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Intubated patients

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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28230644/expanding-the-donor-pool-through-intensive-care-to-facilitate-organ-donation-results-of-a-spanish-multicenter-study
#2
Beatriz Domínguez-Gil, Elisabeth Coll, José Elizalde, Jaime E Herrero, Teresa Pont, Brígida Quindós, Bella Marcelo, María A Bodí, Adolfo Martínez, Agustín Nebra, Francisco Guerrero, José M Manciño, Juan Galán, Miguel Lebrón, Eduardo Miñambres, Rafael Matesanz
BACKGROUND: Intensive Care to facilitate Organ Donation (ICOD) may help to increase the donor pool. We describe the Spanish experience with ICOD. METHODS: ACCORD-Spain consisted of an audit of the donation pathway from patients dead as a result of a devastating brain injury (possible donors) in 68 hospitals during 11/1/2014-4/30/2015. We focused on possible donors whose family was interviewed to discuss organ donation once intensive care with a therapeutic purpose was deemed futile and brain death (BD) was a likely outcome...
February 23, 2017: Transplantation
https://www.readbyqxmd.com/read/28225467/comparison-of-anesthetic-management-and-outcomes-in-patients-having-either-transnasal-or-transoral-endoscopic-odontoid-process-surgery
#3
Matthew A Sexton, Arnoley S Abcejo, Jeffrey J Pasternak
BACKGROUND: Endoscopic neurosurgical procedures involving the upper cervical vertebrae are challenging due to a narrow operating field and close proximity to vital anatomical structures. Historically, transoropharyngeal (transoral) endoscopy has been the preferred approach. More recently, however, an endoscopic transnasal approach was developed as an alternative method in hopes to reduce postoperative dysphagia, a common complication following transoral neurosurgery. METHODS: Twenty-two endoscopic neurosurgical cases involving the odontoid or C1 vertebra were reviewed between January 1, 2005 and December 31, 2015 (17 and 5 through transoral and transnasal approaches, respectively)...
February 20, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28225317/the-appropriate-time-for-closed-reduction-using-local-anesthesia-in-arytenoid-dislocation-caused-by-intubation-a-clinical-research
#4
Zhewei Lou, Zhihong Lin
CONCLUSION: Closed reduction is effective and safe for the treatment of arytenoid dislocation, and the selection of an appropriate time window to perform closed reduction is crucial in achieving relatively stable treatment outcomes and short treatment duration. OBJECTIVE: The aim of this study was to investigate whether there is an appropriate time window to perform closed reduction for unilateral arytenoid dislocation caused by intubation. METHODS: A retrospective chart review was carried out for the cases collected from September 2014 to May 2016 at Second Affiliated Hospital of Zhejiang University, China...
March 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28224729/management-of-hypoxaemic-respiratory-failure-in-a-respiratory-high-dependency-unit
#5
Craig Hukins, Mimi Wong, Michelle Murphy, John Upham
BACKGROUND: There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-ICU settings. AIM: To assess outcomes in HRF (without multi-system disease and not requiring early intubation) directly admitted to a Respiratory High Dependency Unit (R-HDU). METHODS: Retrospective, cohort study of HRF compared to Hypercapnic Respiratory Failure (HCRF) in a R-HDU (2007-2011). Patient characteristics (age, gender, pre-morbid status, diagnoses) and outcomes (non-invasive ventilation (NIV) use, survival, ICU admission) were assessed...
