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Respiratory failure the 4

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https://www.readbyqxmd.com/read/30109943/risk-factors-for-and-prediction-of-hypoxemia-during-tracheal-intubation-of-critically-ill-adults
#1
Andrew C McKown, Jonathan D Casey, Derek W Russell, Aaron M Joffe, David R Janz, Todd W Rice, Matthew W Semler
RATIONALE: Hypoxemia is a common complication during tracheal intubation of critically ill adults and is a frequently used endpoint in airway management research. Identifying patients likely to experience low oxygen saturations during tracheal intubation may be useful for clinical practice and clinical trials. OBJECTIVE: To identify risk factors for lower oxygen saturations and severe hypoxemia during tracheal intubation of critically ill adults and develop prediction models for lowest oxygen saturation and hypoxemia...
August 15, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/30107703/-the-application-of-intestinal-stomas-in-mesenteric-ischemia
#2
S L Sun, W W Ding, B C Liu, X X Fan, X J Wu, J S Li
Objective: To evaluate the application of intestinal stomas in mesenteric ischemia (MI) according to the concept of damage control surgery. Methods: Clinical data of 59 MI patients received intestinal stomas at Jinling Hospital, Nanjing University School of Medicine from January 2010 to June 2017 were analyzed retrospectively. There were 41 male and 18 female patients aging of (51±14) years (ranging from 20 to 86 years). All the patients were divided to two groups according to the degree of bowel ischemia: acute MI group (AMI, bowel necrosis, n =43) and chronic MI group (CMI, bowel stricture, n =16)...
August 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/30105755/splenectomy-in-patients-with-chronic-myelomonocytic-leukemia-indications-histopathological-findings-and-clinical-outcomes-in-a-single-institutional-series-of-39-patients
#3
Prateek Pophali, Pedro Horna, Terra L Lasho, Christy M Finke, Rhett P Ketterling, Naseema Gangat, David Nagorney, Ayalew Tefferi, Mrinal M Patnaik
In a 28-year period, 39 (7%) patients with chronic myelomonocytic leukemia (CMML) (median age 66 years, 64% male) underwent a splenectomy at our institution. Primary indications for splenectomy were refractory thrombocytopenia (36%), progressive spleen related symptoms (33%), emergent splenectomy for splenic rupture (21%), refractory anemia (8%) and prior to allogenic stem cell transplant (3%). Eleven (28%) patients had anemia at the time of splenectomy, of which 3 (27%) were autoimmune. The median time to splenectomy from CMML diagnosis was 6 months (0-40); peri-operative morbidity and mortality rates were 43% and 13%, while the median post-splenectomy survival was 25 months (11-38)...
August 13, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/30105627/severe-atypical-pneumonia-in-critically-ill-patients-a-retrospective-multicenter-study
#4
S Valade, L Biard, V Lemiale, L Argaud, F Pène, L Papazian, F Bruneel, A Seguin, A Kouatchet, J Oziel, S Rouleau, N Bele, K Razazi, O Lesieur, F Boissier, B Megarbane, N Bigé, N Brulé, A S Moreau, A Lautrette, O Peyrony, P Perez, J Mayaux, E Azoulay
BACKGROUND: Chlamydophila pneumoniae (CP) and Mycoplasma pneumoniae (MP) patients could require intensive care unit (ICU) admission for acute respiratory failure. METHODS: Adults admitted between 2000 and 2015 to 20 French ICUs with proven atypical pneumonia were retrospectively described. Patients with MP were compared to Streptococcus pneumoniae (SP) pneumonia patients admitted to ICUs. RESULTS: A total of 104 patients were included, 71 men and 33 women, with a median age of 56 [44-67] years...
August 13, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/30105463/hybrid-pulmonary-vein-stenting-in-infants-with-refractory-to-surgical-pulmonary-vein-stenosis-repair
#5
Ja Kyoung Yoon, Gi Beom Kim, Mi Kyoung Song, Eun Jung Bae, Woong Han Kim, Jae Gun Kwak, Jeong Ryul Lee
Pulmonary vein stenosis (PVS) is still a frustrating disease with extremely high mortality, especially in children with multiple severe PVS. Hybrid pulmonary vein stenting (HPVS) is a rescue treatment for recurrent and malignant PVS. The aim of this study is to share our successful experience with intraoperative HPVS for recurrent PVS after total anomalous pulmonary venous connection (TAPVC) repair in infant. Six patients were identified between 2013 and January 2018, who were diagnosed with recurrent PVS and underwent HPVS in the operating room...
