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ventilator associated pneumonia

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https://www.readbyqxmd.com/read/29149418/randomized-multicenter-trial-of-lateral-trendelenburg-versus-semirecumbent-body-position-for-the-prevention-of-ventilator-associated-pneumonia
#1
Gianluigi Li Bassi, Mauro Panigada, Otavio T Ranzani, Alberto Zanella, Lorenzo Berra, Massimo Cressoni, Vieri Parrini, Hassan Kandil, Giovanni Salati, Paola Selvaggi, Alessandro Amatu, Miquel Sanz-Moncosi, Emanuela Biagioni, Fernanda Tagliaferri, Mirella Furia, Giovanna Mercurio, Antonietta Costa, Tullio Manca, Simone Lindau, Jaksa Babel, Marco Cavana, Chiara Chiurazzi, Joan-Daniel Marti, Dario Consonni, Luciano Gattinoni, Antonio Pesenti, Janine Wiener-Kronish, Cecilia Bruschi, Andrea Ballotta, Pierpaolo Salsi, Sergio Livigni, Giorgio Iotti, Javier Fernandez, Massimo Girardis, Maria Barbagallo, Gabriella Moise, Massimo Antonelli, Maria Luisa Caspani, Antonella Vezzani, Patrick Meybohm, Vladimir Gasparovic, Edoardo Geat, Marcelo Amato, Michael Niederman, Theodor Kolobow, Antoni Torres
PURPOSE: The lateral Trendelenburg position (LTP) may hinder the primary pathophysiologic mechanism of ventilator-associated pneumonia (VAP). We investigated whether placing patients in the LTP would reduce the incidence of VAP in comparison with the semirecumbent position (SRP). METHODS: This was a randomized, multicenter, controlled study in invasively ventilated critically ill patients. Two preplanned interim analyses were performed. Patients were randomized to be placed in the LTP or the SRP...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29143487/nurses-implementation-of-ventilator-associated-pneumonia-prevention-guidelines-an-observational-study-in-jordan
#2
Sami M Aloush
BACKGROUND: Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable. AIMS: The purpose of this study was to assess nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that influence their compliance...
November 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29141794/short-term-outcome-of-adem-results-from-a-retrospective-cohort-study-from-south-india
#3
Mary Iype, P A Mohammed Kunju, Geetha Saradakutty, T S Anish, Mini Sreedharan, Shahanaz M Ahamed
INTRODUCTION: Acute disseminated encephalomyelitis (ADEM), an immune mediated inflammatory disease is common in children. The profile and immediate outcome of children hospitalized with ADEM is scarce in the available literature. OBJECTIVES: We aimed to study the clinical profile of children with ADEM and to look for prognostic factors for outcome at discharge from hospital METHODS: We chose a retrospective cohort study of all children diagnosed with ADEM at our institution between January 2006 and December 2015, and they were evaluated, after excluding other diagnoses when they were summoned for a follow up visit...
November 2017: Multiple Sclerosis and related Disorders
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#4
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140452/mechanical-ventilation-induces-il-4-secretion-in-lungs-and-reduces-the-phagocytic-capacity-of-lung-macrophages
#5
Kenny Bielen, Bart 's Jongers, Jan Boddaert, Christine Lammens, Philippe G Jorens, Surbhi Malhotra-Kumar, Herman Goossens, Samir Kumar-Singh
Patients receiving mechanical ventilation are at risk of developing ventilator-associated pneumonia. Here, we show that clinically utilized ventilation protocols in rat with 5 or 8 mL/kg tidal volumes cause increased IL-4 expression, lowered ratio of TH1:TH2 transcriptional factors (Tbet:Gata3) and increased arginase1-positive (Arg1+) macrophages and eosinophils in lungs. Macrophages from ventilated lungs had reduced ex vivo capacity towards phagocytosing bacteria. Ventilated animals, when further challenged with bacterial pneumonia, continued to show persistence of Arg1+ M2 macrophages as well as an increased bacterial burden compared to spontaneously breathing animals receiving the same bacterial dose...
