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https://www.readbyqxmd.com/read/29438223/knockdown-of-tfpi-anchored-endothelial-cells-exacerbates-lipopolysaccharide-induced-acute-lung-injury-via-nf-%C3%AE%C2%BAb-signaling-pathway
#1
Bao Q Wang, Meng Shi, Jian P Zhang, Xie Wu, Mei J Chang, Zhi H Chen, Hua H Shen, Yuan L Song, Jian Zhou, Chun X Bai
BACKGROUND: As activation of the coagulation system is both a consequence and contributor to acute lung injury (ALI), pulmonary coagulopathy has become a potential target for therapeutic intervention in ALI patients. We investigated the effects and possible mechanisms of endothelial cell (EC)-anchored tissue factor pathway inhibitor (TFPI) on lipopolysaccharide (LPS)-induced ALI in mice. METHODS: To assess the effect of endothelial cell-anchored TFPI deletion on ALI indices, TFPI knockout (cKO) mice were generated...
February 12, 2018: Shock
https://www.readbyqxmd.com/read/29437815/successful-management-of-benign-paroxysmal-positional-vertigo-bppv-in-a-patient-who-was-ventilated-with-a-c3-complete-spinal-injury-on-a-regional-spinal-unit-intensive-care
#2
Lisa Burrows
Benign paroxysmal positional vertigo (BPPV) occurs in 14.5% of patients with spinal cord injury (SCI) and may require intervention on intensive care unit (ICU). A 61-year-old man was admitted to a spinal injury ICU with a traumatic C3 complete SCI following a mountain bike accident. Ventilated but stable he complained of severe dizziness on rolling, during personal cares, which lasted for 40 s. Clinical examination was limited due to the injury and ventilation. Subjective questioning, visio-ocular control and a modified Dix-Hallpike and roll tests confirmed a right posterior canalithiasis BPPV...
February 8, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29422724/effect-of-continuous-versus-intermittent-subglottic-suctioning-on-tracheal-mucosa-by-the-mallinckrodt-taperguard-evac-oral-tracheal-tube-in-intensive-care-unit-ventilated-patients-a-prospective-randomized-study
#3
Philippe Seguin, Harmonie Perrichet, Estelle Le Pabic, Yoann Launey, Marie Tiercin, Romain Corre, Graziella Brinchault, Bruno Laviolle
Background and Aims: A risk of tracheal mucosa injury induced by subglottic suctioning has been raised. Therefore, this prospective randomized study aims to compare the effect of continuous suctioning of subglottic secretions versus intermittent suctioning of subglottic secretions (CSSS vs. ISSS) secretions on tracheal mucosa in front of the suctioning port of the endotracheal tube. Patients and Methods: Patients requiring intubation or reintubation in Intensive Care Unit with an expected ventilation duration > 24 h were eligible...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29420904/unstable-inflation-causing-injury-insight-from-prone-position-and-paired-ct-scans
#4
Yi Xin, Maurizio Cereda, Hooman Hamedani, Mehrdad Pourfathi, Sarmad Siddiqui, Natalie Meeder, Stephen Kadlecek, Ian Duncan, Harrilla Profka, Jennia Rajaei, Nicholas J Tustison, James C Gee, Brian P Kavanagh, Rahim R Rizi
BACKGROUND: It remains unclear how prone positioning improves survival in acute respiratory distress syndrome (ARDS). Using serial computed tomography (CT), we previously reported that 'unstable' inflation, i.e. partial aeration with large tidal density swings (indicating increased local strain) is associated with injury progression. We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation. METHODS: Injury was induced by tracheal hydrochloric acid (HCl) in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low PEEP...
February 8, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29416908/acute-tetraplegia-following-laryngotracheal-reconstruction-surgery
#5
Belgin Erhan, Rahsan Kemerdere, Osman Kizilkilic, Berrin Gunduz, Murat Hanci
Background: Paraplegia following thoracic spinal surgery or abdominal operations is usually attributed to spinal cord ischemia due to interruption of the segmental spinal vascular supply. Alternatively, the etiology of spinal cord ischemia following cervical surgery is less clear. Case Description: A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation...
