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https://www.readbyqxmd.com/read/29161667/pre-hospital-frailty-and-hospital-outcomes-in-adults-with-acute-respiratory-failure-requiring-mechanical-ventilation
#1
Aluko A Hope, Oriade Adeoye, Elizabeth H Chuang, S J Hsieh, Hayley B Gershengorn, Michelle N Gong
PURPOSE: We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. METHODS: This is a cohort study of hospitalized adults with acute respiratory failure (ARF) who required invasive mechanical ventilation for ≥24h in 2013. We used inpatient/outpatient claims from a list of diagnoses from the year before index hospital admission to define PHF...
November 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29161297/prognostic-performance-of-mr-pro-adrenomedullin-in-patients-with-community-acquired-pneumonia-in-the-emergency-department-compared-to-clinical-severity-scores-psi-and-curb
#2
Jacopo Maria Legramante, Maria Mastropasqua, Beniamino Susi, Ottavia Porzio, Marta Mazza, Grazia Miranda Agrippino, Cartesio D Agostini, Antonella Brandi, Germano Giovagnoli, Vito Nicola Di Lecce, Sergio Bernardini, Marilena Minieri
AIM: (i) evaluate the performance of MR-pro-ADM in reflecting the outcome and risk for CAP patients in the emergency department, and (ii) compare the prognostic performance of MR-pro-ADM with that of clinical scores PSI and CURB65. METHODS: Observational prospective, single-center study in patients with suspected community acquired pneumonia (CAP). Eighty one patients underwent full clinical and laboratory assessment as by protocol, and were followed up a 28 days...
2017: PloS One
https://www.readbyqxmd.com/read/29160573/activation-of-voltage-dependent-k-channels-strongly-limits-hypoxia-induced-elevation-of-ca-2-i-in-rat-carotid-body-glomus-cells
#3
Jiaju Wang, Donghee Kim
Large-conductance KCa (BK) and other voltage-dependent K(+) channels (Kv) are highly expressed in carotid body (CB) glomus cells, but their role in hypoxia-induced excitation is still not well defined and remains controversial. We addressed this issue by studying the effects of inhibitors of BK (IBTX) and BK/Kv (TEA/4-AP) on [Ca(2+) ]i responses to a wide range of hypoxia at different levels of resting cell Em. IBTX and TEA/4-AP did not affect the basal [Ca(2+) ]i in isolated glomus cells bathed in 5 mm KClo , but elicited transient increases in [Ca(2+) ]i in cells that were moderately depolarized (11-20 mV) by elevation of [KCl]o (12-20 mm)...
November 21, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29160424/effect-of-prophylactic-non-invasive-mechanical-ventilation-on-functional-capacity-after-heart-valve-replacement-a-clinical-trial
#4
Amaro Afrânio de Araújo-Filho, Manoel Luiz de Cerqueira-Neto, Lucas de Assis Pereira Cacau, Géssica Uruga Oliveira, Telma Cristina Fontes Cerqueira, Valter Joviniano de Santana-Filho
OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group...
October 2017: Clinics
https://www.readbyqxmd.com/read/29159065/train-of-four-stimulation-artifact-mimicking-a-seizure-during-computerized-automated-icu-eeg-monitoring
#5
Laxmi P Dhakal, William O Tatum, William D Freeman
A 54-year-old man was admitted to the intensive care unit with an aneurysmal subarachnoid hemorrhage and subsequently underwent mechanical ventilation and received neuromuscular blocking drugs to control refractory elevated intracranial pressure. During quantitative EEG monitoring, an automated alert was triggered by the train of four peripheral nerve stimulation artifacts. Real-time feedback was made possible due to remote monitoring. This case illustrates how computerized, automated artificial intelligence algorithms can be used beyond typical seizure detection in the intensive care unit for remote monitoring to benefit patient care...
2017: Epilepsy & Behavior Case Reports
https://www.readbyqxmd.com/read/29158899/diaphragm-thickening-fraction-to-predict-weaning-a-prospective-exploratory-study
#6
Sujay Samanta, Ratender Kumar Singh, Arvind K Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
Background: Diaphragm ultrasound (DUS) is a well-established point of care modality for assessment of dimensional and functional aspects of the diaphragm. Amongst various measures, diaphragmatic thickening fraction (DTf) is more comprehensive. However, there is still uncertainty about its capability to predict weaning from mechanical ventilation (MV). The present prospective observational exploratory study assessed the diaphragm at variable negative pressure triggers (NPTs) with US to predict weaning in ICU patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29157220/combined-effects-of-leaks-respiratory-system-properties-and-upper-airway-patency-on-the-performance-of-home-ventilators-a-bench-study
#7
Kaixian Zhu, Claudio Rabec, Jésus Gonzalez-Bermejo, Sébastien Hardy, Sami Aouf, Pierre Escourrou, Gabriel Roisman
BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically "tolerable" leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony ("critical leak") in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA...
November 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29157044/prenatal-complications-are-associated-with-the-postnatal-airway-host-response-and-microbiota-in-intubated-preterm-infants
#8
Brandie D Wagner, Marci K Sontag, J Kirk Harris, Joshua I Miller, Lindsey Morrow, Charles E Robertson, Mark J Stephens, Brenda B Poindexter, Steven H Abman, Peter M Mourani
PURPOSE: To prospectively examine the relationship between prenatal events, postnatal airway host response and microbiota, and clinical outcomes. MATERIALS AND METHODS: Tracheal aspirates collected at 7 days of age from 71 mechanically ventilated infants (median gestational age (GA), 25 weeks [range 23-28]) were simultaneously processed for a 12-plex protein assay and bacterial identification by 16S rRNA sequencing. Phenotypes were determined by unsupervised clustering of the protein analytes...
November 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#9
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156907/the-palliative-care-needs-for-those-advanced-neurology-patients-on-mechanical-ventilator-support
#10
Tsz Kin Kwok
There are mainly two types of needs for the ventilator users with severe neurological diseases: respiratory related needs include mode of ventilation selection, mode of ventilator prescription, maintaining lung recruitment and good airway clearance; non-respiratory related needs include substantial nursing care, adequate nutrition, accessible communication and psychological support. All these are important to maintain the quality of life of these patients.
September 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156906/the-development-of-neurology-palliative-care-service-for-motor-neuron-disease-mnd-patients-hong-kong-experience
#11
Hon Wai Benjamin Cheng, Wai Tsan Tracy Chen, Chun Kwok Angus Chu, Savio Lee, Joo Shium Lee, Yeuk Fai Hong, Yuen Kwan Judy Chung
BACKGROUND: Motor neuron disease (MND) is a neurodegenerative disease characterized by loss of motor neurons in the spinal cord, brainstem and motor cortex. Clinically it is manifested as progressive decline in physical, respiratory, swallowing and communication function and ultimately death. Traditional model of care was fragmented and did not match with patients and carers multi-facet needs. METHODS: A special workgroup for MND patients that includes neurologist, respiratory physician, rehabilitation specialist and palliative care (PC) physician was formed in Hong Kong since year 2013...
September 15, 2017: Annals of Palliative Medicine
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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