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emergency mechanical ventilation

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https://www.readbyqxmd.com/read/29675561/de-escalation-of-antifungal-treatment-in-critically-ill-patients-with-suspected-invasive-candida-infection-incidence-associated-factors-and-safety
#1
Karim Jaffal, Julien Poissy, Anahita Rouze, Sébastien Preau, Boualem Sendid, Marjorie Cornu, Saad Nseir
BACKGROUND: Antifungal treatment is common in critically ill patients, but only a small proportion of patients receiving antifungals have a proven fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in critically ill patients...
April 19, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29671866/isocapnic-hyperventilation-provides-early-extubation-after-head-and-neck-surgery-a-prospective-randomized-trial
#2
K Hallén, P Jildenstål, O Stenqvist, J Oras, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2 )-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). METHODS: Thirty-one adult ASA I-III patients undergoing long-duration (>3 hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n = 16) or control (n = 15)...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29657729/risk-factors-for-prolonged-mechanical-ventilation-in-patients-with-severe-multiple-injuries-and-blunt-chest-trauma-a-single-center-retrospective-case-control-study
#3
Yasuyuki Okabe
Aim: Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). Methods: Consecutive adult patients with multiple severe injuries and blunt chest trauma who treated in Chiba Emergency Medical Center (Chiba, Japan) between January 2008 and December 2015 were enrolled in this retrospective chart-review study...
April 2018: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#4
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29652280/relationship-between-maximum-clot-firmness-in-rotem-%C3%A2-and-postoperative-bleeding-after-coronary-artery-bypass-graft-surgery-in-patients-using-clopidogrel
#5
Rasoul Azarfarin, Fereidoon Noohi, Majid Kiavar, Ziae Totonchi, Avaz Heidarpour, Amir Hendiani, Zahra Sadat Koleini, Saeid Rahimi
Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM® ) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF <50 mm (n = 16) and those with MCF ≥50 mm (n = 44)...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29628332/patients-lived-experience-of-intensive-care-when-being-on-mechanical-ventilation-during-the-weaning-process-a-hermeneutic-phenomenological-study
#6
Catarina Tingsvik, Fredrik Hammarskjöld, Jan Mårtensson, Maria Henricson
BACKGROUND: The medical and nursing care of the patient on mechanical ventilation has developed and proceeds in terms of ventilator functions, sedation strategies and patient participation. New data are needed to explore the weaning process from the patients' perspective. Therefore, the aim of this study was to explore the meaning of being a patient on mechanical ventilation during the weaning process in the intensive care unit. METHODS: This study used van Manen's hermeneutic phenomenological approach...
April 5, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29622330/pediatric-ventilator-management-in-the-emergency-department
#7
REVIEW
Garrett S Pacheco, Jenny Mendelson, Mary Gaspers
Pediatric mechanical ventilation is first initiated by emergency physicians when performing active airway management in a critically ill or injured child. When initiating and adjusting mechanical ventilation, the child has unique anatomy and physiology to consider. The EP is the first to respond to ventilator alarm triggers, and the initial medical provider to resuscitate the ventilated pediatric patient who is deteriorating while in the emergency department. This article uses cases to provide a framework to initiate and troubleshoot mechanical ventilation of pediatric patients in the emergency department...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29622329/pediatric-emergency-noninvasive-ventilation
#8
REVIEW
Chad D Viscusi, Garrett S Pacheco
Noninvasive ventilation (NIV) has emerged as a powerful tool for the pediatric emergency management of acute respiratory failure (ARF). This therapy is safe and well tolerated and seems to frequently prevent both the need for invasive mechanical ventilation and the associated risks/complications. Although NIV can be the primary treatment of ARF resulting from multiple respiratory disease states, it must be meticulously monitored and, when unsuccessful, may aid in preoxygenation for prompt endotracheal intubation and invasive mechanical ventilation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29616405/ventilator-associated-pneumonia-in-pediatric-intensive-care-unit-incidence-risk-factors-and-etiological-agents
#9
Gnanaguru Vijay, Anirban Mandal, Jhuma Sankar, Arti Kapil, Rakesh Lodha, S K Kabra
OBJECTIVES: To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS: This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC)...
