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https://www.readbyqxmd.com/read/28350645/the-use-of-bowel-protocols-in-critically-ill-adult-patients-a-systematic-review-and-meta-analysis
#1
Simon J W Oczkowski, Erick H Duan, Amy Groen, Dawn Warren, Deborah J Cook
OBJECTIVE: Constipation is common among critically ill patients and has been associated with adverse patient outcomes. Many ICUs have developed bowel protocols to treat constipation; however, their effect on clinical outcomes remains uncertain. We conducted a systematic review to determine the impact of bowel protocols in critically ill adults. DATA SOURCES: We searched MEDLINE, Embase, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, and conference abstracts until January 2016...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350644/disassociating-lung-mechanics-and-oxygenation-in-pediatric-acute-respiratory-distress-syndrome
#2
Nadir Yehya, Neal J Thomas
OBJECTIVES: Both oxygenation and peak inspiratory pressure are associated with mortality in pediatric acute respiratory distress syndrome. Since oxygenation and respiratory mechanics are linked, it is difficult to identify which variables, pressure or oxygenation, are independently associated with outcome. We aimed to determine whether respiratory mechanics (peak inspiratory pressure, positive end-expiratory pressure, ΔP [PIP minus PEEP], tidal volume, dynamic compliance [Cdyn]) or oxygenation (PaO2/FIO2) was associated with mortality...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28350642/increased-early-systemic-inflammation-in-icu-acquired-weakness-a-prospective-observational-cohort-study
#3
Esther Witteveen, Luuk Wieske, Tom van der Poll, Marike van der Schaaf, Ivo N van Schaik, Marcus J Schultz, Camiel Verhamme, Janneke Horn
OBJECTIVES: To investigate whether patients who develop ICU-acquired weakness have a different pattern of systemic inflammatory markers compared with critically ill patients who do not develop ICU-acquired weakness. DESIGN: Prospective observational cohort study. SETTING: Mixed medical-surgical ICU of a tertiary care hospital in the Netherlands. PATIENTS: Newly admitted critically ill patients, greater than or equal to 48 hours on mechanical ventilation with a nonneurologic ICU admission diagnosis, were included...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28346962/response-to-comment-on-state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#4
https://www.readbyqxmd.com/read/28346912/optimizing-the-dose-of-erythropoietin-required-to-prevent-acute-ventilation-induced-cerebral-white-matter-injury-in-preterm-lambs
#5
Kyra Y Y Chan, Domenic A LaRosa, Mary Tolcos, Anqi Li, Valerie A Zahra, Graeme R Polglase, Samantha K Barton
Erythropoietin (EPO) is being trialed in preterm neonates for neuroprotection. We have recently demonstrated that a single high bolus dose (5,000 IU/kg) of recombinant human EPO amplified preterm lung and brain ventilation-induced injury. We aimed to determine the optimal dose of EPO to reduce ventilation-induced cerebral white matter inflammation and injury in preterm lambs. Lambs (0.85 gestation) were ventilated with an injurious strategy for 15 min followed by conventional ventilation for 105 min. Lambs were randomized to no treatment (VENT; n = 8) or received a bolus dose of EPO (EPREX®): 300 IU/kg (EPO 300; n = 5), 1,000 IU/kg (EPO 1,000; n = 5), or 3,000 IU/kg (EPO 3,000; n = 5)...
March 28, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28346708/high-resolution-isotopic-monitoring-of-cave-air-co2
#6
Paul Töchterle, Yuri Dublyansky, Nils Stöbener, Magda Mandić, Christoph Spötl
RATIONALE: CO2 is the main driver of many chemical processes in cave environments. Understanding CO2 fluxes in a given cave system through monitoring campaigns has become a standard procedure in a wide variety of fields such as paleoclimatology or show cave management. However, conventional methods lack the resolution of isotopic data to capture many transient processes occurring in caves. METHODS: A novel approach using isotope ratio infrared spectrometry (IRIS) to monitor cave air pCO2 , δ(13) C and δ(18) O values in situ was tested and compared with conventional monitoring methods (handheld pCO2 meter and discrete cave air samples for conventional isotope ratio mass spectrometry)...
