-critical-care-medicine-fellowship-program
#5
Geneva Tatem, Maria Kokas, Cathy L Smith, Bruno DiGiovine
Traditional interviews for residency and fellowship training programs are an important component in the selection process, but can be of variable value due to a non-standardized approach. We redesigned the candidate interview process for our large pulmonary and critical care medicine fellowship program in the United States using a behavioral-based interview structure. The primary goal of this approach was to standardize the assessment of candidates within non-cognitive domains with the goal of selecting those with the best fit for our institution's fellowship program...
March 17, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28306322/recommended-reading-from-rutgers-robert-wood-johnson-medical-school-pulmonary-and-critical-care-medicine-fellows
#6
Sabiha Hussain, Sugeet Jagpal, Saqib H Baig, Edward K Len, Pallak Agarwal
No abstract text is available yet for this article.
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28302546/rheumatic-heart-disease-epidemiology-and-health-systems-barriers-and-facilitators-a-systematic-review-of-studies-from-uganda-and-tanzania
#7
Annesinah H Moloi, Sumaya Mall, Mark E Engel, Renae Stafford, Zhang Wan Zhu, Liesl J Zuhlke, David A Watkins
BACKGROUND: Rheumatic heart disease (RHD) is an important and preventable cause of cardiovascular disease. OBJECTIVES: As part of a recent RHD initiative in Uganda and Tanzania, we systematically reviewed group A streptococcal disease (GAS), acute rheumatic fever (ARF), and RHD in these countries. METHODS: Using a systematic review and meta-analysis/meta-synthesis, we searched PubMed, Embase, and grey literature for quantitative and qualitative studies conducted in Uganda and Tanzania that included individuals affected by GAS, ARF, and RHD...
March 14, 2017: Global Heart
https://www.readbyqxmd.com/read/28302497/building-community-through-a-pulmcc-twitter-chat-to-advocate-for-pulmonary-critical-care-and-sleep
#8
Christopher L Carroll, Kristi Bruno, Pradeep Ramachandran
BACKGROUND: Social media sites such as Twitter can significantly enhance education and advocacy efforts. In 2013, the American College of Chest Physicians (CHEST) launched a Twitter chat series using the hashtag #pulmcc to educate and advocate for topics related to pulmonary, critical care and sleep medicine. METHOD: To assess the reach of these chats, we analyzed the metrics using Symplur analytics, and compared data from each chat, as well as participant data...
March 13, 2017: Chest
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#9
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28292284/is-bulpa-criteria-suitable-for-the-diagnosis-of-probable-invasive-pulmonary-aspergillosis-in-critically-ill-patients-with-chronic-obstructive-pulmonary-disease-a-comparative-study-with-eortc-msg-and-icu-criteria
#10
Linna Huang, Hangyong He, Jingjing Jin, Qingyuan Zhan
BACKGROUND: Three diagnostic criteria have been proposed used for invasive pulmonary aspergillosis (IPA) diagnosis, namely EORTC/ MSG criteria, Bulpa criteria and intensive care unit (ICU) criteria. The Bulpa criteria were proposed to diagnose IPA in chronic obstructive pulmonary disease (COPD) patients specially. Our aim is to verify that whether the Bulpa criteria are the most suitable for diagnosing probable IPA in critically ill COPD patients compared with the other two criteria. METHODS: We included critically ill COPD patients admitted to the ICU from April 2006 to August 2013...
March 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28289497/interventional-therapy-for-pulmonary-embolism
#11
Alan B Lumsden, Erik Suarez
Patients with pulmonary embolism (PE) present with highly variable clinical symptoms and often have accompanying comorbidities. Timely diagnosis and treatment are critical to help prevent recurrence and increased morbidity/mortality. While open surgical thrombectomy was once reserved only for those with massive PE and hemodynamic compromise, it has been reevaluated with a focus on careful patient selection and early intervention. Lately, there has been increased interest in catheter-based interventions and in combining these with an open surgical component to decrease the magnitude of the intervention-for example, direct placement of large-bore thrombectomy devices directly into the right ventricle via sternotomy or subxiphoid approaches...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28288286/recommended-reading-from-the-newyork-presbyterian-hospital-weill-cornell-medicine-pulmonary-and-critical-care-medicine-fellows
#12
Kevin C Ma, Daniel S Jones, David R Price, Meredith L Turetz
No abstract text is available yet for this article.
