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Weaning ventilation

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https://www.readbyqxmd.com/read/28096834/does-the-apache-ii-score-predict-performance-of-activities-of-daily-living-in-patients-discharged-from-a-weaning-center
#1
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
INTRODUCTION: Data regarding the functional status of patients after prolonged mechanical ventilation are scarce, and little is known about its clinical predictors. AIM: To investigate whether the Acute Physiology and Chronic Health Evaluation (APACHE) II score on admission may predict performance in activities of daily living on discharge from a weaning center. MATERIAL AND METHODS: All consecutive patients admitted between January 1, 2012 and December 31, 2013 were enrolled (n = 130)...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28096571/acute-respiratory-failure-and-mechanical-ventilation-in-pregnant-patient-a-narrative-review-of-literature
#2
REVIEW
Pradeep Kumar Bhatia, Ghansham Biyani, Sadik Mohammed, Priyanka Sethi, Pooja Bihani
Physiological changes of pregnancy imposes higher risk of acute respiratory failure (ARF) with even a slight insult and remains an important cause of maternal and fetal morbidity and mortality. Although pregnant women have different respiratory physiology and different causes of ARF, guidelines specific to ventilatory settings, goals of oxygenation and weaning process could not be framed due to lack of large-scale randomized controlled trials. During the 2009 H1N1 pandemic, pregnant women had higher morbidity and mortality compared to nonpregnant women...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#3
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074826/extracorporeal-membrane-oxygenation-for-repair-of-tracheal-injury-during-transhiatal-esophagectomy
#4
Lilibeth Fermin, Sarah Arnold, Lorena Nunez, Danny Yakoub
Extracorporeal Membrane Oxygenation (ECMO) for repair of tracheal injury during transhiatal esophagectomy Tracheal injury is a rare but potentially fatal complication of esophagectomies requiring prompt recognition and treatment. We describe a case of tracheal injury recognized in the operative period of an open transhiatal esophagectomy for squamous cell carcinoma of the mid to distal esophagus. When injury was discovered, attempts to improve oxygenation and ventilation by conventional methods were unsuccessful...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#5
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28063121/monitoring-of-electrical-activity-of-the-diaphragm-shows-failure-of-t-piece-trial-earlier-than-protocol-based-parameters-in-prolonged-weaning-in-non-communicative-neurological-patients
#6
Oliver Trapp, Mascha Fiedler, Michael Hartwich, Martin Schorl, Armin Kalenka
BACKGROUND: The weaning target in tracheotomised patients is not extubation, but spontaneous breathing without the support of a ventilator. Overloading the respiratory pump during such spontaneous breathing trials is unfavorable, prolongs weaning time, and increases morbidity and mortality. The goal of this study was to evaluate the electrical activity of the diaphragm during a t-piece trial in non-communicative neurological patients and the comparison to clinical parameters of exhaustion...
January 6, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28053973/noninvasive-ventilation-during-the-weaning-process-in-chronically-critically-ill-patients
#7
Jesus Sancho, Emilio Servera, Luis Jara-Palomares, Emilia Barrot, Raquel Sanchez-Oro-Gómez, F Javier Gómez de Terreros, M Jesús Martín-Vicente, Isabel Utrabo, M Belen Núñez, Alicia Binimelis, Ernest Sala, Enrique Zamora, Gonzalo Segrelles, Angel Ortega-Gonzalez, Fernando Masa
Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials...
October 2016: ERJ Open Research
https://www.readbyqxmd.com/read/28050205/tracheostomy-in-the-intensive-care-unit-a-university-hospital-in-a-developing-country-study
#8
Mohammad Waheed El-Anwar, Ahmad Abdel-Fattah Nofal, Mohammad A El Shawadfy, Ahmed Maaty, Alaa Omar Khazbak
Introduction Tracheostomy is the commonest surgical procedure in intensive care units (ICUs). It not only provides stable airway and facilitates pulmonary toilet and ventilator weaning, but also decreases the direct laryngeal injury of endotracheal intubation, and improves patient comfort and daily living activity. Objective The objective of this study is to assess the incidence, indications, timing, complications (early and late), and the outcome of tracheostomy on patients in the intensive care units (ICU) at a university hospital in a developing country...
