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https://www.readbyqxmd.com/read/29907209/using-artificial-intelligence-to-predict-prolonged-mechanical-ventilation-and-tracheostomy-placement
#1
Joshua Parreco, Antonio Hidalgo, Jonathan J Parks, Robert Kozol, Rishi Rattan
BACKGROUND: Early identification of critically ill patients who will require prolonged mechanical ventilation (PMV) has proven to be difficult. The purpose of this study was to use machine learning to identify patients at risk for PMV and tracheostomy placement. MATERIALS AND METHODS: The Multiparameter Intelligent Monitoring in Intensive Care III database was queried for all intensive care unit (ICU) stays with mechanical ventilation. PMV was defined as ventilation >7 d...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29898830/is-there-need-for-technical-investigations-in-order-to-predict-potential-length-of-hospital-stay-of-oral-infections
#2
Maximiliaan Smeets, Bert Gemels, Lisanne Groeneveldt, Constantinus Politis
OBJECTIVE: Oral and maxillofacial infections are generally treated by primary dental or medical caregivers. Nevertheless, because these infections are known to have life-threatening complications, there is a need of clear indicators for emergency services medical staff, particularly in determining when morbidity can be expected and when in-hospital treatment is required. This retrospective study aimed to identify variables that were observable at admission, which could indicate high complication rates, long hospital stays, and/or a need for tracheostomy...
June 10, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#3
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#4
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29648486/physicians-attitudes-when-faced-with-life-threatening-events-in-children-with-severe-neurological-disabilities
#5
Benjy Wosinski, Christopher J Newman
PURPOSE: Children with severe neurological disabilities are at an increased risk of acute, life-threatening events. We assessed physicians' attitudes when making decisions in these situations. METHODS: We surveyed physicians in pediatric intensive care, neurology, and rehabilitation units in Swiss hospitals. The questionnaire explored participants' attitudes toward life-threatening situations in two scenarios: a child with profound intellectual and multiple disabilities (PIMD) and an infant with spinal muscular atrophy (SMA) type I...
April 12, 2018: Developmental Neurorehabilitation
https://www.readbyqxmd.com/read/29621014/laryngoscopy-and-bronchoscopy-in-an-infant-with-a-congenital-laryngeal-web-complicated-by-bilateral-pneumothoraces-a-case-report
#6
Michelle M LeRiger, Marcellene H Franzen, Ryan K Sewell, Greta L Duncan-Wiebe
Neonates with laryngeal webs pose unique challenges to the anesthesiologist. We present a 2-day-old neonate with aphonia and stridor who underwent microdirect laryngoscopy. Intraoperatively, a Cohen type 4 laryngeal web was diagnosed not immediately amenable to resection. Therefore, the decision was made for endotracheal intubation and subsequent tracheostomy. After endotracheal intubation, there was acute respiratory compromise and oxygen desaturation that improved moderately after urgent tracheostomy. A chest radiograph revealed a large pneumothorax...
March 31, 2018: A&A practice
https://www.readbyqxmd.com/read/29514482/decision-making-on-a-deadline-tracheostomy-nutrition-and-autonomy
#7
Steven J Baumrucker, Matt Stolick, Laura Hutchinson, Gregg VandeKieft, Angela Cullop, Ella Farida Meade, Russell W Adkins
No abstract text is available yet for this article.
January 1, 2018: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29507719/the-patient-needing-prolonged-mechanical-ventilation-a-narrative-review
#8
REVIEW
Nicolino Ambrosino, Michele Vitacca
Background: Progress in management has improved hospital mortality of patients admitted to the intensive care units, but also the prevalence of those patients needing weaning from prolonged mechanical ventilation, and of ventilator assisted individuals. The result is a number of difficult clinical and organizational problems for patients, caregivers and health services, as well as high human and financial resources consumption, despite poor long-term outcomes. An effort should be made to improve the management of these patients...
2018: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29386758/challenges-in-management-of-pediatric-life-threatening-neck-and-chest-trauma
#9
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29374088/healthcare-utilisation-and-costs-of-home-mechanical-ventilation
#10
Mika L Nonoyama, Douglas A McKim, Jeremy Road, Denise Guerriere, Peter C Coyte, Marina Wasilewski, Monica Avendano, Sherri L Katz, Reshma Amin, Roger Goldstein, Brandon Zagorski, Louise Rose
BACKGROUND: Individuals using home mechanical ventilation (HMV) frequently choose to live at home for quality of life, despite financial burden. Previous studies of healthcare utilisation and costs do not consider public and private expenditures, including caregiver time. OBJECTIVES: To determine public and private healthcare utilisation and costs for HMV users living at home in two Canadian provinces, and examine factors associated with higher costs. METHODS: Longitudinal, prospective observational cost analysis study (April 2012 to August 2015) collecting data on public and private (out-of-pocket, third-party insurance, caregiving) costs every 2 weeks for 6 months using the Ambulatory and Home Care Record...
January 26, 2018: Thorax
https://www.readbyqxmd.com/read/29197715/end-of-life-care-of-elderly-patients-with-dementia-a-cross-sectional-study-of-family-carer-decision-making
#11
Rafaella I Peixoto, Vera M da Silveira, Rogério D Zimmermann, Adriana de M Gomes
BACKGROUND: Dementia syndromes pose a major worldwide challenge to public health. In terminal stage of dementia, carers are responsible for decision making in end-of-life treatment and there may be multiple factors that contribute to the choice of a palliative or invasive treatment. AIM: To identify possible factors that influence the decision-making of family caregivers on implementing invasive or palliative interventions for people with end stage dementia. DESIGN: A structured interview with family caregivers of elderly patients addressing aspects of the following categories: elderly with dementia, caregiver, medical treatment history...
