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Ventilatory support

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https://www.readbyqxmd.com/read/29916565/-care-related-intervention-in-rehabilitative-pneumology-pulmonary-rehabilitation-in-chronic-obstructive-broncopneumopathies-copd-can-benefit-from-a-multidisciplinary-approach
#1
Michele Vitacca, Dina Visca, Antonio Spanevello
OBJECTIVES: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation. Cardiovascular diseases, osteoporosis, depression/anxiety, musculoskeletal impairment and obstructive sleep apnea are frequent and important comorbidities in COPD, often under-diagnosed, and associated with poor health status and prognosis. METHODS: Pulmonary rehabilitation improves symptoms, quality of life, pulmonary function, and health care in patients with chronic respiratory disease...
February 2018: Giornale Italiano di Medicina del Lavoro Ed Ergonomia
https://www.readbyqxmd.com/read/29914692/incidence-and-clinical-characteristics-of-guillain-barr%C3%A3-syndrome-in-osona-barcelona-spain-2003-2016
#2
J M Aragonès, J Altimiras, F Alonso, G Celedón, S Alfonso, P Roura, A Moreira
INTRODUCTION: According to most studies, the incidence of Guillain-Barré syndrome increases with age, with a peak incidence occurring between 70 and 80 years of age. The objective of this study is to describe the incidence (overall and by sex and age group) and clinical characteristics of Guillain-Barré syndrome in Osona (Barcelona, Spain). METHODS: We performed a retrospective, descriptive, population-based study covering the period 2003 to 2016. RESULTS: The global incidence of Guillain-Barré syndrome is 2...
June 15, 2018: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29910541/noninvasive-ventilation-for-acute-respiratory-failure-due-to-noncystic-fibrosis-bronchiectasis
#3
Vijay Hadda, Gopal Chawla, Pawan Tiwari, Karan Madan, Maroof Ahmad Khan, Anant Mohan, Gopi C Khilnani, Randeep Guleria
Purpose of the Study: Data regarding the use of noninvasive ventilation (NIV) for treatment of acute respiratory failure (ARF) among patients with noncystic fibrosis (CF) bronchiectasis are limited. We intend to describe our experience with NIV use in this setting. Methodology: This was a retrospective study which included 99 patients with bronchiectasis and ARF who required either NIV or invasive mechanical ventilation (IMV). Results: NIV was started as the primary modality of ventilatory support in 81 (66...
May 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29910465/neural-breathing-patterns-in-preterm-newborns-supported-with-non-invasive-neurally-adjusted-ventilatory-assist
#4
Fermín García-Muñoz Rodrigo, Lourdes Urquía Martí, Gloria Galán Henríquez, Sonia Rivero Rodríguez, Alberto Hernández Gómez
OBJECTIVE: To characterize the neural breathing pattern in preterm infants supported with non-invasive neurally adjusted ventilatory assist (NIV-NAVA). STUDY DESIGN: Single-center prospective observational study. The electrical activity of the diaphragm (EAdi) was periodically recorded in 30-second series with the Edi catheter and the Servo-n software (Maquet, Solna, Sweden) in preterm infants supported with NIV-NAVA. The EAdiPeak , EAdiMin , EAdiTonic , EAdiPhasic , neural inspiratory, and expiratory times (nTi and nTe) and the neural respiratory rate (nRR) were calculated...
June 18, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29908681/the-impact-of-early-enteral-nutrition-on-pediatric-acute-respiratory-failure
#5
Amanda Haney, Emily Burritt, Christopher J Babbitt
BACKGROUND AND AIMS: Children who are critically ill undergo metabolic stress and it is important that they receive adequate calories and protein in order to recover. Our objective was to investigate the impact of early enteral nutrition (EEN) on pediatric intensive care (PICU) patients with acute respiratory failure. METHODS: A retrospective cohort study was performed on all patients admitted to a 20 bed PICU at a tertiary children's hospital over a 30 month period...
August 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29899389/calcitriol-trend-following-pediatric-cardiac-surgery-and-association-with-clinical-outcome
#6
Nina Acharya, Dermot R Doherty, Nick Barrowman, Gyaandeo Maharajh, Tara Girolamo, Katie O'Hearn, J Dayre McNally
BACKGROUND: Consistent with accepted practice in stable ambulatory populations, the majority of ICU research has evaluated vitamin D status using a single blood 25-hydroxyvitamin D (25(OH)D) level. Only a limited number of ICU studies have measured the active hormone, 1,25-dihydroxyvitamin D (calcitriol) and none have used change in calcitriol levels to evaluate axis functioning. The objective of this study was to describe the impact of Congenital Heart Disease (CHD) surgery on calcitriol levels and evaluate the relationship between change in postoperative levels and clinical course...
