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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
#1
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...
February 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
#2
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
#3
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
https://www.readbyqxmd.com/read/28100527/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-randomized-controlled-trial
#4
S Humphreys, P Lee-Archer, G Reyne, D Long, T Williams, A Schibler
BACKGROUND: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) was introduced to adult anaesthesia to improve the safety of airway management during apnoea before intubation. The objective of our study was to determine whether THRIVE safely prolongs apnoeic oxygenation in children. METHODS: This was a randomized controlled trial in 48 healthy children, with normal airways and cardiorespiratory function, in age groups 0-6 and 7-24 months, 2-5 and 6-10 yr old, presenting for elective surgery or imaging under general anaesthesia...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28097852/laryngotracheal-edema-due-to-thermal-injury-a-complication-after-thyroidectomy-in-children
#5
Pinar Kendigelen, Ayse C Tutuncu, Gulruh Ashyralyyeva, Senol Emreb, Seval Urkmez, Tughan Utkua, Guner Kaya
Postoperative respiratory insufficiency is a serious complication of total thyroidectomies which can be multifactorial, especially in children. We report two siblings who had undergone thyroidectomy with subsequent respiratory distress. Electrothermal bipolar and harmonic scalpel were used during thyroid dissections. Both patients had early postoperative respiratory problems. The older one suffered from mild respiratory distress for 24 hours and then he spontaneously recovered. The younger one was extubated but then she had serious stridor accompanied with abdominal and intercostal retractions...
1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28095492/growth-hormone-deficiency-is-associated-with-worse-cardiac-function-physical-performance-and-outcome-in-chronic-heart-failure-insights-from-the-t-o-s-ca-ghd-study
#6
Michele Arcopinto, Andrea Salzano, Francesco Giallauria, Eduardo Bossone, Jörgen Isgaard, Alberto M Marra, Emanuele Bobbio, Olga Vriz, David N Åberg, Daniele Masarone, Amato De Paulis, Lavinia Saldamarco, Carlo Vigorito, Pietro Formisano, Massimo Niola, Francesco Perticone, Domenico Bonaduce, Luigi Saccà, Annamaria Colao, Antonio Cittadini
BACKGROUND: Although mounting evidence supports the concept that growth hormone (GH) deficiency (GHD) affects cardiovascular function, no study has systematically investigated its prevalence and role in a large cohort of chronic heart failure (CHF) patients. Aim of this study is to assess the prevalence of GHD in mild-to-moderate CHF and to explore clinical and functional correlates of GHD. METHODS: One-hundred thirty CHF patients underwent GH provocative test with GHRH+arginine and accordingly categorized into GH-deficiency (GHD, n = 88, age = 61...
2017: PloS One
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#7
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28063223/neurally-adjusted-ventilatory-assist-for-infants-under-prolonged-ventilation
#8
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Chang Won Choi, Yong Hoon Jun
BACKGROUND: Severe bronchopulmonary dysplasia (BPD) often leads to prolonged mechanical ventilation lasting several months. Cyanotic episodes frequently occur in these patients, which necessitate long-term sedation and/or intermittent muscle paralysis. Neurally adjusted ventilatory assist (NAVA) might provide precisely the amount of support that these patients need without sedation. METHODS: We reviewed the medical records of preterm infants who underwent a tracheostomy and required mechanical ventilation for more than 6 months during a period of 6 years...
January 7, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28054897/thrombosis-of-the-right-internal-jugular-vein-is-not-a-contraindication-to-ambulatory-veno-venous-extracorporeal-membrane-oxygenation-with-a-bicaval-dual-lumen-single-cannula-system
#9
Anthony Kronfli, Chetan Pasrija, Aakash Shah, Mehrdad Ghoreishi, Jose P Garcia, Si M Pham, Pablo G Sanchez, Zachary N Kon
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement. CASE REPORT: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS)...
