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https://www.readbyqxmd.com/read/28315940/a-multi-faceted-strategy-to-reduce-ventilation-associated-mortality-in-brain-injured-patients-the-bi-vili-project-a-nationwide-quality-improvement-project
#1
Karim Asehnoune, Ségolène Mrozek, Pierre François Perrigault, Philippe Seguin, Claire Dahyot-Fizelier, Sigismond Lasocki, Anne Pujol, Mathieu Martin, Russel Chabanne, Laurent Muller, Jean Luc Hanouz, Emmanuelle Hammad, Bertrand Rozec, Thomas Kerforne, Carole Ichai, Raphael Cinotti, Thomas Geeraerts, Djillali Elaroussi, Paolo Pelosi, Samir Jaber, Marie Dalichampt, Fanny Feuillet, Véronique Sebille, Antoine Roquilly
PURPOSE: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed...
March 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#2
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28294285/evaluation-of-a-flexible-bronchoscope-prototype-designed-for-bronchoscopy-during-mechanical-ventilation-a-proof-of-concept-study
#3
M-A Nay, A Auvet, J Mankikian, V Herve, P-F Dequin, A Guillon
Bronchoscopy during mechanical ventilation of patients' lungs significantly affects ventilation because of partial obstruction of the tracheal tube, and may thus be omitted in the most severely ill patients. It has not previously been possible to reduce the external diameter of the bronchoscope without reducing the diameter of the suction channel, thus reducing the suctioning capacity of the device. We believed that a better-designed bronchoscope could improve the safety of bronchoscopy in patients whose lungs were ventilated...
March 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28287810/evaluation-of-initial-respiratory-support-strategies-in-vlbw-neonates-with-rds
#4
Seyyed Abolfazl Afjeh, Mohammad Kazem Sabzehei, Maryam Khoshnood Shariati, Ahmad Reza Shamshiri, Fatemeh Esmaili
BACKGROUND: Non-invasive ventilation (NIV) has brought about a significant change in care and treatment of respiratory distress syndrome (RDS) in very low birth weight (VLBW) neonates. The present study was designed and conducted to evaluate different strategies of initial respiratory support (IRS) in VLBW neonates hospitalized in the neonatal intensive care unit (NICU). METHODS: This prospective study was conducted over three years (March 21, 2011 to March 20, 2014)...
March 2017: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#5
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#6
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28277990/preventing-facial-pressure-ulcers-in-patients-under-non-invasive-mechanical-ventilation-a-randomised-control-trial
#7
D Peña Otero, D Vazquez Domínguez, L Hernanz Fernández, A Santano Magariño, V Jimenez González, J V García Klepzing, J V Beneit Montesinos
OBJECTIVE: To comparatively assess the efficacy of four different therapeutic strategies to prevent the development of facial pressure ulcers (FPUs) related to the use of non-invasive mechanical ventilation (NIV) with oro-nasal masks in critically ill hospitalised patients. METHOD: This randomised control trial was performed at the high dependency unit in the University General Hospital Gregorio Marañón in Madrid, Spain. Overall, 152 patients with acute respiratory failure were recruited...
March 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28273700/-ventilator-associated-pneumonia-among-premature-infants-34-weeks-gestational-age-in-neonatal-intensive-care-unit-in-china-a-multicenter-study
#8
S J Li, S Y Yan, Y Zhou, K L E E Han, W L Guo, Q Xia, S P Vibhuti, J Z Wang, S W Ji, S H A H Yang, S N Yang, C Shan, C Y Liu, Z Z Yi, R B Liu, L Lin, B Wang, J Q He, Z L Li, Y Pan, L Guo, M X Chen, X N Liu, Y Zhou, L Li, C Q Xiong, Q Qi, X Y Hei, J Cao, Y J Jiang, M Y Zhang, Y Shoo
Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58...
March 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28273238/evaluation-of-self-perception-of-mechanical-ventilation-knowledge-among-brazilian-final-year-medical-students-residents-and-emergency-physicians
#9
Fernando Sabia Tallo, Simone de Campos Vieira Abib, Alexandre Jorgi de Andrade Negri, Paulo Cesar, Renato Delascio Lopes, Antônio Carlos Lopes
OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil...
