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Mechanical ventillation

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https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#1
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913775/role-of-b-type-natriuretic-peptide-in-predicting-in-hospital-outcomes-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-preserved-left-ventricular-function-a-5-year-retrospective-analysis
#2
Saraschandra Vallabhajosyula, Toufik Mahfood Haddad, Pranathi R Sundaragiri, Anas A Ahmed, Muhammad Sarfraz Nawaz, Hamza A A Rayes, Harish C Devineni, Arun Kanmanthareddy, Dustin A McCann, Christopher S Wichman, Ariel M Modrykamien, Lee E Morrow
BACKGROUND: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). METHODS: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively...
December 2, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27913141/acute-lung-injury-and-persistent-small-airway-disease-in-a-rabbit-model-of-chlorine-inhalation
#3
Sadiatu Musah, Connie F Schlueter, David M Humphrey, Karen S Powell, Andrew M Roberts, Gary W Hoyle
Chlorine is a pulmonary toxicant to which humans can be exposed through accidents or intentional releases. Acute effects of chlorine inhalation in humans and animal models have been well characterized, but less is known about persistent effects of acute, high-level chlorine exposures. In particular, animal models that reproduce the long-term effects suggested to occur in humans are lacking. Here, we report the development of a rabbit model in which both acute and persistent effects of chlorine inhalation can be assessed...
November 29, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27912960/music-intervention-during-daily-weaning-trials-a-6-day-prospective-randomized-crossover-trial
#4
Zhan Liang, Dianxu Ren, JiYeon Choi, Mary Beth Happ, Marylyn Hravnak, Leslie A Hoffman
PURPOSE: To examine the effect of patient-selected music intervention during daily weaning trials for patients on prolonged mechanical ventilation. METHODS: Using a crossover repeated measures design, patients were randomized to music vs no music on the first intervention day. Provision of music was alternated for 6 days, resulting in 3 music and 3 no music days. During weaning trials on music days, data were obtained for 30min prior to music listening and continued for 60min while patients listened to selected music (total 90min)...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27912161/a-prospective-randomized-trial-of-tapered-cuff-endotracheal-tubes-with-intermittent-subglottic-suctioning-in-preventing-ventilator-associated-pneumonia-in-critically-ill-patients
#5
Ata Mahmoodpoor, Hadi Hamishehkar, Masoud Hamidi, Kamran Shadvar, Sarvin Sanaie, Samad Ej Golzari, Zahid Hussain Khan, Nader D Nader
BACKGROUND: Endotracheal tube placement is necessary for the control of the airway in patients who are mechanically ventilated. However, prolonged duration of endotracheal tube placement contributes to the development of ventilator-associated pneumonias (VAPs). The aim of this study was to evaluate whether subglottic suctioning using TaperGuard EVAC tubes was effective in decreasing the frequency of VAP. METHODS: A total of 276 mechanically ventilated patients for more than 72 hours were randomly assigned to group E (EVAC tube) and group C (conventional tube)...
November 14, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27912070/cardiac-complications-associated-with-the-influenza-viruses-a-subtype-h7n9-or-pandemic-h1n1-in-critically-ill-patients-under-intensive-care
#6
Jiajia Wang, Hua Xu, Xinjing Yang, Daguo Zhao, Shenlang Liu, Xue Sun, Jian-An Huang, Qiang Guo
BACKGROUND AND OBJECTIVE: The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain. METHODS: Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention...
November 29, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27911872/p120-regulates-beta-catenin-nuclear-translocation-through-e-cadherin-endocytosis-in-ventilator-induced-lung-injury
#7
Changping Gu, Chenyang Dai, Yongtao Sun, Mengjie Liu, Yuelan Wang, Xinyi Wu
Mechanical stretch induces epithelial barrier dysfunction by altering the location and degradation of cellular junction proteins. p120-catenin (p120) is a cell-cell junction protein known to protect against ventilator-induced lung injury (VILI) that results from improper ventilation of patients. In this study, we sought to determine the role of p120 in VILI and its relationship with the cellular response to mechanical stretch. Mouse lung epithelial cells (MLE-12) transfected with p120 siRNA, p120 cDNA, or E-cadherin siRNA were subjected to 20% cyclic stretch for 2 or 4 hours...
