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Mechanical and non-invasive ventilation

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https://www.readbyqxmd.com/read/28820175/noninvasive-mechanical-ventilation-in-early-acute-respiratory-distress-syndrome
#1
Alice Grassi, Giuseppe Foti, John G Laffey, Giacomo Bellani
Non invasive ventilation (NIV) has a well established role in the treatment of acute-on-chronic respiratory failure and cardiogenic pulmonary oedema. Its role in acute hypoxaemic respiratory failure has been increasingly investigated, but its impact on the management and the outcome of the subset of patients affected by acute respiratory distress syndrome (ARDS) is still to be determined. ARDS could be a risk factor for NIV failure and in these patient delayed endotracheal intubation can lead to an increased mortality...
August 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#2
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28818610/surfactant-and-continuous-positive-airway-pressure-for-the-prevention-of-chronic-lung-disease-history-reality-and-new-challenges
#3
REVIEW
Hany Aly, Mohamed A Mohamed, Jen-Tien Wung
The discovery of surfactant was one of the most significant research events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered non-viable. However, the prevention of chronic lung disease did not progress and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. A dilemma exists over the priorities in premature management to intubate and administer surfactant or not to intubate and support these infants non-invasively with the use of continuous positive airway pressure...
August 14, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#4
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28803440/electrical-impedance-tomography-for-diagnosis-and-monitoring-of-pulmonary-function-disorders-in-the-intensive-care-unit-case-report-and-review-of-literature
#5
Szymon Białka, Maja Copik, Katarzyna Rybczyk, Hanna Misiołek
The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28803139/the-effect-of-age-on-the-manifestations-and-outcomes-of-invasive-pneumococcal-disease-in-adults
#6
Thomas J Marrie, Gregory J Tyrrell, Sumit R Majumdar, Dean T Eurich
BACKGROUND: While a considerable amount is known about the effect of age on the manifestations and outcomes of pneumonia, the same is not true for invasive pneumococcal disease . METHODS: This was a prospective, observational study of all cases (2435) of invasive pneumococcal disease in adults in Northern Alberta from 2000 to 2014. Rates of invasive pneumococcal disease/100,000, sociodemographic variables, clinical characteristics, and invasive pneumococcal disease -related outcomes were compared for the following age groups - 17 to 54, 55 -64, 65 to 74 and 75 years and over...
August 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#7
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to160 United States adult ICUs during 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
August 8, 2017: Chest
https://www.readbyqxmd.com/read/28797895/patterns-of-c-reactive-protein-ratio-predicts-outcomes-in-healthcare-associated-pneumonia-in-critically-ill-patients-with-cancer
#8
Ligia S C F Rabello, Pedro Póvoa, Jose R Lapa E Silva, Luciano C P Azevedo, Fernando Jose da Silva Ramos, Thiago Lisboa, Marcio Soares, Jorge I F Salluh
PURPOSE: Describe the patterns of C-reactive protein relative changes in response to antibiotic therapy in critically ill cancer patients with healthcare-associated pneumonia (HCAP) and its ability to predict outcome. METHODS: Secondary analysis of a prospective cohort of critically ill cancer patients with HCAP. CRP was sampled every other day from D0 to D6 of antibiotic therapy. Patients were classified according to an individual pattern of CRP-ratio response: fast - CRP at D4 of therapy was <0...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28766281/nebulized-antibiotics-in-mechanically-ventilated-patients-a-challenge-for-translational-research-from-technology-to-clinical-care
#9
REVIEW
Stephan Ehrmann, Jean Chastre, Patrice Diot, Qin Lu
Nebulized antibiotic therapy directly targets airways and lung parenchyma resulting in high local concentrations and potentially lower systemic toxicities. Experimental and clinical studies have provided evidence for elevated lung concentrations and rapid bacterial killing following the administration of nebulized antibiotics during mechanical ventilation. Delivery of high concentrations of antibiotics to infected lung regions is the key to achieving efficient nebulized antibiotic therapy. However, current non-standardized clinical practice, the difficulties with implementing optimal nebulization techniques and the lack of robust clinical data have limited its widespread adoption...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28762449/the-value-of-internal-jugular-vein-collapsibility-index-in-sepsis
#10
Murat Haliloğlu, Beliz Bilgili, Alper Kararmaz, İsmail Cinel
BACKGROUND: Rapid, accurate, and reproducible assessment of intravascular volume status is crucial in order to predict the efficacy of volume expansion in septic patients. The aim of this study was to verify the feasibility and usefulness of the internal jugular vein collapsibility index (IJV-CI) as an adjunct to the inferior vena cava collapsibility index (IVC-CI) to predict fluid responsiveness in spontaneously-breathing patients with sepsis. METHODS: Three stages of sonographic scanning were performed...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#11
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28749853/the-icu-is-becoming-a-main-battlefield-for-severe-maternal-rescue-in-china-an-8-year-single-center-clinical-experience
#12
Liu Yuqi, Guoliang Tan, Shang Chengming, Sun Xuri
OBJECTIVES: To review the characteristics of and to identify the reasons for severe maternal admissions to the ICU. DESIGN: This was an analytical, observational, open, and retrospective study. SETTING: In our ICU. PATIENTS: A total of 487 severe maternal cases were reviewed during the 8-year study period of January 2009 to December 2016. INTERVENTION: None. MEASUREMENTS AND MAIN RESULTS: A total of 487 severe maternal cases (12...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28749114/characteristics-and-outcomes-of-patients-with-hematological-malignancies-admitted-for-intensive-care-a-single-centre-experience
#13
Shafaq Maqsood, Farhana Badar, Abdul Hameed
Background and Purpose: Patients with hematological malignancies admitted to an intensive care unit (ICU) generally have a high mortality rate. The aim of our study was to assess the characteristics and outcomes of such patients and to identify factors predicting ICU mortality. Material and Methods: This retrospective chart review was conducted in the intensive care unit (ICU) of Shaukat Khanum Memorial Cancer Hospital and Research Centre over a period of 5 years, from January 2010 to January 2015. Results: Characteristics :A total of 213 patients were included in this study...
