keyword
https://read.qxmd.com/read/38060622/nomograms-for-the-prediction-of-decannulation-in-patients-with-neurological-injury-a-study-based-on-clinical-practice
#21
JOURNAL ARTICLE
Jibing Ou, Liqing Yao, Yutong Fu, Qiuyi Li, Yihuan Lu, Min Jin, Lu Zou, Yongqian Han, Chunyan Xu
BACKGROUND: Rational prediction of the probability of decannulation in tracheotomy patients is of great importance to clinicians and patients' families. This study aimed to develop a prediction model for decannulation in tracheotomized patients with neurological injury using routine clinical data and blood tests. METHODS: We developed a prediction model based on 186 tracheotomized patients, and data were collected from January 2018 to March 2021. The least absolute shrinkage and selection operator (LASSO) regression model was used to optimize feature selection for the decannulation risk model...
December 7, 2023: International Journal of Neuroscience
https://read.qxmd.com/read/38050799/home-ventilation-in-low-resource-settings-learning-to-do-more-with-less
#22
JOURNAL ARTICLE
Marco Zampoli, Jane Booth, Diane M Gray, Aneesa Vanker
Long-term ventilation (LTV) in children at home, especially invasive ventilation, is not widely available nor practised in low-resource settings (LRS). Barriers to providing LTV include underdeveloped pediatric critical care services, limited expertise in pediatric LTV, limited capacity to screen for sleep-disordered breathing (SDB) and high cost of LTV equipment and consumables. Additional challenges encountered in LRS may be unreliable electricity supply and difficult socioeconomic conditions. Where LTV at home has been successfully implemented, caregivers and families in LRS must often take full responsibility for their child's care as professional home-based nursing care is scarce...
December 5, 2023: Pediatric Pulmonology
https://read.qxmd.com/read/37988077/patient-outcomes-after-long-term-acute-care-hospital-closures
#23
JOURNAL ARTICLE
Anica C Law, Nicholas A Bosch, Yang Song, Archana Tale, Robert W Yeh, Jeremy M Kahn, Jennifer P Stevens, Allan J Walkey
IMPORTANCE: Long-term acute care hospitals (LTCHs) are common sites of postacute care for patients recovering from severe respiratory failure requiring mechanical ventilation (MV). However, federal payment reform led to the closure of many LTCHs in the US, and it is unclear how closure of LTCHs may have affected upstream care patterns at short-stay hospitals and overall patient outcomes. OBJECTIVE: To estimate the association between LTCH closures and short-stay hospital care patterns and patient outcomes...
November 1, 2023: JAMA Network Open
https://read.qxmd.com/read/37981883/-utilization-of-hospice-resources-in-adult-intensive-care-units-a-comparison-between-users-and-non-users
#24
JOURNAL ARTICLE
Chieh-Han Su, Yu-Chang Yeh, Jaw-Shiun Tsai, Chia-Chun Tang
BACKGROUND: The application of palliative care is limited and challenging in intensive care units (ICUs) because of complex factors such as time constraints and unpredictable disease progression. Although research results and international consensus stress the early use of palliative care, utilization remains low, resulting in increased risks of ineffective medical care and poor quality of death. Improving this situation requires a comprehensive understanding of the palliative condition in ICUs...
December 2023: Hu Li za Zhi the Journal of Nursing
https://read.qxmd.com/read/37971341/trajectory-after-tracheostomy-sobering-data-for-decision-makers
#25
EDITORIAL
Richard H Savel, Ariel L Shiloh
No abstract text is available yet for this article.
December 1, 2023: Critical Care Medicine
https://read.qxmd.com/read/37964652/parent-perspectives-on-the-child-experience-of-pediatric-home-ventilation-via-tracheostomy
#26
JOURNAL ARTICLE
Holly Hoa Vo, Amanda H Mercer, Nicholas A Jabre, Carrie M Henderson, Renee D Boss, Benjamin S Wilfond
BACKGROUND AND OBJECTIVE: Parents facing the decision of whether to initiate pediatric mechanical ventilation via tracheostomy ("home ventilation") report wanting information about what to expect for life at home for their child. The study objective is to explore parent descriptions of the child experience of home ventilation to increase awareness for clinicians in the inpatient setting caring for these children. METHODS: Semistructured interviews were conducted using purposive sampling of parents with children who initiated home ventilation within the previous 5 years from 3 geographically diverse academic medical centers...