November 30, 2016: Oncotarget
https://www.readbyqxmd.com/read/27910706/intravenous-oxygen-a-novel-method-of-oxygen-delivery-in-hypoxemic-respiratory-failure
#8
Jonathan A Gehlbach, Kyle J Rehder, Michael A Gentile, David A Turner, Daniel J Grady, Ira M Cheifetz
Hypoxemic respiratory failure is a common problem in critical care. Current management strategies, including mechanical ventilation and extracorporeal membranous oxygenation, can be efficacious but these therapies put patients at risk for toxicities associated with invasive forms of support. Areas Covered: In this manuscript, we discuss intravenous oxygen (IVO2), a novel method to improve oxygen delivery that involves intravenous administration of a physiologic solution containing dissolved oxygen at hyperbaric concentrations...
December 2, 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#9
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27909610/comparison-and-evaluation-of-the-effects-of-administration-of-postoperative-non-invasive-mechanical-ventilation-methods-in-for-a-penny-in-for-a-pound
#10
COMMENT
Alastair J Glossop, Antonio M Esquinas
No abstract text is available yet for this article.
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27909608/comparison-of-two-different-enteral-nutrition-protocol-in-critically-ill-patients
#11
Sibel Büyükçoban, Mert Akan, Uğur Koca, Merih Yıldız Eğlen, Meltem Çiçeklioğlu, Ömür Mavioğlu
OBJECTIVE: In this study, two enteral nutrition protocols with different gastric residual volumes (GRVs) and different monitoring intervals were compared with respect to gastrointestinal intolerance findings in intensive care unit (ICU) patients. METHODS: The study was carried out prospectively in 60 patients in the anaesthesiology and reanimation ICU under mechanical ventilation support, who were scheduled to take enteral feeding. Patients were sequentially divided into two groups: Group 1, GRV threshold of 100 mL, and monitoring interval of 4 hours, and Group 2, GRV threshold of 200 mL, monitoring interval of 8 hours...
October 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27908333/pitfalls-in-the-treatment-of-sepsis
#12
REVIEW
Lars-Kristofer N Peterson, Karin Chase
Sepsis is a challenging, dynamic, pathophysiology requiring expertise in diagnosis and management. Controversy exists as to the most sensitive early indicators of sepsis and sepsis severity. Patients presenting to the emergency department often lack complete history or clinical data that would point to optimal management. Awareness of these potential knowledge gaps is important for the emergency provider managing the septic patient. Specific areas of management including the initiation and management of mechanical ventilation, the appropriate disposition of the patient, and consideration of transfer to higher levels of care are reviewed...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27907966/getting-rid-of-weakness-in-the-icu-an-updated-approach-to-the-acute-management-of-myasthenia-gravis-and-guillain-barr%C3%A3-syndrome
#13
Alexis A Lizarraga, Karlo J Lizarraga, Michael Benatar
After prompt diagnosis, severe myasthenia gravis and Guillain-Barré syndrome (GBS) usually require management in the intensive care unit. In the myasthenic patient, recognition of precipitating factors is paramount, and frequent monitoring of bulbar, upper airway, and/or respiratory muscle strength is needed to identify impending myasthenic crisis. Noninvasive ventilation can be attempted prior to intubation and mechanical ventilation in the setting of respiratory failure. Cholinesterase inhibitors should be discontinued, but resumed prior to extubation, and steroid dosage could be increased once the airway is secured...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#14
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907956/intensive-care-management-of-the-endovascular-stroke-patient
#15
Julian Bösel
Acute ischemic stroke caused by the occlusion of large brain vessels can be treated effectively by mechanical thrombectomy, as proved by recent strong and consistent evidence from high-quality randomized trials. This new era of endovascular stroke treatment, however, poses particular challenges that go far beyond the so far gold standard of intravenous thrombolysis alone. Because these stroke patients usually present with severe neurologic deficits, may be unstable from cardiac or pulmonary instability, have to endure an invasive intervention of sometimes long duration, may suffer complications and require close postinterventional follow-up, they often demand intensive care measures...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27906765/hemodynamic-disturbances-in-the-early-phase-after-subarachnoid-hemorrhage-regional-cerebral-blood-flow-studied-by-bedside-xenon-enhanced-ct
#16
Henrik Engquist, Anders Lewén, Tim Howells, Ulf Johnson, Elisabeth Ronne-Engström, Pelle Nilsson, Per Enblad, Elham Rostami
BACKGROUND: The mechanisms leading to neurological deterioration and the devastating course of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) are still not well understood. Bedside xenon-enhanced computerized tomography (XeCT) enables measurements of regional cerebral blood flow (rCBF) during neurosurgical intensive care. In the present study, CBF characteristics in the early phase after severe SAH were explored and related to clinical characteristics and early clinical course outcome...