March 27, 2017: Rapid Communications in Mass Spectrometry: RCM
https://www.readbyqxmd.com/read/28346529/human-amnion-epithelial-cells-modulate-the-inflammatory-response-to-ventilation-in-preterm-lambs
#7
Jacqueline M Melville, Courtney A McDonald, Robert J Bischof, Graeme R Polglase, Rebecca Lim, Euan M Wallace, Graham Jenkin, Timothy J Moss
Ventilation of preterm neonates causes pulmonary inflammation that can contribute to lung injury, propagate systemically and result in long-term disease. Modulation of this initial response may reduce lung injury and its sequelae. We aimed to determine the effect of human amnion epithelial cells (hAECs) on immune activation and lung injury in preterm neonatal lambs. Preterm lambs received intratracheal hAECs (90x106) or vehicle, prior to 2 h of mechanical ventilation. Within 5 min of ventilation onset, lambs also received intravenous hAECs (90x106) or vehicle...
2017: PloS One
https://www.readbyqxmd.com/read/28346263/minimally-invasive-aortic-valve-replacement-via-right-anterior-minithoracotomy-and-central-aortic-cannulation-a-13-year-experience
#8
Daniel M Bethencourt, Jennifer Le, Gabriela Rodriguez, Robert W Kalayjian, Gregory S Thomas
OBJECTIVE: This study reports the evolution of a minimally invasive aortic valve replacement (mini-AVR) technique that uses a right anterior minithoracotomy approach with central cannulation, for a 13-year period. This technique has become our standard approach for isolated primary AVR in nearly all patients. METHODS: This observational study evaluated perioperative clinical outcomes of patients 18 years or older who underwent mini-AVR from November 2003 to June 2015...
March 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28346261/advantages-of-minimal-access-versus-conventional-aortic-valve-replacement-in-elderly-or-severely-obese-patients
#9
Calogera Pisano, Pasquale Totaro, Oreste Fabio Triolo, Vincenzo Argano
OBJECTIVE: The aim of our study was to investigate potential clinical advantages of minimal access versus conventional surgical approach in older and severely obese patients undergoing isolated aortic valve replacement (AVR). METHODS: One hundred thirty-five patients undergoing isolated primary AVR were enrolled. Propensity score matching was used to compare 42 selected patients operated on ministernotomy (MS, group B) with 42 selected patients operated on full sternotomy (FS, group A)...
March 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#10
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28345964/end-tidal-carbon-dioxide-as-a-prognostic-feature-in-pulmonary-arterial-hypertension
#11
Caitlin E Welch, Evan L Brittain, Alexander L Newman, Ivan M Robbins, Meredith E Pugh, John H Newman, Anna R Hemnes
RATIONALE: Pulmonary arterial hypertension (PAH) is characterized in part by increased dead space ventilation, which can be estimated noninvasively at the bedside by measurement of end-tidal CO2 (ETCO2). OBJECTIVES: Prior work has demonstrated that ETCO2 is lower in PAH than control patients, but whether ETCO2 has prognostic value is unknown. We hypothesized that lower measurements of ETCO2 in patients with PAH correlate with worse long-term outcomes. METHODS: Patients with PAH seen in our referral clinic were prospectively recruited for ETCO2 measurement between September 2009 and February 2010...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28345959/ventilatory-inefficiency-and-exertional-dyspnea-in-early-chronic-obstructive-pulmonary-disease
#12
J Alberto Neder, Danilo C Berton, Paulo de Tarso Müller, Amany F Elbehairy, Alcides Rocha, Paolo Palange, Denis E O'Donnell
Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning. Cardiopulmonary exercise testing can uncover exertional dyspnea and its physiological determinants in patients with preserved or only mildly-reduced FEV1. Dyspnea in mild COPD can largely be explained by increased "wasted" ventilation in the physiological dead space which heightens the drive to breathe and worsens the inspiratory mechanical constraints...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28345744/eleven-years-of-children-methadone-poisoning-in-a-referral-center-a-review-of-453-cases
#13
Hossein Hassanian-Moghaddam, Masumeh Hakiminejhad, Fariba Farnaghi, Amirhossein Mirafzal, Nasim Zamani, Ali Kabir
OBJECTIVES: Methadone can be fatal due to respiratory failure even in little doses. This study aimed to evaluate the possible risk factors of death and/or intubation in methadone-poisoned children of 12 years or younger. DESIGN: Retrospective routine database study. SETTING: The only tertiary hospital for children poisoning in Tehran. PATIENTS: Four hundred fifty-three methadone-poisoned patients aged 12 or younger were studied between 2001 and 2012...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345685/-carbon-nanotubes-characteristic-of-the-substance-biological-effects-and-occupational-exposure-levels
#14
REVIEW
Anna Maria Świdwińska-Gajewska, Sławomir Czerczak
Carbon nanotubes (CNTs) are a diverse group of nano-objects in terms of structure, size (length, diameter), shape and characteristics. The growing interest in these structures is due to the increasing number of people working in exposure to CNTs. Occupational exposure to carbon nanotubes may occur in research laboratories, as well as in plants producing CNTs and their nanocomposites. Carbon nanotubes concentration at the emission source may reach 107 particles/cm<sup>3</sup>. These values, however, are considerably reduced after the application of adequate ventilation...
