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https://www.readbyqxmd.com/read/28820557/papillary-muscle-rupture-in-an-adolescent-with-no-coronary-lesions
#1
Tatjana Lejko Zupanc, Mateja Logar
A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors' hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28820175/noninvasive-mechanical-ventilation-in-early-acute-respiratory-distress-syndrome
#2
Alice Grassi, Giuseppe Foti, John G Laffey, Giacomo Bellani
Non invasive ventilation (NIV) has a well established role in the treatment of acute-on-chronic respiratory failure and cardiogenic pulmonary oedema. Its role in acute hypoxaemic respiratory failure has been increasingly investigated, but its impact on the management and the outcome of the subset of patients affected by acute respiratory distress syndrome (ARDS) is still to be determined. ARDS could be a risk factor for NIV failure and in these patient delayed endotracheal intubation can lead to an increased mortality...
August 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#3
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28819204/prognostic-factors-and-outcomes-of-unplanned-extubation
#4
Chien-Ming Chao, Mei-I Sung, Kuo-Chen Cheng, Chih-Cheng Lai, Khee-Siang Chan, Ai-Chin Cheng, Shu-Chen Hsing, Chin-Ming Chen
This study investigated the prognostic factors and outcomes of unplanned extubation (UE) in patients in a medical center's 6 intensive care units (ICUs) and calculated their mortality risk. We retrospectively reviewed the medical records of all adult patients in Chi Mei Medical Center who underwent UE between 2009 and 2015. During the study period, there were 305 episodes of UE in 295 ICU patients (men: 199 [67.5%]; mean age: 65.7 years; age range: 18-94 years). The mean Acute Physiology and Chronic Health Evaluation (APACHE) II score was 16...
August 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28818854/nasal-midazolam-vs-ketamine-for-neonatal-intubation-in-the-delivery-room-a-randomised-trial
#5
Christophe Milési, Julien Baleine, Thibault Mura, Fernando Benito-Castro, Félicie Ferragu, Gérard Thiriez, Pierre Thévenot, Clémentine Combes, Ricardo Carbajal, Gilles Cambonie
OBJECTIVE: To compare the effectiveness of sedation by intranasal administration of midazolam (nMDZ) or ketamine (nKTM) for neonatal intubation. DESIGN: A multicentre, prospective, randomised, double-blind study. SETTING: Delivery rooms at four tertiary perinatal centres in France. PATIENTS: Preterm neonates with respiratory distress requiring non-emergent endotracheal intubation for surfactant instillation. INTERVENTIONS: Treatment was randomly allocated, with each neonate receiving a bolus of 0...
August 17, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28818610/surfactant-and-continuous-positive-airway-pressure-for-the-prevention-of-chronic-lung-disease-history-reality-and-new-challenges
#6
REVIEW
Hany Aly, Mohamed A Mohamed, Jen-Tien Wung
The discovery of surfactant was one of the most significant research events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered non-viable. However, the prevention of chronic lung disease did not progress and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. A dilemma exists over the priorities in premature management to intubate and administer surfactant or not to intubate and support these infants non-invasively with the use of continuous positive airway pressure...
August 14, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28818509/the-use-of-high-flow-nasal-cannula-in-the-pediatric-emergency-department
#7
REVIEW
Katherine N Slain, Steven L Shein, Alexandre T Rotta
OBJECTIVES: To summarize the current literature describing high-flow nasal cannula (HFNC) use in children, the components and mechanisms of action of a HFNC system, the appropriate clinical applications, and its role in the pediatric emergency department (ED). SOURCES: A computer-based search of PubMed/MEDLINE and Google Scholar for literature on HFNC use in children was performed. DATA SUMMARY: HFNC, a non-invasive respiratory support modality, provides heated and fully humidified gas mixtures to patients via a nasal cannula interface...
