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"Mechanical Ventilation" AND "Emergency"

Xiao Lu, ChunShuang Wu, YuZhi Gao, Mao Zhang
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy has been shown to reduce the need for mechanical ventilation and decrease the duration of hospital and intensive care unit (ICU) stays for patients with a severely compromised respiratory system. This study aims to observe the evolution of lung aeration via lung ultrasound score (LUS) in a chest-injured population who had been treated with HFNC oxygen therapy, and to assess the benefit of the HFNC oxygen therapy in trauma patients...
December 4, 2018: Journal of Intensive Care Medicine
Ying-Ming Shih, Marcus S Cooke, Chih-Hong Pan, Mu-Rong Chao, Chiung-Wen Hu
A reliable and fast liquid chromatography-tandem mass spectrometry method has been developed for the simultaneous determination of three oxidized nucleic acid damage products in urine, 8-oxoguanine (8-oxoGua), 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodGuo) and 8-oxo-7,8-dihydroguanosine (8-oxoGuo). We applied this method to assess the effect of various urine workup procedures on the urinary concentrations of the oxidized nucleic acid products. Our results showed that frozen urine samples must be warmed (i...
November 26, 2018: Redox Biology
Toribiong Uchel, Shahniwaz Labana, Stephanie Tancer, Victoria Gonzalez, Daniel Kapadia, Zain Kulairi, Muhammad Kashlan
BACKGROUND Lymphatic circulation in the thorax enters the systemic blood flow at the subclavian vein. Instances where diversion occurs leads to complications such as pleural effusion. A rare complication of lymphatic diversion results in fluid accumulation in the bronchial tree, causing plastic bronchitis. The following case is the first ever report of plastic bronchitis presenting with pneumopericardium. CASE REPORT A 24-year-old female presented to our Emergency Department with an asthma exacerbation. After initiating bronchodilators, a chest radiograph (CXR) showed extensive subcutaneous emphysema, pneumomediastinum, and pneumothorax with atelectasis of the left lung...
December 3, 2018: American Journal of Case Reports
Rodolfo Espinoza, José Roberto Lapa E Silva, Anke Bergmann, Ulisses de Oliveira Melo, Flávio Elias Calil, Robson Correa Santos, Jorge I F Salluh
OBJECTIVE: Describe characteristics and outcomes of CAP admitted to public ICUs in Brazil. METHODS: Retrospective cohort study in 4 Tertiary Public Hospitals in Rio de Janeiro, Brazil during 2016. Patients admitted to ICUs with a diagnosis of community-acquired pneumonia were included. Clinical and outcomes data were collected from Epimed Monitor System. RESULTS: From 7902 admissions, 802 patients (10, 1%) were included and analyzed. Main source of admission was the emergency department (78, 3%)...
November 22, 2018: Journal of Critical Care
Leanne M Aitken, Tracey Bucknall, Bridie Kent, Marion Mitchell, Elizabeth Burmeister, Samantha J Keogh
BACKGROUND: The sedation needs of critically ill patients have been recognized as a core component of critical care that is vital to assist recovery and ensure humane treatment. Evidence suggests that sedation requirements are not always optimally managed. Suboptimal sedation, both under- and over-sedation, have been linked to short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Strategies to improve sedation assessment and management have been proposed...
November 12, 2018: Cochrane Database of Systematic Reviews
V Abraham, B J Manley, L S Owen, M J Stewart, P G Davis, C T Roberts
The Paediatric Infant and Perinatal Emergency Retrieval (PIPER) service based in Melbourne, Victoria performs approximately 2800 transfers of neonates and young infants annually, of which >1100 are emergency transfers. Respiratory distress is common in this population, and treatment has traditionally been provided with nasal continuous positive airway pressure (CPAP), or endotracheal mechanical ventilation (MV). Heated, humidified nasal high-flow (nHF) treatment is increasingly popular in neonatal care,(1) including in tertiary and non-tertiary centres in Victoria...
