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weaning review

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https://www.readbyqxmd.com/read/28730666/weaning-of-proton-pump-inhibitors-in-patients-with-suspected-laryngopharyngeal-reflux-disease
#1
R Jun Lin, Shaum Sridharan, Libby J Smith, VyVy N Young, Clark A Rosen
OBJECTIVE: To evaluate the feasibility of a proton pump inhibitor (PPI) weaning protocol in a cohort of patients following successful empiric treatment for suspected laryngopharyngeal reflux disease (LPRD). STUDY DESIGN: Retrospective chart review. METHODS: LPRD patients were weaned from PPIs using a standardized weaning protocol. Symptom recurrence rate following PPI wean and present PPI use were determined. All numeric data were analyzed...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28730131/clinical-study-of-congenital-esophageal-stenosis-comparison-according-to-association-of-esophageal-atresia-and-tracheoesophageal-fistula
#2
Soo-Hong Kim, Hyun-Young Kim, Sung-Eun Jung, Seong-Cheol Lee, Kwi-Won Park
PURPOSE: Congenital esophageal atresia (CES) is a rare congenital disease. The severity of symptoms is variable; thus, diagnosis is difficult and tends to be delayed. CES is frequently accompanied by esophageal atresia (EA) with/without tracheoesophageal fistula (TEF). We investigated the characteristics of CES by reviewing our experience with CES patients and researched the differences between CES with EA-TEF and isolated CES. METHODS: A total of 31 patients underwent operations for CES were reviewed retrospectively...
June 2017: Pediatric Gastroenterology, Hepatology & Nutrition
https://www.readbyqxmd.com/read/28728546/successful-rescue-combination-of-extracorporeal-membrane-oxygenation-high-frequency-oscillatory-ventilation-and-prone-positioning-for-the-management-of-severe-methicillin-resistant-staphylococcus-aureus-pneumonia-complicated-by-pneumothorax-a-case-report-and
#3
Hangyong He, Hao Wang, Xuyan Li, Xiao Tang, Rui Wang, Bing Sun, Zhaohui Tong
BACKGROUND: To describe the experience of combination therapy with extracorporeal membrane oxygenation(ECMO), high-frequency oscillatory ventilation(HFOV) and prone positioning in treating severe respiratory failure caused by community acquired methicillin resistant Staphylococcus aureus(CA-MRSA). CASE PRESENTATION: A 30-year-old female presented with fever and dyspnea for 3 days. She was diagnosed CA-MRSA pneumonia complicated by severe respiratory failure, pneumothorax and neutropenia...
July 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28720673/challenges-with-implementation-of-a-respiratory-therapist-driven-protocol-of-spontaneous-breathing-trials-in-the-pediatric-icu
#4
Conrad Krawiec, Dale Carl, Christy Stetter, Lan Kong, Gary D Ceneviva, Neal J Thomas
BACKGROUND: Timely ventilator liberation is crucial in the pediatric ICU. In many pediatric ICUs, the decision to initiate weaning is driven by the physician, which may lead to delays in ventilator liberation. The objectives of this quality improvement project were to develop and implement a respiratory therapist (RT)-led protocol for screening for spontaneous breathing trial (SBT) readiness, to test protocol feasibility, and to evaluate its impact on SBT timing. METHODS: A retrospective chart review was performed on all intubated patients in the pediatric ICU for 18 months prior to protocol institution...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28718889/veno-arterial-extracorporeal-membrane-oxygenation-support-in-patients-undergoing-aortic-surgery
#5
Zhaopeng Zhong, Chunjing Jiang, Feng Yang, Xing Hao, Jialin Xing, Hong Wang, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an option for mechanical support for patients with postcardiotomy cardiogenic shock (PCS). However, the use of VA-ECMO in patients suffering from aortic disease with PCS has not been greatly reported. This is a retrospective review of adult patients undergoing aortic surgery who received VA-ECMO support to treat refractory PCS from August 2009 to May 2016. A total of 36 patients who underwent aortic surgery with VA-ECMO support for refractory PCS were included...