February 22, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28224078/complications-of-anesthesia-during-electroconvulsive-therapy-due-to-undiagnosed-obstructive-sleep-apnea-a-case-study
#6
Georgia Trakada, Lemonia Velentza, Angeliki Konsta, Athanasia Pataka, Paul Zarogoulidis, Dimitris Dikeos
This is a case description of two patients with bipolar affective disorder, who presented complications, possibly due to underlying, undiagnosed obstructive sleep apnea syndrome (OSAS), during anesthesia for electroconvulsive therapy (ECT). The first patient, just after receiving the second ECT, developed tachypnea with spasm of the upper airways and severe oxygen desaturation He was intubated and transferred to the medical intensive care unit where he was extubated 15 h later. The second patient, just after the eighth ECT, developed tachycardia and severe hypertension...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#7
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#8
Michael W Hubble, Clark Tyson
: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28222696/a-comparison-of-the-transillumination-assisted-technique-versus-midline-approach-technique-in-novices-a-prospective-randomized-controlled-trial-about-the-bonfils-intubation-fiberscope
#9
Jian Wang, Lan Yuan, Guoqiang Fu, Wei Tang, Guijie Yu, Feng Guo, Jiangang Song
BACKGROUND: The present study aimed to compare the safety and efficacy for novices to conduct intubation with the Bonfils intubation fiberscope (BIF) using the transillumination-assisted or midline approach technique in patients with normal airways. METHODS: In this prospective randomized control study, 10 trainees were assigned to the transillumination-assisted technique group (T group) or the midline approach technique group (R group). Each trainee was required to conduct intubation in 50 patients...
February 21, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28221205/muscle-relaxation-for-tracheal-intubation-during-paediatric-anaesthesia-a-meta-analysis-and-trial-sequential-analysis
#10
Florence Julien-Marsollier, Daphné Michelet, Myriam Bellon, Anne-Laure Horlin, Jean-Michel Devys, Souhayl Dahmani
BACKGROUND: Muscle relaxation for tracheal intubation during paediatric anaesthesia remains a subject of debate. OBJECTIVE: The aim of the current meta-analysis was to investigate the effect of muscle relaxants (MR) compared with opioids on intubation conditions in children. DESIGN: Meta-analysis of randomised controlled studies and GRADE analysis. DATA SOURCES: Exhaustive literature analysis. ELIGIBILITY CRITERIA: Clinical trials, with no high-risk bias, that examined the effect of MR in comparison with opioids on intubation conditions (excellent: primary outcome, acceptable: secondary outcome) in children were included...
February 17, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28221200/pathogenic-link-between-postextubation-pneumonia-and-ventilator-associated-pneumonia-an-experimental-study
#11
Emanuele Rezoagli, Alberto Zanella, Massimo Cressoni, Lorenzo De Marchi, Theodor Kolobow, Lorenzo Berra
BACKGROUND: The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours...
February 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28220484/bedside-ultrasonography-to-guide-intubation-for-a-patient-with-an-unexpected-cervical-tracheal-stenosis-a-case-report
#12
Y He, W D Yao, X J Jin
No abstract text is available yet for this article.
February 20, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28219617/techniques-and-outcomes-of-emergency-airway-management-in-japan-an-analysis-of-two-multicentre-prospective-observational-studies-2010-2016
#13
Yukari Goto, Tadahiro Goto, Yusuke Hagiwara, Yusuke Tsugawa, Hiroko Watase, Hiroshi Okamoto, Kohei Hasegawa
OBJECTIVES: Continuous surveillance of emergency airway management practice is imperative in improving quality of care and patient safety. We aimed to investigate the changes in the practice of emergency airway management and the related outcomes in the emergency departments (EDs) in Japan. METHODS: We conducted an analysis of the data from two prospective, observational, multicentre registries of emergency airway management-the Japanese Emergency Airway Network (JEAN)-1 and -2 Registries from April 2010 through May 2016...
February 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28219331/a-comparison-of-videolaryngoscopes-for-tracheal-intubation-in-predicted-difficult-airway-a-feasibility-study
#14
Maria Vargas, Antonio Pastore, Fulvio Aloj, John G Laffey, Giuseppe Servillo
BACKGROUND: Videolaryngoscopy has become increasingly attractive for the routine management of the difficult airway. Glidescope® is well studied in the literature while imago V-Blade® is a recent videolaryngoscope. This is a feasibility study with 1:1 case-control sequential allocation comparing Imago V-Blade ® and Glidescope® in predicted difficult airway settings. METHODS: Two senior anesthesiologists with no clinical experience in video assisted intubation but previously trained in a simulated scenario, performed the endotracheal intubations with Imago V-Blade® and Glidescope®...
