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https://www.readbyqxmd.com/read/28103536/evidence-based-guidelines-for-the-use-of-tracheostomy-in-critically-ill-patients
#1
Néstor Raimondi, Macarena R Vial, José Calleja, Agamenón Quintero, Albán Cortés, Edgar Celis, Clara Pacheco, Sebastián Ugarte, José M Añón, Gonzalo Hernández, Erick Vidal, Guillermo Chiappero, Fernando Ríos, Fernando Castilleja, Alfredo Matos, Enith Rodriguez, Paulo Antoniazzi, José Mario Teles, Carmelo Dueñas, Jorge Sinclair, Lorenzo Martínez, Ingrid von der Osten, José Vergara, Edgar Jiménez, Max Arroyo, Camilo Rodríguez, Javier Torres, Sebastián Fernandez-Bussy, Joseph L Nates
OBJECTIVES: To provide evidence-based guidelines for tracheostomy in critically ill adult patients and identify areas needing further research. METHODS: A taskforce composed of representatives of 10 member countries of the Pan-American and Iberic Federation of Societies of Critical and Intensive Therapy Medicine and of the Latin American Critical Care Trial Investigators Network developed recommendations based on the Grading of Recommendations Assessment, Development and Evaluation system...
October 20, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28103448/bedside-contribution-of-electrical-impedance-tomography-to-set-positive-end-expiratory-pressure-for-ecmo-treated-severe-ards-patients
#2
Guillaume Franchineau, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Charles-Edouard Luyt, Alain Combes, Matthieu Schmidt
RATIONALE: Optimal positive end-expiratory pressure (PEEP) is unknown in severe acute respiratory distress syndrome (ARDS) patients on extracorporeal membrane oxygenation (ECMO) receiving mechanical ventilation with very low tidal volume. OBJECTIVES: To evaluate electrical impedance tomography's (EIT) ability to monitor a PEEP trial and to derive from EIT the best compromise PEEP in this setting. METHODS: A decremental PEEP trial (20-0 cmH2O) in 5 cmH2O steps was monitored by EIT, with lung images divided into four ventral-to-dorsal horizontal regions of interest...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28103130/serum-progesterone-levels-in-pregnant-women-with-obstructive-sleep-apnea-a-case-control-study
#3
Jennifer Lee, Elizabeth E Eklund, Geralyn Lambert-Messerlian, Glenn E Palomaki, Kristen Butterfield, Patrizia Curran, Ghada Bourjeily
BACKGROUND: Pregnancy is a risk factor for sleep disordered breathing, including obstructive sleep apnea (OSA). Progesterone, one of the key hormones in pregnancy, a known respiratory drive stimulant, increases ventilation and may protect against OSA. We aimed to examine the relationship between circulating progesterone and OSA, after accounting for body weight and gestational age. METHODS: A case control study was conducted of pregnant women with OSA and those at low risk for the disorder...
January 19, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28102961/assessing-the-use-of-4dct-ventilation-in-pre-operative-surgical-lung-cancer-evaluation
#4
Yevgeniy Vinogradskiy, Matthew Jackson, Leah Schubert, Bernard Jones, Richard Castillo, Edward Castillo, Thomas Guerrero, John Mitchell, Chad Rusthoven, Moyed Miften, Brian Kavanagh
PURPOSE: A primary treatment option for lung cancer patients is surgical resection. Patients who have poor lung function prior to surgery are at increased risk of developing serious and life-threatening complications after surgical resection. Surgeons use nuclear medicine ventilation-perfusion (VQ) scans along with pulmonary function test (PFT) information to assess a patient's pre-surgical lung function. The nuclear medicine images and pre-surgery PFTs are used to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung tissue that would be lost with surgical resection...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28102857/vocal-fold-paralysis-in-preterm-infants-prevalence-and-analysis-of-risk-factors
#5
J Jabbour, M Uhing, T Robey
OBJECTIVE: To calculate the prevalence of vocal fold paralysis (VFP) in preterm (<37 weeks of gestation) infants at a single neonatal intensive care unit (NICU) and identify risk factors for the development of VFP. STUDY DESIGN: This is a case control study of all surviving preterm infants admitted to the NICU at Children's Hospital of Wisconsin from 2006 to 2012, comparing those with and without VFP. Multivariate analysis was performed to identify significant risk factors for VFP...
January 19, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28102521/clinical-assessment-and-train-of-four-measurements-in-critically-ill-patients-treated-with-recommended-doses-of-cisatracurium-or-atracurium-for-neuromuscular-blockade-a-prospective-descriptive-study
#6
Pierre Bouju, Jean-Marc Tadié, Nicolas Barbarot, Julien Letheulle, Fabrice Uhel, Pierre Fillatre, Guillaume Grillet, Angélique Goepp, Yves Le Tulzo, Arnaud Gacouin
BACKGROUND: Despite few studies, a monitoring of a neuromuscular blockade with a train of four (TOF) is recommended in intensive care unit (ICU). Our objective was to compare the results of ulnar and facial TOF measurements with an overall clinical assessment for neuromuscular blockade in ICU patients treated with recommended doses of atracurium or cisatracurium, including patients with acute respiratory disease syndrome (ARDS). METHODS: We prospectively included in two ICUs 119 patients, 94 with ARDS, who required a neuromuscular blockade for more than 24 h...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28102438/non-invasive-ventilation-in-hypoxemic-acute-respiratory-failure-is-it-still-possible
#7
EDITORIAL
Christophe Girault, Miquel Ferrer, Antoni Torres
No abstract text is available yet for this article.
