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https://www.readbyqxmd.com/read/27900922/-extracorporeal-life-support-for-legionella-pneumonia
#1
W A C Koekkoek, C Savelkoul, P R Wijnandts, M Platenkamp, D W Donker, D H T Tjan
BACKGROUND: Legionella species cause 5% of all community acquired pneumonias. However, Legionella pneumonia results relatively often in admission to the intensive care unit (ICU). A significant complication is the development of acute respiratory distress syndrome (ARDS). The ICU mortality rate for Legionella pneumonia is > 30% with conventional treatments. CASE DESCRIPTION: A 64-year-old male was admitted to the ICU with respiratory failure due to Legionella pneumonia complicated by ARDS...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#2
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#3
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27894277/human-limb-skeletal-muscle-wasting-and-architectural-remodeling-during-five-to-ten-days-intubation-and-ventilation-in-critical-care-an-observational-study-using-ultrasound
#4
Peter Turton, Richard Hay, Jonathon Taylor, Jamie McPhee, Ingeborg Welters
BACKGROUND: Critically ill patients frequently suffer muscle weakness whilst in critical care. Ultrasound can reliably track loss of muscle size, but also quantifies the arrangement of the muscle fascicles, known as the muscle architecture. We sought to measure both pennation angle and fascicle length, as well as tracking changes in muscle thickness in a population of critically ill patients. METHODS: On days 1, 5 and 10 after admission to critical care, muscle thickness was measured in ventilated critically ill patients using bedside ultrasound...
November 29, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27875410/should-we-use-driving-pressure-to-set-tidal-volume
#5
Domenico L Grieco, Lu Chen, Martin Dres, Laurent Brochard
PURPOSE OF REVIEW: Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CRS) is mostly affected by the volume of the baby lung, the ratio VT/CRS (i.e. the driving pressure, ΔP) may potentially help tailoring interventions on VT setting. RECENT FINDINGS: Driving pressure is the ventilatory variable most strongly associated with changes in survival and has been shown to be the key mediator of the effects of mechanical ventilation on outcome in the acute respiratory distress syndrome...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27874846/communications-and-relationships-between-patient-and-nurse-in-intensive-care-unit-knowledge-knowledge-of-the-work-knowledge-of-the-emotional-state
#6
Chiara Foà, Lisa Cavalli, Alessia Maltoni, Nicoletta Tosello, Chiara Sangilles, Ilaria Maron, Marina Borghini, Giovanna Artioli
BACKGROUND AND AIM: In an Intensive Care Unit (ICU) the communication between nurse and patient, the core of the care, is often hindered by patient's cognitive alterations and critical situation, by devices employed for the mechanical ventilation, and by the clinical and care-giving setting. How to overcome these barriers? How is the relational and communicative approach between nurse and patient unable to express him or herself to be managed? The available literature reveals that studies on communication with difficult patients, such as those treated in ICU are currently scarce...
November 22, 2016: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/27871554/evaluation-of-ph-on-removed-tracheal-tubes-after-general-anesthesia-a-prospective-observational-study
#7
Shiho Deguchi, Nobuyasu Komasawa, Takeshi Ueno, Michi Omori, Toshiaki Minami
STUDY OBJECTIVE: Aspiration pneumonia is a complication of tracheal intubation and mechanical ventilation. We hypothesized that tracheal tubes removed after anesthesia that have an acidic pH may reflect latent regurgitation of gastric fluid. DESIGN: A prospective observational study. SETTING: Operating room. PATIENTS: Tracheal tubes removed from 200 patients (age range, 20-85 years) who had undergone general anesthesia with tracheal intubation and gastric tube placement were examined...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27864942/a-review-of-capture-and-post-release-mortality-of-elasmobranchs
#8
REVIEW
J R Ellis, S R McCully Phillips, F Poisson
There is a need to better understand the survivorship of discarded fishes, both for commercial stocks and species of conservation concern. Within European waters, the landing obligations that are currently being phased in as part of the European Union's reformed common fisheries policy means that an increasing number of fish stocks, with certain exceptions, should not be discarded unless it can be demonstrated that there is a high probability of survival. This study reviews the various approaches that have been used to examine the discard survival of elasmobranchs, both in terms of at-vessel mortality (AVM) and post-release mortality (PRM), with relevant findings summarized for both the main types of fishing gear used and by taxonomic group...
