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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28524040/-a-case-of-the-severe-human-infection-by-avian-influenza-h7n9-was-rescued-successfully-by-the-sepsis-bundle
#2
Shaohong Wang, Jintao Liu, Haili Luo, Xianguo Pan, Tongmei Yuan, Xuemei Long
One confirmed diagnosis case of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523583/respiratory-support-after-extubation-noninvasive-ventilation-or-high-flow-nasal-cannula-as-appropriate
#3
Tommaso Mauri, Giacomo Grasselli, Samir Jaber
No abstract text is available yet for this article.
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#4
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28518131/incidence-of-respiratory-viral-infection-in-infants-with-respiratory-symptoms-evaluated-for-late-onset-sepsis
#5
J B Cerone, R P Santos, D Tristram, D M Lamson, K A Stellrecht, K St George, M J Horgan, A Rios
OBJECTIVE: To determine the frequency, etiology and impact of respiratory viral infection (RVI) on infants evaluated for late-onset sepsis (LOS), defined as sepsis occurring >72 h of life, in the neonatal intensive care unit. STUDY DESIGN: Prospective observational study conducted from 6 March 2014 to 3 May 2016 on infants evaluated for LOS. PCR viral panel performed on nasopharyngeal specimens among infants with clinical suspicion for RVI. Sequence analysis was performed to determine viral subtypes...
May 18, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28517022/impact-and-management-of-left-ventricular-function-on-the-prognosis-of-takotsubo-syndrome
#6
Ibrahim El-Battrawy, Uzair Ansari, Siegfried Lang, Michael Behnes, Katja Schramm, Christian Fastner, Xiaobo Zhou, Jürgen Kuschyk, Erol Tülümen, Susanne Röger, Martin Borggrefe, Ibrahim Akin
AIMS: Early research has proposed that patients with Takotsubo syndrome (TTS) could have a higher mortality rate than the general population. Our study was conducted to determine the short- and long-term outcome of TTS patients associated with a significantly compromised left ventricular function on hospital admission. METHODS AND RESULTS: Our institutional database constituted a collective of 112 patients diagnosed with TTS between 2003 and 2015. The patients were classified into two groups based on the left ventricular ejection fraction (LVEF), with those presenting with a LVEF >35% on admission categorized into one group (n=65, 58%) and those presenting with LVEF ≤35% (n=47, 42%) categorized into another group...
May 18, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28514777/direct-measurement-of-tissue-oxygenation-in-neonates-via-resonance-raman-spectroscopy-a-pilot-study
#7
Anjali Iyengar, Andrew Gaillardetz, Hocine Tighiouart, Betsabee Castillo, Padraic Romfh, Jonathan M Davis
BACKGROUND: The ability to monitor tissue oxygenation in neonates remains a challenge due to limited blood supply and the reliance on invasive procedures. Resonance Raman spectroscopy noninvasively measures tissue oxygenation (RRS-StO2). Peripheral tissue oxygenation using this novel technology has not been described in neonates. OBJECTIVES: To examine the relationship between short-term RRS-StO2 measurements and central venous saturation (ScvO2) and pulse oximetry (SpO2) in preterm and term neonates...
May 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28505486/respiratory-support-techniques-to-avoid-desaturation-in-critically-ill-patients-requiring-endotracheal-intubation-a-systematic-review-and-meta-analysis
#8
REVIEW
Vincenzo Russotto, Andrea Cortegiani, Santi Maurizio Raineri, Cesare Gregoretti, Antonino Giarratano
PURPOSE: To evaluate which respiratory support method for critically ill patients undergoing endotracheal intubation (ETI) is associated with less desaturation. METHODS: We searched PubMed, Cochrane Library, Scopus and CINAHL databases. We included randomized (RCT) and non-randomized (non-RCT) studies investigating any method of respiratory support before/during ETI compared to a reference control. RESULTS: Apneic oxygenation (ApOx) was the most commonly investigated respiratory support technique for critically ill patients undergoing intubation (4 RCTs, 358 patients)...