February 1, 2017: Clinics
https://www.readbyqxmd.com/read/28260695/non-invasive-breath-monitoring-with-enose-does-not-improve-glucose-diagnostics-in-critically-ill-patients-in-comparison-to-continuous-glucose-monitoring-in-blood
#10
Jan Hendrik Leopold, Lieuwe Bos, Camilla Colombo, Peter Sterk, Marcus Schultz, Ameen Abu-Hanna
INTRODUCTION: Continuous glucose monitoring (CGM) can be beneficiary in critically ill patients. Current CGM devices rely on subcutaneous or blood plasma glucose measurements and consequently there is an increased risk of infections and the possibility of loss of blood with each measurement. A potential method to continuously and non-invasively measure blood glucose levels is using exhaled breath. A correlation between blood glucose levels and volatile organic compounds (VOCs) in the exhaled breath was already reported...
March 6, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28258358/assessment-of-sleep-in-patients-receiving-invasive-mechanical-ventilation-in-a-specialized-weaning-unit
#11
Sophie Emilia Huttmann, Katharina Wilms, Christine Hamm, Friederike Sophie Magnet, Wolfram Windisch, Jan Hendrik Storre
INTRODUCTION: A restful sleep is essential for regenerative processes and remains crucial for patients recovering from stressful periods in the intensive care unit. The current study aimed to assess sleep quality in critically ill patients receiving invasive mechanical ventilation within a specialized weaning unit in hospital. METHODS: Tracheotomized subjects undergoing prolonged weaning from mechanical ventilation were included in the study. Polysomnography and gas exchange monitoring was performed during nocturnal ventilation...
March 3, 2017: Lung
https://www.readbyqxmd.com/read/28257153/assessment-of-continuous-pain-in-newborns-admitted-to-nicus-in-18-european-countries
#12
Kanwaljeet J S Anand, Mats Eriksson, Elaine M Boyle, Alejandro Avila-Alvarez, Randi Dovland Andersen, Kosmas Sarafidis, Tarja Polkki, Cristina Matos, Paola Lago, Thalia Papadouri, Simon Attard-Montalto, Mari-Liis Ilmoja, Sinno Simons, Rasa Tameliene, Bart van Overmeire, Angelika Berger, Anna Dobrzanska, Michael Schroth, Lena Bergqvist, Emilie Courtois, Jessica Rousseau, Ricardo Carbajal
AIM: Continuous pain occurs routinely, even after invasive procedures, or inflammation and surgery, but clinical practices associated with assessments of continuous pain remain unknown. METHODS: A prospective cohort study in 243 Neonatal Intensive Care Units (NICUs) from 18 European countries recorded frequency of pain assessments, use of mechanical ventilation, sedation, analgesia, or neuromuscular blockade for each neonate upto 28 days after NICU admission. RESULTS: Only 2113/6648 (31·8%) of neonates received assessments of continuous pain, occurring variably among tracheal ventilation (TrV, 46·0%), noninvasive ventilation (NiV, 35·0%), and no ventilation (NoV, 20·1%) groups (p<0·001)...
March 3, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#13
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
March 1, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28251105/carbapenemase-producing-enterobacteriaceae-risk-factors-for-infection-and-impact-of-resistance-on-outcomes
#14
Shanthi Mariappan, Uma Sekar, Arunagiri Kamalanathan
BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) have increased in recent years leading to limitations of treatment options. The present study was undertaken to detect CPE, risk factors for acquiring them and their impact on clinical outcomes. METHODS: This retrospective observational study included 111 clinically significant Enterobacteriaceae resistant to cephalosporins subclass III and exhibiting a positive modified Hodge test. Screening for carbapenemase production was done by phenotypic methods, and polymerase chain reaction was performed to detect genes encoding them...
January 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28250604/quality-of-life-improves-with-individualized-home-based-exercises-in-critical-care-survivors
#15
Aayushi G Shelly, Nivedita S Prabhu, Priyanka Jirange, Asha Kamath, K Vaishali
THE AIM OF THE STUDY: This study aims to determine the effect of individualized home-based exercise on the quality of life post-Intensive Care Unit (ICU) discharge. SUBJECTS: Adult patients invasively mechanically ventilated for more than 48 h in medical ICU. METHODOLOGY: Thirty-five patients were enrolled prospectively in this study. They were interviewed to complete short form 36 (SF-36) version 2 questionnaire and were randomly allocated to control and experimental group by block randomization...