November 15, 2023: Hospital Pediatrics
https://read.qxmd.com/read/37934151/predictors-and-prognosis-of-tracheostomy-in-relapsing-polychondritis
#27
JOURNAL ARTICLE
Ruxue Yin, Dong Xu, Qian Wang, Mengtao Li, Wen Zhang, Fengchun Zhang, Xiaofeng Zeng, Nan Jiang, Yong Hou
OBJECTIVE: Airway obstruction can occur in patients with relapsing polychondritis (RP) with laryngeal involvement, occasionally requiring tracheostomy to avoid serious complications. Herein, we assessed the risk factors for tracheostomy and developed a risk prediction model. METHODS: Clinical characteristics of patients with RP, with and without tracheostomy, were compared using multivariate logistic regression analysis to identify risk factors. A nomogram was developed to predict the population at risk of requiring tracheostomy...
November 2, 2023: Rheumatology
https://read.qxmd.com/read/37931902/utility-of-bedside-ultrasound-in-percutaneous-tracheostomy
#28
JOURNAL ARTICLE
Simon Meredith, Zein Kattih, Brenda Garcia, Viera Lakticova, Bushra Mina, Margarita Oks, Anup Singh
Background: Percutaneous tracheostomy placement is a common procedure performed in the intensive care unit. The use of an anterior neck ultrasound exam is routinely performed preprocedure, allowing for vessel visualization in determining the safety and feasibility of performing the procedure bedside. This prospective observational cohort study was conducted to determine whether vasculature in the anterior neck, seen on bedside ultrasound exam, contributes to bleeding complications during or after percutaneous tracheostomy (PCT) placement...
November 6, 2023: Journal of Intensive Care Medicine
https://read.qxmd.com/read/37931498/perinatal-airway-management-in-neonatal-goiter-a-healthcare-cost-and-utilization-project-hcup-kids-inpatient-database-analysis
#29
JOURNAL ARTICLE
Maya N Matabele, Christie Cheng, Manasa Venkatesh, Samantha Barr, Johanna Ellefson, Michael Beninati, Inna N Lobeck, Michael D Puricelli
INTRODUCTION: Fetal goiter is a rare congenital disorder that can present with life-threatening neonatal airway obstruction. Lifesaving and function-preserving airway management strategies are available, but routine delivery affords a limited window for intervention. Accordingly, fetal goiter is reported among the most common indications for ex-utero intrapartum treatment (EXIT). While EXIT prolongs the window for airway intervention to benefit the neonate, it elevates the risk to the pregnant person and requires extensive resources; therefore, data to guide ideal treatment selection are essential...
December 2023: International Journal of Pediatric Otorhinolaryngology
https://read.qxmd.com/read/37907398/to-trach-or-not-to-trach-long-term-tracheostomy-outcomes-in-infants-with-bpd
#30
REVIEW
Matthew J Kielt, Jonathan C Levin
See Bonus NeoBriefs videos and downloadable teaching slides Infants born preterm who are diagnosed with bronchopulmonary dysplasia (BPD) demonstrate a wide spectrum of illness severity. For infants with the most severe forms of BPD, safe discharge from the hospital may only be possible by providing long-term ventilation via a surgically placed tracheostomy. Though tracheostomy placement in infants with BPD is infrequent, recent reports suggest that rates of tracheostomy placement are increasing in this population...
