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Weaning ventilation

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https://www.readbyqxmd.com/read/29229252/implementation-of-an-early-extubation-protocol-in-cardiac-surgical-patients-decreased-ventilator-time-but-not-intensive-care-unit-or-hospital-length-of-stay
#1
Matthew Richey, Ashley Mann, Jianghua He, Emmanuel Daon, Katy Wirtz, Allegra Dalton, Brigid C Flynn
OBJECTIVE: The optimal timing of extubation following cardiac surgery is currently unknown. Protocols implemented in order to achieve a rapid extubation may achieve this goal, but not prove beneficial in terms of outcomes. DESIGN: A prospective clinical trial. SETTING: Tertiary care cardiac surgical intensive care unit. PARTICIPANTS: Adult cardiac surgical patients. INTERVENTIONS: Implementation of an 8-tier multidisciplinary rapid weaning protocol...
November 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221294/using-m-mode-ultrasonography-to-assess-diaphragm-dysfunction-and-predict-the-success-of-mechanical-ventilation-weaning-in-elderly-patients
#2
Daozheng Huang, Huan Ma, Wenzhao Zhong, Xiaoting Wang, Yan Wu, Tiehe Qin, Shouhong Wang, Ning Tan
Background: Ultrasonography (US) is a non-invasive and commonly available bedside diagnostic tool. The aim of this study was to assess the utility of M-mode US on ventilator weaning outcomes in elderly patients. Methods: This was a single center, prospective, observational study in patients aged 80 years or older who were in the medical intensive care unit, had undergone mechanical ventilation for >48 hours, and met the criteria for a spontaneous breathing trial (SBT)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29213205/hypercapnic-ventilatory-response-in-the-weaning-of-patients-with-prolonged-mechanical-ventilation
#3
Chung-Shu Lee, Ning-Hung Chen, Li-Pang Chuang, Chih-Hao Chang, Li-Fu Li, Shih-Wei Lin, Hsiung-Ying Huang
Objective: To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [[Formula: see text]] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2 ]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods: A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29212551/extracorporeal-membrane-oxygenation-for-life-threatening-asthma-refractory-to-mechanical-ventilation-analysis-of-the-extracorporeal-life-support-organization-registry
#4
Hye Ju Yeo, Dohyung Kim, Doosoo Jeon, Yun Seong Kim, Peter Rycus, Woo Hyun Cho
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in cases of near-fatal asthma (NFA) has increased, but the benefits and potential complications of this therapy have yet to be fully investigated. METHODS: Cases were extracted from the Extracorporeal Life Support Organization Registry between March 1992 and March 2016. All patients with a diagnosis of asthma (according to the International Classification of Diseases 9th edition), who also received ECMO, were extracted...
December 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29209502/monitoring-diaphragm-function-in-a-patient-with-myasthenia-gravis-electrical-activity-of-the-diaphragm-vs-maximal-inspiratory-pressure
#5
Yukiko Koyama, Takeshi Yoshida, Akinori Uchiyama, Yuji Fujino
Background: Maximal inspiratory pressure (MIP) is used to assess respiratory muscle strength of patients with myasthenia gravis (MG) requiring ventilatory support. Electrical activity of the diaphragm (E-di) has been used to guide weaning. Case presentation: The MIP and tidal volume/ΔE-di (the patient-to-ventilator breath contribution) were monitored in a 12-year-old girl with MG requiring ventilator support. The same ventilatory settings were maintained until extubation...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29201833/in-reply-successful-extubation-after-weaning-failure-by-non-invasive-ventilation-in-patients-with-neurmuscular-disease-do-we-appreciate-the-bigger-picture
#6
Sun Mi Kim, Yu Hui Won, Seong-Woong Kang
No abstract text is available yet for this article.
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29201832/letter-to-the-editor-successful-extubation-after-weaning-failure-by-noninvasive-ventilation-in-patients-with-neuromuscular-disease-do-we-appreciate-the-bigger-picture
#7
COMMENT
Alastair J Glossop, Antonio M Esquina
No abstract text is available yet for this article.