August 14, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28818319/-a-comparative-cost-analysis-of-single-use-versus-reusable-fiberoptic-bronchoscopes-is-single-use-fiberscope%C3%A2-worth-it
#8
M Videau, K Rghioui, B Mottet, A Sainfort, I Lefort
OBJECTIVE: To present a minimization-cost analysis to compare reusable and single-use fiberscopes in a French health institution. MATERIALS AND METHODS: The amortization cost assessment has been achieved over a period of five years, and took into account the acquisition and maintenance costs, as well as the costs related to disinfection of reusable fiberscopes. The cost of single-use fiberscopes was calculated according to its acquisition and elimination costs. Finally, we compared the costs of single-use vs...
August 14, 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/28818188/healthcare-outcomes-in-undocumented-immigrants-undergoing-two-emergency-dialysis-approaches%C3%A2
#9
S Jawad Sher, Ranjani N Moorthi, Waqas Aftab, Sharon M Moe, Christopher S Weaver, Frank C Messina, Nancy M Martinez-Hoover, Melissa D Anderson, Michael T Eadon
BACKGROUND: Current estimates suggest 6,500 undocumented end-stage renal disease (ESRD) patients in the United States are ineligible for scheduled hemodialysis and require emergent dialysis. In order to remain in compliance with Emergency Medicaid, an academic health center altered its emergency dialysis criteria from those emphasizing interdialytic interval to a set emphasizing numerical thresholds. We report the impact of this administrative change on the biochemical parameters, utilization, and adverse outcomes in an undocumented patient cohort...
August 17, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#10
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28817604/therapeutic-flexible-airway-endoscopy-of-small-children-in-a-tertiary-referral-center-11-years-experience
#11
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Use of therapeutic flexible airway endoscopy (TFAE) is very limited in pediatrics. We report our clinical experiences and long term outcomes of TFAE in small children from a single tertiary referral center. METHODS: This is a retrospective cohort study. Small children with their body weight no more than 5.0 kg who had received TFAE between 2005 and 2015 were enrolled. Demographic information and outcomes were reviewed and analyzed from medical charts and TFAE videos...
2017: PloS One
https://www.readbyqxmd.com/read/28817480/revised-national-estimates-of-emergency-department-visits-for-sepsis-in-the-united-states
#12
Henry E Wang, Allison R Jones, John P Donnelly
OBJECTIVES: The emergency department is an important venue for initial sepsis recognition and care. We sought to determine contemporary estimates of the epidemiology of U.S. emergency department visits for sepsis. DESIGN: Analysis of data from the National Hospital Ambulatory Medical Care Survey. SETTING: U.S. emergency department visits, 2009-2011. PATIENTS: Adult (age, ≥ 18 yr) emergency department sepsis patients...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28816919/enteral-nutrition-practices-in-critically-ill-children-requiring-noninvasive-positive-pressure-ventilation
#13
Matthew K Leroue, Ryan J Good, Heather E Skillman, Angela S Czaja
OBJECTIVES: Evaluate the practice of providing enteral nutrition in critically ill children requiring noninvasive positive pressure ventilation. DESIGN: Retrospective cohort study. SETTING: PICU within a quaternary care children's hospital. PATIENTS: PICU patients older than 30 days requiring noninvasive positive pressure ventilation for greater than or equal to 24 hours from August 2014 to June 2015. Invasive mechanical ventilation prior to noninvasive positive pressure ventilation and inability to receive enteral nutrition at baseline were additional exclusionary criteria...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28816881/the-shikani-optical-stylet-as-an-alternative-to-awake-fiberoptic-intubation-in-patients-at-risk-of-secondary-cervical-spine-injury-a-randomized-controlled-trial
#14
Rabab S S Mahrous, Aly M M Ahmed
BACKGROUND: Conventional intubation of the trachea and consequent prone positioning of anesthetized patients with cervical spine instability may result in secondary neurological injury. Historically, flexible fiberoptics used to be the chief choice for patients presenting with cervical spine instability surgery with difficult airway. Recently, the rigid optical stylets have shown promise in assisting difficult intubations. PURPOSE: The aim of the present study was to compare the efficacy of Shikani optical stylet (SOS) with the flexible fiberscope for awake intubation in patients with cervical spine instability...
