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weaning ultrasound

Doaa El Amrousy, Mohamed Elkashlan, Nagat Elshmaa, Ahmed Ragab
OBJECTIVES: To assess the efficacy of ultrasound-guided laryngeal air column width difference in predicting postextubation stridor in children. DESIGN: Prospective observational study. SETTING: Single, tertiary care pediatric hospital. PATIENTS: This study was carried out at PICU and surgical ICU, Tanta University Hospital on 400 ventilated children between January 2015 and May 2017. Patients who received mechanical ventilation and met criteria for a weaning trial were included...
March 1, 2018: Critical Care Medicine
Nicholas R Zessis, Jennifer L Nicholas, Stephen I Stone
Bilateral adrenal hemorrhages rarely occur during the neonatal period and are often associated with traumatic vaginal deliveries. However, the adrenal gland has highly regenerative capabilities and adrenal insufficiency typically resolves over time. We evaluated a newborn female after experiencing fetal macrosomia and a traumatic vaginal delivery. She developed acidosis and acute renal injury. Large adrenal hemorrhages were noted bilaterally on ultrasound, and she was diagnosed with adrenal insufficiency based on characteristic electrolyte changes and a low cortisol (4...
2018: Endocrinology, Diabetes & Metabolism Case Reports
Pattarin Pirompanich, Sasithon Romsaiyut
Background: Weaning failure is a crucial hindrance in critically ill patients. Rapid shallow breathing index (RSBI), a well-known weaning index, has some limitations in predicting weaning outcomes. A new weaning index using point-of-care ultrasound with diaphragmic thickening fraction (DTF) has potential benefits for improving weaning success. The aim of this study was to evaluate the efficacy of a combination of DTF and RSBI for predicting successful weaning compared to RSBI alone. Methods: This prospective study enrolled patients from the medical intensive care unit or ward who were using mechanical ventilation and readied for weaning...
2018: Journal of Intensive Care
K K Patel, L Howe, N Haack, C Heuer, G W Asher, P R Wilson
This paper investigates Leptospira borgpeterseni serovar Hardjobovis and L. interrogans serovar Pomona as potential causes of sub-optimum pregnancy rates and mid-term abortion in farmed red deer. Rising two-year-old (R2, n = 22,130) and mixed-age (MA, n = 36,223) hinds from 87 and 71 herds, respectively, throughout New Zealand were ultrasound scanned early in gestation (Scan-1) and a sub-sample re-scanned (Scan-2) 55-89 days later and mid-term daily abortion rate calculated. A sub-sample of sera from pregnant and non-pregnant hinds at both scans, both with (case herds) and without aborted hinds was tested for Leptospira using the microscopic agglutination test with titre cut-point ≥1:48 as positive...
February 2018: Veterinary Microbiology
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
Christie L Glau, Thomas W Conlon, Adam S Himebauch, Nadir Yehya, Scott L Weiss, Robert A Berg, Akira Nishisaki
OBJECTIVES: Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm atrophy in children with acute respiratory failure. DESIGN: Prospective, observational study. SETTING: Single-center tertiary noncardiac PICU in a children's hospital. PATIENTS: Invasively ventilated children with acute respiratory failure...
February 5, 2018: Pediatric Critical Care Medicine
El Hamidi Hay, Andy Roberts
Environmental effects have been shown to influence several economically important traits in beef cattle. In this study, genotype x nutritional environment interaction has been evaluated in a composite beef cattle breed (50% Red Angus, 25% Charolais, 25% Tarentaise). Four nutritional environments (MARG-RES, MARG-CTRL, ADEQ-RES and ADEQ-CTRL) were created based on 2 levels of winter supplement provided to dams grazing winter range during gestation (MARG and ADEQ) and 2 levels of input to offspring during post-weaning development (RES and CTRL)...
January 29, 2018: Journal of Animal Science
Ling Luo, Yidan Li, Xiukai Chen, Bing Sun, Wenxiong Li, Wei Gu, Shuo Wang, Song Zhao, Yanwei Lv, Mulei Chen, Jingen Xia, Feng Sui, Xue Mei, Huanzhong Shi, Zhaohui Tong
BACKGROUND: Ultrasound is a convenient tool to evaluate cardiac and diaphragm function. The ratio (E/Ea) of mitral Doppler inflow velocity to annular tissue Doppler wave velocity by transthoracic echocardiography (TTE) and diaphragmatic excursion (DE) by diaphragm ultrasound have been confirmed in predicting extubation outcomes independently, however their different roles in the weaning process have not been determined until now. METHODS: We designed a cohort study to preform diaphragm ultrasound and TTE before and after the spontaneous breathing trial (SBT) in difficult-to-wean patients...
December 1, 2017: BMC Pulmonary Medicine
Arshad Hayat, Aslam Khan, Amir Khalil, Asma Asghar
OBJECTIVE: To measure the diaphragmatic excursion and its outcome on weaning from mechanical ventilation. STUDY DESIGN: Cross-sectional comparative study. PLACE AND DURATION OF STUDY: Medical Intensive Care Unit (ICU), Military Hospital (MH), Rawalpindi, Pakistan, from January to December 2014. METHODOLOGY: Diaphragmatic excursion (DE) in cm was measured through ultrasound by marking liver and spleen displacement in patients who fulfilled the criteria of removal from ventilatory support...
