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https://www.readbyqxmd.com/read/28926488/potential-acceptability-of-a-pediatric-ventilator-management-computer-protocol
#1
Katherine A Sward, Christopher J L Newth, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Allan Doctor, J Michael Dean, Richard Holobkov, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome. DESIGN: Survey/questionnaire. SETTING: The eight PICUs in the Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: One hundred twenty-two physicians (attendings and fellows). INTERVENTIONS: None...
September 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28926151/hospital-in-the-home-nurses-recognition-and-response-to-clinical-deterioration
#2
Erika Gray, Judy Currey, Julie Considine
AIMS AND OBJECTIVES: To obtain an understanding of how HITH (Hospital in the Home) nurses recognise and respond to clinical deterioration in patients receiving care at home or in their usual place of residence. BACKGROUND: Recognising and responding to clinical deterioration is an international safety priority and a key nursing responsibility. Despite an increase in care delivery in home environments, how HITH nurses recognise and respond to clinical deterioration is not yet fully understood...
September 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28925893/big-data-analyses-for-continuous-evaluation-of-pharmacotherapy-a-proof-of-principle-with-doxapram-in-preterm-infants
#3
Robert Flint, Willem van Weteringen, Swantje Völler, Jarinda A Poppe, Birgit Cp Koch, Ronald de Groot, Dick Tibboel, Catherijne Aj Knibbe, Irwin Km Reiss, Sinno Hp Simons
BACKGROUND: Drug effect evaluation is often based on subjective interpretation of a selection of patient data. Continuous analyses of high frequency patient monitor data are a valuable source to measure drug effects. However, these have not yet been fully explored in clinical care. We aim to evaluate the usefulness and applicability of high frequency physiological data for analyses of pharmacotherapy. METHODS: As a proof of principle, the effects of doxapram, a respiratory stimulant, on the oxygenation in preterm infants were studied...
September 18, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28925861/perioperative-pulmonary-medication-management
#4
Johnathan Ross Renew, Stephen Aniskevich
BACKGROUND: Pulmonary conditions such as asthma and chronic obstructive pulmonary disease (COPD) are common conditions that warrant special consideration in the perioperative period. When these patients undergo surgical interventions, they have risk of complications such as bronchospasm, hypoxia, and even postoperative respiratory failure that warrants unplanned intensive care unit admission. Thus, clinicians must be familiar with pulmonary medication regimens that are critical for maintaining stable homeostasis of these chronic conditions...
September 18, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#5
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924310/use-of-corticosteroids-in-acute-respiratory-distress-syndrome-perspective-from-an-indian-intensive-care-unit
#6
Naveen G S Chandra, Saraschandra Vallabhajosyula, Barkur A Shastry, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula, Kavita Saravu
BACKGROUND: Acute respiratory distress syndrome (ARDS) causes overwhelming inflammation, which serves as a potential target for corticosteroids. Despite extensive Western literature, there are no Indian studies evaluating steroids in ARDS. METHODS: This was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2 mg/kg/day), whereas others received low-dose (1 mg/kg/day) steroids...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28924245/understanding-the-factors-affecting-self-management-of-copd-from-the-perspectives-of-healthcare-practitioners-a-qualitative-study
#7
Oladapo J Ogunbayo, Sian Russell, James J Newham, Karen Heslop-Marshall, Paul Netts, Barbara Hanratty, Eileen Kaner
Self-management is recognised as an essential criteria for the provision of high quality care for chronic obstructive pulmonary disease (COPD). The management of COPD is usually delivered by a wide range of healthcare practitioners. This study aimed to understand the factors affecting self-management of COPD from the perspectives of the different multidisciplinary healthcare teams involved in COPD care. Semi-structured interviews were conducted with participants from primary care, specialist respiratory and pulmonary rehabilitation (PR) teams...
