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https://www.readbyqxmd.com/read/29777602/-suspension-of-respiratory-support-in-patients-with-amyotrophic-lateral-sclerosis
#1
Agustín A Silberberg, Josefina Robetto, Mora Achával
Decision making in advanced Amyotrophic Lateral Sclerosis (ALS) patients keeps on being a controversial issue. The aim of this work is to discuss ethical implications of withdrawing respiratory support treatment in patients with ALS. Through a bibliographic search on Pubmed database (2010-2016) we investigated whether or not the use of Non-Invasive Ventilation (NIV) and Mechanical Ventilation (MV) would increase survival and quality of life. We included 38 review articles. From these papers, results and ethical implications of initiating and mainly withdrawing respiratory support were analyzed...
May 2018: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#2
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29773291/cost-utility-of-non-invasive-mechanical-ventilation-analysis-and-implications-in-acute-respiratory-failure-a-brief-narrative-review
#3
REVIEW
Antonello Nicolini, Sven Stieglitz, Pierre Bou-Khalil, Antonio Esquinas
The growing interest in the quality of patient care at the levels of the health care managers, insurance companies, and health professionals is evident. Further, the growing population requires good quality health services. In this review, we analyzed the cost-effectiveness of noninvasive ventilation (NIV) in an acute setting for the treatment of respiratory failure. The strength of this review is that it identified and summarized the most relevant studies regarding various aspects of the cost-utility of NIV in an acute setting...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#4
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29764401/management-of-acute-respiratory-failure-in-interstitial-lung-diseases-overview-and-clinical-insights
#5
REVIEW
Paola Faverio, Federica De Giacomi, Luca Sardella, Giuseppe Fiorentino, Mauro Carone, Francesco Salerno, Jousel Ora, Paola Rogliani, Giulia Pellegrino, Giuseppe Francesco Sferrazza Papa, Francesco Bini, Bruno Dino Bodini, Grazia Messinesi, Alberto Pesci, Antonio Esquinas
BACKGROUND: Interstitial lung diseases (ILDs) are a heterogeneous group of diseases characterized by widespread fibrotic and inflammatory abnormalities of the lung. Respiratory failure is a common complication in advanced stages or following acute worsening of the underlying disease. Aim of this review is to evaluate the current evidence in determining the best management of acute respiratory failure (ARF) in ILDs. METHODS: A literature search was performed in the Medline/PubMed and EMBASE databases to identify studies that investigated the management of ARF in ILDs (the last search was conducted on November 2017)...
May 15, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29755078/-re-expansion-pulmonary-edema-after-surgery-for-spontaneous-tension-hemopneumothorax-report-of-a-case
#6
Masanobu Hayakawa, Kazuyuki Oda
A 23-year-old man was admitted to our hospital because of chest pain and dyspnea. X-ray and computed tomography showed left tension hemopneumothorax. After the emergent surgery, re-expansion pulmonary edema (RPE) occurred. Non-invasive positive pressure ventilation (NPPV) was applied to control RPE and RPE was successfully recovered. NPPV may be useful in managing RPE.
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29752619/a-feasibility-study-into-adenosine-triphosphate-measurement-in-exhaled-breath-condensate-a-potential-bedside-method-to-monitor-alveolar-deformation
#7
Philip van der Zee, Peter Somhorst, Jeroen Molinger, Djo Hasan, Diederik Gommers
Recent research suggested an important role for pulmonary extracellular adenosine triphosphate (ATP) in the development of ventilation-induced lung injury. This injury is induced by mechanical deformation of alveolar epithelial cells, which in turn release ATP to the extracellular space. Measuring extracellular ATP in exhaled breath condensate (EBC) may be a non-invasive biomarker for alveolar deformation. Here, we study the feasibility of bedside ATP measurement in EBC. We measured ATP levels in EBC in ten subjects before and after an exercise test, which increases respiratory parameters and alveolar deformation...
