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https://www.readbyqxmd.com/read/29470503/sevoflurane-posttreatment-prevents-oxidative-and-inflammatory-injury-in-ventilator-induced-lung-injury
#1
Julie Wagner, Karl M Strosing, Sashko G Spassov, Ziwei Lin, Helen Engelstaedter, Sabine Tacke, Alexander Hoetzel, Simone Faller
Mechanical ventilation is a life-saving clinical treatment but it can induce or aggravate lung injury. New therapeutic strategies, aimed at reducing the negative effects of mechanical ventilation such as excessive production of reactive oxygen species, release of pro-inflammatory cytokines, and transmigration as well as activation of neutrophil cells, are needed to improve the clinical outcome of ventilated patients. Though the inhaled anesthetic sevoflurane is known to exert organ-protective effects, little is known about the potential of sevoflurane therapy in ventilator-induced lung injury...
2018: PloS One
https://www.readbyqxmd.com/read/29470245/intra-aortic-balloon-pump-use-before-left-ventricular-assist-device-implantation-insights-from-the-intermacs-registry
#2
Adam D DeVore, Bradley G Hammill, Chetan B Patel, Manesh R Patel, Joseph G Rogers, Carmelo A Milano, Adrian F Hernandez
Use of durable, continuous-flow left ventricular assist devices (LVADs) has expanded rapidly, although data are limited regarding optimization strategies before LVAD implantation. We examined current use of intra-aortic balloon pumps (IABPs) before LVAD implantation and compared outcomes of patients with IABP use to those without. We analyzed data from the Interagency Registry for Mechanical Assisted Circulatory Support (INTERMACS) on patients who underwent LVAD implantation between 2006 and 2014. We limited the analysis to patients with an admitting diagnosis of LVAD placement...
March 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29468848/time-trend-analysis-of-long-term-outcome-of-patients-with-haematological-malignancies-admitted-at-dutch-intensive-care-units
#3
Vera A de Vries, Marcella C A Müller, M Sesmu Arbous, Bart J Biemond, Nicole M A Blijlevens, Nuray Kusadasi, Goda C W Choi, Alexander P J Vlaar, David J van Westerloo, Hanneke C Kluin-Nelemans, Walter M van den Bergh
A few decades ago, the chances of survival for patients with a haematological malignancy needing Intensive Care Unit (ICU) support were minimal. As a consequence, ICU admission policy was cautious. We hypothesized that the long-term outcome of patients with a haematological malignancy admitted to the ICU has improved in recent years. Furthermore, our objective was to evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE) II score. A total of 1095 patients from 5 Dutch university hospitals were included from 2003 until 2015...
February 22, 2018: British Journal of Haematology
https://www.readbyqxmd.com/read/29467961/the-outcomes-and-prognostic-factors-of-acute-respiratory-failure-in-the-patients-90-years-old-and-over
#4
Wan-Ling Chen, Chin-Ming Chen, Shu-Chen Kung, Ching-Min Wang, Chih-Cheng Lai, Chien-Ming Chao
This retrospective cohort study investigated the outcomes and prognostic factors in nonagenarians (patients 90 years old or older) with acute respiratory failure. Between 2006 and 2016, all nonagenarians with acute respiratory failure requiring invasive mechanical ventilation (MV) were enrolled. Outcomes including in-hospital mortality and ventilator dependency were measured. A total of 173 nonagenarians with acute respiratory failure were admitted to the intensive care unit (ICU). A total of 56 patients died during the hospital stay and the rate of in-hospital mortality was 32...
