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invasive mechanical ventilation

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https://www.readbyqxmd.com/read/28431343/measurement-of-physical-activity-levels-in-the-intensive-care-unit-and-functional-outcomes-an-observational-study
#1
Lisa J Beach, Kate Fetterplace, Lara Edbrooke, Selina M Parry, Rachel Curtis, Thomas Rechnitzer, Sue Berney, Linda Denehy
PURPOSE: Primary aims were: (1) objectively quantify levels of physical activity with the sensewear armband mini-fly motion sensor (SWA-MF), (2) evaluate the correlation of SWA-MF measurement of active and resting energy expenditure against the ICU Mobility scale (IMS) and indirect calorimetry respectively. MATERIALS AND METHODS: Adults mechanically ventilated ≥48h and anticipated to remain in ICU≥5days were included. Physical activity (PA) was measured using a SWA-MF (over the first five days); energy expenditure was measured with both the SWA-MF and the Deltatrac II metabolic cart on day three; highest level of mobility was assessed on the IMS...
April 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28424565/invasive-pneumococcal-disease-still-lots-to-learn-and-a-need-for-standardized-data-collection-instruments
#2
T J Marrie, G J Tyrrell, Sumit R Majumdar, Dean T Eurich
Background. Large studies of invasive pneumococcal disease (IPD) are frequently lacking detailed clinical information. Methods. A population-based 15-year study of IPD in Northern Alberta. Results. 2435 patients with a mean age of 54.2 years formed the study group. Males outnumbered females and Aboriginal and homeless persons were overrepresented. High rates of smoking, excessive alcohol use, and illicit drug use were seen. Almost all (87%) had a major comorbidity and 15% had functional limitations prior to admission...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#3
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28412382/use-of-nebulized-antimicrobials-for-the-treatment-of-respiratory-infections-in-invasively-mechanically-ventilated-adults-a-position-paper-from-the-european-society-of-clinical-microbiology-and-infectious-diseases
#4
Jordi Rello, Candela Solé-Lleonart, Jean-Jacques Rouby, Jean Chastre, Stijn Blot, Garyfallia Poulakou, Charles-Edouard Luyt, Jordi Riera, Lucy B Palmer, Jose M Pereira, Tim Felton, Jayesh Dhanani, Matteo Bassetti, Tobias Welte, Jason A Roberts
With an established role in cystic fibrosis and bronchiectasis, nebulized antibiotics are increasingly being used to treat respiratory infections in critically ill invasively mechanically ventilated adult patients. Although there is limited evidence describing their efficacy and safety, in an era of need for new strategies to enhance antibiotic effectiveness because of a shortage of new agents and increases in antibiotic resistance, the potential of nebulization of antibiotics to optimize therapy is considered of high interest, particularly in patients infected with multidrug-resistant (MDR) pathogens...
April 13, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28408618/national-policies-fostering-hospice-care-increased-hospice-utilization-and-reduced-the-invasiveness-of-end-of-life-care-for-cancer-patients
#5
Yu-Yun Shao, Emily Han-Chung Hsiue, Chih-Hung Hsu, Chien-An Yao, Ho-Min Chen, Mei-Shu Lai, Ann-Lii Cheng
BACKGROUND: In 2011, two national policies aiming to foster hospice services for terminal cancer patients took effect in Taiwan. The single-payer National Health Insurance of Taiwan started to reimburse full hospice services. The national hospital accreditation program, which graded all hospitals, incorporated hospice utilization in its evaluation. We assessed the impact of these national policies. METHODS: A cohort of 249,394 patients aged ≥18 years who died of cancer between 2008 and 2013 were identified from the National Death Registry...