14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28052047/mechanical-ventilatory-modes-and-cardioventilatory-phase-synchronization-in-acute-respiratory-failure-patients
#10
Claudio Enrico Mazzucco, Andrea Marchi, Vlasta Bari, Beatrice De Maria, Stefano Guzzetti, Ferdinando Raimondi, Emanuele Catena, Davide Ottolina, Carla Amadio, Silvio Cravero, Tommaso Fossali, Riccardo Colombo, Alberto Porta
Cardioventilatory phase synchronization was studied in ten critically ill patients admitted in intensive care unit (ICU) for acute respiratory failure under two mechanical ventilatory modes: i) pressure controlled ventilation (PCV); ii) pressure support ventilation (PSV). The two modalities were administered to the same patient in different times in a random order. Cardioventilatory phase interactions were typified by plotting the relative position of a heartbeat, detected from the electrocardiogram and collected in n groups, within m ventilatory cycles as a function of the progressive cardiac beat number via the synchrogram...
January 4, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28050000/the-effects-of-plasma-exchange-on-severe-vasculitis-with-diffuse-alveolar-hemorrhage
#11
Kimihiko Goto, Kentaro Nakai, Hideki Fujii, Shinichi Nishi
Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is a life-threatening disease characterized by rapidly progressive glomerulonephritis (RPGN) and diffuse alveolar hemorrhage (DAH). Glucocorticoids and immunosuppressants are commonly used to treat this disease but may induce irreversible side effects, particularly in elderly patients. We herein report the case of a 76-year-old woman with RPGN. After methylprednisolone pulse therapy, DAH occurred, and she required ventilatory support. After plasma exchange, her serum creatinine level improved, and she was discharged with home oxygen therapy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28049363/circulating-chromogranin-b-levels-in-patients-with-acute-respiratory-failure-data-from-the-finnali-study
#12
Peder Langeland Myhre, Mats Stridsberg, Rita Linko, Marjatta Okkonen, Ståle Nygård, Geir Christensen, Ville Pettilä, Torbjørn Omland, Helge Røsjø
PURPOSE: Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown. METHODS: We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days...
January 3, 2017: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/28043661/use-of-noninvasive-and-invasive-mechanical-ventilation-in-cardiogenic-shock-a-prospective-multicenter-study
#13
Mari Hongisto, Johan Lassus, Tuukka Tarvasmaki, Alessandro Sionis, Heli Tolppanen, Matias Greve Lindholm, Marek Banaszewski, John Parissis, Jindrich Spinar, Jose Silva-Cardoso, Valentina Carubelli, Salvatore Di Somma, Josep Masip, Veli-Pekka Harjola
BACKGROUND: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over non-invasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the use of NIV and MV. METHODS: 219 CS patients were categorized by the maximum intensity of ventilatory support they needed during the first 24h into MV (n=137; 63%) , NIV (n=26; 12%), and supplementary oxygen (n=56; 26%) groups...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28024955/pregnancy-as-a-risk-factor-for-severe-outcomes-from-influenza-virus-infection-a-systematic-review-and-meta-analysis-of-observational-studies
#14
REVIEW
Dominik Mertz, Johanna Geraci, Judi Winkup, Bradford D Gessner, Justin R Ortiz, Mark Loeb
BACKGROUND: Pregnancy is considered to be an important risk factor for severe complications following influenza virus infection. As a consequence, WHO recommendations prioritize pregnant women over other risk groups for influenza vaccination. However, the risk associated with pregnancy has not been systematically quantified. PURPOSE: Systematic review and meta-analysis of observational studies that reported on pregnancy as a risk factor for severe outcomes from influenza virus infection...
December 23, 2016: Vaccine
https://www.readbyqxmd.com/read/28013308/neonatal-pneumothorax-a-descriptive-regional-danish-study
#15
Louise Vibede, Emil Vibede, Mette Bendtsen, Lia Pedersen, Finn Ebbesen
BACKGROUND: Neonatal pneumothorax (PTX) can occur due to underlying pulmonary disease and/or ventilatory support. PTX can also develop at the onset of respiration. PTX can be life-threatening, and prompt diagnosis is essential to reduce mortality. OBJECTIVE: To analyse aetiology, demographic aspects, age at diagnosis, required treatment (specifically drainage), and prognosis of all cases of neonatal PTX observed in the North Jutland Region of Denmark from 1 January 2006 to 31 December 2014...
