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https://www.readbyqxmd.com/read/29895331/immunocompromised-patients-with-acute-respiratory-distress-syndrome-secondary-analysis-of-the-lung-safe-database
#1
Andrea Cortegiani, Fabiana Madotto, Cesare Gregoretti, Giacomo Bellani, John G Laffey, Tai Pham, Frank Van Haren, Antonino Giarratano, Massimo Antonelli, Antonio Pesenti, Giacomo Grasselli
BACKGROUND: The aim of this study was to describe data on epidemiology, ventilatory management, and outcome of acute respiratory distress syndrome (ARDS) in immunocompromised patients. METHODS: We performed a post hoc analysis on the cohort of immunocompromised patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) study. The LUNG SAFE study was an international, prospective study including hypoxemic patients in 459 ICUs from 50 countries across 5 continents...
June 12, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29869478/-about-a-cresol-intoxication
#2
S Fatihi, P Mols
Cresols are phenol derivatives commonly used as surface disinfectants. Ingestion may cause local mucocutaneous damage and extensive systemic toxicity : central nervous, cardiovascular, hematological, hepatic, renal and pulmonary. We describe the case of a 33-year-old woman who swallowed, without suicidal intent, 50 to 70 cm3 of a 50% cresol solution. Coma occurred within 5 minutes of ingestion, she presented a bradypnea with desaturation, and the SMUR team performed on-site an orotracheal intubation. On arrival at the hospital, the patient had typical caustic lesions around her mouth...
May 30, 2018: Revue Médicale de Bruxelles
https://www.readbyqxmd.com/read/29861406/the-effect-of-mandibular-distraction-osteogenesis-on-airway-obstruction-and-polysomnographic-parameters-in-children-with-robin-sequence
#3
Amanda Lucas da Costa, Denise Manica, Cláudia Schweiger, Gabriel Kuhl, Leo Sekine, Simone Chaves Fagondes, Marcus Vinicius Collares, Paulo Jose Cauduro Marostica
INTRODUCTION: The optimal surgical technique for the management of patients with Robin Sequence (RS) has not been established. One of the most commonly used surgical techniques, mandibular distraction osteogenesis (MDO), is still controversial because of its potential risks and the lack of clear evidence of its efficacy. OBJECTIVES: To assess variations in airway patency, clinical symptoms, and polysomnographic parameters in children with RS who underwent MDO. METHODS: In this prospective cohort study, 38 patients with RS were evaluated before and after MDO...
May 18, 2018: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29849328/myasthenic-crisis-in-pregnancy
#4
David M French, E Page Bridges, Matthew C Hoskins, Charles M Andrews, Cecil H Nelson
This case reviews the management of a 27-year-old pregnant female in myasthenic crisis. She presented to the emergency department in respiratory distress refractory to standard therapy, necessitating airway and ventilatory support and treatment with plasmapheresis. Myasthenic crisis in the setting of pregnancy is rare and presents unique management challenges for emergency physicians.
November 2017: Clinical practice and cases in emergency medicine
https://www.readbyqxmd.com/read/29805409/frequency-of-acute-kidney-injury-in-tetanus-patients-of-paedriatic-intensive-care-unit-a-public-hospital-experience
#5
Faizia Naseem, Abid Hussain, Fehmina Arif
Background and Objective: Tetanus is a potentially fatal but preventable disease. Mortality is related to severity of the disease, cardiovascular, pulmonary and renal complications. Acute kidney injury (AKI) is a frequent and lethal complication of tetanus. The objective was to determine the frequency of AKI in tetanus patients managed in a public hospital. Methods: Children aged 1-12 years admitted in Paediatric Intensive Care Unit (PICU) with the clinical diagnosis of tetanus over three and half years were recruited for the retrospective study...
March 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29801509/successful-ventilation-through-a-r%C3%A3-sch-intubation-guide-catheter-in-severe-laryngotracheal-stenosis
#6
Victoria Van Regemorter, Arnaud Potié, Sandra Schmitz, Jean-Louis Scholtes, Laurent Veevaete, Michel Van Boven
BACKGROUND: Providing adequate ventilation may remain complex in patients with severe proximal laryngotracheal stenosis, especially when the airway is shared with the surgeon during tracheal resection surgery. We describe an effective alternative to standard endotracheal intubation using a Rüsch flexible intubation guide catheter. METHODS: In two patients undergoing tracheal repair surgery, we failed to insert a 5.0 inner diameter endotracheal tube (6.9 mm outer diameter) or a 6...