September 18, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28924136/a-case-of-tracheobronchomalacia-mimicking-acute-pulmonary-embolism
#8
Stefani M Schwartz, Katherine J Greco, Venugopal Reddy
BACKGROUND Pulmonary embolism is a common acute postoperative complication and is associated with 100,000 deaths per year in the USA. Tracheobronchomalacia is an uncommon condition, which presents with similar symptoms to pulmonary embolism, including hypoxemia, tachycardia, and shortness of breath. We describe a case of a patient who presented with postoperative pulmonary symptoms that were initially thought to be due to pulmonary embolism. However, following imaging investigations these symptoms were found to be due to tracheobronchomalacia...
September 19, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28923817/patient-willingness-to-have-tests-to-guide-antibiotic-use-for-respiratory-tract-infections-from-the-wwami-region-practice-and-research-network-wprn
#9
Malaika Schwartz, Victoria Hardy, Gina A Keppel, William Alto, Jaime Hornecker, Beth Robitaille, Jon Neher, John Holmes, M Ashworth Dirac, Allison M Cole, Matthew Thompson
INTRODUCTION: The majority of consultations for acute respiratory tract infections (RTIs) lead to prescriptions for antibiotics, which have limited clinical benefit. We explored patients' willingness to have blood tests as part of the diagnostic work-up for RTIs, and patient knowledge about antibiotics. METHODS: Patients at 6 family medicine clinics were surveyed. Regression modeling was used to determine independent predictors of willingness to have venous and point-of-care (POC) blood tests, and knowledge of the value of antibiotics for RTIs...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923806/improving-the-health-of-patients-and-communities-evolving-practice-based-research-pbr-and-collaborations
#10
Kevin Fiscella
This issue illustrates how research from practice-based research networks has evolved to span a spectrum from improving patient-level care and practice quality to improving health within local and global communities. Articles address patient-level improvements (a biomarker for cardiovascular disease progression, late-onset anorexia nervosa, complementary health approaches used by patients, and patient preferences related to antibiotics for acute respiratory infections); practice-level improvements (selection of types of fecal immunochemical tests, practice facilitation, practice registry implementation, community-based outreach, and bidirectional texting); and community-level improvements (primary care-public health partnership, influenza surveillance, and establishing family medicine training abroad)...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923760/commonly-used-patient-reported-outcomes-do-not-improve-prediction-of-copd-exacerbations-a-multicenter-4-5-year-prospective-cohort-study
#11
Alexandra Strassmann, Anja Frei, Sarah R Haile, Gerben Ter Riet, Milo A Puhan
BACKGROUND: Several cross-sectional and short-term studies suggest that patient-reported outcomes (PROs) may be useful to (help) predict COPD exacerbations but evidence from long-term prospective cohort studies is missing. Our aim was to assess if PROs add to the prediction of exacerbations. METHODS: 408 primary care COPD patients participated in the multicenter prospective ICE COLD ERIC cohort. PROs included the Chronic Respiratory Disease Questionnaire, the Hospital Anxiety and Depression Scale, the Feeling Thermometer and the LASA Physical Activity Questionnaire (LAPAQ)...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#12
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
August 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#13
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28921478/interstitial-pneumonia-with-autoimmune-features-an-additional-risk-factor-for-ards
#14
Giacomo Grasselli, Beatrice Vergnano, Maria Rosa Pozzi, Vittoria Sala, Gabriele D'Andrea, Vittorio Scaravilli, Marco Mantero, Alberto Pesci, Antonio Pesenti
BACKGROUND: Interstitial pneumonia with autoimmune features (IPAF) identifies a recently recognized autoimmune syndrome characterized by interstitial lung disease and autoantibodies positivity, but absence of a specific connective tissue disease diagnosis or alternative etiology. We retrospectively reviewed the clinical presentation, diagnostic workup and management of seven critically ill patients who met diagnostic criteria for IPAF. We compared baseline characteristics and clinical outcome of IPAF patients with those of the population of ARDS patients admitted in the same period...
