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"Mechanical Ventilation" AND "Emergency"

Andrea Wolfler, Gianfranco Raimondi, Cecilia Pagan de Paganis, Elena Zoia
INTRODUCTION: Bronchiolitis is one of the most frequent reasons for PICU admission in children less than 1 year of age. It causes a wide spectrum of clinical scenarios from mild to severe respiratory failure and supportive therapy range from HFNC to nonconventional ventilation and ECMO in the most severe forms. Aim of this article is to review the available ventilation mode in children with bronchiolitis and the scientific evidence. EVIDENCE ACQUISITION: The main medical databases were explored to search for clinical trials that address management strategies for respiratory support of infants with RSV infection...
October 18, 2018: Minerva Pediatrica
Laura Fuchs Bahlis, Luciano Passamani Diogo, Ricardo de Souza Kuchenbecker, Sandra Costa Fuchs
OBJECTIVE: To describe the patient profile, mortality rates, the accuracy of prognostic scores, and mortality-associated factors in patients with community-acquired pneumonia (CAP) in a general hospital in Brazil. METHODS: This was a cohort study involving patients with a clinical and laboratory diagnosis of CAP and requiring admission to a public hospital in the interior of Brazil between March 2014 and April 2015. We performed multivariate analysis using a Poisson regression model with robust variance to identify factors associated with in-hospital mortality...
July 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
Berit Lindahl, Sue Kirk
AIM: To analyse and synthesise the research that has investigated the experience of home in relation to home mechanical ventilation (HMV). METHOD: Systematic integrative review. Four electronic databases (CINAHL, PubMed, Scopus and ISI Web of Knowledge) were searched between January 2010 and April 2017 as well as reference lists of included studies. Quantitative and qualitative studies meeting the inclusion criteria were critically appraised. Study findings were inductively analysed and synthesised using the integrative approach...
October 15, 2018: Scandinavian Journal of Caring Sciences
Nisha Krishnakant Raiker, Hector Cajigas
A 49-year-old man presented to the emergency department with acute-onset dyspnoea and hypoxaemia 1 day following nasal surgery for obstructive sleep apnoea. A chest X-ray showed diffuse bilateral pulmonary infiltrates. Supplemental 100% fractional inspired oxygen (FiO2 ) via non-rebreather mask was delivered with resulting arterial oxygen tension:FiO2 ratio of 67. Transthoracic echocardiogram demonstrated normal heart function. A clinical diagnosis of severe acute respiratory distress syndrome (ARDS) was promptly made...
October 12, 2018: BMJ Case Reports
Elizabeth Lee Daugherty Biddison, Ruth Faden, Howard S Gwon, Darren P Mareiniss, Alan C Regenberg, Monica Schoch-Spana, Jack Schwartz, Eric S Toner
The threat of a catastrophic public health emergency causing life threatening illness or injury on a massive scale has prompted extensive federal, state, and local preparedness efforts. Modeling studies suggest that an influenza pandemic similar to that of 1918 would require ICU and mechanical ventilation capacity that is significantly greater than what is available. Several groups have published recommendations for allocating life-support measures during a public health emergency. Because there are multiple ethically permissible approaches to allocating scarce life-sustaining resources and because the public will bear the consequences of these decisions, knowledge of public perspectives and moral points of reference on these issues is critical...
October 11, 2018: Chest
Yi Cai, Johnathan Ross Renew, Robert Ratzlaff
Acute porphyria is a group of rare disorders in the biosynthesis pathway of heme that can result in severe neurovisceral attacks leading to morbidity and mortality. Perioperative complications have been largely prevented due to avoidance of precipitants and early treatment of symptoms. However, these measures may not always be successful, because not all physiological stressors can be evaded. This case illustrates a porphyria attack precipitated by prolonged cardiopulmonary bypass that manifested as postoperative delayed emergence, failure to wean from mechanical ventilation, autonomic insufficiency requiring significant vasoactive agents, and, ultimately, failure to thrive...
October 11, 2018: A&A practice
Mark Schieren, Andreas B Böhmer, Rolf Lefering, Thomas Paffrath, Frank Wappler, Jerome Defosse
INTRODUCTION: Chest trauma and obesity are both associated with increased risks for respiratory complications (e.g. hypoxia, hypercarbia, pneumonia), which are frequent causes of posttraumatic morbidity and mortality. However, as there is only limited and inconsistent evidence, the aim of our study was to analyse the effect of body mass index (BMI) on patient outcomes after thoracic trauma. PATIENTS AND METHODS: We screened 50.519 patients entered in TraumaRegister DGU® , between 2004-2009, when the BMI was part of the standardized dataset...