May 12, 2018: Purinergic Signalling
https://www.readbyqxmd.com/read/29746721/melatonin-for-the-promotion-of-sleep-in-adults-in-the-intensive-care-unit
#8
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Patients in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and patients perceive the quality of their sleep to be poor whilst in the ICU. Artificial lighting during night-time hours in the ICU may contribute to reduced production of melatonin in critically ill patients...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29744618/association-between-central-venous-pressure-as-assessed-by-echocardiography-left-ventricular-function-and-acute-cardio-renal-syndrome-in-patients-with-st-segment-elevation-myocardial-infarction
#9
Shafik Khoury, Arie Steinvil, Amir Gal-Oz, Gilad Margolis, Aviram Hochstatd, Yan Topilsky, Gad Keren, Yacov Shacham
BACKGROUND: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients with heart failure. None of these trials, however, has evaluated the effect of acute myocardial ischemia on the occurrence of acute kidney injury (AKI). METHODS: We conducted a retrospective study of 1336 ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) between June 2012 and June 2016...
May 9, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29744242/non-invasive-mechanical-ventilation-in-critically-ill-trauma-patients-a-systematic-review
#10
REVIEW
Annia Schreiber, Fatma Yıldırım, Giovanni Ferrari, Andrea Antonelli, Pablo Bayoumy Delis, Murat Gündüz, Marcin Karcz, Peter Papadakos, Roberto Cosentini, Yalım Dikmen, Antonio M Esquinas
There is limited literature on non-invasive mechanical ventilation (NIMV) in patients with polytrauma-related acute respiratory failure (ARF). Despite an increasing worldwide application, there is still scarce evidence of significant NIMV benefits in this specific setting, and no clear recommendations are provided. We performed a systematic review, and a search of clinical databases including MEDLINE and EMBASE was conducted from the beginning of 1990 until today. Although the benefits in reducing the intubation rate, morbidity and mortality are unclear, NIMV may be useful and does not appear to be associated with harm when applied in properly selected patients with moderate ARF at an earlier stage of injury by experienced teams and in appropriate settings under strict monitoring...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29742220/humidification-and-heating-of-inhaled-gas-in-patients-with-artificial-airway-a-narrative-review
#11
Gustavo Adrián Plotnikow, Matias Accoce, Emiliano Navarro, Norberto Tiribelli
Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29732184/spontaneous-breathing-during-veno-venous-extracorporeal-membrane-oxygenation
#12
REVIEW
Stefania Crotti, Nicola Bottino, Elena Spinelli
Veno-venous extracorporeal membrane oxygenation (VV ECMO) has started to be applied in awake spontaneously breathing patients as an alternative to invasive mechanical ventilation. As the physiologic cardiorespiratory variability is increased in this condition, the dynamic interaction between patient respiratory activity and extracorporeal system function affects the clinical management. The effect of extracorporeal CO2 removal on patient respiratory drive is variable and not always predictable, with some patients responding to CO2 removal with a decrease in respiratory rate and effort and other patients demonstrating a persistently high work of breathing independent on CO2 unload...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29728768/therapeutic-decisions-in-als-patients-cross-cultural-differences-and-clinical-implications
#13
Peter M Andersen, Magdalena Kuzma-Kozakiewicz, Jürgen Keller, Helena E A Aho-Oezhan, Katarzyna Ciecwierska, Natalia Szejko, Cynthia Vázquez, Sarah Böhm, Gisela Badura-Lotter, Thomas Meyer, Susanne Petri, Katharina Linse, Andreas Hermann, Olof Semb, Erica Stenberg, Simona Nackberg, Johannes Dorst, Ingo Uttner, Ann-Cristin Häggström, Albert C Ludolph, Dorothée Lulé
OBJECTIVE: Quantitative analysis of decision-making on therapeutic options in different sociocultural context in amyotrophic lateral sclerosis (ALS). METHODS: ALS patients (n = 244) were consecutively recruited in Germany (n = 83), Poland (n = 83), and Sweden (n = 78) in a prospective cross-cultural study ( www.NEEDSinALS.com ). They were interviewed on preferences for therapeutic techniques including invasive (IV) and non-invasive ventilation (NIV), as well as percutaneous endoscopic gastrostomy (PEG) and on hypothetical termination of these using quantitative questions...
May 4, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29726838/estimating-regions-of-air-trapping-from-electrical-impedance-tomography-data
#14
Jennifer L Mueller, Peter A Muller, Michelle Mellenthin, Rashmi Murthy, Michael Capps, Melody Alsaker, Robin Deterding, Scott D Sagel, Emily DeBoer
OBJECTIVE: Electrical impedance tomography (EIT) has been shown as a viable non-invasive, bedside imaging modality to monitor lung function.This paper introduces a method for identifying regions of air trapping from EIT data collected during tidal breathing and breath-holding maneuvers. APPROACH: Ventilation-perfusion index maps are computed from dynamic EIT images. These maps are then used to identify regions of air trapping in the area of the lung as regions that are poorly ventilated but well perfused throughout the breathing and cardiac cycles...