July 18, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28716832/mechanical-circulatory-support-devices-for-acute-right-ventricular-failure
#6
REVIEW
Navin K Kapur, Michele L Esposito, Yousef Bader, Kevin J Morine, Michael S Kiernan, Duc Thinh Pham, Daniel Burkhoff
Right ventricular (RV) failure remains a major cause of global morbidity and mortality for patients with advanced heart failure, pulmonary hypertension, or acute myocardial infarction and after major cardiac surgery. Over the past 2 decades, percutaneously delivered acute mechanical circulatory support pumps specifically designed to support RV failure have been introduced into clinical practice. RV acute mechanical circulatory support now represents an important step in the management of RV failure and provides an opportunity to rapidly stabilize patients with cardiogenic shock involving the RV...
July 18, 2017: Circulation
https://www.readbyqxmd.com/read/28716150/swedish-norwegian-co-operation-in-the-treatment-of-three-hypothermia-victims-a-case-report
#7
Anders Wetting Carlsen, Nils K Skjaervold, Nils Johan Berg, Øystein Karlsen, Eli Gunnarson, Alexander Wahba
BACKGROUND: Accidental hypothermia with cardiac arrest represents a challenge for pre-hospital rescuers as well as in-hospital staff. For pre-hospital personnel, the main focus is to get the patient to the correct destination without unnecessary delay. For in-hospital personnel early information is vital to assess the possibility for resuscitation with extracorporeal re-warming. The challenge is augmented when rescuers must cross national borders to reach and/or deliver the patients. We present a case where three adolescent boys suffered severe hypothermia after a canoeing accident in Sweden...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28716039/extra-corporeal-membrane-oxygenation-for-refractory-cardiogenic-shock-after-adult-cardiac-surgery-a-systematic-review-and-meta-analysis
#8
Maziar Khorsandi, Scott Dougherty, Omar Bouamra, Vasudev Pai, Philip Curry, Steven Tsui, Stephen Clark, Stephen Westaby, Nawwar Al-Attar, Vipin Zamvar
BACKGROUND: Postcardiotomy cardiogenic shock (PCCS) refractory to inotropic support and intra-aortic balloon pump (IABP) occurs rarely but is almost universally fatal without mechanical circulatory support. In this systematic review and meta-analysis we looked at the evidence behind the use of veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in refractory PCCS from a patient survival rate and determinants of outcome viewpoint. METHODS: A systematic review was performed in January 2017 using PubMed (with no defined time period) using the keywords "postcardiotomy", "cardiogenic shock", "extracorporeal membrane oxygenation" and "cardiac surgery"...
July 17, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28704244/implementation-of-a-standardized-transfusion-protocol-for-cardiac-patients-treated-with-venoarterial-extracorporeal-membrane-oxygenation-is-associated-with-decreased-blood-component-utilization-and-may-improve-clinical-outcome
#9
Christine M Cahill, Neil Blumberg, Amy E Schmidt, Peter A Knight, Amber L Melvin, Howard T Massey, Joseph M Delehanty, Seth B Zebrak, Majed A Refaai
BACKGROUND: Extracorporeal membrane oxygenation supplies oxygenated blood to the body supporting the heart and lungs. Survival rates of 20% to 50% are reported among patients receiving ECMO for cardiac arrest, severe cardiogenic shock, or failure to wean from cardiopulmonary bypass following cardiac surgery. Bleeding is one of the most common complications in ECMO patients due to coagulopathy, systemic anticoagulation, and the presence of large bore cannulas at systemic pressure. Absence of a standardized transfusion protocol in this population leads to inconsistent transfusion practices...
