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weaning ultrasound

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https://www.readbyqxmd.com/read/28343681/ultrasound-evaluation-of-diaphragm-function-and-its-application-in-critical-patients-mechanical-ventilation-and-brachial-plexus-block
#1
F de B de la Quintana Gordon, B Nacarino Alcorta, M Fajardo Pérez
Before diaphragm ultrasonography, assessment of diaphragm function was very difficult due to the complex nature of its exploration. The use of this new technique has shed light on diagnostic problems and treatment with an improvement in final outcomes for critically ill patients, in whom the incidence of diaphragm weakness or dysfunction has been underestimated. Better knowledge of diaphragm function enables us earlier diagnosis by quantification of diaphragm contractile activity or evaluation of functional status after delivery of plexus block anaesthesia, facilitating therapeutic decisions...
March 23, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#2
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28237336/effect-of-numbers-of-sperm-and-timing-of-a-single-post-cervical-insemination-on-the-fertility-of-weaned-sows-treated-with-ovugel-%C3%A2
#3
R V Knox, K C Esparza-Harris, M E Johnston, S K Webel
Variability in estrus and ovulation requires multiple inseminations during estrus to ensure one AI occurs close to ovulation. Induction of ovulation after weaning improves synchrony of ovulation and allows for fixed time AI. However, the interaction between number of sperm in the AI dose and the timing of insemination has not been fully investigated. The objective of this study was to determine the effects of sperm numbers used in a single post-cervical insemination (PCAI) and the timing of insemination following induced ovulation in weaned sows...
April 1, 2017: Theriogenology
https://www.readbyqxmd.com/read/28215891/thoracic-ultrasound-assessment-of-lung-consolidation-at-weaning-in-holstein-dairy-heifers-reproductive-performance-and-survival
#4
A G V Teixeira, J A A McArt, R C Bicalho
The objective of this study was to determine the association of lung consolidation at weaning with later reproductive performance and survival. Ultrasonography of the lungs was performed at 60 d of life in recently weaned Holstein heifer calves from a single farm in New York State. Thoracic screening covered the right 2nd through 10th and left 3rd through 9th intercostal spaces and was performed using a 6.2-MHz linear transducer. Each calf was classified as not having lung consolidation (hyperechoic line with reverberation artifact with or without comet tail) or with lung consolidation (any detectable heterogeneous hypoechoic area)...
February 16, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28183365/calm-merino-ewes-have-a-higher-ovulation-rate-and-more-multiple-pregnancies-than-nervous-ewes
#5
E van Lier, K W Hart, C Viñoles, B Paganoni, D Blache
In 1990, two selection lines of Merino sheep were established for low and high behavioural reactivity (calm and nervous temperament) at the University of Western Australia. Breeding records consistently showed that calm ewes weaned 10% to 19% more lambs than the nervous ewes. We hypothesise that calm ewes could have a higher ovulation rate than nervous ewes and/or calm ewes could have a lower rate of embryo mortality than nervous ewes. We tested these hypotheses by comparing the ovulation rate and the rate of embryo mortality between the calm and nervous lines before and after synchronisation and artificial insemination...
February 10, 2017: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/28177361/effects-of-temperament-on-physiological-productive-and-reproductive-responses-in-beef-cows
#6
R F Cooke, K M Schubach, R S Marques, R F G Peres, L G T Silva, R S Carvalho, R S Cipriano, D W Bohnert, A V Pires, J L M Vasconcelos
This experiment evaluated the effects of temperament on physiological, productive, and reproductive responses in beef cows. A total of 953 lactating, multiparous, non-pregnant Nelore cows (age = 99 ± 2 mo; days post-partum = 51.4 ± 0.3 d; BCS = 5.34 ± 0.04; BW = 430 ± 2 kg) were allocated into 8 groups of approximately 120 cows each. Groups were assigned to an estrus synchronization + timed-AI protocol at the beginning of the breeding season. Concurrently with AI, blood samples were collected, hair samples were clipped from the tail switch, and cow temperament was evaluated via chute score and exit velocity...