December 24, 2016: Neonatology
https://www.readbyqxmd.com/read/28013296/thoracoabdominal-asynchrony-is-not-associated-with-oxyhemoglobin-saturation-in-recovering-premature-infants
#16
Colleen Brennan, Lara Ulm, Samuel Julian, Aaron Hamvas, Thomas Ferkol, Julie Hoffman, Laura Linneman, James Kemp
BACKGROUND: Recovering premature infants are at risk for hypoxemia and lack of synchrony between their rib cage and abdomen due to airflow obstruction and poor respiratory compliance. Thoracoabdominal asynchrony (TAA) is a useful marker of resistive and elastic lung properties. Whether TAA predicts oxygenation is unknown. OBJECTIVES: We investigated oxyhemoglobin saturation (SpO2%) and TAA (phase angle, φ) in preterm infants with/without high-humidity nasal cannula (HHNC)...
December 24, 2016: Neonatology
https://www.readbyqxmd.com/read/28003557/comparing-the-effects-of-two-different-levels-of-hyperoxygenation-on-gas-exchange-during-open-endotracheal-suctioning-a-randomized-crossover-study
#17
Jacqueline Rodrigues de Freitas Vianna, Valéria Amorim Pires Di Lorenzo, Miléa Mara Lourenço da Silva Simões, Maurício Jamami
BACKGROUND: Endotracheal suctioning is required for mechanically ventilated patients to maintain a patent airway. Studies show that open endotracheal suctioning affects respiratory mechanics and gas exchange. The aim of this study was to compare the effectiveness of hyperoxygenation with FIO2 + 0.20 above baseline and hyperoxygenation with FIO2 1.0 in preventing hypoxemia, and to determine the impact of open endotracheal suctioning on the pulmonary ventilation of critical subjects receiving mechanical ventilatory support...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/28000205/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-ii-controlled-vs-spontaneous-ventilation
#18
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
The second part of this overview on early severe ARDS delineates the pros and cons of the following: a) controlled mechanical ventilation (CMV: lowered oxygen consumption and perfect patient-to-ventilator synchrony), to be used during acute cardio-ventilatory distress in order to "buy time" and correct circulatory insufficiency and metabolic defects (acidosis, etc.); b) spontaneous ventilation (SV: improved venous return, lowered intrathoracic pressure, absence of muscle atrophy). Given a stabilized early severe ARDS, as soon as the overall clinical situation improves, spontaneous ventilation will be used with the following stringent conditionalities: upfront circulatory optimization, upright positioning, lowered VO2, lowered acidotic and hypercapnic drives, sedation without ventilatory depression and without lowered muscular tone, as well as high PEEP (titrated on transpulmonary pressure, or as a second best: "trial"-PEEP) with spontaneous ventilation + pressure support (or newer modes of ventilation)...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28000204/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-i-pathophysiology
#19
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Severe acute respiratory distress syndrome (ARDS, PaO₂/FiO₂ < 100 on PEEP ≥ 5 cm H₂O) is treated using controlled mechanical ventilation (CMV), recently combined with muscle relaxation for 48 h and prone positioning. While the amplitude of tidal volume appears set < 6 mL kg⁻¹, the level of positive end-expiratory pressure (PEEP) remains controversial. This overview summarizes several salient points, namely: a) ARDS is an oxygenation defect: consolidation/ difuse alveolar damage is reversed by PEEP and/or prone positioning, at least during the early phase of ARDS b) ARDS is a dynamic disease and partially iatrogenic...
2016: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/27995289/the-fetus-with-ectopia-cordis-experience-and-expectations-from-two-centers
#20
Maria C Escobar-Diaz, Sherzana Sunderji, Wayne Tworetzky, Anita J Moon-Grady
Ectopia cordis (EC) is a rare congenital anomaly often associated with congenital heart disease (CHD). There is a lack of contemporary information on EC diagnosed prenatally. We sought to combine the experiences of two regional referral centers in order to evaluate current outcomes for EC. Clinical, echocardiographic features and perinatal outcomes of fetuses with EC managed at two large cardiac centers from 1995 to 2014 were retrospectively reviewed. Seventeen fetuses with EC were diagnosed at a median gestational age of 23 weeks (range 17-36)...
December 19, 2016: Pediatric Cardiology
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