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"Mechanical Ventilation" AND "Emergency"

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https://www.readbyqxmd.com/read/30097303/intraoperative-initiation-of-a-modified-ardsnet-protocol-increases-survival-of-septic-patients-with-severe-acute-respiratory-distress-syndrome
#1
Athanasios Chalkias, Theodoros Xanthos, Effie Papageorgiou, Artemis Anania, Apostolos Beloukas, Fotios Pavlopoulos
PURPOSE: To assess the intraoperative initiation and feasibility of a modified NIH-NHLBI ARDS Network Mechanical Ventilation Protocol (mARDSNet protocol) in septic patients with severe ARDS. MATERIALS AND METHODS: This prospective observational study included consecutive adult septic patients with severe ARDS who underwent emergency abdominal surgery prior to intensive care unit (ICU) admission. The primary outcome was survival to hospital discharge and at 90 days...
August 7, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/30076547/characteristics-and-outcome-of-patients-with-newly-diagnosed-advanced-or-metastatic-lung-cancer-admitted-to-intensive-care-units-icus
#2
C Barth, M Soares, A C Toffart, J F Timsit, G Burghi, C Irrazabal, N Pattison, E Tobar, B F Almeida, U V Silva, L C Azevedo, A Rabbat, C Lamer, A Parrot, V C Souza-Dantas, F Wallet, F Blot, G Bourdin, C Piras, J Delemazure, M Durand, J Salluh, E Azoulay, Virginie Lemiale
BACKGROUND: Although patients with advanced or metastatic lung cancer have poor prognosis, admission to the ICU for management of life-threatening complications has increased over the years. Patients with newly diagnosed lung cancer appear as good candidates for ICU admission, but more robust information to assist decisions is lacking. The aim of our study was to evaluate the prognosis of newly diagnosed unresectable lung cancer patients. METHODS: A retrospective multicentric study analyzed the outcome of patients admitted to the ICU with a newly diagnosed lung cancer (diagnosis within the month) between 2010 and 2013...
August 4, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/30056844/development-and-testing-of-a-novel-anaesthesia-induction-ventilation-protocol-for-patients-with-cardiogenic-shock-complicating-acute-myocardial-infarction
#3
Athanasios Chalkias, Fotios Pavlopoulos, Effie Papageorgiou, Christos Tountas, Artemis Anania, Maria Panteli, Apostolos Beloukas, Theodoros Xanthos
BACKGROUND: Cardiogenic shock is a life-threatening condition and patients might require rapid sequence induction (RSI) and mechanical ventilation. In this study, we evaluated a new RSI/mechanical ventilation protocol in patients with acute myocardial infarction complicated by cardiogenic shock. METHODS: We included consecutive adult patients who were transferred to the emergency department. The RSI protocol included 5 phases: preoxygenation, pretreatment, induction/paralysis, intubation, and mechanical ventilation (PPIIM)...
August 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/30050258/spontaneous-pneumoperitoneum-in-pediatric-patients-dilemmas-in-management
#4
Rahul Gupta
Context: Pneumoperitoneum is typically a surgical emergency, particularly in neonates. However, pneumoperitoneum can rarely present without gastrointestinal perforation which is known as spontaneous pneumoperitoneum. Aims: This study aims to analyze the outcome of pediatric patients with spontaneous pneumoperitoneum and describe our experience. Settings and Design: A retrospective study performed from January 2014 to May 2017. Materials and Methods: The study included all pediatric patients admitted in a tertiary care institute...
July 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/30045800/-ultrasonic-monitoring-of-carotid-blood-flow-in-interposed-abdominal-pulling-pressing-cardiopulmonary-resuscitation
#5
Nan Zhang, Hong Zhang, Zheng Ni, Shaohong Shang, Gang Chen, Liying Zhang, Xiang Li, Jingwei Zhu, Zheng Cao, Suxia Ma
OBJECTIVE: To explore the difference in ultrasonic monitoring in carotid blood flow, resuscitation effects and prognosis between interposed abdominal pulling-pressing cardiopulmonary resuscitation (IAPP-CPR) and standard cardiopulmonary resuscitation (STD-CPR). METHODS: Seventy-five cardiac arrest (CA) patients admitted to emergency department of Shijingshan Teaching Hospital of Capital Medical University from June 2015 to December 2017 were enrolled. The patients were divided into STD-CPR group and IAPP-CPR group according to the treatment orders of them and the desire of relatives...
