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https://www.readbyqxmd.com/read/28544843/a-new-sign-of-severe-aortic-regurgitation-detected-through-airflow-analysis-in-mechanical-ventilation
#1
Juan C Garcia-Rubira, Maria J Cristo-Ropero, Manuel Almendro-Delia, Rafael Hidalgo-Urbano
A 72-year-old female with a previous history of aortic valve replacement by biological prosthesis was admitted with progressive heart failure. The clinical course was unfavorable, requiring inotropic support and invasive mechanical ventilation. Auto-triggering of the ventilator from cardiac origin has been previously described, and explained as a consequence of hyperdynamic circulation. In our case, the oscillatory movements due to the aortic regurgitation are transmitted to the airway. Early recognition of this condition can facilitate not only the correction this asynchrony in mechanical ventilation but also should raise the suspicion of aortic regurgitation...
January 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28542364/inspiratory-muscle-activation-increases-with-copd-severity-as-confirmed-by-non-invasive-mechanomyographic-analysis
#2
Leonardo Sarlabous, Abel Torres, José A Fiz, Juana M Martínez-Llorens, Joaquim Gea, Raimon Jané
There is a lack of instruments for assessing respiratory muscle activation during the breathing cycle in clinical conditions. The aim of the present study was to evaluate the usefulness of the respiratory muscle mechanomyogram (MMG) for non-invasively assessing the mechanical activation of the inspiratory muscles of the lower chest wall in both patients with chronic obstructive pulmonary disease (COPD) and healthy subjects, and to investigate the relationship between inspiratory muscle activation and pulmonary function parameters...
2017: PloS One
https://www.readbyqxmd.com/read/28541747/evidence-based-utilization-of-non-invasive-ventilation-and-patient-outcomes
#3
Anuj B Mehta, Ivor S Douglas, Allan J Walkey
RATIONALE: Strong evidence supports use of non-invasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure (strong evidence conditions). Despite unclear benefits of NIV for other causes of acute respiratory failure, utilization for conditions with weaker evidence is increasing despite evidence demonstrating higher mortality for patients who suffer NIV failure (progression from NIV to invasive mechanical ventilation (IMV)) compared to being treated initially with IMV...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28540346/less-invasive-surfactant-administration-reduces-the-need-for-mechanical-ventilation-in-preterm-infants-a-meta-analysis
#4
Christine S M Lau, Ronald S Chamberlain, Shyan Sun
Neonatal respiratory distress syndrome due to surfactant deficiency is associated with high morbidity and mortality in preterm infants, and the use of less invasive surfactant administration (LISA) has been increasingly studied. This meta-analysis found that LISA via thin catheter significantly reduced the need for mechanical ventilation within the first 72 hours (relative risk [RR] = 0.677; P = .021), duration of mechanical ventilation (difference in means [MD] = -39.302 hours; P < .001), duration of supplemental oxygen (MD = -68...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28540195/conversion-from-prolonged-intravenous-fentanyl-infusion-to-enteral-methadone-in-critically-ill-children
#5
Vijay Srinivasan, Daniel Pung, Sean P O'Neill
AIM: To describe our institutional experience with conversion from intravenous (IV) fentanyl infusion directly to enteral methadone and occurrence of withdrawal in critically ill mechanically ventilated children exposed to prolonged sedation and analgesia. METHODS: With Institutional Review Board approval, we retrospectively studied consecutively admitted invasively mechanically ventilated children (0-18 years) sedated with IV fentanyl infusion > 5 d and subsequently converted directly to enteral methadone...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28535788/endexpiratory-lung-volume-measurement-correlates-with-the-ventilation-perfusion-mismatch-in-lung-injured-pigs
#6
Jens Kamuf, Andreas Garcia-Bardon, Bastian Duenges, Tanghua Liu, Antje Jahn-Eimermacher, Florian Heid, Matthias David, Erik K Hartmann
BACKGROUND: In acute respiratory respiratory distress syndrome (ARDS) a sustained mismatch of alveolar ventilation and perfusion (VA/Q) impairs the pulmonary gas exchange. Measurement of endexpiratory lung volume (EELV) by multiple breath-nitrogen washout/washin is a non-invasive, bedside technology to assess pulmonary function in mechanically ventilated patients. The present study examines the association between EELV changes and VA/Q distribution and the possibility to predict VA/Q normalization by means of EELV in a porcine model...
May 23, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28530332/-treatment-of-mechanically-ventilated-patients-in-an-internal-medicine-department-overview-2013
#7
Jacov Kogan, Alex Rodnitsky, Ornit Cohen, Svetlana Turkot, Yevgenia Tziba, Boris Golzman
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28524027/-effect-of-chest-physiotherapy-in-patients-undergoing-mechanical-ventilation-a-prospective-randomized-controlled-trial
#8
Hui Zeng, Zhen Zhang, Yuan Gong, Miao Chen
OBJECTIVE: To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28522773/severe-neurological-symptoms-following-synthetic-cannabinoid-intoxication
#9
F van Gorp, L C Wejden, N A Stienstra, E M Kuck, L E M Haas
Synthetic cannabinoids are becoming increasingly popular as substances of abuse. However, in the Netherlands synthetic cannabinoid intoxications are rare. We report a 16-year-old male who became deeply comatose and was admitted to the intensive care unit for invasive mechanical ventilation after a buse of aninitially unknown drug. Routine toxicology screening with an immunoassay only detected tetrahydrocannabinol, but additional tests with liquid chromatography mass spectrometry revealed synthetic cannabinoid use...