November 30, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27906709/looking-closer-at-acute-respiratory-distress-syndrome-the-role-of-advanced-imaging-techniques
#17
Giacomo Bellani, Jean-Jaques Rouby, Jean-Michel Constantin, Antonio Pesenti
PURPOSE OF REVIEW: Advanced imaging techniques have provided invaluable insights in understanding of acute respiratory distress syndrome (ARDS) and the effect of therapeutic strategies, thanks to the possibility of gaining regional information and moving from simple 'anatomical' information to in-vivo functional imaging. RECENT FINDINGS: Computed tomography (CT) led to the understanding of several ARDS mechanisms and interaction with mechanical ventilation. It is nowadays frequently part of routine diagnostic workup, often leading to treatment changes...
November 30, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27906705/arterial-pressure-variation-in-elective-noncardiac-surgery-identifying-reference-distributions-and-modifying-factors
#18
Michael R Mathis, Samuel A Schechtman, Milo C Engoren, Amy M Shanks, Aleda Thompson, Sachin Kheterpal, Kevin K Tremper
BACKGROUND: Assessment of need for intravascular volume resuscitation remains challenging for anesthesiologists. Dynamic waveform indices, including systolic and pulse pressure variation, are demonstrated as reliable measures of fluid responsiveness for mechanically ventilated patients. Despite widespread use, real-world reference distributions for systolic and pulse pressure variation values have not been established for euvolemic intraoperative patients. The authors sought to establish systolic and pulse pressure variation reference distributions and assess the impact of modifying factors...
December 1, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27904641/the-effect-of-daily-sedation-interruption-protocol-on-early-incidence-of-ventilator-associated-pneumonia-among-patients-hospitalized-in-critical-care-units-receiving-mechanical-ventilation
#19
Mehdi Shahabi, Hojatollah Yousefi, Ahmad Reza Yazdannik, Babak Alikiaii
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common side effect in patients who receive intravenous sedation infusion. In routine care, after starting sedation infusion for patients who receive mechanical ventilation, interruption of sedation starts without protocol. This study aimed to evaluate the effect of daily sedation vacation protocol on the incidence of VAP in mechanically ventilated patients. MATERIALS AND METHODS: In this clinical trial study, 80 patients with intravenous sedation infusion were selected and randomly allocated to intervention and control groups...
September 2016: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/27904565/is-type-2-diabetes-mellitus-in-mechanically-ventilated-adult-trauma-patients-potentially-related-to-the-occurrence-of-ventilator-associated-pneumonia
#20
Hadi Darvishi-Khezri, Abbas Alipour, Amir Emami Zeydi, Abolfazl Firouzian, Ghahraman Mahmudi, Melody Omrani-Nava
BACKGROUND: Ventilator-associated pneumonia (VAP) is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV) in the intensive care unit (ICU). Patients with type 2 diabetes mellitus (T2DM) are considered to be more susceptible to several types of infections including community-acquired pneumonia. However, it is not clear whether T2DM is a risk factor for the development of VAP. The purpose of this study was to determine the risk of VAP for diabetic and nondiabetic mechanically ventilated trauma patients...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
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