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Ventilatory support

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https://www.readbyqxmd.com/read/28320035/srage-is-elevated-in-the-lungs-of-premature-infants-receiving-mechanical-ventilation
#1
Henry J Rozycki, Jennifer Bradley, Simon Karam
Background Soluble receptor for advanced glycation end-products (sRAGE), a soluble isoform of the RAGE receptor, is elevated in lungs from patients with acute conditions such as acute respiratory distress syndrome and bronchiolitis. This study investigated whether sRAGE is present in ventilated infants. Methods Tracheal aspirates from the first week or the fifth week of life were obtained from intubated very low birth weight subjects and analyzed by Western blot. Immunohistochemistry analysis for sRAGE was performed on paraffin-embedded lung autopsy slides from 19 other infants...
March 20, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28281412/early-hybrid-approach-and-enteral-feeding-algorithm-could-reduce-the-incidence-of-necrotising-enterocolitis-in-neonates-with-ductus-dependent-systemic-circulation
#2
Lucia Manuri, Stefano Morelli, Salvatore Agati, Michele B Saitta, Lilia Oreto, Giuseppe Mandraffino, Enrico Iannace, Fiore S Iorio, Paolo Guccione
BACKGROUND: The reported incidence of necrotising enterocolitis in neonates with complex CHD with ductus-dependent systemic circulation ranges from 6.8 to 13% despite surgical treatment; the overall mortality is between 25 and 97%. The incidence of gastrointestinal complications after hybrid palliation for neonates with ductus-dependent systemic circulation still has to be defined, but seems comparable with that following the Norwood procedure. METHODS: We reviewed the incidence of gastrointestinal complications in a series of 42 consecutive neonates with ductus-dependent systemic circulation, who received early hybrid palliation associated with a standardised feeding protocol...
January 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28279284/a-26-year-old-man-on-prolonged-mechanical-ventilatory-support-with-a-sudden-elevation-in-peak-pressures
#3
Karan Singh, Mangala Narasimhan
No abstract text is available yet for this article.
March 2017: Chest
https://www.readbyqxmd.com/read/28272069/does-prehospital-time-affect-survival-of-major-trauma-patients-where-there-is-no-prehospital-care
#4
S B Dharap, S Kamath, V Kumar
BACKGROUND: Survival after major trauma is considered to be time dependent. Efficient prehospital care with rapid transport is the norm in developed countries, which is not available in many lower middle and low-income countries. The aim of this study was to assess the effect of prehospital time and primary treatment given on survival of major trauma patients in a setting without prehospital care. MATERIALS AND METHODS: This prospective observational study was carried out in a university hospital in Mumbai, from January to December 2014...
March 3, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/28257985/microbiological-aspects-of-fournier-s-gangrene
#5
Tuncay Yilmazlar, Baris Gulcu, Ozgen Isik, Ersin Ozturk
BACKGROUND: Fournier's gangrene (FG) is a devastating disease that is characterized by necrotizing fasciitis of the perineal, genital, or perianal region. Broad-spectrum antibiotics are the key component of its treatment. However, there is paucity of data regarding the optimal empirical antibiotherapy for FG. MATERIALS AND METHODS: Data from patients who underwent surgery for FG between January 2007 and December 2012 were retrieved from a prospectively collected departmental FG database...
February 28, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28238441/mechanical-ventilation-in-acute-respiratory-distress-syndrome-the-open-lung-revisited
#6
L Amado-Rodríguez, C Del Busto, E García-Prieto, G M Albaiceta
Acute respiratory distress syndrome (ARDS) is still related to high mortality and morbidity rates. Most patients with ARDS will require ventilatory support. This treatment has a direct impact upon patient outcome and is associated to major side effects. In this regard, ventilator-associated lung injury (VALI) is the main concern when this technique is used. The ultimate mechanisms of VALI and its management are under constant evolution. The present review describes the classical mechanisms of VALI and how they have evolved with recent findings from physiopathological and clinical studies, with the aim of analyzing the clinical implications derived from them...
February 23, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28236395/nursing-strategies-for-effective-weaning-of-the-critically-ill-mechanically-ventilated-patient
#7
REVIEW
Darian Ward, Paul Fulbrook
The risks imposed by mechanical ventilation can be mitigated by nurses' use of strategies that promote early but appropriate reduction of ventilatory support and timely extubation. Weaning from mechanical ventilation is confounded by the multiple impacts of critical illness on the body's systems. Effective weaning strategies that combine several interventions that optimize weaning readiness and assess readiness to wean, and use a weaning protocol in association with spontaneous breathing trials, are likely to reduce the requirement for mechanical ventilatory support in a timely manner...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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