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Ventilator management

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https://www.readbyqxmd.com/read/28342626/understanding-the-health-care-utilization-of-children-who-require-medical-technology-a-descriptive-study-of-children-who-require-tracheostomies
#1
Regena Spratling
Children who require medical technology have complex chronic illnesses. This medical technology, including ventilators, oximeters, tracheostomy tubes, and feeding tubes, allows children and their families to live at home; however, the management of the children's care by informal caregivers is complex with the need for intensive, specialized care. The purpose of this study was to examine the sociodemographic and clinical characteristics that affect health care utilization in a population of children who require medical technology...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28339976/effects-of-two-different-broiler-flooring-systems-on-production-performances-welfare-and-environment-under-commercial-production-conditions
#2
H Li, X Wen, R Alphin, Z Zhu, Z Zhou
Research comparing conventional litter and alternative perforated flooring (netting) systems is relatively limited under commercial production conditions. A comprehensive comparison of broiler production performances, welfare quality, and housing environment of two broiler houses with conventional litter and new perforated plastic floors was conducted over four flocks for eight months in eastern China. The two broiler houses each had 31,700 broilers per flock on average and were ventilated using a negative-pressure system...
March 3, 2017: Poultry Science
https://www.readbyqxmd.com/read/28338488/respiratory-complications-management-and-treatments-for-neuromuscular-disease-in-children
#3
MyMy C Buu
PURPOSE OF REVIEW: To summarize current literature describing the respiratory complications of neuromuscular disease (NMD) and the effect of respiratory interventions and to explore new gene therapies for patients with NMD. RECENT FINDINGS: Measurements of respiratory function focus on vital capacity and maximal inspiratory and expiratory pressure and show decline over time. Management of respiratory complications includes lung volume recruitment, mechanical insufflation-exsufflation, chest physiotherapy and assisted ventilation...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28338487/the-evolution-of-disease-chronic-lung-disease-of-infancy-and-pulmonary-hypertension
#4
Michael C Tracy, David N Cornfield
PURPOSE OF REVIEW: Bronchopulmonary dysplasia (BPD) or chronic lung disease of infancy BPD was originally described 50 years ago, in 1967 by Northway et al. This article possesses two fundamental objectives to provide: a brief historical perspective on BPD; and an update relative to current notions of epidemiology, pathophysiology, evaluation, and clinical management of BPD complicated by vascular disease. The review highlights areas of consensus and ongoing uncertainty. RECENT FINDINGS: The clinical cause and presentation of infants with BPD has evolved over the past several decades...
March 23, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28336165/suspicious-outbreak-of-ventilator-associated-pneumonia-caused-by-burkholderia-cepacia-in-a-surgical-intensive-care-unit
#5
LiPing Guo, Gang Li, Jian Wang, Xia Zhao, Shupeng Wang, Li Zhai, Hongbin Jia, Bin Cao
BACKGROUND: We reviewed Burkholderia cepacia infections in a hospital from 2013-2016 to report a suspicious outbreak that occurred in a surgical intensive care unit in 2015, and to outline the infection control measures adopted thereafter. METHODS: Review of the health care-associated infection data regarding B cepacia via the surveillance system, hospital information system, electronic medical records, and laboratory information system together with the outbreak investigation was managed by the health care-associated infection control team...
March 20, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#6
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, S Fein, L A Eidelman, A Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005- 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28331629/congenital-diaphragmatic-hernia-a-review
#7
REVIEW
Praveen Kumar Chandrasekharan, Munmun Rawat, Rajeshwari Madappa, David H Rothstein, Satyan Lakshminrusimha
Congenital Diaphragmatic hernia (CDH) is a condition characterized by a defect in the diaphragm leading to protrusion of abdominal contents into the thoracic cavity interfering with normal development of the lungs. The defect may range from a small aperture in the posterior muscle rim to complete absence of diaphragm. The pathophysiology of CDH is a combination of lung hypoplasia and immaturity associated with persistent pulmonary hypertension of newborn (PPHN) and cardiac dysfunction. Prenatal assessment of lung to head ratio (LHR) and position of the liver by ultrasound are used to diagnose and predict outcomes...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28331444/post-liver-transplant-delirium-increases-mortality-and-length-of-stay
#8
Nathan Oliver, Humberto Bohorquez, Stephanie Anders, Andrew Freeman, Kerry Fine, Emily Ahmed, David S Bruce, Ian C Carmody, Ari J Cohen, John Seal, Trevor W Reichman, George E Loss
BACKGROUND: Incidence of delirium after liver transplantation (LT) has been reported to occur in 10%-47% of patients and is associated with increased hospital and intensive care unit lengths of stay and poor outcomes. METHODS: Our primary objective was to evaluate the incidence and predisposing risk factors for developing delirium after LT. Our secondary objectives were to describe how delirium is managed in patients after LT, to examine the utilization of resources associated with delirium after LT, and to analyze the outcomes of patients who were treated for delirium after LT...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#9
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28330573/implication-of-general-anaesthetic-and-sedation-techniques-in-temporomandibular-joint-disorders%C3%A2-%C3%A2-a-systematic-review
#10
J Talaván-Serna, J M Montiel-Company, C Bellot-Arcís, J M Almerich-Silla
The purpose of this study was to conduct a systematic review of the literature on temporomandibular joint damage directly related to general anaesthesia and sedation. We searched MEDLINE, SCOPUS and the COCHRANE Library for titles and abstracts containing terms related to the subject. The search delimiters were analytical and descriptive studies with abstracts in Spanish, German, English or French, with no time limit. The search was updated in January 2015. Of the 398 articles found, 89 were duplicates and only 28 were of interest...