April 4, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29615922/sensory-processing-and-integration-at-the-carotid-body-tripartite-synapse-neurotransmitter-functions-and-effects-of-chronic-hypoxia
#10
REVIEW
Erin M Leonard, Shaima Salman, Colin A Nurse
Maintenance of homeostasis in the respiratory and cardiovascular systems depends on reflexes that are initiated at specialized peripheral chemoreceptors that sense changes in the chemical composition of arterial blood. In mammals, the bilaterally-paired carotid bodies (CBs) are the main peripheral chemoreceptor organs that are richly vascularized and are strategically located at the carotid bifurcation. The CBs contribute to the maintenance of O2 , CO2 /H+ , and glucose homeostasis and have attracted much clinical interest because hyperactivity in these organs is associated with several pathophysiological conditions including sleep apnea, obstructive lung disease, heart failure, hypertension, and diabetes...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29615073/advanced-airway-management-in-hoist-and-longline-operations-in-mountain-hems-considerations-in-austere-environments-a-narrative-review-this-review-is-endorsed-by-the-international-commission-for-mountain-emergency-medicine-icar-medcom
#11
REVIEW
Urs Pietsch, Jürgen Knapp, Oliver Kreuzer, Ludwig Ney, Giacomo Strapazzon, Volker Lischke, Roland Albrecht, Patrick Phillips, Simon Rauch
BACKGROUND: Providing sufficient oxygenation and ventilation is of paramount importance for the survival of emergency patients. Therefore, advanced airway management is one of the core tasks for every rescue team. Endotracheal intubation is the gold standard to secure the airway in the prehospital setting. This review aims to highlight special considerations for advanced airway management preceding human external cargo (HEC) evacuations. METHODS: We systematically searched MEDLINE, EMBASE, and PubMed in August 2017 for articles on airway management and ventilation in patients before hoist or longline operation in HEMS...
April 3, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29614795/full-atrioventricular-block-secondary-to-acute-poisoning-mercury-a-case-report
#12
Amelia Geraldine Peregrina-Chávez, María Del Rayo Ramírez-Galindo, Rolando Chávez-Martínez, Cesar Anuar Delahanty-Delgado, Fernando Vazquez-Alaniz
Background: The biological behaviour and clinical significance of mercury toxicity vary according to its chemical structure. Mercury differs in its degree of toxicity and in its effects on the nervous, digestive and immune systems as well as on organs such as the lungs, kidneys, skin, eyes and heart. Human exposure occurs mainly through inhalation of elemental mercury vapours during industrial and artisanal processes such as artisanal and small-scale gold mining. Case presentation: A 52-years-old female, housewife, with a body mass index of 25...
April 2, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29599604/review-article-update-on-current-and-emergent-data-on-hepatopulmonary-syndrome
#13
REVIEW
Stergios Soulaidopoulos, Evangelos Cholongitas, George Giannakoulas, Maria Vlachou, Ioannis Goulis
Hepatopulmonary syndrome (HPS) is a frequent pulmonary complication of end-stage liver disease, characterized by impaired arterial oxygenation induced by intrapulmonary vascular dilatation. Its prevalence ranges from 4% to 47% in patients with cirrhosis due to the different diagnostic criteria applied among different studies. Nitric oxide overproduction and angiogenesis seem to be the hallmarks of a complicated pathogenetic mechanism, leading to intrapulmonary shunting and ventilation-perfusion mismatch. A classification of HPS according to the severity of hypoxemia has been suggested...
