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https://www.readbyqxmd.com/read/27899532/long-term-management-for-ventilator-assisted-children-in-hong-kong-2-decades-experience
#1
Shuk-Kuen Chau, Ada Wing-Yan Yung, So-Lun Lee
BACKGROUND: The population of children receiving long-term mechanical ventilation is growing worldwide, but only limited data exist in Asian regions. The objective of the study was to review the management of these children in Hong Kong over the past 2 decades. METHODS: This was a retrospective cohort study. Hospital records from subjects receiving mechanical ventilation for >3 months were retrieved. Demographic characteristics and medical information of subjects (≤21 y old) under the care of the ventilator program at the Duchess of Kent Children's Hospital between 1997 and 2015 were reviewed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879954/comparison-of-terminal-extubation-and-terminal-weaning-as-mechanical-ventilation-withdrawal-in-icu-patients
#2
Damien Thellier, Pierre Y Delannoy, Olivier Robineau, Agnès Meybeck, Nicolas Boussekey, Arnaud Chiche, Olivier Leroy, Hugues Georges
BACKGROUND: Terminal extubation (TE) is applied in some intensive care unit (ICU) patients when a decision of withdrawal of mechanical ventilation is decided. Other units prefer terminal weaning (TW) with no removal of the endotracheal tube. We report our experience with these two procedures. METHODS: We conducted a retrospective study analyzing patients deceased in our ICU after a decision of life sustained therapy (LST) during the year 2013. TE was proposed to family members for patients presenting with two medical conditions: lack of vasoactive drugs (VAD) and SaO2 > 95% with a FIO2 < 50%...
November 23, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#3
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27843007/a-systematic-review-and-meta-analysis-of-intensive-multidisciplinary-intervention-for-pediatric-feeding-disorders-how-standard-is-the-standard-of-care
#4
William G Sharp, Valerie M Volkert, Lawrence Scahill, Courtney E McCracken, Barbara McElhanon
OBJECTIVE: To assess models of care and conduct a meta-analysis of program outcomes for children receiving intensive, multidisciplinary intervention for pediatric feeding disorders. STUDY DESIGN: We searched Medline, PsycINFO, and PubMed databases (2000-2015) in peer-reviewed journals for studies that examined the treatment of children with chronic food refusal receiving intervention at day treatment or inpatient hospital programs. Inclusion criteria required the presentation of quantitative data on food consumption, feeding behavior, and/or growth status before and after intervention...
November 8, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27807279/design-and-implementation-of-pharyngeal-electrical-stimulation-for-early-de-cannulation-in-tracheotomized-phast-trac-stroke-patients-with-neurogenic-dysphagia-a-prospective-randomized-single-blinded-interventional-study
#5
Rainer Dziewas, Satish Mistry, Shaheen Hamdy, Jens Minnerup, Ingeborg Van Der Tweel, Wolf Schäbitz, Philip M Bath
RATIONALE: Ongoing dysphagia in stroke patients weaned from mechanical ventilation often requires long-term tracheotomy to protect the airway from aspiration. In a recently reported single-centre pilot study, a significantly larger proportion (75%) of tracheotomized dysphagic stroke patients regained sufficient control of airway management allowing tracheotomy tube removal (decannulation) 24-72 h after pharyngeal electrical stimulation (PES) compared to controls who received standard therapy over the same time period (20%)...
November 2, 2016: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/27793231/non-invasive-mechanical-ventilation-after-the-successful-weaning-a-comparison-with-the-venturi-mask
#6
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...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27784322/spontaneous-breathing-trial-and-post-extubation-work-of-breathing-in-morbidly-obese-critically-ill-patients
#7
Martin Mahul, Boris Jung, Fabrice Galia, Nicolas Molinari, Audrey de Jong, Yannaël Coisel, Rosanna Vaschetto, Stefan Matecki, Gérald Chanques, Laurent Brochard, Samir Jaber
BACKGROUND: Predicting whether an obese critically ill patient can be successfully extubated may be specially challenging. Several weaning tests have been described but no physiological study has evaluated the weaning test that would best reflect the post-extubation inspiratory effort. METHODS: This was a physiological randomized crossover study in a medical and surgical single-center Intensive Care Unit, in patients with body mass index (BMI) >35 kg/m(2) who were mechanically ventilated for more than 24 h and underwent a weaning test...
October 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27677861/can-diaphragmatic-ultrasonography-performed-during-the-t-tube-trial-predict-weaning-failure-the-role-of-diaphragmatic-rapid-shallow-breathing-index
#8
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
https://www.readbyqxmd.com/read/27677033/weaning-results-of-a-consecutive-series-of-125-adolescent-idiopathic-scoliosis-treated-by-the-new-lyon-brace-art-brace
#9
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
https://www.readbyqxmd.com/read/27676204/time-to-decannulation-and-associated-risk-factors-in-the-post-acute-rehabilitation-of-critically-ill-patients-with-intensive-care-unit-acquired-weakness-a-cohort-study
#10
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
https://www.readbyqxmd.com/read/27642461/reduced-plasma-concentrations-of-vitamin-b6-and-increased-plasma-concentrations-of-the-neurotoxin-3-hydroxykynurenine-are-associated-with-nodding-syndrome-a-case-control-study-in-gulu-and-amuru-districts-northern-uganda
#11
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
https://www.readbyqxmd.com/read/27639509/-non-invasive-mechanical-ventilation-after-the-successful-weaning-a-comparison-with-the-venturi-mask
#12
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
https://www.readbyqxmd.com/read/27625446/evaluation-of-a-mapleson-d-cpap-system-for-weaning-of-mechanical-ventilation-in-pediatric-patients
#13
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
https://www.readbyqxmd.com/read/27561025/-predictors-of-extubation-failure-in-neurosurgical-patients
#14
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
https://www.readbyqxmd.com/read/27502103/bosentan-as-adjunctive-therapy-for-persistent-pulmonary-hypertension-of-the-newborn-results-of-the-randomized-multicenter-placebo-controlled-exploratory-trial
#15
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
https://www.readbyqxmd.com/read/27468525/gastrostomy-tube-weaning-and-treatment-of-severe-selective-eating-in-childhood-experience-in-israel-using-an-intensive-three-week-program
#16
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
https://www.readbyqxmd.com/read/27386708/managing-the-weaning-of-a-temporary-tracheostomy
#17
REVIEW
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
https://www.readbyqxmd.com/read/27366397/the-comparison-of-automatic-tube-compensation-atc-and-t-piece-during-weaning
#18
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
https://www.readbyqxmd.com/read/27339104/implementation-of-a-respiratory-rehabilitation-protocol-weaning-from-the-ventilator-and-tracheostomy-in-difficult-to-wean-patients-with-spinal-cord-injury
#19
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
https://www.readbyqxmd.com/read/27333201/a-descriptive-comparison-of-approaches-to-paediatric-tube-weaning-across-five-countries
#20
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
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