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Ards management

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https://www.readbyqxmd.com/read/29218772/signals-for-identifying-cows-at-risk-of-subacute-ruminal-acidosis-in-dairy-veterinary-practice
#1
REVIEW
E Humer, J R Aschenbach, V Neubauer, I Kröger, R Khiaosa-Ard, W Baumgartner, Q Zebeli
Controlling rumen disorders is critical to ensure successful dairy herd health management. Lactation diets of dairy cows are commonly rich in concentrates and low in physically effective fibre. Feeding of these diets increases the risk of rumen disorders with far-reaching consequences for cattle health, welfare and sustainability of dairy production. The term subacute ruminal acidosis or SARA is often used as a synonym for poor rumen health. Being subclinical, SARA lacks of clear symptoms and is therefore difficult to diagnose and to control in the practice...
December 8, 2017: Journal of Animal Physiology and Animal Nutrition
https://www.readbyqxmd.com/read/29216950/-effect-of-early-enteral-nutrition-standardized-treatment-on-blood-glucose-and-prognosis-in-acute-respiratory-distress-syndrome-patients-with-mechanical-ventilation
#2
Chunmiao Zhong, Chaohui Ji, Zhuquan Dai, Kai Fu, Xiaohong Wen, Huibin Pan
OBJECTIVE: To study the effect of early entreat nutrition (EN) standardized treatment on optimization of blood glucose control and prognosis in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation (MV). METHODS: Forty-two patients with MV of ARDS admitted to Huzhou First Municipal People's Hospital from April 2015 to March 2017 were enrolled. April 1st, 2016 was taken as the time node, the patients treated from April 1st, 2015 to March 31st, 2016 were assigned in the control group (n = 20), while the patients treated from April 1st, 2016 to March 31st, 2017 were included in the experimental group (n = 22)...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#3
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29207669/breath-analysis-by-gas-chromatography-mass-spectrometry-and-electronic-nose-to-screen-for-pleural-mesothelioma-a-cross-sectional-case-control-study
#4
Kevin Lamote, Paul Brinkman, Lore Vandermeersch, Matthijs Vynck, Peter J Sterk, Herman Van Langenhove, Olivier Thas, Joris Van Cleemput, Kristiaan Nackaerts, Jan P van Meerbeeck
Rationale: Malignant pleural mesothelioma (MPM) is mainly caused by previous exposure to asbestos fibers and has a poor prognosis. Due to a long latency period between exposure and diagnosis, MPM incidence is expected to peak between 2020-2025. Screening of asbestos-exposed individuals is believed to improve early detection and hence, MPM management. Recent developments focus on breath analysis for screening since breath contains volatile organic compounds (VOCs) which reflect the cell's metabolism...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29194057/approaches-and-techniques-to-avoid-development-or-progression-of-acute-respiratory-distress-syndrome
#5
François Beloncle, Alain Mercat
PURPOSE OF REVIEW: Despite major improvement in ventilation strategies, hospital mortality and morbidity of the acute respiratory distress syndrome (ARDS) remain high. A lot of therapies have been shown to be ineffective for established ARDS. There is a growing interest in strategies aiming at avoiding development and progression of ARDS. RECENT FINDINGS: Recent advances in this field have explored identification of patients at high-risk, nonspecific measures to limit the risks of inflammation, infection and fluid overload, prevention strategies of ventilator-induced lung injury and patient self-inflicted lung injury, and pharmacological treatments...
November 30, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#6
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in-ards-a-narrative-review
#7
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung protective ventilation has become the cornerstone of management in patients with ARDS. A subset of patients are unable to tolerate lung protective ventilation without significant carbon dioxide elevation. In these patients permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated carbon dioxide levels have significant physiological effects. In this narrative review, we highlight clinically relevant end organ effects in both animal models and clinical studies...
November 21, 2017: Chest
https://www.readbyqxmd.com/read/29173964/outcomes-after-resection-versus-non-resection-management-of-penetrating-grade-iii-and-iv-pancreatic-injury-a-trauma-quality-improvement-tqip-databank-analysis
#8
Shahin Mohseni, Jeremy Holzmacher, Gabriel Sjolin, Rebecka Ahl, Babak Sarani
BACKGROUND: High-grade traumatic pancreatic injuries are associated with significant morbidity and mortality. Non-resection management is associated with fewer complications in pediatric patients. The present study evaluates outcomes following resection versus non-resection management of severe pancreatic injury caused by penetrating trauma. METHODS: A retrospective study of the Trauma Quality Improvement Program (TQIP) database was performed from 1/2010 to 12/2014...
November 21, 2017: Injury
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#9
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29146420/extracorporeal-membrane-oxygenation-used-successfully-in-a-near-fatal-case-of-opioid-induced-acute-respiratory-distress-syndrome
#10
Karen Greenberg, Benjamin Kohl
Acute Respiratory Distress Syndrome (ARDS) was first recognized during the 1960s. It is a distinct type of hypoxemic respiratory failure characterized by acute abnormality of both lungs. Extracorporeal membrane oxygenation (ECMO) is being increasingly used for patients with severe ARDS refractory to otherwise conventional management. A 29year old male arrived with Emergency Medical Services (EMS) status post presumed heroin overdose. He was administered Naloxone 2mg intravenously prior to arrival in the emergency department...