November 1, 2023: NeoReviews
https://read.qxmd.com/read/37878376/a-mindfulness-based-resiliency-program-for-caregivers-of-patients-with-severe-acute-brain-injury-transitioning-out-of-critical-care-protocol-for-an-open-pilot-trial
#31
JOURNAL ARTICLE
Alexander Mattia Presciutti, Emily Woodworth, Elizabeth Rochon, Molly Neale, Melissa Motta, Joseph Piazza, Ana-Maria Vranceanu, David Yi-Gin Hwang
BACKGROUND: Caregivers of patients with severe acute brain injuries (SABI) that lead to coma and require intensive care unit (ICU) treatment often experience chronic emotional distress. To address this need, we developed the Coma Family (COMA-F) program, a mindfulness-based resiliency intervention for these caregivers. OBJECTIVE: We will conduct an open pilot trial of COMA-F (National Institutes of Health Stage IA). Here we describe our study protocol and proposed intervention content...
October 25, 2023: JMIR Research Protocols
https://read.qxmd.com/read/37868025/identifying-patterns-of-medical-intervention-in-acute-respiratory-failure-a-retrospective-observational-study
#32
JOURNAL ARTICLE
Jacqueline M Kruser, Kartikey Sharma, Jane L Holl, Omid Nohadani
IMPORTANCE: Characterizing medical interventions delivered to ICU patients over time and their relationship to outcomes can help set expectations and inform decisions made by patients, clinicians, and health systems. OBJECTIVES: To determine whether distinct and clinically relevant pathways of medical intervention can be identified among adult ICU patients with acute respiratory failure. DESIGN SETTING AND PARTICIPANTS: Retrospective observational study using all-payer administrative claims data from 2012 to 2014...
October 2023: Critical care explorations
https://read.qxmd.com/read/37864489/early-tracheostomy-may-be-performed-safely-in-obese-covid-19-patients-supported-on-vv-ecmo
#33
JOURNAL ARTICLE
Ian A Tamargo, Christina Creel-Bulos, Maria C Callahan, Casey Miller, Sagar B Dave, Gustavo A Parrilla, Joshua L Chan, Mani A Daneshmand, Jeffrey Javidfar
OBJECTIVE: Obese patients with coronavirus disease 2019 (COVID-19)-associated acute respiratory failure (ARDS) often require prolonged intubation. However, data are sparse regarding optimal tracheostomy timing in obese adults with COVID-19 requiring venovenous extracorporeal membrane oxygenation (VV-ECMO). This study retrospectively describes the course of obese patients with COVID-19 who underwent tracheostomy on VV-ECMO between March 2020 and December 2022. METHODS: There were 62 participants with a median age of 43 (interquartile range [IQR] 33 to 53) years and a median body mass index of 42 (IQR 34 to 50) kg/m2 who received VV-ECMO for COVID-19-associated ARDS...
2023: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://read.qxmd.com/read/37833495/evaluating-caregiver-clinician-communication-for-tracheostomy-placement-in-the-neonatal-intensive-care-unit-a-qualitative-inquiry
#34
JOURNAL ARTICLE
Kylie M Bushroe, Kelly D Crisp, Mary C Politi, Steven K Brennan, Ashley J Housten
OBJECTIVE: Identify stakeholders' tracheostomy decision-making information priorities in the Neonatal Intensive Care Unit (NICU). STUDY DESIGN: English-speaking caregivers and clinicians who participated in NICU tracheostomy discussions between January 2017 and December 2021 were eligible. They reviewed a pediatric tracheostomy communication guide prior to meeting. Interviews focused on tracheostomy decision-making experiences, communication preferences, and guide perceptions...
October 13, 2023: Journal of Perinatology: Official Journal of the California Perinatal Association
https://read.qxmd.com/read/37761012/tracheostomy-in-severe-bronchopulmonary-dysplasia-how-to-decide-in-the-absence-of-evidence
#35
REVIEW
Audrey N Miller, Edward G Shepherd, Amy Manning, Humra Shamim, Tendy Chiang, George El-Ferzli, Leif D Nelin
Infants with the most severe forms of bronchopulmonary dysplasia (BPD) may require long-term invasive positive pressure ventilation for survival, therefore necessitating tracheostomy. Although life-saving, tracheostomy has also been associated with high mortality, postoperative complications, high readmission rates, neurodevelopmental impairment, and significant caregiver burden, making it a highly complex and challenging decision. However, for some infants tracheostomy may be necessary for survival and the only way to facilitate a timely and safe transition home...
