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Respiratory failure the 4

Freja Stæhr Holm, Pradeesh Sivapalan, Niels Seersholm, Theis Skovsgaard Itenov, Per Hjort Christensen, Jens-Ulrik Stæhr Jensen
BACKGROUND: Gelsolin is an actin-scavenger controlling the tissue damage from actin in the blood. Gelsolin levels in circulation drops when tissue damage and corresponding actin release is pronounced due to catabolic conditions. The purpose of this study was to determine if low plasma gelsolin independently predicts a reduced chance of weaning from ventilator-demanding respiratory failure in critically ill patients within 28 days from admission. RESULTS: This cohort study included 746 critically ill patients with ventilator-demanding respiratory failure from the randomized clinical trial, "Procalcitonin And Survival Study"...
October 18, 2018: Shock
N He, Y Y Yan, Y Q Ying, M Yi, G Q Yao, Q G Ge, S D Zhai
Pharmacokinetic parameters can be significantly altered for acute kidney injury (AKI), extracorporeal membrane oxygenation (ECMO) and continuous veno-venous hemofiltration therapy (CVVH). Here we reported a case of individualized vancomycin dosing for a patient diagnosed as severe acute pancreatitis treated with concurrent ECMO and CVVH. A 65 kg 32-year-old woman was admitted to hospital presented with severe acute pancreatitis (SAP), respiratory failure, metabotropic acidosis and hyperkalemia. She was admitted to intensive care unit (ICU) on hospital day 1 and was initiated on CVVH...
October 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Kalpit Devani, Paris Charilaou, Dhruvil Radadiya, Bhaumik Brahmbhatt, Mark Young, Chakradhar Reddy
OBJECTIVES: To assess national trends of AP (acute pancreatitis) admissions, outcomes, prevalence of AKI (acute kidney injury) in AP, and impact of AKI on inpatient mortality. METHODS: We queried the Nationwide Inpatient Sample database from 2003 to 2012 to identify AP admissions using ICD-9-CM codes. After excluding patients with missing information on age, gender, and inpatient mortality, we used ICD-9-CM codes to identify complications of AP, specifically AKI...
October 5, 2018: Pancreatology: Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]
Vera A de Vries, Marcella C A Müller, M Sesmu Arbous, Bart J Biemond, Nicole M A Blijlevens, Nuray Kusadasi, Lambert R F Span, Alexander P J Vlaar, David J van Westerloo, Hanneke C Kluin-Nelemans, Walter M van den Bergh
OBJECTIVES: Historically, patients with a hematologic malignancy have one of the highest mortality rates among cancer patients admitted to the ICU. Therefore, physicians are often reluctant to admit these patients to the ICU. The aim of our study was to examine the survival of patients who have a hematologic malignancy and multiple organ failure admitted to the ICU. DESIGN: This retrospective cohort study, part of the HEMA-ICU study group, was designed to study the survival of patients with a hematologic malignancy and organ failure after admission to the ICU...
October 17, 2018: Critical Care Medicine
Fay H Johnston, Farhad Salimi, Grant J Williamson, Sarah B Henderson, Jiayun Yao, Martine Dennekamp, Karen Smith, Michael J Abramson, Geoffrey G Morgan
BACKGROUND: Ambulance data provide a useful source of population-based and spatiotemporally resolved information for assessing health impacts of air pollution in non-hospital settings. We used the clinical records of paramedics to quantify associations between PM2.5 and diabetic, cardiovascular, and respiratory conditions commonly managed by those responding to calls for emergency ambulance services. METHODS: We evaluated 394,217 paramedic assessments from three states in Southeastern Australia (population 13...
October 16, 2018: Epidemiology
Salvatore Docimo, Konstantinos Spaniolas, Maria Altieri, Andrew Bates, Mark Talamini, Aurora Pryor
BACKGROUND: Patients undergoing abdominal wall reconstruction (AWR) are at an increased risk of developing respiratory complications. Previous studies have demonstrated that postoperative findings, such as an increase in plateau pressure greater than 6 cm H2 O following fascial closure, creates an increased risk of postoperative respiratory complications. The purpose of this study is to determine if specific preoperative characteristics are an indicator for postoperative respiratory failure...
October 17, 2018: Surgical Endoscopy
Catharina Hommelsheim, Mathias Sichau, Roland Heipel, Eckhard Müller, Sören Gatermann, Michael Pfeifer, Santiago Ewig
BACKGROUND: The impact of respiratory tract pathogens and infection on outcomes in patients with prolonged weaning is largely unknown. OBJECTIVE: We studied predictors of weaning outcomes (death and failure to achieve spontaneous ventilation) in a population treated during a 3.5-year period in a specialized and certified weaning centre. METHODS: Patient data were retrieved retrospectively from the clinical charts. Complete datasets were available in 173 patients...
