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https://www.readbyqxmd.com/read/28212589/a-multicenter-initiative-for-critical-congenital-heart-disease-newborn-screening-in-texas-neonatal-intensive-care-units
#1
Alice Gong, Charleta Guillory, Liza Creel, Judith Ellen Livingtson, Tiffany M McKee-Garrett, Regine Fortunov
Objective The objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU). Design A NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU. Results We trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings...
February 17, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28209638/the-effect-of-implementing-an-automated-oxygen-control-on-oxygen-saturation-in-preterm-infants
#2
H A Van Zanten, K L A M Kuypers, B J Stenson, T E Bachman, S C Pauws, A B Te Pas
OBJECTIVE: To evaluate the effect of implementing automated oxygen control as routine care in maintaining oxygen saturation (SpO2) within target range in preterm infants. METHODS: Infants <30 weeks gestation in Leiden University Medical Centre before and after the implementation of automated oxygen control were compared. The percentage of time spent with SpO2 within and outside the target range (90-95%) was calculated. SpO2 values were collected every minute and included for analysis when infants received extra oxygen...
February 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28206993/hemodynamic-effects-of-sodium-bicarbonate-administration
#3
A C Katheria, M K Brown, K Hassan, D M Poeltler, D A Patel, V K Brown, J B Sauberan
OBJECTIVE: To describe the hemodynamic changes that occur with sodium bicarbonate (NaHCO3) administration in premature neonates. STUDY DESIGN: This retrospective study included premature neonates 23 to 31+6 weeks of gestational age who underwent continuous cardiac and cerebral monitoring as participants in prospective trials at our institution, and who received NaHCO3 infused over 30 min in the first 24 h of life. Blood pressure (BP), heart rate, cardiac output (CO), SpO2 and cerebral oximetry (StO2) were captured every 2 s...
February 16, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28198754/relationship-between-adverse-tracheal-intubation-associated-events-and-picu-outcomes
#4
Margaret M Parker, Gabrielle Nuthall, Calvin Brown, Katherine Biagas, Natalie Napolitano, Lee A Polikoff, Dennis Simon, Michael Miksa, Eleanor Gradidge, Jan Hau Lee, Ashwin S Krishna, David Tellez, Geoffrey L Bird, Kyle J Rehder, David A Turner, Michelle Adu-Darko, Sholeen T Nett, Ashley T Derbyshire, Keith Meyer, John Giuliano, Erin B Owen, Janice E Sullivan, Keiko Tarquinio, Pradip Kamat, Ronald C Sanders, Matthew Pinto, G Kris Bysani, Guillaume Emeriaud, Yuki Nagai, Melissa A McCarthy, Karen H Walson, Paula Vanderford, Anthony Lee, Jesse Bain, Peter Skippen, Ryan Breuer, Sarah Tallent, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. STUDY DESIGN: Prospective cohort study with 35 PICUs using a multicenter tracheal intubation quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from January 2013 to June 2015...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28178369/burden-of-human-metapneumovirus-infections-in-patients-with-cancer-risk-factors-and-outcomes
#5
Firas El Chaer, Dimpy P Shah, Joumana Kmeid, Ella J Ariza-Heredia, Chitra M Hosing, Victor E Mulanovich, Roy F Chemaly
BACKGROUND: Human metapneumovirus (hMPV) causes upper and lower respiratory tract infections (URIs and LRIs, respectively) in healthy and immunocompromised patients; however, its clinical burden in patients with cancer remains unknown. METHODS: In a retrospective study of all laboratory-confirmed hMPV infections treated at the authors' institution between April 2012 and May 2015, clinical characteristics, risk factors for progression to an LRI, treatment, and outcomes in patients with cancer were determined...
February 8, 2017: Cancer
https://www.readbyqxmd.com/read/28177206/propofol-sedation-reduces-diaphragm-activity-in-spontaneously-breathing-patients-ultrasound-assessment
#6
Monica Rocco, Luigi Maggi, Giorgio Ranieri, Giovanni Ferrari, Cesare Gregoretti, Giorgio Conti, Roberto A DE Blasi
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and end-expiration (TEE)...
February 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28171856/the-safety-of-laryngeal-mask-airway-assisted-bronchoscopy-versus-standard-nasal-bronchoscopy
#7
Daniel Alon, Barak Pertzov, Evgeni Gershman, Miryam Frishman, Nader Abdel Rahman, Dror Rosengarten, Mordechai R Kramer
BACKGROUND: The use of laryngeal mask airway (LMA) for fiberoptic bronchoscopy was first described in 1982. The LMA was found to be beneficial in operator view, flexibility, and also in maintaining stable oxygen saturation. Despite its advantages, the use of LMA has not become widespread. OBJECTIVE: The aim of this paper was to evaluate the safety of LMA-assisted bronchoscopy compared to standard nasal bronchoscopy. METHODS: We conducted a prospective randomized trial...
