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https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#1
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28665065/prophylactic-versus-early-rescue-surfactant-treatment-in-preterm-infants-born-at-less-than-30-weeks-gestation-or-with-birth-weight-less-than-or-equal-1-250-grams
#2
Jiyoung Chun, Se In Sung, Yo Han Ho, Jisook Kim, Ga Young Park, Shin Ae Yoon, So Yoon Ahn, Yun Sil Chang, Won Soon Park
Prophylactic surfactant is known to be effective to reduce chronic lung disease in preterm infants compared with rescue surfactant treatment. In Korea, early prophylactic surfactant therapy was introduced in 2011. However, recently, the increased utilization of antenatal steroids and early stabilization through continuous positive airway pressure (CPAP) in the delivery room may have changed the risks and benefits of prophylactic surfactant therapy of infants at high risk of respiratory distress syndrome (RDS)...
August 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28629932/systemic-antimicrobial-prophylaxis-in-burn-patients-a-systematic-review
#3
REVIEW
Guillermo Enrique Ramos
OBJECTIVE: To review studies of systemic antibiotic prophylaxis in burn patients. METHODS: Human clinical trials during the period 1966-2016 where prophylactic systemic antibiotics were compared with placebo or no intervention were identified in electronic databases. RESULTS: Nineteen trials met the selection criteria. Early post-burn period prophylaxis was assessed in non severe burn patients (6 trials), and in severe burn patients (7 trials)...
June 16, 2017: Journal of Hospital Infection
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/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#5
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28367431/a-3-year-old-girl-with-recurrent-infections-and-autoimmunity-due-to-a-stat1-gain-of-function-mutation-the-expanding-clinical-presentation-of-primary-immunodeficiencies
#6
Juan Carlos Aldave Becerra, Enrique Cachay Rojas
We report a 3-year-old Peruvian girl, born to non-consanguineous parents. At the age of 8 months, she had a severe pneumonia complicated with empyema that required thoracic drainage and mechanical ventilation. Although no microorganisms were isolated, the patient recovered with broad-spectrum antibiotics. Since that date, she has presented multiple episodes of pneumonia and recurrent episodes of bronchospasm. At 1 year 5 months of age, the patient began with recurrent episodes of oropharyngeal, vaginal, and skin candidiasis, which improved transiently after using oral azole drugs...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28270114/violation-of-prophylactic-vancomycin-administration-timing-is-a-potential-risk-factor-for-rate-of-surgical-site-infections-in-cardiac-surgery-patients-a-prospective-cohort-study
#7
Paolo Cotogni, Cristina Barbero, Roberto Passera, Lucina Fossati, Giorgio Olivero, Mauro Rinaldi
BACKGROUND: Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and the rate of SSIs. METHODS: A prospective cohort study was carried out over 1-year period in all consecutive adult patients undergoing elective cardiac surgery...
March 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#8
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28207796/post-extubation-stridor-in-respiratory-syncytial-virus-bronchiolitis-is-there-a-role-for-prophylactic-dexamethasone
#9
Esther S Veldhoen, Charlotte A Smulders, Teus H Kappen, Job C Calis, Job van Woensel, Paulien A M Raymakers-Janssen, Louis J Bont, Marije P Hennus
AIM: The purpose of this study was to determine the incidence of reintubation due to upper airway obstruction in a homogeneous group of ventilated infants with Respiratory Syncytial Virus bronchiolitis. Our secondary objective was to determine whether prophylactic administration of dexamethasone prior to extubation was associated with decreased risk of reintubation. METHODS: This retrospective observational study in two Pediatric Intensive Care Units in 2 university hospitals in The Netherlands included two hundred patients younger than 13 months admitted with respiratory insufficiency caused by Respiratory Syncytial Virus bronchiolitis, requiring invasive mechanical ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/28203436/chest-physiotherapy-in-mechanically-ventilated-patients-without-pneumonia-a-narrative-review
#10
REVIEW
Herbert D Spapen, Jouke De Regt, Patrick M Honoré
A beneficial adjuvant role of chest physiotherapy (CPT) to promote airway clearance, alveolar recruitment, and ventilation/perfusion matching in mechanically ventilated (MV) patients with pneumonia or relapsing lung atelectasis is commonly accepted. However, doubt prevails regarding the usefulness of applying routine CPT in MV subjects with no such lung diseases. In-depth narrative review based on a literature search for prospective randomized trials comparing CPT with a non-CPT strategy in adult patients ventilated for at least 48 h...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28114736/cromolyn-sodium-for-the-prevention-of-chronic-lung-disease-in-preterm-infants
#11
REVIEW
Geraldine Ng, Arne Ohlsson
BACKGROUND: This is an update of a review last published by Cochrane in June 2012 entitled "Cromolyn sodium for the prevention of chronic lung disease in preterm infants", which included two studies. This 2016 update identified no further studies.Chronic lung disease (CLD) frequently occurs in preterm infants and has a multifactorial aetiology including inflammation. Cromolyn sodium is a mast cell stabiliser that inhibits neutrophil activation and neutrophil chemotaxis and therefore may have a role in the prevention of CLD...