November 21, 2018: Acta Paediatrica
Varun Mehta, Rajesh Kumar, Siddharth Parkash, Sanjeev Singla, Arshdeep Singh, Jagdeep Chaudhary, Hardeep Bains
BACKGROUND/AIMS: Necrotizing pancreatitis has morbidity and mortality rates exceeding most of the other acute medical emergencies despite the best possible medical and surgical care. Early surgical intervention has a high operative risk. MATERIALS AND METHODS: This prospective open-label study was designed to evaluate the role of percutaneous catheter drainage (PCD) of pancreatic necrosis as primary treatment of acute necrotizing pancreatitis. An ultrasound/computed tomography-guided drainage was performed with 10 or 12 Fr catheters using a 0...
November 16, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Hayden Hyatt, Rafael Deminice, Toshinori Yoshihara, Scott K Powers
Prolonged skeletal muscle inactivity (e.g. limb immobilization, bed rest, mechanical ventilation, spinal cord injury, etc.) results in muscle atrophy that manifests into a decreased quality of life and in select patient populations, a higher risk of morbidity and mortality. Thus, understanding the processes that contribute to muscle atrophy during prolonged periods of muscle disuse is an important area of research. In this regard, mitochondrial dysfunction has been directly linked to the muscle wasting that occurs during extended periods of skeletal muscle inactivity...
November 16, 2018: Archives of Biochemistry and Biophysics
Stefan Knecht, Bettina Studer
Neurorehabilitation comprises medical and functional treatment. If patients in the post-hospital phase need acute medical interventions but these cannot be provided by the rehabilitation center, patients must be referred to suitable acute care hospitals; however, such referrals incur additional costs, are fraught with medical risks and delay further rehabilitation. We evaluated how integrating non-neurological medical specialties and a hospital unit into a neurorehabilitation center affects the rate of acute hospital referrals...
November 16, 2018: Der Nervenarzt
Ipek Saadet Edipoglu, Fatma Celik, Elif Cirakoglu Marangoz, Gulin Haroglu Orcan
BACKGROUND: While foetal distress is typically associated with ischaemic injury, few studies have assessed neonatal morbidity for emergency caesarean section. Moreover, the decision of the anaesthetic technique may be of paramount importance in emergency caesareans, because of the limited time and increased risk. We aimed to evaluate the effect of the anaesthetic technique on neonatal morbidity in emergency caesarean indicated for foetal distress. METHODS: This was a single-centre, prospective observational study, conducted between July-2015 and December-2015...
2018: PloS One
Radek Vančata, Jan Lhotský, Václav Beránek, Josef Krištof, Richard Rokyta
Severe carbon monoxide intoxication may cause tissue injury by hypoxemia and histotoxicity. The affection of the heart muscle often leads to transient global or regional systolic dysfunction of left ventricle or both ventricles and increased occurences of malignant arrhytmias. On the contrary, stress-induced cardiomyopathy is described as temporary segmental loss of contractility, mostly in apical segments of the left ventricle with mid- and basal sparing and less common hypokinesias in mid- or basal parts, or affection of both ventricles...
2018: Vnitr̆ní Lékar̆ství
Holly E Depinet, Michelle Eckerle, Olga Semenova, Jareen Meinzen-Derr, Lynn Babcock
OBJECTIVE: To inform the future development of a pediatric prehospital sepsis tool, we sought to 1) describe the characteristics, emergent care, and outcomes for children with septic shock who are transported by emergency medicine services (EMS) and compare them to those self-transported; and 2) determine the EMS capture rate of common sepsis screening parameters and the concordance between the parameters documented in the EMS record and in the emergency department (ED) record. METHODS: This is a retrospective cohort study of children ages 0 through 21 years who presented to a pediatric ED with septic shock between 11/2013 and 06/2016...
November 15, 2018: Prehospital Emergency Care
Thamer Kassim, Toufik Mahfood Haddad, Amandeep Rakhra, Amjad Kabach, Ahmad Qurie, Mohammad Selim, Ali S Nayfeh, Ahmed Aly, Mark J Holmberg
Amitriptyline is a widely prescribed tricyclic antidepressant (TCA) with a very concerning cardiotoxicity profile, but it is one that has not been discussed much in literature. Here, we present a case of amitriptyline toxicity presenting as myocarditis with pericardial involvement. A 21-year-old male with no previous cardiac history presented to the emergency department (ED) with a decreased level of consciousness after an amitriptyline overdose as a suicidal attempt. For concerns with airway protection, the patient was intubated and subsequently admitted to the intensive care unit (ICU)...