August 13, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/30103057/dural-arteriovenous-fistulas-at-the-petrous-apex
#6
Jingwei Li, Jian Ren, Shiwei Du, Feng Ling, Guilin Li, Hongqi Zhang
OBJECT: Dural arteriovenous fistulas (DAVFs) at the petrous apex are rare but may cause subarachnoid hemorrhage (SAH) or severe brainstem edema. The current study aimed to summarize their clinical features and discuss the classification. METHODS: During a 15-year period, 64 consecutive patients with DVAF at the petrous apex were reviewed. According to their angioarchitecture, these cases were classified as follows: Type I, no venous ectasia (48.4%); Type II, venous ectasia but with normal vein proximal to the fistula (29...
August 10, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30100406/inadequacy-of-pulse-oximetry-in-the-catheterization-laboratory-an-exploratory-study-monitoring-respiratory-status-using-arterial-blood-gases-during-cardiac-catheterization-with-conscious-sedation
#7
Zaher Fanari, Asim A Mohammed, Jaya D Bathina, Desiree T Hodges, Kelsey Doorey, Nicholas Gagliano, Kirk N Garratt, William S Weintraub, Andrew J Doorey
BACKGROUND: Benzodiazepines and opioids are commonly used for conscious sedation (CS) in cardiac catheterization laboratory (CCL) patients. Both drugs are known to predispose to hypoxemia, apnea and decreased responsiveness to PCO2 , resulting in decreased arterial pH and PO2 , as well as increased PCO2 . We want to determine the effects of CS on arterial blood gas (ABG) in CCL patient, and identify if pulse oximetry monitoring is adequate. METHODS: We enrolled 18 subjects undergoing elective catheterization...
August 1, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/30098575/non-invasive-positive-pressure-ventilation-in-lung-transplant-recipients-with-acute-respiratory-failure-beyond-the-perioperative-period
#8
Samuel P Wiles, Charles R Lane, Ali Ataya, Mourad H Senussi, Madhu Sasidhar, Xiaofeng Wang, Tarik Hanane
PURPOSE: The purpose of this study is to evaluate outcomes in MICU lung transplant recipients with acute respiratory failure treated with non-invasive positive pressure ventilation (NPPV) and identify factors associated with NPPV failure (need for intubation). METHODS: Retrospective chart review of all lung transplant recipients who were admitted with acute respiratory failure to the MICU from January 2009-August 2016 was completed. Logistic regression analysis was performed to determine which factors were independently associated with NPPV failure...
August 1, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/30095746/randomized-study-of-early-continuous-positive-airways-pressure-in-acute-respiratory-failure-in-children-with-impaired-immunity-scarf-isrctn82853500
#9
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasi, Amy Jones, Christine Mackerness, Susan George, Paul Veys, Samiran Ray, Paul R Mouncey, David A Harrison, Kathy Rowan
OBJECTIVES: Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children. DESIGN: We undertook an open, parallel-group randomized trial in three pediatric hospitals. SUBJECTS: Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates...
August 7, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30083554/phenytoin-and-rifampin-do-not-decrease-levels-in-acute-tacrolimus-toxicity
#10
Benjamin O Lawson, Heemesh Seth, Dan Quan
Tacrolimus is used in bone marrow transplant patients to prevent graft-versus-host disease. There have been few case reports of tacrolimus toxicity (>30 ng/mL) in solid organ recipients as well as in nontransplant patients. Several case reports suggest phenytoin and rifampin decrease tacrolimus levels in toxicity, but does it actually make a difference? A 60-year-old man with acute myeloblastic leukemia after allogenic stem cell transplant with fever, diarrhea, and abdominal pain was transferred to the intensive care unit for persistent hypotension and acute hypoxic respiratory failure requiring intubation...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/30080776/comparing-percutaneous-to-open-access-for-extracorporeal-membrane-oxygenation-in-pediatric-respiratory-failure
#11
Sarah B Cairo, Mary Arbuthnot, Laura Boomer, Michael W Dingeldein, Alexander Feliz, Samir Gadepalli, Christopher R Newton, Pramod Puligandla, Robert Ricca, Peter Rycus, Adam M Vogel, Guan Yu, Ziqiang Chen, David H Rothstein
OBJECTIVES: Evaluate trends in method of access (percutaneous cannulation vs open cannulation) for pediatric extracorporeal membrane oxygenation and determine the effects of cannulation method on morbidity and mortality. DESIGN: Retrospective cohort study. SETTING AND SUBJECTS: The Extracorporeal Life Support Organization's registry was queried for pediatric patients on extracorporeal membrane oxygenation for respiratory failure from 2007 to 2015...
