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Ventilator associated events

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https://www.readbyqxmd.com/read/28720671/the-impact-of-ventilator-associated-events-in-critically-ill-subjects-with-prolonged-mechanical-ventilation
#1
Hidetsugu Kobayashi, Shigehiko Uchino, Masanori Takinami, Shoichi Uezono
BACKGROUND: The Centers for Disease Control and Prevention recently released a surveillance definition for respiratory complications in ventilated patients, ventilator-associated events (VAE), to replace ventilator-associated pneumonia (VAP). VAE consists of ventilator-associated conditions (VAC), infection-related ventilator-associated complications (IVAC), and possible VAP. A duration of mechanical ventilation of at least 4 d is required to diagnose VAE. However, the observed duration of mechanical ventilation was < 4 d in many previous studies...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28697252/association-of-positive-airway-pressure-with-cardiovascular-events-and-death-in-adults-with-sleep-apnea-a-systematic-review-and-meta-analysis
#2
REVIEW
Jie Yu, Zien Zhou, R Doug McEvoy, Craig S Anderson, Anthony Rodgers, Vlado Perkovic, Bruce Neal
Importance: Sleep apnea (obstructive and central) is associated with adverse cardiovascular risk factors and increased risks of cardiovascular disease. Positive airway pressure (PAP) provides symptomatic relief, whether delivered continuously (CPAP) or as adaptive servo-ventilation (ASV), but the associations with cardiovascular outcomes and death are unclear. Objective: To assess the association of PAP vs control with cardiovascular events and death in patients with sleep apnea...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#3
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28695347/telavancin-in-the-treatment-of-concurrent-staphylococcus-aureus-bacteremia-a-retrospective-analysis-of-atlas-and-attain-studies
#4
Samuel E Wilson, Donald R Graham, Whedy Wang, Jon B Bruss, Bibiana Castaneda-Ruiz
INTRODUCTION: Concurrent Staphylococcus aureus bacteremia (SAB) worsens outcomes and increases mortality in patients with complicated skin and skin structure infections (cSSSI), hospital-acquired bacterial pneumonia, and ventilator-associated bacterial pneumonia (HABP/VABP). These challenges highlight the need for alternative treatments. Telavancin (TLV), a bactericidal lipoglycopeptide with high in vitro potency, effectively treats patients with cSSSI and HABP/VABP caused by Gram-positive pathogens, particularly S...
July 10, 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#5
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
July 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28682883/nivolumab-induced-myasthenia-gravis-in-a-patient-with-squamous-cell-lung-carcinoma-case-report
#6
Yu-Hsiu Chen, Feng-Cheng Liu, Chang-Hung Hsu, Chih-Feng Chian
RATIONALE: Nivolumab (Nivo) is an immune checkpoint inhibitor that has been used to treat advanced melanoma, nonsmall cell lung carcinoma, and renal cell carcinoma since 2015. Nivo is associated with several side effects, including hepatitis, pneumonitis, acute renal failure, endocrine disorder, and other immune-related adverse events. Here, we describe the case of a 65-year-old man with squamous cell lung carcinoma who developed myasthenia gravis (MG) after a third Nivo infusion. PATIENT CONCERNS: A 65-year-old man with advanced squamous cell lung carcinoma developed ptosis, diplopia, drop head, and general weakness 5 days after a third Nivo infusion...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28676203/-frequency-type-and-predictors-of-pleuropulmonary-complications-during-the-first-thirty-days-after-cardiopulmonary-bypass-surgery-in-children
#7
Jessica Jacqueline Hernández-López, Alejandro Solano-Gutiérrez, Flor Teresita Rosas-Aragón, Airam Gabriela Antúnez-Soto, Janet Flores-Lujano, Juan Carlos Nuñez-Enríquez
OBJECTIVE: To determine the frequency, type and predictors of pleuropulmonary complications in the first thirty postoperative days of patients undergoing surgery without cardiopulmonary bypass. METHODS: A retrospective cohort study was carried out between January 2013 and December 2014. It includes all patients with congenital heart disease who underwent cardiac surgery with a sternal or thoracic approach, without cardiopulmonary bypass with a registered admission to Neonatal or Pediatric Intensive Care...
