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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
#1
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/28203432/acute-respiratory-distress-syndrome-and-chemical-burns-after-exposure-to-chlorine-containing-bleach-a-case-report
#2
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/28188062/mechanical-ventilation-in-patients-subjected-to-extracorporeal-membrane-oxygenation-ecmo
#3
M L Sánchez
Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28164622/using-the-expression-of-mirnas-as-biomarkers-for-the-evaluation-acute-respiratory-distress-syndrome-in-the-critically-ill-polytrauma-patient
#4
REVIEW
Marius Papurica, Alexandru F Rogobete, Carmen A Cradigati, Mirela Sarandan, Raluca Dumache, Lavinia M Bratu, Sonia E Popovici, Dorel Sandesc, Corina Vernic, Ovidiu H Bedreag
BACKGROUND: A high percentage of critically ill polytrauma patients develop acute respiratory distress syndrome (ARDS), both because of the primary traumatic injuries and because of the secondary post-traumatic injuries. For adequate management of these patients, new complex evaluation and monitoring methods are needed, methods that could answer as many questions as possible regarding the pathophysiological changes associated with ARDS. Currently, a series of clinical and biochemical markers are being used which unfortunately do not respond to the needs of an intensive care clinician...
August 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28157820/high-frequency-oscillatory-ventilation-still-a-role
#5
Jensen Ng, Niall D Ferguson
PURPOSE OF REVIEW: In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. This review provides an overview of these new clinical data and also explores new areas of investigation for HFOV in adults. RECENT FINDINGS: While prior meta-analyses suggested benefit for HFOV, updated systematic reviews published this year, which include two large recent clinical trials, now show no statistically significant impact of HFOV on mortality in adults with ARDS...
February 2, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28143991/short-term-survival-of-acute-respiratory-distress-syndrome-patients-at-a-single-tertiary-referral-centre-in-indonesia
#6
Zulkifli Amin, Hasna Afifah, Chrispian Oktafbipian Mamudi
AIM: to identify the 28-day short-term survival rate in patients with acute respiratory distress syndrome (ARDS). METHODS: this is a retrospective cohort study conducted at a tertiary referral hospital in Jakarta, Indonesia. We conducted the study for 10 months and data was extracted from medical records between October 2015 and August 2016. The primary end point of the study was 28-day short-term survival rate using the initial date of ARDS diagnosis as the index time...
October 2016: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28137935/meal-timing-and-frequency-implications-for-cardiovascular-disease-prevention-a-scientific-statement-from-the-american-heart-association
#7
Marie-Pierre St-Onge, Jamy Ard, Monica L Baskin, Stephanie E Chiuve, Heather M Johnson, Penny Kris-Etherton, Krista Varady
Eating patterns are increasingly varied. Typical breakfast, lunch, and dinner meals are difficult to distinguish because skipping meals and snacking have become more prevalent. Such eating styles can have various effects on cardiometabolic health markers, namely obesity, lipid profile, insulin resistance, and blood pressure. In this statement, we review the cardiometabolic health effects of specific eating patterns: skipping breakfast, intermittent fasting, meal frequency (number of daily eating occasions), and timing of eating occasions...
January 30, 2017: Circulation
https://www.readbyqxmd.com/read/28132594/extracorporeal-membrane-oxygenation-in-the-management-of-post-pneumonectomy-air-leak-and-adult-respiratory-distress-syndrome-of-the-non-operated-lung
#8
Szkorupa Marek, Simek Martin, Zuscich Ondrej, Chudacek Josef, Neoral Cestmir, Lonsky Vladimir
Post-pneumonectomy air leak and severe respiratory failure of the non-operated lung is considered to be a life-threatening complication of lung surgery. We present the case report of a 68-year-old man who underwent a right pneumonectomy for spinocellular carcinoma. Refractory respiratory failure occurred following bronchial stump air leakage and adult respiratory distress syndrome (ARDS) of the non-operated lung. Established veno-venous extracorporeal membrane oxygenation (VV ECMO) was utilized to maintain tissue oxygenation while re-do surgery was performed...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28132075/extracorporeal-carbon-dioxide-removal-ecco2r-in-patients-with-acute-respiratory-failure
#9
REVIEW
Andrea Morelli, Lorenzo Del Sorbo, Antonio Pesenti, V Marco Ranieri, Eddy Fan
PURPOSE: To review the available knowledge related to the use of ECCO2R as adjuvant strategy to mechanical ventilation (MV) in various clinical settings of acute respiratory failure (ARF). METHODS: Expert opinion and review of the literature. RESULTS: ECCO2R may be a promising adjuvant therapeutic strategy for the management of patients with severe exacerbations of COPD and for the achievement of protective or ultra-protective ventilation in patients with ARDS without life-threatening hypoxemia...