May 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28502521/-extracorporeal-life-support-in-thoracic-surgery-what-are-the-indications-and-the-pertinence
#9
REVIEW
J Reeb, A Olland, S Renaud, O Collange, X Delabranche, N Santelmo, F Meziani, P-M Mertes, G Massard, P-E Falcoz
INTRODUCTION: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine. STATE OF THE ART: ECLS technologies should only be undertaken in expert centers...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28499736/-children-s-medically-complex-diseases-unit-a-model-required-in-all-our-hospitals
#10
Francisco José Climent Alcalá, Marta García Fernández de Villalta, Luis Escosa García, Aroa Rodríguez Alonso, Luis Adolfo Albajara Velasco
INTRODUCTION: The increase in survival of children with severe diseases has led to the rise of children with chronic diseases, sometimes with lifelong disabilities. In 2008, a unit for the specific care of medically complex children (MCC) was created in Hospital La Paz. OBJECTIVES: To describe the work and care activities of this Unit. Patients and methods An analysis was performed on all discharge reports of the Unit between January 2014 and July 2016. RESULTS: The MCC Unit has 6 beds and daily outpatient clinic...
May 9, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28494828/treatment-of-persistent-pulmonary-hypertension-of-the-newborn-use-of-pulmonary-vasodilators-in-term-neonates
#11
Caitlyn Luecke, Christopher McPherson
Persistent pulmonary hypertension of the newborn (PPHN) represents a challenging condition associated with significant morbidity. A successful transition from intrauterine to extrauterine life is contingent on adequate pulmonary vasodilation. Several pathophysiologies contribute to the failure of this cascade and may result in life-threatening hypoxia and acidosis in the newborn. Management includes optimal respiratory support, adequate sedation and analgesia, and support of vascular tone and cardiac function...
May 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28489289/introducing-high-flow-nasal-cannula-to-the-neonatal-transport-environment
#12
Michael A Boyle, Arunava Dhar, Susan Broster
We are encouraged to see that other neonatal transport services are using High-Flow nasal cannula (HFNC) respiratory support during neonatal transport as outlined by Brunton et al (1). The experiences appear to be broadly similar across the two services, however, due to the central location of the neonatal transport base and the well served road network in the East of England region air transports are not conducted. Despite the increasing numbers of articles relating to HFNC use in neonatal units and consensus statements on best practice there is a relative paucity of data relating to its use on transport (2,3)...
May 10, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28488361/clonidine-for-sedation-and-analgesia-for-neonates-receiving-mechanical-ventilation
#13
REVIEW
Olga Romantsik, Maria Grazia Calevo, Elisabeth Norman, Matteo Bruschettini
BACKGROUND: Although routine administration of pharmacologic sedation or analgesia during mechanical ventilation in preterm neonates is not recommended, its use in clinical practice remains common. Alpha-2 agonists, mainly clonidine and dexmedetomidine, are used as adjunctive (or alternative) sedative agents alongside opioids and benzodiazepines. Clonidine has not been systematically assessed for use in neonatal sedation during ventilation. OBJECTIVES: To assess whether clonidine administered to term and preterm newborn infants receiving mechanical ventilation reduces morbidity and mortality rates...
May 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28487624/clara-cell-protein-expression-in-mechanically-ventilated-term-and-preterm-infants-with-respiratory-distress-syndrome-and-at-risk-of-bronchopulmonary-dysplasia-a-pilot-study
#14
José Guzmán-Bárcenas, Antonio Calderón-Moore, Héctor Baptista-González, Claudine Irles
The aim of this pilot study was to determine Clara cell protein (CC16) concentration in bronchoalveolar lavages (BAL) fluid from full-term and preterm (<37 weeks' gestational age) neonates requiring respiratory support, having symptoms of neonatal respiratory distress syndrome, and at risk of bronchopulmonary dysplasia (BPD). We hypothesized that CC16 may be predictive of BPD diagnosis regardless of gestational age. BAL fluid CC16 was measured by ELISA at birth and at day 7 of life. Both groups that developed BPD showed significantly decreased BAL fluid CC16 levels compared to those infants that did not develop the disease...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28487415/randomized-comparison-of-helmet-cpap-versus-high-flow-nasal-cannula-oxygen-in-pediatric-respiratory-distress
#15
Giovanna Vitaliti, Maria Concetta Vitaliti, Maria Carla Finocchiaro, Vita Antonella Di Stefano, Piero Pavone, Nassim Matin, Nazgol Motamed-Gorji, Riccardo Lubrano, Raffaele Falsaperla
BACKGROUND: The current study aimed to compare the efficacy and safety of 2 noninvasive respiratory support methods, which included helmet CPAP and high-flow nasal cannula (HFNC) in children with respiratory distress admitted to a pediatric intermediate care unit. METHODS: This study was a prospective observational study conducted on children with respiratory distress (age 1-24 months) who were admitted to our acute and emergency operative unit. All included subjects were randomly treated with helmet CPAP or HFNC in a 1:1 fashion until their clinical picture, oxygen saturation, and arterial blood gas (ABG) parameters resolved...
