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https://www.readbyqxmd.com/read/29765003/passive-versus-active-circuit-during-invasive-mechanical-ventilation-in-subjects-with-amyotrophic-lateral-sclerosis
#1
Elisa De Mattia, Elisa Falcier, Andrea Lizio, Christian Lunetta, Valeria A Sansone, Nicola Barbarito, Barbara Garabelli, Marino Iatomasi, Elisabetta Roma, Fabrizio Rao, Annalisa Carlucci
BACKGROUND: Until recently, it has been considered essential to maintain the use of a double-limb circuit in patients with amyotrophic lateral sclerosis (ALS) to avoid rebreathing expired air during invasive mechanical ventilation. Currently, life-sustaining home ventilators can work with a single, lighter circuit that is easier to manage. Our aim was to evaluate the effectiveness and safety of a single-limb circuit with intentional leaks (passive circuit) in comparison with a circuit with an expiratory valve (active circuit), in subjects with ALS who use invasive home ventilation...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29753817/arch-augmentation-via-median-sternotomy-for-coarctation-of-aorta-with-proximal-arch-hypoplasia
#2
W Hampton Gray, Winfield J Wells, Vaughn A Starnes, S Ram Kumar
BACKGROUND: Coarctation of the aorta can be associated with hypoplasia of the proximal transverse aortic arch. One approach to manage this condition is via left thoracotomy and extended end-to-end anastomosis with the expectation that the proximal arch will grow over time. Our preferred approach is to augment the aorta via midline sternotomy. We hypothesized that this approach is safe, durable and allows reliable growth of the aorta. METHODS: We identified the records of patients with biventricular anatomy who had coarctation of the aorta, hypoplasia of the proximal transverse arch, and no other cardiac lesion that would mandate cardiopulmonary bypass use and midline sternotomy...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29730235/national-trends-and-outcomes-in-dialysis-requiring-acute-kidney-injury-in-heart-failure-2002-2013
#3
Ashish Correa, Achint Patel, Kinsuk Chauhan, Harshil Shah, Aparna Saha, Mihir Dave, Priti Poojary, Abhishek Mishra, Narender Annapureddy, Shaman Dalal, Ioannis Konstantinidis, Renu Nimma, Shiv Kumar Agarwal, Lili Chan, Girish Nadkarni, Sean Pinney
BACKGROUND: Dialysis-requiring acute kidney injury (D-AKI) is a serious complication in hospitalized heart failure (HF) patients. However, data on national trends are lacking after 2002. METHODS: We used the Nationwide Inpatient Sample (2002-2013) to identify HF hospitalizations with and without D-AKI. We analyzed trends in incidence, in-hospital mortality, length of stay (LoS) and cost. We calculated adjusted odds ratios (aOR) for predictors of D-AKI and for outcomes including in-hospital mortality and adverse discharge (discharge to skilled nursing facilities, nursing homes, etc)...
May 3, 2018: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/29703009/acute-respiratory-failure-requiring-mechanical-ventilation-in-severe-chronic-obstructive-pulmonary-disease-copd
#4
Shruti K Gadre, Abhijit Duggal, Eduardo Mireles-Cabodevila, Sudhir Krishnan, Xiao-Feng Wang, Katrina Zell, Jorge Guzman
There are limited data on the epidemiology of acute respiratory failure necessitating mechanical ventilation in patients with severe chronic obstructive pulmonary disease (COPD). The prognosis of acute respiratory failure requiring invasive mechanical ventilation is believed to be grim in this population. The purpose of this study was to illustrate the epidemiologic characteristics and outcomes of patients with underlying severe COPD requiring mechanical ventilation.A retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between January 2008 and December 2012 with a diagnosis of severe COPD and requiring invasive mechanical ventilation for acute respiratory failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29702071/incentive-spirometry-after-lung-resection-a-randomized-controlled-trial
#5
Peter Ra Malik, Christine Fahim, Jordyn Vernon, Priya Thomas, Colin Schieman, Christian J Finley, John Agzarian, Yaron Shargall, Forough Farrokhyar, Wael C Hanna
BACKGROUND: Incentive spirometry (IS) is thought to reduce the incidence of postoperative pulmonary complications (PPC) after lung resection. We sought to determine whether the addition of IS to routine physiotherapy following lung resection results in a lower rate of PPC, as compared to physiotherapy alone. METHODS: A single-blind prospective randomized controlled trial was conducted in adults undergoing lung resection. Individuals with previous lung surgery or home oxygen were excluded...
