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Respiratory therapy care

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https://www.readbyqxmd.com/read/28333157/consensus-approach-to-nasal-high-flow-therapy-in-neonates
#1
B A Yoder, B Manley, C Collins, K Ives, A Kugelman, A Lavizzari, M McQueen
OBJECTIVE: Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations. STUDY DESIGN: Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28332328/paediatric-high-flow-nasal-cannula-therapy-in-children-with-bronchiolitis-a-retrospective-safety-and-efficacy-study-in-a-non-tertiary-environment
#2
Michelle Davison, Mike Watson, Leesa Wockner, Frances Kinnear
OBJECTIVE: The objective was to examine the safety and efficacy of high-flow nasal cannula (HFNC) therapy for children with bronchiolitis in a non-tertiary paediatric setting. METHODS: This was a single-centre retrospective study conducted over 26 months (March 2013-April 2015) on children aged 1-23 months with suspected bronchiolitis, who commenced on HFNC therapy in either the ED or the ward. Changes with respect to baseline data were analysed for effect on work of breathing (WOB), heart rate (HR) and respiratory rate (RR)...
April 2017: Emergency Medicine Australasia: EMA
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
#3
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/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#4
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28326177/characterization-of-secondary-care-for-copd-in-sweden
#5
Josefin Sundh, Christer Janson, Gunnar Johansson, Anders Lindén, Claes-Göran Löfdahl, Thomas Sandström, Kjell Larsson
Introduction: Only a selected proportion of chronic obstructive pulmonary disease (COPD) patients are managed in secondary care. The aim of this study was to characterize disease severity, treatment and structure of secondary care for COPD in Sweden. Methods: Information was collected from 29 of 33 existing secondary care units of respiratory medicine in Sweden, using both individual data from 373 consecutively enrolled COPD patients with Global initiative on Obstructive Lung Disease (GOLD) stage III-IV and a structural questionnaire about available resources at the units...
2017: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28318077/the-effectiveness-of-familiar-auditory-stimulus-on-hospitalized-neonates-physiologic-responses-to-procedural-pain
#6
Elham Azarmnejad, Forogh Sarhangi, Mahrooz Javadi, Nahid Rejeh, Susan Amirsalari, Seyed Davood Tadrisi
Hospitalized neonates usually undergo different painful procedures. This study sought to test the effects of a familiar auditory stimulus on the physiologic responses to pain of venipuncture among neonates in intensive care unit. The study design is quasi-experimental. The randomized clinical trial study was done on 60 full-term neonates admitted to the neonatal intensive care unit between March 20 to June 20, 2014. The neonates were conveniently selected and randomly allocated to the control and the experimental groups...
March 20, 2017: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/28306515/decentralized-safety-concept-for-closed-loop-controlled-intensive-care
#7
Jan Kühn, Christian Brendle, André Stollenwerk, Martin Schweigler, Stefan Kowalewski, Thorsten Janisch, Rolf Rossaint, Steffen Leonhardt, Marian Walter, Rüdger Kopp
This paper presents a decentralized safety concept for networked intensive care setups, for which a decentralized network of sensors and actuators is realized by embedded microcontroller nodes. It is evaluated for up to eleven medical devices in a setup for automated acute respiratory distress syndrome (ARDS) therapy. In this contribution we highlight a blood pump supervision as exemplary safety measure, which allows a reliable bubble detection in an extracorporeal blood circulation. The approach is validated with data of animal experiments including 35 bubbles with a size between 0...
March 17, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28303236/treating-the-critically-ill-with-radiotherapy-lessons-learned-from-a-young-woman-with-cardiac-angiosarcoma
#8
Emma C Fields, Bryan Squires, Harry Lomas
BACKGROUND: Treating patients who are critically ill with radiotherapy (RT) brings a unique set of challenges as it involves treating patients who require mechanical life support, unconventional positioning, and a multidisciplinary team approach to ensure safety. However, when the benefits of such treatment outweigh the risks, the challenges can be overcome, as demonstrated in this unique case of cardiac angiosarcoma. CASE DESCRIPTION: This is a case of a 42-year-old female with a right sided cardiac angiosarcoma who quickly developed cardiac tamponade and respiratory failure related to compression of her right heart by the tumor...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28299589/respiratory-variation-in-peak-aortic-velocity-accurately-predicts-fluid-responsiveness-in-children-undergoing-neurosurgery-under-general-anesthesia
#9
Kavita G Morparia, Srijaya K Reddy, Laura J Olivieri, Michael C Spaeder, Jennifer J Schuette
The determination of fluid responsiveness in the critically ill child is of vital importance, more so as fluid overload becomes increasingly associated with worse outcomes. Dynamic markers of volume responsiveness have shown some promise in the pediatric population, but more research is needed before they can be adopted for widespread use. Our aim was to investigate effectiveness of respiratory variation in peak aortic velocity and pulse pressure variation to predict fluid responsiveness, and determine their optimal cutoff values...
