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Ventilator associated events

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https://www.readbyqxmd.com/read/29906680/an-updated-assessment-of-morbidity-and-mortality-following-skull-base-surgical-approaches
#1
Brittany N Burton, Jenny Q Hu, Aria Jafari, Richard D Urman, Ian F Dunn, W Linda Bi, Adam S DeConde, Rodney A Gabriel
OBJECTIVES: Updated multi-institutional database studies assessing perioperative risk factors on 30-day morbidity and mortality after skull base surgeries are limited. We aim to identify perioperative risk factors and report the incidence of 30-day morbidity and mortality in adult patients after skull base surgery. PATIENTS AND METHODS: We queried the 2007-2016 American College of Surgeons National Surgical Quality Improvement program database to identify patients who underwent anterior, middle, or posterior skull base surgery...
June 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29899704/the-relationship-between-respiratory-related-premotor-potentials-and-small-perturbations-in-ventilation
#2
Anna L Hudson, Marie-Cécile Niérat, Mathieu Raux, Thomas Similowski
Respiratory-related premotor potentials from averaged electroencephalography (EEG) over the motor areas indicate cortical activation in healthy participants to maintain ventilation in the face of moderate inspiratory or expiratory loads. These experimental conditions are associated with respiratory discomfort, i.e., dyspnea. Premotor potentials are also observed in resting breathing in patients with reduced automatic respiratory drive or respiratory muscle strength due to respiratory or neurological disease, presumably in an attempt to maintain ventilation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29888382/performance-of-the-oxylog%C3%A2-1000-portable-ventilator-in-a-hyperbaric-environment
#3
Lie Sui An, Loy Shun Ting, Lee Cheng Chuan, Kim Soo Joang, Soh Chai Rick
INTRODUCTION: The management of mechanically ventilated patients in the hyperbaric environment requires knowledge of how the physical properties of gases change under pressure and how this affects the operation of the ventilator. The primary objective of this study was to test the performance of the Dräger Oxylog 1000® ventilator in a hyperbaric environment. METHODS: Each of two ventilators was connected to a mechanical test lung system with an in-built pressure gauge...
June 30, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29884487/a-role-for-very-low-dose-recombinant-activated-factor-vii-in-refractory-bleeding-after-cardiac-surgery-lessons-from-an-observational-study
#4
Till Hoffmann, Alexander Assmann, Angelika Dierksen, Elisabeth Roussel, Sebastian Ullrich, Artur Lichtenberg, Alexander Albert, Stephan Sixt
OBJECTIVES: Although off-label use of recombinant activated factor VII against refractory bleeding is incorporated in current guideline recommendations, safety concerns persist predominantly with respect to thromboembolic complications. We analyzed the safety and efficacy of recombinant activated factor VII at a very low dose in cardiosurgical patients with refractory bleeding. METHODS: This prospective study includes 1180 cardiosurgical patients at risk of bleeding...
April 18, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29882346/efficacy-of-prophylactic-dexmedetomidine-in-preventing-postoperative-junctional-ectopic-tachycardia-in-pediatric-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#5
REVIEW
Laxmi V Ghimire, Fu-Sheng Chou
BACKGROUND: Junctional ectopic tachycardia is a serious tachyarrhythmic complication following pediatric cardiac surgery. It is difficult to manage and is associated with significant morbidity and mortality. Conventional nonpharmacological and pharmacological measures have shown limited effects. Dexmedetomidine is an α2 agonist which has recently been shown in multiple studies to be effective. AIMS: The aim of this systematic review with meta-analysis was to evaluate the efficacy of prophylactic dexmedetomidine administration in the prevention of junctional ectopic tachycardia in pediatric patients following cardiac surgeries...
June 7, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29881987/management-and-outcomes-of-acute-respiratory-distress-syndrome-patients-with-and-without-comorbid-conditions
#6
Elie Azoulay, Virginie Lemiale, Bruno Mourvillier, Maite Garrouste-Orgeas, Carole Schwebel, Stéphane Ruckly, Laurent Argaud, Yves Cohen, Bertrand Souweine, Laurent Papazian, Jean Reignier, Guillaume Marcotte, Shidasp Siami, Hatem Kallel, Michael Darmon, Jean-François Timsit
RATIONALE: The standard of care for patients with acute respiratory distress syndrome (ARDS) has been developed based on studies that usually excluded patients with major comorbidities. OBJECTIVES: To describe treatments and outcomes according to comorbidities in patients with ARDS admitted to 19 ICUs (1997-2014). METHODS: Patients were grouped based on comorbidities. Determinants of day-28 mortality were identified by multivariable Cox analysis stratified on center...
