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https://www.readbyqxmd.com/read/27899469/emergency-surgical-airways-following-activation-of-a-difficult-airway-management-team-in-hospitalized-critically-ill-patients-a-case-series
#1
REVIEW
Joseph M Darby, Gregory Halenda, Courtney Chou, Joseph J Quinlan, Louis H Alarcon, Richard L Simmons
INTRODUCTION: An emergency surgical airway (ESA) is widely recommended for securing the airway in critically ill patients who cannot be intubated or ventilated. Little is known of the frequency, clinical circumstances, management methods, and outcomes of hospitalized critically ill patients in whom ESA is performed outside the emergency department or operating room environments. METHODS: We retrospectively reviewed all adult patients undergoing ESA in our intensive care units (ICUs) and other hospital units from 2008 to 2012 following activation of our difficult airway management team (DAMT)...
November 28, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27836002/cardiac-dysfunction-induced-by-weaning-from-mechanical-ventilation-incidence-risk-factors-and-effects-of-fluid-removal
#2
Jinglun Liu, Feng Shen, Jean-Louis Teboul, Nadia Anguel, Alexandra Beurton, Nadia Bezaz, Christian Richard, Xavier Monnet
BACKGROUND: Weaning-induced pulmonary oedema (WiPO) is a well-recognised cause of failure of weaning from mechanical ventilation, but its incidence and risk factors have not been reliably described. We wanted to determine the incidence and risk factors in a population of critically ill patients. In addition, we wanted to describe the effects of diuretics when they are administered in this context. METHODS: We monitored 283 consecutive spontaneous breathing trials (SBT; T-piece trial) performed in 81 patients...
November 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27762595/an-official-american-thoracic-society-american-college-of-chest-physicians-clinical-practice-guideline-liberation-from-mechanical-ventilation-in-critically-ill-adults-rehabilitation-protocols-ventilator-liberation-protocols-and-cuff-leak-tests
#3
Timothy D Girard, Waleed Alhazzani, John P Kress, Daniel R Ouellette, Gregory A Schmidt, Jonathon D Truwit, Suzanne M Burns, Scott K Epstein, Andres Esteban, Eddy Fan, Miquel Ferrer, Gilles L Fraser, Michelle Gong, Catherine Hough, Sangeeta Mehta, Rahul Nanchal, Sheena Patel, Amy J Pawlik, Curtis N Sessler, Thomas Strøm, William Schweickert, Kevin C Wilson, Peter E Morris
BACKGROUND: Interventions that lead to earlier liberation from mechanical ventilation can improve patient outcomes. This guideline, a collaborative effort between the American Thoracic Society (ATS) and the American College of Chest Physicians (CHEST), provides evidence-based recommendations to optimize liberation from mechanical ventilation in critically ill adults. METHODS: Two methodologists performed evidence syntheses to summarize available evidence relevant to key questions about liberation from mechanical ventilation...
October 20, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27758969/extracorporeal-membrane-oxygenation-support-for-life-threatening-acute-severe-status-asthmaticus
#4
Gabriella Di Lascio, Edvin Prifti, Elmi Messai, Adriano Peris, Guy Harmelin, Roland Xhaxho, Albana Fico, Guido Sani, Massimo Bonacchi
INTRODUCTION: Status asthmaticus is a life-threatening condition characterized by progressive respiratory failure due to asthma that is unresponsive to standard therapeutic measures. We used extracorporeal membrane oxygenation (ECMO) to treat patients with near-fatal status asthamticus who did not respond to aggressive medical therapies and mechanical ventilation under controlled permissive hypercapnia. MATERIALS AND METHODS: Between January 2011 and October 2015, we treated 16 adult patients with status asthmaticus (8 women, 8 men, mean age: 50...