March 24, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28345684/-analysis-of-changes-in-radiographic-lung-image-and-lung-ventilation-disorders-in-workers-occupationally-exposed-to-chrysotile-in-the-past
#15
Elżbieta Cwynar, Beata Świątkowska, Jarosław Tomczyk
BACKGROUND: The adverse health effects of occupational exposure to asbestos dust may occur several years after first exposure. The objective of the study was to assess the relationship between lesions in the respiratory system and the factors contributing to occupational exposure to asbestos described in the first medical examination as well as to analyze the factors responsible for the progression of these changes in further medical tests. MATERIAL AND METHODS: The study group comprised 591 former workers of asbestos processing plant "Gambit" in Lubawka...
March 24, 2017: Medycyna Pracy
https://www.readbyqxmd.com/read/28345481/cost-effectiveness-analysis-of-implementing-an-antimicrobial-stewardship-programme-in-critical-care-units
#16
Jesus Ruiz-Ramos, Juan Frasquet, Eva Romá, Jose Luis Poveda-Andres, Miguel Salavert-Leti, Alvaro Catellanos, Paula Ramirez
AIMS: To evaluate the cost-effectiveness of antimicrobial stewardship (AS) programme implementation focused on critical care units based on assumptions for the Spanish setting. MATERIAL AND METHODS: A decision model comparing costs and outcomes of sepsis, community-acquired pneumonia, and nosocomial infections (including catheter-related bacteremia, urinary tract infection, and ventilator-associated pneumonia) in critical care units with or without an AS was designed...
March 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28345358/-instead-of-popping-pills-perhaps-you-should-add-frog-breathing-experiences-of-glossopharyngeal-insufflation-breathing-for-people-with-cervical-spinal-cord-injury
#17
Malin Nygren-Bonnier, Jens Werner, Gabriele Biguet, Sverker Johansson
BACKGROUND: People with cervical spinal cord injury have impaired function of the respiratory muscles, which results in reduced ventilation. Glossopharyngeal insufflation/breathing increases total lung capacity and improves cough function, however, knowledge of the experiences regarding learning and practicing glossopharyngeal insufflation in everyday life is missing. PURPOSE: To describe and explore the experiences of learning and practicing glossopharyngeal insufflation among people with cervical spinal cord injury...
March 27, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28345309/a-survey-of-clinicians-regarding-respiratory-physiotherapy-intervention-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-what-is-current-practice-in-australian-icus
#18
Lisa van der Lee, Anne-Marie Hill, Shane Patman
RATIONALE, AIMS, AND OBJECTIVES: Community-acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency...
March 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28345066/correlation-of-central-venous-pressure-with-venous-blood-gas-analysis-parameters-a-diagnostic-study
#19
Sima Rahim-Taleghani, Alireza Fatemi, Mostafa Alavi Moghaddam, Majid Shojaee, Abdelrahman Ibrahim Abushouk, Mohammad Mehdi Forouzanfar, Alireza Baratloo
OBJECTIVE: This study was conducted to assess the correlation between central venous pressure (CVP) and venous blood gas (VBG) analysis parameters, to facilitate management of severe sepsis and septic shock in emergency department. MATERIAL AND METHODS: This diagnostic study was conducted from January 2014 until June 2015 in three major educational medical centers, Tehran, Iran. For patients selected with diagnosis of septic shock, peripheral blood sample was taken for testing the VBG parameters and the anion gap (AG) was calculated...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28345056/arctic-sea-ice-eurasia-snow-and-extreme-winter-haze-in-china
#20
Yufei Zou, Yuhang Wang, Yuzhong Zhang, Ja-Ho Koo
The East China Plains (ECP) region experienced the worst haze pollution on record for January in 2013. We show that the unprecedented haze event is due to the extremely poor ventilation conditions, which had not been seen in the preceding three decades. Statistical analysis suggests that the extremely poor ventilation conditions are linked to Arctic sea ice loss in the preceding autumn and extensive boreal snowfall in the earlier winter. We identify the regional circulation mode that leads to extremely poor ventilation over the ECP region...
March 2017: Science Advances
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