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weaning of ventilation

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https://www.readbyqxmd.com/read/29158939/mediastinal-tracheostoma-for-treatment-of-tracheostenosis-after-tracheostomy-in-a-patient-with-mucopolysaccharidosis-induced-tracheomalacia
#1
Yasuhiro Chikaishi, Kenichi Kobayashi, Shuichi Shinohara, Akihiro Taira, Yusuke Nabe, Shinji Shinohara, Taiji Kuwata, Masaru Takenaka, Soichi Oka, Ayako Hirai, Kazue Yoneda, Koji Kuroda, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
Background: Treatment of tracheostenosis after tracheostomy in pediatric patients is often difficult. Mucopolysaccharidosis is a lysosomal storage disease that may induce obstruction of the airways. Case Presentation: A 16-year-old male patient underwent long-term follow-up after postnatal diagnosis of type II mucopolysaccharidosis. At 11 years of age, tracheostomy was performed for mucopolysaccharidosis-induced laryngeal stenosis. One week prior to presentation, he was admitted to another hospital on an emergency basis for major dyspnea...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29158899/diaphragm-thickening-fraction-to-predict-weaning-a-prospective-exploratory-study
#2
Sujay Samanta, Ratender Kumar Singh, Arvind K Baronia, Banani Poddar, Afzal Azim, Mohan Gurjar
Background: Diaphragm ultrasound (DUS) is a well-established point of care modality for assessment of dimensional and functional aspects of the diaphragm. Amongst various measures, diaphragmatic thickening fraction (DTf) is more comprehensive. However, there is still uncertainty about its capability to predict weaning from mechanical ventilation (MV). The present prospective observational exploratory study assessed the diaphragm at variable negative pressure triggers (NPTs) with US to predict weaning in ICU patients...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29151423/-guiding-significance-of-diaphragm-function-evaluation-in-ventilation-weaning
#3
Jieying Luo, Xiaotong Han, Maiying Fan, Hui Wen, Jing Xu, Yanfang Pei, Ying Huang
Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation (MV). Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit (ICU), which is simple, non-invasive, and easy to operate...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29151413/-effects-of-mechanical-ventilation-on-diaphragmatic-contractile-function-in-patients-with-aecopd
#4
Feifei Wang, Xiaoping Zhu, Changjing Zhang, Hui Zhu, Yu Feng, Yang Liu, Shaolin Ma
OBJECTIVE: To study diaphragmatic strength in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) during mechanical ventilation (MV), and to explore the predictive value of maximal transdiaphragm pressure (Pdi max) for successful extubation. METHODS: A prospective study was conducted. Twenty-one patients with AECOPD receiving MV admitted to intensive care unit (ICU) of Shanghai East Hospital of Tongji University of School Medicine from February 2015 to May 2017 were enrolled...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29142384/hypercapnic-respiratory-failure-in-case-of-chiari-1-5-malformation-case-report-and-review-of-the-literature
#5
Viralkumar M Vasani, Subhas Kanti Konar, S Satish
Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2 of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142373/a-pilot-study-of-nebulized-heparin-for-prevention-of-ventilator-induced-lung-injury-comparative-effects-with-an-inhaled-corticosteroid
#6
Farzin Ghiasi, Mohsen Sadeghian, Mohammad Emami, Babak Ali Kiaie, Sarah Mousavi
Background: Ventilator-induced lung injury (VILI) is a side effect of mechanical ventilation. Lung inflammation and pulmonary activation of coagulation are induced by mechanical stress. Clinical and preclinical studies show that heparin possesses anti-inflammatory properties. Therefore, we assessed the effects of nebulized heparin in VILI. Methods: Sixty critically ill adult patients who require mechanical ventilation for more than 48 h were included in this prospective, nonrandomized controlled study...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#7
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29141315/-clinical-efficacy-of-one-lung-ventilation-in-treatment-of-children-postoperatively-intractable-atelectasis
#8
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#9