October 6, 2016: Perfusion
https://www.readbyqxmd.com/read/27741103/establishing-predictors-for-successfully-planned-endotracheal-extubation
#5
Chih-Cheng Lai, Chin-Ming Chen, Shyh-Ren Chiang, Wei-Lun Liu, Shih-Feng Weng, Mei-I Sung, Shu-Chen Hsing, Kuo-Chen Cheng
The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27733188/nurse-performed-screening-for-postextubation-dysphagia-a-retrospective-cohort-study-in-critically-ill-medical-patients
#6
Kay Choong See, Si Yu Peng, Jason Phua, Chew Lai Sum, Johncy Concepcion
BACKGROUND: Swallowing difficulties are common, and dysphagia occurs frequently in intensive care unit (ICU) patients after extubation. Yet, no guidelines on postextubation swallowing assessment exist. We aimed to investigate the safety and effectiveness of nurse-performed screening (NPS) for postextubation dysphagia in the medical ICU. METHODS: We conducted a retrospective cohort study of mechanically ventilated patients who were extubated in a 20-bed medical ICU...
October 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27677861/can-diaphragmatic-ultrasonography-performed-during-the-t-tube-trial-predict-weaning-failure-the-role-of-diaphragmatic-rapid-shallow-breathing-index
#7
Savino Spadaro, Salvatore Grasso, Tommaso Mauri, Francesca Dalla Corte, Valentina Alvisi, Riccardo Ragazzi, Valentina Cricca, Giulia Biondi, Rossella Di Mussi, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most widely used indices to predict weaning outcome. Whereas the diaphragm plays a fundamental role in generating VT, in the case of diaphragmatic dysfunction the inspiratory accessory muscles may contribute. If this occurs during a weaning trial, delayed weaning failure is likely since the accessory muscles are more fatigable than the diaphragm. Hence, we hypothesised that the traditional RSBI could be implemented by substituting VT with the ultrasonographic evaluation of diaphragmatic displacement (DD)...
September 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27561025/-predictors-of-extubation-failure-in-neurosurgical-patients
#8
Marco Antonio León-Gutiérrez, Janet Tanus-Hajj, Luis Alejandro Sánchez-Hurtado
BACKGROUND: The information regarding the factors that affect the success of extubation in neurosurgical patients is limited; thus, it is necessary to determine the prevalence, and the associated factors, of extubation failure in neurosurgical patients. METHODS: It was performed a prospective, longitudinal, observational and comparative study in neurosurgical patients with criteria for extubation. In those who the number of endotracheal aspirations had failed 24 hours before extubation, it was analyzed the presence of cough reflex, length of stay and mechanical ventilation days...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27543650/bailout-shunt-banding-for-backward-left-heart-failure-after-adequate-neonatal-coarctectomy-in-borderline-left-hearts
#9
Stephen C Brown, Benedicte Eyskens, Derize Boshoff, Bjorn Cools, Ruth Heying, Filip Rega, Bart Meyns, Marc Gewillig
OBJECTIVES: To determine the outcome of a bailout procedure using the right ventricle to re-assist the left ventricle in neonates after technically adequate coarctectomy but a failing borderline left heart. METHODS: The surgical procedure was performed on bypass. A 'reversed' 6-mm surgical shunt was inserted between the pulmonary trunk and the descending aorta together with bilateral branch pulmonary artery banding. RESULTS: Over a 10-year period, 89 neonates presented with coarctation and small left hearts...
August 19, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27538798/efficacy-of-a-new-technique-intubate-recruit-surfactant-extubate-in-rec-sur-e-in-preterm-neonates-with-respiratory-distress-syndrome-study-protocol-for-a-randomized-controlled-trial
#10
Giovanni Vento, Roberta Pastorino, Luca Boni, Francesco Cota, Virgilio Carnielli, Filip Cools, Carlo Dani, Fabio Mosca, Jane Pillow, Graeme Polglase, Paolo Tagliabue, Anton H van Kaam, Maria Luisa Ventura, Milena Tana, Chiara Tirone, Claudia Aurilia, Alessandra Lio, Cinzia Ricci, Alessandro Gambacorta, Chiara Consigli, Danila D'Onofrio, Camilla Gizzi, Luca Massenzi, Viviana Cardilli, Alessandra Casati, Roberto Bottino, Federica Pontiggia, Elena Ciarmoli, Stefano Martinelli, Laura Ilardi, Mariarosa Colnaghi, Piero Giuseppe Matassa, Valentina Vendettuoli, Paolo Villani, Francesca Fusco, Diego Gazzolo, Alberto Ricotti, Federica Ferrero, Ilaria Stasi, Rosario Magaldi, Gianfranco Maffei, Giuseppe Presta, Roberto Perniola, Francesco Messina, Giovanna Montesano, Chiara Poggi, Lucio Giordano, Enza Roma, Carolina Grassia, Gaetano Ausanio, Fabrizio Sandri, Giovanna Mescoli, Francesco Giura, Giampaolo Garani, Agostina Solinas, Maria Lucente, Gabriella Nigro, Antonello Del Vecchio, Flavia Petrillo, Luigi Orfeo, Lidia Grappone, Lorenzo Quartulli, Antonio Scorrano, Hubert Messner, Alex Staffler, Giancarlo Gargano, Eleonora Balestri, Stefano Nobile, Caterina Cacace, Valerio Meli, Sara Dallaglio, Betta Pasqua, Loretta Mattia, Eloisa Gitto, Marcello Vitaliti, Maria Paola Re, Stefania Vedovato, Alessandra Grison, Alberto Berardi, Francesco Torcetta, Isotta Guidotti, Sandra di Fabio, Eugenia Maranella, Isabella Mondello, Stefano Visentin, Francesca Tormena
BACKGROUND: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs...
