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https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#1
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29680972/prophylactic-catheter-ablation-of-ventricular-tachycardia-in-ischemic-cardiomyopathy-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#2
REVIEW
Varunsiri Atti, Venkat Vuddanda, Mohit K Turagam, Praveen Vemula, Zubair Shah, Himakar Nagam, Srikanth Yandrapalli, Mohammad-Ali Jazayeri, Scott Koerber, Juan Viles Gonzalez, Andrea Natale, Luigi Di Biase, Dhanunjaya R Lakkireddy
BACKGROUND: Catheter ablation is proven to be an effective strategy for drug refractory ventricular tachycardia (VT) in ischemic cardiomyopathy. However, the appropriate timing of VT ablation and identifying the group of patients that may receive the greatest benefit remains uncertain. There is limited data on the effect on prophylactic catheter ablation (PCA) in the prevention of implantable cardioverter defibrillator (ICD) therapy, electrical storm, and mortality. METHODS: We performed a comprehensive literature search through November 1, 2017, for all eligible studies comparing PCA + ICD versus ICD only in eligible patients with ischemic cardiomyopathy...
April 21, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#3
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29663449/mild-hypothermia-33%C3%A2-c-increases-the-inducibility-of-atrial-fibrillation-an-in-vivo-large-animal-model-study
#4
Martin Manninger, Alessio Alogna, David Zweiker, Birgit Zirngast, Stefan Reiter, Viktoria Herbst, Heinrich Maechler, Burkert M Pieske, Frank R Heinzel, Helmut Brussee, Heiner Post, Daniel Scherr
OBJECTIVE: Application of therapeutic mild hypothermia in patients after resuscitation, often accompanied by myocardial infarction, cardiogenic shock and systemic inflammation may impact on cardiac rhythm. We therefore tested susceptibility to atrial arrhythmias during hyperthermia (HT, 40.5°C), normothermia (NT, 38.0°C) and mild hypothermia (MH, 33.0°C). METHODS: Nine healthy, anesthetized closed-chest landrace pigs were instrumented with a quadripolar stimulation catheter in the high right atrium and a decapolar catheter in the coronary sinus...
April 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#5
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29648981/glibenclamide-produces-region-dependent-effects-on-cerebral-edema-in-a-combined-injury-model-of-traumatic-brain-injury-and-hemorrhagic-shock-in-mice
#6
Ruchira Jha, Bradley J Molyneaux, Travis C Jackson, Jessica Wallisch, Seo-Young Park, Samuel M Poloyac, Vincent A Vagni, Keri L Janesko-Feldman, Keito Hoshitsuki, Margaret Beth Minnigh, Patrick M Kochanek
Cerebral edema is critical to morbidity/mortality in TBI and is worsened by hypotension. Glibenclamide may reduce cerebral edema by inhibiting sulfonylurea receptor-1 (Sur1); its effect on diffuse cerebral edema exacerbated by hypotension/resuscitation is unknown. We aimed to determine if glibenclamide improves pericontusional and/or diffuse edema in controlled cortical impact (CCI, 5m/s, 1 mm-depth)+hemorrhagic shock (HS, 35 minutes), and compare its effects in CCI alone. C57/BL6 mice were divided into 5 groups (n=10/group): naïve, CCI+vehicle, CCI+glibenclamide, CCI+HS+vehicle, and CCI+HS+glibenclamide...
March 8, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29642755/successful-treatment-of-ventricular-arrhythmic-storm-with-percutaneous-coronary-intervention-and-catheter-ablation-in-a-patient-with-left-ventricular-assist-device
#7
Nihat Firat Sipahi, Arash Mehdiani, Diyar Saeed, Udo Boeken, Hisaki Makimoto, Artur Lichtenberg, Hannan Dalyanoglu
INTRODUCTION: Ventricular arrhythmias are common in patients with advanced heart failure, which may also persist after sufficient intensive therapy for heart failure even with a left ventricular assist device. Although most ventricular arrhythmias have no hemodynamic relevance during left ventricular assist device support, some patients suffer from right ventricular decompensation due to ventricular arrhythmias resulting in severe hemodynamic deterioration and poor clinical outcomes. METHODS: We describe herein an left ventricular assist device patient with refractory ventricular arrhythmic storm early after left ventricular assist device implantation...
