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Weaning ventilation

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https://www.readbyqxmd.com/read/29687440/hypophosphatemia-and-duration-of-respiratory-failure-and-mortality-in-critically-ill-patients
#1
C K Federspiel, T S Itenov, K Thormar, K D Liu, M H Bestle
BACKGROUND: Hypophosphatemia has been associated with prolonged duration of respiratory failure and increased mortality in critically ill patients, but there is very limited evidence supporting the negative effects of low phosphate. We examined the association between hypophosphatemia at ICU admission and time to successful weaning and 28-day mortality. METHODS: This was a cohort study that included all mechanically ventilated adult patients admitted to the ICU in 2013 at Nordsjaellands Hospital...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29687276/diaphragm-function-and-weaning-from-mechanical-ventilation-an-ultrasound-and-phrenic-nerve-stimulation-clinical-study
#2
Martin Dres, Ewan C Goligher, Bruno-Pierre Dubé, Elise Morawiec, Laurence Dangers, Danielle Reuter, Julien Mayaux, Thomas Similowski, Alexandre Demoule
BACKGROUND: Diaphragm dysfunction is defined by a value of twitch tracheal pressure in response to magnetic phrenic stimulation (twitch pressure) amounting to less than 11 cmH2 O. This study assessed whether this threshold or a lower one would predict accurately weaning failure from mechanical ventilation. Twitch pressure was compared to ultrasound measurement of diaphragm function. METHODS: In patients undergoing a first spontaneous breathing trial, diaphragm function was evaluated by twitch pressure and by diaphragm ultrasound (thickening fraction)...
April 23, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#3
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29671866/isocapnic-hyperventilation-provides-early-extubation-after-head-and-neck-surgery-a-prospective-randomized-trial
#4
K Hallén, P Jildenstål, O Stenqvist, J Oras, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2 )-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). METHODS: Thirty-one adult ASA I-III patients undergoing long-duration (>3 hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n = 16) or control (n = 15)...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#5
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29662873/permissive-hypercapnia-results-in-decreased-functional-vessel-density-in-the-skin-of-extremely-low-birth-weight-infants
#6
Alexandra Francoise Puchwein-Schwepcke, Kristina Schottmayer, Zuzana Mormanová, Jens Dreyhaupt, Orsolya Genzel-Boroviczeny, Ulrich H Thome
Background: Ventilator-induced lung injury with subsequent bronchopulmonary dysplasia remains an important issue in the care of extremely low-birth-weight infants. Permissive hypercapnia has been proposed to reduce lung injury. Hypercapnia changes cerebral perfusion, but its influence on the peripheral microcirculation is unknown. Methods: Data were collected from 12 infants, who were randomized to a permissive high PCO2 target group (HTG) or a control group (CG)...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29658860/pressure-support-breaths-triggered-by-total-artificial-heart-in-invasive-and-non-invasive-mechanical-ventilation
#7
Amit Prasad, Kai Singbartl, Behzad Soleimani, Christoph Brehm, Ali Ghodsizad
Because of the risks associated with extended mechanical ventilation, it is desirable to extubate patients as early as possible. However, weaning patients from mechanical ventilation too early has risks associated with it as well. Thus, it is important to note that in the two cases presented here, pressure-supported breaths were falsely triggered by a patient's a Syncardia® total artificial heart (TAH), influencing decisions about weaning the patient from mechanical ventilation.
March 2, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657718/endotracheal-tube-clamping-and-extracorporeal-membrane-oxygenation-to-resuscitate-massive-pulmonary-haemorrhage
#8
Chien-Feng Lee, Chun-Ta Huang, Sheng-Yuan Ruan
Massive pulmonary haemorrhage is a life-threatening and difficult-to-manage condition. In certain circumstances, traditional approaches for haemoptysis may not be effective. Here, we report a 64-year-old man presenting with dyspnoea and leg oedema. He was diagnosed with microscopic polyangiitis due to positive perinuclear anti-neutrophil cytoplasmic antibody and other supportive evidence. His hospital course was complicated with massive pulmonary haemorrhage, which led to hypoxic respiratory failure, shock, and pulseless electrical activity...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29650284/-home-non-invasive-ventilation-for-chronic-obstructive-pulmonary-disease
#9
S Toujani, S Dabboussi, H Snene, M Mjid, S Kamoun, A Hedhli, S Cheikh Rouhou, R Cheikh, M Beji, Y Ouahchi, J Cherif
INTRODUCTION: The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial. AIM: To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population. METHODS: We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital...