August 3, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30075063/distribution-of-alveolar-interstitial-syndrome-in-dogs-and-cats-with-respiratory-distress-as-assessed-by-lung-ultrasound-versus-thoracic-radiographs
#12
Jessica L Ward, Gregory R Lisciandro, Teresa C DeFrancesco
OBJECTIVE: To assess distribution of alveolar-interstitial syndrome (AIS) detected by lung ultrasound (LUS) compared to thoracic radiographs (TXR). DESIGN: Prospective study. SETTING: University teaching hospital. ANIMALS: Seventy-six dogs and 24 cats with acute respiratory distress or tachypnea. INTERVENTIONS: Patients underwent LUS and TXR within 6 hours. Lung ultrasound images were scored for presence and quantity of B-lines in 4 lung quadrants (right cranial, right caudal, left cranial, left caudal)...
August 3, 2018: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/30074980/self-reported-management-of-iv-fluids-and-fluid-accumulation-in-children-with-acute-respiratory-failure
#13
Amanda B Hassinger, Stacey L Valentine
OBJECTIVES: Observational studies have shown that fluid overload is independently associated with increased morbidity in critically ill children, especially with respiratory pathology. It is unknown if recent evidence has influenced clinical practice. We sought to describe current IV fluid management in pediatric acute respiratory distress syndrome. DESIGN: Multinational, cross-sectional electronic survey. SETTING: Pediatric Acute Lung Injury and Sepsis Investigators Network...
August 2, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30071995/continuously-updated-estimation-of-heart-transplant-waitlist-mortality
#14
Eugene H Blackstone, Jeevanantham Rajeswaran, Vincent B Cruz, Eileen M Hsich, Marijan Koprivanac, Nicholas G Smedira, Katherine J Hoercher, Lucy Thuita, Randall C Starling
BACKGROUND: Heart transplant allocation in the United States is made on the basis of coarse tiers, defined by mechanical circulatory devices and therapy for advanced heart failure, updated infrequently as a patient's condition deteriorates. Thus, many patients die awaiting heart transplantation. What is needed is a tool that continuously updates risk of mortality as a patient's condition changes to inform clinical decision making. OBJECTIVES: This study sought to develop a decision aid that aggregates adverse events and measures of end-organ function into a continuously updated waitlist mortality estimate...
August 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/30071876/high-flow-nasal-cannula-oxygen-therapy-decreases-postextubation-neuroventilatory-drive-and-work-of-breathing-in-patients-with-chronic-obstructive-pulmonary-disease
#15
Rosa Di Mussi, Savino Spadaro, Tania Stripoli, Carlo Alberto Volta, Paolo Trerotoli, Paola Pierucci, Francesco Staffieri, Francesco Bruno, Luigi Camporota, Salvatore Grasso
BACKGROUND: The physiological effects of high-flow nasal cannula O2 therapy (HFNC) have been evaluated mainly in patients with hypoxemic respiratory failure. In this study, we compared the effects of HFNC and conventional low-flow O2 therapy on the neuroventilatory drive and work of breathing postextubation in patients with a background of chronic obstructive pulmonary disease (COPD) who had received mechanical ventilation for hypercapnic respiratory failure. METHODS: This was a single center, unblinded, cross-over study on 14 postextubation COPD patients who were recovering from an episode of acute hypercapnic respiratory failure of various etiologies...
August 2, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/30060083/venetoclax-bendamustine-and-rituximab-in-patients-with-relapsed-or-refractory-nhl-a-phase-1b-dose-finding-study
#16
S de Vos, L J Swinnen, D Wang, E Reid, N Fowler, J Cordero, M Dunbar, S H Enschede, C Nolan, A M Petrich, J A Ross, A H Salem, M Verdugo, S Agarwal, L Zhou, M Kozloff, L J Nastoupil, C R Flowers
Background: Venetoclax is a selective, potent inhibitor of the anti-apoptotic BCL-2 protein approved for treatment of chronic lymphocytic leukemia. We conducted a dose-finding study of venetoclax in combination with bendamustine-rituximab (BR) in patients with relapsed/refractory non-Hodgkin's lymphoma (NHL). Patients and methods: BR was given for 6 cycles at standard doses. Intermittent and continuous oral venetoclax administration was explored at 50mg-1200mg daily doses...
