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Respiratory therapy care

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https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#1
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28443360/overview-of-procalcitonin-assays-and-procalcitonin-guided-protocols-for-the-management-of-patients-with-infections-and-sepsis
#2
Philipp Schuetz, Celine Bretscher, Luca Bernasconi, Beat Mueller
Procalcitonin is a surrogate infection blood marker whose levels help estimate the likelihood of bacterial infections and correlate with their resolution. Recent trials have revealed the benefits of inclusion of procalcitonin in antibiotic stewardship protocols for initiation and discontinuation of antimicrobial therapy. Areas covered: Procalcitonin-guided antibiotic stewardship protocols have shown appreciable reductions in antibiotic use and duration of therapy in respiratory infections, sepsis, and other infections, with positive effects on clinical outcomes...
April 26, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28442901/characteristics-of-copd-patients-initiating-treatment-with-aclidinium-or-tiotropium-in-primary-care-in-catalonia-a-population-based-study
#3
Mònica Monteagudo, Montse Roset, Teresa Rodriguez-Blanco, Laura Muñoz, Marc Miravitlles
OBJECTIVE: To describe and compare demographic and clinical profile of patients newly initiated on aclidinium (ACL) or tiotropium (TIO) and identify factors associated with newly initiated ACL in real-life clinical practice during 2013 in Catalonia. DESIGN: We performed a population-based, retrospective, observational study with data obtained from the Information System for Research Development in Primary Care, a population database that contains information of 5...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28434626/-continuous-positive-airway-pressure-in-obstructive-sleep-apnea
#4
Jean Claude Meurice, Elise Antone, Mylene Gilbert, Audrey Watrin, Vanessa Bironneau
Continuous positive airway pressure (CPAP) is currently the most used and efficient therapy in OSAS. Efficiency of CPAP on sleep respiratory disorders is the same whether in fixed or automatic mode. Larger studies are required to evaluate their respective beneficial impact on cardiovascular or metabolic complications of OSAS. Close medical monitoring is necessary during the first weeks of CPAP therapy. Compliance to CPAP therapy is crucial for efficacy in preventing cardiovascular or metabolic complications of OSAS...
April 20, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28431445/-near-drowning-with-good-outcome-after-ecmo-therapy-and-therapeutic-hypothermia-despite-20-minutes-of-anoxia-and-16-hours-of-hypoxia
#5
Peter Stachon, Johannes Kalbhenn, Stephan Walterspacher, Christoph Bode, Dawid Staudacher
Introduction Drowning with submersion over 10 minutes is associated with a high mortality. Here, we present a case, in which a good neurological outcome was achieved after interdisciplinary, intensive care therapy despite submersion of 20 minutes followed by 16 hours of hypoxia. History A 19 year old man drowned in fresh-water. After 20 minutes submersion he was localized and salvaged from 8 meters depth and primarily resuscitated successfully after 10 minutes. Within the next hour, there condition worsened by respiratory deterioration due to a massive capillary leak syndrome in addition to a disseminated intravascular coagulation...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28430296/effect-of-body-mass-index-on-the-outcome-of-surgical-patients-receiving-extracorporeal-devices-vv-ecmo-pecla-for-respiratory-failure
#6
Justyna Swol, Dirk Buchwald, Justus T Strauch, Thomas A Schildhauer, Christopher Ull
INTRODUCTION: To determine whether obese surgical patients are at a significant disadvantage in terms of outcomes after extracorporeal device (ECD) support, such as veno-venous extracorporeal membrane oxygenation (VV ECMO) or pumpless extracorporeal lung assist (pECLA), for respiratory failure, the relationship between body mass index (BMI) and hospital outcomes was analyzed. METHODS: This retrospective study included data on patients who were supported with an ECD between January 1, 2008 and December 31, 2014...
April 20, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28425965/comparison-of-cpap-and-hfnc-in-management-of-bronchiolitis-in-infants-and-young-children
#7
Majken Bisgaard Pedersen, Signe Vahlkvist
Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced We conducted a retrospective study of treatment with CPAP vs. HFNC between 2013 and 2015, comparing the development in respiratory rate, fraction of inspired oxygen (FiO2) and heart rate, treatment failure, duration of treatment, and length of hospital stay. A sample size of 49 children were included. Median age was 1.9 months. Median baseline pCO₂ was 7...