2018: Surgical Neurology International
https://www.readbyqxmd.com/read/29406378/downward-trend-in-pediatric-resident-laryngoscopy-participation-in-picus
#6
Aayush Gabrani, Taiki Kojima, Ronald C Sanders, Asha Shenoi, Vicki Montgomery, Simon J Parsons, Sandeep Gangadharan, Sholeen Nett, Natalie Napolitano, Keiko Tarquinio, Dennis W Simon, Anthony Lee, Guillaume Emeriaud, Michelle Adu-Darko, John S Giuliano, Keith Meyer, Ana Lia Graciano, David A Turner, Conrad Krawiec, Adnan M Bakar, Lee A Polikoff, Margaret Parker, Ilana Harwayne-Gidansky, Benjamin Crulli, Paula Vanderford, Ryan K Breuer, Eleanor Gradidge, Aline Branca, Lily B Grater-Welt, David Tellez, Lisa V Wright, Matthew Pinto, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. DESIGN: Prospective cohort study. SETTING: Twenty-five PICUs at various children's hospitals across the United States. PATIENTS: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children)...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29405258/videolaryngoscopy-vs-macintosh-laryngoscopy-for-double-lumen-tube-intubation-in-thoracic-surgery-a-systematic-review-and-meta-analysis-trials
#7
REVIEW
T T Liu, L Li, L Wan, C H Zhang, W L Yao
Double-lumen intubation is more difficult than single-lumen tracheal intubation. Videolaryngoscopes have many advantages in airway management. However, the advantages of videolaryngoscopy for intubation with a double-lumen tube remain controversial compared with traditional Macintosh laryngoscopy. In this study, we searched MEDLINE, Embase, Cochrane Library and the Web of Science for randomised controlled trials comparing videolaryngoscopy with Macintosh laryngoscopy for double-lumen tube intubation. We found that videolaryngoscopy provided a higher success rate at first attempt for double-lumen tube intubation, with an odds ratio (95%CI) of 2...
February 6, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29399461/figure-of-8-reconstruction-technique-for-chronic-posterior-sternoclavicular-joint-dislocation
#8
Dean Wang, Christopher L Camp, Brian C Werner, Joshua S Dines, David W Altchek
Dislocation of the sternoclavicular joint is a rare injury and typically requires high-energy forces applied through the joint. Initial treatment is dependent on the direction of dislocation, with acute reduction indicated for posterior dislocations presenting with signs of tracheal, esophageal, or neurovascular compression. Although most patients do well with conservative treatment after the initial trauma, some can have persistent pain and scapular dyskinesia due to instability or locked dislocation of the sternoclavicular joint...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29392073/transverse-cervicothoracic-stabbing-multidisciplinary-management-of-a-surgical-emergency
#9
Elena Molina Fernández, Ramón Moreno-Luna, Francisco López Navas, Marta López Porras, C Giménez, Serafín Sánchez Gómez
Tracheobronchial injuries are closely related to orotracheal intubations and chest traumas. Stabbing injuries are very rare and often life threatening because of the damage to vital structures such as the respiratory tract and large arterial or venous vessels. Early diagnosis and treatment of penetrating neck injuries increase survival rates. We report a case of the tracheobronchial section with a penetrating stabbing wound on the left laterocervical area associated with contralateral pneumothorax, requiring urgent surgical pulmonary repair, tracheal suture, and tracheotomy...
September 2017: Turkish Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29357510/gbt1118-a-compound-that-increases-the-oxygen-affinity-of-hemoglobin-improves-survival-in-murine-hypoxic-acute-lung-injury
#10
Nathan D Putz, Ciara M Shaver, Kobina Dufu, Chien-Ming Li, Qing Xu, Athiwat Hutchaleelaha, Josh Lehrer-Graiwer, Susan M Majka, Lorraine B Ware, Julie A Bastarache
BACKGROUND: Acute respiratory distress syndrome (ARDS) is characterized by lung inflammation and pulmonary edema leading to arterial hypoxemia and death if the hypoxemia is severe. Strategies to correct hypoxemia have the potential to improve clinical outcomes in ARDS. The goal of this study was to evaluate the potential of hemoglobin modification as a novel therapy for ARDS-induced hypoxemia. METHODS: The therapeutic effect of two different doses of GBT1118, a compound that increases the oxygen affinity of hemoglobin was evaluated in a murine model of acute lung injury induced by intra-tracheal LPS instillation 24 hours prior to exposure to 5% or 10% hypoxia...