July 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28698263/ventilator-induced-diaphragmatic-dysfunction-diagnosis-and-role-of-pharmacological-agents
#10
REVIEW
Won-Young Kim, Chae-Man Lim
The use of controlled mechanical ventilation results in a major reduction of diaphragmatic contractile force together with atrophy of diaphragm muscle fibers, which is a condition known as ventilator-induced diaphragmatic dysfunction. Ventilator-induced diaphragmatic dysfunction is one of the major contributors to weaning difficulties and even increased mortality. This review summarizes the current data on the pathogenesis and diagnosis of ventilator-induced diaphragmatic dysfunction, and it outlines the use of ultrasonography for diaphragm evaluation...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28696547/heat-stress-in-pregnant-sows-thermal-responses-and-subsequent-performance-of-sows-and-their-offspring
#11
REVIEW
Matthew C Lucy, Timothy J Safranski
Seasonal infertility is a significant problem in the swine industry, and may be influenced by photoperiod and heat stress. Heat stress during gestation in particular affects pregnancy, resulting in long-term developmental damage to the offspring. This review summarizes what is known about how heat stress on the pregnant sow affects lactation and her offspring. Sows responded to heat stress during gestation with increased rectal temperature, respiration rate, and skin temperature, and tended to reduce their activity-which may have changed their body composition, increasing the adipose-to-muscle ratio...
July 11, 2017: Molecular Reproduction and Development
https://www.readbyqxmd.com/read/28673890/rates-of-seizure-freedom-after-surgical-resection-of-diffuse-low-grade-gliomas
#12
REVIEW
Phillip A Bonney, Lillian B Boettcher, Joshua D Burks, Cordell Baker, Andrew K Conner, Tats Fujii, Vivek A Mehta, Robert G Briggs, Michael E Sughrue
OBJECTIVE: Patients with diffuse low-grade gliomas (DLGG) typically present with seizures. We sought to review the neurosurgical literature for seizure outcome after resection of these tumors. METHODS: Using PubMed, we identified surgical series reporting seizure freedom rates for Grade II astrocytoma, oligoastrocytoma, and oligodendroglioma. Inclusion criteria included seizure outcomes reported specifically for DLGG and at least 10 patients with follow-up data...
June 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28667793/physiological-mechanisms-through-which-heat-stress-compromises-reproduction-in-pigs
#13
REVIEW
Jason W Ross, Benjamin J Hale, Jacob T Seibert, Matthew R Romoser, Malavika K Adur, Aileen F Keating, Lance H Baumgard
Seasonal variations in environmental temperatures impose added stress on domestic species bred for economically important production traits. These heat-mediated stressors vary on a seasonal, daily, or spatial scale, and negatively impact behavior and reduce feed intake and growth rate, which inevitably lead to reduced herd productivity. The seasonal infertility observed in domestic swine is primarily characterized by depressed reproductive performance, which manifests as delayed puberty onset, reduced farrowing rates, and extended weaning-to-estrus intervals...
July 1, 2017: Molecular Reproduction and Development
https://www.readbyqxmd.com/read/28661576/physiological-alterations-associated-with-intrauterine-growth-restriction-in-fetal-pigs-causes-and-insights-for-nutritional-optimization
#14
REVIEW
Junjun Wang, Cuiping Feng, Ting Liu, Meng Shi, Guoyao Wu, Fuller W Bazer
Intrauterine growth restriction (IUGR) remains a major problem in swine production since the associated low birth weight leads to high rates of pre-weaning morbidity and mortality plus permanent retardation of growth and development. Complex biological events-including genetics, epigenetics, maternal maturity, maternal nutrition, placenta efficiency, uterine capacity, and other environmental factors-can affect fetal growth and development during late gestation, as well as maturity of oocytes, duration of estrus, and both implantation and placentation of conceptuses in uteri of sows...
