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Weaning from mechanical ventilation

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https://www.readbyqxmd.com/read/28526862/significant-clinical-factors-associated-with-long-term-mortality-in-critical-cancer-patients-requiring-prolonged-mechanical-ventilation
#1
Li-Ta Keng, Kuei-Pin Chung, Shu-Yung Lin, Sheng-Kai Liang, Jui-Chen Cheng, I-Chun Chen, Yen-Fu Chen, Hou-Tai Chang, Chia-Lin Hsu, Jih-Shuin Jerng, Hao-Chien Wang, Ping-Hung Kuo, Huey-Dong Wu, Jin-Yuan Shih, Chong-Jen Yu
Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6...
May 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28524029/-predictive-value-of-left-ventricular-diastolic-dysfunction-on-mechanical-ventilation-weaning
#2
Hui Wang, Ming Ma, Desheng Chen, Gang Li, Shupeng Wang, Jingen Xia, Jun Duan
OBJECTIVE: To investigate the predictive value of left ventricular diastolic function on mechanical ventilation weaning in patients with left ventricular ejection fraction (LVEF) > 0.50. METHODS: A retrospective case control study was conducted. Sixty-five patients with LVEF > 0.50 undergoing mechanical ventilation for more than 48 hours admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from June 2014 to December 2016 were enrolled...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28522351/effect-of-early-supplemental-parenteral-nutrition-in-the-paediatric-icu-a-preplanned-observational-study-of-post-randomisation-treatments-in-the-pepanic-trial
#3
Ilse Vanhorebeek, Sascha Verbruggen, Michaël P Casaer, Jan Gunst, Pieter J Wouters, Jan Hanot, Gonzalo Garcia Guerra, Dirk Vlasselaers, Koen Joosten, Greet Van den Berghe
BACKGROUND: Large randomised controlled trials have shown that early supplemental parenteral nutrition in patients admitted to adult and paediatric intensive care units (PICUs) is harmful. Overdosing of energy with too little protein was suggested as a potential reason for this. This study analysed which macronutrient was associated with harm caused by early supplemental parenteral nutrition in the Paediatric Early versus Late Parenteral Nutrition In Critical Illness (PEPaNIC) randomised trial...
May 15, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28515948/cerebral-air-embolism-associated-with-penetrating-lung-injury-a-case-report-and-review-of-the-literature
#4
Ayumu Yamaoka, Kei Miyata, Eichi Narimatsu, Eiji Sakawaki, Sonoko Sakawaki, Suguru Hirayama, Shuji Uemura, Naoya Yama
CASE: A 44-year-old man intentionally stabbed himself in the anterior neck and left thorax with a fruit knife. Physical examination revealed two open wounds entering the thoracic cavity in the front chest, and a stab wound entering the trachea at the neck. Two chest tubes were initially inserted for the left lung injury with open hemopneumothorax. Nevertheless, the worsening oxygenation required positive pressure ventilation (PPV) with endotracheal intubation. OUTCOME: Right hemiparesis was found during weaning from PPV...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/28505685/-weaning-unit-of-the-university-medicine-greifswald-institutional-structure-and-weaning-results-from-prolonged-ventilation-over-10-years
#5
A Müller-Heinrich, C Warnke, A Heine, T Bollmann, M Boesche, C Schäper, B Stubbe, S Friesecke, S B Felix, S Gläser, A Obst, R Ewert
The increasing importance of intensive care medicine including mechanical ventilation has been accompanied by the demand of weaning opportunities for patients undergoing prolonged mechanical ventilation. Consequently, specialised clinical institutions, focusing on the weaning from mechanical ventilation, have been established since the 1980 s.The present article illustrates the structural development and results of such a specialised institution at the University Medicine Greifswald, using data of 616 patients collected within the past ten years (2006 - 2015)...
May 15, 2017: Pneumologie
https://www.readbyqxmd.com/read/28502363/-weaning-from-mechanical-ventilation-role-of-conventional-methods-and-non-invasive-ventilation-for-weaning
#6
C Girault, A Gacouin
No abstract text is available yet for this article.
