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JOURNAL ARTICLE
Farnoosh Tajik, Marzieh Mahmoodi, Parviz Azodi, Faezeh Jahanpour
INTRODUCTION: Having a hospitalized neonate is a stressful experience for parents, especially mothers. Thus, in recent years, a paradigm shift occurred in the neonatal units, focusing on the needs of parents and supporting them in addition to caring for neonates. The aim of this study was to evaluate the nurse-mother communication and support in neonatal units in Bushehr, Iran. METHOD: This descriptive cross-sectional study was performed in neonatal units of 6 hospitals in Bushehr, Iran, in 2022...
April 30, 2024: Heliyon
#22
REVIEW
Elisa Estenssoro, Iván González, Gustavo A Plotnikow
Acute respiratory distress syndrome (ARDS), first described in 1967, is characterized by acute respiratory failure causing profound hypoxemia, decreased pulmonary compliance, and bilateral CXR infiltrates. After several descriptions, the Berlin definition was adopted in 2012, which established three categories of severity according to hypoxemia (mild, moderate and severe), specified temporal aspects for diagnosis, and incorporated the use of non-invasive ventilation. The COVID-19 pandemic led to changes in ARDS management, focusing on continuous monitoring of oxygenation and on utilization of high-flow oxygen therapy and lung ultrasound...
April 20, 2024: Medicina intensiva
#23
JOURNAL ARTICLE
Sascha Meyer, Johannes Bay, Axel R Franz, Harald Erhardt, Lars Klein, Jutta Petzinger, Christoph Binder, Susanne Kirschenhofer, Anja Stein, Britta Hüning, Axel Heep, Eva Cloppenburg, Julia Muyimbwa, Torsten Ott, Julia Sandkötter, Norbert Teig, Susanne Wiegand, Michael Schroth, Andrea Kick, Donald Wurm, Corinna Gebauer, Knud Linnemann, Jochen Kittel, Christian Wieg, Ursula Kiechl-Kohlendorfer, Susanne Schmidt, Ralf Böttger, Wolfgang Thomas, Francisco Brevis Nunez, Antje Stockmann, Thomas Kriebel, Andreas Müller, Daniel Klotz, Patrick Morhart, Donatus Nohr, Hans Konrad Biesalski, Eleni Z Giannopoulou, Susanne Hilt, Martin Poryo, Stefan Wagenpfeil, Nadja Haiden, Christian Ruckes, Anne Ehrlich, Ludwig Gortner
BACKGROUND: Vitamin A plays a key role in lung development, but there is no consensus regarding the optimal vitamin A dose and administration route in extremely low birthweight (ELBW) infants. We aimed to assess whether early postnatal additional high-dose fat-soluble enteral vitamin A supplementation versus placebo would lower the rate of moderate or severe bronchopulmonary dysplasia or death in ELBW infants receiving recommended basic enteral vitamin A supplementation. METHODS: This prospective, multicentre, randomised, parallel-group, double-blind, placebo-controlled, investigator-initiated phase 3 trial conducted at 29 neonatal intensive care units in Austria and Germany assessed early high-dose enteral vitamin A supplementation (5000 international units [IU]/kg per day) or placebo (peanut oil) for 28 days in ELBW infants...
April 18, 2024: Lancet Respiratory Medicine
#24
JOURNAL ARTICLE
Julia D Michels-Zetsche, Janina Schubert-Haack, Katrin Tanck, Benjamin Neetz, Gabriele Iberl, Michael Müller, Axel Kempa, Biljana Joves, Andreas Rheinhold, Alessandro Ghiani, Konstantinos Tsitouras, Armin Schneider, Christoph Rauch, Patrick Gehrig, Elena Biehler, Thomas Fleischauer, Simone Britsch, Timm Frerk, Joachim Szecsenyi, Felix J F Herth, Franziska C Trudzinski
BACKGROUND: PRiVENT (PRevention of invasive VENTilation) is an evaluation of a bundle of interventions aimed at the prevention of long-term invasive mechanical ventilation. One of these elements is an e-learning course for healthcare professionals to improve weaning expertise. The aim of our analysis is to examine the implementation of the course in cooperating intensive care units. METHODS: The course has been developed through a peer review process by pulmonary and critical care physicians in collaboration with respiratory therapists, supported by health services researchers and a professional e-learning agency...