April 1, 2018: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/29628145/percutaneous-biventricular-impella-support-in-therapy-refractory-cardiogenic-shock
#8
Cheng-Ying Chiu, Robert Hättasch, Damaris Praeger, Fabian Knebel, Karl Stangl, Ivan Diaz Ramirez, Henryk Dreger
INTRODUCTION: Percutaneous mechanical circulatory support systems have increasingly been adopted as a bail out strategy in patients with cardiogenic shock. Since studies showed mostly mixed results, however, the use of support systems remains a case by case decision. CASE: Here, we report on a case of therapy-refractory cardiogenic shock due to acute myocardial infarction treated with percutaneous right and left ventricular assist devices (Impella RP and CP). CONCLUSION: Due to myocardial stunning, even patients with fulminant cardiogenic shock have the potential for full recovery...
April 5, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29626610/health-related-quality-of-life-after-extracorporeal-cardiopulmonary-resuscitation-in-refractory-cardiac-arrest
#9
T Spangenberg, J Schewel, A Dreher, F Meincke, E Bahlmann, H van der Schalk, F Kreidel, C Frerker, M Stoeck, B Bein, K-H Kuck, A Ghanem
BACKGROUND: Recent data identifies extracorporeal cardio-pulmonary resuscitation (eCPR) as a potential addendum of conventional cardiopulmonary-resuscitation (cCPR) in highly specified circumstances and selected patients. However, consented criteria indicating eCPR are lacking. Therefore we provide first insights into the health-related quality of life (HRQoL) outcomes of patients treated with eCPR in a real world setting. METHODS: Retrospective single-center experience of 60 consecutive patients treated with eCPR between 01/2014 and 06/2016 providing 1-year survival- and HRQoL data obtained through the Short-Form 36 Survey (SF-36) after refractory out-of-hospital- (OHCA) and in-hospital cardiac arrest (IHCA) of presumed cardiac etiology...
April 4, 2018: Resuscitation
https://www.readbyqxmd.com/read/29619399/celiac-disease-and-secondary-amyloidosis-a-possible-causal-association
#10
Ankit Chhoda, Deepanshu Jain, Mradul Kumar Daga, Vineeta Batra
We report a rare case of secondary renal amyloidosis in a patient with probable celiac disease presenting as nephrotic syndrome. A 30-year-old man with chronic diarrhea presented with progressive anasarca for 2 years. On further evaluation, he had hypoalbuminemia, significant nephrotic-range proteinuria, and elevated levels of anti-tissue transglutaminase. Renal biopsy suggested deposition of amorphous Congo red-positive material in the glomerular mesangium, positive for amyloid A amyloidosis. Endoscopic duodenal biopsy suggested blunting of the villous architecture and chronic inflammation of the lamina propria...
2018: ACG Case Reports Journal
https://www.readbyqxmd.com/read/29607156/clinical-outcome-comparison-of-patients-with-septic-shock-defined-by-the-new-sepsis-3-criteria-and-by-previous-criteria
#11
Seung Mok Ryoo, Gu Hyun Kang, Tae Gun Shin, Sung Yeon Hwang, Kyuseok Kim, You Hwan Jo, Yoo Seok Park, Sung-Hyuk Choi, Young Hoon Yoon, Woon Yong Kwon, Gil Joon Suh, Tae Ho Lim, Kap Su Han, Han Sung Choi, Sung Phil Chung, Won Young Kim
Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29600445/tumor-lysate-based-vaccines-on-the-road-to-immunotherapy-for-gallbladder-cancer
#12
REVIEW
Daniel Rojas-Sepúlveda, Andrés Tittarelli, María Alejandra Gleisner, Ignacio Ávalos, Cristián Pereda, Iván Gallegos, Fermín Eduardo González, Mercedes Natalia López, Jean Michel Butte, Juan Carlos Roa, Paula Fluxá, Flavio Salazar-Onfray
Immunotherapy based on checkpoint blockers has proven survival benefits in patients with melanoma and other malignancies. Nevertheless, a significant proportion of treated patients remains refractory, suggesting that in combination with active immunizations, such as cancer vaccines, they could be helpful to improve response rates. During the last decade, we have used dendritic cell (DC) based vaccines where DCs loaded with an allogeneic heat-conditioned melanoma cell lysate were tested in a series of clinical trials...
March 29, 2018: Cancer Immunology, Immunotherapy: CII
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#13
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29594044/a-phase-ib-ii-study-of-ganetespib-with-doxorubicin-in-advanced-solid-tumors-including-relapsed-refractory-small-cell-lung-cancer
#14
Deepa S Subramaniam, Stephen V Liu, Jeanette Crawford, Jenna Kramer, Jillian Thompson, Hongkun Wang, Giuseppe Giaccone
Introduction: Small cell lung cancer (SCLC) accounts for 15% of all lung cancers and is characterized by high response rates to cytotoxic chemotherapy and equally high rates of relapse. Many resistance mechanisms have been proposed including resistance to doxorubicin via induction of a heat shock response. Ganetespib is a novel and potent non-geldanamycin heat shock protein 90 (Hsp90) inhibitor. In preclinical studies, synergy between ganetespib and doxorubicin was shown. We conducted a phase Ib/II study of the safety, tolerability, and preliminary efficacy of the combination of ganetespib and doxorubicin...