March 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29046086/the-provision-of-surgical-tracheostomies-by-maxillofacial-surgeons-in-the-uk-time-for-a-dedicated-tracheostomy-team
#12
P Chohan, R Elledge, M K Virdi, G M Walton
Surgical tracheostomy is a commonly provided service by surgical teams for patients in intensive care where percutaneous dilatational tracheostomy is contraindicated. A number of factors may interfere with its provision on shared emergency operating lists, potentially prolonging the stay in intensive care. We undertook a two-part project to examine the factors that might delay provision of surgical tracheostomy in the intensive care unit. The first part was a prospective audit of practice within the University Hospital Coventry...
February 2018: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28980128/changes-in-routine-laboratory-tests-and-survival-in-amyotrophic-lateral-sclerosis
#13
Jessica Mandrioli, Edoardo Rosi, Nicola Fini, Antonio Fasano, Silvia Raggi, Anna Laura Fantuzzi, Giorgio Bedogni
The aim of this study is to evaluate the association between changes in routinely prescribed laboratory tests and tracheostomy-free survival in amyotrophic lateral sclerosis (ALS). Two hundred seventy-five ALS patients were retrospectively studied. BMI, forced vital capacity, hemoglobin, hematocrit, lymphocytes, cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides, proteins, albumin, creatine-phosphokinase, iron, ferritin, transferrin, glucose, urea, uric acid, and creatinine were measured every 6 months from baseline to 24 months, death or study end, together with the probability of death or tracheostomy...
December 2017: Neurological Sciences
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#14
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
December 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28928262/the-use-of-speaking-valves-in-children-with-tracheostomy-tubes
#15
REVIEW
Weeda Zabih, Theresa Holler, Faiza Syed, Laurie Russell, Jennifer Allegro, Reshma Amin
One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making...
December 2017: Respiratory Care
https://www.readbyqxmd.com/read/28709052/colon-cancer-metastasis-to-the-thyroid-gland-a-case-report
#16
M I Coelho, M N Albano, C E Costa Almeida, L S Reis, N Moreira, C M C Almeida
INTRODUCTION: Thyroid metastases from colorectal cancer are uncommon and few cases are described in literature. CASE PRESENTATION: A 64-year-old female patient presented with an asymptomatic right cervical nodule with a rapid growth six years after sigmoidectomy for cancer and two years after resection of colorectal lung metastases. Increased CA 19.9 was identified and a thoracoabdominal CT scan revealed the onset of new metastatic bilateral pulmonary lesions. Neck ultrasonography showed a suspicious nodule in the right thyroid lobe, and Fine-needle Aspiration Cytology (FNAC) of the nodule lead to the diagnosis of colorectal cancer metastasis...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#17
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28685809/follow-up-after-intensive-care-treatment-a-questionnaire-survey-of-intensive-care-aftercare-in-denmark
#18
C K W Kjer, S Estrup, L M Poulsen, O Mathiesen
BACKGROUND: Rehabilitation efforts after treatment in the intensive care unit (ICU) are termed intensive care aftercare. It includes both early in-hospital follow-up after ICU-discharge and late follow-up after hospital discharge. This study aims to investigate the current ICU-aftercare activities in Denmark. METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to the heads of all 31 general ICUs in Denmark. Specialized ICUs were not included...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28675111/outcomes-of-tracheostomy-with-concomitant-and-delayed-percutaneous-endoscopic-gastrostomy-in-the-neuroscience-critical-care-unit
#19
Christa O'Hana S Nobleza, Vinciya Pandian, Ravirasmi Jasti, David H Wu, Marek A Mirski, Romergryko G Geocadin
BACKGROUND: In patients with severe neurologic conditions, percutaneous endoscopic gastrostomy (PEG) is typically performed either alone or with a tracheostomy. The characteristics and outcomes of patients receiving PEG concomitantly with a tracheostomy (CTPEG) and those receiving delayed PEG (DPEG) after a tracheostomy were compared. METHODS: Retrospective cohort study in a 24-bed neuroscience critical care unit (NCCU) at a tertiary care hospital. Consecutive patients admitted to the NCCU from April 2007 to July 2013 who underwent percutaneous tracheostomy and gastrostomy by the percutaneous tracheostomy team were included and grouped according to the timing of PEG placement: CTPEG versus DPEG...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28673655/peak-inspiratory-flow-as-predictor-for-tracheotomy
#20
M Lesnik, J J Sanchez-Guerrero, O De Crouy Chanel, C Hervé, J Guerlain, S Périé
OBJECTIVES: Quantitative evaluation of upper airway obstruction cannot be commonly performed under acute dyspnea, especially in head and neck cancer (HNC); the decision whether or not to perform airway control surgery may be difficult to reach. Peak inspiratory flow (PIF) has been previously demonstrated to be a useful tool to decide on decannulation after HNC surgery. The aim of the present study was to assess the role of PIF as a standardized non-invasive tool in quantifying severe inspiratory dyspnea requiring emergency tracheostomy...
February 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
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