November 13, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#6
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29134423/perioperative-respiratory-complications-current-evidence-and-strategy-discussed-in-2017-ja-symposium
#7
K Hirota, M Yamakage, S Hashimoto, T Asai, S Isono
Respiratory management during general anesthesia aims to safely secure the airway and maintain adequate ventilation to deliver oxygen to the vital organs, maintaining homeostasis even during surgery. Despite its clinical importance, anesthesiologists often encounter difficulties in properly managing respiration during the perioperative period, leading to severe respiratory complications. In this year's JA symposium, 5 editorial board members of Journal of Anesthesia (JA) who are experts in the field of respiratory management in anesthesia discussed the following topics: quitting smoking before surgery: exposure to passive smoke is damaging to children, ventilator-associated pneumonia, high inspiratory oxygen concentration and lung injury, aspiration pneumonia, and postoperative respiratory management strategy in patients with obstructive sleep apnea...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29132696/development-and-validation-of-an-automated-ventilator-associated-event-electronic-surveillance-system-a-report-of-a-successful-implementation
#8
Courtney Hebert, Jennifer Flaherty, Justin Smyer, Jing Ding, Julie E Mangino
BACKGROUND: Surveillance is an important tool for infection control; however, this task can often be time-consuming and take away from infection prevention activities. With the increasing availability of comprehensive electronic health records, there is an opportunity to automate these surveillance activities. The objective of this article is to describe the implementation of an electronic algorithm for ventilator-associated events (VAEs) at a large academic medical center METHODS: This article reports on a 6-month manual validation of a dashboard for VAEs...
November 10, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29128779/noninvasive-ventilation-failure-in-pneumonia-patients-%C3%A2-65years-old-the-role-of-cough-strength
#9
Yueling Hong, Jun Duan, Linfu Bai, Xiaoli Han, Shicong Huang, Shuliang Guo
PURPOSE: To explore the association between cough strength and outcomes in elderly patients who received noninvasive ventilation (NIV) due to acute respiratory failure caused by pneumonia. MATERIALS AND METHODS: We enrolled patients ≥65years old with acute respiratory failure caused by pneumonia. Just before NIV treatment, cough strength was assessed on a cough-strength scale graded from 0 to 5. Patients graded 0-2 were defined as having no/weak coughs and those graded 3-5 were defined as having moderate/strong coughs...
November 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#10
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29126595/burn-patients-with-infection-related-ventilator-associated-complications-have-worse-outcomes-compared-to-those-without-ventilator-associated-events
#11
Duraid Younan, Russell Griffin, Ahmed Zaky, Jean-Francois Pittet, Bernard Camins
BACKGROUND: The Centers for Disease Control and Prevention (CDC) replaced its definition for ventilator-associated pneumonia (VAP) in 2013. The aim of the current study is to compare the outcome of burn patients with ventilator associated events (VAEs). METHODS: Burn patients with at least two days of ventilator support were identified from the registry between 2013 and 2016. Kruskal-Wallis and Fisher's exact tests were utilized for continuous and categorical variables, respectively...
October 31, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29124026/risk-factors-for-pneumonia-in-ventilated-trauma-patients-with-multiple-rib-fractures
#12
Hyun Oh Park, Dong Hoon Kang, Seong Ho Moon, Jun Ho Yang, Sung Hwan Kim, Joung Hun Byun
Background: Ventilator-associated pneumonia (VAP) is a common disease that may contribute to morbidity and mortality among trauma patients in the intensive care unit (ICU). This study evaluated the associations between trauma factors and the development of VAP in ventilated patients with multiple rib fractures. Methods: We retrospectively and consecutively evaluated 101 patients with multiple rib fractures who were ventilated and managed at our hospital between January 2010 and December 2015, analyzing the associations between VAP and trauma factors in these patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29122697/early-administration-of-appropriate-antimicrobial-agent-to-improve-the-outcome-of-carbapenem-resistant-acinetobacter-baumannii-complex-bacteremic-pneumonia
#13
Seong Yeon Park, Eun Jung Lee, Tark Kim, Shi Nae Yu, Ki-Ho Park, Mi Suk Lee, Se Yoon Park, Min Hyok Jeon, Tae Hyong Kim, Eun Ju Choo
BACKGROUND: Carbapenem resistant Acinetobacter baumannii complex (CRABC) is an emerging pathogen that causes bloodstream infections and nosocomial pneumonia. This study aimed to describe the severe infection associated with CRABC bacteremic pneumonia and to investigate risk factors for 28-day mortality. METHODS: All patients ≥18 years of age with a CRABC bacteremic pneumonia were enrolled retrospectively at five teaching hospitals in South Korea. Empirical antimicrobial therapy was defined as appropriate if administration of at least one antimicrobial agent, to which the causative pathogen was susceptible, more than 48 hours, within 5 days of the onset of bacteremia...
