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https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#1
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28218802/non-invasive-ventilation-for-cystic-fibrosis
#2
REVIEW
Fidelma Moran, Judy M Bradley, Amanda J Piper
BACKGROUND: Non-invasive ventilation may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis by providing ventilatory support and avoiding tracheal intubation. Using non-invasive ventilation, in the appropriate situation or individuals, can improve lung mechanics through increasing airflow and gas exchange and decreasing the work of breathing. Non-invasive ventilation thus acts as an external respiratory muscle. This is an update of a previously published review...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28197044/the-impact-of-early-tracheostomy-in-neurotrauma-patients-a-retrospective-study
#3
Kapil G Zirpe, Deepali Vishnu Tambe, Abhijit M Deshmukh, Sushma K Gurav
BACKGROUND: Although majority of neurotrauma patients require long term ventilatory support but the timing of tracheostomy in such patients is controversial. METHOD: This retrospective study was conducted at a Tertiary Care Hospital, Pune, India. Patients >18 years of age, who underwent percutaneous tracheostomy (PCT) from June 2010 to November 2014 at neurotrauma unit (NTU) of hospital, were included. Patients were divided in two groups according to the timing of tracheostomy, early tracheostomy (ET) group (≤5 days; N=100) and late tracheostomy (LT) group (>5 days; N=64)...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28181274/hereditary-myopathies-with-early-respiratory-insufficiency-in-adults
#4
Elie Naddaf, Margherita Milone
INTRODUCTION: Hereditary myopathies with early respiratory insufficiency as a predominant feature of the clinical phenotype are uncommon and underestimated in adults. METHODS: We reviewed the clinical and laboratory data of patients with hereditary myopathies that demonstrated early respiratory insufficiency prior to the need for ambulatory assistance. Only patients with disease-causing mutations or a specific histopathological diagnosis were included. Patients with cardiomyopathy were excluded...
February 9, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28150165/elective-delivery-versus-expectant-management-for-pre-eclampsia-a-meta-analysis-of-rcts
#5
Yonghong Wang, Min Hao, Stephanie Sampson, Jun Xia
PURPOSE: To evaluate the effectiveness and safety of elective delivery versus expectant management for women with pre-eclampsia (PE) and to assess neonatal outcomes before and after 34 weeks gestation. METHODS: We searched Biomed Central, CINAHL, Cochrane Library, Embase, HMIC, Medline, and WHO trial registry, British Nursing Index, ClinicalTrials.gov, Current Controlled Trials, and Web of Science on 16 March, 2016. 1704 citations were identified. Randomised controlled trials comparing elective delivery with expectant management for women with PE were included...
March 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28149245/acute-respiratory-distress-syndrome-in-burn-patients-incidence-and-risk-factor-analysis
#6
L Silva, L Garcia, B Oliveira, M Tanita, J Festti, L Cardoso, L Lavado, C Grion
After a burn lesion, Acute Respiratory Distress Syndrome (ARDS) may occur via direct lung injury due to inhaled smoke and fumes or mediated by the inflammatory response associated with the burn or its infectious complications. The aim of the present study is to assess the epidemiologic profile of ARDS in adult burn patients admitted to intensive care in a burn unit at a university hospital. A prospective cohort study was performed from January to December 2012. Demographic and diagnostic data, prognostic scores, etiology and data on the extent and depth of burns were collected...