May 25, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29799892/-seronegative-catastrophic-antiphospholipid-syndrome-in-pediatrics-clinical-case
#7
Ericka Vargas-Quevedo, Eduardo Ordoñez-Gutiérrez, Jorge Enrique Trejo-Gómora, Lénica Anahí Chávez-Aguilar, Rubén Peña-Vélez
INTRODUCTION: The antiphospholipid syndrome is an acquired autoimmune thrombophilia, characterized by arterial and/or venous thrombosis. Rarely, this condition can have a catastrophic presenta tion, with high mortality, and presence of microangiopathy and involvement of three or more organs. OBJECTIVE: To describe the clinical presentation and evolution of a pediatric patient with catastrophic antiphospholipid syndrome, with a seronegative onset form, whose response to aggressive therapy was favorable...
April 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29792537/recognizing-quantifying-and-managing-patient-ventilator-asynchrony-in-invasive-and-noninvasive-ventilation
#8
Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Luisa Liparota, Nicola Lombardo, Federico Longhini, Paolo Navalesi
Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and non-invasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, considering the techniques used to properly detect asynchronies, by either ventilator waveform observation, or through systems based on more complexes mathematical algorithms, by means of adjunctive signals, such as the electrical activity of the diaphragm or esophageal pressure...
May 24, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29764401/management-of-acute-respiratory-failure-in-interstitial-lung-diseases-overview-and-clinical-insights
#9
REVIEW
Paola Faverio, Federica De Giacomi, Luca Sardella, Giuseppe Fiorentino, Mauro Carone, Francesco Salerno, Jousel Ora, Paola Rogliani, Giulia Pellegrino, Giuseppe Francesco Sferrazza Papa, Francesco Bini, Bruno Dino Bodini, Grazia Messinesi, Alberto Pesci, Antonio Esquinas
BACKGROUND: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. METHODS: A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017)...
May 15, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#10
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29738021/unusual-case-of-central-alveolar-hypoventilation-lessons-learned-from-ventilatory-management-of-patients-with-alveolar-hypoventilation-in-critical-care-conditions
#11
https://www.readbyqxmd.com/read/29716709/management-of-electrical-storm-of-unstable-ventricular-tachycardia-in-post-myocardial-infarction-patients-a-single-centre-experience
#12
B Hygriv Rao, Mohammed Sadiq Azam, Geetesh Manik
OBJECTIVE: This is a case series of consecutive patients with past myocardial infarction presenting with Electrical Storm (ES) of unstable ventricular tachycardia (VT) treated by a protocol directed algorithm. METHODS: Management protocol involved treatment of reversible causes, ventilatory & hemodynamic support, administration of antiarrhythmic drugs (AAD) & maximally tolerated doses of beta-blockers, stellate ganglionectomy and Radiofrequency ablation (RFA) guided by Electro Anatomic Mapping (EAM)...
March 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29705765/practice-of-ventilation-in-middle-income-countries-provent-imic-rationale-and-protocol-for-a-prospective-international-multicentre-observational-study-in-intensive-care-units-in-asia
#13
Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Reza Hashemian, Madiha Hashmi, Hisham Ahmed Imad, Kanishka Indraratna, Shivakumar Iyer, Gyan Kayastha, Bhuvana Krishna, Hassan Moosa, Behzad Nadjm, Rajyabardhan Pattnaik, Sriram Sampath, Louise Thwaites, Ni Ni Tun, Nor'azim Mohd Yunos, Salvatore Grasso, Frederique Paulus, Marcelo Gama de Abreu, Paolo Pelosi, Arjen M Dondorp, Marcus J Schultz
INTRODUCTION: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29705730/paediatric-traumatic-cardiac-arrest-a-delphi-study-to-establish-consensus-on-definition-and-management
#14
Annette C Rickard, James Vassallo, Tim Nutbeam, Mark D Lyttle, Ian K Maconochie, Doyo G Enki, Jason E Smith
AIMS: Paediatric traumatic cardiac arrest (TCA) is associated with low survival and poor outcomes. The mechanisms that underlie TCA are different from medical cardiac arrest; the approach to treatment of TCA may therefore also need to differ to optimise outcomes. The aim of this study was to explore the opinion of subject matter experts regarding the diagnosis and treatment of paediatric TCA, and to reach consensus on how best to manage this group of patients. METHODS: An online Delphi study was conducted over three rounds, with the aim of achieving consensus (defined as 70% agreement) on statements related to the diagnosis and management of paediatric TCA...