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29195690/completed-fda-feasibility-trial-of-surgically-placed-temporary-diaphragm-pacing-electrodes-a-promising-option-to-prevent-and-treat-respiratory-failure
#8
Raymond P Onders, Alan Markowitz, Vanessa P Ho, Jeff Hardacre, Yuri Novitsky, Christopher Towe, MaryJo Elmo, Cindy Kaplan, Robert Schilz
BACKGROUND: Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS: A prospective FDA feasibility trial evaluated temporary DP electrodes implanted in each hemi-diaphragm during a subject's primary procedure. Objectives included: ability to provide ventilation, stability analysis with diaphragm electromyography, and adverse event monitoring...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29185398/diaphragmatic-excursion-does-it-predict-successful-weaning-from-mechanical-ventilation
#9
Arshad Hayat, Aslam Khan, Amir Khalil, Asma Asghar
OBJECTIVE: To measure the diaphragmatic excursion and its outcome on weaning from mechanical ventilation. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Medical Intensive Care Unit (ICU), Military Hospital (MH), Rawalpindi, Pakistan, from January to December 2014. METHODOLOGY: Diaphragmatic excursion (DE) in cm was measured through ultrasound by marking liver and spleen displacement in patients who fulfilled the criteria of removal from ventilatory support...
December 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29184423/propofol-or-benzodiazepines-for-short-and-long-term-sedation-in-intensive-care-units-an-economic-evaluation-based-on-meta-analytic-results
#10
Lorenzo Pradelli, Massimiliano Povero, Hartmut Bürkle, Tim-Gerald Kampmeier, Giorgio Della-Rocca, Astrid Feuersenger, Jean-Francois Baron, Martin Westphal
Purpose: This evaluation compares propofol and benzodiazepine sedation for mechanically ventilated patients in intensive care units (ICUs) in order to identify the potential economic benefits from different payers' perspectives. Methods: The patient-level simulation model incorporated efficacy estimates from a structured meta-analysis and ICU-related costs from Italy, Germany, France, UK, and the USA. Efficacy outcomes were ICU length of stay (LOS), mechanical ventilation duration, and weaning time...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29181382/reinnervation-of-the-diaphragm-by-the-inferior-laryngeal-nerve-to-the-phrenic-nerve-in-ventilator-dependent-tetraplegic-patients-with-c3-5-damage
#11
Eric Verin, Capucine Morelot-Panzini, Jesus Gonzalez-Bermejo, Benoit Veber, Brigitte Perrouin Verbe, Brigitte Soudrie, Anne Marie Leroi, Jean Paul Marie, Thomas Similowski
The aim of this study was to evaluate the feasibility of unilateral diaphragmatic reinnervation in humans by the inferior laryngeal nerve. This pilot study included chronically ventilated tetraplegic patients with destruction of phrenic nerve motoneurons. Five patients were included. They all had a high level of tetraplegia, with phrenic nerve motor neuron destruction. They were highly dependent on ventilation, without any possibility of weaning. They did not have other chronic pathologies, especially laryngeal disease...
October 2017: ERJ Open Research
https://www.readbyqxmd.com/read/29181137/transfusion-related-acute-lung-injury-trali-in-two-thalassaemia-patients-caused-by-the-same-multiparous-blood-donor
#12
Annita Kolnagou, Christina N Kontoghiorghe, George J Kontoghiorghes
We report two separate episodes of transfusion-related acute lung injury (TRALI) in two thalassaemia patients who received red blood cell transfusions from the same multiparous donor. Both cases had the same symptomatology and occurred within 60 minutes of transfusion. The patients presented dyspnoea, sweating, fatigue, dizziness, fever, and sense of losing consciousness. The chest x-ray showed a pulmonary oedema-like picture with both lungs filled with fluid. The patients were treated in the intensive therapy unit...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#13
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29178042/correction-to-terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#14
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
Correction to: Intensive Care Med (2017) DOI 10.1007/s00134-017-4891-0.
November 24, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29173205/effect-of-maternal-dyslipidaemia-on-the-cardiorespiratory-physiology-and-biochemical-parameters-in-male-rat-offspring
#15
Keyth Sulamitta L Guimarães, Emmanuel Veríssimo de Araújo, Jailane Souza Aquino, Danilo Assis Gadelha, Camille Moura Balarini, João Henrique Costa-Silva, Marciane Magnani, Hubert Vidal, Valdir Andrade Braga, José Luiz de Brito Alves
The present study evaluated the effects of maternal dyslipidaemia on blood pressure (BP), cardiorespiratory physiology and biochemical parameters in male offspring. Wistar rat dams were fed either a control (CTL) or a dyslipidaemic (DLP) diet during pregnancy and lactation. After weaning, both CTL and DLP offspring received standard diet. On the 30th and 90th day of life, blood samples were collected for metabolic analyses. Direct measurements of BP, respiratory frequency (RF), tidal volume (VT) and ventilation (VE) under baseline condition, as well as during hypercapnia (7 % CO2) and hypoxia (KCN, 0·04 %), were recorded from awake 90-d-old male offspring...
