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https://www.readbyqxmd.com/read/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#1
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29720570/ripk3-mediates-pathogenesis-of-experimental-ventilator-induced-lung-injury
#2
Ilias I Siempos, Kevin C Ma, Mitsuru Imamura, Rebecca M Baron, Laura E Fredenburgh, Jin-Won Huh, Jong-Seok Moon, Eli J Finkelsztein, Daniel S Jones, Michael Torres Lizardi, Edward J Schenck, Stefan W Ryter, Kiichi Nakahira, Augustine Mk Choi
In patients requiring ventilator support, mechanical ventilation (MV) may induce acute lung injury (ventilator-induced lung injury [VILI]). VILI is associated with substantial morbidity and mortality in mechanically ventilated patients with and without acute respiratory distress syndrome. At the cellular level, VILI induces necrotic cell death. However, the contribution of necroptosis, a programmed form of necrotic cell death regulated by receptor-interacting protein-3 kinase (RIPK3) and mixed-lineage kinase domain-like pseudokinase (MLKL), to the development of VILI remains unexplored...
May 3, 2018: JCI Insight
https://www.readbyqxmd.com/read/29706811/use-of-neuromuscular-blocking-agents-in-acute-respiratory-distress-syndrome
#3
REVIEW
G Tsai-Nguyen, Ariel M Modrykamien
Acute respiratory distress syndrome is the result of an acute inflammatory response of the lungs, causing severe hypoxemia. A variety of therapeutic modalities have been extensively studied, with only a few demonstrating improvement in survival. Specifically, mechanical ventilation with use of low tidal volumes, prone positioning, and treatment with neuromuscular blocking agents have proven beneficial. This article focuses on the utilization of neuromuscular blocking agents in this entity. In particular, we briefly review the mechanism of action of neuromuscular blockades, the latest published evidence supporting their use in acute respiratory distress syndrome, and current recommendations for their utilization in clinical practice...
April 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29686542/factors-among-patients-receiving-prone-positioning-for-the-acute-respiratory-distress-syndrome-found-useful-for-predicting-mortality-in-the-intensive-care-unit
#4
Ariel M Modrykamien, Yahya Daoud
Optimal mechanical ventilation management in patients with the acute respiratory distress syndrome (ARDS) involves the use of low tidal volumes and limited plateau pressure. Refractory hypoxemia may not respond to this strategy, requiring other interventions. The use of prone positioning in severe ARDS resulted in improvement in 28-day survival. To determine whether mechanical ventilation strategies or other parameters affected survival in patients undergoing prone positioning, a retrospective analysis was conducted of a consecutive series of patients with severe ARDS treated with prone positioning...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29675085/lipomeningomyelocele-with-fatty-filum-terminale-in-a-patient-with-jarcho-levin-syndrome-a-rare-association-requiring-special-attention
#5
Suyash Singh, Kuntal K Das, Raj Kumar
Lipomeningomyelocele (LMMC) with Jarcho-Levin syndrome (JLS) is extremely rare. The syndromic association is one of LMMC with JLS is one of phenotype of spondylocostal dysostosis (SCD). SCD is an autosomal-recessive disorder characterized by defects in the vertebrae and abnormalities of the ribs in the form of segmental fusion, malalignment, or absence of a few ribs. These patients are prone to pulmonary insufficiency and repeated infections. Close anesthetic vigil is also needed to maintain optimal ventilation during surgery...
October 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/29663993/-meta-analysis-of-observing-prone-position-ventilation-role-in-the-oxygenation-of-severe-pneumonia-patients
#6
Yuming Du, Yan Li, Rongqing Sun, Bo Yuan, Min Gao, Lirui Wang
OBJECTIVE: To systematically evaluate the clinical effect of prone position mechanical ventilation on the improvement of oxygenation in patients with severe pneumonia. METHODS: Pubmed, Embase, Cochrane Library, CNKI, Wanfang Data and VIP database were searched from the time of database built up until December 10th, 2017. All the published randomized controlled trials (RCTs) about the effects of prone position ventilation on the oxygenation of severe pneumonia patients were screened, and were confirmed by the literature reference citation retrieval...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29628666/cardiopulmonary-resuscitation-unusual-techniques-for-unusual-situations
#7
Vidhu Bhatnagar, Kavitha Jinjil, Deepak Dwivedi, Rohit Verma, Urvashi Tandon
Background: The cardiopulmonary resuscitation (CPR) in prone position has been dealt with in 2010 American Heart Association (AHA) guidelines but have not been reviewed in 2015 guidelines. The guidelines for patients presenting with cardiac arrest under general anesthesia in lateral decubitus position and regarding resuscitation in confined spaces like airplanes are also not available in AHA guidelines. This article is an attempt to highlight the techniques adopted for resuscitation in these unusual situations...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29623221/efficacy-of-dexmedetomidine-versus-ketofol-for-sedation-of-postoperative-mechanically-ventilated-patients-with-obstructive-sleep-apnea
#8
Hatem Elmoutaz Mahmoud, Doaa Abou Elkassim Rashwan
Patients with sleep apnea are prone to postoperative respiratory complications, requiring restriction of sedatives during perioperative care. We performed a prospective randomized study on 24 patients with obstructive sleep apnea (OSA) who underwent elective surgery under general anesthesia. The patients were equally divided into two groups: Group Dex : received dexmedetomidine loading dose 1 mcg/kg IV over 10 min followed by infusion of 0.2-0.7 mcg/kg/hr; Group KFL : received ketofol as an initial bolus dose 500 mcg/kg IV (ketamine/propofol 1 : 1) and maintenance dose of 5-10 mcg/kg/min...