February 8, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28169105/current-evidence-on-prevalence-and-clinical-outcomes-of-co-morbid-obstructive-sleep-apnea-and-chronic-obstructive-pulmonary-disease-a-systematic-review
#8
REVIEW
Md Shajedur R Shawon, Jennifer L Perret, Chamara V Senaratna, Caroline Lodge, Garun S Hamilton, Shyamali C Dharmage
The objective of this systematic review is to synthesize the evidence on prevalence, polysomnographic findings and clinical outcomes of co-morbid obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) - known as the "overlap syndrome". We systematically searched PubMed on 1 December 2015 using appropriate medical subject headings (MeSH) and text words to capture prevalence studies and comparative studies of any observational design examining the clinical outcomes in patients with co-existent COPD and OSA...
April 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28167000/urine-cysteinyl-leukotriene-levels-in-children-with-sleep-disordered-breathing-before-and-after-adenotonsillectomy
#9
A Satdhabudha, P Sritipsukho, S Manochantr, W Chanvimalueng, U Chaumrattanakul, P Chaumphol
OBJECTIVES: Obstructive sleep apnea (OSA) is a common problem in children and is associated with increased cardiovascular, neurobehavioral and somatic growth consequences. Cysteinyl leukotrienes (CysLTs) play a major role with local and systemic relations to the pathophysiology of OSA. The level of CysLTs in urine, blood, exhaled breath and adenotonsillar tissue of OSA children are increased. However it remains unclear whether inflammatory marker levels are alleviated after adenotonsillectomy...
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28166839/pre-flight-evaluation-of-adult-patients-with-cystic-fibrosis-a-cross-sectional-study
#10
Elisabeth Edvardsen, Aina Akerø, Ole Henning Skjønsberg, Bjørn Skrede
BACKGROUND: Air travel may imply a health hazard for patients with cystic fibrosis (CF) due to hypobaric environment in the aircraft cabin. The objective was to identify pre-flight variables, which might predict severe hypoxaemia in adult CF patients during air travel. METHODS: Thirty adult CF-patients underwent pre-flight evaluation with spirometry, arterial oxygen tension (PaO2), pulse oximetry (SpO2) and cardiopulmonary exercise testing (CPET) at sea level (SL)...
February 6, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28159810/impaired-peripheral-vasodilation-during-graded-systemic-hypoxia-in-healthy-older-adults-role-of-the-sympathoadrenal-system
#11
Jennifer C Richards, Anne R Crecelius, Dennis G Larson, Gary J Luckasen, Frank A Dinenno
Systemic hypoxia is a physiological and pathophysiological stress that activates the sympathoadrenal system and, in young adults, leads to peripheral vasodilation. We tested the hypothesis that peripheral vasodilation to graded systemic hypoxia is impaired in older healthy adults and that this age-associated impairment is due to attenuated β-adrenergic mediated vasodilation and elevated α-adrenergic vasoconstriction. Forearm blood flow was measured (Doppler ultrasound) and vascular conductance (FVC) was calculated in 12 young (24±1 yrs) and 10 older (63±2 yrs) adults to determine the local dilatory responses to graded hypoxia (90, 85, and 80% O2 saturations) in control conditions, following local intra-arterial blockade of β-receptors (propranolol), and combined blockade of α+β receptors (phentolamine + propranolol)...
February 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#12
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigschnekt, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or SpO2 to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n=21). Lambs were resuscitated as per NRP guidelines...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28154110/oxygen-saturation-ranges-for-healthy-newborns-within-24%C3%A2-hours-at-1800%C3%A2-m
#13
Melissa C Morgan, Beth Maina, Mary Waiyego, Catherine Mutinda, Jalemba Aluvaala, Michuki Maina, Mike English
There are minimal data to define normal oxygen saturation (SpO2) levels for infants within the first 24 hours of life and even fewer data generalisable to the 7% of the global population that resides at an altitude of >1500 m. The aim of this study was to establish the reference range for SpO2 in healthy term and preterm neonates within 24 hours in Nairobi, Kenya, located at 1800 m. A random sample of clinically well infants had SpO2 measured once in the first 24 hours. A total of 555 infants were enrolled...
February 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28153478/perfusion-index-and-pulse-oximetry-screening-for-congenital-heart-defects
#14
Federico Schena, Irene Picciolli, Massimo Agosti, Antonio Alberto Zuppa, Gianvincenzo Zuccotti, Luciana Parola, Giulia Pomero, Giorgio Stival, Markus Markart, Silvia Graziani, Luigi Gagliardi, Cristina Bellan, Simona La Placa, Giuseppe Limoli, Gabriella Calzetti, Andrea Guala, Enza Bonello, Fabio Mosca
OBJECTIVE: To evaluate the efficacy of combined pulse oximetry (POX) and perfusion index (PI) neonatal screening for severe congenital heart defects (sCHD) and assess different impacts of screening in tertiary and nontertiary hospitals. STUDY DESIGN: A multicenter, prospective study in 10 tertiary and 6 nontertiary maternity hospitals. A total of 42 169 asymptomatic newborns from among 50 244 neonates were screened; exclusion criteria were antenatal sCHD diagnosis, postnatal clinically suspected sCHD, and neonatal intensive care unit admission...