January 28, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28125527/an-open-lung-strategy-in-the-management-of-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#10
Jun Lu, Xing Wang, Mingqi Chen, Lu Cheng, Qiuhua Chen, Hua Jiang, Zhiguang Sun
PURPOSE: An Open lung strategy (OLS) that includes positive end expiratory pressure (PEEP) and recruitment maneuvers (RMs) during mechanical ventilation is probably an important treatment method in patients with acute respiratory distress syndrome (ARDS). However, the effect of OLS is unknown. We therefore hypothesized that patients with ARDS may benefit from OLS treatment. METHODS: We identified relevant randomized controlled trials by searching through Pubmed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials updated to May 22, 2016...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28121615/physiological-closed-loop-control-of-mechanical-ventilation-and-extracorporeal-membrane-oxygenation
#11
Christian Brendle, Thorsten Mülders, Jan Kühn, Thorsten Janisch, Rüdger Kopp, Rolf Rossaint, Andre Stollenwerk, Stefan Kowalewski, Berno Misgeld, Steffen Leonhardt, Marian Walter
A new concept is presented for cooperative automation of mechanical ventilation and extracorporeal membrane oxygenation (ECMO) therapy for treatment of acute respiratory distress syndrome (ARDS). While mechanical ventilation is continuously optimized to promote lung protection, extracorporeal gas transfer rates are simultaneously adjusted to control oxygen supply and carbon dioxide removal using a robust patient-in-the-loop control system. In addition, the cooperative therapy management uses higher-level algorithms to adjust both therapeutic approaches...
January 25, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28114715/-prolonged-weaning-in-patients-with-ards
#12
Stephan Braune, Bernd Schönhofer
The clinical course of moderate to severe ARDS often leads to prolonged weaning. Prolonged weaning utilizes considerable resources in intensive care medicine and is associated with a high mortality. The pathophysiology of prolonged weaning is complex and its understanding mandatory for its successful management. This article discusses and summarizes the most important causes of prolonged weaning and the corresponding treatment strategies to liberate patients with ARDS from the ventilator.
January 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28114193/the-homburg-lung-efficacy-and-safety-of-a-minimal-invasive-pump-driven-device-for-veno-venous-extracorporeal-carbon-dioxide-removal
#13
Frederik Seiler, Franziska Trudzinski, Kai Hennemann, Tom Niermeyer, Christian Schmoll, Annegret Kamp, Robert Bals, Ralf Muellenbach, Hendrik Haake, Philipp M Lepper
Extracorporeal carbon dioxide removal (ECCO2R) is increasingly considered a viable therapeutic approach in the management of hypercapnic lung failure in order to avoid intubation or to allow lung-protective ventilator settings. This study aimed to analyze efficacy and safety of a minimal-invasive ECCO2R device, the Homburg lung. The Homburg lung is a pump-driven system for veno-venous ECCO2R with ¼" tubing and a 0.8 m surface oxygenator. Vascular access is usually established via a 19F/21cm bilumen cannula in the right internal jugular vein...
January 19, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#14
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVES: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
February 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28067677/the-microbiome-in-mechanically-ventilated-patients
#15
Yudong Yin, Peter Hountras, Richard G Wunderink
PURPOSE OF REVIEW: Discovery of a normal lung microbiome requires reassessment of our concepts of HAP/VAP pathogenesis and has important implications for clinical diagnosis and management. RECENT FINDINGS: Changes in the microbiome of dental plaque are associated with increased risk of HAP/VAP. A transition to a lung microbiome enriched with gut flora is found in ARDS with an increased inflammatory response in patients with this change in microbial flora. A characteristic microbiome pattern of higher amounts of bacterial DNA, lower community diversity, and greater relative abundance of a single species characterize pneumonia and occasionally identify bacteria not found in culture...
