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Weaning from mechanical ventilation

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https://www.readbyqxmd.com/read/29142373/a-pilot-study-of-nebulized-heparin-for-prevention-of-ventilator-induced-lung-injury-comparative-effects-with-an-inhaled-corticosteroid
#1
Farzin Ghiasi, Mohsen Sadeghian, Mohammad Emami, Babak Ali Kiaie, Sarah Mousavi
Background: Ventilator-induced lung injury (VILI) is a side effect of mechanical ventilation. Lung inflammation and pulmonary activation of coagulation are induced by mechanical stress. Clinical and preclinical studies show that heparin possesses anti-inflammatory properties. Therefore, we assessed the effects of nebulized heparin in VILI. Methods: Sixty critically ill adult patients who require mechanical ventilation for more than 48 h were included in this prospective, nonrandomized controlled study...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29141527/decreases-in-mixed-venous-blood-o2-saturation-in-cardiac-surgery-patients-following-extubation
#2
Jeffrey Williams, Anna McLean, Jalil Ahari, Arun Jose, Georges Al-Helou, Italo Ibi, Farzad Najam Md, Guillermo Gutierrez
BACKGROUND: Decreases in mixed venous O2 saturation (SvO2) have been reported to occur in postcardiac surgery patients during weaning from mechanical ventilation. Our aim was to establish whether the physiological mechanism responsible for this phenomenon was a decrease in systemic O2 delivery (DO2) or an increase in global O2 consumption ([Formula: see text]O2). METHODS: We studied 21 mechanically ventilated, postoperative cardiac patients for 30 minutes before and 60 minutes after extubation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29137068/carnitine-acylcarnitine-translocase-deficiency-with-c-199-10-t-g-and-novel-c-1a-g-mutation-two-case-reports-and-brief-literature-review
#3
Hui-Ming Yan, Hao Hu, Aisha Ahmed, Bing-Bing Feng, Jing Liu, Zheng-Jun Jia, Hua Wang
RATIONALE: Carnitine-acylcarnitine translocate deficiency (CACTD) is a rare and life-threatening, autosomal recessive disorder of fatty acid β-oxidation characterized by hypoketotic hypoglycemia, hyperammonemia, cardiomyopathy, liver dysfunction, and muscle weakness; culminating in early death. To date, CACTD cases screened from the Chinese mainland population, especially patient with compound heterozygote with c.199-10T>G and a novel c.1A>G mutation in the SLC25A20 gene has never been described...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#4
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29135527/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#5
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
November 9, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29132698/risk-factor-analysis-for-intraoperative-extracorporeal-membrane-oxygenation-weaning-failure-after-lung-transplantation
#6
Kyoung Shik Narm, Seokkee Lee, Jee Won Suh, Anes Kim, Jin Gu Lee, Moo Suk Park, Song Yee Kim, Joo Han Song, Su Jin Jeong, Hyo Chae Paik
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been widely used for hemodynamic support during lung transplantation (LTx). We evaluated the risk factors associated with failure of weaning from ECMO in the operating room during LTx. METHODS: We retrospectively reviewed 74 consecutive patients who had undergone LTx from March 2013 to February 2016. Patients who underwent single LTx, multiorgan transplantation, and LTx for pulmonary hypertension were excluded...
November 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#7
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29109556/management-of-mechanical-ventilation-in-patients-with-hospital-acquired-pneumonia-a-retrospective-observational-study
#8
Radovan Uvizl, Tomas Herkel, Katerina Langova, Petr Jakubec
BACKGROUND: Hospital-acquired pneumonia (HAP) in intensive care patients is a frequent reason for mechanical ventilation (MV). The management of MV and ventilator weaning vary, depending on the type of lung inflammation. This retrospective, observational study screened the data from all patients admitted to the intensive care unit (ICU) of the Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc between 2011 and 2016...
November 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#9
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#10
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29084407/hypoxemia-episodes-during-day-and-night-and-their-impact-on-oxygen-saturation-targeting-in-mechanically-ventilated-preterm-infants
#11
Deepak Jain, Carmen D'Ugard, Jose Bello, Eduardo Bancalari, Nelson Claure
BACKGROUND: Hypoxemia episodes (HE) occur frequently in ventilated preterm infants and hinder the achievement of arterial oxygen saturation (SpO2) targets. These episodes may increase the risk for retinopathy of prematurity and neurodevelopmental disability. There are no data on the variation in HE and SpO2 targeting between day and night. OBJECTIVE: The aim of this study was to evaluate the difference between day and night on the frequency and severity of HE and achievement of SpO2 targets...
October 31, 2017: Neonatology
https://www.readbyqxmd.com/read/29063594/late-7-days-systemic-postnatal-corticosteroids-for-prevention-of-bronchopulmonary-dysplasia-in-preterm-infants
#12
REVIEW
Lex W Doyle, Jeanie L Cheong, Richard A Ehrenkranz, Henry L Halliday
BACKGROUND: Many preterm infants who survive go on to develop bronchopulmonary dysplasia, probably as the result of persistent inflammation in the lungs. Corticosteroids have powerful anti-inflammatory effects and have been used to treat individuals with established bronchopulmonary dysplasia. However, it is unclear whether any beneficial effects outweigh the adverse effects of these drugs. OBJECTIVES: To examine the relative benefits and adverse effects of late systemic postnatal corticosteroid treatment (> 7 days) for preterm infants with evolving or established bronchopulmonary dysplasia...
