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Tube weaning

Savino Spadaro, Salvatore Grasso, Tommaso Mauri, Francesca Dalla Corte, Valentina Alvisi, Riccardo Ragazzi, Valentina Cricca, Giulia Biondi, Rossella Di Mussi, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most widely used indices to predict weaning outcome. Whereas the diaphragm plays a fundamental role in generating VT, in the case of diaphragmatic dysfunction the inspiratory accessory muscles may contribute. If this occurs during a weaning trial, delayed weaning failure is likely since the accessory muscles are more fatigable than the diaphragm. Hence, we hypothesised that the traditional RSBI could be implemented by substituting VT with the ultrasonographic evaluation of diaphragmatic displacement (DD)...
September 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Jean Claude De Mauroy, Sophie Pourret, Frédéric Barral
OBJECTIVE: ART is the acronym for Asymmetry, Rigid, Torsion. The realization of this brace is based on new concepts (circled helicoid, global detorsion, Soft Contact, Mayonnaise tube effect, axilla baby lift, wrench & bolt…). The excellent in-brace correction has been proved on a consecutive series of 141 AIS selected according to the SRS criteria in a prospective database. Results at six months and a year were compared with those of the former Lyon brace and confirm that these good results remain constant...
September 2016: Annals of Physical and Rehabilitation Medicine
Simone Thomas, Wolfgang Sauter, Ulrike Starrost, Marcus Pohl, Jan Mehrholz
BACKGROUND: Treatment of critical illness on intensive-care-units (ICU) results often in persistent invasive endotracheal intubation which might delay rehabilitation and increases the risk of mortality. Recent longitudinal studies have described the recovery of critically ill people, but the detailed time course of decannulation in patients with chronic critical illness with ICU- acquired muscle weakness (ICUAW) is not well known. AIM: The aim of our study was therefore to describe the decannulation times and associated risk factors in patients who are chronic critically ill with ICU acquired weakness...
September 27, 2016: European Journal of Physical and Rehabilitation Medicine
James Henry Obol, Denis Anywar Arony, Ronald Wanyama, Kenneth Luryama Moi, Bongomin Bodo, Patrick Olwedo Odong, Michael Odida
INTRODUCTION: Nodding syndrome was first reported in Uganda in 2003 among internally displaced populations. Risk factors for the syndrome remain unknown. We therefore explored vitamin B6 deficiency and resulting high 3-hydroxykynurenine (3-HK) levels as risk factor for nodding syndrome in Northern Uganda. METHODS: Case-control study conducted in Gulu and Amuru districts. Cases were children/young adults with nodding syndrome. Healthy children/young adults were recruited as controls from same community as cases...
2016: Pan African Medical Journal
Esra Adıyeke, Asu Ozgultekin, Guldem Turan, Altay Iskender, Gamze Canpolat, Abdullah Pektaş, Osman Ekinci
BACKGROUND AND OBJECTIVES: This study compared the rates of acute respiratory failure, reintubation, length of intensive care stay and mortality in patients in whom the non-invasive mechanical ventilation (NIMV) was applied instead of the routine venturi face mask (VM) application after a successful weaning. METHODS: Following the approval of the hospital ethics committee, 62 patients who were under mechanical ventilation for at least 48hours were scheduled for this study...
September 14, 2016: Revista Brasileira de Anestesiologia
Miguel Angel Palomero-Rodríguez, Héctor Chozas de Arteaga, Yolanda Laporta Báez, Jesús de Vicente Sánchez, Pascual Sanabria Carretero, Pilar Sánchez Conde, Antonio Pérez Ferrer
BACKGROUND: Over the last years, we have used a flow-inflating bag circuit with a nasotracheal or nasopharyngeal tube as an interface to deliver effective CPAP support in infants ("Mapleson D CPAP system"). The primary goal of this study was to assess the usefulness of the "Mapleson D CPAP system" for weaning of mechanical ventilation (MV) in infants who received MV over 24 h. MATERIALS AND METHODS: All infants who received MV for more than 24 h in the last year were enrolled in the study...
September 2016: Lung India: Official Organ of Indian Chest Society
Marco Antonio León-Gutiérrez, Janet Tanus-Hajj, Luis Alejandro Sánchez-Hurtado
BACKGROUND: The information regarding the factors that affect the success of extubation in neurosurgical patients is limited; thus, it is necessary to determine the prevalence, and the associated factors, of extubation failure in neurosurgical patients. METHODS: It was performed a prospective, longitudinal, observational and comparative study in neurosurgical patients with criteria for extubation. In those who the number of endotracheal aspirations had failed 24 hours before extubation, it was analyzed the presence of cough reflex, length of stay and mechanical ventilation days...