April 19, 2024: BMC Medical Education
#25
JOURNAL ARTICLE
Jia Song, Qiancheng Luo, Xinle Lai, Weihang Hu, Yihua Yu, Minjia Wang, Kai Yang, Gongze Chen, Wenwei Chen, Qian Li, Caibao Hu, Shijin Gong
BACKGROUND: Weaning from invasive mechanical ventilation (MV) is a complex and challenging process that involves multiple pathophysiological mechanisms. A combined ultrasound evaluation of the heart, lungs, and diaphragm during the weaning phase can help to identify risk factors and underlying mechanisms for weaning failure. This study aimed to investigate the accuracy of lung ultrasound (LUS), transthoracic echocardiography (TTE), and diaphragm ultrasound for predicting weaning failure in critically ill patients...
April 20, 2024: Annals of Intensive Care
#26
JOURNAL ARTICLE
L Hao, T H G F Bakkes, A van Diepen, N Chennakeshava, R A Bouwman, A J R De Bie Dekker, P H Woerlee, F Mojoli, M Mischi, Y Shi, S Turco
BACKGROUND AND OBJECTIVE: Mechanical ventilation is a life-saving treatment for critically-ill patients. During treatment, patient-ventilator asynchrony (PVA) can occur, which can lead to pulmonary damage, complications, and higher mortality. While traditional detection methods for PVAs rely on visual inspection by clinicians, in recent years, machine learning models are being developed to detect PVAs automatically. However, training these models requires large labeled datasets, which are difficult to obtain, as labeling is a labour-intensive and time-consuming task, requiring clinical expertise...
April 12, 2024: Computer Methods and Programs in Biomedicine
#27
JOURNAL ARTICLE
Bill Pruitt, Mary Catherine Hodges
Mechanical ventilation is rarely a simple matter. Skill and knowledge are required to operate the ventilator modes, choose the optimal settings, and understand many monitored variables. Supporting the patient safely and effectively is the top priority in providing mechanical ventilation. This article discusses mechanical ventilation in adults.
May 1, 2024: Nursing
#28
JOURNAL ARTICLE
Malini Maya, Ramachandran Rameshkumar, Tamil Selvan, Chinnaiah Govindhareddy Delhikumar
OBJECTIVES: To compare high-flow nasal cannula (HFNC) versus nasal prong bubble continuous positive airway pressure (b-CPAP) in children with moderate to severe acute bronchiolitis. DESIGN: A randomized controlled trial was carried out from August 2019 to February 2022. (Clinical Trials Registry of India number CTRI/2019/07/020402). SETTING: Pediatric emergency ward and ICU within a tertiary care center in India. PATIENTS: Children 1-23 months old with moderate to severe acute bronchiolitis...
April 19, 2024: Pediatric Critical Care Medicine
#29
JOURNAL ARTICLE
Kamila Resova, Lukas Knybel, Tereza Parackova, Marian Rybar, Karel Cwiertka, Jakub Cvek
BACKGROUND: Stereotactic ablative radiotherapy (SABR) is the standard treatment for medically inoperable early-stage non-small cell lung cancer (ES-NSCLC), but which patients benefit from stereotactic radiotherapy is unclear. The aim of this study was to analyze prognostic factors for early mortality. METHODS: From August 2010 to 2022, 617 patients with medically inoperable, peripheral or central ES-NSCLC were treated with SABR at our institution. We retrospectively evaluated the data from 172 consecutive patients treated from 2018 to 2020 to analyze the prognostic factors associated with overall survival (OS)...
April 18, 2024: Radiation Oncology
#30
REVIEW
Mayur Murali, Melody Ni, Dan S Karbing, Stephen E Rees, Matthieu Komorowski, Dominic Marshall, Padmanabhan Ramnarayan, Brijesh V Patel
Invasive mechanical ventilation is a key supportive therapy for patients on intensive care. There is increasing emphasis on personalised ventilation strategies. Clinical decision support systems (CDSS) have been developed to support this. We conducted a narrative review to assess evidence that could inform device implementation. A search was conducted in MEDLINE (Ovid) and EMBASE. Twenty-nine studies met the inclusion criteria. Role allocation is well described, with interprofessional collaboration dependent on culture, nurse:patient ratio, the use of protocols, and perception of responsibility...