March 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28298861/retinopathy-of-prematurity-revisiting-incidence-and-risk-factors-from-oman-compared-to-other-countries
#10
Zenaida Soriano Reyes, Sharef Waadallah Al-Mulaabed, Flordeliz Bataclan, Cheryl Montemayor, Anuradha Ganesh, Sanaa Al-Zuhaibi, Huda Al-Waili, Fatma Al-Wahibi
PURPOSE: The purpose of this study is to determine the incidence of retinopathy of prematurity (ROP) and the maternal/neonatal risk factors at a tertiary care hospital in Oman, compared to other countries. PATIENTS AND METHODS: A retrospective analysis of premature neonates born with gestational age (GA) 24-32 weeks at Sultan Qaboos University Hospital, Oman, from January 2007 to December 2010. Maternal and neonatal in-hospital course was retrieved. The incidence of ROP was reported...
January 2017: Oman Journal of Ophthalmology
https://www.readbyqxmd.com/read/28298164/the-most-appropriate-therapeutic-strategy-for-acute-lower-respiratory-tract-infections-a-delphi-based-approach
#11
Francesco Blasi, Ercole Concia, Bruno Del Prato, Massimo Giusti, Teresita Mazzei, Barbara Polistena, Alessandro Rossi, Stefania Stefani, Andrea Novelli
Lower respiratory tract infections (LRTIs) cause high morbidity and mortality worldwide. Empiric therapy often base the choice of antibiotic treatment on antibacterial spectrum of the agent rather than on its pharmacological properties or the pathogen resistance profile. Inappropriate prescribing leads to therapeutic failure and antibiotic resistance, with increasing direct and indirect health costs. A consensus on appropriate prescribing in LRTI therapy was appraised by this Delphi exercise, based on a panel of 70 pulmonologists, coordinated by a Scientific Committee of nine experts in respiratory medical care...
March 15, 2017: Journal of Chemotherapy
https://www.readbyqxmd.com/read/28295542/unexpected-recalcitrant-course-of-drug-induced-erythema-multiforme-like-eruption-and-interstitial-pneumonia-sequentially-occurring-after-nivolumab-therapy
#12
Hisashi Nomura, Hayato Takahashi, Satsuki Suzuki, Yuichi Kurihara, Shotaro Chubachi, Ichiro Kawada, Hiroyuki Yasuda, Tomoko Betsuyaku, Masayuki Amagai, Takeru Funakoshi
Vemurafenib improves survival of melanoma patients. However, cutaneous side-effects commonly occur in them. Nivolumab and ipilimumab are monoclonal antibodies against programmed death 1 and cytotoxic T-lymphocyte-associated antigen 4, both of which regulate excessive T-cell activation. Although these agents induce antitumor immunity against melanoma, the modified immune condition may result in an unexpected adverse reaction which has not been observed previously. Herein, we report a case who manifested severe erythema multiforme-like eruption with mucosal involvement associated with vemurafenib following nivolumab...
March 11, 2017: Journal of Dermatology
https://www.readbyqxmd.com/read/28294866/-treatment-of-patients-with-stable-ischemic-heart-disease-in-real-clinical-practice-in-russia-the-choice-2-program
#13
G Glezer M, On Behalf Of The Choice-Study Participants On Behalf Of The Choice-Study Participants
OBJECTIVE: in the framework of an open post-marketing observational national program CHOICE-2 to assess correspondence between recommendations for management of patients with stable angina and actual clinical practice, as well as to assess effect of treatment with cytoprotector trimetazidine on clinical course of the disease. MATERIAL AND METHODS: Participating physicians (n=185 from 46 regions of Russian Federation) recruited 896 patients with ischemic heart disease (IHD)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28292972/respiratory-therapy-faculty-knowledge-of-and-attitudes-toward-interprofessional-education
#14
Marlo M Vernon, Nicole M Moore, Lisa-Anne Cummins, Stephanie E Reyes, Andrew J Mazzoli, Vahe Heboyan, Gianluca De Leo
BACKGROUND: Interprofessional education (IPE) improves collaboration and patient care through joint education between health professions. Respiratory therapy (RT) faculty were surveyed to evaluate their knowledge and attitudes toward IPE. We report current opportunities for IPE from faculty and compare responses from associate's, bachelor's, and master's degree programs and profit versus nonprofit institutions. METHODS: We developed an online survey based on IPE literature and questions modified for the RT discipline...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28292527/enteral-nutrition-volume-is-not-correlated-with-lower-respiratory-tract-infection-in-patients-on-mechanical-ventilation
#15
A Colomar, B Guardiola, J A Llompart-Pou, I Ayestarán, J Rodríguez-Pilar, M Ferreruela, J M Raurich
OBJECTIVE: To evaluate the effect of enteral nutrition volume, gastrointestinal function and the type of acid suppressive drug upon the incidence of lower respiratory tract infections in critically ill patients on mechanical ventilation (MV). DESIGN: A retrospective secondary analysis was carried out. SETTING: The Intensive Care Unit of a University Hospital. PATIENTS OR PARTICIPANTS: Patients≥18-years-old expected to need MV for more than four days, and receiving enteral nutrition by nasogastric tube within 24h of starting MV...
