Read by QxMD icon Read

home mechanical ventilation

Anuja Bandyopadhyay, A Ioana Cristea, Stephanie D Davis, Veda L Ackerman, James E Slaven, Hasnaa E Jalou, Deborah C Givan, Ameet Daftary
RATIONALE: There is a lack of evidence regarding factors associated with failure of tracheostomy decannulation. OBJECTIVES: We aimed to identify characteristics of pediatric patients who fail a tracheostomy decannulation challenge Methods: A retrospective review was performed on all patients who had a decannulation challenge at a tertiary care center from June 2006 to October 2013. Tracheostomy decannulation failure was defined as reinsertion of the tracheostomy tube within 6 months of the challenge...
October 21, 2016: Annals of the American Thoracic Society
Joan M Teno, Pedro Gozalo, Nita Khandelwal, J Randall Curtis, David Meltzer, Ruth Engelberg, Vincent Mor
Importance: Mechanical ventilation may be lifesaving, but in certain persons, such as those with advanced dementia, it may prolong patient suffering without a clear survival benefit. Objective: To describe the use and outcomes of mechanical ventilation and its association with the increasing numbers of intensive care unit (ICU) beds in the United States for patients with advanced dementia residing in a nursing home 120 days before that hospital admission. Design, Setting, and Participants: This retrospective cohort study evaluated Medicare beneficiaries with advanced dementia hospitalized from January 1, 2000, to December 31, 2013, using the Minimum Data Set assessments linked with Medicare part A claims...
October 10, 2016: JAMA Internal Medicine
Gary S Winzelberg, Laura C Hanson
No abstract text is available yet for this article.
October 10, 2016: JAMA Internal Medicine
M B F Powell, C R Ahlers-Schmidt, M Engel, B T Bloom
OBJECTIVE: To define the impact of care standardization on caffeine and cardiorespiratory monitoring at neonatal intensive care unit (NICU) discharge. STUDY DESIGN: Electronic records were abstracted for infants aged 24-36 weeks gestation with birth weights appropriate for gestational age. Infants who died, transferred prior to discharge, had major pulmonary anomalies, required a home monitor for mechanical ventilation or had a family history of sudden infant death syndrome were excluded...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Anne E Sales, Mary Ersek, Orna K Intrator, Cari Levy, Joan G Carpenter, Robert Hogikyan, Helen C Kales, Zach Landis-Lewis, Tobie Olsan, Susan C Miller, Marcos Montagnini, Vyjeyanthi S Periyakoil, Sheri Reder
BACKGROUND: The program "Implementing Goals of Care Conversations with Veterans in VA LTC Settings" is proposed in partnership with the US Veterans Health Administration (VA) National Center for Ethics in Health Care and the Geriatrics and Extended Care Program Offices, together with the VA Office of Nursing Services. The three projects in this program are designed to support a new system-wide mandate requiring providers to conduct and systematically record conversations with veterans about their preferences for care, particularly life-sustaining treatments...
September 29, 2016: Implementation Science: IS
Adam Ogna, Julie Nardi, Helene Prigent, Maria-Antonia Quera Salva, Cendrine Chaffaut, Laure Lamothe, Sylvie Chevret, Djillali Annane, David Orlikowski, Frederic Lofaso
BACKGROUND: Restrictive respiratory failure is a major cause of morbidity and mortality in neuromuscular diseases (NMD). Home mechanical ventilation (HMV) is used to treat hypoventilation, and its efficiency is mostly assessed by daytime blood gases or nocturnal oxygen saturation monitoring (SpO2). Non-invasive transcutaneous measure of CO2 (TcCO2) allows to directly assess nocturnal hypercapnia and to detect residual hypoventilation with a higher sensitivity than SpO2. We aimed to compare the prognostic value of nocturnal SpO2 and TcCO2 in ventilated adult NMD patients...
2016: Frontiers in Medicine
Daniela J Lamas, Robert L Owens, R Nicholas Nace, Anthony F Massaro, Nathan J Pertsch, Jonathon Gass, Rachelle E Bernacki, Susan D Block
OBJECTIVE: Chronically critically ill patients have recurrent infections, organ dysfunction, and at least half die within 1 year. They are frequently cared for in long-term acute care hospitals, yet little is known about their experience in this setting. Our objective was to explore the understanding and expectations and goals of these patients and surrogates. DESIGN: We conducted semi-structured interviews with chronically critically ill long-term acute care hospital patients or surrogates...