July 28, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/30059459/safety-of-early-tracheostomy-in-trauma-patients-after-anterior-cervical-fusion
#17
Claudia Patricia Lozano Guzman, Kevin A Chen, Joshua A Marks, Jay S Jenoff, Murray J Cohen, Michael S Weinstein
BACKGROUND: Cervical spine injuries (CSI) can have major effects on the respiratory system and carry a high incidence of pulmonary complications. Respiratory failure can be due to spinal cord injuries, concomitant facial fractures or chest injury, airway obstruction, or cognitive impairments. Early tracheostomy (ET) is often indicated in patients with CSI. However, in patients with anterior cervical fusion (ACF), concerns about cross-contamination often delay tracheostomy placement. This study aims to demonstrate the safety of ET within four days of ACF METHODS: Retrospective chart review was performed for all trauma patients admitted to our institution between 2001-2015 with diagnosis of CSI who required both ACF and tracheostomy, +/- posterior cervical fusion (PCF), during the same hospitalization...
August 7, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/30045769/mortality-risk-factors-and-causes-of-death-in-swedish-patients-with-open-tibial-fractures-a-nationwide-study-of-3-777-patients
#18
Ulrika Tampe, Lukas W Widmer, Rüdiger J Weiss, Karl-Åke Jansson
BACKGROUND: Open tibial fractures are serious, complicated injuries. Previous studies suggested an increased risk of death, however, this has not been studied in large population-based settings. We aimed to analyze mortality including causes of death in all patients with open tibial fractures in Sweden. Moreover, we wanted to compare mortality rates with the Swedish population and determine whether treatment-related or demographic variables were independently associated with death. METHOD: We searched the Swedish National Hospital Discharge Register for all patients with open tibial fracture between 1998 and 2010...
July 25, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/30045171/early-predictors-of-abdominal-hemorrhage-among-critically-ill-patients-with-pancreatitis-a-prospective-cohort-study
#19
Eduardo Labarca, Felix Zubia, Enrique Maraví-Poma, Felipe Martinez
OBJECTIVE: To establish incidence, risk factors, and prognostic implications of abdominal hemorrhage (AH) among critically ill patients with acute pancreatitis (AP). METHODS: Prospective cohort study in 46 intensive care units aimed at describing the characteristics of critically ill patients with AP (Epidemiología de la Pancreatitis Aguda en Medicina Intensiva Study). Adult patients with AP and at least 1 organ failure were included. The presence of AH was established either by using computed tomography, magnetic resonance imaging, or by direct visualization during surgery...
July 24, 2018: Pancreas
https://www.readbyqxmd.com/read/30044935/prehospital-plasma-during-air-medical-transport-in-trauma-patients-at-risk-for-hemorrhagic-shock
#20
RANDOMIZED CONTROLLED TRIAL
Jason L Sperry, Francis X Guyette, Joshua B Brown, Mark H Yazer, Darrell J Triulzi, Barbara J Early-Young, Peter W Adams, Brian J Daley, Richard S Miller, Brian G Harbrecht, Jeffrey A Claridge, Herb A Phelan, William R Witham, A Tyler Putnam, Therese M Duane, Louis H Alarcon, Clifton W Callaway, Brian S Zuckerbraun, Matthew D Neal, Matthew R Rosengart, Raquel M Forsythe, Timothy R Billiar, Donald M Yealy, Andrew B Peitzman, Mazen S Zenati
BACKGROUND: After a person has been injured, prehospital administration of plasma in addition to the initiation of standard resuscitation procedures in the prehospital environment may reduce the risk of downstream complications from hemorrhage and shock. Data from large clinical trials are lacking to show either the efficacy or the risks associated with plasma transfusion in the prehospital setting. METHODS: To determine the efficacy and safety of prehospital administration of thawed plasma in injured patients who are at risk for hemorrhagic shock, we conducted a pragmatic, multicenter, cluster-randomized, phase 3 superiority trial that compared the administration of thawed plasma with standard-care resuscitation during air medical transport...
July 26, 2018: New England Journal of Medicine
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