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https://www.readbyqxmd.com/read/28203436/chest-physiotherapy-in-mechanically-ventilated-patients-without-pneumonia-a-narrative-review
#1
REVIEW
Herbert D Spapen, Jouke De Regt, Patrick M Honoré
A beneficial adjuvant role of chest physiotherapy (CPT) to promote airway clearance, alveolar recruitment, and ventilation/perfusion matching in mechanically ventilated (MV) patients with pneumonia or relapsing lung atelectasis is commonly accepted. However, doubt prevails regarding the usefulness of applying routine CPT in MV subjects with no such lung diseases. In-depth narrative review based on a literature search for prospective randomized trials comparing CPT with a non-CPT strategy in adult patients ventilated for at least 48 h...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28198552/cortical-spreading-depolarizations-in-the-postresuscitation-period-in-a-cardiac-arrest-male-rat-model
#2
Frederik Boe Hansen, Niels Secher, Morten Skovgaard Jensen, Leif Østergaard, Else Tønnesen, Asger Granfeldt
Neurological injury develops over days following cardiac arrest (CA); however, the exact mechanisms remain unknown. After stroke or trauma, the progression of neurological injury is associated with cortical-spreading depolarizations (CSDs). The objective was to investigate whether CA and subsequent resuscitation in rats are associated with 1) the development of spontaneous negative direct current (DC) shifts indicative of CSDs, and 2) changes in artificially induced CSDs in the postresuscitation period. Male Sprague-Dawley rats were randomized into four groups: 1) CA 90, 2) Control 90, 3) CA 360, and 4) Control 360...
February 15, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28195835/neonatal-resuscitation-program-rolling-refresher-maintaining-chest-compression-proficiency-through-the-use-of-simulation-based-education
#3
Jose R Cepeda Brito, Patrick G Hughes, Kimberly S Firestone, Fabiana Ortiz Figueroa, Karan Johnson, Terra Ruthenburg, Robyn McKinney, M David Gothard, Rami Ahmed
BACKGROUND: Structured training courses have shown to improve patient outcomes; however, guidelines are inconsistently applied in up to 50% of all neonatal resuscitations. This is partly due to the fact that psychomotor skills needed for resuscitation decay within 6 months to a year from the completion of a certification course. Currently, there are no recommendations on how often refresher training should occur to prevent skill decay. PURPOSE: Improve provider proficiency and confidence in the performance of neonatal resuscitation with a focus on chest compression effectiveness...
February 10, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28187791/primary-mediastinal-large-b-cell-lymphoma-in-a-woman-who-is-human-immunodeficiency-virus-positive-presenting-with-superior-vena-cava-syndrome-a-case-report
#4
Pedro Pallangyo, Paulina Nicholaus, Frederick Lyimo, Elikaanany Urio, Peter Kisenge, Mohamed Janabi
BACKGROUND: The risk of non-Hodgkin lymphoma is increased 200-fold in individuals seropositive for human immunodeficiency virus compared to those free from human immunodeficiency virus. Human immunodeficiency virus-associated non-Hodgkin lymphoma is known for its atypical presentation, aggressive ability, widespread involvement, poor response to chemotherapy, and high relapse potential which makes both the diagnosis and management a difficult undertaking especially in resource-poor settings...
February 11, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28187154/comparison-of-different-inspiratory-triggering-settings-in-automated-ventilators-during-cardiopulmonary-resuscitation-in-a-porcine-model
#5
Dingyu Tan, Jun Xu, Shihuan Shao, Yangyang Fu, Feng Sun, Yazhi Zhang, Yingying Hu, Joseph Walline, Huadong Zhu, Xuezhong Yu
BACKGROUND: Mechanical ventilation via automated in-hospital ventilators is quite common during cardiopulmonary resuscitation. It is not known whether different inspiratory triggering sensitivity settings of ordinary ventilators have different effects on actual ventilation, gas exchange and hemodynamics during resuscitation. METHODS: 18 pigs enrolled in this study were anaesthetized and intubated. Continuous chest compressions and mechanical ventilation (volume-controlled mode, 100% O2, respiratory rate 10/min, and tidal volumes 10ml/kg) were performed after 3 minutes of ventricular fibrillation...
2017: PloS One
https://www.readbyqxmd.com/read/28186477/bilateral-sagittal-split-mandibular-osteotomies-for-enhanced-exposure-of-the-anterior-cervical-spine-in-children-technical-note
#6
Michael Karsy, Neal Moores, Faizi Siddiqi, Douglas L Brockmeyer, Robert J Bollo
The bilateral sagittal split mandibular osteotomy (BSSMO), a common maxillofacial technique for expanding the oropharynx during treatment of micrognathia, is a rarely employed but useful adjunct to improve surgical access to the ventral cervical spine in children. Specifically, it provides enhanced exposure of the craniocervical junction in the context of midface hypoplasia, and of the subaxial cervical spine in children with severe kyphosis. The authors describe their technique for BSSMO and evaluate long-term outcomes in patients...