June 7, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29880507/abnormal-ventilation-perfusion-scan-is-associated-with-pulmonary-hypertension-in-sickle-cell-adults
#7
Alem Mehari, Norris Igbineweka, Darlene Allen, Jim Nichols, Swee Lay Thein, Nargues A Weir
Pulmonary hypertension (PH) in adults with sickle cell disease (SCD) is associated with early mortality. Chronic thromboembolic pulmonary hypertension (CTEPH) is an important complication and contributor to PH in SCD, but likely underappreciated. Guidelines recommend ventilation-perfusion scintigraphy (V/Q) as imaging modality of choice to exclude CTEPH. Data on V/Q are limited in SCD. Objective: To compare the performance of V/Q with computed tomography pulmonary angiography (CTPA) and to report clinical outcomes associated with abnormal V/Q...
June 7, 2018: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/29863636/cricoid-pressure-during-induction-for-tracheal-intubation-in-critically-ill-children-a-report-from-national-emergency-airway-registry-for-children
#8
Taiki Kojima, Ilana Harwayne-Gidansky, Asha N Shenoi, Erin B Owen, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ron C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: Cricoid pressure is often used to prevent regurgitation during induction and mask ventilation prior to high-risk tracheal intubation in critically ill children. Clinical data in children showing benefit are limited. Our objective was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in PICU. DESIGN: A retrospective cohort study of a multicenter pediatric airway quality improvement registry...
June 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29862492/interventions-for-preventing-upper-gastrointestinal-bleeding-in-people-admitted-to-intensive-care-units
#9
REVIEW
Ingrid Toews, Aneesh Thomas George, John V Peter, Richard Kirubakaran, Luís Eduardo S Fontes, Jabez Paul Barnabas Ezekiel, Joerg J Meerpohl
BACKGROUND: Upper gastrointestinal (GI) bleeding due to stress ulcers contributes to increased morbidity and mortality in people admitted to intensive care units (ICUs). Stress ulceration refers to GI mucosal injury related to the stress of being critically ill. ICU patients with major bleeding as a result of stress ulceration might have mortality rates approaching 48.5% to 65%. However, the incidence of stress-induced GI bleeding in ICUs has decreased, and not all critically ill patients need prophylaxis...
June 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29802440/-patient-endangerment-due-to-device-diversity-discussion-of-a-risk-factor-based-on-the-results-of-two-surveys-of-german-hospitals
#10
K Lange, A Brinker, M Nowak, C Zöllner, W Lauer
BACKGROUND: The Federal Institute for Drugs and Medical Devices (BfArM) was notified of an event in which it was not possible to sufficiently ventilate a patient suffering a severe asthma attack. It turned out that the ventilation pressures used by the device for pressure-controlled ventilation were below the values set by the user, which the user was not aware of. The ventilation pressures chosen by the user exceeded the preset alarm limits of the ventilator. This pressure and alarm management significantly differed from that of other ventilators used in the hospital...
May 25, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29796368/adverse-outcomes-and-prediction-of-cardiopulmonary-complications-in-elective-spine-surgery
#11
Peter G Passias, Gregory W Poorman, Edward Delsole, Peter L Zhou, Samantha R Horn, Cyrus M Jalai, Shaleen Vira, Bassel Diebo, Virginie Lafage
Study Design: Retrospective cohort study. Objectives: The purpose of this study was to report incidence of cardiopulmonary complications in elective spine surgery, demographic and surgical predictors, and outcomes. Understanding the risks and predictors of these sentinel events is important for risk evaluation, allocation of hospital resources, and counseling patients. Methods: A retrospective review of the National Surgical Quality Improvement Program (NSQIP) was performed on 60 964 patients undergoing elective spine surgery (any region; laminectomy, arthrodesis, discectomy, or laminoplasty) between 2011 and 2013...
May 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29789465/efficacy-safety-and-usability-of-remifentanil-as-premedication-for-insure-in-preterm-neonates
#12
Hadiyah Y Audil, Sara Tse, Chad Pezzano, Amy Mitchell-van Steele, Joaquim M B Pinheiro
Background : We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives : To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil's safety and usability in a teaching hospital context. Methods : Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU)...
May 22, 2018: Children
https://www.readbyqxmd.com/read/29785655/early-results-after-operatively-versus-non-operatively-treated-flail-chest-a-retrospective-study-focusing-on-outcome-and-complications
#13
Mathieu M E Wijffels, Tjebbe Hagenaars, Diba Latifi, Esther M M Van Lieshout, Michael H J Verhofstad
PURPOSE: Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications...