November 27, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/29171247/care-of-patients-undergoing-weaning-from-mechanical-ventilation-in-critical-care
#16
Susan Elliott, Nicola Morrell-Scott
There are several reasons why mechanical ventilation - the use of an artificial device to assist a patient to breathe - may be initiated, for example to enable general anaesthesia for patients undergoing surgery, and for those with a compromised airway or respiratory failure. It is important that critical care nurses have the skills and knowledge to care for patients who are undergoing weaning from mechanical ventilation. This is to ensure that patients are weaned safely and as soon as possible, to improve their outcomes and avoid an increase in patient mortality and morbidity through complications that can arise such as airway trauma and ventilator-associated pneumonia...
November 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29166922/herpes-simplex-type-1-pneumonitis-and-acute-respiratory-distress-syndrome-in-a-patient-with-chronic-lymphatic-leukemia-a-case-report
#17
Miriam Luginbuehl, Alexander Imhof, Alexander Klarer
BACKGROUND: Pulmonary pathogenicity of herpes simplex virus type 1 in patients in intensive care without classic immunosuppression as well as the necessity of antiviral treatment in the case of herpes simplex virus detection in respiratory specimens in these patients is controversial. We present a case of acute respiratory distress syndrome in a patient with stable chronic lymphatic leukemia not requiring treatment, in whom we diagnosed herpes simplex virus type 1 bronchopneumonitis based on herpes simplex virus type 1 detection in bronchoalveolar lavage fluid and clinical response to antiviral treatment...
November 23, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29162728/evaluating-the-value-of-the-respiratory-therapist-where-is-the-evidence-focus-on-the-barnes-jewish-hospital-experience
#18
Marin H Kollef
Currently, >20 million people in the United States have asthma, and approximately 15 million adults have been diagnosed with COPD, with approximately the same number not yet having been diagnosed with this condition. Moreover, the overall burden of respiratory diseases is still increasing, in part due to environmental factors, such as air pollution. At the same time, the number of patients requiring hospitalization as well as the number of individuals admitted to ICUs from emergency departments has been on the rise over the last decade...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/29158939/mediastinal-tracheostoma-for-treatment-of-tracheostenosis-after-tracheostomy-in-a-patient-with-mucopolysaccharidosis-induced-tracheomalacia
#19
Yasuhiro Chikaishi, Kenichi Kobayashi, Shuichi Shinohara, Akihiro Taira, Yusuke Nabe, Shinji Shinohara, Taiji Kuwata, Masaru Takenaka, Soichi Oka, Ayako Hirai, Kazue Yoneda, Koji Kuroda, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
Background: Treatment of tracheostenosis after tracheostomy in pediatric patients is often difficult. Mucopolysaccharidosis is a lysosomal storage disease that may induce obstruction of the airways. Case Presentation: A 16-year-old male patient underwent long-term follow-up after postnatal diagnosis of type II mucopolysaccharidosis. At 11 years of age, tracheostomy was performed for mucopolysaccharidosis-induced laryngeal stenosis. One week prior to presentation, he was admitted to another hospital on an emergency basis for major dyspnea...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29158899/diaphragm-thickening-fraction-to-predict-weaning-a-prospective-exploratory-study
#20
Sujay Samanta, Ratender Kumar Singh, Arvind K Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
Background: Diaphragm ultrasound (DUS) is a well-established point of care modality for assessment of dimensional and functional aspects of the diaphragm. Amongst various measures, diaphragmatic thickening fraction (DTf) is more comprehensive. However, there is still uncertainty about its capability to predict weaning from mechanical ventilation (MV). The present prospective observational exploratory study assessed the diaphragm at variable negative pressure triggers (NPTs) with US to predict weaning in ICU patients...
2017: Journal of Intensive Care
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