February 2017: J Stomatol Oral Maxillofac Surg
https://www.readbyqxmd.com/read/28330410/outcome-and-management-of-refractory-respiratory-failure-with-timely-extracorporeal-membrane-oxygenationsingle-center-experience-with-legionella-pneumonia
#11
Roberto Roncon-Albuquerque, Rodrigo Vilares-Morgado, Gert-Jan van der Heijden, João Ferreira-Coimbra, Paulo Mergulhão, José Artur Paiva
OBJECTIVE: To analyze the management and outcome of patients with refractory respiratory failure complicating severe Legionella pneumonia rescued with extracorporeal membrane oxygenation (ECMO) in our Center. DESIGN AND SETTING: Observational study of patients with refractory respiratory failure treated with ECMO in Hospital S.João (Porto, Portugal), between November 2009 and September 2016. PARTICIPANTS: A total of 112 patients rescued with ECMO, of which 14 had Legionella pneumonia...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#12
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#13
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28328587/bedside-breath-wise-visualization-of-bronchospasm-by-electrical-impedance-tomography-could-improve-perioperative-patient-safety-a-case-report
#14
Pedro de la Oliva, Andreas D Waldmann, Stephan H Böhm, Cristina Verdú-Sánchez, Antonio Pérez-Ferrer, Elena Alvarez-Rojas
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28328285/intrapulmonary-artery-balloon-pulsation-improves-circulatory-function-after-acute-myocardial-infarction-in-pigs
#15
Rahma Ouardani, Nikos Magkoutis, Philippe Bonnin, Chantal Kang, Antoni W Kedra, Georgios Sideris, Michel Bonneau, Sebastian Voicu
AIM: To examine whether pulmonary artery balloon pulsation (PABP) could improve circulatory function in acute myocardial infarction (AMI) in pigs. METHODS/RESULTS: Ten downsize pigs were sedated and ventilated. AMI was induced by inserting a plug into the left anterior descending artery. A pulsation balloon was placed in the pulmonary artery in all animals. In the treatment group (TG), pulsations began when life-threatening arrhythmia or > 30% drop in mean blood pressure (MBP) or > 40% decrease in cardiac output compared to baseline occurred...
March 22, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/28327493/noninvasive-ventilation-open-issues-for-nursing-research
#16
Stefano Bambi, Enrica Mati, Christian De Felippis, Alberto Lucchini
According to the current literature, Noninvasive Ventilation (NIV) is a well-recognized respiratory support technique for patients affected by Acute Respiratory Failure (ARF). As highlighted by recent meta-analysis, a tight adherence to protocols regarding patients' selection criteria, relative or absolute contraindications, plus highly skilled and experienced operators, can positively affect the NIV performance and mortality rates. Positive outcome from NIV respiratory support is dependent from: patient's clinical condition and education needs; confidence of the staff with NIV technology; choice and management of the most suitable interface available prevention of interface complications; nutritional assessment (artificial feeding if required) and conditioning of medical gas...
March 14, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28326202/venovenous-extracorporeal-membrane-oxygenation-as-a-treatment-for-obesity-hypoventilation-syndrome
#17
Nao Umei, Shingo Ichiba
The mortality rate for respiratory failure resulting from obesity hypoventilation syndrome is high if it requires ventilator management. We describe a case of severe acute respiratory failure resulting from obesity hypoventilation syndrome (BMI, 60.2 kg/m(2)) successfully treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). During ECMO management, a mucus plug was removed by bronchoscopy daily and 18 L of water was removed using diuretics, resulting in weight loss of 24 kg. The patient was weaned from ECMO on day 5, extubated on day 16, and discharged on day 21...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28325709/early-referral-to-coronary-artery-bypass-grafting-following-acute-coronary-syndrome-trends-and-outcomes-from-the-acute-coronary-syndrome-israeli-survey-acsis-2000-2010
#18
Robert Klempfner, Yaron D Barac, Arwa Younis, Eran Kopel, Anan Younis, Goldkorn Ronen, Elad Maor, Yaron Arbel, David Rott, Ilan Goldenberg, Dan Aravot
BACKGROUND: Limited information exists on whether changes in medical practices over the study decades have affected the outcomes of acute coronary syndrome (ACS) patients who undergo early coronary artery bypass surgery (CABG) during index hospitalisation. METHODS: Data on trends for early CABG referral and associated outcomes were obtained among 11,485 ACS patients enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) 2000-2010. RESULTS: Among 11,485 patients, 566 (5%) were referred to early CABG...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#19
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28319476/anesthesia-in-patients-with-infectious-disease-caused-by-multi-drug-resistant-bacteria
#20
Sharon Einav, Yonit Wiener-Well
PURPOSE OF REVIEW: Up to 50% of specific bacterial strains in healthcare admission facilities are multidrug-resistant organisms (MDROs). Involvement of anesthesiologists in management of patients carrying/at risk of carrying MDROs may decrease transmission in the Operating Room (OR). RECENT FINDINGS: Anesthesiologists, their work area and tools have all been implicated in MDRO outbreaks. Causes include contamination of external ventilation circuits and noncontribution of filters to prevention, inappropriate decontamination procedures for nondisposable equipment (e...
March 17, 2017: Current Opinion in Anaesthesiology
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