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https://www.readbyqxmd.com/read/29775382/data-mining-cmmss-how-to-convert-data-into-knowledge
#1
Larry Fennigkoh, D Courtney Nanney
Although the healthcare technology management (HTM) community has decades of accumulated medical device-related maintenance data, little knowledge has been gleaned from these data. Finding and extracting such knowledge requires the use of the well-established, but admittedly somewhat foreign to HTM, application of inferential statistics. This article sought to provide a basic background on inferential statistics and describe a case study of their application, limitations, and proper interpretation. The research question associated with this case study involved examining the effects of ventilator preventive maintenance (PM) labor hours, age, and manufacturer on needed unscheduled corrective maintenance (CM) labor hours...
January 2018: Biomedical Instrumentation & Technology
https://www.readbyqxmd.com/read/29774726/single-lung-ventilation-associated-to-ecmo-an-alternative-approach-to-manage-ventilator-induced-lung-injuries-in-infants
#2
Matteo Di Nardo, Joseph Nunziata, Francesca Stoppa, Margherita Lonero, Daniela Perrotta, Corrado Cecchetti, Salvatore Grasso
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29773355/pain-assessment-and-management-by-nurses-in-a-geriatric-setting-discrepancies-between-guidelines-and-documented-practice
#3
Irit Shahar, Gad Mendelson, Shlomit Gerbi, Merav Ben Natan
Pain is a common subjective symptom among older adults in general and among older adult residents in long-term geriatric facilities in particular. Pain diminishes older adults' quality of life and may impair their ability to recover from various illnesses. Therefore, the Israeli Ministry of Health has issued guidelines on effectively assessing and treating pain in this population. To examine discrepancies between the Ministry of Health's pain assessment guidelines and documented practice by nursing staff at a long-term geriatric care facility and whether these discrepancies correlate to characteristics of the nurses, the wards, and the patients' characteristics...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29773292/health-related-quality-of-life-measurement-in-patients-with-chronic-respiratory-failure
#4
REVIEW
Toru Oga, Wolfram Windisch, Tomohiro Handa, Toyohiro Hirai, Kazuo Chin
The improvement of health-related quality of life (HRQL) is an important goal in managing patients with chronic respiratory failure (CRF) receiving long-term oxygen therapy (LTOT) and/or domiciliary noninvasive ventilation (NIV). Two condition-specific HRQL questionnaires have been developed to specifically assess these patients: the Maugeri Respiratory Failure Questionnaire (MRF) and the Severe Respiratory Insufficiency Questionnaire (SRI). The MRF is more advantageous in its ease of completion; conversely, the SRI measures diversified health impairments more multi-dimensionally and discriminatively with greater balance, especially in patients receiving NIV...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29773291/cost-utility-of-non-invasive-mechanical-ventilation-analysis-and-implications-in-acute-respiratory-failure-a-brief-narrative-review
#5
REVIEW
Antonello Nicolini, Sven Stieglitz, Pierre Bou-Khalil, Antonio Esquinas
The growing interest in the quality of patient care at the levels of the health care managers, insurance companies, and health professionals is evident. Further, the growing population requires good quality health services. In this review, we analyzed the cost-effectiveness of noninvasive ventilation (NIV) in an acute setting for the treatment of respiratory failure. The strength of this review is that it identified and summarized the most relevant studies regarding various aspects of the cost-utility of NIV in an acute setting...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29773072/formal-procedure-to-facilitate-the-decision-to-withhold-or-withdraw-life-sustaining-interventions-in-a-neonatal-intensive-care-unit-a-seven-year-retrospective-study
#6
G Sorin, R Vialet, B Tosello
BACKGROUND: Neonatal deaths are often associated with the complex decision to limit or withdraw life-sustaining interventions (LSIs) rather than therapeutic impasses. Despite the existence of a law, significant disparities in clinical procedures remain. This study aimed to assess deaths occurring in a Neonatal Intensive Care Unit (NICU) and measure the impact of a traceable Limitation or Withdrawal of Active Treatment (LWAT) file on the treatment of these newborns. METHODS: In this monocentric retrospective study, we reviewed all consecutive neonatal deaths occurring during two three-year periods among patients in the NICU at the North Hospital of Marseille: cohort 1 (from 2009 to 2011 without the LWAT file) and cohort 2 (from 2013 to 2015 after introduction of the LWAT file)...