April 20, 2017: Children
https://www.readbyqxmd.com/read/28422850/tuberculosis-associated-hemophagocytic-lymphohistiocytosis-with-initial-presentation-of-fever-of-unknown-origin-in-a-general-hospital-an-analysis-of-8-clinical-cases
#8
Yun Zhang, Guangyu Liang, Hongli Qin, Yuanjie Li, Xuejun Zeng
The study aimed to investigate the clinical features and prognoses of patients with tuberculosis (TB) who had secondary hemophagocytic lymphohistiocytosis (HLH).Patients first presenting with fever of unknown origin, who were ultimately diagnosed with TB-associated secondary HLH, were assessed retrospectively. We summarized and analyzed clinical manifestations, laboratory examinations, diagnoses, treatments, and prognoses of patients using clinical data, outpatient follow-up, and telephone follow-up in combination with literature review...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421272/-the-pathology-of-adverse-events-with-immune-checkpoint-inhibitors
#9
V H Koelzer, K Glatz, L Bubendorf, A Weber, A Gaspert, G Cathomas, A Lugli, A Zippelius, W Kempf, K D Mertz
BACKGROUND: Immunotherapy has gained importance with the development of new effective cancer treatments. Immune checkpoint inhibitors (ICI) are monoclonal antibodies that promote T‑cell mediated tumor immune rejection. Checkpoint blockade also carries the risk of inducing autoimmune reactions ("immune related adverse events", irAEs). The diagnosis and classification of irAEs constitute a new and important field in pathology. AIM: Practice-oriented review of the diagnosis and classification of irAEs...
April 18, 2017: Der Pathologe
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#10
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28416250/therapeutic-hypothermia-for-neonates-with-hypoxic-ischemic-encephalopathy
#11
REVIEW
Ming-Chou Chiang, Yuh-Jyh Jong, Chyi-Her Lin
Therapeutic hypothermia (TH) is a recommended regimen for newborn infants who are at or near term with evolving moderate-to-severe hypoxic ischemic encephalopathy (HIE). The Task Force of the Taiwan Child Neurology Society and the Taiwan Society of Neonatology held a joint meeting in 2015 to establish recommendations for using TH on newborn patients with HIE. Based on current evidence and experts' experiences, this review article summarizes the key points and recommendations regarding TH for newborns with HIE, including: (1) selection criteria for TH; (2) choices of method and equipment for TH; (3) TH prior to and during transport; (4) methods for temperature maintenance, monitoring, and rewarming; (5) systemic care of patients during TH, including the care of respiratory and cardiovascular systems, management of fluids, electrolytes, and nutrition, as well as sedation and drug metabolism; (6) monitoring and management of seizures; (7) neuroimaging, prognostic factors, and outcomes; and (8) adjuvant therapy for TH...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#12
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28407743/new-drugs-new-toxicities-severe-side-effects-of-modern-targeted-and-immunotherapy-of-cancer-and-their-management
#13
REVIEW
Frank Kroschinsky, Friedrich Stölzel, Simone von Bonin, Gernot Beutel, Matthias Kochanek, Michael Kiehl, Peter Schellongowski
Pharmacological and cellular treatment of cancer is changing dramatically with benefits for patient outcome and comfort, but also with new toxicity profiles. The majority of adverse events can be classified as mild or moderate, but severe and life-threatening complications requiring ICU admission also occur. This review will focus on pathophysiology, symptoms, and management of these events based on the available literature.While standard antineoplastic therapy is associated with immunosuppression and infections, some of the recent approaches induce overwhelming inflammation and autoimmunity...
April 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28402990/the-use-of-gmp-produced-bone-marrow-derived-stem-cells-in-combination-with-extra-corporeal-membrane-oxygenation-in-ards-an-animal-model
#14
Ergin Kocyildirim, Nayra Cárdenes, Antony Ting, Eder Cáceres, Christian Bermúdez, Mauricio Rojas
RDS is the result of a wide variety of disorders, which can be associated with different clinical disorders or systemic diseases directly affecting the lungs. Currently, the only existing therapy is limited to supportive care. In a 6-hour pilot study, we analyzed the use of the combination of both stem cell and ECMO strategies to prevent or treat severe lung injury. A total of 11 sheep were used. 5 sheep received E. coli endotoxin as a control group (Group 1). 3 sheep that received E. coli endotoxin were treated with veno-venous ECMO support in Group 2...
April 11, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28395936/efficacy-of-mepolizumab-add-on-therapy-on-health-related-quality-of-life-and-markers-of-asthma-control-in-severe-eosinophilic-asthma-musca-a-randomised-double-blind-placebo-controlled-parallel-group-multicentre-phase-3b-trial
#15
Geoffrey L Chupp, Eric S Bradford, Frank C Albers, Daniel J Bratton, Jie Wang-Jairaj, Linda M Nelsen, Jennifer L Trevor, Antoine Magnan, Anneke Ten Brinke
BACKGROUND: Mepolizumab, an anti-interleukin-5 monoclonal antibody approved as add-on therapy to standard of care for patients with severe eosinophilic asthma, has been shown in previous studies to reduce exacerbations and dependency on oral corticosteroids compared with placebo. We aimed to further assess mepolizumab in patients with severe eosinophilic asthma by examining its effect on health-related quality of life (HRQOL). METHODS: We did a randomised, double-blind, placebo-controlled, parallel-group, multicentre, phase 3b trial (MUSCA) in 146 hospitals or research centres in 19 countries worldwide...