January 23, 2018: Oncotarget
https://www.readbyqxmd.com/read/29467674/an-improved-dynamic-model-for-the-respiratory-response-to-exercise
#5
Leidy Y Serna, Miguel A Mañanas, Alher M Hernández, Roberto A Rabinovich
Respiratory system modeling has been extensively studied in steady-state conditions to simulate sleep disorders, to predict its behavior under ventilatory diseases or stimuli and to simulate its interaction with mechanical ventilation. Nevertheless, the studies focused on the instantaneous response are limited, which restricts its application in clinical practice. The aim of this study is double: firstly, to analyze both dynamic and static responses of two known respiratory models under exercise stimuli by using an incremental exercise stimulus sequence (to analyze the model responses when step inputs are applied) and experimental data (to assess prediction capability of each model)...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29467544/ultrasound-detection-of-diaphragm-position-in-the-region-for-lung-monitoring-by-electrical-impedance-tomography-during-laparoscopy
#6
Kristyna Buzkova, Martin Muller, Ales Rara, Karel Roubik, Tomas Tyll
BACKGROUND AND AIMS: During laparoscopic surgery, a capnoperitoneum is created to optimize the operating space for surgeons. One effect of this is abdominal pressure which alters the physiological thoraco-abdominal configuration and pushes the diaphragm and lungs cranially. Since the lung image acquired by electrical impedance tomography (EIT) depends on the conditions within the thorax and abdomen, it is crucial to know the diaphragm position to determine the effect of diaphragm shift on EIT thorax image...
February 21, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29467461/the-association-of-aspirin-use-with-severity-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-a-retrospective-cohort-study
#7
Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
Little is known about the effect of long-term aspirin use on acute severity of COPD. We hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). We conducted a retrospective cohort study using large population-based data from 2012 through 2013. Among 206,686 patients (aged ≥40 years) hospitalized for AECOPD, aspirin users had lower in-hospital mortality (1...
February 21, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29466596/acute-respiratory-distress-syndrome-advances-in-diagnosis-and-treatment
#8
Eddy Fan, Daniel Brodie, Arthur S Slutsky
Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually. Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years. Evidence Review: We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 2012 to 2017 focusing on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29466591/effect-of-haloperidol-on-survival-among-critically-ill-adults-with-a-high-risk-of-delirium-the-reduce-randomized-clinical-trial
#9
Mark van den Boogaard, Arjen J C Slooter, Roger J M Brüggemann, Lisette Schoonhoven, Albertus Beishuizen, J Wytze Vermeijden, Danie Pretorius, Jan de Koning, Koen S Simons, Paul J W Dennesen, Peter H J Van der Voort, Saskia Houterman, J G van der Hoeven, Peter Pickkers
Importance: Results of studies on use of prophylactic haloperidol in critically ill adults are inconclusive, especially in patients at high risk of delirium. Objective: To determine whether prophylactic use of haloperidol improves survival among critically ill adults at high risk of delirium, which was defined as an anticipated intensive care unit (ICU) stay of at least 2 days. Design, Setting, and Participants: Randomized, double-blind, placebo-controlled investigator-driven study involving 1789 critically ill adults treated at 21 ICUs, at which nonpharmacological interventions for delirium prevention are routinely used in the Netherlands...
February 20, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29465631/near-infrared-cerebral-oximetry-to-predict-outcome-after-pediatric-cardiac-surgery-a-prospective-observational-study
#10
Marine Flechet, Fabian Güiza, Dirk Vlasselaers, Lars Desmet, Stoffel Lamote, Heidi Delrue, Marc Beckers, Michaël P Casaer, Pieter Wouters, Greet van den Berghe, Geert Meyfroidt
OBJECTIVES: To assess whether near-infrared cerebral tissue oxygen saturation, measured with the FORESIGHT cerebral oximeter (CAS Medical Systems, Branford, CT) predicts PICU length of stay, duration of invasive mechanical ventilation, and mortality in critically ill children after pediatric cardiac surgery. DESIGN: Single-center prospective, observational study. SETTING: Twelve-bed PICU of a tertiary academic hospital. PATIENTS: Critically ill children and infants with congenital heart disease, younger than 12 years old, admitted to the PICU between October 2012 and November 2015...