October 17, 2018: Respiration; International Review of Thoracic Diseases
Haley J Appaneal, Aisling R Caffrey, Maya Beganovic, Sanja Avramovic, Kerry L LaPlante
Background: Though recurrent Clostridium difficile infection (CDI) is common and poses a major clinical concern, data are lacking regarding mortality among patients who survive their initial CDI and have subsequent recurrences. Risk factors for mortality in patients with recurrent CDI are largely unknown. Methods: Veterans Affairs patients with a first CDI (stool sample with positive C. difficile toxin(s) and ≥2 days CDI treatment) were included (2010-2014). Subsequent recurrences were defined as additional CDI episodes ≥14 days after the stool test date and within 30 days of the end of treatment...
August 2018: Open Forum Infectious Diseases
Zhiheng Xu, Yimin Li, Jianmeng Zhou, Xi Li, Yongbo Huang, Xiaoqing Liu, Karen E A Burns, Nanshan Zhong, Haibo Zhang
BACKGROUND: High-flow nasal cannula (HFNC) can be used as an initial support strategy for patients with acute respiratory failure (ARF) and after extubation. However, no clear evidence exists to support or oppose HFNC use in clinical practice. We summarized the effects of HFNC, compared to conventional oxygen therapy (COT) and noninvasive ventilation (NIV), on important outcomes including treatment failure and intubation/reintubation rates in adult patients with ARF and after extubation...
October 16, 2018: Respiratory Research
Chien-Cheng Huang, Chung-Han Ho, Yi-Chen Chen, Chien-Chin Hsu, Yi-Fong Wang, Hung-Jung Lin, Jhi-Joung Wang, How-Ran Guo
The purpose of this study was to evaluate the effects of hyperbaric oxygen therapy (HBOT) on reducing neurological sequelae (NS) in patients with carbon monoxide poisoning (COP). Using a nationwide database of insurance claims in Taiwan, we conducted a population-based cohort study to identify 24,046 patients with COP diagnosed between 1999 and 2012, including 6793 (28.2%) patients who received HBOT and 17,253 (71.8%) patients who did not. We followed the two cohorts of patients and compared the occurrence of NS...
October 13, 2018: Journal of Clinical Medicine
Michael W Sjoding, Timothy P Hofer, Ivan Co, Jakob I McSparron, Theodore J Iwashyna
RATIONALE: Because the Berlin ARDS definition has only moderate reliability, physicians disagree about the diagnosis of ARDS in some patients. Understanding the clinical differences between patients with agreement and disagreement in the diagnosis of ARDS may provide insight into the epidemiology and pathophysiology of this syndrome, and inform strategies to improve reliability of ARDS diagnosis. OBJECTIVES: To characterize patients with diagnostic disagreement in ARDS among critical care trained physicians and compare them to patients with a consensus that ARDS developed...
October 15, 2018: Annals of the American Thoracic Society
Keiko Ohnari, Kazumasa Okada, Osamu Higuchi, Hidenori Matsuo, Hiroaki Adachi
An 82-year-old woman developed neck weakness and dysarthria with antibodies against acetylcholine receptor (AChR) and low-density lipoprotein receptor-related protein 4 (LRP4). Myasthenia gravis (MG) was diagnosed by edrophonium and repetitive nerve stimulation tests. Her symptoms resolved completely by immunotherapy. One year later, she presented with muscle weakness and bulbar palsy accompanied by atrophy and fasciculation. Her tendon reflexes were brisk, and Babinski's sign was positive. She was diagnosed with probable amyotrophic lateral sclerosis (ALS)...
2018: Internal Medicine
Sander Bus, Dagmar Verbaan, Bertjan J Kerklaan, Marieke E S Sprengers, William P Vandertop, Jan Stam, Gerrit J Bouma, Pepijn van den Munckhof
PURPOSE: According to the international guidelines, acute subdural hematomas (aSDH) with a thickness of >10 mm, or causing a midline shift of >5 mm, should be surgically evacuated. However, high mortality rates in older patients resulted in ongoing controversy whether elderly patients benefit from surgery. We identified predictors of outcome in a single-centre cohort of elderly patients undergoing surgical evacuation of aSDH or subacute subdural hematoma (saSDH). MATERIALS AND METHODS: This retrospective study included all patients aged ≥65 years undergoing surgical evacuation of aSDH/saSDH from 2000 to 2015...