September 30, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28149028/comparative-evaluation-of-central-venous-pressure-and-sonographic-inferior-vena-cava-variability-in-assessing-fluid-responsiveness-in-septic-shock
#7
Manjri Garg, Jyotsna Sen, Sandeep Goyal, Dhruva Chaudhry
OBJECTIVE: Fluid infusion, the most critical step in the resuscitation of patients with septic shock, needs preferably continuous invasive hemodynamic monitoring. The study was planned to evaluate the efficacy of ultrasonographically measured inferior vena cava collapsibility index (IVC CI) in comparison to central venous pressure (CVP) in predicting fluid responsiveness in septic shock. MATERIALS AND METHODS: Thirty-six patients of septic shock requiring ventilatory support (invasive/noninvasive) were included...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28146296/nasal-intermittent-positive-pressure-ventilation-nippv-versus-nasal-continuous-positive-airway-pressure-ncpap-for-preterm-neonates-after-extubation
#8
REVIEW
Brigitte Lemyre, Peter G Davis, Antonio G De Paoli, Haresh Kirpalani
BACKGROUND: Previous randomised trials and meta-analyses have shown that nasal continuous positive airway pressure (NCPAP) is a useful method for providing respiratory support after extubation. However, this treatment sometimes 'fails' in infants, and they may require endotracheal re-intubation with its attendant risks and expense. Nasal intermittent positive pressure ventilation (NIPPV) can augment NCPAP by delivering ventilator breaths via nasal prongs. Older children and adults with chronic respiratory failure benefit from NIPPV, and the technique has been applied to neonates...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28141793/sex-specific-associations-between-cerebrovascular-blood-pressure-autoregulation-and-cardiopulmonary-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#9
Raul Chavez-Valdez, Matthew O'Connor, Jamie Perin, Michael Reyes, Jillian Armstrong, Charlamaine Parkinson, Maureen Gilmore, Jacky Jennings, Frances J Northington, Jennifer K Lee
BACKGROUND: Cardiopulmonary injury is common in neonatal encephalopathy, but the link with cerebrovascular dysfunction is unknown. We hypothesized that cerebral autoregulation is associated with cardiopulmonary injury in neonates treated with therapeutic hypothermia (TH) for neonatal encephalopathy. METHODS: The cerebral hemoglobin volume index (HVx) from near-infrared spectroscopy was used to identify the mean arterial blood pressure (MAP) with optimal autoregulatory vasoreactivity (MAPOPT)...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28139102/-primary-versus-secondary-closure-ventilatory-and-nutritional-differences-in-patients-with-gastrosquisis
#10
M Dore Reyes, P Triana Junco, S Barrena Delfa, J L Encinas, M Romo Muñoz, A Vilanova Sánchez, G Chocarro Amatriain, F Hernández Oliveros, L Martínez Martínez, M López-Santamaría
AIM OF THE STUDY: Optimal surgical treatment of patients with gastroschisis remains controversial. Recent studies suggest better outcomes with secondary closure techniques (surgical or preformed silo). The purpose of the study is to identify differences in outcome of infants treated with traditional primary closure (PC) versus surgical silo (SS). PATIENTS AND METHODS: Retrospective study of patients primarily treated of gastroschisis between 2004 and 2014. Patients were divided in PC and SS according to abdominal wall closure...
April 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28138234/respiratory-muscle-activity-and-patient-ventilator-asynchrony-during-different-settings-of-noninvasive-ventilation-in-stable-hypercapnic-copd-does-high-inspiratory-pressure-lead-to-respiratory-muscle-unloading
#11
Marieke L Duiverman, Anouk S Huberts, Leo A van Eykern, Gerrie Bladder, Peter J Wijkstra
INTRODUCTION: High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient-ventilator asynchrony (PVA). PATIENTS AND METHODS: Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28123647/phenotypic-contrasts-of-duchenne-muscular-dystrophy-in-women-two-case-reports
#12
Karen T Nozoe, Ricardo T Akamine, Diego R Mazzotti, Daniel N Polesel, Luís F Grossklauss, Sergio Tufik, Monica L Andersen, Gustavo A Moreira
We discussed two cases of symptomatic female carriers to Duchenne Muscular Dystrophy. The first case is a 20 year-old girl with classical phenotypic manifestation of the disease, similar to the condition in boys. The case 2 is a 62 year-old woman with progressive muscular weakness. The disease is much less common in woman than men so both cases described here are considered rare forms of the disease, with several clinical implications. In both cases, a progressive muscle weakness, impairment in walking and sleeping was observed, in addition to obstructive sleep apnea syndrome and alveolar hypoventilation, that required noninvasive ventilatory support...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28121640/veno-venous-extracorporeal-membrane-oxygenation-use-in-the-treatment-of-bleomycin-pulmonary-toxicity
#13
Aakash Shah, Chetan Pasrija, Anthony Kronfli, Brody Wehman, Bartley P Griffith, Pablo G Sanchez, Jose P Garcia, Zachary N Kon
Pulmonary toxicity is a devastating complication of bleomycin chemotherapy. This insult is likely exacerbated by the free radical injury induced by high inspired oxygen content, which is required to support these patients. Traditional treatment consists of high-dose corticosteroids. We report the case of a 45-year-old man who developed bleomycin pulmonary toxicity, which failed to respond to treatment with high-dose corticosteroids. We used protective mechanical ventilatory settings while supported on veno-venous extracorporeal membrane oxygenation using a bicaval dual-lumen, single cannula system to allow for lung recovery...
January 24, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28117330/successful-tracheostomy-decannulation-after-complete-or-sensory-incomplete-cervical-spinal-cord-injury
#14
D H Kim, S W Kang, W A Choi, H J Oh
STUDY DESIGN: Retrospective study. OBJECTIVES: To report the successful tracheostomy decannulation/extubation in cervical spinal cord injury (C-SCI) patients. SETTING: Tertiary university hospital, pulmonary rehabilitation center. METHODS: Complete or sensory incomplete C-SCI patients who had received invasive acute phase respiratory management, and succeeded in decannulation/extubation became candidates of this study...