April 5, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28393724/clinical-characteristics-and-outcome-of-healthcare-associated-pneumonia-in-turkey
#16
Canan Gündüz, Mehmet Sezai Taşbakan, Abdullah Sayıner, Aykut Çilli, Oğuz Kılınç, Ayşın Şakar Coşkun
Introduction: Pneumonia in cases with preceding hospitalization, hemodialysis, intravenous therapy, wound care, or chemotherapy within the prior 30 days and residence in nursing homes are defined as healthcare associated pneumonia (HCAP). The aim of this study was to compare the demographic and laboratory data, isolated causative agents and prognosis of patients with community-acquired pneumonia (CAP) and HCAP in a large population in Turkey. Materials and Methods: The data of 785 cases (average age 65...
September 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/28393258/intermittent-noninvasive-ventilation-after-extubation-in-patients-with-chronic-respiratory-disorders-a-multicenter-randomized-controlled-trial-vhyper
#17
Frédéric Vargas, Marc Clavel, Pascale Sanchez-Verlan, Sylvain Garnier, Alexandre Boyer, Hoang-Nam Bui, Benjamin Clouzeau, Charline Sazio, Aissa Kerchache, Olivier Guisset, Antoine Benard, Julien Asselineau, Bernard Gauche, Didier Gruson, Stein Silva, Philippe Vignon, Gilles Hilbert
PURPOSE: Early noninvasive ventilation (NIV) after extubation decreases the risk of respiratory failure and lowers 90-day mortality in patients with hypercapnia. Patients with chronic respiratory disease are at risk of extubation failure. Therefore, it could be useful to determine the role of NIV with a discontinuous approach, not limited to patients with hypercapnia. We assessed the efficacy of early NIV in decreasing respiratory failure after extubation in patients with chronic respiratory disorders...
April 9, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28391305/the-effectiveness-of-singing-or-playing-a-wind-instrument-in-improving-respiratory-function-in-patients-with-long-term-neurological-conditions-a-systematic-review
#18
Kexin Ang, Matthew Maddocks, Huiying Xu, Irene J Higginson
Background: Many long-term neurological conditions adversely affect respiratory function. Singing and playing wind instruments are relatively inexpensive interventions with potential for improving respiratory function; however, synthesis of current evidence is needed to inform research and clinical use of music in respiratory care. Objective: To critically appraise, analyze, and synthesize published evidence on the effectiveness of singing or playing a wind instrument to improve respiratory function in people with long-term neurological conditions...
March 1, 2017: Journal of Music Therapy
https://www.readbyqxmd.com/read/28388376/how-much-and-what-type-of-protein-should-a-critically-ill-patient-receive
#19
Juan B Ochoa Gautier, Robert G Martindale, Saúl J Rugeles, Ryan T Hurt, Beth Taylor, Daren K Heyland, Stephen A McClave
Protein loss, manifested as loss of muscle mass, is observed universally in all critically ill patients. Depletion of muscle mass is associated with impaired function and poor outcomes. In extreme cases, protein malnutrition is manifested by respiratory failure, lack of wound healing, and immune dysfunction. Protecting muscle loss focused initially on meeting energy requirements. The assumption was that protein was being used (through oxidation) as an energy source. In healthy individuals, small amounts of glucose (approximately 400 calories) protect muscle loss and decrease amino acid oxidation (protein-sparing effect of glucose)...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28382598/patients-with-anca-associated-vasculitis-admitted-to-the-intensive-care-unit-with-acute-vasculitis-manifestations-a-retrospective-and-comparative-multicentric-study
#20
Julien Demiselle, Johann Auchabie, François Beloncle, Philippe Gatault, Steven Grangé, Damien Du Cheyron, Jean Dellamonica, Sonia Boyer, Dimitri Titeca Beauport, Lise Piquilloud, Julien Letheulle, Christophe Guitton, Nicolas Chudeau, Guillaume Geri, François Fourrier, René Robert, Emmanuel Guérot, Julie Boisramé-Helms, Pierre Galichon, Pierre-François Dequin, Alexandre Lautrette, Pierre-Edouard Bollaert, Ferhat Meziani, Loïc Guillevin, Nicolas Lerolle, Jean-François Augusto
PURPOSE: Data for ANCA-associated vasculitis (AAV) patients requiring intensive care are scarce. METHODS: We included 97 consecutive patients with acute AAV manifestations (new onset or relapsing disease), admitted to 18 intensive care units (ICUs) over a 10-year period (2002-2012). A group of 95 consecutive AAV patients with new onset or relapsing disease, admitted to two nephrology departments with acute vasculitis manifestations, constituted the control group...
December 2017: Annals of Intensive Care
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