September 14, 2016: Critical Care Medicine
Samih Z Thalji, Anai N Kothari, Paul C Kuo, Michael J Mosier
OBJECTIVE: To examine the development of acute kidney injury (AKI) after burn injury as an independent risk factor for increased morbidity and mortality over initial hospitalization and 1-year follow-up. BACKGROUND: Variability in fluid resuscitation and difficulty recognizing early sepsis are major barriers to preventing AKI after burn injury. Expanding our understanding of the burden AKI has on the clinical course of burn patients would highlight the need for standardized protocols...
September 8, 2016: Annals of Surgery
Jerry A Nick, Silvia M Caceres, Jennifer E Kret, Katie R Poch, Matthew Strand, Anna V Faino, David P Nichols, Milene T Saavedra, Jennifer L Taylor-Cousar, Mark W Geraci, Ellen L Burnham, Michael B Fessler, Benjamin T Suratt, Edward Abraham, Marc Moss, Kenneth C Malcolm
Acute Respiratory Distress Syndrome (ARDS) severity may be influenced by heterogeneity of neutrophil activation. Interferon-stimulated genes (ISG) are a broad gene family induced by Type I interferons, often as a response to viral infections, which evokes extensive immunomodulation. We tested the hypothesis that over- or under-expression of immunomodulatory ISG by neutrophils is associated with worse clinical outcomes in patients with ARDS. Genome-wide transcriptional profiles of circulating neutrophils isolated from patients with sepsis-induced ARDS (n = 31) and healthy controls (n = 19) were used to characterize ISG expression...
2016: PloS One
(no author information available yet)
BACKGROUND: In 40 % of all ventilated patients weaning is problematic. Prolonged weaning is associated with an increased mortality. METHODS: For the first time, data on epidemiology and outcomes of 6899 patients with prolonged weaning from the WeanNet register are published in this study. RESULTS: Patients with prolonged weaning suffer from profound comorbidities (median 5 relevant comorbidities). The majority of patients (62.2 %) were successfully weaned from the ventilator and dischared from the weaning unit without invasive ventialtion after a median of 33 days...
September 2016: Deutsche Medizinische Wochenschrift
Yoshihisa Morimoto, Takaki Sugimoto, Hiroki Arase, Fumiya Haba
INTRODUCTION: Postoperative pulmonary edema is a fatal adverse event after a cardiac surgery. We here report successful management using airway pressure release ventilation (APRV) for severe hypoxia with pulmonary edema after a cardiac surgery. PRESENTATION OF CASE: A 58-year-old man underwent an uneventful mitral valve repair. Immediately afterwards, the patient became agitated and made vigorous inspiratory efforts. His oxygen saturation dropped to 90%. Coarse inspiratory rhonchi were heard on auscultation, and copious, pink, frothy sputum was obtained with suctioning...
2016: International Journal of Surgery Case Reports
Anita K Simonds
Prevalence studies have shown heterogeneous use of home mechanical ventilation (HMV) in different conditions, but a marked increase in uptake especially in users of non-invasive ventilation (NIV). While there have been randomised controlled trials of NIV in acute exacerbations of COPD, for weaning from invasive ventilation and post-extubation respiratory failure, the evidence base for long term NIV and comparisons with invasive ventilation are less well-developed. The combination of NIV and cough assist devices has reduced the indications for tracheotomy ventilation in some situations eg...
August 25, 2016: Annals of the American Thoracic Society
Jennifer G Andrews, Aida Soim, Shree Pandya, Christina P Westfield, Emma Ciafaloni, Deborah J Fox, David J Birnkrant, Christopher M Cunniff, Daniel W Sheehan
BACKGROUND: Duchenne muscular dystrophy (DMD) causes progressive respiratory muscle weakness and decline in function, which can go undetected without monitoring. DMD respiratory care guidelines recommend scheduled respiratory assessments and use of respiratory assist devices. To determine the extent of adherence to these guidelines, we evaluated respiratory assessments and interventions among males with DMD in the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) from 2000 to 2011...