August 18, 2016: Trials
https://www.readbyqxmd.com/read/27537189/a-novel-video-assisted-approach-to-excimer-laser-guided-cardiac-implantable-electronic-devices-lead-extraction
#11
Patrick Zardo, Henning Busk, Johannes Hadem, Hassina Baraki, George Kensah, Ingo Kutschka
OBJECTIVE: Even though roughly 90% of all implanted cardiac implantable electronic devices leads can be removed through conventional techniques, presence of large vegetations or thrombi, fractured leads, previous failed extraction, or long duration from implantation often impede classical transvenous extraction. In these cases, laser-assisted procedures represent a highly successful alternative and have a low procedural complication rate with major adverse events in less than 2% of cases...
May 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27457232/surgical-intervention-strategies-for-congenital-tracheal-stenosis-associated-with-a-tracheal-bronchus-based-on-the-location-of-stenosis
#12
Keiichi Morita, Akiko Yokoi, Hiroaki Fukuzawa, Chieko Hisamatsu, Kosuke Endo, Yuichi Okata, Akihiko Tamaki, Yasuhiko Mishima, Yoshihiro Oshima, Kosaku Maeda
PURPOSE: The aim of this study was to determine the appropriate surgical intervention strategies for congenital tracheal stenosis (CTS) associated with a tracheal bronchus based on the location of stenosis. METHODS: The medical records of 13 pediatric patients with CTS associated with a tracheal bronchus at a single institution between January 2006 and December 2015 were retrospectively reviewed. RESULTS: Type 1: tracheal stenosis above the right upper lobe bronchus (RULB) (n = 1)...
September 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27404044/perioperative-predictors-of-extubation-failure-and-the-effect-on-clinical-outcome-after-infratentorial-craniotomy
#13
Ye-Hua Cai, Hai-Tang Wang, Jian-Xin Zhou
BACKGROUND The purpose of the study was to analyze the risk factors for failed extubation in subjects submitted to infratentorial craniotomy. MATERIAL AND METHODS Patients aged over 18 years who received infratentorial craniotomy for brain tumor resection were consecutively included in this study. Perioperative variables were collected and analyzed. Univariate analyses and multiple logistic regression were used to derive factors related to failed extubation. Patients had follow-up care until either out of hospital or death...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27388444/predictive-factors-for-efficacy-and-safety-of-prophylactic-theophylline-for-extubation-in-infants-with-apnea-of-prematurity
#14
Tomoko Kondo, Yuki Kondo, Yuji Orita, Fumi Mitarai, Yoichi Ishitsuka, Mitsuru Irikura, Yoshihiro Shimodozono, Tsutomu Douchi, Yasuo Takeda, Tetsumi Irie
PURPOSE: This study aimed to evaluate predictive factors involved in efficacy and safety in Japanese infants who received theophylline therapy to prevent apnea of prematurity (AOP) after weaning from mechanical ventilation. METHODS: We retrospectively reviewed the medical records of infants who were administered intravenous aminophylline (theophylline ethylenediamine) for AOP at the neonatal intensive care unit, Kagoshima University Hospital, Japan, between January 2009 and June 2013...
