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https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#1
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28929060/laser-assisted-double-layer-endoscopic-repair-of-laryngeal-clefts-our-experience-in-11-cases
#2
Danah Aljomah, Jaber Alshammari
Laryngeal cleft is a rare congenital malformation of the respiratory tract leading to a high level of morbidity and mortality, recently being diagnosed with increased frequency. Management throughout the years included medical and surgical. The open surgical technique is more commonly used although it has higher risk and need longer post-operative care. Recently surgical endoscopic repair was introduced using different techniques. To evaluate the clinical features of infants and children presenting with laryngeal clefts, and review endoscopic management modality especially the technique and results of repair using double-layer (2 layers) technique...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28892669/development-of-a-prediction-model-for-long-term-quality-of-life-in-critically-ill-patients
#3
Sandra Oeyen, Karel Vermeulen, Dominique Benoit, Lieven Annemans, Johan Decruyenaere
PURPOSE: We developed a prediction model for quality of life (QOL) 1 year after intensive care unit (ICU) discharge based upon data available at the first ICU day to improve decision-making. METHODS: The database of a 1-year prospective study concerning long-term outcome and QOL (assessed by EuroQol-5D) in critically ill adult patients consecutively admitted to the ICU of a university hospital was used. Cases with missing data were excluded. Utility indices at baseline (UIb) and at 1 year (UI1y) were surrogates for QOL...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28882178/differential-lung-ventilation-via-tracheostomy-using-two-endotracheal-tubes-in-an-infant-a-case-report
#4
Demet Demirkol, Yasemin Ataman, Gökhan Gündoğdu
BACKGROUND: This case report presents differential lung ventilation in an infant. The aim is to define an alternative technique for performing differential lung ventilation in children. To the best of our knowledge, this is the first report of this kind. CASE PRESENTATION: A 4.2-kg, 2.5-month-old Asian boy was referred to our facility with refractory hypoxemia and hypercarbia due to asymmetric lung disease with atelectasis of the left lung and hyperinflation of the right lung...
September 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28876220/the-application-of-the-modified-surgical-wound-dressing-in-wound-care-after-tracheotomy
#5
Mei Feng, Ying Wu, Jing Zhu, Xiaoling Wu
INTRODUCTION: This study was performed to observe the efficacy of a modified surgical wound dressing applied as part of decannulation wound care after tracheotomy. METHODS: Eighty-four patients were randomly allocated into a traditional care group, a surgical wound dressing group, and a modified surgical wound dressing group. Each group comprised 28 patients. The following outcomes were observed and analyzed: infection rate, wound closure time, dressing change frequency, cost of wound care, and patients' comfort...
2017: Regenerative Medicine Research
https://www.readbyqxmd.com/read/28875324/-extreme-obesity-particular-aspect-of-invasive-and-noninvasive-ventilation
#6
REVIEW
M Deppe, P Lebiedz
The obesity rate is increasing worldwide and the percentage of obese patients in the intensive care unit (ICU) is rising concomitantly. Ventilatory support strategies in obese patients must take into account the altered pathophysiological conditions. Unfortunately, prospective randomized multicenter trials on this subject are lacking. Therefore, current strategies are based on the individual experiences of ICU physicians and single-center studies. Noninvasive ventilation (NIV) in critically ill patients with acute respiratory failure and obesity hypoventilation syndrome (OHS) is an efficient treatment option and should be provided as early as possible is an effort to avoid intubation...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28872117/electroencephalographic-heart-rate-and-galvanic-skin-response-assessment-for-an-advertising-perception-study-application-to-antismoking-public-service-announcements
#7
Giulia Cartocci, Myriam Caratù, Enrica Modica, Anton Giulio Maglione, Dario Rossi, Patrizia Cherubino, Fabio Babiloni
The evaluation of advertising, products, and packaging is traditionally performed through methods based on self-reports and focus groups, but these approaches often appear poorly accurate in scientific terms. Neuroscience is increasingly applied to the investigation of the neurophysiological bases of the perception of and reaction to commercial stimuli to support traditional marketing methods. In this context, a particular sector or marketing is represented by public service announcements (PSAs). The objective of this protocol is to apply electroencephalography (EEG) and autonomic signal analysis to study responses to selected antismoking PSAs...
August 28, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28853427/ear-nose-and-throat-ent-aspects-of-obstructive-sleep-apnea-syndrome-osas-diagnosis-and-therapy
#8
Desiderio Passali, Maria Carla Spinosi, Francesco Maria Passali
This article analyzes the role played by the ear, nose and throat (ENT) specialist in the diagnosis and treatment of the Obstructive Sleep Apnea Syndrome (OSAS). DIAGNOSIS: The instrumental methods of investigation of otolaryngology expertise are fiberoptic rhinolaryngoscopy and sleep endoscopy. To better define and treat OSAS it is essential to define location, extension and degree of obstruction. The major limitation of rhinolaryngoscopy is that it is conducted while the patient is awake...