April 13, 2017: Oncologist
https://www.readbyqxmd.com/read/28406813/effects-of-hypercapnia-and-hypercapnic-acidosis-on-hospital-mortality-in-mechanically-ventilated-patients
#6
Ravindranath Tiruvoipati, David Pilcher, Hergen Buscher, John Botha, Michael Bailey
OBJECTIVES: Lung-protective ventilation is used to prevent further lung injury in patients on invasive mechanical ventilation. However, lung-protective ventilation can cause hypercapnia and hypercapnic acidosis. There are no large clinical studies evaluating the effects of hypercapnia and hypercapnic acidosis in patients requiring mechanical ventilation. DESIGN: Multicenter, binational, retrospective study aimed to assess the impact of compensated hypercapnia and hypercapnic acidosis in patients receiving mechanical ventilation...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#7
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399457/cumulative-pain-related-stress-and-developmental-outcomes-among-low-risk-preterm-infants-at-one-year-corrected-age
#8
Iris Morag, Ifat Rotem, Mor Frisch, Israel Hendler, Michal J Simchen, Leah Leibovitz, Ayala Maayan-Metzger, Tzipora Strauss
BACKGROUND: Extensive exposure of preterm infants to pain-related stress (PRS) at a time of physiological immaturity and rapid brain development may contribute to altered neurodevelopment. OBJECTIVE: To examine the relationship between early PRS and neurodevelopmental outcomes among low-risk very preterm infants at the age of one year corrected age (CA). METHODS: Participants included 107 infants born <32weeks gestational age (GA) and monitored prospectively at 12...
April 8, 2017: Early Human Development
https://www.readbyqxmd.com/read/28398925/urgent-chemotherapy-for-life-threatening-complications-related-to-solid-neoplasms
#9
Yoann Zerbib, Antoine Rabbat, Muriel Fartoukh, Naïke Bigé, Claire Andréjak, Julien Mayaux, Nicolas De Prost, Benoît Misset, Virginie Lemiale, Fabrice Bruneel, Julien Maizel, Sylvie Ricome, Frédéric Jacobs, Caroline Bornstain, Hervé Dupont, François Baudin, Elie Azoulay, Frédéric Pène
OBJECTIVES: Solid neoplasms can be directly responsible for organ failures at the time of diagnosis or relapse. The management of such specific complications relies on urgent chemotherapy and eventual instrumental or surgical procedures, combined with advanced life support. We conducted a multicenter study to address the prognosis of this condition. DESIGN: A multicenter retrospective (2001-2015) chart review. SETTING: Medical and respiratory ICUs...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28394977/-clinical-and-epidemiological-changes-of-candidemia-among-adult-patients-from-2000-to-2013
#10
Leonardo Siri, Paulette Legarraga, Patricia García, Tamara González, Ricardo Rabagliati
BACKGROUND: Invasive Candida spp. infections have been described more frequently. AIM: To characterize the epidemiological data of candidemia in recent years. METHODS: A retrospective study of adult patients in a University Hospital in Santiago, Chile, with 1 or more documented episodes of candidemia, from January 2000 to December 2013. RESULTS: One hundred and twenty episodes of candidemia were identified in 120 patients, annual incidence of 0...
February 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#11
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28390055/extracorporeal-co2-removal-by-hemodialysis-in-vitro-model-and-feasibility
#12
Alexandra G May, Ayan Sen, Matthew E Cove, John A Kellum, William J Federspiel
BACKGROUND: Critically ill patients with acute respiratory distress syndrome and acute exacerbations of chronic obstructive pulmonary disease often develop hypercapnia and require mechanical ventilation. Extracorporeal carbon dioxide removal can manage hypercarbia by removing carbon dioxide directly from the bloodstream. Respiratory hemodialysis uses traditional hemodialysis to remove CO2 from the blood, mainly as bicarbonate. In this study, Stewart's approach to acid-base chemistry was used to create a dialysate that would maintain blood pH while removing CO2 as well as determine the blood and dialysate flow rates necessary to remove clinically relevant CO2 volumes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28389539/microbiota-in-exhaled-breath-condensate-and-the-lung
#13
Laura Glendinning, Steven Wright, Peter Tennant, Andrew C Gill, David Collie, Gerry McLachlan
The lung microbiota is commonly sampled using relatively invasive bronchoscopic procedures. Exhaled breath condensate (EBC) collection potentially offers a less invasive alternative for lung microbiota sampling. We compared lung microbiota samples retrieved by protected specimen brushings (PSB) and exhaled breath condensate collection. We also sought to assess whether aerosolised antibiotic treatment would influence the lung microbiota and whether EBC was sensitive enough to detect such changes.EBC was collected from 6 conscious sheep, and then from the same anaesthetised sheep during mechanical ventilation...