December 14, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29335475/discontinuous-ventilator-weaning-of-patients-with-acute-sci
#11
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#12
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29323630/fatal-innominate-artery-hemorrhage-in-a-patient-with-tetraplegia-case-report-and-literature-review
#13
Ahmad Zaheer Qureshi
Context Hemorrhage is one of the potentially fatal complications of tracheostomy. A rare but lethal cause of tracheostomy related bleeding is hemorrhage from the innominate artery. This occurs following tracheo-innominate artery fistula (TIF) formation, which is associated with a mortality rate of more than 85%. Here, we report the case of an individual with tetraplegia and a tracheostomy who died as a result of innominate artery hemorrhage. This case highlights the possible causes and interventions associated with this complication, and provides insight into tracheostomy related bleeding in patients with spinal cord injury (SCI)...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29317750/exhaled-air-dispersion-during-bag-mask-ventilation-and-sputum-suctioning-implications-for-infection-control
#14
Matthew T V Chan, Benny K Chow, Thomas Lo, Fanny W Ko, Susanna S Ng, Tony Gin, David S Hui
Mask ventilation and coughing during oro-tracheal suctioning produce aerosols that enhance nosocomial transmission of respiratory infections. We examined the extent of exhaled air dispersion from a human-patient-simulator during mask ventilation by different groups of healthcare workers and coughing bouts. The simulator was programmed to mimic varying severity of lung injury. Exhaled airflow was marked with tiny smoke particles, and highlighted by laser light-sheet. We determined the normalized exhaled air concentration in the leakage jet plume from the light scattered by smoke particles...
January 9, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29306264/management-of-right-main-bronchial-rupture-with-a-double-lumen-endotracheal-tube-in-a-patient-with-blunt-chest-trauma
#15
Seung Hwan Seol, Woon Jeong Lee, Seon Hee Woo, Dae Hui Kim, Jong Hui Suh
Tracheobronchial disruption is one of the most severe injuries caused by blunt chest trauma. It may cause airway obstruction and resulting life-threatening respiratory deficiency. However, the clinical presentations are variable and frequently difficult to diagnose. We report a case of a previously healthy 16-year-old man with complete right main bronchial transection sustained after a vehicular accident, who had progressive dyspnea, subcutaneous emphysema in the neck and anterior chest wall, and bilateral tension pneumothorax...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#16
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29284857/to-compare-the-effect-of-two-different-doses-of-dexmedetomidine-on-the-attenuation-of-airway-and-pressor-response-during-tracheostomy-tube-change-in-traumatic-brain-injury-patients
#17
Abdul Alim Khan, Neeraj Kumar, Yashpal Singh, Atul Kumar Singh, Sharad Kumar Mathur
Background: Tracheostomy tube (TT) change is the common procedure in trauma Intensive Care Unit (ICU) and almost always associated with cough reflex, increase in blood pressure, and heart rate. Dexmedetomidine (DEX) is a selective α2-adrenergic receptor agonist well studied for the prevention of pressor response during laryngoscopy and extubation, but literature on prevention of pressor response during TT change is lacking. Aims: The aim of this study is to compare two doses (0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29281616/influence-of-type-of-congenital-heart-defects-on-epithelial-lining-fluid-composition-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#18
Manuela Simonato, Aldo Baritussio, Virgilio P Carnielli, Luca Vedovelli, Gianclaudio Falasco, Michele Salvagno, Massimo Padalino, Paola Cogo
BACKGROUND: In children with congenital heart disease (CHD), altered pulmonary circulation compromises gas exchange. Moreover, pulmonary dysfunction is a complication of cardiac surgery with cardiopulmonary bypass (CPB). No data are available on the effect of different CHDs on lung injury. The aim of this study was to analyze epithelial lining fluid (ELF) surfactant composition in children with CHD. METHODS: Tracheal aspirates (TAs) from 72 CHD children [age 2.9 (0...
December 27, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29236845/comparison-between-conventional-protective-mechanical-ventilation-and-high-frequency-oscillatory-ventilation-associated-with-the-prone-position
#19
José Roberto Fioretto, Susiane Oliveira Klefens, Rafaelle Fernandes Pires, Cilmery Suemi Kurokawa, Mario Ferreira Carpi, Rossano César Bonatto, Marcos Aurélio Moraes, Carlos Fernando Ronchi
OBJECTIVE: To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. METHODS: Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15)...
December 7, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29231967/therapeutic-potential-of-porcine-bronchoalveolar-fluid-derived-mesenchymal-stromal-cells-in-a-pig-model-of-lps-induced-ali
#20
Mahesh Khatri, Levi Arthur Richardson
In this study, we isolated mesenchymal stromal (stem) cells (MSCs) from broncho-alveolar lavage fluid (BAL) of 2-6 week-old commercial pigs. BAL-MSCs displayed fibroblastic morphology and possessed self-renewal properties. Similar to bone-marrow MSCs, BAL-MSCs expressed mesenchymal markers and both cell types lacked the expression of hematopoetic markers. BAL-MSCs, when cultured in differentiation induction media, differentiated into adipocytes, osteocytes and chondrocytes. Next, we examined if BAL-MSCs have the ability to treat lipopolysaccharide (LPS)-induced acute lung injury (ALI) in a pig model...
December 12, 2017: Journal of Cellular Physiology
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