May 21, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29784517/treprostinil-improves-persistent-pulmonary-hypertension-associated-with-congenital-diaphragmatic-hernia
#14
Kendall M Lawrence, Holly L Hedrick, Heather M Monk, Lisa Herkert, Lindsay N Waqar, Brian D Hanna, William H Peranteau, Natalie E Rintoul, Rachel K Hopper
OBJECTIVE: To evaluate the effect of continuous treprostinil in infants with severe pulmonary hypertension associated with congenital diaphragmatic hernia (CDH) on specific markers of pulmonary hypertension severity and to report the safety and tolerability of treprostinil. STUDY DESIGN: We conducted a retrospective cohort study of infants with CDH-associated pulmonary hypertension treated with treprostinil from January 2011 to September 2016. Severity of pulmonary hypertension was assessed by echocardiogram and serum B-type natriuretic peptide (BNP) by using time points before initiation and 24 hours, 1 week, and 1 month after treprostinil initiation...
May 18, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29770752/ventilator-bundle-compliance-and-risk-of-ventilator-associated-events
#15
Bryan D Harris, Gale A Thomas, Matthew H Greene, Steven S Spires, Thomas R Talbot
OBJECTIVEVentilator bundles encompass practices that reduce the risk of ventilator complications, including ventilator-associated pneumonia. The impact of ventilator bundles on the risk of developing ventilator-associated events (VAEs) is unknown. We sought to determine whether decreased compliance to the ventilator bundle increases the risk for VAE development.DESIGNNested case-control study.SETTINGThis study was conducted at 6 adult intensive care units at an academic tertiary-care center in Tennessee.PATIENTSIn total, 273 patients with VAEs were randomly matched in a 1:4 ratio to controls by mechanical ventilation duration and ICU type...
June 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29770192/safety-and-efficacy-of-n-acetyl-cysteine-for-prophylaxis-of-ventilator-associated-pneumonia-a-randomized-double-blind-placebo-controlled-clinical-trial
#16
Mojtaba Sharafkhah, Ali Abdolrazaghnejad, Nader Zarinfar, Abolfazl Mohammadbeigi, Ali Massoudifar, Sahand Abaszadeh
Ventilator-associated-pneumonia (VAP) is characterized by morbidity, mortality, and prolonged length of stay in intensive care unit (ICU). The present study aimed to examine the effect of N-acetyl-cysteine (NAC) in preventing VAP in patients hospitalized in ICU. We performed a prospective, randomized, double-blind, placebo-controlled trial of 60 mechanically ventilated patients at high risk of developing VAP. NAC (600 mg/twice daily) and placebo (twice daily) were administered to NAC group ( n = 30) and control group ( n = 30), respectively, through the nasogastric tube in addition to routine care...
January 2018: Medical Gas Research
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#17
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29768017/the-signaling-network-resulting-in-ventilator-induced-diaphragm-dysfunction
#18
Huibin Tang, Joseph B Shrager
Mechanical ventilation (MV) is a life-saving measure for those incapable of adequately ventilating or oxygenating without assistance. Unfortunately, even brief periods of MV result in diaphragm weakness (i.e., "ventilator-induced diaphragm dysfunction" - VIDD) that may render it difficult to wean the ventilator. Prolonged MV is associated with cascading complications and is a strong risk factor for death. Thus, prevention of VIDD may have a dramatic impact on mortality rates. Here, we summarized the current understanding of the pathogenic events underlying VIDD...
May 16, 2018: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#19
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29755626/the-impact-of-admission-serum-creatinine-on-major-adverse-clinical-events-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention
#20
Poornima Vinod, Taylor Kann, Shyam Polaconda, Alibel Bello, Mohamed Khayata, Fernando Munoz, Vinod Krishnappa, Rupesh Raina
Background: Impaired renal function has been shown in previous studies to be an independent predictor of cardiovascular adverse events amongst patients admitted for percutaneous coronary intervention (PCI) following ST-segment elevation myocardial infarction (STEMI). This study investigates the impact of admission serum creatinine (SCr) on major cardiovascular outcomes among STEMI patients undergoing PCI. Methods: A retrospective study of patients admitted for PCI following STEMI was conducted using the National Cardiovascular Database Action Registry (NCDR) at Cleveland Clinic Akron General (CCAG) Hospital...
April 2018: Cardiology Research
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