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https://www.readbyqxmd.com/read/28937423/deep-serratus-plane-catheter-for-management-of-acute-postthoracotomy-pain-after-descending-aortic-aneurysm-repair-in-a-morbidly-obese-patient-a-case-report
#1
Renuka M George, Maria Yared, Sylvia H Wilson
Regional procedures for postthoracotomy pain control have classically focused on paravertebral blocks and thoracic epidurals; however, these techniques may be challenging in an increasingly obese population and contraindicated with numerous anticoagulant and antiplatelet agents. While less studied, truncal blocks allow analgesic intervention for this growing patient cohort. This case report describes placement of a deep serratus anterior plane catheter in an intubated, morbidly obese patient with a lumbar drain who failed extubation secondary to acute postthoracotomy pain...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#2
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28919813/a-prospective-double-blinded-randomized-comparison-of-ultrasound-guided-femoral-nerve-block-with-lateral-femoral-cutaneous-nerve-block-versus-standard-anesthetic-management-for-pain-control-during-and-after-traumatic-femur-fracture-repair-in-the-pediatric-population
#3
Nicole M Elsey, Joseph D Tobias, Kevin E Klingele, Ralph J Beltran, Tarun Bhalla, David Martin, Giorgio Veneziano, Julie Rice, Dmitry Tumin
BACKGROUND: Traumatic injury of the femur resulting in femoral fracture may result in significant postoperative pain. As with other causes of acute pain, regional anesthesia may offer a benefit over conventional therapy with intravenous opioids. This study prospectively assesses the effects of femoral nerve blockade with a lateral femoral cutaneous nerve block (FN-LFCN) on intraoperative anesthetic requirements, postoperative pain scores, and opioid requirements. MATERIALS AND METHODS: Seventeen pediatric patients (age 2-18 years) undergoing surgical repair of a traumatic femur fracture fulfilled the study criteria and were randomly assigned to general anesthesia with either an FN-LFCN block (n = 10) or intravenous opioids (n = 7)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28916211/diaphragmatic-fenestration-for-refractory-chylothorax-after-congenital-cardiac-surgery-in-infants
#4
T K Susheel Kumar, Kaitlin Balduf, Umar Boston, Christopher Knott-Craig
OBJECTIVE: Medically refractory chylous pleural effusion after congenital heart surgery is associated with significant morbidity and mortality, especially in infants. We reviewed our experience with diaphragmatic fenestration procedure in this group of patients. METHODS: A retrospective chart review of all patients who had diaphragmatic fenestrations for chylous effusion at our institution over a 2-year period was performed. RESULTS: A total of 9 diaphragmatic fenestration procedures were performed in 8 patients who had failed medical management of chylous pleural effusions...
August 17, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28874612/role-of-integrated-pulmonary-index-in-identifying-extubation-failure
#5
Ramandeep Kaur, David L Vines, Li Liu, Robert A Balk
BACKGROUND: The integrated pulmonary index (IPI) utilizes an algorithm based on the measurement of end-tidal carbon dioxide, breathing frequency, heart rate, and oxygen saturation to provide an assessment of the patient's ventilatory status. This clinical trial was designed to determine whether lower IPI values were associated with extubation failure. METHODS: This prospective observational trial was conducted in an academic medical center. After institutional review board approval, 100 mechanically ventilated subjects were enrolled...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28832898/spontaneous-breathing-trials-after-prolonged-mechanical-ventilation-monitored-by-electrical-impedance-tomography-an-observational-study
#6
Z Zhao, S-Y Peng, M-Y Chang, Y-L Hsu, I Frerichs, H-T Chang, K Möller
BACKGROUND: The study objective was to examine the correlation between regional ventilation distribution measured with electrical impedance tomography (EIT) and weaning outcomes during spontaneous breathing trial (SBT). METHODS: Fifteen patients received 100% automatic tube compensation (ATC) during the first and 70% during the second hour. Another 15 patients received external continuous positive airway pressure (CPAP) of 5 and 7.5 cmH2 O during the first and second hours, respectively...
August 17, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28832706/behavior-of-lung-ultrasound-findings-during-spontaneous-breathing-trial
#7
Ana Carolina Peçanha Antonio, Cassiano Teixeira, Priscylla Souza Castro, Augusto Savi, Juçara Gasparetto Maccari, Roselaine Pinheiro Oliveira, Marli Maria Knorst
Objective: We aimed to investigate a potential association between B-lines and weaning failure. Methods: Fifty-seven subjects eligible for ventilation liberation were enrolled. Patients with tracheostomy were excluded. Lung ultrasound assessments of six thoracic zones were performed immediately before and at the exnd of the spontaneous breathing trial. B-predominance was defined as any profile with anterior bilateral B-pattern. Patients were followed up to 48 hours after extubation...
August 21, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28830363/recovery-and-prediction-of-postoperative-muscle-power-is-it-still-a-problem
#8
Martin Zoremba, Dennis Kornmann, Benjamin Vojnar, Rene Burchard, Thomas Wiesmann, Hinnerk Wulf, Thomas Kratz
BACKGROUND: In the postoperative period, immediate recovery of muscular power is essential for patient safety, but this can be affected by anaesthetic drugs, opioids and neuromuscular blocking agents (NMBA). In this cohort study, we evaluated anaesthetic and patient-related factors contributing to reduced postoperative muscle power and pulse oximetric saturation. METHODS: We prospectively observed 615 patients scheduled for minor surgery. Premedication, general anaesthesia and respiratory settings were standardized according to standard operating procedures (SOP)...