April 28, 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29679681/inhibition-of-protein-kinase-a-and-girk-channel-reverses-fentanyl-induced-respiratory-depression
#15
Xiaonan Liang, Zheng Yong, Ruibin Su
Opioid-induced respiratory depression is a major obstacle to improving the clinical management of moderate to severe chronic pain. Opioids inhibit neuronal activity via various pathways, including calcium channels, adenylyl cyclase, and potassium channels. Currently, the underlying molecular pathway of opioid-induced respiratory depression is only partially understood. This study aimed to investigate the mechanisms of opioid-induced respiratory depression in vivo by examining the effects of different pharmacological agents on fentanyl-induced respiratory depression...
June 11, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29593914/rituximab-induced-pulmonary-edema-managed-with-extracorporeal-life-support
#16
Jacob R Miller, Warren Isakow, Muhammad F Masood, Patrick Aguilar, Kristen M Sanfilippo, Keki R Balsara, Akinobu Itoh
Though rare, rituximab has been reported to induce severe pulmonary edema. We describe the first report of ECLS utilization for this indication. A 31-year-old female with severe thrombotic thrombocytopenic purpura developed florid pulmonary edema after rituximab infusion. Despite advanced ventilatory settings, she developed severe respiratory acidosis and remained hypoxemic with a significant vasopressor requirement. Since her pulmonary insult was likely transient, ECLS was considered. Due to combined cardiorespiratory failure, she received support with peripheral venoarterial ECLS...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29576822/predisposing-factors-clinical-assessment-management-and-outcomes-of-agitation-in-the-trauma-intensive-care-unit
#17
Saeed Mahmood, Omaima Mahmood, Ayman El-Menyar, Mohammad Asim, Hassan Al-Thani
BACKGROUND: Agitation occurs frequently among critically ill patients admitted to the intensive care unit (ICU). We aimed to evaluate the frequency, predisposing factors and outcomes of agitation in trauma ICU. METHODS: A retrospective analysis was conducted to include patients who were admitted to the trauma ICU between April 2014 and March 2015. Data included patient's demographics, initial vitals, associated injuries, Ramsey Sedation Scale, Glasgow Coma Scale, head injury lesions, use of sedatives and analgesics, head interventions, ventilator days, and ICU length of stay...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29566734/acute-exacerbation-of-idiopathic-pulmonary-fibrosis-lessons-learned-from-acute-respiratory-distress-syndrome
#18
REVIEW
Alessandro Marchioni, Roberto Tonelli, Lorenzo Ball, Riccardo Fantini, Ivana Castaniere, Stefania Cerri, Fabrizio Luppi, Mario Malerba, Paolo Pelosi, Enrico Clini
Idiopathic pulmonary fibrosis (IPF) is a fibrotic lung disease characterized by progressive loss of lung function and poor prognosis. The so-called acute exacerbation of IPF (AE-IPF) may lead to severe hypoxemia requiring mechanical ventilation in the intensive care unit (ICU). AE-IPF shares several pathophysiological features with acute respiratory distress syndrome (ARDS), a very severe condition commonly treated in this setting.A review of the literature has been conducted to underline similarities and differences in the management of patients with AE-IPF and ARDS...
March 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29557595/complications-during-esophageal-endoscopy-with-or-without-baloon-dilation-under-general-anesthesia-in-pediatric-patients-a-prospective-and-observational-study
#19
Pinar Kendigelen, Ayse C Tutuncu, Senol Emre, Fatis Altindas, Guner Kaya
BACKGROUND: Complications can occur during esophagoscopy as a result of applied procedure in children, especially during dilation techic. Our aim was to identify cardio-respiratory alterations during esophagoscopy with or without baloon dilation under anesthesia in children, and to investigate the postoperative complications. METHODS: Prospective, observational study of endoscopic procedures in patients 0-16 years. The patients were divided into two groups: the endoscopy-dilation group (Group ED: endoscopy and balloon dilation due to esophageal stricture) and endoscopy without dilation (Group E: endoscopy for diagnostic reasons, control esophagoscopy or sclerotherapy)...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29507719/the-patient-needing-prolonged-mechanical-ventilation-a-narrative-review
#20
REVIEW
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
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