2016: Revista Médica del Instituto Mexicano del Seguro Social
Robin H Steinhorn, Jeffrey Fineman, Andjela Kusic-Pajic, Peter Cornelisse, Martine Gehin, Pegah Nowbakht, Christine M Pierce, Maurice Beghetti
OBJECTIVE: To evaluate the efficacy, safety, and pharmacokinetics of the endothelin receptor antagonist bosentan as adjunctive therapy for neonates with persistent pulmonary hypertension of the newborn (PPHN). STUDY DESIGN: This was a phase 3, multicenter, randomized, placebo-controlled exploratory trial (FUTURE-4). Eligible patients were >34 weeks gestation, <7 days old, receiving inhaled nitric oxide (iNO) treatment (≥4 hours), and had persistent respiratory failure (oxygenation index [OI] ≥12)...
October 2016: Journal of Pediatrics
Tzippora Shalem, Akiva Fradkin, Marguerite Dunitz-Scheer, Tal Sadeh-Kon, Tali Goz-Gulik, Yael Fishler, Batia Weiss
BACKGROUND: Children dependent on gastrostomy tube feeding and those with extremely selective eating comprise the most challenging groups of early childhood eating disorders. We established, for the first time in Israel, a 3 week intensive weaning and treatment program for these patients based on the "Graz model." OBJECTIVES: To investigate the Graz model for tube weaning and for treating severe selective eating disorders in one center in Israel. METHODS: Pre-program assessment of patients' suitability to participate was performed 3 months prior to the study, and a treatment goal was set for each patient...
June 2016: Israel Medical Association Journal: IMAJ
Erica Everitt
The second article of this four-part series on tracheostomy care describes the process of weaning patients off a tracheostomy, decannulation of the tube and aftercare. The role of the multidisciplinary team is discussed, as well as the importance of psychological care of patients who may be anxious about their ability to breathe without a tube.
May 18, 2016: Nursing Times
Çiğdem Selek, Perihan Ergin Özcan, Günseli Orhun, Evren Şentürk, İbrahim Özkan Akıncı, Nahit Çakar
OBJECTIVE: Automatic Tube Compensation (ATC) is a newly developed mechanical ventilatory support method. The aim of this study was to compare the ATC and the T-piece as a weaning method. METHODS: Patients who were treated in ICU with mechanical ventilation for longer than 24 hours were included in this prospective clinical study. Fifty patients were divided into two groups for weaning, ATC or T-piece group. Patients tolerating 30 minutes spontaneous breathing trial underwent immediate extubation...
April 2014: Turkish Journal of Anaesthesiology and Reanimation
Ibrahim Gundogdu, Erhan Arif Ozturk, Ebru Umay, Ozgur Zeliha Karaahmet, Ece Unlu, Aytul Cakci
PURPOSE: Following repeated weaning failures in acute care services, spinal cord injury (SCI) patients who require prolonged mechanical ventilation and tracheostomy are discharged to their homes or skilled nursing facilities, with a portable mechanical ventilator (MV) and/or tracheostomy tube (TT) with excess risk of complications, high cost and low quality of life. We hypothesized that many difficult-to-wean patients with cervical SCI can be successfully managed in a rehabilitation clinic...
June 23, 2016: Disability and Rehabilitation
Alison Y GArdiner, Peter J Vuillermin, David G Fuller
PURPOSE: Many children are requiring tube weaning intervention as a result of increased survival rates of high risk infants and the temporary use of feeding tubes. This study aimed to describe service delivery models and treatment approaches in a variety of paediatric feeding/tube weaning programs. METHOD: A questionnaire on tube weaning was formulated based on a literature review. Purposive maximum variation sampling was used to include feeding/ weaning programs operating in a variety of settings and countries...