2018: Critical Care Research and Practice
https://www.readbyqxmd.com/read/29602990/safety-of-laparoscopic-fundoplication-in-children-under-5-kg-a-comparative-study
#9
Jean-Baptiste Marret, Claire Dupont-Lucas, Thierry Petit, Benjamin Menahem, Camille Godet, Philippe Ravasse, Julien Rod
BACKGROUND: Laparoscopic fundoplication in children under 5 kg is still debated. Our objective was to evaluate the safety and efficacy of laparoscopic fundoplication (LF) in children under 5 kg. METHODS: We reviewed the cases of 96 children treated by laparoscopic fundoplication between 2005 and 2014. Thirty-five patients had a weight of 5 kg or less at the time of LF (Low Weight Group) and 61 patients had a weight between 5.1 and 10 kg (High Weight Group). The pre-operative, peri-operative, post-operative data regarding surgery and anesthesia were compared between groups...
March 30, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29599422/fatal-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-infection-in-patients-after-kidney-transplantation-a-report-of-five-cases
#10
Paweł Zatorski, Agata Adamczyk, Maciej Kosieradzki, Teresa Baczkowska, Dariusz Kosson, Janusz Trzebicki
BACKGROUND In the general population, swine influenza is a self-limited infection. Patients after kidney transplantation, however, are at increased risk for complications and mortality from influenza A (H1N1). Acute respiratory distress syndrome (ARDS) complicates up to 55% of influenza-related pneumonia in hospitalized patients and carries a mortality of 40-46%. We describe our experience in intensive care of kidney transplant patients with ARDS complicating influenza A (H1N1) pneumonia during a flu outbreak...
March 30, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29596015/continuous-negative-abdominal-pressure-mechanism-of-action-and-comparison-with-prone-position
#11
Takeshi Yoshida, Doreen Engelberts, Gail Otulakowski, Bhushan Katira, Niall D Ferguson, Laurent Brochard, Marcelo B P Amato, Brian P Kavanagh
We recently reported that continuous negative abdominal pressure (CNAP) could recruit dorsal atelectasis in experimental lung injury, and that oxygenation improved at different transpulmonary pressure values compared with increases in airway pressure (31). The mechanism of recruitment with CNAP is uncertain; and, its impact compared with a commonly proposed alternative approach to recruitment -prone positioning- is not known. We hypothesized that CNAP recruits lung by decreasing the vertical Ppl gradient (i...
March 29, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29582802/the-surgical-outcome-of-minimally-invasive-pharyngo-laryngo-oesophagectomy-in-prone-position
#12
Mariko Ogino, Yuma Ebihara, Akihiro Homma, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Yo Kurashima, Soichi Murakami, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
PURPOSE: Pharyngo-laryngo-oesophagectomy (PLE) which is mainly indicated for cervical oesophageal cancer or synchronous double cancer of the thoracic oesophagus and the pharynx or larynx, is extremely invasive. Since minimally invasive oesophagectomy (MIE) using video-assisted thoracic surgery has become popular recently, the procedure can be adopted to PLE. Moreover, the use of the prone position (PP) in MIEs has been increasing recently because technical advantages and fewer post-operative complications were reported...
March 23, 2018: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/29580895/the-effect-of-mobile-laminar-airflow-units-on-airborne-bacterial-contamination-during-neurosurgical-procedures
#13
Ann-Christin von Vogelsang, Petter Förander, Martin Arvidsson, Peter Löwenhielm
BACKGROUND: Surgical site infections (SSIs) after neurosurgery are potentially life threatening and entails great costs. SSI can occur from airborne bacteria in the operating room (OR), and ultraclean air is desired during infection-prone clean procedures. Door openings and the number of persons present in the OR affects the air quality. Mobile laminar airflow (MLAF) units, with horizontal laminar airflow, have previously shown to effectively reduce airborne bacterial contamination. AIM: To assess the effect of MLAF units on airborne bacterial contamination during neurosurgical procedures...