August 22, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28829819/evaluation-of-diaphragmatic-function-in-mechanically-ventilated-children-an-ultrasound-study
#9
En-Pei Lee, Shao-Hsuan Hsia, Hsiu-Feng Hsiao, Min-Chi Chen, Jainn-Jim Lin, Oi-Wa Chan, Chia-Ying Lin, Mei-Chin Yang, Sui-Ling Liao, Shen-Hao Lai
BACKGROUND: The recovery of diaphragmatic function is vital for successful extubation from mechanical ventilation. Recent studies have detected diaphragm atrophy in ventilated adults by using ultrasound, but no similar report has been conducted in children. In the current study, we hypothesized that mechanically ventilated children may also develop diaphragm atrophy and diaphragmatic dysfunction. MATERIALS AND METHODS: Children who were admitted to the pediatric intensive care unit and were newly intubated for mechanical ventilation were enrolled into this prospective case-control study...
2017: PloS One
https://www.readbyqxmd.com/read/28820557/papillary-muscle-rupture-in-an-adolescent-with-no-coronary-lesions
#10
Tatjana Lejko Zupanc, Mateja Logar
A 21-year-old man with Wolff-Parkinson-White syndrome presented to the authors' hospital with ventricular fibrillation. Coronary angiography failed to demonstrate coronary stenosis, but temporary mechanical circulatory support resolved the ventricular fibrillation and the patient was extubated eight days later. On the next day, however, he had to be re-intubated with symptoms of congestive heart failure. Echocardiography revealed new severe mitral regurgitation and a mobile mass, while emergency surgery revealed a posteromedial papillary muscle rupture (PMR)...
March 2017: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#11
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28790279/-perioperative-management-of-fontan-operation
#12
Koichi Sughimoto, Kagami Miyaji
Surgical results of Fontan operation has been improved over the decades due to the introduction of the staged operations and some modifications of Fontan route from the classical atrio-pulmonary connection to total cavo-pulmonary connection. However, issues remain because of the single ventricular physiology of Fontan circulation. This article explains about the preoperative checklist for Fontan operation and tips on the postoperative management including an early extubation, use of inhaled nitric oxide after extubation, anticoagulation therapy, and efficacy of angiotensin converting enzyme inhibitor, supported by the cutting-edge evidence...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28754225/-low-dose-propofol-vs-lidocaine-for-relief-of-resistant-post-extubation-laryngospasm-in-the-obstetric-patient
#13
Ali M Mokhtar, Ahmed A Badawy
BACKGROUND: Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5mg.kg(-1)) vs. lidocaine (1.5mg.kg(-1)) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. METHOD: This study was conducted over 2 years on all obstetric patients scheduled for cesarean delivery...
July 25, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28746528/simple-motor-tasks-independently-predict-extubation-failure-in-critically-ill-neurological-patients
#14
Fernanda Machado Kutchak, Marcelo de Mello Rieder, Josué Almeida Victorino, Carla Meneguzzi, Karla Poersch, Luiz Alberto Forgiarini, Marino Muxfeldt Bianchin
Objective: To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. Methods: This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#15
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#16
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28704843/outcomes-of-infants-who-failed-to-extubate-despite-systemic-corticosteroids
#17
Alain Cuna, Tamorah Lewis, Alexandra Oschman, Hong Ying Dai, Katie Brophy, Michael Norberg, Michael Nyp, William Truog
No abstract text is available yet for this article.
July 13, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28704815/relaxation-rate-of-the-respiratory-muscles-and-prediction-of-extubation-outcome-in-prematurely-born-infants
#18
Theodore Dassios, Ourania Kaltsogianni, Anne Greenough
BACKGROUND: Accurate prediction of extubation outcome could result in a significant reduction of respiratory morbidity in premature neonates. OBJECTIVES: To assess whether the respiratory muscle time constant of relaxation (τ) predicted extubation outcome in mechanically ventilated, premature infants. METHODS: Forty-six mechanically ventilated infants with a median gestational age of 26 (interquartile range [IQR] 25-29) weeks were prospectively studied...
July 14, 2017: Neonatology
https://www.readbyqxmd.com/read/28693057/-the-value-of-the-excursion-of-diaphragm-tested-by-ultrosonography-to-predict-weaning-from-mechanical-ventilation-in-icu-patients
#19
L X Liu, D Su, Z J Hu
Objective: To evaluate the excursion of the diaphragm and analyze the value in predicting weaning from mechanical ventilation in intensive care unit patients. Methods: The patients with mechanical ventilation (>48 hours) in ICU at Hebei Forth Medical University Hospital from June 2014 to December were classified into a success group or a failure group according to the weaning outcome. T-piece spontaneous breathing (SBT), airway occlusion pressure at 0.1 sec (P(0.1)) and maximal inspiratory pressure (MIP), rapid shallow breathing index (RSBI) and P(0...
July 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/28650903/thigh-ultrasound-monitoring-identifies-decreases-in-quadriceps-femoris-thickness-as-a-frequent-observation-in-critically-ill-children
#20
Frederic V Valla, David K Young, Muriel Rabilloud, Uvaraj Periasami, Manoj John, Florent Baudin, Carole Vuillerot, Aurélie Portefaix, Deborah White, Jenna A Ridout, Rosan Meyer, Bénédicte Gaillard Le Roux, Etienne Javouhey, Nazima Pathan
OBJECTIVES: Significant muscle wasting develops in critically ill adults, with subsequent worse outcomes. In the pediatric setting, occurrence and effects of muscle wasting are undescribed; this is in part due to a lack of validated, objective methods for assessing muscle wasting. A single measurement of quadriceps femoris thickness has failed to show consistent reproducibility. We hypothesized that averaging repeated measurements could afford good reproducibility to allow for quadriceps femoris thickness decline detection and monitoring...
August 2017: Pediatric Critical Care Medicine
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