July 1, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28675094/effect-of-increased-body-mass-index-on-complication-rates-during-laryngotracheal-surgery-utilizing-jet-ventilation
#8
Rachel A Barry, Daniel S Fink, Dusty Cole Pourciau, Kasey Hayley, Rachael Lanius, Schuylor Hayley, Eddy Sims, Andrew J McWhorter
Objective Jet ventilation has been used for >30 years as an anesthetic modality for laryngotracheal surgery. Concerns exist over increased risk with elevated body mass index (BMI). We reviewed our experience using jet ventilation for laryngotracheal stenosis to assess for complication rates with substratification by BMI. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods A total of 126 procedures with jet ventilation were identified from October 2006 to December 2014...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28667196/patient-safety-during-procedural-sedation-using-capnography-monitoring-a-systematic-review-and-meta-analysis
#9
Rhodri Saunders, Michel M R F Struys, Richard F Pollock, Michael Mestek, Jenifer R Lightdale
OBJECTIVE: To evaluate the effect of capnography monitoring on sedation-related adverse events during procedural sedation and analgesia (PSA) administered for ambulatory surgery relative to visual assessment and pulse oximetry alone. DESIGN AND SETTING: Systematic literature review and random effects meta-analysis of randomised controlled trials (RCTs) reporting sedation-related adverse event incidence when adding capnography to visual assessment and pulse oximetry in patients undergoing PSA during ambulatory surgery in the hospital setting...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28658042/coagulation-profile-as-a-risk-factor-for-30-day-morbidity-following-cervical-laminectomy-and-fusion
#10
Rachel S Bronheim, Eric K Oermann, Samuel K Cho, John M Caridi
STUDY DESIGN: Retrospective analysis of prospectively collected data. OBJECTIVE: To determine the ability of abnormal coagulation profile to predict adverse events following Posterior cervical laminectomy and fusion (PCLF). SUMMARY OF BACKGROUND DATA: PCLF is an increasingly common procedure used to treat a variety of traumatic and degenerative spinal conditions. Abnormal coagulation profile is associated with postoperative adverse events, including blood transfusion...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28652112/multinational-retrospective-case-control-study-of-risk-factors-for-the-development-of-late-invasive-pulmonary-aspergillosis-following-kidney-transplantation
#11
Francisco López-Medrano, Mario Fernández-Ruiz, José Tiago Silva, Peggy L Carver, Christian van Delden, Esperanza Merino, María José Pérez-Saez, Milagros Montero, Julien Coussement, Milene de Abreu Mazzolin, Carlos Cervera, Lidia Santos, Nuria Sabé, Anne Scemla, Elisa Cordero, Leónidas Cruzado-Vega, Paloma Leticia Martín-Moreno, Óscar Len, Eddison Rudas, Alfredo Ponce de León, Mariano Arriola, Ricardo Lauzurica, Miruna D David, Claudia González-Rico, Fernando Henríquez-Palop, Jesús Fortún, Marcio Nucci, Oriol Manuel, José Ramón Paño-Pardo, Miguel Montejo, Antonio Vena, Beatriz Sánchez-Sobrino, Auxiliadora Mazuecos, Julio Pascual, Juan Pablo Horcajada, Thanh Lecompte, Asunción Moreno, Jordi Carratalà, Marino Blanes, Domingo Hernández, Erick Alejandro Hernández-Méndez, María Carmen Fariñas, Manuel Perelló-Carrascosa, Patricia Muñoz, Amado Andrés, José María Aguado
OBJECTIVES: To assess the risk factors for the development of late-onset invasive pulmonary aspergillosis (IPA) after kidney transplantation (KT). METHODS: We performed a multinational case-control study that retrospectively recruited 112 KT recipients diagnosed with IPA between 2000 and 2013. Controls were matched (1:1 ratio) by center and date of transplantation. Immunosuppression-related events (IREs) included the occurrence of non-ventilator-associated pneumonia, tuberculosis, cytomegalovirus disease and/or de novo malignancy...
June 23, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28644101/safety-and-cost-efficiency-of-a-restrictive-transfusion-protocol-in-patients-with-traumatic-brain-injury
#12
Laura B Ngwenya, Catherine G Suen, Phiroz E Tarapore, Geoffrey T Manley, Michael C Huang
OBJECTIVE Blood loss and moderate anemia are common in patients with traumatic brain injury (TBI). However, despite evidence of the ill effects and expense of the transfusion of packed red blood cells, restrictive transfusion practices have not been universally adopted for patients with TBI. At a Level I trauma center, the authors compared patients with TBI who were managed with a restrictive (target hemoglobin level > 7 g/dl) versus a liberal (target hemoglobin level > 10 g/dl) transfusion protocol. This study evaluated the safety and cost-efficiency of a hospital-wide change to a restrictive transfusion protocol...
