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https://www.readbyqxmd.com/read/28239810/totally-thoracoscopic-surgery-for-atrial-myxomas-resection-and-atrial-septal-defect-repair
#1
L Deng, G-W Zhang, Z-H Liu, W-X Meng, H-Y Liu
OBJECTIVE: The purpose of this study is to compare the effectiveness and safety of thoracoscopic surgery and traditional median sternotomy. PATIENTS AND METHODS: 64 patients with atrial myxoma and 114 patients with atrial septal defect were collected from Mar 2012 to Aug 2015. 40 atrial myxoma and 77 atrial septal defect (ASD) patients underwent totally thoracoscopic surgery technique, while 24 atrial myxoma and 37 ASD patients underwent traditional median sternotomy...
February 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28238622/validation-of-the-portuguese-severe-respiratory-insufficiency-questionnaire-for-home-mechanically-ventilated-patients
#2
C Ribeiro, D Ferreira, S Conde, P Oliveira, W Windisch
The aim of this study was to develop and validate the professional translation and cultural adaptation of the Portuguese Severe Respiratory Insufficiency (SRI) Questionnaire. The sample was composed of 93 patients (50 male patients, 53.8%) with a mean age of 66.3 years. The most frequent diagnostic groups were chronic obstructive pulmonary disease, obesity hypoventilation syndrome and restrictive chest wall disorders. The patients were asked to fill in both the SRI and SF-36 questionnaires. Factor analysis of the SRI questionnaire was performed leading to an explained variance of 73%, and resulted in 13 components...
February 23, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28238441/mechanical-ventilation-in-acute-respiratory-distress-syndrome-the-open-lung-revisited
#3
L Amado-Rodríguez, C Del Busto, E García-Prieto, G M Albaiceta
Acute respiratory distress syndrome (ARDS) is still related to high mortality and morbidity rates. Most patients with ARDS will require ventilatory support. This treatment has a direct impact upon patient outcome and is associated to major side effects. In this regard, ventilator-associated lung injury (VALI) is the main concern when this technique is used. The ultimate mechanisms of VALI and its management are under constant evolution. The present review describes the classical mechanisms of VALI and how they have evolved with recent findings from physiopathological and clinical studies, with the aim of analyzing the clinical implications derived from them...
February 23, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28237894/early-continuous-renal-replacement-therapy-in-septic-acute-kidney-injury-could-be-defined-by-its-initiation-within-24-hours-of-vasopressor-infusion
#4
Seung Don Baek, Hoon Yu, Seulgi Shin, Hyang-Sook Park, Mi-Soon Kim, So Mi Kim, Eun Kyoung Lee, Jai Won Chang
PURPOSE: The optimal timing for the initiation of early continuous renal replacement therapy (CRRT) is uncertain and requires a practically feasible definition with acceptable evidence. MATERIALS AND METHODS: We investigated the clinical impacts of 3-time interval parameters on the morbidity and mortality of 177 patients with septic shock-induced acute kidney injury: (1) time from vasopressor initiation to CRRT initiation (Tvaso-CRRT), (2) time from intensive care unit (ICU) admission to CRRT initation (TICU-CRRT), and (3) time from endotracheal intubation to CRRT initiation (Tendo-CRRT)...
December 27, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28237274/time-for-a-paradigm-shift-assessing-for-anxiety-in-patients-receiving-mechanical-ventilation
#5
EDITORIAL
Glen Au, Jaclynn R Johnson, Linda L Chlan
No abstract text is available yet for this article.
February 23, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28236873/perianesthetic-refractory-anaphylactic-shock-with-cefuroxime-in-a-patient-with-history-of-penicillin-allergy-on-multiple-antihypertensive-medications
#6
Deb Sanjay Nag, Devi Prasad Samaddar, Shashi Kant, Pratap Rudra Mahanty
We report a case of perianesthetic refractory anaphylactic shock with cefuroxime in a patient with history of penicillin allergy on regular therapy with atenolol, losartan, prazosin and nicardipine. Severe anaphylactic shock was only transiently responsive to 10mL of (1:10,000) epinephrine and needed norepinephrine and dopamine infusion. Supportive therapy with vasopressors and inotropes along with mechanical ventilation for the next 24hours resulted in complete recovery. She was successfully operated upon 2 weeks later with the same anesthetic drugs but intravenous ciprofloxacin as the alternative antibiotic for perioperative prophylaxis...