November 6, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/29120150/incidence-etiology-and-outcome-of-ventilator-associated-pneumonia-in-patients-with-percutaneous-tracheotomy
#14
Tihana Magdić Turković, Melanija Obraz, Milana Zlatić Glogoški, Ida Juranić, Bruna Bodulica, Josipa Kovačić
Although the incidence of ventilator-associated pneumonia (VAP) is very high, there are still many uncertainties about clinical course of VAP among tracheotomized patients. The goal of the present study was to determine the impact of tracheotomy on VAP incidence and etiology, as well as outcome of VAP patients with tracheotomy. The study was conducted in a 15-bed Surgical and Neurosurgical Intensive Care Unit (ICU), Sestre milosrdnice University Hospital Center in Zagreb, Croatia. The study included all patients undergoing only percutaneous tracheotomy during the study period...
March 2017: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29119023/improvement-in-quality-metrics-outcomes-and-patient-and-family-satisfaction-in-a-neurosciences-intensive-care-unit-after-creation-of-a-dedicated-neurocritical-care-team
#15
Yaw Sarpong, Premkumar Nattanmai, Ginger Schelp, Robert Bell, Keerthivaas Premkumar, Erin Stapleton, Ashley McCormick, Christopher R Newey
Introduction: Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods: This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment...
2017: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29113712/prior-antimicrobial-therapy-duration-influences-causative-pathogens-identification-in-ventilator-associated-pneumonia
#16
Jean-François Llitjos, Marlène Amara, Ahlem Benzarti, Guillaume Lacave, Jean-Pierre Bedos, Béatrice Pangon
OBJECTIVE: To determine whether prior antimicrobial therapy, divided in recent or current antibiotic treatment, influences the identification rate and/or the type of causative pathogens in patients with suspected episodes of ventilator-acquired pneumonia. DESIGN: Monocentric retrospective study. SETTING: Intensive car unit in a universitary hospital. PATIENTS: 230 episodes of ventilator-associated pneumonia with a Clinical Pulmonary Infection Score≥6 were retrospectively evaluated...
October 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29110799/acute-postoperative-management-after-lung-transplantation
#17
REVIEW
Christopher Potestio, Desmond Jordan, Bessie Kachulis
Despite many advances in the field of lung transplantation, lung transplant recipients have the lowest median survival of any solid organ transplant population. Complications such as reperfusion injury, graft rejection, infection, and anastomotic breakdown increase morbidity and mortality during the immediate postoperative period. Ventilator management with lung protective strategies can not only minimize ventilator time and mitigate the risk of ventilator-associated pneumonia, but it may also decrease the risk of primary graft dysfunction and graft failure...
June 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29108843/outcomes-following-elective-resection-of-congenital-pulmonary-airway-malformations-are-equivalent-after-3-months-of-age-and-a-weight-of-5-kg
#18
Brian C Gulack, Harold J Leraas, Brian Ezekian, Jina Kim, Christopher Reed, Obinna O Adibe, Henry E Rice, Elisabeth T Tracy
PURPOSE: Resection of congenital pulmonary airway malformations (CPAMs) is often performed to reduce the risk of recurrent infection and malignant transformation. However, there is substantial variation in the timing of resection. This study was performed to determine the association of age and weight on outcomes following elective resection of CPAMs. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database from 2012 to 2014 was queried for infants undergoing elective resection of a CPAM...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29100677/accelerant-related-burns-and-drug-abuse-challenging-combination
#19
Leslie T F Leung, Anthony Papp
BACKGROUND: Accelerants are flammable substances that may cause explosion when added to existing fires. The relationships between drug abuse and accelerant-related burns are not well elucidated in the literature. Of these burns, a portion is related to drug manufacturing, which have been shown to be associated with increased burn complications. OBJECTIVES: 1) To evaluate the demographics and clinical outcomes of accelerant-related burns in a Provincial Burn Centre...
October 31, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29098448/incidence-of-airway-complications-in-patients-using-endotracheal-tubes-with-continuous-aspiration-of-subglottic-secretions
#20
Jordi Vallés, Susana Millán, Emili Díaz, Eva Castanyer, Xavier Gallardo, Ignacio Martín-Loeches, Marta Andreu, Mario Prenafeta, Paula Saludes, Jorge Lema, Montse Batlle, Néstor Bacelar, Antoni Artigas
BACKGROUND: Continuous aspiration of subglottic secretions is effective in preventing ventilator-associated pneumonia, but it involves a risk of mucosal damage. The main objective of our study was to determine the incidence of airway complications related to continuous aspiration of subglottic secretions. METHODS: In consecutive adult patients with continuous aspiration of subglottic secretions, we prospectively recorded clinical airway complications during the period after extubation...
November 2, 2017: Annals of Intensive Care
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