January 2017: International Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/28042370/review-of-critical-illness-myopathy-and-neuropathy
#9
Starane Shepherd, Ayush Batra, David P Lerner
Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28041730/effects-of-cinnamaldehyde-or-monensin-on-performance-of-weaned-holstein-dairy-heifers
#10
C E Chapman, H Chester-Jones, D Ziegler, J A Clapper, P S Erickson
The objective of this 70-d study was to determine the effects of the essential oil cinnamaldehyde compared with the ionophore monensin on performance of weaned Holstein dairy heifers. Eighty-four Holstein dairy heifers (91 ± 3.33 d of age; 109 ± 7.55 kg) were housed in a naturally ventilated curtain side-wall, straw-bedded barn in 12 pens with 7 heifers/pen (3.98 m(2)/head). Heifers were randomly assigned to 1 of 4 treatments in a completely randomized design: (1) control (CON; carrier, 908 g of ground corn), (2) monensin sodium [MON; 1 mg/kg of body weight (BW) + carrier], (3) cinnamaldehyde (CIN1; 1 mg/kg of BW + carrier), or (4) cinnamaldehyde (CIN2; 2 mg/kg of BW + carrier)...
December 29, 2016: Journal of Dairy Science
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#11
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28007867/chest-wall-stabilization-in-ventilator-dependent-traumatic-flail-chest-patients-who-benefits-%C3%A2
#12
Gregor J Kocher, Siamak Sharafi, Luis Filipe Azenha, Ralph A Schmid
OBJECTIVES: Traumatic flail chest is a potentially life threatening injury, often associated with prolonged invasive mechanical ventilation and intensive care unit stay. This study evaluates the usefulness and cost-effectiveness of surgical rib stabilization in patients with flail chest resulting in ventilator dependent respiratory insufficiency. METHODS: A retrospective study on a consecutive series of patients with flail chest with the need for mechanical ventilation was performed...
December 22, 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/27984285/standardization-of-ventilator-weaning-benefits-both-researchers-and-clinicians
#13
Silvia M Hartmann, Jerry J Zimmerman
No abstract text is available yet for this article.
January 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27980751/a-case-of-veno-venous-extracorporeal-membrane-oxygenation-for-severe-respiratory-failure-in-a-superobese-patient
#14
Mirko Belliato, Luca Cremascoli, Anna Aliberti, Michele Pagani, Carlo Pellegrini, Giorgio Antonio Iotti
After risk assessment, veno-venous extracorporeal membrane oxygenation (ECMO) has been achieved in a superobese adult patient as a bridge to recovery of respiratory failure, despite the weight-related difficulties. Early v-v ECMO implantation could be considered to support and to conduct weaning both from sedation and from invasive mechanical ventilation, with the goal to perform physiokinesitherapy during awake ECMO.
December 2016: Clinical Case Reports
https://www.readbyqxmd.com/read/27979608/early-mobilization-reduces-duration-of-mechanical-ventilation-and-intensive-care-unit-stay-in-patients-in-acute-respiratory-failure
#15
Chih-Cheng Lai, Willy Chou, Khee-Siang Chan, Kuo-Chen Cheng, Kuo-Shu Yuan, Chien-Ming Chao, Chin-Ming Chen
OBJECTIVES: To evaluate the effects of a quality improvement program to introduce early mobilization on the outcome of mechanical ventilation (MV) patients in the Intensive Care Unit (ICU). DESIGN: A retrospective observational study SETTING: 19-beds ICU at a medical center PARTICIPANTS: All adults MV patients admitted a medical ICU INTERVENTION: A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, and patients' family) initiated the protocol within 72 hours of MV, when patients become hemodynamically stable...