February 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29465203/-use-of-protective-lung-ventilation-regimen-in-cardiac-surgery-patients
#11
T A Pshenichniy, B A Akselrod, I V Titova, N A Trekova, M V Khrustaleva
BACKGROUND: In cardiac surgery, protective lung ventilation and/or preventive brdnchoscopy (PB) are able to decrease lung injury effects of cardiopulmonary bypass (CPB) and mechanical ventilation. OBJECTIVES: define lung complication risks, evaluate the effect ofprotective lung ventilation (PLV) on lung functioning, and investigate the feasibility ofpreventive PB in higher pulmonary risk (PR) patients. MATERIALS AND METHODS: 66 patients participated in prospective randomized research...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29465046/clinical-and-laboratory-features-of-metformin-intoxication-in-suicidal-patients-attending-an-intensive-care-unit
#12
A Cetinkaya, D Avci, A Erden, O Akca, O Ozer, U Kalan, A I Gunal
Introduction: This study has been performed for the purpose of researching the complications occurred at patients who took metformin overdose in an attempt to suicide. None of the patients has the diagnosis of diabetes mellitus and never used metformin. Materials and Methods: This retrospective cross-sectional study was carried out with 21 patients who has neither diagnosed diabetes mellitus nor taken metformin for suicide before. Results: It was observed that there is a moderate, negative (r = -0...
February 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29464691/a-pilot-study-of-hyperoxemia-on-neurological-injury-inflammation-and-oxidative-stress
#13
M Lång, M B Skrifvars, J Siironen, P Tanskanen, M Ala-Peijari, T Koivisto, S Djafarzadeh, S Bendel
BACKGROUND: Normobaric hyperoxia is used to alleviate secondary brain ischaemia in patients with traumatic brain injury (TBI), but clinical evidence is limited and hyperoxia may cause adverse events. METHODS: An open label, randomised controlled pilot study comparing blood concentrations of reactive oxygen species (ROS), interleukin 6 (IL-6) and neuron-specific enolase (NSE) between two different fractions of inspired oxygen in severe TBI patients on mechanical ventilation...
February 20, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29464690/bis-monitoring-versus-clinical-assessment-for-sedation-in-mechanically-ventilated-adults-in-the-intensive-care-unit-and-its-impact-on-clinical-outcomes-and-resource-utilization
#14
REVIEW
Rajesh M Shetty, Antonio Bellini, Dhuleep S Wijayatilake, Mark A Hamilton, Rajesh Jain, Sunil Karanth, ArunKumar Namachivayam
BACKGROUND: Patients admitted to intensive care and on mechanical ventilation, are administered sedative and analgesic drugs to improve both their comfort and interaction with the ventilator. Optimizing sedation practice may reduce mortality, improve patient comfort and reduce cost. Current practice is to use scales or scores to assess depth of sedation based on clinical criteria such as consciousness, understanding and response to commands. However these are perceived as subjective assessment tools...
February 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29463632/an-injured-man-with-acute-altered-mental-status
#15
Hung-Yu Chuang, Lu-Chih Kung, Ming-Yuan Huang
CLINICAL INTRODUCTION: A 58-year-old man sustained injuries due to accidental fall from a height of 5 m onto a solid floor while operating a crane. He was fully conscious without external evidence of head injury when presented to the ED. The patient had multiple fractures involving the fourth, fifth and seventh of the left ribs, left iliac wing and superior ramus of the pelvis, comminuted fracture of the left femur shaft, and an open fracture of the mandible. Two hours after ED presentation, the patient developed acute confusion and lethargy, which rapidly progressed to coma and respiratory distress, and was subsequently intubated with mechanical ventilation support...