July 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/30045333/chlorine-gas-inhalation-manifesting-with-severe-acute-respiratory-distress-syndrome-successfully-treated-by-high-volume-hemofiltration-a-case-report
#6
Lian Wang, Dingqian Wu, Jianqiang Wang
RATIONALE: There have been occasional reports of respiratory dysfunction associated with acute chlorine gas inhalation. However, management of acute chlorine-related inhalation injury is largely empirical, supportive, and sometimes challenging. PATIENT CONCERNS: A 43-year-old man was transferred to the emergency department because of accidental chlorine inhalation and rapidly progressive dyspnea. DIAGNOSES: The patient was diagnosed with acute respiratory distress syndrome due to chlorine gas exposure...
July 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30045296/an-analysis-of-the-relationship-between-the-applied-medical-rescue-actions-and-the-return-of-spontaneous-circulation-in-adults-with-out-of-hospital-sudden-cardiac-arrest
#7
Klaudiusz Nadolny, Lukasz Szarpak, Joanna Gotlib, Mariusz Panczyk, Maciej Sterlinski, Jerzy Robert Ladny, Jacek Smereka, Robert Galazkowski
Sudden cardiac arrest (SCA) is a significant medical and social issue, the main cause of death in Europe and the United States.The aim of the research was to evaluate the effectiveness of emergency medical procedures applied by emergency medical teams in prehospital care in the context of return of spontaneous circulation (ROSC).The case-control study was based on the medical documentation of the Rescue Service in Katowice (responsible for monitoring 2.7 million inhabitants of the region) referring to 2016...
July 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/30031375/miller-fisher-syndrome-bickerstaff-brainstem-encephalitis-and-guillain-barr%C3%A3-syndrome-overlap-with-persistent-non-demyelinating-conduction-blocks-a-case-report
#8
Angela Puma, Jeanne Benoit, Sabrina Sacconi, Antonino Uncini
BACKGROUND: Miller Fisher syndrome (MFS) and Bickerstaff's Brainstem Encephalitis (BBE) share some clinical features and a common immunological profile characterized by anti-GQ1b antibodies. Some MFS patients overlap with Guillain-Barré syndrome (GBS) or BBE. We report a patient with MFS, BBE, and axonal GBS overlap in whom serial electrophysiological studies showed persistent motor conduction blocks (CBs). CASE PRESENTATION: A 61-year-old man acutely developed ophtalmoparesis, ataxia and areflexia suggesting MFS...
July 21, 2018: BMC Neurology
https://www.readbyqxmd.com/read/30013702/simple-changes-to-emergency-department-workflow-improve-analgesia-in-mechanically-ventilated-patients
#9
Derek L Isenberg, Katrina M Kissman, Ellie P Salinski, Mark A Saks, Loreen B Evans
Introduction: In 2013 the Society for Critical Care Medicine (SCCM) published guidelines for the management of pain and agitation in the intensive care unit (ICU). These guidelines recommend using an analgesia-first strategy in mechanically ventilated patients as well as reducing the use of benzodiazepines. Benzodiazepines increase delirium in ICU patients thereby increasing ICU length of stay. We sought to determine whether a simple educational intervention for emergency department (ED) staff, as well as two simple changes in workflow, would improve adherence to the SCCM guidelines...
July 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30007823/inspiratory-muscle-training-for-intensive-care-patients-a-multidisciplinary-practical-guide-for-clinicians
#10
REVIEW
Bernie Bissett, I Anne Leditschke, Margot Green, Vince Marzano, Sarajane Collins, Frank Van Haren
OBJECTIVES: To describe a multidisciplinary approach to inspiratory muscle training (IMT) for patients in the intensive care unit (ICU). BACKGROUND: Inspiratory muscle weakness is a known consequence of prolonged mechanical ventilation, and there is emerging evidence that specific IMT can ameliorate this weakness. However, IMT is not yet standard practice in many ICUs, possibly because of the wide variety of methods reported and a lack of published practical guidelines...