September 18, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28920631/pneumocystis-jirovecii-genotyping-experience-in-a-tertiary-care-hospital-in-northern-italy
#15
Pietro Pini, Carlotta F Orsi, Annunziata La Regina, Samuele Peppoloni, Federica Berrilli, Elisabetta Blasi, David Di Cave
Respiratory samples from Pneumocystis jirovecii pneumonia (PJP) cases collected at a tertiary-care university hospital in Modena were analyzed for the presence of specific polymorphisms in the mitochondrial large subunit ribosomal RNA (mtLSU-rRNA). Retrospectively, 57 cases were selected in a six-year period and 34 out of the 57 processed BAL samples returned PCR positive results, thus allowing further molecular analysis. The following P.jirovecii genotype distribution was observed: genotype 3 (50%), genotype 2 (23%), genotype 1 (18%), genotypes 1 or 4 (9%)...
July 2017: New Microbiologica
https://www.readbyqxmd.com/read/28919320/is-selective-echocardiography-in-duodenal-atresia-the-future-standard-of-care
#16
Abid Khan, Sharman Tan Tanny, Elizabeth J Perkins, Rodney W Hunt, John M Hutson, Sebastian K King, Bryn Jones, Warwick J Teague
BACKGROUND: Duodenal atresia (DA) is associated with cardiac defects that may have perioperative care implications. Standard preoperative care includes echocardiography to identify such cardiac defects, but this dogma has been challenged. We aimed to assess selective and selective strategies for preoperative echocardiography in DA patients. METHODS: Single-center retrospective review of neonates with DA over a 16-year period was performed. Data included preoperative cardiovascular and respiratory examination, chest x-ray, and echocardiography...
September 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28919116/global-regional-and-national-age-sex-specific-mortality-for-264-causes-of-death-1980-2016-a-systematic-analysis-for-the-global-burden-of-disease-study-2016
#17
(no author information available yet)
BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year...
September 16, 2017: Lancet
https://www.readbyqxmd.com/read/28918409/qualitative-interview-study-of-parents-perspectives-concerns-and-experiences-of-the-management-of-lower-respiratory-tract-infections-in-children-in-primary-care
#18
Amy Halls, Catherine Van't Hoff, Paul Little, Theo Verheij, Geraldine M Leydon
OBJECTIVE: To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. DESIGN: Qualitative semistructured interview study. SETTING: UK primary care. PARTICIPANTS: 23 parents of children aged 6 months to 10 years presenting with LRTI in primary care. METHOD: Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918401/return-to-work-and-lost-earnings-after-acute-respiratory-distress-syndrome-a-5-year-prospective-longitudinal-study-of-long-term-survivors
#19
Biren B Kamdar, Kristin A Sepulveda, Alexandra Chong, Robert K Lord, Victor D Dinglas, Pedro A Mendez-Tellez, Carl Shanholtz, Elizabeth Colantuoni, Till M von Wachter, Peter J Pronovost, Dale M Needham
BACKGROUND: Delayed return to work is common after acute respiratory distress syndrome (ARDS), but has undergone little detailed evaluation. We examined factors associated with the timing of return to work after ARDS, along with lost earnings and shifts in healthcare coverage. METHODS: Five-year, multisite prospective, longitudinal cohort study of 138 2-year ARDS survivors hospitalised between 2004 and 2007. Employment and healthcare coverage were collected via structured interview...
September 16, 2017: Thorax
https://www.readbyqxmd.com/read/28918395/non-invasive-high-frequency-oscillatory-ventilation-in-preterm-infants-a-randomised-controlled-cross-over-trial
#20
Daniel Klotz, Hendryk Schneider, Stefan Schumann, Benjamin Mayer, Hans Fuchs
OBJECTIVE: Non-invasive high-frequency oscillatory ventilation (nHFOV) has recently been described as a novel mode of respiratory support for premature infants. This study was designed to determine whether nHFOV decreases CO2 partial pressure (pCO2) in premature infants more effectively than non-invasive continuous positive airway pressure (nCPAP). DESIGN: Non-blinded prospective randomised controlled cross-over study. SETTING: University Medical Center tertiary neonatal intensive care unit...
September 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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