June 29, 2017: Molecular Reproduction and Development
https://www.readbyqxmd.com/read/28652117/simultaneous-resection-of-multiple-metastatic-brain-tumors-with-multiple-keyhole-craniotomies
#15
Cordell Michael Baker, Chad A Glenn, Robert G Briggs, Josh D Burks, Adam D Smitherman, Andrew K Conner, Allison E Williams, Muhammad U Malik, Ozer Algan, Michael E Sughrue
BACKGROUND: The proper management of symptomatic patients with two or more brain metastases is not entirely clear and the surgical outcomes of these patients undergoing multiple simultaneous craniotomies have not been well described. In this manuscript, we describe patient outcomes after simultaneously resecting metastatic lesions through multiple keyhole craniotomies. METHODS: We conducted a retrospective review of data obtained on all patients undergoing resection of multiple brain metastases in one operation between 2014 and 2016...
June 23, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#16
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28646588/duration-and-cessation-characteristics-of-heparinization-after-finger-replantation-a-retrospective-analysis-of-outcomes
#17
Johnny I Efanov, Julia Khriguian, Sophie Cassier, Elie Boghossian, Patrick G Harris, Joseph Bou-Merhi, M A Danino
BACKGROUND: To prevent postoperative thrombosis, indications for anticoagulation in finger replantation have been described, but no consensus has yet been found for cessation protocols. The aim of this study is to investigate cessation methods of intravenous anticoagulation after finger replantation. METHODS: A retrospective review of all patients treated for a finger replantation between December 2014 and July 2016 was performed. Only those who required postoperative treatment with intravenous heparin were extracted...
June 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28645964/the-predictive-value-of-serial-changes-in-diaphragm-function-during-the-spontaneous-breathing-trial-for-weaning-outcome-a-study-protocol
#18
Pengmin Zhou, Zhongheng Zhang, Yucai Hong, Huabo Cai, Hui Zhao, Peifeng Xu, Yiming Zhao, Shengping Lin, Xuchang Qin, JiaWei Guo, Yun Pan, Junru Dai
INTRODUCTION: There is a variety of tools being used in clinical practice for the prediction of weaning success from mechanical ventilation. However, their diagnostic performances are less than satisfactory. The purpose of this study is to investigate the value of serial changes in diaphragm function measured by ultrasound during the spontaneous breathing trial (SBT) as a weaning predictor. METHODS AND ANALYSIS: This is a prospective observational study conducted in a 10-bed medical emergency intensive care unit (EICU) in a university-affiliated hospital...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28628264/controlling-lactation-oestrus-the-final-frontier-for-breeding-herd-management
#19
REVIEW
William H E J van Wettere, Alice C Weaver, Emma C Greenwood, Robyn Terry, Paul E Hughes, Karen L Kind
Lactation anoestrus limits the flexibility of modern pig production systems such that any increase in lactation length reduces farrowing frequency, and thus profit. This review focuses on post-partum development of the sow's reproductive system, the physiology of lactation anoestrus and how it can be overcome, as well as the fertility of sows mated while lactating. The propensity for sows to ovulate spontaneously while lactating is high (24-31%), and a high proportion of sows will ovulate rapidly and synchronously in response to combinations of altered suckling (split weaning, interrupted suckling), daily boar contact, exogenous gonadotrophins, and group housing...
June 19, 2017: Molecular Reproduction and Development
https://www.readbyqxmd.com/read/28627353/-ultrasonographic-evaluation-of-diaphragm-structure-and-function
#20
Feifei Wang, Xiaoping Zhu, Shaolin Ma
Diaphragm is the principal respiratory muscle. Diaphragm dysfunction resulting from mechanical ventilation, chronic cardiopulmonary disease, medicine, cardio-thoracic surgery, septic shock and chronic malnutrition predisposes to weaning failure from mechanical ventilation and prolongs intensive care unit (ICU) stay. Traditionally, the method of assessment of diaphragm structure and function was invasive, lacking specific, and was difficult to be used bedside. A number of recent studies have been suggested that ultrasonographic evaluation has been proposed as an accurate, safe and noninvasive method of quantification of diaphragm structure and function...
March 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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