July 11, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29999603/sustained-lung-inflation-at-birth-via-short-binasal-prong-in-very-low-birth-weight-preterm-infants-a-retrospective-study
#11
Mehmet Buyuktiryaki, Hayriye G Kanmaz, Nilufer Okur, Handan Bezirganoglu, Buse Bekmez, Gulsum Kadioglu Simsek, Fuat E Canpolat, Suna S Oguz, Cuneyt Tayman
BACKGROUND AND OBJECTIVES: It is believed, that sustained lung inflation (SLI) at birth in preterm infants reduces the need for mechanical ventilation (MV) and improves respiratory outcomes. The aim of this study was to compare need for MV in preterm infants at high risk for respiratory distress syndrome (RDS) after prophylactic SLI via short binasal prongs at birth combined with early nasal continuous positive airway pressure (nCPAP) versus nCPAP alone. METHODS: Medical records of infants born at 260/7 to 296/7 weeks gestation through 2015 and 2017 were retrospectively assessed...
July 12, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29998395/a-comparison-of-short-term-outcomes-between-laparoscopic-and-open-emergent-repair-of-perforated-peptic-ulcers
#12
Daniel L Davenport, Walker R Ueland, Shyanie Kumar, Margaret Plymale, Andrew C Bernard, J Scott Roth
BACKGROUND: We compared 30-day outcomes in patients undergoing emergent open and laparoscopic repair of perforated peptic ulcers in a large multicenter cohort. METHODS: Prospectively obtained data in the American College of Surgeons National Surgical Quality Improvement Program public use files from 2010 to 2016 were reviewed. Perioperative risks and outcomes were compared in unmatched and propensity-matched groups using parametric/non-parametric statistical tests as appropriate...
July 11, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29998357/a-research-pathway-for-the-study-of-the-delivery-and-disposition-of-nebulised-antibiotics-an-incremental-approach-from-in-vitro-to-large-animal-models
#13
Jayesh A Dhanani, Jeremy Cohen, Suzanne L Parker, Hak-Kim Chan, Patricia Tang, Benjamin J Ahern, Adeel Khan, Manoj Bhatt, Steven Goodman, Sara Diab, Jivesh Chaudhary, Jeffrey Lipman, Steven C Wallis, Adrian Barnett, Michelle Chew, John F Fraser, Jason A Roberts
BACKGROUND: Nebulised antibiotics are frequently used for the prevention or treatment of ventilator-associated pneumonia. Many factors may influence pulmonary drug concentrations with inaccurate dosing schedules potentially leading to therapeutic failure and/or the emergence of antibiotic resistance. We describe a research pathway for studying the pharmacokinetics of a nebulised antibiotic during mechanical ventilation using in vitro methods and ovine models, using tobramycin as the study antibiotic...
July 11, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29981630/analysis-of-helicopter-transported-trauma-patients-at-a-regional-trauma-center
#14
Christina Sebastian, Kevin Collopy, Thomas V Clancy, Elizabeth Acquista
Our medical center's regional helicopter emergency medical service (HEMS) serves southeastern North Carolina. Judicious HEMS use is vital to ensure that the resource is available for critically injured patients and to reduce morbidity and mortality by providing timely access to definitive care. We reviewed HEMS use, clinical outcomes, and overtriage rates. The data included airlifted trauma patients from January 2004 to December 2012. Of 1210 total patients, 733 were flown directly from the scene (FS) and 477 from referring hospitals (FH)...