January 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28144415/acute-cardiovascular-and-hemodynamic-responses-to-low-intensity-eccentric-resistance-exercise-with-blood-flow-restriction
#15
Behzad Bazgir, Mojtaba Rezazadeh Valojerdi, Hamid Rajabi, Rouhollah Fathi, Seyed Mojtaba Ojaghi, Mohammad Kazem Emami Meybodi, Gabriel R Neto, Mostafa Rahimi, Alireza Asgari
BACKGROUND: Recently it has been suggested that low intensity (LI) resistance exercise (RE) alone or in combination with blood flow restriction (BFR) can be applied for cardiovascular function improvement or rehabilitation. OBJECTIVES: The aim of the present study was to investigate the acute effects of LI eccentric RE with and without BFR on heart rate (HR), rate pressure product (RPP), blood pressure (BP) parameters [systolic, diastolic, and mean arterial pressure (MAP)], oxygen saturation (SpO2) and rate of perceived exertion (RPE)...
December 2016: Asian Journal of Sports Medicine
https://www.readbyqxmd.com/read/28123650/post-operative-capnostream-monitoring-in-patients-with-obstructive-sleep-apnoea-symptoms-case-series
#16
Vasanth Rao Kadam, Mazyar Danesh
Obstructive sleep apnoea (OSA) patients on opioid analgesic have an increased incidence of postoperative respiratory complications; prevention of these may be possible with appropriate post-operative monitoring. We recruited 4 OSA patients who had general anaesthesia for orthopaedic and septoplasty surgery. They required Patient Controlled Analgesia (PCA) or oral opioids in the post-operative period, hence continuous Saturation of Oxygen (Spo2), End Tidal Carbon dioxide (EtCo2) monitoring on Capnostream monitor with Integrated Pulmonary Index (IPI) was organized in high dependency unit...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28122489/feasibility-of-the-modified-sequential-organ-function-assessment-score-in-a-resource-constrained-setting-a-prospective-observational-study
#17
Cornelius Sendagire, Michael S Lipnick, Sam Kizito, Rebecca Kruisselbrink, Daniel Obua, Joseph Ejoku, Lameck Ssemogerere, Jane Nakibuuka, Arthur Kwizera
BACKGROUND: Sub-Saharan Africa has a great burden of critical illness with limited health care resources. We evaluated the feasibility and utility of the modified Sequential Organ Function Assessment (mSOFA) score in assessing morbidity and mortality in the National Referral Hospital's intensive care unit (ICU) for one year. METHODS: We conducted a prospective, observational cohort study on patients above 12 years of age admitted to the ICU at Mulago Hospital (Kampala, Uganda)...
January 26, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28121834/pao2-fio2-ratio-derived-from-the-spo2-fio2-ratio-to-improve-mortality-prediction-using-the-pediatric-index-of-mortality-3-score-in-transported-intensive-care-admissions
#18
Samiran Ray, Libby Rogers, Christina Pagel, Sainath Raman, Mark J Peters, Padmanabhan Ramnarayan
OBJECTIVES: To derive a relationship between the SpO2/FIO2 ratio and PaO2/FIO2 ratio across the entire range of SpO2 values (0-100%) and to evaluate whether mortality prediction using the Pediatric Index of Mortality-3 can be improved by the use of PaO2/FIO2 values derived from SpO2/FIO2. DESIGN: Retrospective analysis of prospectively collected data. SETTING: A regional PICU transport service. PATIENTS: Children transported to a PICU...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28121211/heated-intravenous-fluids-alone-fail-to-prevent-hypothermia-in-cats-under-general-anaesthesia
#19
Geraldine Jourdan, Caroline Didier, Erwan Chotard, Sandra Jacques, Patrick Verwaerde
Objectives The objective was to evaluate the clinical efficiacy of a constant rate infusion of heated fluid as the sole means of preventing intraoperative hypothermia in cats. Methods This randomised, prospective, clinical study was conducted at a university teaching veterinary hospital. Female cats (American Society of Anesthesiologists [ASA] grade I) undergoing elective surgery by laparotomy under general anaesthesia (acepromazine 0.05 mg/kg SC; morphine 0.2 mg/kg IV; propofol IV titrated, isoflurane 2% in 100% oxygen) were randomised in two groups...
January 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28119497/risk-for-cardiorespiratory-instability-following-transfer-to-a-monitored-step-down-unit
#20
Eliezer Bose, Lujie Chen, Gilles Clermont, Artur Dubrawski, Michael R Pinsky, Dianxu Ren, Leslie A Hoffman, Marilyn Hravnak
BACKGROUND: Hospitalized patients who develop at least one instance of cardiorespiratory instability (CRI) have poorer outcomes. We sought to describe the admission characteristics, drivers, and time to onset of initial CRI events in monitored step-down unit (SDU) patients. METHODS: Admission characteristics and continuous monitoring data (frequency 1/20 Hz) were recorded in 307 subjects. Vital sign deviations beyond local instability trigger threshold criteria, with a tolerance of 40 s and cumulative duration of 4 of 5 min, were classified as CRI events...
January 24, 2017: Respiratory Care
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