January 2017: Journal of Animal Science
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#7
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28104135/renal-allograft-aspergillus-infection-presenting-with-obstructive-uropathy-a-case-report
#8
L Sadagah, M Alharbi, M Alshomrani, A Almalki
BACKGROUND: Isolated renal allograft aspergillosis is rare and usually presents with fever and decreased glomerular filtration rate. Presentation with obstructive uropathy caused by aspergillus fungal balls is much less common. We report a young male patient who presented with obstructive uropathy secondary to isolated renal allograft aspergillus infection 6 weeks after transplant. He was treated with nephrectomy and antifungal medications. CASE PRESENTATION: A 29-year-old Saudi male patient had a recent living non-related kidney transplantation in Pakistan...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28042157/follicular-dynamics-and-ovulation-time-in-gilts-and-post-weaning-sows
#9
Sara I Williams, R Luzbel de la Sota
Ultrasonography was used to study follicular dynamics from the beginning of estrus to ovulation in pubertal gilts and post-weaning sows. Ultrasound turned out to be a useful tool to determine patterns of growth of preovulatory follicles, to predict ovulation time, and to design protocols for fixed time insemination.
January 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#10
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/27766377/-diaphragm-dysfunction-facts-for-clinicians
#11
REVIEW
C S Bruells, G Marx
Diaphragm function is crucial for patient outcome in the ICU setting and during the treatment period. The occurrence of an insufficiency of the respiratory pump, which is predominantly formed by the diaphragm, may result in intubation after failure of noninvasive ventilation. Especially patients suffering from chronic obstructive pulmonary disease are in danger of hypercapnic respiratory failure. Changes in biomechanical properties and fiber texture of the diaphragm are further cofactors directly leading to a need for intubation and mechanical ventilation...
October 20, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27756436/acute-presentation-of-a-giant-intrathyroidal-parathyroid-adenoma-a-case-report
#12
Stephanie Rutledge, Michele Harrison, Martin O'Connell, Tadhg O'Dwyer, Maria M Byrne
BACKGROUND: We report the case of a giant intrathyroidal parathyroid adenoma weighing 59 g in a young woman presenting acutely with severe hypercalcemia requiring correction and adequate preoperative management prior to surgery. Parathyroid adenomas account for 85 % of cases of primary hyperparathyroidism. Those weighing more than 3.5g are classified as giant parathyroid adenomas. There are only 25 cases of parathyroid adenomas weighing over 30g reported in the literature. With the wide availability of biochemical screening tests in Western countries, mildly elevated calcium levels are often discovered incidentally...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27682813/diaphragmatic-dysfunction-is-characterized-by-increased-duration-of-mechanical-ventilation-in-subjects-with-prolonged-weaning
#13
Zhihua Lu, Qiuping Xu, Yuehua Yuan, Ge Zhang, Feng Guo, Huiqing Ge
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27647376/ultrasonographic-diaphragmatic-excursion-is-inaccurate-and-not-better-than-the-mrc-score-for-predicting-weaning-failure-in-mechanically-ventilated-patients
#14
Cédric Carrie, Chloé Gisbert-Mora, Eline Bonnardel, Bernard Gauche, Matthieu Biais, Frédéric Vargas, Gilles Hilbert
PURPOSE: To assess the ability of diaphragmatic ultrasound (US) to predict weaning failure in mechanically ventilated patients undergoing a first spontaneous breathing trial (SBT). METHODS: During a 4-month period, 67 consecutive patients eligible for a first SBT underwent US measurements of maximal diaphragmatic excursion (MDE) by a right anterior subcostal approach. Weaning failure was defined as either the failure of SBT or the need for resumption of ventilatory support for acute respiratory failure or death within 48h following successful extubation...
February 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27620292/assessment-of-diaphragmatic-dysfunction-in-the-critically-ill-patient-with-ultrasound-a-systematic-review
#15
Massimo Zambon, Massimiliano Greco, Speranza Bocchino, Luca Cabrini, Paolo Federico Beccaria, Alberto Zangrillo
PURPOSE: Diaphragmatic dysfunction (DD) has a high incidence in critically ill patients and is an under-recognized cause of respiratory failure and prolonged weaning from mechanical ventilation. Among different methods to assess diaphragmatic function, diaphragm ultrasonography (DU) is noninvasive, rapid, and easy to perform at the bedside. We systematically reviewed the current literature assessing the usefulness and accuracy of DU in intensive care unit (ICU) patients. METHODS: Pubmed, Cochrane Database of Systematic Reviews, Embase, Scopus, and Google Scholar Databases were searched for pertinent studies...