June 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29981456/outbreak-of-hypervirulent-klebsiella-pneumoniae-harboring-bla-vim-2-among-mechanically-ventilated-drug-poisoning-patients-with-high-mortality-outcome-in-iran
#15
Amir Mohammad Ali Tabrizi, Farzad Badmasti, Fereshteh Shahcheraghi, Omid Azizi
OBJECTIVES: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infections are associated with increased rate of treatment failure and death. Several studies have reported isolates with combined hypervirulent and antibiotics resistance phenotype. METHODS: Herein, we studied molecular characteristics of hypervirulent K. pneumoniae isolated from mechanically ventilated patients admitted to toxicological ICU. String test, antibiotic susceptibility, virulence factors and plasmid replicon typing were carried out...
July 4, 2018: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/29977935/an-unusual-cause-of-failure-to-ventilate
#16
John T Denny, Sagar S Mungekar, Benjamin R Landgraf, Zoe M Rocke, Valerie A McRae, Christian P McDonough, James T Tse, Scott J Mellender, Geza K Kiss
We report an unusual case of endotracheal tube failure. It was due to a manufacturing defect in the internal white plastic piece that is normally depressed by the luer-lock syringe within the blue pilot balloon. Prior to use, the endotracheal tube was tested and functioned normally. A 64-year-old patient in the intensive care unit with a history of hypertension was being mechanically ventilated after uneventful abdominal surgery. After several hours in the intensive care unit, he was noted to be suddenly no longer receiving adequate tidal volumes from the ventilator...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29977788/diffusion-weighted-magnetic-resonance-imaging-directed-biopsy-of-a-metastatic-bone-tumor-lung-adenocarcinoma-with-alk-rearrangement
#17
Makoto Hibino, Yuka Otsuka, Kazunari Maeda, Shigeto Horiuchi, Minoru Fukuda, Tetsuri Kondo
A previously healthy 44-year-old Japanese man with a 5-month history of lumbago presented to the emergency department with acute respiratory failure caused by pneumonia, and was immediately intubated. Computed tomography revealed a lung mass, pleural effusion, and multiple osteolytic lesions; however, the results of thoracentesis and bronchial brushing were not definitive. We performed a bone tumor biopsy guided by diffusion-weighted magnetic resonance imaging (DW-MRI) with mechanical ventilation, which enabled the diagnosis of ALK rearrangement-positive lung adenocarcinoma...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29977498/incidence-mechanisms-and-impact-outcome-of-hyperglycaemia-in-severe-scorpion-envenomed-patients
#18
REVIEW
Mabrouk Bahloul, Olfa Turki, Anis Chaari, Mounir Bouaziz
Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed, hyperglycaemia was associated with the severity of clinical manifestations of severe scorpion envenomation requiring intensive care unit (ICU) admission. In fact, the presence of hyperglycaemia was associated with the presence of respiratory failure, pulmonary oedema, haemodynamic instability, neurological failure, multisystem organ failure, and an increased mortality and ICU length of stay...
July 2018: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29977465/sepsis-in-a-panorama-what-the-cardiovascular-physician-should-know
#19
REVIEW
Deepa B Gotur
Sepsis accounts for an estimated 30 million cases and 6 million deaths globally each year. According to a multidisciplinary task force convened by the Society of Critical Care Medicine and European Society of Intensive Care Medicine, sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. Sepsis is a medical emergency, so much so that the World Health Organization made it a global health priority. Since patients with cardiovascular diseases have unique risk factors for sepsis, prompt and accurate diagnosis is critical...
April 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29974010/capillary-leak-syndrome-aggravated-by-influenza-type-a-infection
#20
James L Lawrence, Hussam Hindi
A 41-year-old female presented to the emergency department with nausea, vomiting, and diarrhea. Five days prior to this, she tested positive for influenza type A in an urgent care clinic and received Tamiflu. She also complained of generalized weakness in her extremities. Her initial labs were concerning for a grossly elevated hemoglobin and hematocrit despite adequate fluid resuscitation. Her condition continued to worsen as she developed distal cyanosis in all of her extremities and pulselessness. She was treated with IV hydration, bicarbonate, heparin, vasopressors, albumin replacement, Tamiflu, and phlebotomy...
April 30, 2018: Curēus
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