December 12, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27977533/successful-management-of-fulminant-guillain-barr%C3%A3-syndrome-and-its-complications
#16
Atsushi Kamei, Manami Akasaka, Nami Araya, Ken Ishikawa, Akira Takada, Hiromi Furukawa, Sachiko Tanifuji, Maya Asami, Yurie Nasu, Kotaro Oyama, Shoichi Chida
A 3-year-old girl presented with muscle weakness of her limbs and trunk 6 days after developing symptoms of common cold. Two days later, she experienced respiratory arrest with a Glasgow Coma Scale score of 3, necessitating endotracheal intubation. Therefore, she was transferred to our hospital with suspected acute encephalopathy. Although no abnormalities were observed on brain and spinal magnetic resonance imaging and electroencephalography, peripheral nerve conduction velocity tests failed to evoke motor and sensory nerve action potentials...
December 12, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27974112/-effect-of-early-caffeine-treatment-on-the-need-for-respirator-therapy-in-preterm-infants-with-respiratory-distress-syndrome
#17
Qiao-Zhen Wei, Ping Su, Jin-Tian Han, Xia Zhang, Yu-Hui Duan
OBJECTIVE: To study the efficacy of early caffeine treatment in preterm infants with respiratory distress syndrome (RDS). METHODS: A prospective controlled clinical trial was performed. A total of 59 preterm infants with RDS were enrolled and divided into a caffeine group (30 infants) and a control group (29 infants). Caffeine was administered in the caffeine group and control group at the same dosage at 12-24 hours after birth and before extubation respectively...
December 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/27956916/h1n1-influenza-patient-saved-by-extracorporeal-membrane-oxygenation-first-report-from-iran
#18
Alireza Jahangirifard, Zargham Hossein Ahmadi, Majid Golestani Eraghi, Payam Tabarsi, Majid Marjani, Afshin Moniri, Seyed Ali Reza Nadji, Seyed Mohammad Reza Hashemian, Ali Akbar Velayati
Respiratory failure is a serious complication of H1N1 influenza that, if not properly managed, can cause death. When mechanical ventilation is not effective, the only way to save the patient's life is extracorporeal membrane oxygenation (ECMO). A prolonged type of cardiopulmonary bypass, ECMO is a high-cost management modality compared to other conventional types and its maintenance requires skilled personnel. Such staff usually comprises the members of open-heart surgical teams. Herein, we describe a patient with H1N1 influenza and severe respiratory failure not improved by mechanical ventilation who was admitted to Masih Daneshvari Medical Center in March 2015...
July 6, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27951475/activation-of-respiratory-muscles-during-weaning-from-mechanical-ventilation
#19
Stephan Walterspacher, Julia Gückler, Fabian Pietsch, David Johannes Walker, Hans-Joachim Kabitz, Michael Dreher
PURPOSE: Respiratory muscle dysfunction is a key component of weaning failure. Balancing respiratory muscle loading and unloading by applying different ventilation modes along with spontaneous breathing episodes are established weaning strategies. However, the effects of body positioning on the respiratory muscles during weaning remains unclear. MATERIALS AND METHODS: This study aimed at assessing respiratory drive by surface electromyography (EMG) of the diaphragm (EMGdia) and parasternal muscles (EMGpara) in tracheotomized patients during prolonged weaning in 3 randomized body positions-supine, 30° semirecumbent, and 80° sitting-during mechanical ventilation and spontaneous breathing...
December 2, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27941112/antisynthetase-syndrome-ass-presenting-as-acute-respiratory-distress-syndrome-ards-in-a-patient-without-myositis-features
#20
Venkat Kiran Kanchustambham, Swetha Saladi, Sarah Mahmoudassaf, Setu Patolia
A woman aged 61 years presented to the emergency room with a 1-week history of dyspnoea on exertion and dry cough. X-ray of the chest showed diffuse interstitial opacities and was started on antibiotics and furosemide, and despite these measures, patient's respiratory status worsened, prompting endotracheal intubation. CT of the chest showed diffuse bilateral ground glass opacities and underwent bronchoscope with trans-bronchial biopsy that showed chronic bronchitis. Pt was empirically started on intravenous steroids due to concerns for interstitial lung disease (ILD)...
December 9, 2016: BMJ Case Reports
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