February 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28218729/exhaled-breath-metabolomics-for-the-diagnosis-of-pneumonia-in-intubated-and-mechanically-ventilated-intensive-care-unit-icu-patients
#15
Pouline M P van Oort, Sanne de Bruin, Hans Weda, Hugo H Knobel, Marcus J Schultz, Lieuwe D Bos, On Behalf Of The Mars Consortium
The diagnosis of hospital-acquired pneumonia remains challenging. We hypothesized that analysis of volatile organic compounds (VOCs) in exhaled breath could be used to diagnose pneumonia or the presence of pathogens in the respiratory tract in intubated and mechanically-ventilated intensive care unit patients. In this prospective, single-centre, cross-sectional cohort study breath from mechanically ventilated patients was analysed using gas chromatography-mass spectrometry. Potentially relevant VOCs were selected with a p-value < 0...
February 19, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28218212/laryngeal-mask-airway-for-cesarean-delivery-a-5-year-retrospective-cohort-study
#16
Zhi-Yu Geng, Dong-Xin Wang
BACKGROUND: The laryngeal mask airway (LMA) is the most commonly used rescue airway in obstetric anesthesia. The aim of this retrospective cohort study was to evaluate the application of the LMA in parturients undergoing cesarean delivery (CD) for 5 years in our hospital. As a secondary objective, we investigated the incidence of airway-related complication in obstetric general anesthesia (GA). METHODS: We collected electronic data for all obstetric patients who received GA for CD between January 2010 and December 2014 in Peking University First Hospital...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28217398/comparison-of-intubation-success-and-glottic-visualization-using-king-vision-and-c-mac-videolaryngoscopes-in-patients-with-cervical-spine-injuries-with-cervical-immobilization-a-randomized-clinical-trial
#17
Dhanyasi Shravanalakshmi, Prasanna U Bidkar, K Narmadalakshmi, Suman Lata, Sandeep K Mishra, S Adinarayanan
BACKGROUND: Glottic visualization can be difficult with cervical immobilization in patients with cervical spine injury. Indirect laryngoscopes may provide better glottic visualization in these groups of patients. Hence, we compared King Vision videolaryngoscope, C-MAC videolaryngoscope for endotracheal intubation in patients with proven/suspected cervical spine injury. METHODS: After standard induction of anesthesia, 135 patients were randomized into three groups: group C (conventional C-MAC videolaryngoscope), group K (King Vision videolaryngoscope), and group D (D blade C-MAC videolaryngoscope)...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217396/predictive-model-of-length-of-stay-and-discharge-destination-in-neuroscience-admissions
#18
M M Stecker, M Stecker, J Falotico
BACKGROUND: The purpose of this study was to try and determine the best predictors of hospital length of stay and discharge destination in patients admitted to a neuroscience service. METHODS: Valid data was collected for 170 patients. Variables included age, gender, location prior to admission, principle diagnosis, various physiological measurements upon admission, comorbidity, independence in various activities of daily living prior to admission, length of stay, and disposition upon discharge...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28217183/affection-of-the-respiratory-muscles-in-combined-complex-i-and-iv-deficiency
#19
Josef Finsterer, Helmut Rauschka, Liane Segal, Gabor G Kovacs, Boris Rolinski
OBJECTIVES: Combined complex I+IV deficiency has rarely been reported to manifest with the involvement of the respiratory muscles. CASE REPORT: A 45y male was admitted for hypercapnia due to muscular respiratory insufficiency. He required intubation and mechanical ventilation. He had a previous history of ophthalmoparesis since age 6y, ptosis since age 23y, and anterocollis since at least age 40y. Muscle biopsy from the right deltoid muscle at age 41y was indicative of mitochondrial myopathy...
2017: Open Neurology Journal
https://www.readbyqxmd.com/read/28217065/unsuspected-subglottic-web-in-a-child-managed-for-severe-respiratory-obstruction
#20
Reena, Arun Kumar, Shrawin Kumar Singh, Vineet Agrawal
Subglottic stenosis is a known complication of a traumatic and prolonged intubation. In a child, subglottic area is narrower and more prone to damage by an oversized or overinflated endotracheal tube. The stenosis can present with complaints of change in voice, croup, or respiratory obstruction. Those presenting with respiratory obstruction require immediate diagnosis under direct laryngoscopy and timely corrective intervention under general anesthesia. A 4-year-old child came to the emergency department with severe respiratory obstruction...
January 2017: Saudi Journal of Anaesthesia
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