September 28, 2018: Injury
Yun Tae Jung, Myung Jun Kim, Jae Gil Lee, Seung Hwan Lee
Mechanical ventilation (MV) is the most common therapeutic modality used for critically ill patients. However, prolonged MV is associated with high morbidity and mortality. Therefore, it is important to avoid both premature extubation and unnecessary prolongation of MV. Although some studies have determined the predictors of early weaning success and failure, only a few have investigated these factors in critically ill surgical patients who require postoperative MV. The aim of this study was to evaluate predictors of early weaning failure from MV in critically ill patients who had undergone emergency gastrointestinal (GI) surgery...
October 2018: Medicine (Baltimore)
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Acute respiratory distress syndrome (ARDS) is not a failure of the neurological command of the ventilatory muscles or of the ventilatory muscles; it is an oxygenation defect. As positive pressure ventilation impedes the cardiac function, paralysis under general anaesthesia and controlled mandatory ventilation should be restricted to the interval needed to control the acute cardio-ventilatory distress observed upon admission into the critical care unit (CCU; "salvage therapy" during "shock state")...
September 2018: Turkish Journal of Anaesthesiology and Reanimation
Andreas Schönfeld, B Jensen, H M Orth, D Tappe, T Feldt, D Häussinger
Clinical presentation of leptospirosis ranges from asymptomatic infection to fulminant, life-threatening disease. Pulmonary involvement in terms of severe pulmonary haemorrhage syndrome (SPHS) has recently become a more frequently reported facet of leptospirosis and correlates with high mortality rates. It has not yet been described in returning German travellers. We present a case of a healthy young man developing massive pulmonary haemorrhage and severe ARDS requiring mechanical ventilation and high-dose catecholamines after travelling to Indonesia...
September 18, 2018: Infection
Yuichiro Miura, Tatsuya Watanabe, Toshihiko Uchida, Tatsuro Nawa, Naobumi Endo, Taichi Fukuzawa, Ryuji Ohkubo, Junji Takeyama, Ayako Sasaki, Kiyoshi Hayasaka
Congenital central hypoventilation syndrome is a disorder of respiratory control caused by mutations in the paired-like homeobox 2B gene. Mutations in the paired-like homeobox 2B gene are also responsible for Hirschsprung's disease. Variant Hirschsprung's disease is a rarer disorder that does not meet the diagnostic criteria of Hirschsprung's disease, although severe functional bowel obstruction persists. We present a case of an extremely low birth weight infant with congenital central hypoventilation syndrome and variant Hirschsprung's disease...
September 15, 2018: European Journal of Medical Genetics
Min Jiang, Jun Wang, Shuangshuang Gu, Nan Cai, Yao Liu, Qiuling Zhang, Peng Xu, Fei He
OBJECTIVE: To investigate the clinical features and prognosis risk factors of the elderly and youth patients with acute severe poisoning. METHODS: Adult patients with acute severe poisoning in the emergency intensive care unit (EICU) of Nanjing Drum Tower Hospital from January 2008 to December 2017 were enrolled. The patients were divided into the elderly group (age ≥ 60 years) and the youth group (16 years ≤ age < 60 years), the clinical data of the two groups were analyzed...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Huijie Yu, Lingfang Zhang, Songao Xu, Jun Xu, Hui Sun, Xiangyun Zhu, Xiaoqin Xu, Weizhong Cao
OBJECTIVE: To observe the effects of insulin caliper for blood glucose control on glycemic central tendency, fluctuation and incidence of hypoglycemia, etc., in emergent and critical patients to evaluate its application value. METHODS: A prospective single-blinded randomized parallel controlled intervention study was conducted. One hundred patients with severe hyperglycemia requiring treatment with insulin infusion admitted to emergency department and intensive care unit (ICU) of the First Hospital of Jiaxing from November 2015 to November 2017 were enrolled, and they were divided into the caliper group (used patented product insulin calipers for blood glucose control to adjust insulin dose for blood glucose control) and the conventional group (used paper-based insulin dose modification scheme to adjust insulin dose for blood glucose control) on average by random number table, 50 in each group...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Ying Zhang, Jun Su, Jingquan Wang, Guangzhang Tang, Wei Hu, Jinghong Mao, Wanwen Ren, Yi Liu, Zhenghe Yu
Patients transferred out of the intensive care unit (ICU) are always impaired by sleep disorders. Cognitive behavioral therapy for insomnia (CBT-I) and eszopiclone are 2 commonly prescribed strategies for insomnia. In the current study, the effect of the combined application of the 2 methods on sleep disorders in ICU transferred out patients was assessed.Twenty-nine insomnia patients receiving combined treatment of CBT-I and eszopiclone and a corresponding number of patients treated with eszopiclone were collected...