June 23, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28628002/-bundle-practices-and-ventilator-associated-events-not-enough-erratum
#13
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28618390/thirty-day-non-seizure-outcomes-following-temporal-lobectomy-for-adult-epilepsy
#14
Brandon A Sherrod, Matthew C Davis, Kristen O Riley
OBJECTIVE: Multi-institutional rates of acute adverse outcomes other than seizures after temporal lobectomy (TL) are not well understood. Here we analyzed short-term morbidity and mortality following TL using a validated national database. PATIENTS AND METHODS: The multi-institutional American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was queried by Current Procedural Terminology (CPT) code for TL procedures performed for adult patients with diagnoses related to epilepsy from 2008 to 2014...
June 8, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28617038/relation-of-subclinical-serum-creatinine-elevation-to-adverse-in-hospital-outcomes-among-myocardial-infarction-patients
#15
Gilad Margolis, Amir Gal-Oz, Shafik Khoury, Gad Keren, Yacov Shacham
BACKGROUND: Acute kidney injury is associated with adverse outcomes after acute ST elevation myocardial infarction (STEMI). It remains unclear, however, whether subclinical increase in serum creatinine that does not reach the consensus criteria for acute kidney injury is also related to adverse outcomes in STEMI patients undergoing primary percutaneous coronary intervention. METHODS: We conducted a retrospective study of 1897 consecutive STEMI patients between January 2008 and May 2016 who underwent primary percutaneous coronary intervention, and in whom acute kidney injury was not diagnosed throughout hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28616212/hypophosphatemia-in-critically-ill-patients-with-acute-kidney-injury-treated-with-hemodialysis-is-associated-with-adverse-events
#16
Cynthia Lim, Han Khim Tan, Manish Kaushik
Background. Hypophosphatemia in critically ill patients may be exacerbated by renal replacement therapy (RRT). We aimed to identify risk factors and adverse outcomes associated with hypophosphatemia in intensive care patients treated with RRT for acute kidney injury (AKI). Methods. This was a secondary analysis of data from a single-center prospective cohort study of medical and surgical intensive care patients with RRT for AKI between 18 December 2010 and 3 April 2013. Demographic, comorbidity, laboratory and RRT data were retrieved from patient case notes and electronic medical records...
June 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28614140/a-comparison-of-clinical-characteristics-and-outcomes-of-ventilator-associated-pneumonias-among-burn-patients-by-diagnostic-criteria-set
#17
Duraid Younan, Russell Griffin, Thomas Swain, Eric Schinnerer, Jean-Francois Pittet, Bernard Camins
OBJECTIVES: The National Healthcare Safety Network (NHSN) replaced its old definition for ventilator associated pneumonia (VAP) with ventilator associated events (VAEs) in 2013. Little data is available comparing the two definitions in burn patients. METHODS: Data from 2011-2014 were collected on burn patients mechanically ventilated for at least two days. VAP was determined using two methods: (1) pneumonia as defined by the previous more clinical CDC (NHSN) definition captured in the burn registry; (2) pneumonia as defined by the recent CDC (NHSN) standard of Ventilator-Associated Events where patients meeting the criteria for possible VAP (PVAP) were considered having a pneumonia...
June 13, 2017: Shock
https://www.readbyqxmd.com/read/28612697/what-is-the-applicability-of-a-novel-surveillance-concept-of-ventilator-associated-events
#18
Miia Jansson, Tero Ala-Kokko, Lauri Ahvenjärvi, Jaana Karhu, Pasi Ohtonen, Hannu Syrjälä
BACKGROUND In 2013, the Centers for Disease Control and Prevention released a novel surveillance concept called the "ventilator-associated event," which focused surveillance on objective measures of complications among patients that underwent invasive ventilations. OBJECTIVE To evaluate the concordance and possible differences in efficacy (ie, disease severity and outcomes) between 2 surveillance paradigms: (1) infection-related ventilator-associated complications (iVAC) and (2) on conventional ventilator-associated pneumonia (VAP)...
June 14, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28607334/interhospital-transfer-of-critically-ill-patients
#19
Thomas Kiss, Alisa Bölke, Peter M Spieth
Transportation of a patient between medical facilities without interruption of the medical treatment can be a challenging task. This review aims to define the term "interhospital transport" and give a general overview of the steps for organizing a transfer. Furthermore we discuss the team qualification, equipment standards and how to manage adverse events before and during transport by means of patient triage. The advanced interhospital transport of the critically ill patient can be defined as follows: "transportation of a patient between medical facilities without interruption of the medical treatment and monitoring due to the underlying disease by means of specific medical, technical equipment and knowledge with the objective of improved patient care"...
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28606716/the-relation-between-given-volume-and-heart-rate-during-newborn-resuscitation
#20
J E Linde, J Schulz, J M Perlman, K Øymar, L Blacy, H Kidanto, H L Ersdal
BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR...
June 9, 2017: Resuscitation
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