August 28, 2017: La Medicina del Lavoro
https://www.readbyqxmd.com/read/28840259/treatment-outcomes-of-recurrent-respiratory-papillomatosis-retrospective-analysis-of-juvenile-and-adult-cases
#9
V-A Papaioannou, A Lux, S Voigt-Zimmermann, C Arens
BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease of viral etiology which is characterized by multiple, recurrent growth of papillomas in the aerodigestive tract. MATERIALS AND METHODS: The surgical outcomes and the recurrence rates of 106 patients with RRP of the larynx were analyzed. The patients were treated at the University of Magdeburg between 1983 and 2014. The surgical outcomes of conventional and laser surgery regarding time to relapse and complications were compared...
August 24, 2017: HNO
https://www.readbyqxmd.com/read/28838625/-which-surgery-for-mediastinum-tumor-experience-of-the-department-of-thoracic-surgery-of-chu-hassan-ii-of-f%C3%A3-s
#10
S Rabiou, M Lakranbi, T Ghizlane, H Elfatemi, M Serraj, Y Ouadnouni, M Smahi
INTRODUCTION: Tumors of the mediastinum are a heterogeneous group of dysembryoplatic and neoplastic diseases essentially with different prognoses and therapeutic. These tumors develop slowly and remain long asymptomatic in 40-50% of cases. The purpose of our work is to bring the result of surgical management in diagnostic and therapeutic of principal mediastinum tumors framework. PATIENTS AND METHOD: We reviewed retrospectively the records of 68 patients in our training, between January 2009 and December 2013, for tumor of the mediastinum in the diagnostic framework and or therapy...
August 21, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28810268/swallowing-mechanics-associated-with-artificial-airways-bolus-properties-and-penetration-aspiration-status-in-trauma-patients
#11
Angela M Dietsch, Christopher B Rowley, Nancy Pearl Solomon, William G Pearson
Purpose: Artificial airway procedures such as intubation and tracheotomy are common in the treatment of traumatic injuries, and bolus modifications may be implemented to help manage swallowing disorders. This study assessed artificial airway status, bolus properties (volume and viscosity), and the occurrence of laryngeal penetration and/or aspiration in relation to mechanical features of swallowing. Method: Coordinates of anatomical landmarks were extracted at minimum and maximum hyolaryngeal excursion from 228 videofluoroscopic swallowing studies representing 69 traumatically injured U...
September 18, 2017: Journal of Speech, Language, and Hearing Research: JSLHR
https://www.readbyqxmd.com/read/28806114/-endoscopic-ultra-dream-pulse-laser-surgery-of-laryngomalacia-our-experiences-gained-during-the-introduction-of-the-method-in-hungary
#12
Zoltán Tóbiás, Dóra Pálinkó, Balázs Sztanó, Miklós Csanády, Péter Gál, László Rovó
INTRODUCTION: Congenital stridor and dyspnoe are caused by laryngomalacia in most cases. AIM: In this article we present a new, surgical method for treating severe laryngomalacia in patients under the age of 1, where ultrapulsated (UDP) laser beam is used for supraglottoplasty. Ultra dream pulse laser creates lesser thermical side damage in the tissue, therefore the risk of postoperative laryngeal oedema and scarring is lower. METHOD: We present 10 cases and the endoscopic UDP-laser surgery of patients under the age of 1 with severe laryngomalacia...
August 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28802782/a-case-of-galen-vein-thrombosis-occurring-after-bilateral-acetabular-fractures-in-the-tibet-plateau-what-can-we-learn
#13
Dong-Ping Ye, Shun-Li Zhang, Quan-Hong Xu, Lin-Jie Wei
Hypoxia leads to increased red blood cells and blood viscosity at high altitude while moderate trauma increases coagulation in blood. Under the above-mentioned conditions, venous sinus thrombosis is more likely to occur. A patient suffering bilateral acetabular fractures together with the gradual disturbance of consciousness was admitted to our hospital. Though computed tomography arteriogram (CTA) of the brain displayed normal blood vessels; bilateral thalamus and brainstem infarction were found on head computed tomography (CT) and Galen vein thrombosis on cerebral computed tomography venography (CTV)...