January 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28101364/hemodynamic-effects-of-electrical-muscle-stimulation-in-the-prophylaxis-of-deep-vein-thrombosis-for-intensive-care-unit-patients-a-randomized-trial
#12
Masahiro Ojima, Ryosuke Takegawa, Tomoya Hirose, Mitsuo Ohnishi, Tadahiko Shiozaki, Takeshi Shimazu
BACKGROUND: Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT. METHODS: This study included 26 patients admitted to a single ICU...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28073106/surfactant-need-by-gestation-for-very-preterm-babies-initiated-on-early-nasal-cpap-a-danish-observational-multicentre-study-of-6-628-infants-born-2000-2013
#13
Rikke Wiingreen, Gorm Greisen, Finn Ebbesen, Jesper Padkær Petersen, Gitte Zachariassen, Tine Brink Henriksen, Bo Mølholm Hansen
BACKGROUND: In recent years, early nasal continuous positive airway pressure (nCPAP) as respiratory support for preterm infants is being advocated as an alternative to prophylactic surfactant and treatment with mechanical ventilation. A number of infants treated with early nCPAP do not need treatment with surfactant, but few studies provide data on this. Since the 1990s, the first approach to respiratory support to preterm infants in Denmark has been early nCPAP combined with surfactant administration by the INSURE method by which the infant is intubated and surfactant administration is followed by rapid extubation to nCPAP if possible...
2017: Neonatology
https://www.readbyqxmd.com/read/27987397/prophylactic-versus-clinically-driven-antibiotics-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-a-randomized-pilot-study
#14
Suada Filekovic Ribaric, Matjaz Turel, Rihard Knafelj, Vojka Gorjup, Rade Stanic, Primoz Gradisek, Ognjen Cerovic, Tomislav Mirkovic, Marko Noc
AIM: To investigate benefits of prophylactic antibiotics in comatose survivors of out-of-hospital cardiac arrest (OHCA). METHODS: Patients without evidence of tracheobronchial aspiration on admission bronchoscopy were randomized to prophylactic Amoxicillin-Clavulanic acid 1.2g every 8h (P) or clinically-driven antibiotics (C) administered if signs of infection developed during initial 7days of intensive care unit (ICU) stay. RESULTS: Among 83 patients enrolled between September 2013 and February 2015, tracheobronchial aspiration was documented in 23 (28%)...
February 2017: Resuscitation
https://www.readbyqxmd.com/read/27960245/bronchodilators-for-the-prevention-and-treatment-of-chronic-lung-disease-in-preterm-infants
#15
REVIEW
Geraldine Ng, Orlando da Silva, Arne Ohlsson
BACKGROUND: Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased compliance and tidal volume and decreased pulmonary resistance have been documented with the use of bronchodilators in infants with CLD. Therefore, bronchodilators might have a role in the prevention and treatment of CLD. OBJECTIVES: To determine the effect of bronchodilators given as prophylaxis or as treatment for CLD on mortality and other complications of preterm birth in infants at risk for or identified as having CLD...
December 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27813024/cytomegalovirus-infection-in-immunocompetent-critically-ill-adults-literature-review
#16
REVIEW
Awad Al-Omari, Fadi Aljamaan, Waleed Alhazzani, Samer Salih, Yaseen Arabi
Cytomegalovirus (CMV) infection is increasingly recognized in critically ill immunocompetent patients. Some studies have demonstrated an association between CMV disease and increased mortality rates, prolonged intensive care unit and hospital length of stay, prolonged mechanical ventilation, and nosocomial infections. However, there is a considerable controversy whether such association represents a causal relationship between CMV disease and unfavorable outcomes or just a marker of the severity of the critical illness...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#17
REVIEW
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27723018/the-effect-of-general-anaesthesia-and-neuromuscular-blockade-on-eustachian-tube-compliance-a-prospective-study
#18
Akeelesh Mungur, Guy Cochard, Yves Ozier, Pierre Lafère
OBJECTIVE: The most common complications of hyperbaric oxygen treatment (HBOT) are related to pressure changes on gas-containing cavities. Therefore, inability to auto-inflate the middle ear may result in transient or permanent hearing loss. However, it seems that middle ear barotrauma (MEBt) does not develop more often in mechanically ventilated patients than in ambulatory patients. This might be explained by deep sedation of these patients. Therefore, the aim of this study was to determine whether anaesthesia and/or neuromuscular blockade can influence Eustachian tube (ET) function...
September 2016: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/27677650/inhibitory-effect-of-high-frequency-greater-occipital-nerve-electrical-stimulation-on-trigeminovascular-nociceptive-processing-in-rats
#19
Olga A Lyubashina, Sergey S Panteleev, Alexey Y Sokolov
Electrical stimulation of the greater occipital nerve (GON) has recently shown promise as an effective non-pharmacological prophylactic therapy for drug-resistant chronic primary headaches, but the neurobiological mechanisms underlying its anticephalgic action are not elucidated. Considering that the spinal trigeminal nucleus (STN) is a key segmental structure playing a prominent role in pathophysiology of headaches, in the present study we evaluated the effects of GON electrical stimulation on ongoing and evoked firing of the dura-sensitive STN neurons...
February 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/27635481/pantoprazole-or-placebo-for-stress-ulcer-prophylaxis-pop-up-randomized-double-blind-exploratory-study
#20
RANDOMIZED CONTROLLED TRIAL
Shane P Selvanderan, Matthew J Summers, Mark E Finnis, Mark P Plummer, Yasmine Ali Abdelhamid, Michael B Anderson, Marianne J Chapman, Christopher K Rayner, Adam M Deane
OBJECTIVES: Pantoprazole is frequently administered to critically ill patients for prophylaxis against gastrointestinal bleeding. However, comparison to placebo has been inadequately evaluated, and pantoprazole has the potential to cause harm. Our objective was to evaluate benefit or harm associated with pantoprazole administration. DESIGN: Prospective randomized double-blind parallel-group study. SETTING: University-affiliated mixed medical-surgical ICU...
October 2016: Critical Care Medicine
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