May 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28521581/association-between-the-use-of-magnesium-sulfate-as-neuroprotector-in-prematurity-and-the-neonatal-hemodynamic-effects
#10
Rodrigo Dias Nunes, Flávia Duarte Schutz, Jefferson Luiz Traebert
PURPOSE: Cerebral palsy is often associated with prematurity and magnesium sulfate (MgSO4), has been used as neuroprotector, with favorable results. However, its mechanism of action has not been fully elucidated. This study aimed to evaluate the association between MgSO4 at the imminent premature delivery and neonatal hemodynamic effects. MATERIALS AND METHODS: A cross-sectional study involving 94 newborns (NB) between 24 and 32 weeks at a Brazilian hospital was performed...
May 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28520948/relationship-between-body-mass-index-and-outcomes-among-hospitalized-patients-with-community-acquired-pneumonia
#11
Anna M Bramley, Carrie Reed, Lyn Finelli, Wesley H Self, Krow Ampofo, Sandra R Arnold, Derek J Williams, Carlos G Grijalva, Evan J Anderson, Chris Stockmann, Christopher Trabue, Sherene Fakhran, Robert Balk, Jonathan A McCullers, Andrew T Pavia, Kathryn M Edwards, Richard G Wunderink, Seema Jain
Background: The effect of body mass index (BMI) on community-acquired pneumonia (CAP) severity is unclear. Methods: We investigated the relationship between BMI and CAP outcomes [hospital length of stay (LOS), intensive care unit (ICU) admission, and invasive mechanical ventilation] in hospitalized CAP patients from the CDC Etiology of Pneumonia in the Community (EPIC) study, adjusting for age, demographics, underlying conditions, and smoking status (adults only)...
May 17, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#12
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28515741/respiratory-functional-status-after-conventional-and-minimally-invasive-aortic-valve-replacement-surgery-a-propensity-score-analysis
#13
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Kamil Fijorek, Michał Mędrzycki, Janusz Andres, Bogusław Kapelak
INTRODUCTION: Reports describing respiratory function of patients after conventional or minimally invasive cardiac surgery are infrequent. AIM: To compare pulmonary functional status after conventional (AVR) and after minimally invasive, through right anterior minithoracotomy, aortic valve replacement (RT-AVR). MATERIAL AND METHODS: This was an observational analysis of 212 patients scheduled for RT-AVR and 212 for AVR between January 2011 and December 2014 selected using propensity score matching...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28503300/how-to-decrease-bronchopulmonary-dysplasia-in-your-neonatal-intensive-care-unit-today-and-tomorrow
#14
REVIEW
Leif D Nelin, Vineet Bhandari
Bronchopulmonary dysplasia, or BPD, is the most common chronic lung disease in infants. Genetic predisposition and developmental vulnerability secondary to antenatal and postnatal infections, compounded with exposure to hyperoxia and invasive mechanical ventilation to an immature lung, result in persistent inflammation, culminating in the characteristic pulmonary phenotype of BPD of impaired alveolarization and dysregulated vascularization. In this article, we highlight specific areas in current management, and speculate on therapeutic strategies that are on the horizon, that we believe will make an impact in decreasing the incidence of BPD in your neonatal intensive care units...
2017: F1000Research
https://www.readbyqxmd.com/read/28502363/-weaning-from-mechanical-ventilation-role-of-conventional-methods-and-non-invasive-ventilation-for-weaning
#15
C Girault, A Gacouin
No abstract text is available yet for this article.
May 10, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28495265/continuous-positive-airway-pressure-for-children-with-undifferentiated-respiratory-distress-in-ghana-an-open-label-cluster-crossover-trial
#16
Patrick T Wilson, Frank Baiden, Joshua C Brooks, Marilyn C Morris, Katie Giessler, Damien Punguyire, Gavin Apio, Akua Agyeman-Ampromfi, Sara Lopez-Pintado, Justice Sylverken, Kwadwo Nyarko-Jectey, Harry Tagbor, Rachel T Moresky
BACKGROUND: In low-income and middle-income countries, invasive mechanical ventilation is often not available for children at risk of death from respiratory failure. We aimed to determine if continuous positive airway pressure (CPAP), a form of non-invasive ventilation, decreases all-cause mortality in children with undifferentiated respiratory distress in Ghana. METHODS: This open-label, cluster, crossover trial was done in two Ghanaian non-tertiary hospitals where invasive mechanical ventilation is not routinely available...
June 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#17
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#18
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28469127/surgical-experience-of-primary-cardiac-tumor-single-institution-23-year-report
#19
Shuanglei Li, Changqing Gao
BACKGROUND Primary cardiac tumors are rare but have favorable surgical prognosis. Previous studies have been small series studies with limited surgical approaches. To date, few studies have examined the clinical features associated with different surgical procedures. MATERIAL AND METHODS In a search of the cardiovascular surgery database of our institution, we retrospectively identified 225 patients who had cardiac tumor resection from January 1993 to May 2016. The patients' clinical characteristics and operation information were reviewed, and the operation parameters, postoperative complications, and short-term prognosis among robotic, mini-thoracotomy, and conventional procedures in our center were compared...
May 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28468263/an-evaluation-of-a-continuing-education-program-for-family-caregivers-of-ventilator-dependent-children-with-spinal-muscular-atrophy-sma
#20
Deborah S Boroughs
Until 25 years ago, there were limited options for long-term mechanical ventilation of children, and the majority of children were cared for in hospitals. However, with improving technology, the pediatric intensive care unit has moved from the hospital to a home setting, as children with increasingly complex healthcare needs are now often cared for by family members. One of the most complex care conditions involves ventilator and tracheostomy support. Advanced respiratory technologies that augment natural respiratory function prolong the lives of children with respiratory compromise; however, this care often comes with serious risks, including respiratory muscle impairment, respiratory failure, and chronic pulmonary disease...
April 29, 2017: Children
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