June 13, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29869478/-about-a-cresol-intoxication
#7
S Fatihi, P Mols
Cresols are phenol derivatives commonly used as surface disinfectants. Ingestion may cause local mucocutaneous damage and extensive systemic toxicity : central nervous, cardiovascular, hematological, hepatic, renal and pulmonary. We describe the case of a 33-year-old woman who swallowed, without suicidal intent, 50 to 70 cm3 of a 50% cresol solution. Coma occurred within 5 minutes of ingestion, she presented a bradypnea with desaturation, and the SMUR team performed on-site an orotracheal intubation. On arrival at the hospital, the patient had typical caustic lesions around her mouth...
May 30, 2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/29861406/the-effect-of-mandibular-distraction-osteogenesis-on-airway-obstruction-and-polysomnographic-parameters-in-children-with-robin-sequence
#8
Amanda Lucas da Costa, Denise Manica, Cláudia Schweiger, Gabriel Kuhl, Leo Sekine, Simone Chaves Fagondes, Marcus Vinicius Collares, Paulo Jose Cauduro Marostica
INTRODUCTION: The optimal surgical technique for the management of patients with Robin Sequence (RS) has not been established. One of the most commonly used surgical techniques, mandibular distraction osteogenesis (MDO), is still controversial because of its potential risks and the lack of clear evidence of its efficacy. OBJECTIVES: To assess variations in airway patency, clinical symptoms, and polysomnographic parameters in children with RS who underwent MDO. METHODS: In this prospective cohort study, 38 patients with RS were evaluated before and after MDO...
May 18, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29860680/rapid-onset-plasma-leakage-of-extracorporeal-oxygenation-membranes-possibly-due-to-hyperbilirubinemia
#9
Yoshiko Kida, Shinichiro Ohshimo, Michihito Kyo, Yuko Tanabe, Kei Suzuki, Koji Hosokawa, Nobuaki Shime
Extracorporeal membrane oxygenation (ECMO) is an emerging tool for supporting cardiopulmonary function in patients with cardiorespiratory failure or arrest. The oxygenator of the ECMO circuit requires effective oxygenation and removal of carbon dioxide from the blood. Major problems that can occur with the oxygenator include plasma leakage, one of the late-onset serious complications necessitating device replacement. However, the rapid onset of plasma leakage is rare. We present a 1-year-old boy with acute respiratory failure due to Pneumocystis and Aspergillus pneumonia...
June 2, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29852508/clinical-outcomes-among-diagnostic-subgroups-of-infants-with-severe-bronchopulmonary-dysplasia-through-2-years-of-age
#10
Gangaram Akangire, Winston Manimtim, Michael F Nyp, Janelle Noel-MacDonnell, Allyssa N Kays, William E Truog, Jane B Taylor
OBJECTIVE:  This article aimed to identify readmission risk factors through 2 years of life for infants with severe bronchopulmonary dysplasia (BPD) who do not require tracheostomy and ventilatory support after neonatal intensive care unit (NICU) discharge. It also aimed to identify if clinical differences exist between the subcategories of severe BPD. STUDY DESIGN:  A retrospective chart review was performed on 182 infants with severe BPD born between 2010 and 2015...
May 31, 2018: American Journal of Perinatology
https://www.readbyqxmd.com/read/29849328/myasthenic-crisis-in-pregnancy
#11
David M French, E Page Bridges, Matthew C Hoskins, Charles M Andrews, Cecil H Nelson
This case reviews the management of a 27-year-old pregnant female in myasthenic crisis. She presented to the emergency department in respiratory distress refractory to standard therapy, necessitating airway and ventilatory support and treatment with plasmapheresis. Myasthenic crisis in the setting of pregnancy is rare and presents unique management challenges for emergency physicians.
November 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29843259/unusual-complication-of-fulminant-congenital-cytomegalovirus-infection
#12
T Arun Babu, Y Soliman, K Mohammad
Persistent pulmonary hypertension of newborn (PPHN) is a very rare manifestation of congenital cytomegalovirus (CMV) infection. PPHN associated with CMV can be severe but is usually transient and responds well to antiviral therapy. We report a rare case of PPHN that occurred in the setting of fulminant congenital CMV infection and successful treatment with antiviral therapy along with review of the very few cases reported in literature. A male appropriate for gestational Age (AGA) newborn developed rapidly progressive respiratory distress starting at 11 hours of life requiring ventilatory support and 100% oxygen...
