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https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#1
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28228969/prevention-and-treatment-of-neonatal-nosocomial-infections
#2
REVIEW
Jayashree Ramasethu
Nosocomial or hospital acquired infections threaten the survival and neurodevelopmental outcomes of infants admitted to the neonatal intensive care unit, and increase cost of care. Premature infants are particularly vulnerable since they often undergo invasive procedures and are dependent on central catheters to deliver nutrition and on ventilators for respiratory support. Prevention of nosocomial infection is a critical patient safety imperative, and invariably requires a multidisciplinary approach. There are no short cuts...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28225424/committee-opinion-no-689-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#3
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28225419/committee-opinion-no-689-summary-delivery-of-a-newborn-with-meconium-stained-amniotic-fluid
#4
(no author information available yet)
In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns...
March 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28224729/management-of-hypoxaemic-respiratory-failure-in-a-respiratory-high-dependency-unit
#5
Craig Hukins, Mimi Wong, Michelle Murphy, John Upham
BACKGROUND: There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-ICU settings. AIM: To assess outcomes in HRF (without multi-system disease and not requiring early intubation) directly admitted to a Respiratory High Dependency Unit (R-HDU). METHODS: Retrospective, cohort study of HRF compared to Hypercapnic Respiratory Failure (HCRF) in a R-HDU (2007-2011). Patient characteristics (age, gender, pre-morbid status, diagnoses) and outcomes (non-invasive ventilation (NIV) use, survival, ICU admission) were assessed...
February 22, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28222804/can-body-mass-index-predict-clinical-outcomes-for-patients-with-acute-lung-injury-acute-respiratory-distress-syndrome-a-meta-analysis
#6
Yue-Nan Ni, Jian Luo, He Yu, Yi-Wei Wang, Yue-Hong Hu, Dan Liu, Bin-Miao Liang, Zong-An Liang
BACKGROUND: The effects of body mass index (BMI) on the prognosis of acute respiratory distress syndrome (ARDS) are controversial. We aimed to further determine the relationship between BMI and the acute outcomes of patients with ARDS. METHODS: We searched the Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and ISI Web of Science for trials published between 1946 and July 2016, using "BMI" or "body mass index" or "overweight" or "obese" and "ARDS" or "ALI" or "acute respiratory distress syndrome" or "acute lung injury", without limitations on publication type or language...
February 22, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28222699/suspicion-of-respiratory-tract-infection-with-multidrug-resistant-enterobacteriaceae-epidemiology-and-risk-factors-from-a-paediatric-intensive-care-unit
#7
Hanna Renk, Lenja Stoll, Felix Neunhoeffer, Florian Hölzl, Matthias Kumpf, Michael Hofbeck, Dominik Hartl
BACKGROUND: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. METHODS: A retrospective single-centre analysis of Enterobacteriaceae isolates from the lower respiratory tract of ventilated PICU patients from 2005 to 2014 was performed...
February 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28221172/interventional-pulmonology-in-chronic-obstructive-pulmonary-disease
#8
Daniela Gompelmann, Nilab Sarmand, Felix J F Herth
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) and emphysema are widespread diseases associated with progressive dyspnea because of airflow limitation and hyperinflation. Fundamental therapeutic strategies consist of pulmonary rehabilitation, pharmacotherapy, long-term oxygen therapy, noninvasive ventilation, and surgical therapeutic approaches. RECENT FINDINGS: In the last 14 years, endoscopic therapeutic modalities emerged as a substantial part of severe COPD and emphysema treatment...
February 17, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#9
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28219399/noninvasive-detection-of-alarming-intracranial-pressure-changes-by-auditory-monitoring-in-early-management-of-brain-injury-a-prospective-invasive-versus-noninvasive-study
#10
Fabrice Giraudet, François Longeras, Aurélien Mulliez, Aurélie Thalamy, Bruno Pereira, Paul Avan, Laurent Sakka
BACKGROUND: In brain-injured patients intracranial pressure (ICP) is monitored invasively by a ventricular or intraparenchymal transducer. The procedure requires specific expertise and exposes the patient to complications such as malposition, hemorrhage or infection. As inner-ear fluid compartments are connected to the cerebrospinal fluid space, ICP changes elicit subtle changes in the physiology of the inner ear. Notably, we previously demonstrated that the phase of cochlear microphonic potential (CM) generated by sound stimuli rotates with ICP...
February 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28219324/non-anti-coagulant-factors-associated-with-filter-life-in-continuous-renal-replacement-therapy-crrt-a-systematic-review-and-meta-analysis
#11
Matthew Brain, Elizabeth Winson, Owen Roodenburg, John McNeil
BACKGROUND: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis...