January 19, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28101662/strategies-to-prevent-cast-formation-in-patients-with-plastic-bronchitis-undergoing-heart-transplantation
#8
John J Parent, Robert K Darragh, Jeffrey G Gossett, Thomas D Ryan, Chet R Villa, Angela Lorts, John L Jefferies, Jeffrey A Towbin, Clifford Chin
Plastic bronchitis, a rare complication after Fontan palliation, carries a high morbidity and mortality risk. Heart transplantation is an effective treatment option, but casts may occur in the early post-operative period. We present a case series detailing peri-operative management strategies to minimize morbidity and mortality related to plastic bronchitis in patients undergoing heart transplantation. Patient 1 received no treatment pre-, intra-, or post-transplant for prevention of bronchial casts and developed severe respiratory acidosis 18 h following transplant...
January 19, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#9
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
January 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28101565/use-of-neuromuscular-electrical-stimulation-to-preserve-the-thickness-of-abdominal-and-chest-muscles-of-critically-ill-patients-a-randomized-clinical-trial
#10
Ana M Dall' Acqua, Amanda Sachetti, Laura J Santos, Fernando A Lemos, Tanara Bianchi, Wagner S Naue, Alexandre S Dias, Graciele Sbruzzi, Silvia R R Vieira
OBJECTIVE: To evaluate and compare the effects of neuromuscular electrical stimulation combined with conventional physical therapy on muscle thickness in critically ill patients. DESIGN: Double-blind, randomized controlled trial. PATIENTS: Twenty-five patients participated in the study. METHODS: Patients on mechanical ventilation for 24-48 h were randomized to an intervention group (neuromuscular electrical stimulation + conventional physical therapy) or a conventional group (sham neuromuscular electrical stimulation + conventional physical therapy)...
January 19, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28101415/endoscopic-sensing-of-alveolar-ph
#11
D Choudhury, M G Tanner, S McAughtrie, F Yu, B Mills, T R Choudhary, S Seth, T H Craven, J M Stone, I K Mati, C J Campbell, M Bradley, C K I Williams, K Dhaliwal, T A Birks, R R Thomson
Previously unobtainable measurements of alveolar pH were obtained using an endoscope-deployable optrode. The pH sensing was achieved using functionalized gold nanoshell sensors and surface enhanced Raman spectroscopy (SERS). The optrode consisted of an asymmetric dual-core optical fiber designed for spatially separating the optical pump delivery and signal collection, in order to circumvent the unwanted Raman signal generated within the fiber. Using this approach, we demonstrate a ~100-fold increase in SERS signal-to-fiber background ratio, and demonstrate multiple site pH sensing with a measurement accuracy of ± 0...
January 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28101364/hemodynamic-effects-of-electrical-muscle-stimulation-in-the-prophylaxis-of-deep-vein-thrombosis-for-intensive-care-unit-patients-a-randomized-trial
#12
Masahiro Ojima, Ryosuke Takegawa, Tomoya Hirose, Mitsuo Ohnishi, Tadahiko Shiozaki, Takeshi Shimazu
BACKGROUND: Deep vein thrombosis (DVT) is a major complication in critical care. There are various methods of prophylaxis, but none of them fully prevent DVT, and each method has adverse effects. Electrical muscle stimulation (EMS) could be a new effective approach to prevent DVT in intensive care unit (ICU) patients. We hypothesized that EMS increases the venous flow of the lower limbs and has a prophylactic effect against the formation of DVT. METHODS: This study included 26 patients admitted to a single ICU...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28101311/a-hospital-based-retrospective-comparative-study-of-complications-outcomes-clinical-and-laboratory-parameters-of-malaria-with-and-without-neurological-involvement
#13
Sohaib Ahmad, Nadia Shirazi, Nowneet K Bhat, Minakshi Dhar, Garima Mittal, Manish Mittal, Nidhi Kaeley, Manoj Kumar
BACKGROUND & OBJECTIVES: Classically associated with Plasmodium (P.) falciparum, neurological complications in severe malaria is associated with increased morbidity and mortality. However, reports implicate the long considered benign P. vivax for causing severe malaria as well. We aimed to analyse the cerebral complications in malaria, and study if there is a species-related difference in the presentation and outcomes. METHODS: We retrospectively compared patients with malaria hospitalised from 2009-15, with (n=105) and without (n=1155) neurological involvement regarding outcomes, complications, demographic attributes, clinical features, and laboratory parameters...