March 11, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28290130/the-choosing-wisely-initiative-in-infectious-diseases
#16
REVIEW
Clara Lehmann, Reinhard Berner, Johannes R Bogner, Oliver A Cornely, Katja de With, Susanne Herold, Winfried V Kern, Sebastian Lemmen, Mathias W Pletz, Bernhard Ruf, Bernd Salzberger, Hans Jürgen Stellbrink, Norbert Suttorp, Andrew J Ullmann, Gerd Fätkenheuer, Norma Jung
OBJECTIVE: "Choosing Wisely" is a growing international campaign aiming at practice changes to improve patient health and safety by both, conduct of essential and avoidance of unnecessary diagnostic, preventive and therapeutic procedures. The goal is to create an easily recognizable and distributable list ("Choosing Wisely items") that addresses common over- and underuse in the management of infectious diseases. METHODS: The German Society of Infectious Diseases (DGI) participates in the campaign "Klug Entscheiden" by the German Society of Internal Medicine...
March 13, 2017: Infection
https://www.readbyqxmd.com/read/28287810/evaluation-of-initial-respiratory-support-strategies-in-vlbw-neonates-with-rds
#17
Seyyed Abolfazl Afjeh, Mohammad Kazem Sabzehei, Maryam Khoshnood Shariati, Ahmad Reza Shamshiri, Fatemeh Esmaili
BACKGROUND: Non-invasive ventilation (NIV) has brought about a significant change in care and treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) neonates. The present study was designed and conducted to evaluate different strategies of initial respiratory support (IRS) in VLBW neonates hospitalized in the neonatal intensive care unit (NICU). METHODS: This prospective study was conducted over three years (March 21, 2011 to March 20, 2014)...
March 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28281491/status-epilepticus-refractory-and-super-refractory
#18
REVIEW
Deepanshu Dubey, Jayantee Kalita, Usha K Misra
Status epilepticus (SE) is an important neurological emergency. It is defined as seizures lasting for 5 minutes or more or recurrent seizures without recovery of consciousness to baseline between the attacks. Refractory SE (RSE) is defined as SE persisting despite sufficient dose of benzodiazepines and at least one antiepileptic drug (AED), irrespective of time. Super refractory SE (SRSE) is defined as SE that continues for 24 hours or more after the use of anesthetic therapy, including cases that recur on weaning of the anesthestic agent...
2017: Neurology India
https://www.readbyqxmd.com/read/28270656/raising-awareness-of-bronchiectasis-in-primary-care-overview-of-diagnosis-and-management-strategies-in-adults
#19
James D Chalmers, Sanjay Sethi
Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28265980/outcomes-in-elderly-patients-admitted-to-the-intensive-care-unit-with-solid-tumors
#20
Edouard Auclin, Anaïs Charles-Nelson, Baptiste Abbar, Emmanuel Guérot, Stéphane Oudard, Caroline Hauw-Berlemont, Constance Thibault, Alexandra Monnier, Jean-Luc Diehl, Sandrine Katsahian, Jean-Yves Fagon, Julien Taieb, Nadia Aissaoui
BACKGROUND: As the population ages and cancer therapies improve, there is an increased call for elderly cancer patients to be admitted to the intensive care unit (ICU). This study aimed to assess short-term survival and prognostic factors in critically ill patients with solid tumors aged ≥65 years. METHODS: We conducted a retrospective study. The primary endpoint was ICU mortality. Resumption of anticancer therapy in patients who survived the ICU stay and 90-day mortality were secondary endpoints...
December 2017: Annals of Intensive Care
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