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https://www.readbyqxmd.com/read/28821360/development-and-implementation-of-an-early-mobility-program-for-mechanically-ventilated-pediatric-patients
#1
Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, Mary L deAlmeida
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#2
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28820557/papillary-muscle-rupture-in-an-adolescent-with-no-coronary-lesions
#3
Tatjana Lejko Zupanc, Mateja Logar
A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors' hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#4
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#5
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28817604/therapeutic-flexible-airway-endoscopy-of-small-children-in-a-tertiary-referral-center-11-years-experience
#6
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Use of therapeutic flexible airway endoscopy (TFAE) is very limited in pediatrics. We report our clinical experiences and long term outcomes of TFAE in small children from a single tertiary referral center. METHODS: This is a retrospective cohort study. Small children with their body weight no more than 5.0 kg who had received TFAE between 2005 and 2015 were enrolled. Demographic information and outcomes were reviewed and analyzed from medical charts and TFAE videos...
2017: PloS One
https://www.readbyqxmd.com/read/28816968/two-portal-versus-three-port-video-assist-thoracoscopic-surgery-for-early-stage-nonsmall-cell-lung-cancer-a-retrospective-study
#7
Xiaokun Yan, Xiaochun Chen, Guangbin Li, Shaomu Chen
This study was conducted to compare the perioperative outcomes of two-portal and three-port video-assist thoracoscopic surgery (VATS) for early stage nonsmall cell lung cancer.In this retrospective analysis, 279 cases of two-port VATS with a single utility port and 152 cases of three-port VATS performed by our department from October 2010 to December 2014 were collected. The operative time, volume of intraoperative blood loss, number of dissected lymph nodes, volume of postoperative pleural drainage, postoperative extubation time, and duration of postoperative hospitalization were compared between these 2 groups...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28814761/transplantation-of-bioengineered-rat-lungs-recellularized-with-endothelial-and-adipose-derived-stromal-cells
#8
Ryoichiro Doi, Tomoshi Tsuchiya, Norisato Mitsutake, Satoshi Nishimura, Mutsumi Matsuu-Matsuyama, Yuka Nakazawa, Tomoo Ogi, Sadanori Akita, Hiroshi Yukawa, Yoshinobu Baba, Naoya Yamasaki, Keitaro Matsumoto, Takuro Miyazaki, Ryotaro Kamohara, Go Hatachi, Hideyori Sengyoku, Hironosuke Watanabe, Tomohiro Obata, Laura E Niklason, Takeshi Nagayasu
Bioengineered lungs consisting of a decellularized lung scaffold that is repopulated with a patient's own cells could provide desperately needed donor organs in the future. This approach has been tested in rats, and has been partially explored in porcine and human lungs. However, existing bioengineered lungs are fragile, in part because of their immature vascular structure. Herein, we report the application of adipose-derived stem/stromal cells (ASCs) for engineering the pulmonary vasculature in a decellularized rat lung scaffold...
August 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#9
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28810649/effect-of-dexmedetomidine-combined-with-sufentanil-on-preventing-emergence-agitation-in-children-receiving-sevoflurane-anesthesia-for-cleft-palate-repair-surgery
#10
Ke Luo, Jun-Mei Xu, Lin Cao, Ju Gao
The aim of the present study was to observe whether dexmedetomidine (DEX) combined with sufentanil decreased emergence agitation (EA) in children receiving sevoflurane anesthesia for cleft palate repair surgery. Children undergoing elective cleft palate repair surgery were randomly allocated into the DEX + sufentanil group (group DS; n=50) and the normal saline + fentanyl group (group SF; n=50). Patients in group DS were treated with 0.5 µg/kg DEX prior to induction of anesthesia, whereas patients in group SF received an equal volume of normal saline...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810268/swallowing-mechanics-associated-with-artificial-airways-bolus-properties-and-penetration-aspiration-status-in-trauma-patients
#11
Angela M Dietsch, Christopher B Rowley, Nancy Pearl Solomon, William G Pearson
Purpose: Artificial airway procedures such as intubation and tracheotomy are common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in relation to mechanical features of swallowing. Method: Coordinates of anatomical landmarks were extracted at minimum and maximum hyolaryngeal excursion from 228 videofluoroscopic swallowing studies representing 69 traumatically injured U...
August 15, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28806204/preoxygenation-before-extubation-a-road-to-patient-safety-less-traveled
#12
Amitabh Dutta
No abstract text is available yet for this article.