August 14, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28816565/dacryocystectomy-as-a-treatment-of-chronic-dacryocystitis-in-the-elderly
#15
Mariana N Meireles, Magda Mh Viveiros, Roberta Lfs Meneghin, Alicia Galindo-Ferreiro, Mariângela Ea Marques, Silvana A Schellini
To evaluate the dacryocystectomy (DCT) outcomes for chronic dacryocystitis in an elderly population over 70 years old. A retrospective chart review was performed for patients over 70 years old who were diagnosed with chronic dacryocystitis and underwent DCT at the Botucatu School of Medicine, UNESP, Brazil, from 2007 to July 2014. Data were collected about patient demographics, age, gender, previous nasal, or ophthalmic diseases, symptoms related to the lacrimal drainage system preoperatively and postoperatively, signs of enlargement of the lacrimal sac (regurgitation of secretion), and histopathologic evaluation...
August 17, 2017: Orbit
https://www.readbyqxmd.com/read/28816011/lessons-learnt-from-incidents-involving-the-airway-and-breathing-reported-from-australasian-emergency-departments
#16
Carmel Crock, Kim Hansen, Toby Fogg, Angela Cahill, Anita Deakin, William B Runciman
OBJECTIVE: To review incident reports relating to problems encountered during the ED management of patients with 'airway or breathing' problems, with the aim of finding and highlighting common themes within these rare events, and making recommendations to further improve patient safety in the areas in which deficiencies have been identified. METHODS: Thematic analysis of 36 incidents reported from Australasian EDs, which were related to problems with airway and breathing...
August 16, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28815143/analyzing-electronic-medical-records-to-predict-risk-of-dit-death-intubation-or-transfer-to-icu-in-pediatric-respiratory-failure-or-related-conditions
#17
Teeradache Viangteeravat, Oguz Akbilgic, Robert Lowell Davis
Large volumes of data are generated in hospital settings, including clinical and physiological data generated during the course of patient care. Our goal, as proof of concept, was to identify early clinical factors or traits useful for predicting the outcome, of death, intubation, or transfer to ICU, for children with pediatric respiratory failure. We implemented both supervised and unsupervised methods to extend our understanding on statistical relationships in clinical and physiological data. As a supervised learning method, we use binary logistic regression to predict the risk of developing DIT outcome...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814597/hydropneumothorax-as-an-iatrogenic-complication-after-nasogastric-intubation
#18
Hugo Jorge Casimiro, Joana Carreira, Beatriz Navarro, Mário Parreira
No abstract text is available yet for this article.
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814580/ventrain-from-theory-to-practice-bridging-until-re-tracheostomy
#19
Bianca Maria Wahlen, Hassan Al-Thani, Ayman El-Menyar
Imminent upper airway obstruction due to life-threatening tracheal stenosis of any cause is challenging. A 77-year-old woman, with a history of temporal tracheostomy for prolonged mechanical ventilation, presented with life-threatening tracheal stenosis to the emergency department. After failed intubation with a 5.0 mm internal diameter endotracheal tube, the patient was ventilated via a tube exchanger using Ventrain. Ventrain is a manual ventilation device that, in addition to oxygen supply during inspiration, initiates expiration by actively removing gas from the lungs by suction...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814478/effect-of-patient-weight-on-first-pass-success-and-neuromuscular-blocking-agent-dosing-for-rapid-sequence-intubation-in-the-emergency-department
#20
Asad E Patanwala, John C Sakles
OBJECTIVES: The primary objective of this study was to determine the association between patient weight and first pass success (FPS) during rapid sequence intubation (RSI) in the ED. The secondary objective was to evaluate the association between patient weight and neuromuscular blocking agent (NMBA) dosing. METHODS: This was a retrospective cohort study conducted in a tertiary care academic ED. Consecutive adult patients who underwent RSI in the ED between January 2014 and June 2016 were included...
August 16, 2017: Emergency Medicine Journal: EMJ
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