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https://www.readbyqxmd.com/read/29031240/colonization-of-oropharynx-and-lower-respiratory-tract-in-critical-patients-risk-of-ventilator-associated-pneumonia
#1
Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
OBJECTIVE: To investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied...
October 2, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29021724/inhalation-injury-in-a-burn-unit-a-retrospective-review-of-prognostic-factors
#2
D Monteiro, I Silva, P Egipto, A Magalhães, R Filipe, A Silva, A Rodrigues, J Costa
Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI...
June 30, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/29017451/multiplex-pcr-point-of-care-testing-versus-routine-laboratory-based-testing-in-the-treatment-of-adults-with-respiratory-tract-infections-a-quasi-randomised-study-assessing-impact-on-length-of-stay-and-antimicrobial-use
#3
Denise Andrews, Yumela Chetty, Ben S Cooper, Manjinder Virk, Stephen K Glass, Andrew Letters, Philip A Kelly, Malur Sudhanva, Dakshika Jeyaratnam
BACKGROUND: Laboratory-based respiratory pathogen (RP) results are often available too late to influence clinical decisions such as hospitalisation or antibiotic treatment due to time delay in transport of specimens and testing schedules. Ward-based i.e. point of care (POC) testing providing rapid results may alter the clinical management pathway. METHODS: FilmArray® RP polymerase chain reaction (PCR) systems were placed in three in-patient and out-patient medical areas...
October 10, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28993038/capnography-in-the-emergency-department-a-review-of-uses-waveforms-and-limitations
#4
Brit Long, Alex Koyfman, Michael A Vivirito
BACKGROUND: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. OBJECTIVE OF THE REVIEW: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. DISCUSSION: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28992737/asenapine-iloperidone-and-lurasidone-exposures-in-young-children-reported-to-u-s-poison-centers
#5
Gina Stassinos, Wendy Klein-Schwartz
CONTEXT: Asenapine, iloperidone and lurasidone are relatively new atypical antipsychotics. There is limited information on toxicity on pediatric exposures to these drugs. The objective of this study was to compare toxicity associated with asenapine, iloperidone and lurasidone exposures in young children. METHODS: A retrospective study of U.S. National Poison Data System from 2010 to 2015 of single substance exposures to asenapine, iloperidone or lurasidone in children <6 years of age that were followed to known outcome was performed...
October 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28991047/vasopressors-do-not-influence-cerebral-critical-closing-pressure-during-systemic-inflammation-evoked-by-experimental-endotoxemia-and-sepsis-in-humans
#6
Judith Maria Dimphena van den Brule, Roeland Stolk, Elisabeth Janine Vinke, Lex Maxim van Loon, Peter Pickkers, Johannes Gerardus van der Hoeven, Matthijs Kox, Cornelia Wilhelmina Elisabeth Hoedemaekers
AIM: The aim of this study was to investigate the effects of different vasopressors on the cerebral vasculature during experimental human endotoxemia and sepsis. We used the critical closing pressure (CrCP) as a measure of cerebral vascular tone. METHODS: We performed a prospective pilot study, at the intensive care department (ICU) of a tertiary care university hospital in the Netherlands, in 40 healthy male subjects during experimental human endotoxemia (administration of bacterial lipopolysaccharide [LPS]) and in 10 patients with severe sepsis or septic shock...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28990179/therapeutic-bronchoscopy-vs-standard-of-care-in-acute-respiratory-failure-a-systematic-review
#7
REVIEW
K L Ellekjaer, T S Meyhoff, M H Møller
BACKGROUND: We aimed to assess patient-important benefits and harms of therapeutic bronchoscopy vs. standard of care (no bronchoscopy) in critically ill patients with acute respiratory failure (ARF). METHODS: We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) according to the Cochrane Handbook and GRADE methodology, including a predefined protocol (PROSPERO no. CRD42016046235). We included randomized clinical trials (RCTs) comparing therapeutic bronchoscopy to standard of care in critically ill patients with ARF...
November 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28984373/pulmonary-ultrasound-scoring-system-for-intubated-critically-ill-patients-and-its-association-with-clinical-metrics-and-mortality-a-prospective-cohort-study
#8
David M Tierney, Lori L Boland, Josh D Overgaard, Joshua S Huelster, Ann Jorgenson, James P Normington, Roman R Melamed
PURPOSE: Pulmonary ultrasound (PU) examination at the point-of-care can rapidly identify the etiology of acute respiratory failure (ARF) and assess treatment response. The often-subjective classification of PU abnormalities makes it difficult to document change over time and communicate findings across providers. The study goal was to develop a simple, PU scoring system that would allow for standardized documentation, have high interprovider agreement, and correlate with clinical metrics...