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28805958/large-orbital-defect-reconstruction-in-the-setting-of-globe-sparing-maxillectomy-the-titanium-hammock-and-layered-fibula-technique
#13
Samuel J Trosman, Timothy M Haffey, Rafael A Couto, Michael A Fritz
INTRODUCTION: The purpose of our study was to describe a novel technique for reconstruction of orbital defects after maxillectomy using a non-anatomic titanium mesh suspension of orbital contents for both support and volume correction. This construct is then articulated with a layered fibula osteocutaneous free flap that restores orbital rim, zygoma, and maxillary alveolus. We herein present our application of this technique, including refinements over time and long-term outcomes. METHODS: A retrospective review was performed on 12 patients who underwent reconstruction of Brown class III orbitopalatomaxillary defects with extensive orbital involvement (at minimum complete orbital floor and rim absent) with titanium mesh sling and a layered fibula free flap...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28805238/ultrasound-assessment-of-gastric-contents-in-children-undergoing-elective-ear-nose-and-throat-surgery-a-prospective-cohort-study
#14
F-P Desgranges, A-C Gagey Riegel, C Aubergy, M de Queiroz Siqueira, D Chassard, L Bouvet
Ultrasound examination of the gastric antrum allows reliable assessment of gastric contents and volume. Postoperative assessment of gastric contents before recovery from anaesthesia could help the physician to choose the most appropriate extubation technique after surgery in children. In this prospective observational study, we assessed whether significant changes occurred in gastric contents during the intra-operative period in children undergoing elective ear, nose and throat (ENT) surgery. Children aged between six months and 16 years were recruited consecutively...
August 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28804692/one-case-with-dexmedetomidine-induced-stuporous-state-in-epileptic-patient-undergoing-abdominal-surgery
#15
Dong-Ji Han, Zhi-Gang He, Zhi-Qiang Zhou, Li Feng, Cheng Liu, Yan Xiang, Hong-Bing Xiang
A 56-year-old epileptic patient underwent right hemicolectomy and cholecystectomy surgery under general endotracheal anesthesia. Anesthesia was maintained with sevoflurane, and sufentanil, rocuronium, and dexmedetomidine infusions. After the operation and confirmation of neuromuscular recovery, the patient woke from anesthesia within 15 min and successfully extubated. After the vital signs of patient were stable, the patient was transported to post anesthesia care unit (PACU). 6 h after the surgery, he fell into a stuporous state for lasting 14 h and EEG showed no epileptiform discharges...
2017: American Journal of Neurodegenerative Disease
https://www.readbyqxmd.com/read/28803657/early-extubation-after-cardiac-surgery-the-evolution-continues
#16
EDITORIAL
Hilary P Grocott
No abstract text is available yet for this article.
July 25, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28802997/prophylactic-use-of-an-intra-aortic-balloon-pump-in-a-high-risk-patient-with-peripartum-cardiomyopathy-requiring-cesarean-delivery
#17
R S Samalavicius, L Puodziukaite, I Radaviciute, I Norkiene, K Urbonas, I Misiuriene, V Janusauskas, A Zorinas, K Rucinskas, P Serpytis
The use of intra-aortic balloon counter-pulsation for circulatory support in pregnant women with cardiac failure is limited to several case reports. Few publications have addressed the use of intra-aortic balloon counter-pulsation during delivery. We report a case using prophylactic intra-aortic counter-pulsation during the management of a cesarean delivery in a patient with peripartum cardiomyopathy. A 28-year-old primigravid female at 37weeks of gestation was admitted with signs of worsening heart failure, and transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 25%...
July 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28802344/creating-a-highly-reliable-neonatal-intensive-care-unit-through-safer-systems-of-care
#18
REVIEW
Patoula G Panagos, Stephen A Pearlman
Neonates requiring intensive care are at high risk for medical errors due to their unique characteristics and high acuity. Designing a safer work environment begins with safe processes. Creating a culture of safety demands the involvement of all organizational levels and an interdisciplinary approach. Adverse events can result from suboptimal communication and lack of a shared mental model. This chapter describes tools to promote better patient safety in the NICU through monitoring adverse events, improving communication and using information technology...
September 2017: Clinics in Perinatology
https://www.readbyqxmd.com/read/28799626/extubation-in-patients-undergoing-extracorporeal-life-support
#19
Amélie Bataillard, Amélie Hebrard, Lucie Gaide-Chevronnay, Cécile Martin, Michel Durand, Albaladejo Pierre, Jean Francois Payen
PURPOSE: Extracorporeal life support (ECLS) is a cardiopulmonary support system used for the treatment of severe cardiac and/or respiratory failure. Mortality is high partly because of the severity of the condition that requires support. The use of ECLS is generally associated with heavy sedation. The aim of this study was to demonstrate the feasibility of stopping sedation, allowing extubation of patients supported by ECLS. METHODS: 196 patients supported by ECLS for a period of 4 years were included...
August 7, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28798877/previously-undiagnosed-spinal-and-bulbar-muscular-atrophy-as-a-cause-of-airway-obstruction-after-robot-assisted-laparoscopic-prostatectomy
#20
Miyuki Niki, Taihei Tachikawa, Yuka Sano, Hiroki Miyawaki, Aisa Matoi, Yukari Okano, Nobutaka Kariya, Tsuneo Tatara, Munetaka Hirose
BACKGROUND: Preoperative vocal cord paralysis is a risk factor for postoperative respiratory distress following extubation after general anesthesia. We present an unusual case where a geriatric patient developed airway obstruction after robot-assisted laparoscopic prostatectomy. CASE PRESENTATION: A 67-year-old male, who had suffered from left vocal cord paralysis of unknown etiology, was scheduled for robot-assisted laparoscopic prostatectomy (RALP). General anesthesia was performed without any problems...
2017: Case Reports in Anesthesiology
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