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https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#1
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810276/-home-mechanical-ventilation-concepts-and-therapy-recommendations
#2
Sarah Bettina Schwarz, Friederike Sophie Magnet, Bernd Schönhofer, Wolfram Windisch
The prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28803432/quality-of-life-in-home-ventilated-children-and-their-families
#3
Rafael González, Amaya Bustinza, Sarah N Fernandez, Miriam García, Silvia Rodriguez, Ma Ángeles García-Teresa, Mirella Gaboli, Silvia García, Olaia Sardón, Diego García, Antonio Salcedo, Antonio Rodríguez, Ma Carmen Luna, Arturo Hernández, Catalina González, Alberto Medina, Estela Pérez, Alicia Callejón, Juan D Toledo, Mercedes Herranz, Jesús López-Herce
HMV (home mechanical ventilation) in children has increased over the last years. The aim of the study was to assess perceived quality of life (QOL) of these children and their families as well as the problems they face in their daily life.We performed a multicentric cross-sectional study using a semi-structured interview about the impact of HMV on families and an evaluation questionnaire about perceived QOL by the patient and their families (pediatric quality of life questionnaire (PedsQL4.0)). We studied 41 subjects (mean age 8...
August 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28776915/invasive-out-of-hospital-ventilation-emergencies-and-outcome-an-observational-study-over-a-1-year-period
#4
Sven Stieglitz, Sandhya Matthes, Ilona Kietzmann, Christina Priegnitz, Lars Hagmeyer, Winfried Randerath
OBJECTIVES: The number of ventilated patients is further increasing which leads to an increasing number of patients with weaning failure. In Germany, the treatment of patients with invasive out-of-hospital becomes more and more common. The aim of the study was to observe the outcome, the frequency and character of emergencies of patients with invasive out-of-hospital ventilation. METHODS: We conducted a prospective study over 1 year. 59 invasively ventilated patients living either at home or at nursing homes specialized in ventilator medicine were included...
August 4, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28760317/evaluating-the-use-of-a-stability-guideline-for-long-term-ventilator-dependent-children-discharging-to-home-a%C3%A2-quality-improvement-project
#5
Jacquie Hanks, Catherine A Carrico
INTRODUCTION: Defining stability before discharge for children with severe chronic lung disease requiring home ventilation has historically been dependent on an individual provider's opinion. METHODS: An institutional guideline based on expert opinion was used for patients who were first discharged home on mechanical ventilation. A retrospective review determined if the guideline was used. Electronic medical record changes were initiated to improve compliance with the guideline...
July 28, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28732512/prolonged-acute-care-and-post-acute-care-admission-and-recovery-of-physical-function-in-survivors-of-acute-respiratory-failure-a-secondary-analysis-of-a-randomized-controlled-trial
#6
Anna Neumeier, Amy Nordon-Craft, Dan Malone, Margaret Schenkman, Brendan Clark, Marc Moss
BACKGROUND: The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Little is known about their trajectory of functional recovery. We sought to determine whether prolonged admission influenced the trajectory of physical function recovery and whether patient age modified the recuperation rate. METHODS: We performed a secondary analysis of a randomized clinical trial of intensive physical therapy for patients with acute respiratory failure requiring mechanical ventilation for ≥4 days...
July 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28720672/1-year-survival-of-subjects-discharged-from-a-long-term-chronic-ventilator-unit
#7
Panagis Galiatsatos, Tracy Friedlander, Dina Dababneh, Katie Nelson, Denise Kelly, Thomas Finucane, Michelle Bellantoni, William B Greenough
INTRODUCTION: Among survivors of intensive care, many remain dependent on mechanical ventilation and are discharged to long-term chronic ventilator units or to skilled nursing facilities. Few long-term outcome data are available on patients transferred from long-term chronic ventilator units. METHODS: We retrospectively followed subjects discharged from a long-term chronic ventilator unit from 2010-2012. We determined where these subjects went, evaluating whether location of discharge had an effect on mortality...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#8
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
September 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#9
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28682893/burden-on-caregivers-of-ventilator-dependent-patients-a-cross-sectional-study
#10
Jui-Fang Liu, Man-Chi Lu, Tien-Pei Fang, Hong-Ren Yu, Hui-Ling Lin, Der-Long Fang
Caring for prolonged mechanical ventilation (PMV) patients imposes heavy psychological, physical, social, and financial burdens on caregivers. Currently, studies regarding the burden on caregivers of PMV patients are scant; therefore, the present study investigated the burden on caregivers of PMV patients.This cross-sectional study was approved by the Institutional Review Board of Zuoying Armed Forces General Hospital. A survey was conducted among the caregivers of PMV patients who were admitted to a chronic respiratory care ward (RCW) or were receiving home care from June to December 2010...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28660425/the-fate-of-mengovirus-on-fiberglass-filter-of-air-handling-units
#11
Victor Bandaly, Aurélie Joubert, Pierre Le Cann, Yves Andres
One of the most important topics that occupy public health problems is the air quality. That is the reason why mechanical ventilation and air handling units (AHU) were imposed by the different governments in the collective or individual buildings. Many buildings create an artificial climate using heating, ventilation, and air-conditioning systems. Among the existing aerosols in the indoor air, we can distinguish the bioaerosol with biological nature such as bacteria, viruses, and fungi. Respiratory viral infections are a major public health issue because they are usually highly infective...