October 6, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28979558/the-significance-of-circadian-rhythms-and-dysrhythmias-in-critical-illness
#9
REVIEW
Helen T McKenna, Irwin Km Reiss, Daniel S Martin
Many physiological and cellular processes cycle with time, with the period between one peak and the next being roughly equal to 24 h. These circadian rhythms underlie 'permissive homeostasis', whereby anticipation of periods of increased energy demand or stress may enhance the function of individual cells, organ systems or whole organisms. Many physiological variables related to survival during critical illness have a circadian rhythm, including the sleep/wake cycle, haemodynamic and respiratory indices, immunity and coagulation, but their clinical significance remains underappreciated...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28978716/immunization-antibiotic-use-and-pneumococcal-colonization-over-a-15-year-period
#10
Grace M Lee, Ken Kleinman, Stephen Pelton, Marc Lipsitch, Susan S Huang, Matt Lakoma, Maya Dutta-Linn, Melisa Rett, William P Hanage, Jonathan A Finkelstein
BACKGROUND: Rates of invasive pneumococcal disease have declined since widespread introduction of pneumococcal conjugate vaccines (PCVs) in the United States. We evaluated the impact of immunization status and recent antibiotic use on an individual child's risk of colonization. METHODS: This study extends previously reported data from children <7 years of age seen for well child or acute care visits in Massachusetts communities. Nasopharyngeal swabs were collected during 6 surveillance seasons from 2000 to 2014...
October 4, 2017: Pediatrics
https://www.readbyqxmd.com/read/28971026/intensive-care-unit-issues-in-eclampsia-and-hellp-syndrome
#11
REVIEW
Melissa Teresa Chu Lam, Elizabeth Dierking
Preeclampsia, eclampsia and HELLP syndrome are life-threatening hypertensive conditions and common causes of ICU admission among obstetric patients The diagnostic criteria of preeclampsia include: 1) systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg on two occasions at least 4 hours apart and 2) proteinuria ≥300 mg/day in a woman with a gestational age of >20 weeks with previously normal blood pressures. Eclampsia is defined as a convulsive episode or altered level of consciousness occurring in the setting of preeclampsia, provided that there is no other cause of seizures...
July 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28966007/risk-factors-and-outcomes-of-severe-acute-respiratory-failure-requiring-invasive-mechanical-ventilation-in-cancer-patients-a-retrospective-cohort-study
#12
F D Martos-Benítez, A Gutiérrez-Noyola, M Badal, N A Dietrich
OBJECTIVES: To determine the risk factors for severe acute respiratory failure requiring invasive mechanical ventilation (SARF-MV) and its effect upon clinical outcomes in critically ill cancer patients. DESIGN: A retrospective cohort study was carried out. SETTING: A 12-bed oncological intensive care unit (ICU) from January 2014 to December 2015. PATIENTS: A total of 878 consecutive cancer patients were included. Patients with an ICU stay of ≤1 day were excluded...
September 28, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28965157/the-effect-of-listening-to-holy-quran-recitation-on-weaning-patients-receiving-mechanical-ventilation-in-the-intensive-care-unit-a-pilot-study
#13
Mohammad Yadak, Khalid Aziz Ansari, Hatem Qutub, Hajed Al-Otaibi, Omar Al-Omar, Nawal Al-Onizi, Faraz Ahmed Farooqi
Mechanical ventilation (MV) causes high level of stress in hospitalized patients. Weaning is the gradual process of decreasing ventilator support that in turn lead to termination of MV and increased respiratory effort, which may exacerbate symptoms and prolong MV. This study aimed to investigate the effect of listening to Holy Quran recitation (HQR) as a non-pharmacological intervention in patients during weaning from mechanical ventilation. This is a randomized controlled trial in which 55 patients admitted in the intensive care unit (ICU) and on mechanical ventilation were recruited...
September 30, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28958272/inclusion-of-the-acute-care-surgeon-in-the-difficult-airway-protocol-a-nine-year-experience
#14
Seong K Lee, Andrew A Rosenthal, Dafney L Davare, Chauniqua Kiffin, Rafael Sanchez, Michael Hurtado, Eddy H Carrillo
An emergency surgical airway is a lifesaving intervention required in the event of airway loss or respiratory failure when conventional endotracheal intubation cannot be performed. The Acute Care Surgery/Trauma Service is a critical component in the angioedema/difficult airway protocol at our institution. We conducted a retrospective review (2007-2016) to analyze the role our service has in managing patients requiring an emergency surgical airway. Cases were analyzed for preexisting conditions, hospital location of procedure, techniques, complications, and mortality...