2016: PloS One
https://www.readbyqxmd.com/read/27371758/biphasic-positive-airway-pressure-or-continuous-positive-airway-pressure-a-randomized-trial
#15
Suresh Victor, Stephen A Roberts, Simon Mitchell, Huma Aziz, Tina Lavender
BACKGROUND: There is currently no clear evidence that nasal-biphasic positive airway pressure (n-BiPAP) confers any advantage over nasal-continuous positive airway pressure (n-CPAP). Our hypothesis was that preterm infants born before 30 weeks' gestation and <2 weeks old when extubated onto n-BiPAP will have a lower risk of extubation failure than infants extubated onto n-CPAP at equivalent mean airway pressure. METHODS: We conducted an unblinded multicenter randomized trial comparing n-CPAP with n-BiPAP in infants born <30 weeks' gestation and <2 weeks old...
August 2016: Pediatrics
https://www.readbyqxmd.com/read/27358097/incidental-diagnosis-of-an-h-type-tracheo-oesophageal-fistula
#16
Peter Donnelly, Steven McVea, Christopher Flannigan, Sanjeev Bali
A 6-day-old term neonate who was intubated on day 1 of life for apnoeic episodes, was transferred to the regional paediatric intensive care unit (PICU) for specialist opinion following 3 failed extubations in the neonatal unit. Escherichia coli congenital pneumonia was diagnosed and the child discharged to the local hospital. Chest radiographs and inflammatory markers were in keeping with infection. However, ongoing difficulties with secretions necessitated readmission to the PICU, following a significant cyanotic episode associated with coughing...
2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27349301/risk-factors-for-extubation-failure-in-extremely-low-birth-weight-infants
#17
Shih-Hsin Wang, Jyun-You Liou, Chien-Yi Chen, Hung-Chieh Chou, Wu-Shiun Hsieh, Po-Nien Tsao
BACKGROUND: Although antenatal steroids and early use nasal continuous positive airway pressure (NCPAP) have significantly improved outcomes of neonatal respiratory distress syndrome, intubation with ventilator support is still commonly required in extremely low birth weight (ELBW) infants. The optimal timing of extubation in ELBW infants remains unclear. METHODS: We retrospectively analyzed all ELBW preterm infants who were admitted to our neonatal intensive care unit (NICU) from January 2009 to December 2013...
June 7, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/27340744/the-use-of-life-saving-extracorporeal-membrane-oxygenation-ecmo-for-pregnant-woman-with-status-asthmaticus
#18
Carolin Steinack, Renato Lenherr, Heidy Hendra, Daniel Franzen
INTRODUCTION: Status asthmaticus can develop into a life-threatening disorder that requires mechanical ventilation. Severe respiratory failure during pregnancy can worsen maternal and fetal outcomes. Previous case studies have demonstrated extracorporeal membrane oxygenation (ECMO) as a life-saving measure for pregnant women with acute respiratory distress syndrome (ARDS) as well as non-pregnant patients with status asthmaticus. CASE STUDY: A 25-year-old woman, who was 5 weeks pregnant, was admitted with status asthmaticus and severe hypercapnic respiratory failure...
June 24, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27310972/swallowing-dysfunction-following-endotracheal-intubation-age-matters
#19
Min-Hsuan Tsai, Shih-Chi Ku, Tyng-Guey Wang, Tzu-Yu Hsiao, Jang-Jaer Lee, Ding-Cheng Chan, Guan-Hua Huang, Cheryl Chia-Hui Chen
To evaluate postextubation swallowing dysfunction (PSD) 21 days after endotracheal extubation and to examine whether PSD is time-limited and whether age matters.For this prospective cohort study, we evaluated 151 adult critical care patients (≥20 years) who were intubated for at least 48 hours and had no pre-existing neuromuscular disease or swallowing dysfunction. Participants were assessed for time (days) to pass bedside swallow evaluations (swallow 50 mL of water without difficulty) and to resume total oral intake...
June 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27290957/air-q-laryngeal-airway-for-rescue-and-tracheal-intubation
#20
Ayman Ads, Frederic Auerbach, Kelly Ryan, Abdel R El-Ganzouri
We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report...
August 2016: Journal of Clinical Anesthesia
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