June 22, 2016: International Journal of Speech-language Pathology
J X Xiao, G M Alugongo, R Chung, S Z Dong, S L Li, I Yoon, Z H Wu, Z J Cao
The aim of this study was to evaluate the effects of Saccharomyces cerevisiae fermentation products (SCFP) in the calf starter and milk on ruminal fermentation, gastrointestinal morphology, and microbial community in the first 56 d of life. Thirty Holstein bull calves were randomly assigned to 1 of 3 groups: a texturized calf starter containing 0 (CON), 0.5, or 1% SCFP (XPC, Diamond V, Cedar Rapids, IA) of dry matter from d 4 to 56. In addition, the XPC-supplemented calves were fed with 1 g/d SCFP (SmartCare, Diamond V, Cedar Rapids, IA) in milk from d 2 to 30...
July 2016: Journal of Dairy Science
Joseph P Garner, Brianna N Gaskill, Kathleen R Pritchett-Corning
Alloparenting, a behavior in which individuals other than the actual parents act in a parental role, is seen in many mammals, including house mice. In wild house mice, alloparental care is only seen when familiar sibling females simultaneously immigrate to a male's territory, so in the laboratory, when a pair of unfamiliar female wild mice are mated with a male, alloparenting does not occur because one female will typically be reproductively suppressed. In contrast, laboratory mice are assumed to alloparent regardless of familiarity or relatedness and are therefore routinely trio bred to increase productivity...
2016: PloS One
Brian D Benneyworth, Jenny M Shao, A Ioana Cristea, Veda Ackerman, Mark D Rodefeld, Mark W Turrentine, John W Brown
BACKGROUND: Tracheostomy following congenital heart disease (CHD) surgery is a rare event and associated with significant mortality. Hospital survival has been reported from 20% to 40%. Late mortality for these patients is not well characterized. METHODS: We performed a retrospective observational study of patients who had a tracheostomy following CHD surgery (excluding isolated patent ductus arteriosus ligation) between January 2000 and December 2013. Patients were categorized into single-ventricle or biventricular physiology groups...
May 2016: World Journal for Pediatric & Congenital Heart Surgery
Kranthi Kumar Gangiti, Jonathan T Gondi, Hemantkumar Nemade, L M Chandra Sekhara Rao Sampathirao, K V V N Raju, T Subramanyeshwar Rao
BACKGROUND: There is a general notion that, total glossectomy with laryngeal preservation leads to high dependency of tracheostomy and/or feeding tube. The objective of this study is to analyze the quality of life in terms of tube dependency following total glossectomy with a modified pectoralis major myocutaneous flap (PMMC) reconstruction and laryngeal suspension. MATERIALS AND METHODS: The retrospective study included consecutive patients operated from July 2012 to February 2015 proven advanced Carcinoma of tongue...
July 2016: Journal of Surgical Oncology
Yaron Avitzur, Glenda Courtney-Martin
Enteral autonomy and freedom from parenteral nutrition dependency is the ultimate therapeutic goal in children with intestinal failure. This can be achieved following attainment of bowel adaptation in conditions such as short bowel syndrome. Enteral nutrition is a major therapeutic cornerstone in the management of children with intestinal failure. It promotes physiological development, bowel adaptation and enhances weaning from parenteral nutrition. The optimal method of delivery, type of nutrients, timing of initiation, promotion of feeds and transition to solid food in children with short bowel syndrome are debated...
April 2016: Best Practice & Research. Clinical Gastroenterology
Anna-Liisa Sutt, Lawrence R Caruana, Kimble R Dunster, Petrea L Cornwell, Chris M Anstey, John F Fraser
BACKGROUND: Patients who require positive pressure ventilation through a tracheostomy are unable to phonate due to the inflated tracheostomy cuff. Whilst a speaking valve (SV) can be used on a tracheostomy tube, its use in ventilated ICU patients has been inhibited by concerns regarding potential deleterious effects to recovering lungs. The objective of this study was to assess end expiratory lung impedance (EELI) and standard bedside respiratory parameters before, during and after SV use in tracheostomised patients weaning from mechanical ventilation...
2016: Critical Care: the Official Journal of the Critical Care Forum
Anuj B Mehta, Colin R Cooke, Renda Soylemez Wiener, Allan J Walkey
OBJECTIVE: Controversy exists regarding perceived benefits of early tracheostomy to facilitate weaning among mechanically ventilated patients, potentially leading to significant practice-pattern variation with implications for outcomes and resource utilization. We sought to determine practice-pattern variation and outcomes associated with tracheostomy timing in the United States. DESIGN: In a retrospective cohort study, we identified mechanically ventilated patients with the most common causes of respiratory failure leading to tracheostomy: pneumonia/sepsis and trauma...
August 2016: Critical Care Medicine
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