October 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29058315/atelectasis-is-inversely-proportional-to-transpulmonary-pressure-during-weaning-from-ventilator-support-in-a-large-animal-model
#13
M Gudmundsson, G Perchiazzi, M Pellegrini, A Vena, G Hedenstierna, C Rylander
BACKGROUND: In mechanically ventilated, lung injured, patients without spontaneous breathing effort, atelectasis with shunt and desaturation may appear suddenly when ventilator pressures are decreased. It is not known how such a formation of atelectasis is related to transpulmonary pressure (PL ) during weaning from mechanical ventilation when the spontaneous breathing effort is increased. If the relation between PL and atelectasis were known, monitoring of PL might help to avoid formation of atelectasis and cyclic collapse during weaning...
October 23, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29050461/comparison-of-clinical-utility-between-diaphragm-excursion-and-thickening-change-using-ultrasonography-to-predict-extubation-success
#14
Jung-Wan Yoo, Seung Jun Lee, Jong Deog Lee, Ho Cheol Kim
Background/Aims: Both diaphragmatic excursion and change in muscle thickening are measured using ultrasonography (US) to assess diaphragm function and mechanical ventilation weaning outcomes. However, which parameter can better predict successful extubation remains to be determined. The aim of this study was to compare the clinical utility of these two diaphragmatic parameters to predict extubation success. Methods: This study included patients subjected to extubation trial in the medical or surgical intensive care unit of a university-affiliated hospital from May 2015 through February 2016...
October 19, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29025380/early-tracheostomy-reduces-time-of-mechanical-ventilation-in-respiratory-high-risk-patients-after-liver-transplant
#15
Sebastian Cammann, Kai Timrott, Florian W R Vondran, Harald Schrem, Frank Lehner, Jürgen Klempnauer, Wolfgang Knitsch, Moritz Kleine
OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29018041/spontaneous-breathing-trials-and-conservative-sedation-practices-reduce-mechanical-ventilation-duration-in-subjects-with-ards
#16
Richard H Kallet, Hanjing Zhuo, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: Spontaneous breathing trials (SBTs) and daily sedation interruptions (DSIs) reduce both the duration of mechanical ventilation and ICU length of stay (LOS). The impact of these practices in patients with ARDS has not previously been reported. We examined whether implementation of SBT/DSI protocols reduce duration of mechanical ventilation and ICU LOS in a retrospective group of subjects with ARDS at a large, urban, level-1 trauma center. METHODS: All ARDS survivors from 2002 to 2016 (N = 1,053) were partitioned into 2 groups: 397 in the pre-SBT/DSI group (June 2002-December 2007) and 656 in the post-SBT/DSI group (January 2009-April 2016)...
October 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28987578/housing-and-management-characteristics-of-calf-automated-feeding-systems-in-the-upper-midwest-united-states
#17
M W Jorgensen, K Janni, A Adams-Progar, H Chester-Jones, J A Salfer, M I Endres
Automated milk feeders are used by dairy producers to manage preweaned calves in group housing, but little is known about how these feeding systems are being used in the United States. To better understand how US dairy producers are operating these systems, this study investigated characteristics of barn design, environment, and management practices on 38 farms in the Upper Midwest United States via a questionnaire and on-farm measurements. Farms using automated feeders ranged in size from 7 to 300 calves on site...
October 4, 2017: Journal of Dairy Science
https://www.readbyqxmd.com/read/28977266/potential-clinical-application-of-surface-electromyography-as-indicator-of-neuromuscular-recovery-during-weaning-tests-after-organophosphate-poisoning
#18
Maria Bernarda Salazar Sánchez, Alher Mauricio Hernández Valdivieso, Miguel Ángel Mañanas Villanueva, Andrés Felipe Zuluaga Salazar
This study aimed to explore the usefulness of measuring respiratory muscle activity in mechanically ventilated patients suffering from acute organophosphate poisoning, with a view towards providing complementary information to determine the best time to suspend ventilatory support. Surface electromyography in respiratory muscles (diaphragm, external intercostal and sternocleidomastoid muscles) was recorded in a young man affected by self-poisoning with an unknown amount of parathion to determine the muscle activity level during several weaning attempts from mechanical ventilation...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28977261/assessment-of-weaning-indexes-based-on-diaphragm-activity-in-mechanically-ventilated-subjects-after-cardiovascular-surgery-a-pilot-study
#19
Isabel Cristina Muñoz Ortega, Alher Mauricio Hernández Valdivieso, Joan Francesc Alonso Lopez, Miguel Ángel Mañanas Villanueva, Luis Horacio Atehortúa Lopez
OBJECTIVE: The aim of this pilot study was to evaluate the feasibility of surface electromyographic signal derived indexes for the prediction of weaning outcomes among mechanically ventilated subjects after cardiac surgery. METHODS: A sample of 10 postsurgical adult subjects who received cardiovascular surgery that did not meet the criteria for early extubation were included. Surface electromyographic signals from diaphragm and ventilatory variables were recorded during the weaning process, with the moment determined by the medical staff according to their expertise...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28974646/factors-associated-with-re-intubation-within-14-days-after-ventilator-liberation
#20
Chia-Chen Chu, Chin-Jung Liu, Suh-May Yen, Wen-Yu Chou, Pei-Tseng Kung, Yuh-Show Tsai, Wen-Chen Tsai
BACKGROUND: According to Taiwan's integrated delivery system policy, ventilator-dependent patients are successfully liberated from mechanical ventilation in accordance with step-down care. However, premature discharge affects the 14-d readmission quality index. Therefore, we explored the risk and related factors of subjects liberated from mechanical ventilation who were re-intubated within 14 d. METHODS: This retrospective study analyzed a cohort of ventilator-dependent subjects 17 y of age and older using a population-based database from the Taiwan National Health Research Institutes Database from 2006 to 2010...
October 3, 2017: Respiratory Care
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