April 9, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29644564/semi-quantitative-cough-strength-score-as-a-predictor-for-extubation-outcome-in-traumatic-brain-injury-a-prospective-observational-study
#10
Abdelrady S Ibrahim, Mohamed G Aly, Khaled A Abdel-Rahman, Mona A Mohamed, Mogedda M Mehany, Eman M Aziz
BACKGROUND: Between 25 and 40% of extubated patients with traumatic brain injury (TBI) in the intensive care unit at our hospital (Assiut University Hospital-Assiut-Egypt) require reintubation. This reflects the importance of developing better criteria for predicting successful extubation in TBI. We evaluated the accuracy of semi-quantitative cough strength score (SCSS) and Glasgow coma scale (GCS) in predicting extubation outcomes in TBI. METHODS: This prospective observational study included patients (18-65 years), with TBI on mechanical ventilation more than 24 h who were ready to be weaned off...
April 11, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29643948/central-venous-oxygen-saturation-as-a-predictor-of-a-successful-spontaneous-breathing-trial-from-mechanical-ventilation-a-prospective-nested-case-control-study
#11
Ioannis Georgakas, Afroditi K Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Kristina Matei, Paraskevi Argyropoulou, Ioannis Stanopoulos
Background: Weaning from mechanical ventilation is a key element in the care of critically ill patients, and Spontaneous Breathing Trial (SBT) is a crucial step in this procedure. This nested case-control study aimed to evaluate whether central oxygen saturation (ScvO2 ) values and their changes could independently predict the SBT outcome among mechanically ventilated patients. Methods: A prospective cohort of patients who were mechanically ventilated for at least 48hours and fulfilled the criteria of readiness to wean constituted the study population...
2018: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/29643669/which-is-better-a-standalone-ventilation-or-perfusion-scan-or-combined-imaging-to-predict-postoperative-fev-1-in-one-seconds-in-patients-posted-for-lung-surgeries-with-borderline-pulmonary-reserve
#12
Padma Subramanyam, P Shanmuga Sundaram
Introduction: Forced expiratory volume in one second (FEV1 ) is an independent predictor for respiratory morbidity. Reports are varied and controversial substantiating the use of either lung perfusion (Q) or ventilation (V) scintigraphy as a single stage investigation to predict postoperative (ppo) FEV1 in patients scheduled for lung resection surgeries. It is said that there is no additional benefit by performing both V/Q scan. As per one of the recommendations, no further respiratory function tests are required for a lobectomy if the postbronchodilator FEV1 is >1...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29628332/patients-lived-experience-of-intensive-care-when-being-on-mechanical-ventilation-during-the-weaning-process-a-hermeneutic-phenomenological-study
#13
Catarina Tingsvik, Fredrik Hammarskjöld, Jan Mårtensson, Maria Henricson
BACKGROUND: The medical and nursing care of the patient on mechanical ventilation has developed and proceeds in terms of ventilator functions, sedation strategies and patient participation. New data are needed to explore the weaning process from the patients' perspective. Therefore, the aim of this study was to explore the meaning of being a patient on mechanical ventilation during the weaning process in the intensive care unit. METHODS: This study used van Manen's hermeneutic phenomenological approach...
April 5, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29627660/variation-in-mortality-rates-after-admission-to-long-term-acute-care-hospitals-for-ventilator-weaning
#14
Jeremy M Kahn, Billie S Davis, Tri Q Le, Jonathan G Yabes, Chung-Chou H Chang, Derek C Angus
PURPOSE: We sought to examine variation in long-term acute care hospital (LTACH) quality based on 90-day in-hospital mortality for patients admitted for weaning from mechanical ventilation. METHODS: We developed an administrative risk-adjustment model using data from Medicare claims. We validated the administrative model against a clinical model using data from LTACHs participating in a 2002 to 2003 clinical registry. We then used our validated administrative model to assess national variation in 90-day in-hospital mortality rates in LTACHs from 2013...