March 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29594463/traumatic-brain-injury-in-indian-children
#14
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/29593190/administration-of-kampo-medicine-through-a-tube-at-an-advanced-critical-care-center
#15
Takahiro Niimura, Yoshito Zamami, Toru Imai, Tsuyoshi Ito, Hidenori Sagara, Hichiya Hiroyuki, Satoru Esumi, Kenshi Takechi, Masaki Imanishi, Toshihiro Koyama, Manabu Amano, Naomi Kurata, Yoshihisa Kitamura, Hironori Nakura, Toshiaki Sendo, Keisuke Ishizawa
n emergency and critical care medical centers, tube administration is employed for patients who have difficulty swallowing oral drugs owing to decreased consciousness or mechanical ventilation. However, tube clogging due to drug injection is a concern. We compared the crushing method with the simple suspension method for the passage of amlodipine, an antihypertensive drug, in combination with rikkunshito, which has been used to treat upper gastrointestinal disorders such as functional dyspepsia and gastroesophageal reflux in emergency and critical care medical centers, to ascertain the effect of Kampo products on the passage of other drugs during tube administration...
2018: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/29582748/airway-management-changes-associated-with-rising-radiologic-incidence-of-external-laryngotracheal-injury
#16
Derrick R Randall, Luke Rudmik, Chad G Ball, J Douglas Bosch
BACKGROUND: Traumatic laryngeal injuries are uncommon life-threatening injuries that require prompt, rational management of a potentially precarious airway. It is unclear whether the current incidence of laryngotracheal injury is due to enhanced injury detection or increased occurrence. The objective of this study was to evaluate the relations between diagnostic imaging with both initial airway management and surgical treatment in patients with external laryngotracheal injuries (ELTIs) in Alberta...
April 2018: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29582210/in-hospital-and-day-120-survival-of-critically-ill-solid-cancer-patients-after-discharge-of-the-intensive-care-units-results-of-a-retrospective-multicenter-study-a-groupe-de-recherche-respiratoire-en-r%C3%A3-animation-en-onco-h%C3%A3-matologie-grrr-oh-study
#17
François Vincent, Marcio Soares, Djamel Mokart, Virginie Lemiale, Fabrice Bruneel, Marouane Boubaya, Frédéric Gonzalez, Yves Cohen, Elie Azoulay, Michaël Darmon
OBJECTIVES: To assess outcomes at hospital discharge and day-120 after intensive care unit (ICU) discharge among patients with solid cancer admitted to ICU and to identify characteristics associated with in-hospital and day-120 after ICU discharge mortalities. DESIGN: International, multicenter, retrospective study. SETTING: Five ICUs in France and Brazil, two located in cancer centers, two in university affiliated and one in general hospitals...
March 27, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29580362/inadequacy-of-algorithmic-ventilator-associated-pneumonia-diagnosis-in-acute-care-surgery
#18
Jacob A Quick, Matthew D Breite, Stephen L Barnes
Clinical utility of algorithms to diagnose ventilator-associated pneumonia (VAP) in surgical patients has not been established. We aimed to test the diagnostic accuracy of two established methods to reliably diagnose VAP in acutely ill and injured surgical patients. After institutional review board approval, we prospectively collected data on 508 mechanically ventilated acute care surgery patients. Microbiologic samples were taken daily from all patients. Demographics, clinical, laboratory, and radiographic data were collected...
February 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29577222/-establishment-of-comprehensive-prediction-model-of-acute-gastrointestinal-injury-classification-of-critically-ill-patients
#19
Yan Wang, Jianrong Wang, Weiwei Liu, Guangliang Zhang
OBJECTIVE: To develop the comprehensive prediction model of acute gastrointestinal injury (AGI) grades of critically ill patients. METHODS: From April 2015 to November 2015, the binary channel gastrointestinal sounds (GIS) monitor system which has been developed and verified by the research group was used to gather and analyze the GIS of 60 consecutive critically ill patients who were admitted in Critical Care Medicine of Chinese PLA General Hospital. Also, the AGI grades (Grande I(-IIII(, the higher the level, the heavier the gastrointestinal dysfunction) were evaluated...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#20
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
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