2017: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/28100942/potential-benefits-of-rib-fracture-fixation-in-patients-with-flail-chest-and-multiple-non-flail-rib-fractures
#14
Meiguang Qiu, Zhanjun Shi, Jun Xiao, Xuming Zhang, Shishui Ling, Hao Ling
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n = 38) and multiple non-flail rib fracture groups (n = 124)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100723/a-respiratory-gated-micro-ct-comparison-of-respiratory-patterns-in-free-breathing-and-mechanically-ventilated-rats
#15
Nancy L Ford, Lynda McCaig, Andrew Jeklin, James F Lewis, Ruud A W Veldhuizen, David W Holdsworth, Maria Drangova
In this study, we aim to quantify the differences in lung metrics measured in free-breathing and mechanically ventilated rodents using respiratory-gated micro-computed tomography. Healthy male Sprague-Dawley rats were anesthetized with ketamine/xylazine and scanned with a retrospective respiratory gating protocol on a GE Locus Ultra micro-CT scanner. Each animal was scanned while free-breathing, then intubated and mechanically ventilated (MV) and rescanned with a standard ventilation protocol (56 bpm, 8 mL/kg and PEEP of 5 cm H2O) and again with a ventilation protocol that approximates the free-breathing parameters (88 bpm, 2...
January 2017: Physiological Reports
https://www.readbyqxmd.com/read/28100714/the-dynamics-of-the-pulmonary-microbiome-during-mechanical-ventilation-in-the-intensive-care-unit-and-the-association-with-occurrence-of-pneumonia
#16
Tetyana Zakharkina, Ignacio Martin-Loeches, Sébastien Matamoros, Pedro Povoa, Antoni Torres, Janine B Kastelijn, Jorrit J Hofstra, B de Wever, Menno de Jong, Marcus J Schultz, Peter J Sterk, Antonio Artigas, Lieuwe D J Bos
RATIONALE: Ventilator-associated pneumonia (VAP) is the most common nosocomial infections in patients admitted to the ICU. The adapted island model predicts several changes in the respiratory microbiome during intubation and mechanical ventilation. OBJECTIVES: We hypothesised that mechanical ventilation and antibiotic administration decrease the diversity of the respiratory microbiome and that these changes are more profound in patients who develop VAP. METHODS: Intubated and mechanically ventilated ICU-patients were included...
January 18, 2017: Thorax
https://www.readbyqxmd.com/read/28100653/minocycline-blocks-glial-cell-activation-and-ventilatory-acclimatization-to-hypoxia
#17
Jennifer Ann Stokes, Tara Elizabeth Arbogast, Esteban A Moya, Zhenxing Fu, Frank L Powell
Ventilatory acclimatization to hypoxia (VAH) is the time-dependent increase in ventilation, which persists upon return to normoxia, and involves plasticity in both central nervous system respiratory centers and peripheral chemoreceptors. We investigated the role of glial cells in VAH in male Sprague Dawley rats using minocycline, an antibiotic that inhibits microglia activation and has anti-inflammatory properties, and barometric pressure plethysmography to measure ventilation. Rats received either minocycline (45mg/kg, i...
January 18, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28100527/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-randomized-controlled-trial
#18
S Humphreys, P Lee-Archer, G Reyne, D Long, T Williams, A Schibler
BACKGROUND: Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) was introduced to adult anaesthesia to improve the safety of airway management during apnoea before intubation. The objective of our study was to determine whether THRIVE safely prolongs apnoeic oxygenation in children. METHODS: This was a randomized controlled trial in 48 healthy children, with normal airways and cardiorespiratory function, in age groups 0-6 and 7-24 months, 2-5 and 6-10 yr old, presenting for elective surgery or imaging under general anaesthesia...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100526/comparison-of-different-techniques-of-central-venous-pressure-measurement-in-mechanically-ventilated-critically-ill-patients
#19
C Roger, L Muller, B Riou, N Molinari, B Louart, H Kerbrat, J-L Teboul, J-Y Lefrant
BACKGROUND: Several techniques exist for measuring central venous pressure (CVP) but little information is available about the accuracy of each method. The aim of this study was to compare different methods of CVP measurements in mechanically ventilated patients. METHODS: CVP was measured in mechanically ventilated patients without spontaneous breathing using four different techniques: 1) end expiratory CVP measurement at the base of the" c" wave (CVPMEASURED), chosen as the reference method; 2) CVP measurement from the monitor averaging CVP over the cardiac and respiratory cycles (CVPMONITOR); 3) CVP measurement after a transient withdrawing of mechanical ventilation (CVPNADIR); 4) CVP measurement corrected for the transmitted respiratory pressure induced by intrinsic PEEP (calculated CVP: CVPCALCULATED)...
February 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28100516/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-children-a-step-forward-in-apnoeic-oxygenation-paradigm-shift-in-ventilation-or-both
#20
EDITORIAL
N Jagannathan, N Burjek
No abstract text is available yet for this article.
February 2017: British Journal of Anaesthesia
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