May 23, 2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29805409/frequency-of-acute-kidney-injury-in-tetanus-patients-of-paedriatic-intensive-care-unit-a-public-hospital-experience
#13
Faizia Naseem, Abid Hussain, Fehmina Arif
Background and Objective: Tetanus is a potentially fatal but preventable disease. Mortality is related to severity of the disease, cardiovascular, pulmonary and renal complications. Acute kidney injury (AKI) is a frequent and lethal complication of tetanus. The objective was to determine the frequency of AKI in tetanus patients managed in a public hospital. Methods: Children aged 1-12 years admitted in Paediatric Intensive Care Unit (PICU) with the clinical diagnosis of tetanus over three and half years were recruited for the retrospective study...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29799892/-seronegative-catastrophic-antiphospholipid-syndrome-in-pediatrics-clinical-case
#14
Ericka Vargas-Quevedo, Eduardo Ordoñez-Gutiérrez, Jorge Enrique Trejo-Gómora, Lénica Anahí Chávez-Aguilar, Rubén Peña-Vélez
INTRODUCTION: The antiphospholipid syndrome is an acquired autoimmune thrombophilia, characterized by arterial and/or venous thrombosis. Rarely, this condition can have a catastrophic presenta tion, with high mortality, and presence of microangiopathy and involvement of three or more organs. OBJECTIVE: To describe the clinical presentation and evolution of a pediatric patient with catastrophic antiphospholipid syndrome, with a seronegative onset form, whose response to aggressive therapy was favorable...
April 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29796067/a-united-kingdom-register-study-of-in-hospital-outcomes-of-patients-receiving-extracorporeal-carbon-dioxide-removal
#15
Carole Cummins, Andrew Bentley, Daniel F McAuley, James J McNamee, Hannah Patrick, Nicholas A Barrett
Introduction: Extracorporeal membrane carbon dioxide removal may have a role in treatment of patients with hypercapnic respiratory failure and refractory hypoxaemia and/or hypercapnia. Methods: We report on the use, outcomes and complications in United Kingdom intensive care units reporting patients on the Extracorporal Life Support Organisation register. Results: Of 60 patients, 42 (70%) had primarily hypoxic respiratory failure and 18 (30%) primarily hypercapnic respiratory failure...
May 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29793585/the-cardiopulmonary-exercise-test-grey-zone-optimising-fitness-stratification-by-application-of-critical-difference
#16
G A Rose, R G Davies, G W Davison, R A Adams, I M Williams, M H Lewis, I R Appadurai, D M Bailey
BACKGROUND: Cardiorespiratory fitness can inform patient care, although to what extent natural variation in CRF influences clinical practice remains to be established. We calculated natural variation for cardiopulmonary exercise test (CPET) metrics, which may have implications for fitness stratification. METHODS: In a two-armed experiment, critical difference comprising analytical imprecision and biological variation was calculated for cardiorespiratory fitness and thus defined the magnitude of change required to claim a clinically meaningful change...
June 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29792537/recognizing-quantifying-and-managing-patient-ventilator-asynchrony-in-invasive-and-noninvasive-ventilation
#17
Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Luisa Liparota, Nicola Lombardo, Federico Longhini, Paolo Navalesi
Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and noninvasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, considering the techniques used to properly detect asynchronies, by either ventilator waveform observation, or through systems based on more complexes mathematical algorithms, by means of adjunctive signals, such as the electrical activity of the diaphragm or esophageal pressure...
May 31, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29789952/carotid-body-ablation-a-new-target-to-address-central-autonomic-dysfunction
#18
REVIEW
Rodrigo Iturriaga
PURPOSE OF REVIEW: An abnormal heightened carotid body (CB) chemoreflex, which produces autonomic dysfunction and sympathetic overactivation, is the common hallmark of obstructive sleep apnea (OSA), resistant hypertension, systolic heart failure (HF), and cardiometabolic diseases. Accordingly, it has been proposed that the elimination of the CB chemosensory input to the brainstem may reduce the autonomic and cardiorespiratory alterations in sympathetic-associated diseases in humans. RECENT FINDINGS: A growing body of evidence obtained in preclinical animal models support that an enhanced CB discharge produces sympathetic hyperactivity, baroreflex sensitivity and heart rate variability impairment, breathing instability, hypertension, and insulin resistance...
May 22, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29783851/the-death-debate-penumbra-conundrum
#19
Robert F Johnson
Determination and declaration of death by neurologic criteria, brain death, is an established and legally accepted clinical practice with profound implications. Concerns regarding the accuracy of this diagnosis raise important clinical, ethical, and legal issues. A recent magazine article highlights these concerns by describing a poignant example of a patient meeting accepted clinical and ancillary testing criteria for brain death in the setting of post cardiac arrest hypoxic ischemic encephalopathy (CA-HIE)...
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29765591/a-case-of-periorbital-necrotizing-fasciitis-rapidly-progressing-to-severe-multiorgan-failure
#20
Paola Eiben, Sancho Rodriguez-Villar
Periorbital necrotizing fasciitis (PNF) is a severe suppurative infection of the subcutaneous tissue and underlying fascia of the periorbital region. Typically, the course of PNF is milder and has a better prognosis than that of necrotizing fasciitis in other parts of the body. As such, this disease is thought to be associated with a significantly smaller risk of morbidity and mortality. Nevertheless, it is a rare and devastating condition that can lead to disfigurement, blindness and death. Early recognition is critical to improved patient outcomes...
April 2018: Journal of Surgical Case Reports
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