February 20, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28215136/protocol-and-statistical-analysis-plan-for-the-randomised-evaluation-of-active-control-of-temperature-versus-ordinary-temperature-management-reactor-trial
#12
Paul J Young, Michael J Bailey, Richard W Beasley, Ross C Freebairn, Naomi E Hammond, Frank M P van Haren, Meg L Harward, Seton J Henderson, Diane M Mackle, Colin J McArthur, Shay P McGuinness, John A Myburgh, Manoj K Saxena, Anne Turner, Steve A R Webb, Rinaldo Bellomo
BACKGROUND: Body temperature can be reduced in febrile patients in the intensive care unit using medicines and physical cooling devices, but it is not known whether systematically preventing and treating fever reduces body temperature compared with standard care. OBJECTIVE: To describe the study protocol and statistical analysis plan for the Randomised Evaluation of Active Control of Temperature versus Ordinary Temperature Management (REACTOR) trial. DESIGN, SETTING AND PARTICIPANTS: Protocol for a phase II, multicentre trial to be conducted in Australian and New Zealand ICUs admitting adult patients...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28214832/the-burden-of-respiratory-disease-in-very-low-birth-weight-infants-changes-in-perinatal-care-and-outcomes-in-a-decade-in-spain
#13
Fermín García-Muñoz Rodrigo, Antonio Losada Martínez, María Dolores Elorza Fernández, Julio Moreno Hernando, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease. OBJECTIVES: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). METHODS: This is a retrospective analysis of data prospectively collected of all VLBW infants included in the Spanish SEN1500 network...
February 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28212451/relationship-between-pre-anesthetic-and-intra-anesthetic-airway-resistance-in-patients-undergoing-general-anesthesia-a-prospective-observational-study
#14
Takamitsu Ikeda, Kanji Uchida, Yasuhiro Yamauchi, Takahide Nagase, Koji Oba, Yoshitsugu Yamada
Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. So far, there have been no attempts to calculate airway resistance using flow-volume curves. Therefore, we performed a prospective, observational study to investigate the relationship between pre-anesthetic and intra-anesthetic airway resistance in patients scheduled for surgery under general anesthesia...
2017: PloS One
https://www.readbyqxmd.com/read/28210325/hot-topics-from-the-assemblies
#15
(no author information available yet)
Cowie et al. present the results of the international, multicentre, randomised, parallel-group SERVE-HF (Treatment of sleep-disordered breathing with predominant central sleep apnea by adaptive servo ventilation in patients with heart failure) trial, which investigated the effects of adding adaptive servo-ventilation (ASV) to guideline based medical management on survival and cardiovascular outcomes in patients with heart failure defined as reduced ejection fraction (<45%) and predominant central sleep apnoea (CSA)...
December 2016: Breathe
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#16
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
: Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
https://www.readbyqxmd.com/read/28210060/effectiveness-of-new-sedation-and-rehabilitation-methods-for-critically-ill-patients-receiving-mechanical-ventilation
#17
Kouji Yamashita, Akiyoshi Takami, Saichi Wakayama, Misato Makino, Yoshihiro Takeyama
[Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a "control group" and an "intervention group", respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28203432/acute-respiratory-distress-syndrome-and-chemical-burns-after-exposure-to-chlorine-containing-bleach-a-case-report
#18
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
Chlorine-containing bleach can cause acute respiratory distress syndrome (ARDS) and chemical burns. However, simultaneous occurrence of the two conditions caused by this agent is very rare. We describe the case of a 74-year-old female who presented with shortness of breath and hemoptysis following accidental exposure to chlorine-containing bleach. She had second- to third-degree chemical burns on both buttocks and thighs, and received mechanical ventilation because of the development of ARDS. Mechanical ventilation was discontinued on day 6 of hospitalization because of the rapid improvement of hypoxemia, and the patient was transferred to another hospital for further management of the chemical burns on day 18...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28199933/idiopathic-neonatal-pneumoperitoneum-a-case-report
#19
Sarah Magdy Abdelmohsen, Mohamed Abdelkader Osman
INTRODUCTION: There have been non-surgical conditions secondary to neonatal pneumoperitoneum (e.g., mechanical ventilation, pulmonary diseases and pneumatosis cystoides intestinalis) that neonates were able to overcome without the need for abdominal exploration. Idiopathic pneumoperitoneum, although similar to perforation of the alimentary tract and the previously mentioned non-surgical conditions, is a rare and benign condition that does not yet have a definite cause. The criteria by which a surgeon decides on which abdomen to open and which one to observe, is ill-defined...
January 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28199243/intraabdominal-surgery-and-anesthesia-management
#20
John Hedley-Whyte
: Inspired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation: A Concept of Atelectasis. By Bendixen HH, Hedley-Whyte J, and Laver MB. New Engl J Med 1963; 269:991-996. Reprinted with permission. ABSTRACT: The purpose of this study was to determine if the pattern of ventilation, by itself, influences oxygenation during anesthesia and surgery and examine the hypothesis that progressive pulmonary atelectasis may occur during constant ventilation whenever periodic hyperventilation is lacking, but is reversible by passive hyperinflation of the lungs...
March 2017: Anesthesiology
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