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Mechanical ventilation

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https://www.readbyqxmd.com/read/29156019/the-aspartate-transaminase-alanine-transaminase-deritis-ratio-predicts-mid-term-mortality-and-renal-and-respiratory-dysfunction-after-left-ventricular-assist-device-implantation
#1
Kevin Pilarczyk, Henning Carstens, Jens Heckmann, Ali Canbay, Achim Koch, Nikolaus Pizanis, Heinz Jakob, Markus Kamler
OBJECTIVES: Preoperative liver dysfunction is a well-known risk factor for adverse events after major surgery. However, there is only little data regarding the precise role of the Model of End-Stage Liver Disease (MELD) score and the De Ritis ratio (DRR, alanine transaminase/aspartate aminotransferase) as a predictor for outcome after left ventricular assist device (LVAD) implantation. METHODS: A retrospective analysis of all patients undergoing LVAD implantation at our institution between January 2012 and August 2014 was performed...
October 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29155460/antarctic-emerald-rockcod-have-the-capacity-to-compensate-for-warming-when-uncoupled-from-co2-acidification
#2
Brittany E Davis, Erin E Flynn, Nathan A Miller, Frederick A Nelson, Nann A Fangue, Anne E Todgham
Increases in atmospheric CO2 levels and associated ocean changes are expected to have dramatic impacts on marine ecosystems. Although the Southern Ocean is experiencing some of the fastest rates of change, few studies have explored how Antarctic fishes may be affected by co-occurring ocean changes, and even fewer have examined early life stages. To date, no studies have characterized potential trade-offs in physiology and behavior in response to projected multiple climate change stressors (ocean acidification and warming) on Antarctic fishes...
November 20, 2017: Global Change Biology
https://www.readbyqxmd.com/read/29154419/clinical-profiles-and-prognosis-of-acute-heart-failure-in-adult-patients-with-dystrophinopathies-on-home-mechanical-ventilation
#3
Abdallah Fayssoil, Rabah Ben Yaou, Adam Ogna, France Leturcq, Olivier Nardi, Bernard Clair, Karim Wahbi, Frederic Lofaso, Pascal Laforet, Denis Duboc, David Orlikowski, Djillali Annane
AIMS: Duchenne muscular dystrophy (DMD) is characterized by respiratory and heart involvements. In the context of permanently wheelchair bound and on mechanical ventilation (MV) patients, the clinical presentation of acute heart failure (AHF) syndrome may be atypical. We sought to describe clinical and genetic profiles and to determine prognosis of DMD and Becker muscular dystrophy (BMD) patients on home MV (HMV), hospitalized for AHF. METHODS AND RESULTS: We included genetically proven DMD and BMD patients on HMV admitted for AHF...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29153959/after-hours-respiratory-physiotherapy-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-an-australian-perspective
#4
Lisa van der Lee, Anne-Marie Hill, Shane Patman
INTRODUCTION: Community acquired pneumonia (CAP) is a common reason for admission to an intensive care unit for intubation and mechanical ventilation, and results in high morbidity and mortality. The primary aim of the study was to investigate availability and provision of respiratory physiotherapy, outside of normal business hours, for intubated and mechanically ventilated adults with CAP in Australian hospitals. MATERIALS AND METHODS: A cross-sectional, mixed methods online survey was conducted...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153826/performance-evaluation-of-phase-angle-and-handgrip-strength-in-patients-undergoing-cardiac-surgery-prospective-cohort-study
#5
Taís Kereski da Silva, Ingrid Dalira Schweigert Perry, Janete Salles Brauner, Orlando Carlos Belmonte Weber, Gabriela Corrêa Souza, Sílvia Regina Rios Vieira
BACKGROUND AND AIMS: The phase angle (PA), derived from bioelectrical impedance analysis (BIA), has been interpreted as a cell membrane integrity indicator, while handgrip strength (HGS) has been used as a prognostic indicator in certain clinical situations, such as in cardiac, oncologic patients with renal disease, hemodialysis patients, HIV-positive patients, and liver disease patients. In addition to prognostic scores, body changes due to surgical procedures indicate the importance of measuring muscle function and cell integrity...