April 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28054897/thrombosis-of-the-right-internal-jugular-vein-is-not-a-contraindication-to-ambulatory-veno-venous-extracorporeal-membrane-oxygenation-with-a-bicaval-dual-lumen-single-cannula-system
#16
Anthony Kronfli, Chetan Pasrija, Aakash Shah, Mehrdad Ghoreishi, Jose P Garcia, Si M Pham, Pablo G Sanchez, Zachary N Kon
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is an ever-emerging method of managing respiratory failure in patients who are refractory to conventional mechanical ventilatory support. An increasingly common method of cannulation involves placement of a bicaval dual-lumen, single cannula via the right internal jugular (IJ) vein. Thrombus in this vein has been considered a contraindication for cannula placement. CASE REPORT: A 45-year-old Hispanic male presented with bleomycin-induced respiratory failure resulting in acute respiratory distress syndrome (ARDS)...
14, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/28040987/fifty-years-of-research-in-ards-is-acute-respiratory-distress-syndrome-a-preventable-disease
#17
Hemang Yadav, B Taylor Thompson, Ognjen Gajic
Despite significant advances in our understanding and management of patients with Acute Respiratory Distress Syndrome (ARDS), the morbidity and mortality from ARDS remains unacceptably high. Given the consistent failure to find effective treatments for established ARDS, the strategic focus of ARDS research has shifted towards identifying patients with or at high risk of ARDS early in the course of the underlying illness where strategies to reduce the development and progression of ARDS and associated organ failures can be systematically evaluated...
December 31, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28012426/perceived-safety-and-efficacy-of-neuromuscular-blockers-for-acute-respiratory-distress-syndrome-among-medical-intensive-care-unit-practitioners-a-multicenter-survey
#18
Heather Torbic, Seth R Bauer, Heather A Personett, Amy L Dzierba, Joanna L Stollings, Lindsay P Ryder, Craig E Daniels, Sean M Caples, Erin N Frazee
PURPOSE: Neuromuscular blocking agents (NMBAs) are frequently used in patients with acute respiratory distress syndrome (ARDS). The purpose of this survey is to describe providers' knowledge and perceived efficacy and safety of NMBAs in patients with ARDS. MATERIALS AND METHODS: We performed a prospective, multicenter survey of medical intensive care unit intensivists, fellows, nurse practitioners (NPs), physician's assistants (PAs), and pharmacists at 5 tertiary care centers between July 2012 and May 2013...
December 7, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28006946/a-novel-experimental-model-of-acute-respiratory-distress-syndrome-in-pig
#19
M Otáhal, M Mlček, I Vítková, O Kittnar
Acute respiratory distress syndrome (ARDS) is severe medical condition occurring in critically ill patients and with mortality of 33-52 % is one of the leading causes of death in critically ill patients. To better understand pathophysiology of ARDS and to verify novel therapeutical approaches a reliable animal model is needed. Therefore we have developed modified lavage model of ARDS in the pig. After premedication (ketamine and midazolam) 35 healthy pigs were anesthetized (propofol, midazolam, morphin, pipecuronium) and orotracheally intubated and ventilated...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/28000204/early-severe-acute-respiratory-distress-syndrome-what-s-going-on-part-i-pathophysiology
#20
Fabrice Petitjeans, Cyrille Pichot, Marco Ghignone, Luc Quintin
Severe acute respiratory distress syndrome (ARDS, PaO₂/FiO₂ < 100 on PEEP ≥ 5 cm H₂O) is treated using controlled mechanical ventilation (CMV), recently combined with muscle relaxation for 48 h and prone positioning. While the amplitude of tidal volume appears set < 6 mL kg⁻¹, the level of positive end-expiratory pressure (PEEP) remains controversial. This overview summarizes several salient points, namely: a) ARDS is an oxygenation defect: consolidation/ difuse alveolar damage is reversed by PEEP and/or prone positioning, at least during the early phase of ARDS b) ARDS is a dynamic disease and partially iatrogenic...
2016: Anaesthesiology Intensive Therapy
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