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https://www.readbyqxmd.com/read/29221484/the-impacts-of-baseline-ventilator-parameters-on-hospital-mortality-in-acute-respiratory-distress-syndrome-treated-with-venovenous-extracorporeal-membrane-oxygenation-a-retrospective-cohort-study
#1
Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a valuable life support in acute respiratory distress syndrome (ARDS) in adult patients. However, the success of VV-ECMO is known to be influenced by the baseline settings of mechanical ventilation (MV) before its institution. This study was aimed at identifying the baseline ventilator parameters which were independently associated with hospital mortality in non-trauma patients receiving VV-ECMO for severe ARDS. METHODS: This retrospective study included 106 non-trauma patients (mean age: 53 years) who received VV-ECMO for ARDS in a single medical center from 2007 to 2016...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29221274/predictors-of-high-flow-nasal-cannula-failure-in-immunocompromised-patients-with-acute-respiratory-failure-due-to-non-hiv-pneumocystis-pneumonia
#2
Won-Young Kim, Heungsup Sung, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
Background: To evaluate the predictors of high flow nasal cannula (HFNC) failure in pneumocystis pneumonia (PCP) patients with acute respiratory failure (ARF). Methods: Fifty-two non-HIV-related PCP subjects were divided into a HFNC success group (44%) and a HFNC failure group (who required mechanical ventilation (MV) despite HFNC application) (56%). The clinical characteristics and physiologic effects were retrospectively reviewed and compared between the groups...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#3
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29218379/a-prospective-international-observational-prevalence-study-on-prone-positioning-of-ards-patients-the-apronet-ards-prone-position-network-study
#4
C Guérin, P Beuret, J M Constantin, G Bellani, P Garcia-Olivares, O Roca, J H Meertens, P Azevedo Maia, T Becher, J Peterson, A Larsson, M Gurjar, Z Hajjej, F Kovari, A H Assiri, E Mainas, M S Hasan, D R Morocho-Tutillo, L Baboi, J M Chrétien, G François, L Ayzac, L Chen, L Brochard, A Mercat
INTRODUCTION: While prone positioning (PP) has been shown to improve patient survival in moderate to severe acute respiratory distress syndrome (ARDS) patients, the rate of application of PP in clinical practice still appears low. AIM: This study aimed to determine the prevalence of use of PP in ARDS patients (primary endpoint), the physiological effects of PP, and the reasons for not using it (secondary endpoints). METHODS: The APRONET study was a prospective international 1-day prevalence study performed four times in April, July, and October 2016 and January 2017...
December 7, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29216950/-effect-of-early-enteral-nutrition-standardized-treatment-on-blood-glucose-and-prognosis-in-acute-respiratory-distress-syndrome-patients-with-mechanical-ventilation
#5
Chunmiao Zhong, Chaohui Ji, Zhuquan Dai, Kai Fu, Xiaohong Wen, Huibin Pan
OBJECTIVE: To study the effect of early entreat nutrition (EN) standardized treatment on optimization of blood glucose control and prognosis in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation (MV). METHODS: Forty-two patients with MV of ARDS admitted to Huzhou First Municipal People's Hospital from April 2015 to March 2017 were enrolled. April 1st, 2016 was taken as the time node, the patients treated from April 1st, 2015 to March 31st, 2016 were assigned in the control group (n = 20), while the patients treated from April 1st, 2016 to March 31st, 2017 were included in the experimental group (n = 22)...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#6
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29212551/extracorporeal-membrane-oxygenation-for-life-threatening-asthma-refractory-to-mechanical-ventilation-analysis-of-the-extracorporeal-life-support-organization-registry
#7
Hye Ju Yeo, Dohyung Kim, Doosoo Jeon, Yun Seong Kim, Peter Rycus, Woo Hyun Cho
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in cases of near-fatal asthma (NFA) has increased, but the benefits and potential complications of this therapy have yet to be fully investigated. METHODS: Cases were extracted from the Extracorporeal Life Support Organization Registry between March 1992 and March 2016. All patients with a diagnosis of asthma (according to the International Classification of Diseases 9th edition), who also received ECMO, were extracted...
December 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29211803/hypoxia-and-inactivity-related-physiological-changes-precede-or-take-place-in-absence-of-significant-rearrangements-in-bacterial-community-structure-the-planhab-randomized-trial-pilot-study
#8
Robert Šket, Nicole Treichel, Susanne Kublik, Tadej Debevec, Ola Eiken, Igor Mekjavić, Michael Schloter, Marius Vital, Jenna Chandler, James M Tiedje, Boštjan Murovec, Zala Prevoršek, Matevž Likar, Blaž Stres
We explored the assembly of intestinal microbiota in healthy male participants during the randomized crossover design of run-in (5 day) and experimental phases (21-day normoxic bed rest (NBR), hypoxic bed rest (HBR) and hypoxic ambulation (HAmb) in a strictly controlled laboratory environment, with balanced fluid and dietary intakes, controlled circadian rhythm, microbial ambiental burden and 24/7 medical surveillance. The fraction of inspired O2 (FiO2) and partial pressure of inspired O2 (PiO2) were 0.209 and 133...