May 17, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29769510/surgical-management-of-a-critical-ischemic-mitral-regurgitation-patient
#7
S A Sunny, S Moinuddin, A B Adhikary, M A Hossain
Functional ischemic mitral regurgitation is strongly associated with poor outcomes in patient with coronary artery disease. The best management for mitral regurgitation at the time of coronary revascularization remains controversial. We report, a case of 58 years-old men admitted to GKNM hospital, Coimbatore, Tamil Nadu, India with chest pain and respiratory distress for last 6 hours during my fellowship training in that hospital. ECG showed acute antero-septal MI. The transthoracic echocardiogram revealed severe left ventricular dysfunction with moderate mitral regurgitation...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29769190/pneumoperitoneum-in-a-neonate-weighing-less-than-500-g-what-do-we-really-know-about-it
#8
Audrienne Sammut, Miguel Soares Oliveira, Claire Jackson, Cristine Sortica da Costa
Pneumoperitoneum in preterm infants is a surgical emergency as it is usually indicative of intestinal perforation. Rare cases of idiopathic pneumoperitoneum have been described in the literature, the underlying causes and pathophysiology of which remain uncertain. We present a case of pneumoperitoneum in an extremely preterm infant with severe growth restriction. This occurred while she was receiving high frequency oscillatory ventilation. She had respiratory distress syndrome with pulmonary interstitial emphysema...
May 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#9
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29765788/early-pulmonary-interstitial-emphysema-in-preterm-neonates-respiratory-management-and-case-report-in-nonventilated-very-low-birth-weight-twins
#10
Judith Gronbach, Harald Ehrhardt, Klaus-Peter Zimmer, Markus Waitz
Early pulmonary interstitial emphysema in extreme preterm neonates is closely linked with respiratory distress syndrome and exposure to mechanical ventilation. In severe cases, maintaining adequate gas exchange aiming to avoid further lung damage and other neonatal morbidities associated with systemic/pulmonary hypoperfusion, prolonged hypoxia, and respiratory acidosis can be challenging and requires in-depth knowledge into the pathophysiology of the disease. Herein, we report on very low birth weight twins who developed early pulmonary interstitial emphysema during noninvasive respiratory support...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29765003/passive-versus-active-circuit-during-invasive-mechanical-ventilation-in-subjects-with-amyotrophic-lateral-sclerosis
#11
Elisa De Mattia, Elisa Falcier, Andrea Lizio, Christian Lunetta, Valeria A Sansone, Nicola Barbarito, Barbara Garabelli, Marino Iatomasi, Elisabetta Roma, Fabrizio Rao, Annalisa Carlucci
BACKGROUND: Until recently, it has been considered essential to maintain the use of a double-limb circuit in patients with amyotrophic lateral sclerosis (ALS) to avoid rebreathing expired air during invasive mechanical ventilation. Currently, life-sustaining home ventilators can work with a single, lighter circuit that is easier to manage. Our aim was to evaluate the effectiveness and safety of a single-limb circuit with intentional leaks (passive circuit) in comparison with a circuit with an expiratory valve (active circuit), in subjects with ALS who use invasive home ventilation...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29764555/-role-of-noninvasive-mechanical-ventilation-in-patients-with-severe-avian-influenza-a-h7n9-complicated-with-acute-respiratory-distress-syndrome
#12
Haili Luo, Shaohong Wang, Feng Shen, Tongmei Yuan, Xianguo Pan, Jingtao Liu, Ling Yao, Juncheng Wu, Xuemei Long
Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29764401/management-of-acute-respiratory-failure-in-interstitial-lung-diseases-overview-and-clinical-insights
#13
REVIEW
Paola Faverio, Federica De Giacomi, Luca Sardella, Giuseppe Fiorentino, Mauro Carone, Francesco Salerno, Jousel Ora, Paola Rogliani, Giulia Pellegrino, Giuseppe Francesco Sferrazza Papa, Francesco Bini, Bruno Dino Bodini, Grazia Messinesi, Alberto Pesci, Antonio Esquinas
BACKGROUND: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. METHODS: A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017)...