September 2018: Medicine (Baltimore)
Zhi Wang, Ming Bai, Ang Zeng, Zhifei Liu, Ru Zhao, Xiaojun Wang
INTRODUCTION: Resulting mostly from major injury or infection, severe acute wounds are often accompanied by septic shock or multiple organ failure and associated with high disability and mortality rates. In managing Chinese patients with wound-derived acute severe illnesses, salvage treatment in the emergency department has traditionally prioritized life support and protection of vital organs before wound repair. OBJECTIVE: This retrospective review evaluated the outcomes of patients with wound-derived acute severe illness who were treated with a new salvage protocol that combined proactive wound care with simultaneous life-support measures...
August 2018: Wounds: a Compendium of Clinical Research and Practice
Luis R Taveras, Jonathan B Imran, Holly B Cunningham, Tarik D Madni, Roberto Taarea, Allison Tompeck, Audra T Clark, Natalie Provenzale, Folarin M Adeyemi, Christian T Minshall, Alexander L Eastman, Michael W Cripps
BACKGROUND: Open abdomen (OA) and temporary abdominal closure (TAC) are common techniques to manage several surgical problems in trauma and emergency general surgery (EGS). Patients with an OA are subjected to prolonged mechanical ventilation. This can lead to increased rates of ventilator-associated pneumonia (VAP). We hypothesized that patients who were extubated with an OA would have a decrease in ventilator hours and as a result would have a lower rate of VAP without an increase in extubation failures...
September 11, 2018: Journal of Trauma and Acute Care Surgery
R Gradl, K S Morgan, M Dierolf, C Jud, L Hehn, B Gunther, W Moller, D Kutschke, L Yang, T Stoeger, D Pfeiffer, B Gleich, K Achterhold, O Schmid, F Pfeiffer
X-ray grating interferometry is a powerful emerging tool in biomedical imaging, providing access to three complementary image modalities. In addition to the conventional attenuation modality, interferometry provides a phase modality that visualises soft tissue structures, and a dark-field modality that relates to the number and size of sub-resolution scattering objects. A particularly strong dark-field signal originates from the alveoli or air sacs in the lung. Dark-field lung radiographs in animal models have already shown increased sensitivity in diagnosing lung diseases such as lung cancer or emphysema, compared to conventional x-ray chest radiography...
September 6, 2018: IEEE Transactions on Medical Imaging
Gustavo Rocha, Paulo Soares, Américo Gonçalves, Ana Isabel Silva, Diana Almeida, Sara Figueiredo, Susana Pissarra, Sandra Costa, Henrique Soares, Filipa Flôr-de-Lima, Hercília Guimarães
Invasive ventilation is often necessary for the treatment of newborn infants with respiratory insufficiency. The neonatal patient has unique physiological characteristics such as small airway caliber, few collateral airways, compliant chest wall, poor airway stability, and low functional residual capacity. Pathologies affecting the newborn's lung are also different from many others observed later in life. Several different ventilation modes and strategies are available to optimize mechanical ventilation and to prevent ventilator-induced lung injury...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Amartya Chakraborti, Anand Jaiswal, Pushpendra Kumar Verma, Ritu Singhal
Background: Long-term mechanical ventilation in an Intensive Care Unit (ICU) exposes the patient to fungal colonization and invasive fungal disease due to the presence of indwelling catheters, administration of broad-spectrum antibiotics, and intravenous corticosteroids. A study is hence required to study the risk factors and incidence of fungal infection in these patients. Methods: A prospective observational study was carried out in the respiratory ICU of a tertiary care hospital for a period of approximately 1 year in which patients on mechanical ventilation (>7 days) were enrolled...
August 2018: Indian Journal of Critical Care Medicine
Aishwarya Govindaswamy, Vijeta Bajpai, Vivek Trikha, Samarth Mittal, Rajesh Malhotra, Purva Mathur
Elizabethkingia meningoseptica ( E. meningoseptica ) is a non-fermenting gram negative organism that is commonly detected in the soil and water but is rarely reported to cause human infection. However it is emerging as a nosocomial pathogen in patients admitted in intensive care units (ICUs). Infections caused by this organism have a high mortality rate due to lack of effective therapeutic regimens and its intrinsic resistance to multiple antibiotics. We report our experience in managing Elizabethkingia meningoseptica ( E...
August 2018: Intractable & Rare Diseases Research
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