February 10, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#7
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28168185/optimal-chest-compression-rate-and-compression-to-ventilation-ratio-in-delivery-room-resuscitation-evidence-from-newborn-piglets-and-neonatal-manikins
#8
REVIEW
Anne Lee Solevåg, Georg M Schmölzer
Cardiopulmonary resuscitation (CPR) duration until return of spontaneous circulation (ROSC) influences survival and neurologic outcomes after delivery room (DR) CPR. High quality chest compressions (CC) improve cerebral and myocardial perfusion. Improved myocardial perfusion increases the likelihood of a faster ROSC. Thus, optimizing CC quality may improve outcomes both by preserving cerebral blood flow during CPR and by reducing the recovery time. CC quality is determined by rate, CC to ventilation (C:V) ratio, and applied force, which are influenced by the CC provider...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28165347/google-glass-for-residents-dealing-with-pediatric-cardiopulmonary-arrest-a-randomized-controlled-simulation-based-study
#9
David Drummond, Cécile Arnaud, Romain Guedj, Alexandre Duguet, Nathalie de Suremain, Arnaud Petit
OBJECTIVES: To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. DESIGN: Randomized controlled study. SETTING: Children's hospital at a tertiary care academic medical center. SUBJECTS: Forty-two first-year pediatric residents. INTERVENTIONS: Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28163233/the-impact-of-first-responder-turnout-and-curb-to-care-intervals-on-survival-from-out-of-hospital-cardiac-arrest
#10
Nicolaas P DeRuyter, Sofia Husain, Lihua Yin, Michele Olsufka, Andrew M McCoy, Charles Maynard, Leonard A Cobb, Thomas D Rea, Michael R Sayre
PURPOSE: Patients with out-of-hospital cardiac arrest (OHCA) are more likely to survive when emergency medical services (EMS) arrive quickly. The purpose of this study was to describe the time response in OHCA with special attention to EMS intervals before wheels roll (Turnout) and after wheels stop (Curb-to-Care) to understand how these intervals contribute to total time response and how they relate to clinical outcome. METHODS: We retrospectively evaluated responses to adult non-traumatic OHCA on EMS arrival from 2009 to 2014 in an urban, fire department based system...
February 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28159377/double-aortic-arch-with-previously-undescribed-head-and-neck-vessel-branching
#11
Sassan Hashemi, W James Parks, Denver Sallee, Timothy Slesnick
Vascular ring in the form of a double aortic arch is a rare anomaly that can cause airway compression. It occasionally occurs with unusual head and neck vessel branching. A 5-year-old boy with chronic respiratory symptoms was referred because of a tracheal indentation on his chest x-ray. Magnetic resonance imaging showed a double aortic arch with arch origins of a common carotid, vertebral, and subclavian on the right and internal and external carotids, vertebral, and subclavian arteries on the left. Our case represents, to our knowledge, the first report of a double aortic arch with 7 separate vessels arising from the transverse arches...
December 1, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#12
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigschnekt, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or SpO2 to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n=21). Lambs were resuscitated as per NRP guidelines...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28157808/improved-clinical-performance-and-teamwork-of-pediatric-interprofessional-resuscitation-teams-with-a-simulation-based-educational-intervention
#13
Elaine Gilfoyle, Deanna A Koot, John C Annear, Farhan Bhanji, Adam Cheng, Jonathan P Duff, Vincent J Grant, Cecilia E St George-Hyslop, Nicole J Delaloye, Afrothite Kotsakis, Carolyn D McCoy, Christa E Ramsay, Matthew J Weiss, Ronald D Gottesman
OBJECTIVES: To measure the effect of a 1-day team training course for pediatric interprofessional resuscitation team members on adherence to Pediatric Advanced Life Support guidelines, team efficiency, and teamwork in a simulated clinical environment. DESIGN: Multicenter prospective interventional study. SETTING: Four tertiary-care children's hospitals in Canada from June 2011 to January 2015. SUBJECTS: Interprofessional pediatric resuscitation teams including resident physicians, ICU nurse practitioners, registered nurses, and registered respiratory therapists (n = 300; 51 teams)...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28150278/the-quality-of-a-newly-developed-infant-chest-compression-method-applied-by-paramedics-a-randomized-crossover-manikin-trial
#14
Jacek Smereka, Mariusz Kasinski, Adam Smereka, Jerzy Robert Ładny, Łukasz Szarpak
BACKGROUND: The etiology of sudden cardiac arrest in infants is different from that in adults, with respiratory failure, sudden infant death syndrome, and drowning being the primary causes in the former. According to the European Resuscitation Council (ERC) and American Heart Association (AHA) recommendations, the quality of chest compressions (CC) is a key element affecting the effectiveness of cardiopulmonary resuscitation (CPR). The current ERC and AHA guidelines recommend the 'two-finger technique' (TFT) or 'two-thumb encircling hands technique' (TTHT) for external CCs during infant CPR...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28146450/patient-simulation-for-assessment-of-layperson-management-of-opioid-overdose-with-intranasal-naloxone-in-a-recently-released-prisoner-cohort
#15
Leo Kobayashi, Traci C Green, Sarah E Bowman, Madeline C Ray, Michelle S McKenzie, Josiah D Rich
INTRODUCTION: Investigators applied simulation to an experimental program that educated, trained, and assessed at-risk, volunteering prisoners on opioid overdose (OD) prevention, recognition, and layperson management with intranasal (IN) naloxone. METHODS: Consenting inmates were assessed for OD-related experience and knowledge then exposed on-site to standardized didactics and educational DVD (without simulation). Subjects were provided with IN naloxone kits at time of release and scheduled for postrelease assessment...