April 17, 2024: British Journal of Anaesthesia
#31
JOURNAL ARTICLE
Y H Xu, Y K Liu, Y Xi, Y Wang, Y M Li
Extracorporeal carbon dioxide removal (ECCO2 R) is a respiratory support technique based on extra-pulmonary gas exchange, which can effectively remove carbon dioxide generated in-vivo, reducing the requirements of respiratory support from mechanical ventilation. With improvements in extracorporeal life support technologies and increasing clinical experience, ECCO2 R has potential value in clinical application with acute respiratory distress syndrome (ARDS). This review article discusses the principles of ECCO2 R, its relevant indications for ARDS, clinical evidence, existing issues, and future directions, aiming to provide more references for the application in ARDS...
April 16, 2024: Zhonghua Yi Xue za Zhi [Chinese medical journal]
#32
JOURNAL ARTICLE
W F Shang, D C Chen
Prone positioning ventilation (PPV) is considered one of the essential therapeutic approaches in the management of acute respiratory distress syndrome (ARDS). Several randomized controlled clinical trials have demonstrated the efficacy of PPV in the treatment of patients with ARDS. However, it is not clear whether PPV treatment can reduce mortality in patients with veno-venous extracorporeal membrane oxygenation (VV-ECMO)-supported ARDS and corona virus disease 2019 (COVID-19)-associated ARDS. This review aims to discuss the known and unknown aspects of the mechanism of PPV for ARDS, the clinical efficacy of PPV for ARDS, VV-ECMO-supported ARDS, and COVID-19-related ARDS...
April 16, 2024: Zhonghua Yi Xue za Zhi [Chinese medical journal]
#33
JOURNAL ARTICLE
G Laguna, F Suárez-Sipmann, G Tusman, J Ripollés, O Díaz-Cambronero, R Pujol, E Rivas, I Garutti, R Mellado, J Vallverdú, A Jacas, A Fervienza, R Marrero, J Librero, J Villar, C Ferrando
BACKGROUND: Postoperative pulmonary complications (PPC) are the most frequent postoperative complications, with an estimated prevalence in elective surgery ranging from 20% in observational cohort studies to 40% in randomized clinical trials. However, the prevalence of PPCs in patients undergoing emergency abdominal surgery is not well defined. Lung-protective ventilation aims to minimize ventilator-induced lung injury and reduce PPCs. The open lung approach (OLA), which combines recruitment manoeuvres (RM) and positive end-expiratory pressure (PEEP) titration, aims to minimize areas of atelectasis and the development of PPCs; however, there is no conclusive evidence in the literature that OLA can prevent PPCs...
April 16, 2024: Revista española de anestesiología y reanimación
#34
JOURNAL ARTICLE
Laura D Zambrano, Margaret M Newhams, Regina M Simeone, Amanda B Payne, Michael Wu, Amber O Orzel-Lockwood, Natasha B Halasa, Jemima M Calixte, Pia S Pannaraj, Kanokporn Mongkolrattanothai, Julie A Boom, Leila C Sahni, Satoshi Kamidani, Kathleen Chiotos, Melissa A Cameron, Aline B Maddux, Katherine Irby, Jennifer E Schuster, Elizabeth H Mack, Austin Biggs, Bria M Coates, Kelly N Michelson, Katherine E Bline, Ryan A Nofziger, Hillary Crandall, Charlotte V Hobbs, Shira J Gertz, Sabrina M Heidemann, Tamara T Bradford, Tracie C Walker, Stephanie P Schwartz, Mary Allen Staat, Samina S Bhumbra, Janet R Hume, Michele Kong, Melissa S Stockwell, Thomas J Connors, Melissa L Cullimore, Heidi R Flori, Emily R Levy, Natalie Z Cvijanovich, Matt S Zinter, Mia Maamari, Cindy Bowens, Danielle M Zerr, Judith A Guzman-Cottrill, Ivan Gonzalez, Angela P Campbell, Adrienne G Randolph
Pediatric COVID-19 vaccination is effective in preventing COVID-19-related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021-October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19-related hospitalization and critical illness among U...