2017: PloS One
https://www.readbyqxmd.com/read/29210062/incidence-of-hyperoxia-and-related-in-hospital-mortality-in-critically-ill-patients-a-retrospective-data-analysis
#9
F Kraft, H Andel, J Gamper, K Markstaller, R Ullrich, K U Klein
BACKGROUND: Mechanical ventilation with oxygen is life-saving, however, may result in hyperoxia. The aim was to analyse the incidence and duration of hyperoxia burden and related in-hospital mortality in critically ill patients. METHODS: Patients of all ages admitted to intensive care units (ICUs) and with mechanical ventilation for at least seven consecutive days were included in this single centre retrospective medical record audit. The main outcome measure was time-weighted arterial partial pressure of oxygen (PaO2 ) over 7 days...
December 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#10
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29203299/evaluation-of-cardiac-index-and-extravascular-lung-water-after-single-lung-transplantation-using-the-transpulmonary-thermodilution-technique-by-the-picco2-device
#11
Alexy Tran-Dinh, Pascal Augustin, Guillaume Dufour, Sigismond Lasocki, Nicolas Allou, Gabriel Thabut, Yves Castier, Philippe Montravers, Mathieu Desmard
OBJECTIVES: First evaluation of the transpulmonary thermodilution technique by the PiCCO2 device to assess cardiac index and pulmonary edema during the postoperative course after single-lung transplantation. DESIGN: Prospective observational study. SETTINGS: Intensive care unit, university hospital (single center). PARTICIPANTS: Single-lung transplant patients. INTERVENTIONS: The authors compared cardiac index measured by PiCCO2 and pulmonary artery catheter and assessed pulmonary edema using extravascular lung water index and pulmonary vascular permeability index measured by PiCCO2...
December 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29202261/intensive-care-unit-randomised-trial-comparing-two-approaches-to-oxygen-therapy-icu-rox-results-of-the-pilot-phase
#12
Paul J Young, Diane M Mackle, Michael J Bailey, Richard W Beasley, Victoria L Bennett, Adam M Deane, Glenn M Eastwood, Simon Finfer, Ross C Freebairn, Edward Litton, Natalie J Linke, Colin J McArthur, Shay P McGuinness, Rakshit Panwar, Rinaldo Bellomo
OBJECTIVE: The objective of the intensive care unit randomised trial comparing two approaches to oxygen therapy (ICU-ROX) pilot phase, which included the first 100 patients of an overall sample of 1000, was to examine feasibility. DESIGN: Investigator-initiated, prospective, parallel-group, pilot randomised controlled trial. SETTING: Six medical-surgical intensive care units (ICUs) in Australia and New Zealand, with participants recruited from September 2015 through June 2016...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29200177/effect-of-body-mass-on-oxygenation-and-intra-abdominal-pressure-when-using-a-jackson-surgical-table-in-the-prone-position-during-lumbar-surgery
#13
Liya Ni, Yuhua Fan, Jinjun Bian, Xiaoming Deng, Yu Ma
STUDY DESIGN: Prospective observational study. OBJECTIVE: To test the hypothesis that different types of surgical frame and the patient's body mass index can affect pulmonary compliance, intra-abdominal pressure (IAP), and oxygenation. SUMMARY OF BACKGROUND DATA: The oxygenation index (PaO2/FiO2) and IAP are known to be associated with body mass index (BMI) when patients are in the supine position. However, there are few reports on the correlation between BMI, the oxygenation index, and IAPin the prone position, especially when a Jackson surgical table is used...
December 1, 2017: Spine
https://www.readbyqxmd.com/read/29194339/risk-factors-for-the-development-of-acute-respiratory-distress-syndrome-following-hemorrhage
#14
Bryce R H Robinson, Mitchell J Cohen, John B Holcomb, Timothy A Pritts, Dina Gomaa, Erin E Fox, Richard D Branson, Rachael A Callcut, Bryan A Cotton, Martin A Schreiber, Karen J Brasel, Jean-Francois Pittet, Kenji Inaba, Jeffery D Kerby, Thomas M Scalea, Charlie E Wade, Eileen M Bulger
BACKGROUND: The Pragmatic Randomized Optimal Platelet and Plasma Ratios (PROPPR) study evaluated the effects of plasma and platelets on hemostasis and mortality after hemorrhage. The pulmonary consequences of resuscitation strategies that mimic whole blood, remain unknown. METHODS: A secondary analysis of the PROPPR study was performed. Injured patients predicted to receive a massive transfusion were randomized to 1:1:1 vs. 1:1:2 plasma-platelet-RBC ratios at 12 Level I North American trauma centers...
November 30, 2017: Shock
https://www.readbyqxmd.com/read/29194281/rbc-transfusions-are-associated-with-prolonged-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#15
Michael E Zubrow, Neal J Thomas, David F Friedman, Nadir Yehya
OBJECTIVES: Blood products are often transfused in critically ill children, although recent studies have recognized their potential for harm. Translatability to pediatric acute respiratory distress syndrome is unknown given that hypoxemia has excluded pediatric acute respiratory distress syndrome patients from clinical trials. We aimed to determine whether an association exists between blood product transfusion and survival or duration of ventilation in pediatric acute respiratory distress syndrome...