July 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28741217/effects-of-non-invasive-ventilation-in-patients-with-acute-respiratory-failure-excluding-post-extubation-respiratory-failure-cardiogenic-pulmonary-edema-and-exacerbation-of-copd-a-systematic-review-and-meta-analysis
#14
Yutaka Kondo, Junji Kumasawa, Atsushi Kawaguchi, Ryutaro Seo, Eishu Nango, Satoru Hashimoto
BACKGROUND: This meta-analysis compared the effects of non-invasive ventilation (NIV) with invasive mechanical ventilation (InMV) and standard oxygen (O2) therapy on mortality and rate of tracheal intubation in patients presenting acute respiratory failure (ARF). METHODS: We searched the MEDLINE, EMBASE and Cochrane Central Register of clinical trials databases between 1949 and May 2015 to identify randomized trials of NIV for ARF. We excluded the ARF caused by extubation, cardiogenic pulmonary edema, and COPD...
July 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28734732/perinatal-and-neonatal-use-of-sedation-and-analgesia
#15
REVIEW
Christopher McPherson, Terrie Inder
Optimal obstetric and neonatal care requires the provision of adequate analgesia for painful procedures. However, anesthetic and analgesic agents have the potential to adversely impact the developing fetal/neonatal brain. In this setting, clinicians must assess the risks and benefits of pharmacologic anesthesia and analgesia for specific indications in this population. General anesthesia is required for non-obstetric surgery and cesarean section in the absence of neuraxial anesthesia for the health of the mother and fetus...
July 19, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28733536/do-cancer-patients-with-dementia-receive-less-aggressive-treatment-in-end-of-life-care-a-nationwide-population-based-cohort-study
#16
Huei-Kai Huang, Jyh-Gang Hsieh, Chia-Jung Hsieh, Ying-Wei Wang
Dementia is a progressive, incurable disease that can deprive patients of the ability to make decisions. This study determines whether dementia influences the medical care that a cancer patient receives at the end of life. We conducted a nationwide population-based cohort study on patients aged ≥20 with newly diagnosed cancer during 2000-2012. After matching to reduce confounders, there were 7,111 patients with and 28,444 without dementia. The adjusted odd ratios (OR) for medical interventions, including intensive care, palliative care, invasive procedures, and advanced diagnostic testing, were calculated for the final month and three months of life by a multiple logistic regression model...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#17
Lars Eichler, Katarzyna Truskowska, A Dupree, P Busch, Alwin E Goetz, Christian Zöllner
BACKGROUND: Bariatric surgery has proven a successful approach in the treatment of morbid obesity and its concomitant diseases such as diabetes mellitus and arterial hypertension. Aiming for optimal management of this challenging patient cohort, tailored concepts directly guided by individual patient physiology may outperform standardized care. Implying esophageal pressure measurement and electrical impedance tomography-increasingly applied monitoring approaches to individually adjust mechanical ventilation in challenging circumstances like acute respiratory distress syndrome (ARDS) and intraabdominal hypertension-we compared our institutions standard ventilator regimen with an individually adjusted positive end expiratory pressure (PEEP) level aiming for a positive transpulmonary pressure (P L) throughout the respiratory cycle...
July 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#18
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28699611/impact-of-high-flow-nasal-cannula-therapy-in-quality-%C3%A4-mprovement-and-clinical-outcomes-in-a-non-invasive-ventilation-device-free-pediatric-%C3%A4-ntensive-care-unit
#19
Fulva Kamit Can, Ayse Berna Anil, Murat Anil, Neslihan Zengin, Alkan Bal, Yuksel Bicilioglu, Gamze Gokalp, Fatih Durak, Gulberat Ince
OBJECTIVE: To analyze the change in quality indicators due to the use of high-flow nasal cannula therapy as a non-invasive ventilation method in children with respiratory distress/failure in a noninvasive ventilation device-free pediatric intensive care unit. METHODS: The study was a retrospective chart review of children with respiratory distress/failure admitted 1 year before (period before high-flow nasal cannula therapy) and 1 year after (period after high-flow nasal cannula therapy) the introduction of high-flow nasal cannula therapy...
July 11, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28698265/risk-factors-for-noninvasive-ventilation-failure-in-critically-ill-subjects-with-confirmed-influenza-infection
#20
Alejandro Rodríguez, Cristina Ferri, Ignacio Martin-Loeches, Emili Díaz, Joan R Masclans, Federico Gordo, Jordi Sole-Violán, María Bodí, Francesc X Avilés-Jurado, Sandra Trefler, Monica Magret, Gerard Moreno, Luis F Reyes, Judith Marin-Corral, Juan C Yebenes, Andres Esteban, Antonio Anzueto, Stefano Aliberti, Marcos I Restrepo
BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation...
July 11, 2017: Respiratory Care
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