November 18, 2016: Journal of Fish Biology
https://www.readbyqxmd.com/read/27819747/infant-position-in-neonates-receiving-mechanical-ventilation
#9
REVIEW
May Rivas-Fernandez, Marta Roqué I Figuls, Ana Diez-Izquierdo, Joaquin Escribano, Albert Balaguer
BACKGROUND: In patients of various ages undergoing mechanical ventilation (MV), it has been observed that positions other than the standard supine position, such as the prone position, may improve respiratory parameters. The benefits of these positions have not been clearly defined for critically ill newborns receiving MV.This is an update of a review first published in 2005 and last updated in 2013. OBJECTIVES: Primary objectiveTo assess the effects of different positioning of newborn infants receiving MV (supine vs prone, lateral decubitus or quarter turn from prone) in improving short-term respiratory outcomes...
November 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27795903/effects-of-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-systemic-stress-response-during-prone-position
#10
Oznur Sen, Mefkur Bakan, Tarik Umutoglu, Nurdan Aydın, Mehmet Toptas, Ibrahim Akkoc
BACKGROUND: Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27790273/clinical-practice-guideline-of-acute-respiratory-distress-syndrome
#11
REVIEW
Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27782908/optimization-of-mechanical-ventilation-in-a-31-year-old-morbidly-obese-man-with-refractory-hypoxemia
#12
Changsheng Zhang, Massimiliano Pirrone, David A E Imber, Jeanne B Ackman, Jacopo Fumagalli, Robert M Kacmarek, Lorenzo Berra
Morbidly obese, critically ill patients are prone to develop hypoxemic respiratory failure and ventilator dependency. The best method for recruiting the lungs of these patients and keeping alveoli open without causing injury remains unclear. We present the case of a 31-year-old patient with severe refractory hypoxemia reversed by lung recruitment maneuvers and subsequent application of positive end-expiratory pressure (PEEP) at a level determined by a decremental PEEP trial. The patient was extubated at a high PEEP level of 22 cm H2O followed by noninvasive ventilatory support after extubation...
October 24, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27752369/meralgia-paresthetica-after-prone-positioning-ventilation-in-the-intensive-care-unit
#13
Christian Svendsen Juhl, Martin Ballegaard, Morten H Bestle, Peer Tfelt-Hansen
Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve (LFCN) caused by external compression of the nerve during its course close to the anterior superior iliac spine. We present a case of a patient with acute respiratory distress induced by Legionella pneumonia who was admitted to the intensive care unit (ICU) for mechanical ventilation. In the ICU, the patient received one session of prone position ventilation for 8.5 consecutive hours. At evaluation six months later, the patient reported persistent bilateral numbness of the anterolateral thigh, which he complained had begun right after he woke up at the ICU...
2016: Case Reports in Critical Care
https://www.readbyqxmd.com/read/27688628/acute-kidney-injury-in-pediatric-intensive-care-unit-incidence-risk-factors-and-outcome
#14
Sheetal Gupta, Ghanshyam Singh Sengar, Praveen K Meti, Anil Lahoti, Mukesh Beniwal, Murlidhar Kumawat
OBJECTIVE: To determine incidence, risk factors, and outcome of acute kidney injury (AKI) in Pediatric Intensive Care Unit (PICU). MATERIALS AND METHODS: This is a prospective, observational study conducted in PICU of Department of Paediatrics, S.P. Medical College, Bikaner, from October 2013 to May 2014. In this study, 536 patients of aged 29 days to 16 years were screened for AKI according to the Pediatric Risk, Injury, Failure, Loss, End-stage Renal Disease (pRIFLE) criteria...