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29137068/carnitine-acylcarnitine-translocase-deficiency-with-c-199-10-t-g-and-novel-c-1a-g-mutation-two-case-reports-and-brief-literature-review
#10
Hui-Ming Yan, Hao Hu, Aisha Ahmed, Bing-Bing Feng, Jing Liu, Zheng-Jun Jia, Hua Wang
RATIONALE: Carnitine-acylcarnitine translocate deficiency (CACTD) is a rare and life-threatening, autosomal recessive disorder of fatty acid β-oxidation characterized by hypoketotic hypoglycemia, hyperammonemia, cardiomyopathy, liver dysfunction, and muscle weakness; culminating in early death. To date, CACTD cases screened from the Chinese mainland population, especially patient with compound heterozygote with c.199-10T>G and a novel c.1A>G mutation in the SLC25A20 gene has never been described...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#11
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29135527/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#12
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
November 9, 2017: A & A Case Reports
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/29132698/risk-factor-analysis-for-intraoperative-extracorporeal-membrane-oxygenation-weaning-failure-after-lung-transplantation
#14
Kyoung Shik Narm, Seokkee Lee, Jee Won Suh, Anes Kim, Jin Gu Lee, Moo Suk Park, Song Yee Kim, Joo Han Song, Su Jin Jeong, Hyo Chae Paik
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used for hemodynamic support during lung transplantation (LTx). We evaluated the risk factors associated with failure of weaning from ECMO in the operating room during LTx. METHODS: We retrospectively reviewed 74 consecutive patients who had undergone LTx from March 2013 to February 2016. Patients who underwent single LTx, multiorgan transplantation, and LTx for pulmonary hypertension were excluded...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#15
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29123889/a-case-of-non-cardiogenic-pulmonary-edema-provoked-by-intravenous-acetazolamide
#16
Yuichiro Ono, Makiko Morifusa, Satoru Ikeda, Chika Kunishige, Yoshiki Tohma
Case: A 61-year-old man was diagnosed with severe chest trauma after a car accident and had had difficulty in weaning from a ventilator because of flail chest and dilated cardiomyopathy. On the 17th day in the intensive care unit, he received i.v. acetazolamide to increase urine output. One hour after the injection, he suddenly developed severe hypoxia. Chest radiography revealed a butterfly shadow. He received other diuretics and a vasodilator, which seemed slowly to resolve the respiratory failure...
July 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29122783/clinical-characteristics-and-prognosis-of-drug-associated-acute-respiratory-distress-syndrome-compared-with-non-drug-associated-acute-respiratory-distress-syndrome-a-single-centre-retrospective-study-in-japan
#17
Keisuke Anan, Kazuya Ichikado, Kodai Kawamura, Takeshi Johkoh, Kiminori Fujimoto, Moritaka Suga
OBJECTIVES: To report the clinical features and prognosis of drug-associatedacute respiratory distress syndrome (ARDS). DESIGN: A retrospective analysis of data collected during a prospective cohort study. SETTING: Intensive care unit in a teaching hospital. PARTICIPANTS: A total of 197 Japanese patients with ARDS diagnosed by the Berlin definition who were admitted to the Division of Respiratory Medicine from October 2004 to December 2015 were enrolled in the study and were classified as two groups according to their causes: a drug-associated ARDS group (n=27) and a non-drug-associated ARDS group (n=170)...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29109556/management-of-mechanical-ventilation-in-patients-with-hospital-acquired-pneumonia-a-retrospective-observational-study
#18
Radovan Uvizl, Tomas Herkel, Katerina Langova, Petr Jakubec
BACKGROUND: Hospital-acquired pneumonia (HAP) in intensive care patients is a frequent reason for mechanical ventilation (MV). The management of MV and ventilator weaning vary, depending on the type of lung inflammation. This retrospective, observational study screened the data from all patients admitted to the intensive care unit (ICU) of the Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc between 2011 and 2016...
November 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#19
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#20
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
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