November 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29138069/traumatic-fractures-of-the-cervical-spine-analysis-of-changes-in-incidence-etiology-concurrent-injuries-and-complications-among-488-262-patients-from-2005-2013
#11
Peter G Passias, Gregory W Poorman, Frank A Segreto, Cyrus M Jalai, Samantha R Horn, Cole A Bortz, Dennis Vasquez-Montes, Bassel G Diebo, Shaleen Vira, Olivia J Bono, Rafael De La Garza-Ramos, John Y Moon, Charles Wang, Brandon P Hirsch, Peter L Zhou, Michael Gerling, Heiko Koller, Virginie Lafage
OBJECTIVE: The etiologies and epidemiology of traumatic cervical spine fracture have not been described with sufficient power or recency. Our goal is to describe demographics, incidence, etiology, spinal cord injuries (SCIs), concurrent injuries, treatments, and complications of traumatic cervical spine fractures. METHODS: Retrospective review of the Nationwide Inpatient Sample. ICD-9 E-Codes identified trauma cases from 2005-2013. Patients with cervical fracture were isolated...
November 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29135617/lessons-to-learn-from-epidemiologic-studies-in-ards
#12
Bairbre A McNicholas, Grainne M Rooney, John G Laffey
PURPOSE OF REVIEW: Recent advances in our understanding of the epidemiology of ARDS has generated key insights into the incidence, risk factors, demographics, management and outcomes from this devastating clinical syndrome. RECENT FINDINGS: ARDS occurs in 10% of all ICU patients, in 23% of all mechanically ventilated patients, with 5.5 cases per ICU bed each year. Although some regional variation exists regarding ARDS incidence, this may be less than previously thought...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#13
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29132978/intensive-care-in-severe-malaria-report-from-the-task-force-on-tropical-diseases-by-the-world-federation-of-societies-of-intensive-and-critical-care-medicine
#14
REVIEW
Dilip R Karnad, Mohd Basri Mat Nor, Guy A Richards, Tim Baker, Pravin Amin
Severe malaria is common in tropical countries in Africa, Asia, Oceania and South and Central America. It may also occur in travelers returning from endemic areas. Plasmodium falciparum accounts for most cases, although P vivax is increasingly found to cause severe malaria in Asia. Cerebral malaria is common in children in Africa, manifests as coma and seizures, and has a high morbidity and mortality. In other regions, adults may also develop cerebral malaria but neurological sequelae in survivors are rare...
November 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29132514/ventilator-strategies-for-chronic-obstructive-pulmonary-disease-and-acute-respiratory-distress-syndrome
#15
REVIEW
Nathan T Mowery
The management of the ventilator in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS) has a dramatic effect on the overall outcome. The incidence of COPD is increasing as the US population grows older. The most effective means to deal with pulmonary complications is to avoid them, but both COPD and ARDS have evidence-based interventions that have been shown to improve outcomes. Pulmonary complications affect up to 40% of patients, and their occurrence is associated with an increased duration of hospital stay, and an increased mortality...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29114830/comparisons-of-interventions-for-preventing-falls-in-older-adults-a-systematic-review-and-meta-analysis
#16
Andrea C Tricco, Sonia M Thomas, Areti Angeliki Veroniki, Jemila S Hamid, Elise Cogo, Lisa Strifler, Paul A Khan, Reid Robson, Kathryn M Sibley, Heather MacDonald, John J Riva, Kednapa Thavorn, Charlotte Wilson, Jayna Holroyd-Leduc, Gillian D Kerr, Fabio Feldman, Sumit R Majumdar, Susan B Jaglal, Wing Hui, Sharon E Straus
Importance: Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise. Objective: To assess the potential effectiveness of interventions for preventing falls. Data Sources: MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Ageline databases from inception until April 2017. Reference lists of included studies were scanned...
November 7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29111984/asbestos-exposures-mesothelioma-incidence-and-mortality-and-awareness-by-general-practitioners-in-the-molise-region-central-italy
#17
Giancarlo Ripabelli, Manuela Tamburro, Domiziana Di Tella, Francesco Carrozza, Michela Lucia Sammarco
OBJECTIVE: To evaluate environmental asbestos sources, mesothelioma incidence and mortality, awareness on asbestos-related diseases (ARD) by general practitioners (GPs) in Molise Region. METHODS: The contaminated sites in three towns were identified by census; mesothelioma incidence (2000-2012) and mortality (2003-2013) was achieved from local registries; GPs were interviewed on practiced population's exposures and ARD diagnosis. RESULTS: 54...
November 3, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29073534/3-month-prognostic-impact-of-severe-acute-renal-failure-under-veno-venous-ecmo-support-importance-of-time-of-onset
#18
C Delmas, T Zapetskaia, J M Conil, B Georges, F Vardon-Bounes, T Seguin, L Crognier, O Fourcade, L Brouchet, V Minville, S Silva
PURPOSE: Veno-venous ECMO is increasingly used for the management of refractory ARDS. In this context, acute kidney injury (AKI) is a major and frequent complication, often associated with poor outcome. We aimed to identify characteristics associated with severe renal failure (Kidney Disease Improving Global Outcome (KDIGO) 3) and its impact on 3-month outcome. METHODS: Between May 2009 and April 2016, 60 adult patients requiring VV-ECMO in our University Hospital were prospectively included...
October 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#19
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29045280/sedation-practice-in-extracorporeal-membrane-oxygenation-treated-patients-with-acute-respiratory-distress-syndrome-a-retrospective-study
#20
Julian deBacker, Erik Tamberg, Laveena Munshi, Lisa Burry, Eddy Fan, Sangeeta Mehta
Our objective was to characterize sedation management in adult patients with severe respiratory distress syndrome (ARDS) treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). We conducted a retrospective chart review of these patients treated at Toronto General Hospital between January 2012 and October 2015. Medications administered (sedative, analgesic, paralytic, and antipsychotic), sedation depth (Sedation Agitation Scale [SAS] score) delirium assessments, and mobilization were recorded daily...
October 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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