November 30, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189633/lung-transplantation-as-a-therapeutic-option-in-acute-respiratory-distress-syndrome
#16
Youjin Chang, Sang Oh Lee, Tae Sun Shim, Sae Hoon Choi, Hyung Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Kyung-Hyun Do, In-Cheol Choi, Sang-Bum Hong, Seung-Il Park
BACKGROUND: Lung transplantation (LTPL) is considered as a salvage therapeutic option in patients with end-stage lung disease. However, there is a lack of sufficient data on the use of LTPL in patients with acute respiratory distress syndrome (ARDS). While there are few case reports on lung transplant for ARDS, no case series exist up to date. The aim of this study was to evaluate the clinical outcomes of patients with ARDS in accordance with the LTPL status. METHODS: Patients who had severe ARDS (PaO2/FiO2 ratio ≤ 100 mmHg with positive end expiratory pressure ≥ 5 cmH2O) and were listed for LTPL with no underlying end-stage lung disease were included in this single-center retrospective study...
November 17, 2017: Transplantation
https://www.readbyqxmd.com/read/29187245/d-%C3%AE-hydroxybutyrate-and-melatonin-for-treatment-of-porcine-hemorrhagic-shock-and-injury-a-melatonin-dose-ranging-study
#17
Andrea Wolf, Kristine E Mulier, Sydne L Muratore, Gregory J Beilman
OBJECTIVE: Treatment with a combination of D-β-hydroxybutyrate (BHB) and melatonin (M) improves survival in hemorrhagic shock models. Our objective was to find the most effective melatonin concentration in combination with 4 molar BHB (4 M BHB). Survival and markers of organ injury were analyzed in pigs exposed to pulmonary contusion, liver crush injury, and hemorrhagic shock and treated with lactated Ringer's solution; 4 M BHB/43 mM M; 4 M BHB/20 mM M; 4 M BHB/10 mM M; 4 M BHB/4...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29186145/respective-impact-of-implementation-of-prevention-strategies-colonization-with-multiresistant-bacteria-and-antimicrobial-use-on-the-risk-of-early-and-late-onset-vap-an-analysis-of-the-outcomerea-network
#18
Wafa Ibn Saied, Bertrand Souweine, Maité Garrouste-Orgeas, Stéphane Ruckly, Michael Darmon, Sébastien Bailly, Yves Cohen, Elie Azoulay, Carole Schwebel, Aguila Radjou, Hatem Kallel, Christophe Adrie, Anne-Sylvie Dumenil, Laurent Argaud, Guillaume Marcotte, Samir Jamali, Laurent Papazian, Dany Goldgran-Toledano, Lila Bouadma, Jean-Francois Timsit
RATIONALE: The impact of prevention strategies and risk factors for early-onset (EOP) versus late-onset (LOP) ventilator-associated pneumonia (VAP) are still debated. OBJECTIVES: To evaluate, in a multicenter cohort, the risk factors for EOP and LOP, as the evolution of prevention strategies. METHODS: 7,784 patients with mechanical ventilation (MV) for at least 48 hours were selected into the multicenter prospective OUTCOMEREA database (1997-2016)...
2017: PloS One
https://www.readbyqxmd.com/read/29186095/-intraoperative-fluid-therapy-during-esophagectomy-followed-by-repair
#19
V A Sizov, M B Raevskaya, N B Kovalerova, D V Ruchkin, V V Subbotin, V V Kazennov, S A Ilyin
AIM: To optimize fluid therapy in transhiatal eshophagectomy by using of goal-oriented infusion therapy based on stroke volume variation. MATERIAL AND METHODS: Our trial enrolled 30 patients who underwent transhiatal esophagectomy followed by repair for the period 2011-2014. Patients were divided into 2 groups. The first group (LT) included 16 patients with liberal fluid therapy. The second group (GDT) consisted of 14 patients in whom goal-oriented fluid therapy was performed...
2017: Khirurgiia
https://www.readbyqxmd.com/read/29179681/low-flow-extracorporeal-co2-removal-in-ards-patients-a-prospective-short-term-crossover-pilot-study
#20
Harlinde Peperstraete, Sunny Eloot, Pieter Depuydt, Filip De Somer, Carl Roosens, Eric Hoste
BACKGROUND: Lung protective mechanical ventilation (MV) is the corner stone of therapy for ARDS. However, its use may be limited by respiratory acidosis. This study explored feasibility of, effectiveness and safety of low flow extracorporeal CO2 removal (ECCO2R). METHODS: This was a prospective pilot study, using the Abylcap® (Bellco) ECCO2R, with crossover off-on-off design (2-h blocks) under stable MV settings, and follow up till end of ECCO2R. Primary endpoint for effectiveness was a 20% reduction of PaCO2 after the first 2-h...
November 28, 2017: BMC Anesthesiology
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