September 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27676319/risk-assessment-in-high-and-low-meld-liver-transplantation
#15
A Schlegel, M Linecker, P Kron, G Györi, M L De Oliveira, B Müllhaupt, P-A Clavien, P Dutkowski
Allocation of liver grafts triggers emotional debates, as those patients, not receiving an organ, are prone to death. We analyzed a high-Model of End-stage Liver Disease (MELD) cohort (laboratory MELD score ≥30, n = 100, median laboratory MELD score of 35; interquartile range 31-37) of liver transplant recipients at our center during the past 10 years and compared results with a low-MELD group, matched by propensity scoring for donor age, recipient age, and cold ischemia time. End points of our study were cumulative posttransplantation morbidity, cost, and survival...
September 27, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27623824/efficiency-of-lung-ventilation-for-people-performing-wind-instruments
#16
Anna Brzęk, Anna Famuła, Anna Kowalczyk, Ryszard Plinta
BACKGROUND: Wind instruments musicians are particularly prone to excessive respiratory efforts. Prolonged wind instruments performing may lead to changes in respiratory tracts and thus to respiratory muscles overload. It may result in decreasing lung tissue pliability and, as a consequence, in emphysema. Aim of the research has been to describe basic spirometric parameters for wind players and causes of potential changes. MATERIAL AND METHODS: Slow and forced spirometry with the use of Micro Lab Viasys (Micro Medical, Great Britain) was conducted on 31 wind musicians (group A)...
2016: Medycyna Pracy
https://www.readbyqxmd.com/read/27622722/inhibition-of-constitutive-nitric-oxide-synthase-does-not-influence-ventilation-perfusion-matching-in-normal-prone-adult-sheep-with-mechanical-ventilation
#17
Mats J Johansson, John-Peder Escobar Kvitting, Torun Flatebø, Anne Nicolaysen, Gunnar Nicolaysen, Sten M Walther
BACKGROUND: Local formation of nitric oxide in the lung induces vasodilation in proportion to ventilation and is a putative mechanism behind ventilation-perfusion matching. We hypothesized that regional ventilation-perfusion matching occurs in part due to local constitutive nitric oxide formation. METHODS: Ventilation and perfusion were analyzed in lung regions (≈1.5 cm) before and after inhibition of constitutive nitric oxide synthase with N-nitro-L-arginine methyl ester (L-NAME) (25 mg/kg) in 7 prone sheep ventilated with 10 cm H2O positive end-expiratory pressure...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27595452/systematic-review-of-complications-and-outcomes-of-diabetic-patients-with-burn-trauma
#18
A A Sayampanathan
OBJECTIVES: We aimed to understand the effect diabetes plays on the extent of complications and patient outcomes in burn trauma. METHODOLOGY: We searched MEDLINE, Science Direct and the Cochrane Review Database for 571 articles. Through our selection criteria, 12 articles were selected for systematic review and meta-analysis. Data was analysed via Review Manager 5.3, using Mantel-Haenszel statistics and random effect models. RESULTS: The odds of a diabetic patient sustaining a wound or local infection was 2...
August 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/27592605/pao2-fio2-deterioration-during-stable-extracorporeal-membrane-oxygenation-associates-with-protracted-recovery-and-increased-mortality-in-severe-acute-respiratory-distress-syndrome
#19
Roberto Roncon-Albuquerque, João Ferreira-Coimbra, Rodrigo Vilares-Morgado, Paulo Figueiredo, José Artur Paiva
BACKGROUND: During extracorporeal membrane oxygenation (ECMO), arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2; PF ratio reflects native and artificial lung blood oxygenation). In this study we analyzed PF ratio during ECMO support and its association with clinical outcome. METHODS: This was a single-center observational study of adult patients (n = 81) undergoing veno-venous ECMO support for severe acute respiratory distress syndrome...
December 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27576283/-acute-respiratory-distress-syndrome
#20
Elisa Estenssoro, Arnaldo Dubin
Acute respiratory distress syndrome (ARDS) is an acute respiratory failure produced by an inflammatory edema secondary to increased lung capillary permeability. This causes alveolar flooding and subsequently deep hypoxemia, with intrapulmonary shunt as its most important underlying mechanism. Characteristically, this alteration is unresponsive to high FIO2 and only reverses with end-expiratory positive pressure (PEEP). Pulmonary infiltrates on CXR and CT are the hallmark, together with decreased lung compliance...
2016: Medicina
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