June 28, 2017: Food and Environmental Virology
https://www.readbyqxmd.com/read/28660206/attitudes-and-preferences-of-home-mechanical-ventilation-users-from-four-european-countries-an-ers-elf-survey
#12
Sarah Masefield, Michele Vitacca, Michael Dreher, Michael Kampelmacher, Joan Escarrabill, Mara Paneroni, Pippa Powell, Nicolino Ambrosino
Home mechanical ventilation is increasingly used by people with chronic respiratory failure. However, there are few reports on attitudes towards treatment. A web-based survey in eight languages was disseminated across 11 European countries to evaluate the perception of home mechanical ventilation provision in ventilator-assisted individuals and caregivers. Out of 787 responders from 11 European countries, 687 were patients and 100 were caregivers. 95% of patients and 94% of caregivers were from only 4 countries (Germany, the Netherlands, Italy, Spain)...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28622004/six-month-morbidity-and-mortality-among-icu-patients-receiving-life-sustaining-therapy-a-prospective-cohort-study
#13
Michael E Detsky, Michael O Harhay, Dominique F Bayard, Aaron M Delman, Anna E Buehler, Saida A Kent, Isabella V Ciuffetelli, Elizabeth Cooney, Nicole B Gabler, Sarah J Ratcliffe, Mark E Mikkelsen, Scott D Halpern
RATIONALE: Understanding long-term outcomes of critically ill patients may inform shared decision making in the ICU. OBJECTIVE: To quantify six-month functional outcomes of general ICU patients, and develop a multivariable model comprising factors present during the first ICU day to predict which patients will return to their baseline function 6 months later. METHODS: We conducted a prospective cohort study in three medical ICUs and two surgical ICUs in three hospitals...
June 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28615115/circulatory-collapse-in-a-parturient-undergoing-cesarean-delivery-a-diagnostic-dilemma
#14
M M Tawfik, M E Taman, A I Tarbay, M Sayed, K A Awad
Embolic events including thromboembolism, air embolism, and amniotic fluid embolism can cause cardiovascular collapse during cesarean delivery. Differentiation between the three conditions is challenging because they share many of the initial clinical and echocardiographic findings, but an accurate, definitive diagnosis allows the administration of specific therapy that may help in saving the life of the mother and/or the fetus. We report a case of cardiovascular collapse during cesarean delivery under general anesthesia; massive pulmonary thromboembolism was suspected and unfractionated heparin was administered...
May 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28610934/boarding-icu-patients-are-our-rounding-practices-subpar
#15
Andrew M Nunn, Justin S Hatchimonji, Daniel N Holena, Mark J Seamon, Brian P Smith, Lewis J Kaplan, Niels D Martin, Patrick M Reilly, C William Schwab, Jose L Pascual
INTRODUCTION: Surgical Intensive Care Unit (SICU) patients "boarding" in ICUs other than the designated home unit have been shown to suffer increased rates of complications. We hypothesized that ICU rounding practices are different when SICU patients are housed in home vs. boarding ICUs. MATERIAL AND METHODS: SICU rounds were observed at an academic quaternary medical center. Individual patient rounding time and order seen on rounds along with patient data and demographics were recorded...
June 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28570147/estimating-arterial-partial-pressure-of-carbon-dioxide-in-ventilated-patients-how-valid-are-surrogate-measures
#16
Boulos S Nassar, Gregory A Schmidt
The arterial partial pressure of carbon dioxide (PaCO2) is an important parameter in critically ill, mechanically ventilated patients. To limit invasive procedures or for more continuous monitoring of PaCO2, clinicians often rely on venous blood gases, capnography, or transcutaneous monitoring. Each of these has advantages and limitations. Central venous Pco2 allows accurate estimation of PaCO2, differing from it by an amount described by the Fick principle. As long as cardiac output is relatively normal, central venous Pco2 exceeds the arterial value by approximately 4 mm Hg...
June 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28569348/black-tar-heroin-skin-popping-as-a-cause-of-wound-botulism
#17
Ihtesham A Qureshi, Mohtashim A Qureshi, Mohammad Rauf Afzal, Alberto Maud, Gustavo J Rodriguez, Salvador Cruz-Flores, Darine Kassar
BACKGROUND: Botulism is a rare potentially fatal and treatable disorder caused by a bacteria-produced toxin that affects the presynaptic synaptic membrane resulting in a characteristic neuromuscular dysfunction. It is caused by either the ingestion of the toxin or the bacteria, inhalation, or wound infection. We present our observations with a descriptive case series of wound botulism secondary to black tar heroin (BTH) injection. METHODS: We report a retrospective single-center case series of 15 consecutive cases of wound botulism presenting to University Medical Center of El Paso...
May 31, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28567028/gelsemium-elegans-poisoning-a-case-with-8%C3%A2-months-of-follow-up-and-review-of-the-literature
#18
Zhou Zhou, Lei Wu, Yuhua Zhong, Xiaobo Fang, Yanmei Liu, Hongbing Chen, Weixi Zhang
BACKGROUND: Gelsemium elegans (G. elegans) is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail. CASE PRESENTATION: A 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28560720/home-mechanical-ventilation-for-stable-copd-in-gold-2017-what-are-we-ventilating
#19
EDITORIAL
Jose L Lopez-Campos, Candelaria Caballero-Eraso, Emilia Barrot-Cortés
No abstract text is available yet for this article.
May 30, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28534110/the-impact-of-disability-in-survivors-of-critical-illness
#20
Carol L Hodgson, Andrew A Udy, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J Gabbe, Alisa M Higgins, Theodore J Iwashyna, Julian Hunt-Smith, Lynne J Murray, Paul S Myles, Jennie Ponsford, David Pilcher, Craig Walker, Meredith Young, D J Cooper
PURPOSE: To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation's Disability Assessment Schedule 2...
May 22, 2017: Intensive Care Medicine
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