March 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29463330/a-chemical-biological-radio-nuclear-cbrn-filter-can-be-added-to-the-air-outflow-port-of-a-ventilator-to-protect-a-home-ventilated-patient-from-inhalation-of-toxic-industrial-compounds
#16
Eliezer Be'eri, Simon Owen, Maurit Beeri, Scott R Millis, Arik Eisenkraft
OBJECTIVES: Chemical-biological-radio-nuclear (CBRN) gas masks are the standard means for protecting the general population from inhalation of toxic industrial compounds (TICs), for example after industrial accidents or terrorist attacks. However, such gas masks would not protect patients on home mechanical ventilation, as ventilator airflow would bypass the CBRN filter. We therefore evaluated in vivo the safety of adding a standard-issue CBRN filter to the air-outflow port of a home ventilator, as a method for providing TIC protection to such patients...
February 21, 2018: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/29463286/bronchopulmonary-dysplasia-clinical-aspects-and-preventive-and-therapeutic-strategies
#17
REVIEW
Nicola Principi, Giada Maria Di Pietro, Susanna Esposito
BACKGROUND: Bronchopulmonary dysplasia (BPD) is the result of a complex process in which several prenatal and/or postnatal factors interfere with lower respiratory tract development, leading to a severe, lifelong disease. In this review, what is presently known regarding BPD pathogenesis, its impact on long-term pulmonary morbidity and mortality and the available preventive and therapeutic strategies are discussed. MAIN BODY: Bronchopulmonary dysplasia is associated with persistent lung impairment later in life, significantly impacting health services because subjects with BPD have, in most cases, frequent respiratory diseases and reductions in quality of life and life expectancy...
February 20, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29463246/next-generation-personalised-model-based-critical-care-medicine-a-state-of-the-art-review-of-in-silico-virtual-patient-models-methods-and-cohorts-and-how-to-validation-them
#18
REVIEW
J Geoffrey Chase, Jean-Charles Preiser, Jennifer L Dickson, Antoine Pironet, Yeong Shiong Chiew, Christopher G Pretty, Geoffrey M Shaw, Balazs Benyo, Knut Moeller, Soroush Safaei, Merryn Tawhai, Peter Hunter, Thomas Desaive
Critical care, like many healthcare areas, is under a dual assault from significantly increasing demographic and economic pressures. Intensive care unit (ICU) patients are highly variable in response to treatment, and increasingly aging populations mean ICUs are under increasing demand and their cohorts are increasingly ill. Equally, patient expectations are growing, while the economic ability to deliver care to all is declining. Better, more productive care is thus the big challenge. One means to that end is personalised care designed to manage the significant inter- and intra-patient variability that makes the ICU patient difficult...
February 20, 2018: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29462474/acute-steroid-myopathy-a-highly-overlooked-entity
#19
Michal Haran, Ami Schattner, Natasha Kozak, Andras Mate, Alain Berrebi, Lev Shvidel
Background: Myopathy in patients being treated with corticosteroids is known primarily among chronically-treated patients or in critically ill and mechanically-ventilated patients receiving corticosteroids, often in high doses. Aim: To highlight the entity of acute, early-onset corticosteroid-treatment-associated myopathy and its characteristics. Design and Methods: Reporting our experience with four patients and reviewing all published reports of myopathy developing ≤14 days of initiating corticosteroid-treatment...
February 15, 2018: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29462333/high-positive-end-expiratory-pressure-during-ex-vivo-lung-perfusion-recruiting-rejected-donor-lungs
#20
Kamal S Ayyat, Toshihiro Okamoto, Hiromichi Niikawa, Kenneth R McCurry
We present an innovative method for recruiting clinically rejected donor lungs using positive end-expiratory pressure titration during ex vivo lung perfusion. Currently, ex vivo lung perfusion protocols are using a standard positive end-expiratory pressure of 5 cmH2O for all cases. Individualized positive end-expiratory pressure titration combined with recruitment manoeuvres has been found to significantly improve pulmonary functions in mechanically ventilated patients. Applying this concept to ex vivo lung perfusion may be helpful in increasing the conversion rate for transplant suitability...
February 14, 2018: Interactive Cardiovascular and Thoracic Surgery
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