2018: Frontiers in Oncology
https://www.readbyqxmd.com/read/29588907/disseminated-toxoplasmosis-in-a-patient-with-advanced-acquired-immunodeficiency-syndrome
#15
Ricardo Garcia Pastorello, Anderson da Costa Lino Costa, Marcio Valente Yamada Sawamura, Antonio Carlos Nicodemo, Amaro Nunes Duarte-Neto
Extracerebral toxoplasmosis, with pulmonary involvement and shock, is a rare form of toxoplasmosis in patients with advanced AIDS. It can mimic pneumocystosis, histoplasmosis, and disseminated tuberculosis, and should be considered in the differential diagnosis of causes of respiratory failure and fulminant disease in this group of individuals, especially in areas where the Toxoplasma gondii infection is highly prevalent and in those without proper use of antimicrobial prophylaxis. We report the case of a 46-year-old male patient who presented to the emergency department with uremia, requiring urgent dialysis...
January 2018: Autopsy & case reports
https://www.readbyqxmd.com/read/29584915/interleukin-1-blockade-in-cardiovascular-diseases-a-clinical-update
#16
Leo F Buckley, Antonio Abbate
Interleukin-1 (IL-1) is the prototypical pro-inflammatory cytokine. IL-1 was implicated as a cardiodepressant factor in septic shock, and subsequent pre-clinical and clinical research has defined important roles for IL-1 in atherosclerosis, acute myocardial infarction (AMI), and heart failure (HF). IL-1 promotes the formation of the atherosclerotic plaque and facilitates its progression and complication. In a large phase III clinical trial of stable patients with prior AMI, blocking IL-1 activity using a monoclonal antibody prevented recurrent atherothrombotic cardiovascular events...
March 23, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29578079/extracorporeal-life-support-for-refractory-cardiogenic-shock-an-efficient-system-support-of-peripheral-organs-more-than-real-ventricular-assist-device%C3%A2
#17
EDITORIAL
Alexandre Ouattara, Alain Rémy, Astrid Quessard
No abstract text is available yet for this article.
March 22, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29563373/fatal-cardiac-hemochromatosis-in-a-patient-with-hereditary-spherocytosis
#18
Takeo Fujino, Shujiro Inoue, Shunsuke Katsuki, Taiki Higo, Tomomi Ide, Yoshinao Oda, Hiroyuki Tsutsui
A 31-year-old man was admitted to our hospital with atrial tachycardia and cardiogenic shock. He had been diagnosed with hereditary spherocytosis (HS) during childhood, but he never received any red blood cell transfusions. Right ventricular endomyocardial biopsy revealed multiple myocardial hemosiderin deposits, and he was diagnosed with cardiac hemochromatosis. In addition to the iron deposition in the heart, the loss of myocyte and severe interstitial fibrosis were present. His cardiac function did not improve even after the cardioversion for atrial tachycardia, and he suffered from recurrent heart failure...
March 20, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29556817/a-review-of-current-treatment-options-for-coccygodynia
#19
REVIEW
Yasmin Elkhashab, Andrew Ng
PURPOSE OF REVIEW: Coccygodynia is pain within the coccyx area. The diagnosis is made clinically with symptoms of pain in the coccyx region and worsening pain in sitting position. The initial treatment is conservative therapy. For patients who do not respond to conservative therapies, there are further interventions available. This includes local injection of local anesthetics and steroids, neurolysis of sacral nerve roots, caudal epidural block, pulse radiofrequency (PRF), intra-rectal massage and manipulation, ganglion impar block, levator ani massage and stretching, coccyx manipulation, and coccygectomy...
March 19, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29531453/extracorporeal-membrane-oxygenation-in-drug-overdose-a-clinical-case-series
#20
C Vignesh, Madhan Kumar, Ramesh Venkataraman, Senthilkumar Rajagopal, Nagarajan Ramakrishnan, Babu K Abraham
Overdose of cardiovascular medications such as beta blockers and calcium channel blockers cause impaired cardiac contractility, vasoplegia, and/or rhythm disturbances. In addition to conventional management of limiting absorption, increasing elimination and hemodynamic support intravenous (IV) calcium infusion, hyperinsulinemia-euglycemia therapy, glucagon infusion, and IV lipid emulsion have been tried. Extracorporeal circulatory assist device support has been reported as a rescue therapy in overdose refractory to maximal medical therapy...
February 2018: Indian Journal of Critical Care Medicine
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