November 16, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#6
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152933/ventilator-induced-lung-injury-does-it-occur-in-children
#7
Martin C Kneyber
Mechanical ventilation is one of the most practiced interventions in the paediatric intensive care unit (PICU). Although unmistakable life-saving, it can also injury the lung, a process coined ventilator induced lung injury (VILI). To date, almost all of our knowledge VILI has been obtained from studies in adults or experimental studies mimicking the adult critical care situation. This leaves the question if VILI is of importance in the paediatric context. Paediatric clinical studies did not confirm an association between large tidal volume (Vt) and adverse outcome...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29152912/physiological-and-anatomical-dead-space-in-mechanically-ventilated-newborn-infants
#8
Theodore Dassios, Paul Dixon, Ann Hickey, Sotirios Fouzas, Anne Greenough
OBJECTIVES: To compare the anatomical (VD-Ana ) and alveolar dead space (VD-Alv ) in term and prematurely born infants and identify the clinical determinants of those indices. WORKING HYPOTHESIS: VD-Ana and VD-Alv will be higher in prematurely born compared to term born infants. STUDY DESIGN: Retrospective analysis of data collected at King's College Hospital NHS Foundation Trust, London, UK. PATIENT SELECTION: Fifty-six infants (11 term, 45 preterm) were studied at a median age of 8 (IQR 2-33) days...
November 20, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29152895/survey-of-financial-burden-of-families-in-the-u-s-with-children-using-home-mechanical-ventilation
#9
Jeffrey D Edwards, Howard B Panitch, Andrei Constantinescu, Rachel L Miller, Patricia W Stone
AIM: To describe and quantify the out-of-pocket expenses, employment loss, and other financial impact related to caring for a child using home mechanical ventilation (HMV). METHOD: We conducted a cross-sectional survey of U.S. families with children who used HMV. Eligible participants were invited to complete a questionnaire addressing household and child characteristics, out-of-pocket expenses, employment loss/reduction, and financial stress. Participants were recruited with the help of three national patient registries...
November 20, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29152465/reproducibility-of-diaphragm-thickness-measurements-by-ultrasonography-in-patients-on-mechanical-ventilation
#10
Ashesh Dhungana, Gopi Khilnani, Vijay Hadda, Randeep Guleria
AIM: To prospectively evaluate the reproducibility of diaphragm thickness measurement by ultrasonography at the bedside by critical care physicians in patients on invasive mechanical ventilation. METHODS: In a prospective observational study of 64 invasively ventilated patients, diaphragmatic thickness measurement was taken by 2 different observers at the same site. Three measurements were taken by each observer and averaged. The intraobserver and interobserver variability was assessed by estimation of intraclass correlation coefficient...
November 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29152423/foodborne-botulism-i-only-had-nacho-cheese-a-case-report
#11
Saad A Choudhry, Muhammad Jahanzaib Anwar, Muhammad Afzal, Abdul Shah
A 32-year-old female presented to the emergency department with complaints of diplopia, followed by dyspnea, chest tightness, congestion, and dysphagia. The patient was resuscitated and initial investigations were done. Within a few hours of the admission, she started developing signs of respiratory failure and was intubated and placed on the mechanical ventilator. The patient denied any ingestion of exotic food, shellfish, raw meat, or raw fish. The patient also denied traveling to any exotic place or recent camping trips...
September 8, 2017: Curēus
https://www.readbyqxmd.com/read/29152421/severe-acute-respiratory-distress-syndrome-after-laparoscopic-appendectomy-in-a-young-adult
#12
Gabriel O Ologun, Daniel Ridley, Nhean D Chea, Daniel Golden, Anne Lihau-N'Kanza, Philip McPhail
Severe acute respiratory distress syndrome after laparoscopic appendectomy for acute appendicitis in a young adult is an uncommon complication. We describe the case of a 25-year-old male who developed severe acute respiratory distress syndrome after an uneventful laparoscopic appendectomy for a perforated appendix, requiring mechanical ventilation in the intensive care unit.