October 13, 2018: British Journal of Neurosurgery
C G Todd, M McGee, K Tiernan, P Crosson, E O'Riordan, J McClure, I Lorenz, B Earley
The study objectives were to: 1) evaluate the diagnostic performance of passive immunity tests for classification of failure of passive transfer (FPT) risk, based on their relationships with calf health and performance, and 2) describe the epidemiology of morbidity and mortality in suckler beef and dairy calves under Irish conditions. A total of 1392 suckler beef calves (n = 111 farms) and 2090 dairy calves (84 farms) were included in this observational study. Blood samples were collected by jugular venipuncture...
November 1, 2018: Preventive Veterinary Medicine
N A Karoli, A V Borodkin, N A Kosheleva, A P Rebrov
AIM: To identify markers of adverse outcomes in patients with a combination of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). MATERIALS AND METHODS: 35 patients with COPD (without an anamnesis of coronary heart disease), 68 patients with COPD and CHF, 28 patients with CHF of ischemic genesis who were on treatment at the State Regional Clinical Hospital of Saratov were examined. The levels of the N-terminal fragment of the natriuretic peptide, galectin-3, the highly sensitive C-reactive protein, the proteins that bind fatty acids, the stiffness parameters of the arterial wall were determined; echocardiography was performed, calculated the index of comorbidity of Charlson...
2018: Kardiologiia
Mei-Zhen Yuan, Qin Fang, Guang-Wei Liu, Min Zhou, Jian-Mei Wu, Chun-Yun Pu
BACKGROUND: The incidence of depression is very common among patients with post-acute coronary syndrome (ACS) and leads to adverse outcomes. AIMS: The aim of this meta-analysis was to detect risk factors for depression among patients with ACS and to provide clinical evidence for its prevention. METHODS: The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline to search the PubMed, Web of Science, EMBASE, and EBSCO databases from January 1996 to March 2018...
October 11, 2018: Journal of Cardiovascular Nursing
Gaston Echaniz, Marcos De Miguel, Glenn Merritt, Plinio Sierra, Pranjal Bora, Nabamallika Borah, Christopher Ciarallo, Miriam de Nadal, Richard J Ing, Adrian Bosenberg
BACKGROUND: Cleft defects are common craniofacial malformations which require early surgical repair. These patients are at high risk of postoperative airway obstruction and respiratory failure. Cleft surgery may require high doses of opioids which may contribute to these complications. OBJECTIVES: To compare the effectiveness of proximal and distal approaches to blocking the maxillary nerve in patients undergoing cleft lip or cleft palate surgery. DESIGN: Randomised, controlled and double-blind study...
October 10, 2018: European Journal of Anaesthesiology
Sarah J Peterson, Liam McKeever, Omar B Lateef, Sally Freels, Giamila Fantuzzi, Carol A Braunschweig
OBJECTIVES: Among critically ill patients, the benefits of nutrition support may vary depending on severity of organ dysfunction. The objective of the current article was to explore the relationship between organ failure and calories exposure with hospital mortality during the first week of acute respiratory distress syndrome. DESIGN: Retrospective observational study. SETTING: Single-center ICU. PATIENTS: Adults admitted to the ICU with a diagnosis of acute respiratory distress syndrome...
October 9, 2018: Critical Care Medicine
John Hui, William J Mauermann, John M Stulak, Andrew C Hanson, Simon Maltais, David W Barbara
BACKGROUND: Previous studies on readmissions after left ventricular assist device (LVAD) implantation have focused on hospital readmissions after dismissal from the index hospitalization. Because few data exist, the purpose of this study was to examine intensive care unit (ICU) readmissions in patients during their initial hospitalization for LVAD implantation to determine reasons for, factors associated with, and incidence of mortality after ICU readmission. METHODS: A retrospective analysis was performed from February 2007 to March 2015 of patients at our institution receiving first-time LVAD implantation...
October 8, 2018: Anesthesia and Analgesia
Jorge Delgado, Jeffrey I Berman, Carolina Maya, Robert H Carson, Susan J Back, Kassa Darge
BACKGROUND: Ureteropelvic junction (UPJ) obstruction is a common cause of renal injury in children. Indications for surgery are still controversial. Currently, there is no threshold to differentiate patients with suspected UPJ obstruction requiring surgery from the ones that do not, or to predict renal outcome after surgery. Several studies have demonstrated that diffusion tensor imaging (DTI) results may correlate with microstructural changes in the kidneys. OBJECTIVE: To evaluate the feasibility of using DTI to identify UPJ obstruction kidneys...
October 8, 2018: Pediatric Radiology
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