May 15, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29763713/practice-of-mechanical-ventilation-in-cardiac-arrest-patients-and-effects-of-targeted-temperature-management-a-substudy-of-the-targeted-temperature-management-trial
#14
Matthew B A Harmon, David M P van Meenen, Annelou L I P van der Veen, Jan M Binnenkade, Josef Dankiewicz, Florian Ebner, Niklas Nielsen, Paolo Pelosi, Marcus J Schultz, Janneke Horn, Hans Friberg, Nicole P Juffermans
AIMS: Mechanical ventilation practices in patients with cardiac arrest are not well described. Also, the effect of temperature on mechanical ventilation settings is not known. The aims of this study were 1) to describe practice of mechanical ventilation and its relation with outcome 2) to determine effects of different target temperatures strategies (33 °C versus 36 °C) on mechanical ventilation settings. METHODS: This is a substudy of the TTM-trial in which unconscious survivors of a cardiac arrest due to a cardiac cause were randomized to two TTM strategies, 33 °C (TTM33) and 36 °C (TTM36)...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#15
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29761867/airway-physical-examination-tests-for-detection-of-difficult-airway-management-in-apparently-normal-adult-patients
#16
REVIEW
Dominik Roth, Nathan L Pace, Anna Lee, Karen Hovhannisyan, Alexandra-Maria Warenits, Jasmin Arrich, Harald Herkner
BACKGROUND: The unanticipated difficult airway is a potentially life-threatening event during anaesthesia or acute conditions. An unsuccessfully managed upper airway is associated with serious morbidity and mortality. Several bedside screening tests are used in clinical practice to identify those at high risk of difficult airway. Their accuracy and benefit however, remains unclear. OBJECTIVES: The objective of this review was to characterize and compare the diagnostic accuracy of the Mallampati classification and other commonly used airway examination tests for assessing the physical status of the airway in adult patients with no apparent anatomical airway abnormalities...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29758575/-descriptive-analysis-of-health-economics-of-intensive-home-care-of-ventilated-patients
#17
Yvonne Lehmann, Julia Ostermann, Thomas Reinhold, Michael Ewers
INTRODUCTION: Long-term ventilated patients in Germany receive intensive care mainly in the patients' home or in assisted-living facilities. There is a lack of knowledge about the nature and extent of resource use and costs associated with care of this small, heterogeneous but overall growing patient group. METHODS: A sub-study in the context of a research project SHAPE analyzed costs of 29 patients descriptively from a social perspective. Direct and indirect costs of intensive home care over a period of three months were recorded and analyzed retrospectively...
May 14, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29757793/technique-utilizing-a-modified-oral-ring-adair-elwyn-tube-to-provide-continuous-oxygen-and-sevoflurane-delivery-during-nasotracheal-intubation-in-an-infant-with-a-difficult-airway-a-case-report
#18
Janice Y Man, John E Fiadjoe, Grace Hsu
Managing the airway of an infant with Pierre Robin sequence (PRS) is particularly challenging for anesthesiologists. Patients with PRS have the triad of micrognathia, glossoptosis, and airway obstruction that potentially and frequently leads to difficulty with both ventilation and intubation. Thus continuous oxygenation and spontaneous ventilation during intubation are essential. We describe a new method to deliver continuous oxygen and volatile anesthetic during nasotracheal intubation in an infant with PRS...
May 15, 2018: A&A practice
https://www.readbyqxmd.com/read/29755094/-giant-intrathoracic-goiter-requiring-emergency-airway-management-report-of-a-case
#19
Marina Shiikawa, Kazuki Hayasaka, Kei Yarimizu, Katsuyuki Suzuki, Makoto Endo, Naoki Yanagawa, Satoshi Shiono
An 81-year-old woman with acute respiratory distress was referred to our hospital. Computed tomography showed a large mass in the upper mediastinum with severe tracheal stenosis. Endotracheal intubation was performed under the preparation of extracorporeal membrane oxygenation and high-frequency jet ventilation, and the tumor was completely removed. The pathologic diagnosis was a goiter. Post-operatively, respiratory distress disappeared. No tumor recurrences have been noted for more than 2 years after surgery...
May 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29755078/-re-expansion-pulmonary-edema-after-surgery-for-spontaneous-tension-hemopneumothorax-report-of-a-case
#20
Masanobu Hayakawa, Kazuyuki Oda
A 23-year-old man was admitted to our hospital because of chest pain and dyspnea. X-ray and computed tomography showed left tension hemopneumothorax. After the emergent surgery, re-expansion pulmonary edema (RPE) occurred. Non-invasive positive pressure ventilation (NPPV) was applied to control RPE and RPE was successfully recovered. NPPV may be useful in managing RPE.
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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