July 3, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28802009/duration-of-tracheostomy-dependence-and-development-of-tracheocutaneous-fistula-in-children
#14
Tu-Anh Ha, Meha Goyal, Julina Ongkasuwan
OBJECTIVE: To determine whether the risk of developing a tracheocutaneous fistula (TCF) increases with longer tracheostomy dependence times in children. STUDY DESIGN: Retrospective review of medical records. METHOD: A retrospective chart review was conducted for all children who both underwent tracheotomy and were decannulated between 2002 and 2011 at a tertiary children's hospital. Charts were analyzed for duration of tracheostomy and evidence of TCF up to 12 months...
August 12, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28793968/application-of-a-flexible-lightwand-in-percutaneous-dilatational-tracheotomy
#15
Zhuang Zhao, Shu Pan, Dunwei Wang, Chengyu Wang, Zhiwen Li
No abstract text is available yet for this article.
August 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28780666/comparison-of-intubation-and-tracheotomy-in-patients-with-deep-neck-infection
#16
Laura Tapiovaara, Leif Bäck, Katri Aro
Possible airway compromise further complicates treatment of deep neck infections (DNI). Airway management is crucial, but factors affecting the method of choice are unclear. We retrospectively evaluated adult DNIs in a single tertiary center covering 10 years, with special attention on airway management. Patient data were retrieved from electronic data files from 2007 to 2016, and included adult patients with DNI operated through the neck. Of the 202 patients, 127 (63%) were male, with a median age of 47 years...
August 5, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28770226/laryngeal-rosai-dorfman-disease-sinus-histiocytosis-with-massive-lymphadenopathy-a-retrospective-study-of-5-cases
#17
Yanyan Niu, Yongjin Li, Jian Wang, Xiaofeng Jin, Dahai Yang, Hong Huo, Wuyi Li
This study was performed to investigate the clinical manifestations, treatment methods, and prognosis of Rosai-Dorfman disease (RDD) with laryngeal involvement. Five clinical cases of RDD with laryngeal involvement diagnosed between 1986 and 2015 were retrospectively analyzed. The laryngeal lesions of these 5 patients mostly involved the glottis and subglottis, with the main symptoms being a hoarse voice and airway obstruction. In addition, the patients mostly exhibited a unilateral or asymmetric onset that was manifested by a laryngeal submucosal nodular mass...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28766955/risk-factors-of-stomal-recurrence-after-laryngectomy-a-systematic-review-and-meta-analysis
#18
REVIEW
Jinyu Mei, Zhaohui Huang, Kaile Wu, Yi Zhao, Jianming Yang, Yehai Liu
OBJECTIVE: We wished to investigate the risk factors for stoma recurrence following laryngectomy. METHODS: PubMed, Cochrane Library, and Embase were searched to identify primary research studies published between January 1, 1967, and October 31, 2016. We only included observational epidemiological studies and used risk ratios (RRs) and 95% confidence intervals (CI) to summarize the primary risk factors associated with recurrence following laryngectomy. RESULTS: A total of 44 articles, including 11 928 patients, were included in the current meta-analysis...
September 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28759530/sevoflurane-attenuates-systemic-inflammation-compared-with-propofol-but-does-not-modulate-neuro-inflammation-a-laboratory-rat-study
#19
Beatrice Beck-Schimmer, Lukas Baumann, Tanja Restin, Philipp Eugster, Melanie Hasler, Christa Booy, Martin Schläpfer
BACKGROUND: Septic encephalopathy is believed to be a result of neuro-inflammation possibly triggered by endotoxins, such as lipopolysaccharides (LPS). Modulation of the immune system is a property of volatile anaesthetics. OBJECTIVE: We aimed to investigate the systemic and cerebral inflammatory response in a LPS-induced sepsis model in rats. We compared two different sedation strategies, intravenous propofol and the volatile anaesthetic sevoflurane, with the hypothesis that the latter may attenuate neuro-inflammatory processes...
July 28, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28758083/successful-extubation-after-weaning-failure-by-noninvasive-ventilation-in-patients-with-neuromuscular-disease-case-series
#20
Sun Mi Kim, Seong-Woong Kang, Young-Chul Choi, Yoon Ghil Park, Yu Hui Won
OBJECTIVE: To report successful cases of extubation from invasive mechanical ventilation at our institution using pulmonary rehabilitation consisting of noninvasive ventilation (NIV) in neuromuscular patients with experience of reintubation. METHODS: Patients who experienced extubation failure via the conventional weaning strategy but afterwards had extubation success via NIV were studied retrospectively. Continuous end-tidal CO2 (ETCO2) and pulse oxyhemoglobin saturation (SpO2) monitoring were performed...
June 2017: Annals of Rehabilitation Medicine
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