March 13, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28284255/a-systematic-review-of-prediction-models-for-prevalent-pulmonary-tuberculosis-in-adults
#13
S S Van Wyk, H H Lin, M M Claassens
A systematic review was conducted to describe the quality and characteristics of prediction models for prevalent pulmonary tuberculosis (PTB) in adults at routine TB care settings. A prediction model was defined as the combination of two or more clinical predictors designed to estimate the probability of having TB. Studies using culture-confirmed PTB as reference standard were included. Models for in-patients, children or specific patient populations were excluded. PubMed, Scopus and the Cochrane Library and abstracts from the International Union Against Tuberculosis and Lung Disease, American Thoracic Society and European Respiratory Society conferences were searched...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28271596/team-based-approach-to-identify-cardiac-toxicity-in-critically-ill-hematopoietic-stem-cell-transplant-recipients
#14
Christopher E Dandoy, Sonata Jodele, Zachary Paff, Russel Hirsch, Thomas D Ryan, John L Jefferies, Michelle Cash, Seth Rotz, Abigail Pate, Michael D Taylor, Javier El-Bietar, Kasiani C Myers, Gregory Wallace, Adam Nelson, Michael Grimley, Thomas Pfeiffer, Adam Lane, Stella M Davies, Ranjit S Chima
INTRODUCTION: We observed pulmonary hypertension (PH), pericardial effusions, and left ventricular systolic dysfunction (LVSD) in multiple critically ill hematopoietic stem cell transplant (HSCT) recipients. We implemented routine structured echocardiography screening for HSCT recipients admitted to the pediatric intensive care unit (PICU) using a standardized multidisciplinary process. METHODS: HSCT recipients admitted to the PICU with respiratory distress, hypoxia, shock, and complications related to transplant-associated thrombotic microangiopathy were screened on admission and every 1-2 weeks thereafter...
March 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28265126/achieving-multidisciplinary-collaboration-for-the-creation-of-a-pulmonary-embolism-response-team-creating-a-team-of-rivals
#15
REVIEW
Christopher Kabrhel
Pulmonary embolism response teams (PERTs) have recently been developed to streamline care for patients with life-threatening pulmonary embolism (PE). PERTs are unique among rapid response teams, in that they bring together a multidisciplinary team of specialists to care for a single disease for which there are novel treatments but few comparative data to guide treatment. The PERT model describes a process that includes activation of the team; real-time, multidisciplinary consultation; communication of treatment recommendations; mobilization of resources; and collection of research data...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28262299/high-risk-for-thoracotomy-but-not-thoracoscopic-lobectomy
#16
Laura L Donahoe, Moira de Valence, Eshetu G Atenafu, Waƫl C Hanna, Thomas K Waddell, Andrew F Pierre, Kazuhiro Yasufuku, Marc de Perrot, Marcelo Cypel, Shaf Keshavjee, Gail E Darling
BACKGROUND: Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28259573/functional-status-predicts-major-complications-and-death-after-endovascular-repair-of-abdominal-aortic-aneurysms
#17
Donald G Harris, Ilynn Bulatao, Connor P Oates, Richa Kalsi, Charles B Drucker, Nandakumar Menon, Tanya R Flohr, Robert S Crawford
OBJECTIVE: Endovascular aneurysm repair (EVAR) is considered a lower risk option for treating abdominal aortic aneurysms and is of particular utility in patients with poor functional status who may be poor candidates for open repair. However, the specific contribution of preoperative functional status to EVAR outcomes remains poorly defined. We hypothesized that impaired functional status, based simply on the ability of patients to perform activities of daily living, is associated with worse outcomes after EVAR...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28257538/multidisciplinary-approach-to-complicated-pregnancy
#18
Josip Andelo Borovac, Josko Bozic, Tina Ticinovic Kurir, Nikola Zaja, Kresimir Kolic, Vedran Hrboka
A nulliparous pregnant woman in her mid-20s and in the 32nd week of gestation presented to the emergency department with severe headache and vomiting. She had an uneventful medical history; however, the physical examination upon hospital admission revealed a hypertensive emergency, papilledema, and 2+ dipstick proteinuria. Upon establishing the diagnosis of preeclampsia, aggressive therapy with corticosteroids, antihypertensive medication, and seizure prophylaxis was initiated. Hemodynamic stability was achieved within 24 hours and the patient remained in the observation unit located within the gynecology clinic...
March 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28257317/pulmonary-infections-in-critical-intensive-care-rapid-diagnosis-and-optimizing-antimicrobial-usage
#19
Ivor S Douglas
PURPOSE OF REVIEW: Diagnosis of pulmonary infection, including hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in the critically ill patient remains a common and therapeutically challenging diagnosis with significant attributable morbidity, mortality, and cost. Current clinical approaches to surveillance, early detection and, conventional culture-based microbiology are inadequate for optimal targeted antibiotic treatment and stewardship. Efforts to enhance diagnosis of HAP and VAP and the impact of these novel approaches on rational antimicrobial selection and stewardship are the focus of recent studies reviewed here...
March 2, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28250610/a-rare-cause-of-pulmonary-edema-in-the-postoperative-period
#20
Kshitij Chatterjee, Penchala S Mittadodla, Clinton Colaco, Rajani Jagana
With the increasing longevity of the population, the annual rates of hip arthroplasties performed have been steadily increasing over the past decade. Given the presence of medical comorbidities in the older patients, the peri-operative care of these individuals requires multi-specialty care, now more than ever. Hip arthroplasty is generally well tolerated, with early mortality after the procedure being <1%. Bone cement implantation syndrome (BCIS) is an entity that is occasionally encountered during or after the surgery...
February 2017: Indian Journal of Critical Care Medicine
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