May 10, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#7
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28461543/predictive-associations-of-music-anxiety-and-sedative-exposure-on-mechanical-ventilation-weaning-trials
#8
Breanna Hetland, Ruth Lindquist, Craig R Weinert, Cynthia Peden-McAlpine, Kay Savik, Linda Chlan
BACKGROUND: Weaning from mechanical ventilation requires increased respiratory effort, which can heighten anxiety and later prolong the need for mechanical ventilation. OBJECTIVES: To examine the predictive associations of music intervention, anxiety, sedative exposure, and patients' characteristics on time to initiation and duration of weaning trials of patients receiving mechanical ventilation. METHODS: A descriptive, correlational design was used for a secondary analysis of data from a randomized trial...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28443268/complicated-postoperative-course-after-pulmonary-artery-sling-repair-and-slide-tracheoplasty
#9
Angelika Weber, Birgit Donner, Marie-Hélène Perez, Stefano Di Bernardo, Daniel Trachsel, Kishore Sandu, Nicole Sekarski
Pulmonary artery sling (PAS) is a rare congenital condition in which the left pulmonary artery (LPA) arises from the right pulmonary artery, and then passes between the trachea and the esophagus to reach the left lung, thereby forming a sling around the airway. It is often associated with intrinsic tracheal stenosis due to complete cartilaginous rings. Therapeutic management nowadays consists of one-stage reimplantation of the LPA and tracheoplasty with cardiopulmonary bypass support. Here, we present a 7-week-old boy with PAS and long-segment tracheal stenosis (LSTS) who underwent surgical intervention consisting of reimplantation of the LPA and slide tracheoplasty...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28441238/diaphragm-activation-in-ventilated-patients-using-a-novel-transvenous-phrenic-nerve-pacing-catheter
#10
Steven Reynolds, Adrian Ebner, Tracy Meffen, Viral Thakkar, Matt Gani, Kaity Taylor, Linda Clark, Gautam Sadarangani, Ramasamy Meyyappan, Rodrigo Sandoval, Elizabeth Rohrs, Joaquín A Hoffer
OBJECTIVES: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28411422/ventilation-distribution-and-lung-recruitment-with-speaking-valve-use-in-tracheostomised-patient-weaning-from-mechanical-ventilation-in-intensive-care
#11
Anna-Liisa Sutt, Chris M Anstey, Lawrence R Caruana, Petrea L Cornwell, John F Fraser
PURPOSE: Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. MATERIALS AND METHODS: A secondary analysis of Electrical Impedance Tomography (EIT) data from a previous study was conducted...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#12
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#13
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#14
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28393778/safety-and-efficacy-of-ketamine-dexmedetomidine-versus-ketamine-propofol-combinations-for-sedation-in-patients-after-coronary-artery-bypass-graft-surgery
#15
Mona Mohamed Mogahd, Mohammed Shafik Mahran, Ghada Foad Elbaradi
BACKGROUND AND AIMS: Prolonged mechanical ventilation after cardiac surgery is associated with serious complications that increase morbidity and mortality. The present study was designed to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for sedation and analgesia in patients after coronary artery bypass graft (CABG) surgery as regards hemodynamics, total fentanyl dose, time of weaning from mechanical ventilation, time of extubation, and any adverse outcome...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28382808/weaning-of-neurological-early-rehabilitation-patients-from-mechanical-ventilation-a-retrospective-observational-study
#16
Jens D Rollnik, Joachim K Krauss, Christoph Gutenbrunner, Claus Wallesch, Thomas Münte, Martin Stangel
BACKGROUND: There is little known about the factors influencing the weaning process of long-term mechanically ventilated patients in the neurological early rehabilitation. AIM: To identify salient clinical and neurophysiological variables with impact upon weaning from mechanical ventilation during neurological and neurosurgical early rehabilitation. DESIGN: Observational, retrospective data analysis. POPULATION: A sample of 65 mechanically ventilated neurological and neurosurgical early rehabilitation patients of the BDH-Clinic Hessisch Oldendorf in Northern Germany...
April 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28380204/pendelluft-diagnosed-from-ventilator-weaning-indexes-obtained-through-bioelectrical-impedance-tomography-a-case-report
#17
Fabiana Aparecida Lopes, Lidiane Andrade Monteiro de Souza, Juliana Tavares Neves Bernardi, Carlos Eduardo Rocha, Luciana Castilho de Figueiredo, Ana Paula Ragonete Dos Anjos Agostini, Desanka Dragosavac, Daniela Cristina Dos Santos Faez
CONTEXT: Today, through major technological advances in diagnostic resources within medicine, evaluation and monitoring of clinical parameters at the patient's bedside in intensive care units (ICUs) has become possible. CASE REPORT: This case report presents results and interpretations from predictive mechanical ventilation weaning indexes obtained through monitoring using chest electrical bioimpedance tomography. These indexes included maximum inspiratory pressure, maximum expiratory pressure, shallow breathing index and spontaneous breathing test...
April 3, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#18
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28377920/automated-weaning-from-mechanical-ventilation-after-off-pump-coronary-artery-bypass-grafting
#19
Evgenia V Fot, Natalia N Izotova, Angelika S Yudina, Aleksei A Smetkin, Vsevolod V Kuzkov, Mikhail Y Kirov
BACKGROUND: The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28373296/a-proteomic-approach-to-identify-alterations-in-the-sumo-network-during-controlled-mechanical-ventilation-in-rat-diaphragm-muscle
#20
Arvind Venkat Namuduri, Gabriel Heras, Jia Mi, Nicola Cacciani, Katarina Hörnaeus, Anne Konzer, Sara Bergström Lind, Lars Larsson, Stefano Gastaldello
The Small Ubiquitin-like Modifier (SUMO) is as a regulator of many cellular functions by reversible conjugation to a broad number of substrates. Under endogenous or exogenous perturbations, the SUMO network becomes a fine sensor of stress conditions by alterations in the expression level of SUMO enzymes and consequently changing the status of SUMOylated proteins. The diaphragm is the major inspiratory muscle, which is continuously active under physiological conditions, but its structure and function is severely affected when passively displaced for long extents during mechanical ventilation (MV)...
April 3, 2017: Molecular & Cellular Proteomics: MCP
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