September 19, 2023: Biomedicines
https://read.qxmd.com/read/37753318/hospice-and-palliative-care-for-patients-in-the-intensive-care-unit-current-status-in-countries-other-than-korea
#36
JOURNAL ARTICLE
Minkyu Jung
Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e...
March 1, 2023: J Hosp Palliat Care
https://read.qxmd.com/read/37746408/rapid-detection-of-carbapenemase-producing-multidrug-resistant-mdr-pathogens-by-modified-carba-np-test-in-ventilator-associated-pneumonia-vap-in-elderly-patients
#37
JOURNAL ARTICLE
Rahil Pasha S A, Ruby Suresh Kumar Yadav, Md Iqbal Ahmed, Pratibha Chandra
Background Ventilator-associated pneumonia (VAP) is defined as pneumonia that develops 48 hours or more after endotracheal intubation or tracheostomy and is brought on by infectious organisms that are not present or incubating during mechanical ventilation. Multidrug-resistant organisms originate primarily from the hospital environment and significantly contribute to ventilator-associated pneumonia. These organisms pose a severe threat, leading to a higher mortality rate due to their resistance to more potent antibiotics...
August 2023: Curēus
https://read.qxmd.com/read/37740270/-a-nurse-s-experience-providing-care-to-a-mother-of-a-toddler-with-cohen-s-syndrome-facing-tracheostomy-decision-making-conflict-using-watson-s-caring-theory
#38
JOURNAL ARTICLE
Ya-Han Lin, Chia-Hui Chien, Shu-Ru Uen, Shao-Yu Tsai
This case involved a 17-month-old toddler with Cohen's syndrome and cerebral palsy who had experienced multiple hospitalizations and operations since birth. During hospitalization, the patient suffered from tracheomalacia and poor swallowing and coughing abilities and had experienced two cardiopulmonary resuscitation events, after which a tracheotomy was suggested. Decision-making regarding the tracheotomy placed the mother under tremendous pressure, who was facing both the life-threatening disease of her son and her burden of care...
October 2023: Hu Li za Zhi the Journal of Nursing
https://read.qxmd.com/read/37646125/dynamic-computed-tomography-for-evaluation-of-tracheobronchomalacia-in-premature-infants-with-bronchopulmonary-dysplasia
#39
JOURNAL ARTICLE
Charles Preston Pugh, Sumera Ali, Amit Agarwal, David N Matlock, Megha Sharma
INTRODUCTION: Dynamic computed tomography (dCT) gives real-time physiological information and objective descriptions of airway narrowing in tracheobronchomalacia (TBM). There is a paucity of literature in the evaluation of TBM by dCT in premature infants with bronchopulmonary dysplasia (BPD). The aim of this study is to describe the findings of dCT and resultant changes in management in premature infants with TBM. METHODS: A retrospective study of 70 infants was performed...
August 30, 2023: Pediatric Pulmonology
https://read.qxmd.com/read/37638787/healthcare-trajectories-and-outcomes-in-the-first-year-after-tracheostomy-based-on-patient-characteristics
#40
JOURNAL ARTICLE
Anuj B Mehta, Daniel D Matlock, Andrew F Shorr, Ivor S Douglas
OBJECTIVES: To define healthcare trajectories after tracheostomy to inform shared decision-making efforts for critically ill patients. DESIGN: Retrospective epidemiologic cohort study. SETTING: California Patient Discharge Database 2018-2019. PATIENTS: Patients who received a tracheostomy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We tracked 1-year outcomes after tracheostomy, including survival and time alive in and out of a healthcare facility (HCF...
December 1, 2023: Critical Care Medicine
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