May 9, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28482105/epidemiology-and-clinical-features-of-human-coronaviruses-in-the-pediatric-population
#16
Litty Varghese, Philip Zachariah, Celibell Vargas, Philip LaRussa, Ryan T Demmer, Yoko E Furuya, Susan Whittier, Carrie Reed, Melissa S Stockwell, Lisa Saiman
Background.: The epidemiology and clinical features of human coronaviruses (HCoVs) in children are not fully characterized. Methods.: A retrospective study of children with HCoV detected by reverse-transcriptase polymerase chain reaction (RT-PCR) was performed for a community cohort and a children's hospital in the same community from January 2013 to December 2014. The RT-PCR assay detected HCoV 229E, HKU1, NL63, and OC43 in nasal swabs from symptomatic children ≤18 years...
May 8, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28476473/decrease-in-delivery-room-intubation-rates-after-use-of-nasal-intermittent-positive-pressure-ventilation-in-the-delivery-room-for-resuscitation-of-very-low-birth-weight-infants
#17
Manoj Biniwale, Fiona Wertheimer
BACKGROUND: The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. OBJECTIVE: To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28472058/poractant-alfa-versus-bovine-lipid-extract-surfactant-for-infants-24-0-to-31-6-weeks-gestational-age-a-randomized-controlled-trial
#18
Brigitte Lemyre, Christoph Fusch, Georg M Schmölzer, Nicole Rouvinez Bouali, Deepti Reddy, Nicholas Barrowman, Nicole Huneault-Purney, Thierry Lacaze-Masmonteil
OBJECTIVES: To compare the efficacy and safety of poractant alfa and bovine lipid extract surfactant in preterm infants. STUDY DESIGN: Randomized, partially-blinded, multicenter trial. Infants <32 weeks needing surfactant before 48 hours were randomly assigned to receive poractant alfa or bovine lipid extract surfactant. The primary outcome was being alive and extubated at 48 hours post-randomization. Secondary outcomes included need for re-dosing, duration of respiratory support and oxygen, bronchopulmonary dysplasia, mortality and complications during administration...
2017: PloS One
https://www.readbyqxmd.com/read/28470921/tracheostomy-as-a-bridge-to-spontaneous-breathing-and-awake-ecmo-in-non-transplant-surgical-patients
#19
J Swol, J T Strauch, T A Schildhauer
AIMS: The tracheostomy is a frequently used procedure for the respiratory weaning of ventilated patients allows sedation free ECLS use in awake patient. The aim of this study is to assess the possibility and highlight the benefits of lowering the impact of sedation in surgical non-transplant patients on ECLS. The specific objective was to investigate the use of tracheostomy as a bridge to spontaneous breathing on ECLS. METHODS AND RESULTS: Of the 95 patients, 65 patients received a tracheostomy, and 5 patients were admitted with a tracheostoma...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28448569/dynamics-and-complexity-of-body-temperature-in-preterm-infants-nursed-in-incubators
#20
Kerstin Jost, Isabelle Pramana, Edgar Delgado-Eckert, Nitin Kumar, Alexandre N Datta, Urs Frey, Sven M Schulzke
BACKGROUND: Poor control of body temperature is associated with mortality and major morbidity in preterm infants. We aimed to quantify its dynamics and complexity to evaluate whether indices from fluctuation analyses of temperature time series obtained within the first five days of life are associated with gestational age (GA) and body size at birth, and presence and severity of typical comorbidities of preterm birth. METHODS: We recorded 3h-time series of body temperature using a skin electrode in incubator-nursed preterm infants...
2017: PloS One
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