March 23, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29576824/ventilator-management-for-acute-respiratory-distress-syndrome-associated-with-avian-influenza-a-h7n9-virus-infection-a-case-series
#14
Hui Xie, Zhi-Gang Zhou, Wei Jin, Cheng-Bin Yuan, Jiang Du, Jian Lu, Rui-Lan Wang
BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still lacking. METHODS: We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7N9 admitted to our ICU over a 3-month period. RESULTS: Eight patients (mean age 57.38±16.75; 5 male) were diagnosed with H7N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome (ARDS), which required MV in ICU...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29575957/ventilator-induced-lung-injury-during-controlled-ventilation-in-patients-with-acute-respiratory-distress-syndrome-less-is-probably-better
#15
Fernanda Ferreira Cruz, Lorenzo Ball, Patricia Rieken Macedo Rocco, Paolo Pelosi
Mechanical ventilation is required to support respiratory function in the acute respiratory distress syndrome (ARDS), but it may promote lung damage, a phenomenon known as ventilator-induced lung injury (VILI). Areas covered: Several mechanisms of VILI have been described, such as: inspiratory and/or expiratory stress inducing overdistension (volutrauma); interfaces between collapsed or edema-filled alveoli with surrounding open alveoli, acting as stress raisers; alveoli that repetitively open and close during tidal breathing (atelectrauma); and peripheral airway dynamics...
March 26, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29572569/the-unprecedented-2014-legionnaires-disease-outbreak-in-portugal-atmospheric-driving-mechanisms
#16
Ana Russo, Célia M Gouveia, Pedro M M Soares, Rita M Cardoso, Manuel T Mendes, Ricardo M Trigo
A large outbreak of Legionnaires' disease occurred in November 2014 nearby Lisbon, Portugal. This epidemic infected 377 individuals by the Legionella pneumophila bacteria, resulting in 14 deaths. The primary source of transmission was contaminated aerosolized water which, when inhaled, lead to atypical pneumonia. The unseasonably warm temperatures during October 2014 may have played a role in the proliferation of Legionella species in cooling tower systems. The episode was further exacerbated by high relative humidity and a thermal inversion which limited the bacterial dispersion...
March 23, 2018: International Journal of Biometeorology
https://www.readbyqxmd.com/read/29566734/acute-exacerbation-of-idiopathic-pulmonary-fibrosis-lessons-learned-from-acute-respiratory-distress-syndrome
#17
REVIEW
Alessandro Marchioni, Roberto Tonelli, Lorenzo Ball, Riccardo Fantini, Ivana Castaniere, Stefania Cerri, Fabrizio Luppi, Mario Malerba, Paolo Pelosi, Enrico Clini
Idiopathic pulmonary fibrosis (IPF) is a fibrotic lung disease characterized by progressive loss of lung function and poor prognosis. The so-called acute exacerbation of IPF (AE-IPF) may lead to severe hypoxemia requiring mechanical ventilation in the intensive care unit (ICU). AE-IPF shares several pathophysiological features with acute respiratory distress syndrome (ARDS), a very severe condition commonly treated in this setting.A review of the literature has been conducted to underline similarities and differences in the management of patients with AE-IPF and ARDS...
March 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29564137/regional-overdistension-during-prone-positioning-in-a-patient-with-acute-respiratory-failure-who-was-ventilated-with-a-low-tidal-volume-a-case-report
#18
Toru Kotani, Masanori Hanaoka, Shinya Hirahara, Hisashi Yamanaka, Eckhard Teschner, Atsuko Shono
Background: Prone positioning may provide a uniform distribution of transpulmonary pressure and contribute to prevent ventilator-induced lung injury. However, despite moderate positive end-expiratory pressure and low tidal volumes, there is still a risk of regional overdistension. Case presentation: A man with refractory hypoxemia was mechanically ventilated with prone positioning. Although prone positioning with a plateau pressure of 18 cmH2 O and a positive end-expiratory pressure of 8 cmH2 O promptly improved oxygenation, regional ventilation monitoring using electrical impedance tomography initially detected decreased distribution in the dorsal region but increased in the ventral, suggesting overdistension...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29543606/ce-original-research-recognizing-delirium-in-hospitalized-children-a-systematic-review-of-the-evidence-on-risk-factors-and-characteristics
#19
Cheryl Holly, Sallie Porter, Mercedes Echevarria, Margaret Dreker, Sevara Ruzehaji
The findings can facilitate earlier recognition and prevention of pediatric delirium. ABSTRACT: Purpose: The purpose of this study was to examine the evidence regarding the risk factors for and characteristics of acute pediatric delirium in hospitalized children. METHODS: The systematic review method within an epidemiological framework of person, place, and time was used. Fifty-two studies were selected for initial retrieval. Of these, after assessment for methodological quality, 21 studies involving 2,616 subjects were included in the review...
March 14, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29521672/effects-of-prone-positioning-on-transpulmonary-pressures-and-end-expiratory-volumes-in-patients-without-lung-disease
#20
Abirami Kumaresan, Robert Gerber, Ariel Mueller, Stephen H Loring, Daniel Talmor
BACKGROUND: The effects of prone positioning on esophageal pressures have not been investigated in mechanically ventilated patients. Our objective was to characterize effects of prone positioning on esophageal pressures, transpulmonary pressure, and lung volume, thereby assessing the potential utility of esophageal pressure measurements in setting positive end-expiratory pressure (PEEP) in prone patients. METHODS: We studied 16 patients undergoing spine surgery during general anesthesia and neuromuscular blockade...
June 2018: Anesthesiology
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