September 8, 2017: Curēus
https://www.readbyqxmd.com/read/29151499/effects-of-rhubarb-on-intestinal-dysmotility-in-critically-ill-patients
#13
Kentaro Shimizu, Mitsuru Kageyama, Hiroshi Ogura, Tomoki Yamada, Takeshi Shimazu
Intestinal dysmotility is a major problem in critically ill patients. This report describes the successful treatment of intestinal dysmotility with rhubarb as a laxative in six critically ill patients on mechanical ventilation.. Bowel movement and defecation occurred in all patients an average of 1.8 days after the administration of powdered rhubarb. In 4 patients who also had gastric reflux, the reflux volume via nasal tube was decreased an average of 3.5 days after the initiation of rhubarb treatment, and enteral nutrition was able to be started...
November 20, 2017: Internal Medicine
https://www.readbyqxmd.com/read/29151423/-guiding-significance-of-diaphragm-function-evaluation-in-ventilation-weaning
#14
Jieying Luo, Xiaotong Han, Maiying Fan, Hui Wen, Jing Xu, Yanfang Pei, Ying Huang
Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation (MV). Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit (ICU), which is simple, non-invasive, and easy to operate...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151417/-effect-of-early-use-of-different-doses-of-enteral-nutrition-on-prognosis-of-patients-with-acute-respiratory-failure
#15
Jianting Gao, Qiuyan Wang
OBJECTIVE: To observe the impact of initial low-dose (trophic type) enteral nutrition (EN) support on mechanical ventilation (MV) time, the incidence of complications and survival rate in patients with acute respiratory failure (ARF). METHODS: A prospective study was conducted. Forty-four patients with ARF undergoing MV admitted to Department of Critical Care Medicine of Hangzhou Traditional Chinese Medical Hospital from September 2015 to February 2017 were enrolled, and they were divided into a trophic feeding group (n = 23, study group) and a standard-dose feeding group (n = 21, control group)...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151413/-effects-of-mechanical-ventilation-on-diaphragmatic-contractile-function-in-patients-with-aecopd
#16
Feifei Wang, Xiaoping Zhu, Changjing Zhang, Hui Zhu, Yu Feng, Yang Liu, Shaolin Ma
OBJECTIVE: To study diaphragmatic strength in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) during mechanical ventilation (MV), and to explore the predictive value of maximal transdiaphragm pressure (Pdi max) for successful extubation. METHODS: A prospective study was conducted. Twenty-one patients with AECOPD receiving MV admitted to intensive care unit (ICU) of Shanghai East Hospital of Tongji University of School Medicine from February 2015 to May 2017 were enrolled...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#17
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte(®) ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg(-1) . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#18
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#19
Gianluigi Li Bassi, Mauro Panigada, Otavio T Ranzani, Alberto Zanella, Lorenzo Berra, Massimo Cressoni, Vieri Parrini, Hassan Kandil, Giovanni Salati, Paola Selvaggi, Alessandro Amatu, Miquel Sanz-Moncosi, Emanuela Biagioni, Fernanda Tagliaferri, Mirella Furia, Giovanna Mercurio, Antonietta Costa, Tullio Manca, Simone Lindau, Jaksa Babel, Marco Cavana, Chiara Chiurazzi, Joan-Daniel Marti, Dario Consonni, Luciano Gattinoni, Antonio Pesenti, Janine Wiener-Kronish, Cecilia Bruschi, Andrea Ballotta, Pierpaolo Salsi, Sergio Livigni, Giorgio Iotti, Javier Fernandez, Massimo Girardis, Maria Barbagallo, Gabriella Moise, Massimo Antonelli, Maria Luisa Caspani, Antonella Vezzani, Patrick Meybohm, Vladimir Gasparovic, Edoardo Geat, Marcelo Amato, Michael Niederman, Theodor Kolobow, Antoni Torres
PURPOSE: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). METHODS: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#20
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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