June 19, 2018: Curēus
Bradley Icard, Douglas J Grider, Sameh Aziz, Edmundo Rubio
Hyalinizing clear cell carcinomas (HCCC), now referred to as clear cell carcinomas (CCC) by the World Health Organization (WHO), are rare tumors usually arising from the salivary glands of the head and neck. We present the first case of a CCC originating from the trachea. A 66 year-old woman with history of hypertension, former smoker, presented to the emergency department reporting worsening shortness of breath. Computed chest tomography revealed a polypoid mass arising from the left posterior-lateral wall of the trachea...
November 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Motohiro Asaki, Takamitsu Masuda, Yasuo Miki
A 57-year-old man presented to the emergency department with fever and progressive altered level of consciousness of 5 days' duration. Three days before admission, influenza A was diagnosed at a clinic. On admission, his vital signs were unstable. Pneumonia was diagnosed through chest computed tomography, and urinary Legionella antigen test was positive. A diagnosis of septic shock due to Legionella and influenza pneumonia was made, and critical care management was initiated, including mechanical ventilation and vasopressors...
2018: Case Reports in Critical Care
Page E Crew, Winston E Abara, Lynda McCulley, Peter E Waldron, Robert D Kirkcaldy, Emily J Weston, Kyle T Bernstein, S Christopher Jones, Susan J Bersoff-Matcha
Background: Gonorrhea is the second most commonly reported notifiable condition in the United States (U.S.). Infrequently, Neisseria gonorrhoeae can cause disseminated gonococcal infection (DGI). Eculizumab, a monoclonal antibody, inhibits terminal complement activation which impairs the ability of the immune system to respond effectively to Neisseria infections. This series describes cases of N. gonorrhoeae infection among patients receiving eculizumab. Methods: Pre- and postmarketing safety reports of N...
November 12, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Petronella Bjurling-Sjöberg, Barbro Wadensten, Ulrika Pöder, Inger Jansson, Lena Nordgren
BACKGROUND: Clinical pathways can enhance care quality, promote patient safety and optimize resource utilization. However, they are infrequently utilized in intensive care. This study aimed to explain the implementation process of a clinical pathway based on a bottom-up approach in an intensive care context. METHODS: The setting was an 11-bed general intensive care unit in Sweden. An action research project was conducted to implement a clinical pathway for patients on mechanical ventilation...
November 6, 2018: BMC Health Services Research
Siva P Namachivayam, Warwick Butt, Johnny Millar, Igor E Konstantinov, Cattram Nguyen, Yves d'Udekem
OBJECTIVES: Early peritoneal dialysis may have a role in modulating the inflammatory response after cardiopulmonary bypass. This study sought to test the effect of early peritoneal dialysis on major adverse events after pediatric cardiac surgery involving cardiopulmonary bypass. DESIGN: In this observational study, the outcomes in infants post cardiac surgery who received early peritoneal dialysis (within 6 hr of completing cardiopulmonary bypass) were compared with those who received late peritoneal dialysis...
November 5, 2018: Pediatric Critical Care Medicine
J Grensemann, M Simon, S Kluge
In acute respiratory insufficiency, oxygenation and/or ventilation support by mechanical ventilation is an integral part of intensive care and emergency medicine. Effective airway management is essential to prevent hypoxic complications during the securing of the airway. This includes for example the recognition of difficult airways and adequate pre-oxygenation. While the laryngeal tube can be used in the context of cardiopulmonary resuscitation in emergency medicine, endotracheal intubation is standard in intensive care medicine...
November 5, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Federico Germini, Giacomo Veronese, Maura Marcucci, Daniele Coen, Deborah Ardemagni, Nicola Montano, Andrea Fabbri
Exacerbations of chronic obstructive pulmonary disease (COPDE) frequently require hospitalizations, may necessitate of invasive mechanical ventilation (IMV), and are associated with a remarkable in-hospital mortality. The BAP-65 score is a risk assessment model (RAM) based on simple variables, that has been proposed for the prediction of these adverse outcomes in patients with COPDE. If showed to be accurate, the BAP-65 RAM might be used to guide the patients management, in terms of destination and treatment...
October 31, 2018: European Journal of Internal Medicine
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