March 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28236803/inhaled-nitric-oxide-in-adult-patients-with-acute-respiratory-distress-syndrome
#7
José Ángel Monsalve-Naharro, Esther Domingo-Chiva, Sergio García Castillo, Pablo Cuesta-Montero, José María Jiménez-Vizuete
In some patients, acute respiratory distress syndrome (ARDS) leads to life-threatening refractory hypoxemia developing. Physicians may consider hypoxemic rescue therapies in an attempt to improve oxygenation in these patients while on conventional mechanical ventilation support. Use of inhaled nitric oxide (iNO) in ARDS is one of the most widely-studied pharmacological interventions over the past two decades. Its efficacy was examined in several randomized clinical trials and has undergone meta-analyses...
March 1, 2017: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/28236395/nursing-strategies-for-effective-weaning-of-the-critically-ill-mechanically-ventilated-patient
#8
REVIEW
Darian Ward, Paul Fulbrook
The risks imposed by mechanical ventilation can be mitigated by nurses' use of strategies that promote early but appropriate reduction of ventilatory support and timely extubation. Weaning from mechanical ventilation is confounded by the multiple impacts of critical illness on the body's systems. Effective weaning strategies that combine several interventions that optimize weaning readiness and assess readiness to wean, and use a weaning protocol in association with spontaneous breathing trials, are likely to reduce the requirement for mechanical ventilatory support in a timely manner...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236394/special-considerations-in-neonatal-mechanical-ventilation
#9
REVIEW
Stacey Dalgleish, Linda Kostecky, Irina Charania
Care of infants supported with mechanical ventilation is complex, time intensive, and requires constant vigilance by an expertly prepared health care team. Current evidence must guide nursing practice regarding ventilated neonates. This article highlights the importance of common language to establish a shared mental model and enhance clear communication among the interprofessional team. Knowledge regarding the underpinnings of an open lung strategy and the interplay between the pathophysiology and individual infant's response to a specific ventilator strategy is most likely to result in a positive clinical outcome...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236393/special-considerations-in-the-nursing-care-of-mechanically-ventilated-children
#10
REVIEW
Karen Dryden-Palmer, Jason Macartney, Leanne Davidson, Faiza Syed, Cathy Daniels, Shaindy Alexander
Mechanical ventilation is often required to support the recovery of critically ill children. Critical care nurses must understand the unique needs of the children and design supportive care that is sensitive to their changing physiology, developmental stage, and socioemotional needs. This article describes the unique considerations in providing care for mechanically ventilated children. It addresses invasive and noninvasive ventilation and the needs of long-term ventilated children and family in critical care...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236392/patient-safety-identifying-and-managing-complications-of-mechanical-ventilation
#11
REVIEW
Heather Baid
Mechanical ventilation is a fundamental aspect of critical care practice to help meet the respiratory needs of critically ill patients. Complications can occur though, as a direct result of being mechanically ventilated, or indirectly because of a secondary process. Preventing, identifying, and managing these complications significantly contribute to the role and responsibilities of critical care nurses in promoting patient safety. This article reviews common ventilator-associated events, including both infectious (eg, ventilator-associated pneumonia) and noninfectious causes (eg, acute respiratory distress syndrome, pulmonary edema, pleural effusion, and atelectasis)...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236391/best-practices-for-managing-pain-sedation-and-delirium-in-the-mechanically-ventilated-patient
#12
REVIEW
Kitty M Garrett
Nursing management of pain, agitation, and delirium in mechanically ventilated patients is a challenge in critical care. Oversedation can lead to delayed extubation, prolonged ventilator days, unnecessary neurologic testing, and complications such as weakness and delirium. Undersedation can lead to self-extubation, invasive line removal, unnecessary patient distress, and injury to self or others. Acquiring an optimal level of sedation requires the bedside nurse to be more vigilant than ever with patient assessment and medication titration...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236390/optimizing-oxygenation-in-the-mechanically-ventilated-patient-nursing-practice-implications
#13
REVIEW
Glenn Barton, Brandi Vanderspank-Wright, Jacqueline Shea
Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236389/early-mobilization-of-mechanically-ventilated-patients