January 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27512490/adrenal-cushing-s-syndrome-in-pregnancy-clinical-and-molecular-characterisation-of-a-case
#16
Anne Trinh, Irene Chan, Maria Alexiadis, Medina Pell, Beena Kumar, Peter J Fuller
BACKGROUND: Cushing's syndrome is rare during pregnancy and more commonly due to adrenal pathology, in contrast to the non-pregnant population. Increased levels of cortisol-binding globulin and placental production of corticotropin-releasing hormone and adrenocorticotropic hormone complicate the diagnostic strategies usually employed. CASE: A 32-year-old G1P0 at 15/40 gestation presented with severe peripheral oedema and excessive weight gain. Examination revealed pitting oedema to the abdominal wall, wide violaceous striae, moon facies and acne...
March 2016: Obstetric Medicine
https://www.readbyqxmd.com/read/27500981/mitigation-of-ventilator-induced-diaphragm-atrophy-by-transvenous-phrenic-nerve-stimulation
#17
Steven C Reynolds, Ramasamy Meyyappan, Viral Thakkar, Bao D Tran, Marc-André Nolette, Gautam Sadarangani, Rodrigo A Sandoval, Laura Bruulsema, Brett Hannigan, Jason W Li, Elizabeth Rohrs, Jason Zurba, Joaquín Andrés Hoffer
RATIONALE: Ventilator-induced diaphragm dysfunction is a significant contributor to weaning difficulty in ventilated critically ill patients. It has been hypothesized that electrically pacing the diaphragm during mechanical ventilation could reduce diaphragm dysfunction. OBJECTIVES: We tested a novel, central line catheter-based, transvenous phrenic nerve pacing therapy for protecting the diaphragm in sedated and ventilated pigs. METHODS: Eighteen Yorkshire pigs were studied...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27468680/ultrasound-guided-laryngeal-air-column-width-difference-and-the-cuff-leak-volume-in-predicting-the-effectiveness-of-steroid-therapy-on-postextubation-stridor-in-adult-are-they-useful
#18
Ghada F El-Baradey, Nagat S El-Shmaa, Fatma Elsharawy
OBJECTIVE: To evaluate the effectiveness of steroids therapy on postextubation stridor (PES) depending on the clinical response, the ultrasound guided laryngeal air column width difference (LACWD) and the cuff leak volume (CLV). DESIGN: Prospective, observer-blinded study. SETTING: Carried out in intensive care unit in Tanta university hospital. PATIENTS: 432 patients of both sexes received mechanical ventilation for more than 24 hours and met defined criteria for a weaning trial...
December 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/27422706/change-in-diaphragmatic-thickness-during-the-respiratory-cycle-predicts-extubation-success-at-various-levels-of-pressure-support-ventilation
#19
Scott Blumhof, David Wheeler, Kendol Thomas, F Dennis McCool, Jorge Mora
PURPOSE: Ultrasonographic assessment of diaphragm function with patients on low levels of pressure support (PS) predicts extubation outcomes, but similar information regarding extubation success under other conditions is lacking. The purpose of this study was to determine whether ultrasound (US) measurements of the diaphragm made on various levels of PS can predict time until successful extubation. METHODS: Fifty-six intubated patients underwent ultrasound of the right hemidiaphragm during a PS wean at varying levels of pressure support (PS 5/5 cm of H2O, 10/5 cm of H2O, and 15/5 cm of H2O)...
August 2016: Lung
https://www.readbyqxmd.com/read/27397793/human-chorionic-gonadotrophin-in-early-gestation-induces-growth-of-estrogenic-ovarian-follicles-and-improves-primiparous-sow-fertility-during-summer
#20
Jemma Seyfang, P Langendijk, T Y Chen, E Bouwman, R N Kirkwood
Reduced summer farrowing rates may be due to inadequate corpora luteal (CL) support. Porcine CL become dependent on LH from 12 d of pregnancy and the embryonic estrogen signal for maternal recognition of pregnancy (MRP) is initiated at about 11-12 d after insemination. We hypothesised that injection of the LH analogue human chorionic gonadotropin (hCG) would induce growth of estrogenic follicles and, by mimicking the signal for MRP and stimulating progesterone secretion, increase primiparous sow fertility. In Experiment 1, during a 28 d lactation 53 mixed parity sows were full-fed either throughout lactation (n=16) or until 18 d and then feed restricted during the last 10 d of lactation (n=36)...
September 2016: Animal Reproduction Science
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