April 18, 2024: MMWR. Morbidity and Mortality Weekly Report
#35
JOURNAL ARTICLE
Vaclav Tegl, Jan Horak, Lukas Nalos, Michala Horakova, Milan Stengl, Martin Matejovic, Jan Benes
OBJECTIVES: The use of hemoadsorption (HA) has become popular in the treatment of vasoplegic states associated with massive cytokine release, including septic shock. However, this approach does not seem to be based on robust evidence, and it does not follow international guidelines. To understand the pathophysiological rationale and timing of HA, we conducted a large animal septic shock experiment. DESIGN: Prospective randomized large-animal peritoneal septic shock experiment...
April 18, 2024: Intensive Care Medicine Experimental
#36
JOURNAL ARTICLE
Sandeep Sainathan, John Ryan, Leonardo Mullinari, Pablo Sanchez
OBJECTIVE: Pediatric Heart-lung transplant (HLTX) is performed for endstage congenital heart disease (CHD) with irreversible pulmonary hypertension or non-congenital heart disease (NCHD) with end-stage heart and lung disease. CHD could influence the outcomes of HTLX due to increased complexity of the operation as compared to NCHD. In this study we evaluated the influence of cardiac diagnosis on outcomes of pediatric HTLX. METHODS: The UNOS database (1987-2022) was queried for primary HTLX in patients <18 years...
April 2024: Clinical Transplantation
#37
JOURNAL ARTICLE
John Tat, Karen Heskett, Gerry R Boss
CONTEXT: Rotenone is a toxic chemical found in various plants, including some used as food. Rotenone poisoning can be fatal and there is no antidote. Mechanistically, rotenone inhibits mitochondrial complex I, leading to reduced ATP production, compensatory glycolytic upregulation and secondary lactate production, and oxidative stress. Our literature review examined acute rotenone poisoning in humans, including exposure scenarios, clinical presentations, and treatments. METHODS: We searched five databases for relevant literature from database inception through the search date: July 12, 2022, pairing controlled vocabulary and keywords for "rotenone" with terms relating to human exposures and outcomes, such as "ingestion," "exposure," and "poisoning...
April 15, 2024: Heliyon
#38
REVIEW
Smitesh Padte, Vikramaditya Samala Venkata, Priyal Mehta, Sawsan Tawfeeq, Rahul Kashyap, Salim Surani
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units (ICUs). This abstract provides a concise summary of the latest developments in critical care, highlighting key areas of innovation. Recent advancements in critical care include Precision Medicine: Tailoring treatments based on individual patient characteristics, genomics, and biomarkers to enhance the effectiveness of therapies. The objective is to describe the recent advancements in Critical Care Medicine...
March 9, 2024: World Journal of Critical Care Medicine
#39
Marjolein C de Jongh, Matthijs Bax, Khalil Ayan, Sakir Akin
BACKGROUND: The prone position is recommended as supportive therapy in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). However, little is known about prone position ventilation in patients with cardiogenic shock supported by extracorporeal membrane oxygenation (ECMO) plus Impella (ECPELLA) developing ARDS. CASE SUMMARY: A 66-year-old man with severe left ventricular dysfunction was admitted to a non-academic ECMO centre for a high-risk coronary artery bypass grafting...
April 2024: European Heart Journal. Case Reports
#40
Jaquelyn Kakalecik, Amanda M Frantz, Michael T Talerico, Thomas A Krupko, Jennifer E Hagen, Matthew R Patrick
Extracorporeal membrane oxygenation (ECMO) has become a salvage therapy for patients with severe acute respiratory distress syndrome (ARDS). The management of orthopaedic trauma in ECMO-supported patients with ARDS remains an evolving area of interest. Orthopaedic injuries are often temporized with external fixators, skeletal traction, or splints due to hemodynamic instability as well as concerns of exacerbating underlying pulmonary injury. However, patients requiring ECMO support do not rely on their pulmonary system for oxygenation, the need for delayed fixation may not apply...
June 2024: Trauma Case Reports
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