#14
REVIEW
Pam Hruska
Critically ill patients requiring mechanical ventilation are least likely to be mobilized and, as a result, are at-risk for prolonged complications from weakness. The use of bed rest and sedation when caring for mechanically ventilated patients is likely shaped by historical practice; however, this review demonstrates early mobilization, with little to no sedation, is possible and safe. Assessing readiness for mobilization in context of progressing patients from passive to active activities can lead to long-term benefits and has been achievable with resource-efficient implementations and team work...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236388/mechanical-ventilation-education-and-transition-of-critical-care-nurses-into-practice
#15
REVIEW
Sandra Goldsworthy
A foundational skill for critical care nurses caring for mechanically ventilated patients. This paper describes challenges and opportunities in preparing nurses to transition into the intensive care environment. Hospitals invest significant funding in educational programs for new critical care nurses so that they can transition effectively into the critical care environment. Simulation has been shown to impact self-efficacy and performance. This paper describes the integration of mechanical ventilation education into a case-based simulation program and the results of a study measuring self-efficacy and transfer of learning before and after the implementation of a simulation intervention...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236262/comparing-effects-between-music-intervention-and-aromatherapy-on-anxiety-of-patients-undergoing-mechanical-ventilation-in-the-intensive-care-unit-a-randomized-controlled-trial
#16
Chiu-Hsiang Lee, Chiung-Ling Lai, Yi-Hui Sung, Mei Yu Lai, Chung-Ying Lin, Long-Yau Lin
PURPOSE: Using patient-reported outcomes and physiological indicators to test the effects of music intervention and aromatherapy on reducing anxiety for intensive care unit (ICU) patients undergoing mechanical ventilation. METHODS: Patients with ICU admission duration >24 h were randomly assigned to a Music intervention group (n = 41), Aromatherapy group (n = 47), or Control group (rest only; n = 44). Each patient in the Music group listened to music; each patient in the Aromatherapy group received lavender essential oil massage on his/her back for 5 min; each patient in the Control group wore noise-canceling headphones...
February 24, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28236042/respiratory-induced-heart-rate-variability-during-slow-mechanical-ventilation-marker-to-exclude-brain-death-patients
#17
Pavel Jurak, Josef Halamek, Vlastimil Vondra, Peter Kruzliak, Vladimir Sramek, Ivan Cundrle, Pavel Leinveber, Mariusz Adamek, Vaclav Zvonicek
BACKGROUND: Respiratory induced heart rate variability (rHRV) was analysed in mechanically ventilated patients during two levels of sedation and brain death. Our aim was to determine whether rHRV can distinguish between different levels of sedation and especially between brain death and sedated patients. METHODS: In this study 30 critically ill and 23 brain death patients were included and four respiratory rates of 15, 12, 8 and 6 breaths per minute, each lasting 5 min were used...
February 24, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28235962/critical-illness-associated-cerebral-microbleeds
#18
Evgenia M Fanou, Jonathan M Coutinho, Patrick Shannon, Tim-Rasmus Kiehl, Marcel M Levi, M Elizabeth Wilcox, Richard I Aviv, Daniel M Mandell
- BACKGROUND AND PURPOSE: Cerebral microbleeds (petechial hemorrhages) are a well-known consequence of cerebral amyloid angiopathy and chronic hypertension among other causes. We report 12 patients with a clinically and radiologically distinct microbleed phenomenon in the cerebral white matter. METHODS: These patients were assessed at the University Health Network (Toronto, Canada) between 2004 and 2014. RESULTS: Median age was 40 years (range, 27-63 years), and 7 out of 12 patients were women...
February 24, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28231030/safety-of-patient-mobilization-and-rehabilitation-in-the-icu-systematic-review-with-meta-analysis
#19
Peter Nydahl, Thiti Sricharoenchai, Saurabh Chandra, Firuzan Sari Kundt, Minxuan Huang, Magdalena Fischill, Dale M Needham
BACKGROUND: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation. OBJECTIVE: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation...
February 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28230150/an-experimental-study-on-the-impacts-of-inspiratory-and-expiratory-muscles-activities-during-mechanical-ventilation-in-ards-animal-model
#20
Xianming Zhang, Juan Du, Weiliang Wu, Yongcheng Zhu, Ying Jiang, Rongchang Chen
In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs' ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically...
February 23, 2017: Scientific Reports
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