May 4, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29725275/td-gc-ms-analysis-of-volatile-markers-emitted-from-mono-and-co-cultures-of-enterobacter-cloacae-and-pseudomonas-aeruginosa-in-artificial-sputum
#15
Oluwasola Lawal, Hugo Knobel, Hans Weda, Tamara M E Nijsen, Royston Goodacre, Stephen J Fowler
Introduction: Infections such as ventilator-associated pneumonia (VAP) can be caused by one or more pathogens. Current methods for identifying these pathogenic microbes often require invasive sampling, and can be time consuming, due to the requirement for prolonged cultural enrichment along with selective and differential plating steps. This results in delays in diagnosis which in such critically ill patients can have potentially life-threatening consequences. Therefore, a non-invasive and timely diagnostic method is required...
2018: Metabolomics: Official Journal of the Metabolomic Society
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#16
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29719268/functional-morphometry-for-the-estimation-of-the-alveolar-surface-area-in-prematurely-born-infants
#17
Theodore Dassios, Konstantinos G Dassios, George Dassios
Conventionally, the alveolar surface area (SA ) has been measured by using post-mortem morphometry. Such studies have highlighted that SA in prematurely-born infants is markedly smaller when compared to term-born infants as a result of postnatal impairment or arrest of alveolar development. We herein explore how, non-invasive measurements of the ventilation/perfusion ratio (VA /Q) can be used to estimate SA in prematurely-born surviving, convalescent infants. We also compare SA in prematurely-born infants measured at term-corrected age, to term-born infants using previously published datasets of VA /Q...
April 29, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29709560/contributing-factors-to-mortality-rates-of-pulmonary-tuberculosis-in-intensive-care-units
#18
Dursun Tatar, Gunes Senol, Cenk Kirakli, Ozlem Edipoglu, Pinar Cimen
BACKGROUND: Tuberculosis (TB) remains an important health problem worldwide. TB patients sometimes require intensive care unit (ICU) treatment. The aim of this study is to establish special features and mortality rates of pulmonary TB patients in ICUs and identify the factors contributing to ICU mortality. METHODS: Medical records of adult patients (>18 years) with a diagnosis of TB who were admitted to the ICU of a referral hospital for chest diseases between 2004 and 2010 were reviewed retrospectively...
April 27, 2018: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29702222/pressure-support-ventilation-vs-continuous-positive-airway-pressure-for-treating-of-acute-cardiogenic-pulmonary-edema-a-pilot-study
#19
Antonio Pagano, Fabio G Numis, Valerio Rosato, Teresa Russo, Giovanni Porta, Giorgio Bosso, Claudia Serra, Mario Masarone, Giuseppe Visone, Fiorella Paladino
Non-invasive ventilation is usually adopted as a support to medical therapy in patients with acute pulmonary edema, but which modality between Pressure Support Ventilation (PSV) and Continuous Positive Airway Pressure (CPAP) has better favourable effects is not been yet well known. Aim of this observational study was to provide data on these different non-invasive ventilation modalities in the management of acute cardiogenic pulmonary edema. One-hundred-fifty-three patients consecutively admitted to the Emergency Room of two different Center were enrolled and randomly assigned to CPAP or PSV...
April 24, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29701198/-a-case-of-severe-obstructive-sleep-apnea-hypopnea-syndrome-with-urinary-and-anal-incontinence
#20
Li Zhou, Ruoyun Ouyang, Ping Chen, Hong Luo, Hanmei Liu, Guiqian Liu
A case of a young male patient, who came to the Second Xiangya Hospital, Central South University because of snoring for 10 years and nocturnal gatism for half month, was analyzed retrospectively. He was diagnosed as obstructive sleep apnea hypopnea syndrome (OSAHS) finally. The patient had been diagnosed and treated as stroke in the local hospital, while urinary and anal incontinence were not relieved. It was a dilemma for him to be properly diagnosed and treated. Polysomnography in our hospital revealed apnea hypopnea index (AHI) at 44...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
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