February 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28140622/exaggerated-interventricular-dependence-among-patients-with-pectus-excavatum-combined-assessment-with-cardiac-mri-and-chest-ct
#16
Alejandro Deviggiano, Javier Vallejos, Natalia Vina, Marcelo Martinez-Ferro, Gaston Bellia-Munzon, Patricia Carrascosa, Gaston A Rodríguez-Granillo
OBJECTIVE: We sought to explore whether patients with pectus excavatum have exaggerated interventricular dependence and to evaluate the impact of the malformation severity (assessed on CT) on both anatomic and functional cardiac parameters (assessed on cardiac MRI). SUBJECTS AND METHODS: The current study involved consecutive patients with a diagnosis of pectus excavatum who were referred to undergo cardiac MRI and chest CT to establish surgical candidacy or to define treatment strategies...
January 31, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28138421/efficacy-and-retention-of-basic-life-support-education-including-automated-external-defibrillator-usage-during-a-physical-education-period
#17
Kae Watanabe, Dalia Lopez-Colon, Jonathan J Shuster, Joseph Philip
The American Heart Association (AHA) advocates for CPR education as a requirement of secondary school curriculum. Unfortunately, many states have not adopted CPR education. Our aim was to investigate a low-cost, time effective method to educate students on Basic Life Support (BLS), including reeducation. This is a prospective, randomized study. Retention was assessed at 4 months post-initial education. Education was performed by AHA-certified providers during a 45-minute physical education class in a middle school in Florida...
March 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/28123614/the-association-of-layperson-characteristics-with-the-quality-of-simulated-cardiopulmonary-resuscitation-performance
#18
Marion Leary, David G Buckler, Daniel J Ikeda, Daiane A Saraiva, Robert A Berg, Vinay M Nadkarni, Audrey L Blewer, Benjamin S Abella
BACKGROUND: Few studies have examined the association of layperson characteristics with cardiopulmonary resuscitation (CPR) provision. Previous studies suggested provider characteristics, including age and gender, were associated with CPR quality, particularly chest compression (CC) depth. We sought to determine the association of subject characteristics, including age and gender with layperson CPR quality during an unannounced simulated CPR event. We hypothesized shallower CC depth in females, and older-aged subjects...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28122604/investigation-of-complications-secondary-to-chest-compressions-before-and-after-the-2010-cardiopulmonary-resuscitation-guideline-changes-by-using-multi-detector-computed-tomography-a-retrospective-study
#19
Jin Ho Beom, Je Sung You, Min Joung Kim, Min Kyung Seung, Yoo Seok Park, Hyun Soo Chung, Sung Phil Chung, Incheol Park
BACKGROUND: The purpose of this study was to identify the relationship between the deeper and faster chest compressions suggested by the 2010 cardiopulmonary resuscitation guidelines and complications arising from chest compressions, using multi-detector computed tomography. METHODS: We performed a retrospective analysis of prospective registry data. This study was conducted with in- and out-of-hospital cardiac arrest patients who underwent successful resuscitation in the emergency departments of two academic tertiary care centres from October 2006 to September 2010 (pre-2010 group) and from October 2011 to September 2015 (post-2010 group)...
January 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28120018/-surgical-treatment-of-achalasia-endoscopic-or-laparoscopic-proposal-for-a%C3%A2-tailored-approach
#20
B H A von Rahden, J Filser, M Al-Nasser, C-T Germer
Primary idiopathic achalasia is the most common form of the rare esophageal motility disorders. A curative therapy which restores the normal motility does not exist; however, the therapeutic principle of cardiomyotomy according to Ernst Heller leads to excellent symptom control in the majority of cases. The established standard approach is Heller myotomy through the laparoscopic route (LHM), combined with Dor anterior fundoplication for reflux prophylaxis/therapy. At least four meta-analyses of randomized controlled trials (RCTs) have demonstrated superiority of LHM over pneumatic dilation (PD); therefore, LHM should be used as first line therapy (without prior PD) in all operable patients...
January 24, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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