December 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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 (DT f ) 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
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
K E Wurtz, J M Siegford, R O Bates, C W Ernst, J P Steibel
Pigs housed in groups are remixed with unfamiliar individuals, which can trigger aggressive interactions, potentially compromising animal welfare. Skin lesions are a reliable indicator trait of aggression and are moderately heritable, suggesting that aggression may be reduced through selection. This study estimated genetic parameters of skin lesions of pigs at multiple life stages, explored genetic correlations of skin lesions between age groups and body location, and studied the relationship between skin lesions and production traits of commercial importance...
October 2017: Journal of Animal Science
P M Furini, R A Azevedo, S R A Rufino, F S Machado, M M Campos, L G R Pereira, T R Tomich, B C Carvalho, G B Santos, S G Coelho
The aim of this study was to determine the effect of increasing total solids (TS) in the liquid diet during the preweaning phase on mammary gland development in dairy heifers. The increase in TS was obtained with the addition of milk replacer powder to whole milk. Crossbreed Holstein-Gyr heifers (n = 60) were distributed in 4 treatments with different TS concentrations: 13.5% (n = 15), 16.1% (n = 15), 18.2% (n = 15), and 20.4% (n = 15). The liquid diets were provided from 5 to 55 d of age. From 56 to 59 d of age, the total amount of liquid feed was reduced by half...
November 2, 2017: Journal of Dairy Science
Hussam Kanaan Hamadah, Mohamed Salim Kabbani
Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. This educational article based mainly on our own experience is highlighting the role of US in detecting the most common causes of respiratory weaning difficulties and extubation failure in postoperative cardiac children through proposed illustration and algorithm...
2017: Journal of Clinical Imaging Science
Suraj Yalamuri, Rebecca Y Klinger, W Michael Bullock, Donald D Glower, Brandi A Bottiger, Jeffrey C Gadsden
INTRODUCTION: Patients undergoing minimally invasive cardiac surgery have the potential for significant pain from the thoracotomy site. We report the successful use of pectoral nerve block types I and II (Pecs I and II) as rescue analgesia in a patient undergoing minimally invasive mitral valve repair. CASE REPORT: In this case, a 78-year-old man, with no history of chronic pain, underwent mitral valve repair via right anterior thoracotomy for severe mitral regurgitation...
November 2017: Regional Anesthesia and Pain Medicine
R R Ulguim, F P Bortolozzo, I Wentz, M Johnston, S K Webel, L Arend, R V Knox
Boar exposure is used to stimulate follicle development and estrus in sows after weaning and also to improve semen uptake and sperm transport with insemination. However, the need and value of boar exposure is uncertain when ovulation induction is used. These studies were designed to determine the effect of daily boar exposure after weaning when used with ovulation induction and fixed time post-cervical artificial insemination (PCAI). In experiment 1, sows were weaned into stalls and assigned to receive 3 min of daily fenceline boar exposure (BE, n = 7) or no boar exposure (NBE, n = 8)...
January 1, 2018: Theriogenology
X Y Li, H Y He, X Tang, R Wang, C Y Zhang, S Q Wang, B Sun, Z H Tong
Objective: To review the experience of percutaneous catheterization for extracorporeal membrane oxygenation (ECMO) by respiratory intensivists at a single institution. Methods: A retrospective review of 87 patients undergoing percutaneous catheterization for ECMO in Department of Respiratory and Critical Care Medicine of Beijing Chaoyang Hospital from November 2009 to January 2017. Subject demographics, type of support, cannulation configuration, types of cannulas, use of imaging modalities, and complications were recorded and summarized...
September 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
Ana M Llamas-Álvarez, Eva M Tenza-Lozano, Jaime Latour-Pérez
BACKGROUND: Deciding the optimal timing for extubation in patients who are mechanically ventilated can be challenging, and traditional weaning predictor tools are not very accurate. The aim of this systematic review and meta-analysis was to assess the accuracy of lung and diaphragm ultrasound for predicting weaning outcomes in critically ill adults. METHODS: MEDLINE, the Cochrane Library, Web of Science, Scopus, LILACS, Teseo, Tesis Doctorales en Red, and OpenGrey were searched, and the bibliographies of relevant studies were reviewed...
December 2017: Chest
Ana Carolina Peçanha Antonio, Cassiano Teixeira, Priscylla Souza Castro, Augusto Savi, Juçara Gasparetto Maccari, Roselaine Pinheiro Oliveira, Marli Maria Knorst
Objective: We aimed to investigate a potential association between B-lines and weaning failure. Methods: Fifty-seven subjects eligible for ventilation liberation were enrolled. Patients with tracheostomy were excluded. Lung ultrasound assessments of six thoracic zones were performed immediately before and at the exnd of the spontaneous breathing trial. B-predominance was defined as any profile with anterior bilateral B-pattern. Patients were followed up to 48 hours after extubation...
August 21, 2017: Revista Brasileira de Terapia Intensiva
Pierfrancesco Fusco, Paolo Scimia, Stefano Di Carlo, Ambra Testa, Antonio Luciani, Emiliano Petrucci, Franco Marinangeli
Painful rib fractures may be a factor in trauma patients remaining intubated and being given postoperative mechanical ventilation after emergency surgery. Regional techniques could provide sufficient analgesia in these patients to enable weaning and extubation and thus prevent or minimize complications related to prolonged ventilatory support. We describe a trauma patient with multiple rib fractures requiring an emergency splenectomy for whom an ultrasound-guided serratus plane block provided good quality pain relief for his rib fractures and enabled fast-track extubation in the operating room...
December 1, 2017: A & A Case Reports
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