September 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28953487/spontaneous-respiration-using-intravenous-anesthesia-and-high-flow-nasal-oxygen-strive-hi-management-of-acute-adult-epiglottitis-a-case-report
#15
Phillip Kwan-Giet Lee, Anton Willis Gerard Booth, Kim Vidhani
High-flow nasal oxygen (HFNO) is a potentially life-saving adjunct in the emergency management of the obstructed airway. HFNO has multiple beneficial applications in critical care and respiratory support, but its use in emergency-obstructed airway management has not been defined. This case report describes spontaneous respiration using intravenous anesthesia and high-flow nasal oxygen to successfully manage acute adult epiglottitis with rapidly progressing airway obstruction. Oxygenation, carbon dioxide levels, and airway patency were maintained, which facilitated endotracheal intubation while the patient was spontaneously breathing during general anesthesia...
September 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28953042/critically-ill-patients-with-the-middle-east-respiratory-syndrome-a-multicenter-retrospective-cohort-study
#16
Yaseen M Arabi, Awad Al-Omari, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Basem Alraddadi, Sarah Shalhoub, Abdullah Almotairi, Kasim Al Khatib, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Ghaleb A Al Mekhlafi, Abdulrahman Al Harthy, Ayman Kharaba, Mashael Al Ahmadi, Musharaf Sadat, Hanan Al Mutairi, Eman Al Qasim, Jesna Jose, Maliha Nasim, Abdulaziz Al-Dawood, Laura Merson, Robert Fowler, Frederick G Hayden, Hanan H Balkhy
OBJECTIVES: To describe patient characteristics, clinical manifestations, disease course including viral replication patterns, and outcomes of critically ill patients with severe acute respiratory infection from the Middle East respiratory syndrome and to compare these features with patients with severe acute respiratory infection due to other etiologies. DESIGN: Retrospective cohort study. SETTING: Patients admitted to ICUs in 14 Saudi Arabian hospitals...
August 3, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28952972/acute-opiate-overdose-an-update-on-management-strategies-in-emergency-department-and-critical-care-unit
#17
Rukma Parthvi, Abhinav Agrawal, Sameer Khanijo, Adey Tsegaye, Arunabh Talwar
BACKGROUND: Opioids are natural, semisynthetic, or synthetic substances that act on opioid receptors in the central nervous system. Clinically, they are prescribed for pain management. Opioid overdose (OOD) occurs when the central nervous system and respiratory drive are suppressed because of excessive consumption of the drug. Symptoms of OOD include drowsiness, slow breathing, pinpoint pupils, cyanosis, loss of consciousness, and death. Due to their addictive potential and easy accessibility opioid addiction is a growing problem worldwide...
September 13, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28947683/headspace-volatile-organic-compounds-from-bacteria-implicated-in-ventilator-associated-pneumonia-analysed-by-td-gc-ms
#18
Oluwasola Lawal, Howbeer Muhamadali, Waqar Ahmed, Iain R White, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Ventilator-associated pneumonia (VAP) is a healthcare-acquired infection arising from the invasion of the lower respiratory tract by opportunistic pathogens in critically ill ventilated patients. The current method of diagnosis requires the culture of an airway sample such as bronchoalveolar lavage, which is invasive to obtain and may take up to seven days to identify a causal pathogen, or indeed rule out infection. While awaiting results, patients are administered empirical antibiotics; risks of this approach include lack of effect on the causal pathogen, contribution to the development of antibiotic resistance and downstream effects such as increased length of intensive care stay, cost, morbidity and mortality...
September 26, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28943457/clinical-staging-of-fibrodysplasia-ossificans-progressiva-fop
#19
Robert J Pignolo, Frederick S Kaplan
Fibrodyplasia ossificans progressiva (FOP) is an ultra-rare genetic condition of heterotopic ossification (HO) that results in progressive loss of joint function, ultimately rendering movement impossible. Death is most commonly the result of thoracic insufficiency syndrome, or complications related to recurrent respiratory infections. There are no current treatments for FOP, but early and emerging clinical trials offer hope for this devastating disease. With the recent reporting of a comprehensive global natural history study, scales to assess joint dysfunction, and a more accurate prediction of joint survival, it is now possible to construct a conceptual framework for the clinical staging of FOP...
September 21, 2017: Bone
https://www.readbyqxmd.com/read/28942692/the-role-of-tele-medicine-in-patients-with-respiratory-diseases
#20
Nicolino Ambrosino, Claudio Fracchia
Tele-medicine is a clinical application connecting a patient with specialized care consultants by means of electronic platforms, potentially able to improve patients' self-management and allow for the care of patients with limited access to health services. This article summarizes the use of tele-medicine as a tool in managing patients suffering from some pathological respiratory conditions. Areas covered: We searched papers published between 1990 and 2017 dealing with tele-medicine and respiratory diseases, chronic obstructive pulmonary disease, asthma, interstitial lung disease, chronic respiratory failure, neuromuscular diseases, critical illness, home mechanical ventilation, and also legal and economic issues...
September 27, 2017: Expert Review of Respiratory Medicine
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