January 24, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28116924/oxygen-therapy-devices-and-portable-ventilators-for-improved-physical-activity-in-daily-life-in-patients-with-chronic-respiratory-disease
#15
Karina Couto Furlanetto, Fabio Pitta
Patients with hypoxemia and chronic respiratory failure may need to use oxygen therapy to correct hypoxemia and to use ventilatory support to augment alveolar ventilation, reverse abnormalities in blood gases (in particular hypercapnia) and reduce the work of breathing. Areas covered: This narrative review provides an overview on the use of oxygen therapy devices or portable ventilators for improved physical activity in daily life (PADL) as well as discusses the issue of lower mobility in daily life among stable patients with chronic respiratory disease who present indication for long-term oxygen therapy (LTOT) or home-based noninvasive ventilation (NIV)...
January 31, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28115003/normal-sleep-on-mechanical-ventilation-in-adult-patients-with-congenital-central-alveolar-hypoventilation-ondine-s-curse-syndrome
#16
Valérie Attali, Christian Straus, Michel Pottier, Marie-Annick Buzare, Capucine Morélot-Panzini, Isabelle Arnulf, Thomas Similowski
BACKGROUND: The purpose of this study was to describe the sleep structure (especially slow wave sleep) in adults with congenital central hypoventilation syndrome (CCHS), a rare genetic disease due to mutations in the PHOX2B gene. Fourteen patients aged 23 (19.0; 24.8) years old (median [1(rst)-3rd quartiles]) with CCHS underwent a sleep interview and night-time attended polysomnography with their ventilatory support. Their sleep variables were compared to those collected in 15 healthy control subjects matched for age, sex and body mass index...
January 23, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28110770/risk-factors-for-noninvasive-ventilation-failure-in-patients-with-acute-cardiogenic-pulmonary-edema-a-prospective-observational-cohort-study
#17
Zujin Luo, Fusheng Han, Yichong Li, Hangyong He, Gen Yang, Yuhong Mi, Yingmin Ma, Zhixin Cao
PURPOSE: We identified risk factors for noninvasive ventilation (NIV) failure in patients with acute cardiogenic pulmonary edema (ACPE). MATERIALS AND METHODS: We conducted an observational cohort study over a 3-year period in a 28-bed emergency intensive care unit (EICU) and prospectively included all consecutive patients in whom NIV was attempted as initial ventilatory support for ACPE. The primary outcome variables were NIV failure rate and risk factors for NIV failure...
January 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28107308/acute-right-heart-failure-after-hemorrhagic-shock-and-trauma-pneumonectomy-a-management-approach-a-blinded-randomized-controlled-animal-trial-using-inhaled-nitric-oxide
#18
Andrea L Lubitz, Lars O Sjoholm, Amy Goldberg, Abhijit Pathak, Thomas Santora, Thomas E Sharp, Markus Wallner, Remus M Berretta, Lauren A Poole, Jichuan Wu, Marla R Wolfson
BACKGROUND: Hemorrhagic shock and pneumonectomy causes an acute increase in pulmonary vascular resistance (PVR). The increase in PVR and right ventricular (RV) afterload leads to acute RV failure, thus reducing left ventricular (LV) preload and output. Inhaled nitric oxide (iNO) lowers PVR by relaxing pulmonary arterial smooth muscle without remarkable systemic vascular effects. We hypothesized that with hemorrhagic shock and pneumonectomy, iNO can be used to decrease PVR and mitigate right heart failure...
2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28101311/a-hospital-based-retrospective-comparative-study-of-complications-outcomes-clinical-and-laboratory-parameters-of-malaria-with-and-without-neurological-involvement
#19
Sohaib Ahmad, Nadia Shirazi, Nowneet K Bhat, Minakshi Dhar, Garima Mittal, Manish Mittal, Nidhi Kaeley, Manoj Kumar
BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analyse the cerebral complications in malaria, and study if there is a species-related difference in the presentation and outcomes. METHODS: We retrospectively compared patients with malaria hospitalised from 2009-15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28100653/minocycline-blocks-glial-cell-activation-and-ventilatory-acclimatization-to-hypoxia
#20
Jennifer Ann Stokes, Tara Elizabeth Arbogast, Esteban A Moya, Zhenxing Fu, Frank L Powell
Ventilatory acclimatization to hypoxia (VAH) is the time-dependent increase in ventilation, which persists upon return to normoxia, and involves plasticity in both central nervous system respiratory centers and peripheral chemoreceptors. We investigated the role of glial cells in VAH in male Sprague Dawley rats using minocycline, an antibiotic that inhibits microglia activation and has anti-inflammatory properties, and barometric pressure plethysmography to measure ventilation. Rats received either minocycline (45mg/kg, i...
January 18, 2017: Journal of Neurophysiology
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