February 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28248714/nebulization-of-antiinfective-agents-in-invasively-mechanically-ventilated-adults-a-systematic-review-and-meta-analysis
#16
Candela Solé-Lleonart, Jean-Jacques Rouby, Stijn Blot, Garyfallia Poulakou, Jean Chastre, Lucy B Palmer, Matteo Bassetti, Charles-Edouard Luyt, Jose M Pereira, Jordi Riera, Tim Felton, Jayesh Dhanani, Tobias Welte, Jose M Garcia-Alamino, Jason A Roberts, Jordi Rello
BACKGROUND: Nebulization of antiinfective agents is a common but unstandardized practice in critically ill patients. METHODS: A systematic review of 1,435 studies was performed in adults receiving invasive mechanical ventilation. Two different administration strategies (adjunctive and substitute) were considered clinically relevant. Inclusion was restricted to studies using jet, ultrasonic, and vibrating-mesh nebulizers. Studies involving children, colonized-but-not-infected adults, and cystic fibrosis patients were excluded...
March 1, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28246074/delirium-after-mechanical-ventilation-in-intensive-care-units-the-cognitive-and-psychosocial-assessment-capa-study-protocol
#17
Daniella Bulic, Michael Bennett, Helen Rodgers, Mary Nourse, Patrick Rubie, Jeffrey Cl Looi, Frank Van Haren
BACKGROUND: In the intensive care unit (ICU), critical illness delirium occurs in the context of multiple comorbidities, multi-organ failure, and invasive management techniques, such as mechanical ventilation, sedation, and lack of sleep. Delirium is characterized by an acute confusional state defined by fluctuating mental status, inattention, and either disorganized thinking or an altered level of consciousness. The long-term cognitive and psychosocial function of patients that experience delirium in the ICU is of crucial interest because preliminary data suggest a strong association between ICU-related delirium and long-term cognitive impairment...
February 28, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28244292/humidified-high-flow-nasal-cannula-versus-nasal-continuous-positive-airway-pressure-as-an-initial-respiratory-support-in-preterm-infants-with-respiratory-distress-a-randomized-controlled-non-inferiority-trial
#18
Jeonghee Shin, Kyuhee Park, Eun Hee Lee, Byung Min Choi
Heated, humidified, high-flow nasal cannula (HHFNC) is frequently used as a noninvasive respiratory support for preterm infants with respiratory distress. But there are limited studies that compares HHFNC with nasal continuous positive airway pressure (nCPAP) only as the initial treatment of respiratory distress in preterm infants immediately after birth. The aim of this study is to assess the effectiveness and safety of HHFNC compared to nCPAP for the initial treatment of preterm infants with respiratory distress...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28236393/special-considerations-in-the-nursing-care-of-mechanically-ventilated-children
#19
REVIEW
Karen Dryden-Palmer, Jason Macartney, Leanne Davidson, Faiza Syed, Cathy Daniels, Shaindy Alexander
Mechanical ventilation is often required to support the recovery of critically ill children. Critical care nurses must understand the unique needs of the children and design supportive care that is sensitive to their changing physiology, developmental stage, and socioemotional needs. This article describes the unique considerations in providing care for mechanically ventilated children. It addresses invasive and noninvasive ventilation and the needs of long-term ventilated children and family in critical care...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236391/best-practices-for-managing-pain-sedation-and-delirium-in-the-mechanically-ventilated-patient
#20
REVIEW
Kitty M Garrett
Nursing management of pain, agitation, and delirium in mechanically ventilated patients is a challenge in critical care. Oversedation can lead to delayed extubation, prolonged ventilator days, unnecessary neurologic testing, and complications such as weakness and delirium. Undersedation can lead to self-extubation, invasive line removal, unnecessary patient distress, and injury to self or others. Acquiring an optimal level of sedation requires the bedside nurse to be more vigilant than ever with patient assessment and medication titration...
December 2016: Critical Care Nursing Clinics of North America
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