April 24, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#6
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29699834/respiratory-muscle-strength-and-state-of-consciousness-values-measured-prior-to-the-decanulation-in-different-levels-of-complexity-a-longitudinal-prospective-case-series-study
#7
L Diaz-Ballve, D Villalba, M Andreu, M Escobar, G Morel-Vulliez, J Lebus, E Rositi
OBJECTIVE: To describe the variables related to effective cough capacity and the state of consciousness measured prior to decannulation and compare their measured values between the different areas of care such as the Intensive Care Unit (ICU), General ward and Mechanical Ventilation Weaning and Rehabilitation Centers (MVWRC). Secondarily analyze the evolution of patients once decannulated. DESIGN: Case series, longitudinal and prospective. SCOPE: Multicentric 31 ICUs (polyvalent) and 5 MVWRC...
April 23, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29681959/levosimendan-in-patients-with-low-ejection-fraction-undergoing-cardiac-surgery
#8
Ewa M Kucewicz-Czech, Tomasz Maciejewski, Barbara Budziarz, Tadeusz Kołodziej, Kazimierz Kiermasz, Leszek Machej
Introduction: Significant impairment of left ventricular function causes low cardiac output syndrome in the immediate postoperative period in 3-14% of patients undergoing surgery, increasing the mortality 15-fold. Aim: To assess the use of levosimendan in patients undergoing cardiac surgery in 2016. Material and methods: The analysis included 14 patients: 3 (21.4%) women and 11 (78.6%) men aged 65.4 ±11.8 years. The mean value of left ventricular ejection fraction amounted to 20 ±6...
March 2018: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29610158/lung-volume-reduction-surgery-for-respiratory-failure-in-infants-with-bronchopulmonary-dysplasia
#9
Bongyeon Sohn, Samina Park, In Kyu Park, Young Tae Kim, June Dong Park, Sung-Hye Park, Chang Hyun Kang
Lung volume reduction surgery (LVRS) can be performed in patients with severe emphysematous disease. However, LVRS in pediatric patients has not yet been reported. Here, we report our experience with 2 cases of pediatric LVRS. The first patient was a preterm infant girl with severe bronchopulmonary dysplasia, pulmonary hypertension, and hypothyroidism. The emphysematous portion of the right lung was removed via sternotomy and right hemiclamshell incision. The patient was discharged on full-time home ventilator support for 3 months after the surgery...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29603130/multicentre-randomized-clinical-trial-of-inspiratory-muscle-training-versus-usual-care-before-surgery-for-oesophageal-cancer
#10
K Valkenet, J C A Trappenburg, J P Ruurda, E M Guinan, J V Reynolds, P Nafteux, M Fontaine, H E Rodrigo, D L van der Peet, S W Hania, M N Sosef, J Willms, C Rosman, H Pieters, J J G Scheepers, T Faber, E A Kouwenhoven, M Tinselboer, J Räsänen, H Ryynänen, R Gosselink, R van Hillegersberg, F J G Backx
BACKGROUND: Up to 40 per cent of patients undergoing oesophagectomy develop pneumonia. The aim of this study was to assess whether preoperative inspiratory muscle training (IMT) reduces the rate of pneumonia after oesophagectomy. METHODS: Patients with oesophageal cancer were randomized to a home-based IMT programme before surgery or usual care. IMT included the use of a flow-resistive inspiratory loading device, and patients were instructed to train twice a day at high intensity (more than 60 per cent of maximum inspiratory muscle strength) for 2 weeks or longer until surgery...
April 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29596679/burn-injuries-in-patients-with-paralysis-a-national-perspective-on-injury-patterns-and-outcomes
#11
Christina E Stiles, Melissa M McLawhorn, Lauren B Nosanov, Jennifer L Paul, Jeffrey W Shupp
The affect of paralysis-related comorbidities on outcomes in burn-injured patients has not been explored. We hypothesize that comorbid paralysis is associated with increased morbidity in this population. All burned patients with prior diagnoses of paralysis were identified from the National Burn Repository (Version 8.0). One-to-one matching of nonparalyzed burn-injured patients was performed, and nonparametric analysis was used to compare the groups. We identified 432 paralyzed patients, who were predominantly male (70...
December 27, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29595563/one-year-outcomes-in-patients-with-acute-respiratory-distress-syndrome-enrolled-in-a-randomized-clinical-trial-of-helmet-versus-facemask-noninvasive-ventilation
#12
Bhakti K Patel, Krysta S Wolfe, Erica L MacKenzie, Dhafer Salem, Cheryl L Esbrook, Amy J Pawlik, Megan Stulberg, Crystal Kemple, Megan Teele, Erin Zeleny, Julia Macleod, Anne S Pohlman, Jesse B Hall, John P Kress
OBJECTIVES: Many survivors of acute respiratory distress syndrome have poor long-term outcomes possibly due to supportive care practices during "invasive" mechanical ventilation. Helmet noninvasive ventilation in acute respiratory distress syndrome may reduce intubation rates; however, it is unknown if avoiding intubation with helmet noninvasive ventilation alters the consequences of surviving acute respiratory distress syndrome. DESIGN: Long-term follow-up data from a previously published randomized controlled trial...