April 7, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/28379133/-non-invasive-ventilation-in-patients-with-diaphragmatic-paralysis-case-report
#14
Magali Blanco, Glenda Ernst, A Salvado, V H Cambursano, E Borsini
Background Diaphragmatic paralysis (DP) is a rare disease, usually secondary to systemic processes, although idiopathic forms have been described. Aim To describe the use of non-invasive ventilation as a treatment to patients with DP. Material and methods Descriptive study about consecutive cases of DP in a general hospital. Results It has been described 4 patients, all of them with a diminished the maximum mouth pressures and vital capacity in supine position. Three patients presented hypercapnia, and one of them, required intubation with invasive mechanical ventilation...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28368490/nasosorption-is-a-minimally-invasive-diagnostic-procedure-for-measurement-of-viral-load-and-markers-of-mucosal-inflammation-in-rsv-bronchiolitis
#15
Ryan S Thwaites, Kazuhiro Ito, Jasmine M S Chingono, Matthew Coates, Hannah C Jarvis, Tanushree Tunstall, Lauren Anderson-Dring, Lindsey Cass, Garth Rapeport, Peter J Openshaw, Simon Nadel, Trevor T Hansel
Background: Existing respiratory mucosal sampling methods are flawed, particularly in a paediatric bronchiolitis setting. Methods: Twenty-four infants with bronchiolitis were recruited: 12 were Respiratory syncytial virus (RSV)+, 12 were RSV-. Infants were sampled by nasosorption (NS) and nasopharyngeal-aspiration (NPA). Results: NS was well tolerated and identified all RSV+ samples. RSV load measured by NS (but not NPA) correlated with length of hospital stay (P=0...
March 27, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28353318/high-flow-nasal-cannula-therapies-for-respiratory-management-in-pediatric-patients
#16
Gang Liu, Conghai Fan, Hongwei Wu
High flow nasal cannula (HFNC) oxygen therapy is a non-invasive form of respiratory support that is rapidly being taken up in paediatric intensive care units (PICU). For infants with bronchiolitis - who are the largest non-elective source of admissions to a PICU - there is some evidence that using HFNC therapy reduces the need for intubation and mechanical ventilation. The aim of this review article is is to explore, describe, critique and add to the evidence surrounding the use of HFNC therapy in the pediatric population for the management of respiratory distress...
March 27, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28347628/factors-affecting-pain-assessment-scores-in-patients-on-mechanical-ventilation
#17
Yumi Ito, Koji Teruya, Hiroshi Kubota, Tomoko Yorozu, Emiko Nakajima
OBJECTIVE: To determine how respiratory status and other aspects of the patients' condition affect pain assessments. METHODS:  Pain was assessed in 20 patients aged ≥20 years who underwent cardiovascular surgery, and required postoperative mechanical ventilation in an intensive care unit using the Behavioral Pain Scale (BPS). A BPS score of ≥6 (pain) versus <6 (no pain) was the dependent variable for determining the effect on pain. RESULTS:  Multiple logistic regression analysis showed that in 99 observations made at rest, pre- and post-turning and pre- and post-tracheal suctioning, the BPS score was significantly affected by gender, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, Richmond Agitation-Sedation Scale score, PaCO2, and HCO3(-)...
March 24, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28346081/pneumocystis-jiroveci-pneumonia-pjp-in-non-hiv-immunocompromised-individuals
#18
Kathleen Schoovaerts, Luc Dirix, Annemie Rutten, Jef Van Schaeren, Bruno Van Herendael, Sofie Van Grieken, Luc Heytens
OBJECTIVES: PJP is a major cause of morbidity and mortality in immunocompromised individuals. Diagnosing PJP is often difficult because respiratory signs might be minimal or absent and the sensitivity of a chest X-ray (CXR) is low. We studied the clinical risk factors in order to increase awareness and facilitate the diagnosis. METHODS: We studied a prospective case series over a one year period (from 1 January 2015 to 1 January 2016) and did a retrospective analysis (from 2013 to 2016) of all PJP positive bronchoalveolar lavage (BAL) analysis...
March 27, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#19
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338550/respiratory-system-function-in-patients-after-minimally-invasive-aortic-valve-replacement-surgery-a-case-control-study
#20
Jarosław Stoliński, Robert Musiał, Dariusz Plicner, Janusz Andres
OBJECTIVE: The aim of the study was to comparatively analyze respiratory system function after minimally invasive, through right minithoracotomy aortic valve replacement (RT-AVR) to conventional AVR. METHODS: Analysis of 201 patients scheduled for RT-AVR and 316 for AVR between January 2010 and November 2013. Complications of the respiratory system and pulmonary functional status are presented. RESULTS: Complications of the respiratory system occurred in 16...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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