March 23, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29626458/re-expansion-pulmonary-edema-after-asd-closure-through-right-sided-mini-thoracotomy
#15
Keiichi Hirose, Senri Miwa, Hisashi Sakaguchi, Shinya Takimoto, Yukiyo Yoshida, Yohei Onga, Yuichi Tara, Kazuo Yamanaka
We described a case suffering from re-expanded pulmonary edema (RPE) after atrial septal defect (ASD) closure through right-sided mini-thoracotomy. After re-expansion of the right lung after weaning from cardiopulmonary bypass (CPB), a large amount of serous slight-hemorrhagic bronchial secretions spilled out from the right bronchus. Positive pressure ventilation and differential ventilation were used. We found no bleeding and decreased secretions 24 hours after the onset of RPE. She was extubated 42 hours after the operation...
April 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29626002/evaluating-off-label-uses-of-acetazolamide
#16
REVIEW
Megan A Van Berkel, Jessica L Elefritz
PURPOSE: Current off-label uses of acetazolamide in hospitalized patients are reviewed. SUMMARY: Acetazolamide is a carbonic anhydrase inhibitor typically used for indications including epilepsy, glaucoma, edema, and altitude sickness but it may be prescribed in hospitalized patients for off-label indications. It inhibits carbonic anhydrase, which leads to reduced hydrogen ion secretion in the proximal renal tubule, resulting in increased bicarbonate and cation excretion and causing urinary alkalization and diuresis...
April 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29619866/enteral-guanfacine-to-treat-severe-anxiety-and-agitation-complicating-critical-care-after-cardiac-surgery
#17
Habib Srour, Komal Pandya, Alex Flannery, Kevin Hatton
This article is the first reported case describing the off-label use of enteral immediate-release guanfacine, a long-acting α-2 adrenergic agonist most commonly used in the treatment of attention-deficit hyperactivity disorder, for sedation in a patient with severe anxiety and agitation limiting mechanical ventilation weaning several days after cardiac surgery. In this case, after several days of unsuccessful attempts to control his agitation and anxiety with conventional therapies, guanfacine therapy was initiated, and the patient was rapidly weaned from all other sedatives and mechanical ventilation shortly thereafter...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29615274/conventional-monitoring-is-not-sufficient-to-assess-respiratory-effort-during-assisted-ventilation
#18
F Ruiz Ferrón, J M Serrano Simón
OBJECTIVE: Study the relationship and concordance between calculated respiratory effort using the signals of the ventilator (Pmus) and that measured in esophageal pressure (Pes) on mechanical ventilation with different levels of respiratory assistance. DESIGN: Prospective cohort study. AMBIT: Intensive Care Unit of 2 universitary hospitals. Patients Patients on weaning time. PROCEDURE: Airway, esophageal and respiratory flow were recorded on CPAP, assist volume control (ACV) and pressure support (PS), with complete (ACV1,PS1) and partial assistance (ACV5,PS5)...
March 31, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29610158/lung-volume-reduction-surgery-for-respiratory-failure-in-infants-with-bronchopulmonary-dysplasia
#19
Bongyeon Sohn, Samina Park, In Kyu Park, Young Tae Kim, June Dong Park, Sung-Hye Park, Chang Hyun Kang
Lung volume reduction surgery (LVRS) can be performed in patients with severe emphysematous disease. However, LVRS in pediatric patients has not yet been reported. Here, we report our experience with 2 cases of pediatric LVRS. The first patient was a preterm infant girl with severe bronchopulmonary dysplasia, pulmonary hypertension, and hypothyroidism. The emphysematous portion of the right lung was removed via sternotomy and right hemiclamshell incision. The patient was discharged on full-time home ventilator support for 3 months after the surgery...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29604150/neurophysiological-study-of-critical-illness-polyneuropathy-and-myopathy-in-mechanically-ventilated-children-additional-aspect-into-pediatric-critical-illness-comorbidities
#20
Ahmed Thabet Mahmoud, Maha A M Tawfik, Sameh Abdallah Abd El Naby, Wafaa Moustafa M Abo El Fotoh, Nagwan Yossery Saleh, Nahla M Said Abd El Hady
BACKGROUND: Critical illness polyneuropathy and myopathy (CIP/CIM) is being increasingly recognized as a significant clinical problem in critically ill children especially who have spent long periods in the intensive care unit. So we aimed to determine the frequency of CIP/CIM among mechanically ventilated children and to analyze the associated risk factors and drawbacks frequently encountered in this cohort. METHODS: The study included 105 patients admitted to the pediatric intensive care unit and underwent mechanical ventilation for ≥7 days...
March 31, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
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