March 27, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29594463/traumatic-brain-injury-in-indian-children
#13
REVIEW
Krishna Chaitanya, Archana Addanki, Rajendra Karambelkar, Rakesh Ranjan
INTRODUCTION: Traumatic brain injury (TBI) in children and adolescents is a community-based medical and educational challenge world-over due to increasing urbanization and motorization. In India, children between 1 to 15 years constitute significant proportion of the total population, who are vulnerable for TBI. In developed countries, pediatric trauma mortality still represents more than half of all childhood fatalities, which is 18 times more common than brain tumors. In this study, we attempted to analyze epidemiological factors, management, and outcome of TBI in children at a tertiary care center in Pune, Maharashtra...
March 29, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29583021/copd-2017-a-year-in-review
#14
Ernesto Crisafulli, Antoni Torres
In this review, we focused on original manuscripts published in the 2017 that provided additional information on the clinical and therapeutic features of the chronic obstructive pulmonary disease (COPD). We have chosen eight of these studies, collected in four topics concerning the pharmacological treatment (tiotropium) of mild-moderate patients, the pharmacological (fluticasone furoate/vilanterol/umeclidinium) and non-pharmacological treatment (non-invasive mechanical ventilation) of severe patients, the etiology of acute exacerbation of COPD involving seasonal airway pathogens and the role of eosinophils with particular interest to the monoclonal antibody directed against interleukin-5 (mepolizumab)...
March 27, 2018: COPD
https://www.readbyqxmd.com/read/29572271/effect-and-impact-of-mechanical-ventilation-in-myotonic-dystrophy-type-1-a-prospective-cohort-study
#15
Ghilas Boussaïd, Hélène Prigent, Pascal Laforet, Jean-Claude Raphaël, Djillali Annane, David Orlikowski, Frédéric Lofaso
Few studies have assessed the impact of home ventilation in patients with myotonic dystrophy type 1 (DM1) and no specific recommendations are available. We assessed the survival associated with category of home ventilation adherence of patients with DM1 followed up at a home ventilation unit using a Cox proportional hazards model. 218 patients were included; those who refused or delayed their acceptance of non-invasive ventilation were at higher risk for severe events (invasive ventilation or death) (P=0.03)...
March 23, 2018: Thorax
https://www.readbyqxmd.com/read/29563946/cardiac-function-associated-with-home-ventilator-care-in-duchenne-muscular-dystrophy
#16
Sangheun Lee, Heeyoung Lee, Lucy Youngmin Eun, Seung Woong Gang
Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital...
February 2018: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29563251/approach-to-home-mechanical-ventilation-prevalence-databases-or-surveys
#17
EDITORIAL
Javier Sayas Catalán, Manel Luján Torné
No abstract text is available yet for this article.
April 2018: Respiratory Care
https://www.readbyqxmd.com/read/29557574/prevalence-and-variability-of-use-of-home-mechanical-ventilators-positive-airway-pressure-and-oxygen-devices-in-the-lombardy-region-italy
#18
Michele Vitacca, Luca Barbano, Daniele Colombo, Olivia Leoni, Enrico Guffanti
Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared...
January 29, 2018: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29549456/quality-of-life-and-life-satisfaction-are-severely-impaired-in-patients-with-long-term-invasive-ventilation-following-icu-treatment-and-unsuccessful-weaning
#19
Sophie Emilia Huttmann, Friederike Sophie Magnet, Christian Karagiannidis, Jan Hendrik Storre, Wolfram Windisch
BACKGROUND: Health-related quality of life (HRQL), life satisfaction, living conditions, patients' attitudes towards life and death, expectations, beliefs and unmet needs are all poorly understood aspects associated with patients receiving invasive home mechanical ventilation (HMV) following ICU treatment and unsuccessful weaning. Therefore, the present study aimed to assess (1) HRQL, (2) life satisfaction and (3) patients' perspectives on life and death associated with invasive HMV as the consequence of unsuccessful weaning...
March 16, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29543640/anesthesia-for-percutaneous-pulmonary-valve-implantation-a-case-series
#20
Rafael Arboleda Salazar, Jane Heggie, Piotr Wolski, Eric Horlick, Mark Osten, Massimiliano Meineri
BACKGROUND: Twenty percent of patients born with congenital heart disease present with right ventricular outflow tract abnormalities. These patients require multiple surgical procedures in their lifetime. Transcatheter pulmonary valve replacement (TPVR) has become a viable alternative to conventional pulmonary valve and right ventricular outflow tract surgery in pediatric and adult populations. In this retrospective review, we analyze the perioperative management of adult patients who underwent TPVR in our center...
March 14, 2018: Anesthesia and Analgesia
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