October 2016: Respiratory Care
Narendra R Dereddy, Eniko K Pivnick, Kirtikumar Upadhyay, Ramasubbareddy Dhanireddy, Ajay J Talati
Objectives Trisomy 18 is presumed to be a lethal chromosomal abnormality; medical management of infants with this aneuploidy is controversial. Our objective was to describe our approach and experience with trisomy 18 infants. Study Design We reviewed the initial hospital course, management, and factors predicting discharge from the hospital from two large tertiary care neonatal intensive care units in the southern United States over 26 years. Results Of the 29 infants with trisomy 18, 21 (72%) died in the hospital and 8 (28%) were discharged home...
August 4, 2016: American Journal of Perinatology
Eva Klaskova, Jiri Drabek, Milada Hobzova, Vratislav Smolka, Miroslav Seda, Jiri Hyjanek, Rastislav Slavkovsky, Jana Stranska, Martin Prochazka
BACKGROUND: Congenital central hypoventilation syndrome (CCHS) is a rare genetic disorder resulting from mutations in the PHOX2B gene located on chromosome 4p12.3, characterized by hypoventilation secondary to missing responses to both hypercapnia and hypoxia. CASE REPORT: Proband. A girl, hospitalised 5 times for respiratory failure from 6 weeks old, presented at 4 years of age severe cyanosis related to pneumonia. Tracheostomy was done, and she was discharged home using a portable positive pressure ventilator during sleep...
August 2, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Philip A Gaudreau, Hannah Greenlick, Tiffany Dong, Michelle Levy, Alyssa Hackett, Diego Preciado, George Zalzal, Brian K Reilly
Importance: Pediatric tracheostomy is commonly performed for upper airway obstruction and prolonged mechanical ventilation. Children undergoing tracheostomy typically have multiple chronic medical problems that place them at high risk for readmission and additional complications. Objective: To determine whether the institution of a postoperative protocol for parent education and wound care with a nurse trained in tracheostomy care decreases the rate of readmission and other complications...
October 1, 2016: JAMA Otolaryngology—Head & Neck Surgery
Erika J MacIntyre, Leyla Asadi, Doug A Mckim, Sean M Bagshaw
Background. The prevalence of patients supported with home mechanical ventilation (HMV) for chronic respiratory failure has increased. However, the clinical outcomes associated with HMV are largely unknown. Methods. We performed a systematic review of studies evaluating patients receiving HMV for indications other than obstructive lung disease, reporting at least one clinically relevant outcome including health-related quality of life (HRQL) measured by validated tools; hospitalization requirements; caregiver burden; and health service utilization...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
G Mallach, M St-Jean, M MacNeill, D Aubin, L Wallace, T Shin, K Van Ryswyk, R Kulka, H You, D Fugler, Eric Lavigne, A J Wheeler
Previous research has shown that indoor benzene levels in homes with attached garages are higher than homes without attached garages. Exhaust ventilation in attached garages is one possible intervention to reduce these concentrations. To evaluate the effectiveness of this intervention a randomized crossover study was conducted in 33 Ottawa homes in winter 2014. VOCs including BTEX (benzene, toluene, ethylbenzene and xylenes), nitrogen dioxide, carbon monoxide and air exchange rates were measured over four 48-hour periods when a garage exhaust fan was turned on or off...
July 22, 2016: Indoor Air
Hanan H Balkhy, Thamer H Alenazi, Majid M Alshamrani, Henry Baffoe-Bonnie, Yaseen Arabi, Raed Hijazi, Hail M Al-Abdely, Aiman El-Saed, Sameera Al Johani, Abdullah M Assiri, Abdulaziz Bin Saeed
BACKGROUND Since the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported. OBJECTIVE To describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia. METHODS We conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV...
October 2016: Infection Control and Hospital Epidemiology
C S Bruells, J Bickenbach, G Marx
Weaning from mechanical ventilation is generally not the most urgent topic on many ICUs, because acutely endangered patients are usually the staff's main focus. Nevertheless, even these patients whose underlying problem has been mostly solved-whether it was neurologic, internal or surgical-are in need of a structured weaning strategy. The aim of this weaning "road map" is ventilator independence, decannulation and regaining of muscular strength. Achieving of these aims needs a well-educated team of physicians, nurses, respiratory/physical therapists, logopedists and pychologists...
July 13, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"