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Gastric aspiration

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https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#1
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28425145/prevalence-of-gastroesophageal-reflux-in-cats-during-anesthesia-and-effect-of-omeprazole-on-gastric-ph
#2
R S Garcia, P C Belafsky, A Della Maggiore, J M Osborn, B H Pypendop, T Pierce, V J Walker, A Fulton, S L Marks
BACKGROUND: Gastroesophageal reflux (GER) is poorly characterized in anesthetized cats, but can cause aspiration pneumonia, esophagitis, and esophageal stricture formation. OBJECTIVE: To determine whether pre-anesthetic orally administered omeprazole increases gastric and esophageal pH and increases serum gastrin concentrations in anesthetized cats, and to determine the prevalence of GER using combined multichannel impedance and pH monitoring. ANIMALS: Twenty-seven healthy cats undergoing elective dental procedures...
April 19, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28414135/gastrointestinal-behavior-of-itraconazole-in-humans-part-1-supersaturation-from-a-solid-dispersion-and-a-cyclodextrin-based-solution
#3
Joachim Brouwers, Sophie Geboers, Raf Mols, Jan Tack, Patrick Augustijns
This study evaluated the fasted state gastrointestinal behavior of the lipophilic drug itraconazole, orally administered to healthy volunteers as either a solid dispersion (Sporanox(®) capsules) or a cyclodextrin-based solution (Sporanox(®) solution). Following intake of the drug products, gastric and duodenal fluids were aspirated and analyzed for itraconazole concentration, total content and solubilizing capacity. Release of itraconazole from the solid dispersion generated high and metastable supersaturated levels in the stomach, but the dissolved fraction in the duodenum remained extremely low (median 2...
April 13, 2017: International Journal of Pharmaceutics
https://www.readbyqxmd.com/read/28362573/ultrasound-assessed-gastric-antral-area-correlates-with-aspirated-tube-feed-volume-in-enterally-fed-critically-ill-patients
#4
Vibhu Sharma, Deepthi Gudivada, Renaud Gueret, John Bailitz
BACKGROUND: Enteral tube feed (ETF) intolerance occurs frequently in hospitalized patients and more so in critically ill patients. Most critical care nurses continue to assess gastric residual volume (GRV), especially among those with a history of ETF intolerance. We hypothesized that ultrasound assessment of GRV correlates directly with aspirated tube feed volume. METHODS: This was a prospective cohort study of a convenience sample of critically ill mechanically ventilated patients admitted to an intensive care unit receiving ETF...
April 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28355374/qualitative-and-quantitative-ultrasound-assessment-of-gastric-content
#5
Flora Margarida Barra Bisinotto, Patrícia Luísa Pansani, Luciano Alves Matias da Silveira, Aline de Araújo Naves, Ana Cristina Abdu Peixoto, Hellen Moreira de Lima, Laura Bisinotto Martins
Objective: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. Method: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal...
February 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#6
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28331424/gastric-schwannoma-with-enlargement-of-the-regional-lymph-nodes-resected-using-laparoscopic-distal-gastrectomy-report-of-a-patient
#7
Shota Shimizu, Hiroaki Saito, Yusuke Kono, Yuki Murakami, Hirohiko Kuroda, Tomoyuki Matsunaga, Yoji Fukumoto, Tomohiro Osaki, Yoshiyuki Fujiwara
Preoperative differential diagnosis of gastric submucosal tumors has generally been difficult because they are covered with normal mucosa. However, recent advances in endoscopic ultrasound (EUS)-guided sampling of submucosal gastrointestinal lesions have made it possible to achieve preoperative differential diagnosis of gastric submucosal tumors. A 76-year-old woman was referred to our hospital with a gastric submucosal tumor. The tumor was observed in the antrum of the stomach. It was preoperatively diagnosed as a schwannoma after immunohistochemical evaluation of a biopsy specimen, obtained using endoscopic ultrasound-guided fine needle aspiration...
March 2017: Yonago Acta Medica
https://www.readbyqxmd.com/read/28303301/impact-of-tapered-cuff-tracheal-tube-on-microaspiration-of-gastric-contents-in-intubated-critically-ill-patients-a-multicenter-cluster-randomized-cross-over-controlled-trial
#8
Emmanuelle Jaillette, Christophe Girault, Guillaume Brunin, Farid Zerimech, Hélène Behal, Arnaud Chiche, Céline Broucqsault-Dedrie, Cyril Fayolle, Franck Minacori, Isabelle Alves, Stéphanie Barrailler, Julien Labreuche, Laurent Robriquet, Fabienne Tamion, Emmanuel Delaporte, Damien Thellier, Claire Delcourte, Alain Duhamel, Saad Nseir
PURPOSE: Studies on the impact of tapered-cuff tracheal tubes on rates of microaspiration and ventilator-associated pneumonia (VAP) in intubated patients have reported conflicting results. The aim of this study was to determine the influence of this shape of tracheal cuff on abundant microaspiration of gastric contents in critically ill patients. METHODS: All patients intubated in the intensive care unit (ICU) and requiring mechanical ventilation for at least 48 h were eligible for this multicenter cluster-randomized controlled cross-over open-label study...
March 16, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28297827/-application-of-bedside-ultrasound-in-measuring-gastric-residual-volume-in-neurosurgical-critical-patients-with-enteral-nutrition-support
#9
L Cao, X H Ye, J Li, L N Zhang, L Li, W Y Zhang, L L Deng
Objective: To explore the effect of bedside ultrasound in measuring gastric residual volume in neurosurgical critical patients with enteral nutrition support. Method: From March to August 2016, 70 critically neurological patients with continues enteral nutrition who admitted in Intensive Care Unit (ICU) were randomized into two groups. The observation group applied the bedside ultrasound monitoring gastric residual volume every day to guide the implementation of enteral nutrition. The control group used syringes withdrawing every 8 hours to measure the gastric residual volume...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28292405/selected-endoscopic-gastric-devices-for-obesity
#10
REVIEW
Kartik Sampath, Richard I Rothstein
This article focuses on the stomach target devices that are currently in various stages of development. Approved intragastric balloons, devices targeting small bowel and aspiration techniques, are described in other contributions to this issue. Bariatric endoscopic devices targeting the stomach directly alter gastric physiology and promote weight loss by potentially changing functional gastric volume, gastric emptying, gastric wall compliance, neurohormonal signaling, and, thereby, satiety. Many stomach-targeting devices are on the horizon for clinical use, and further study will determine the safety and efficacy for clinical use...
April 2017: Gastrointestinal Endoscopy Clinics of North America
https://www.readbyqxmd.com/read/28287530/open-tracheostomy-gastric-acid-aspiration-murine-model-of-acute-lung-injury-results-in-maximal-acute-nonlethal-lung-injury
#11
Ravi Alluri, Hilliard L Kutscher, Barbara A Mullan, Bruce A Davidson, Paul R Knight
Acid pneumonitis is a major cause of sterile acute lung injury (ALI) in humans. Acid pneumonitis spans the clinical spectrum from asymptomatic to acute respiratory distress syndrome (ARDS), characterized by neutrophilic alveolitis, and injury to both alveolar epithelium and vascular endothelium. Clinically, ARDS is defined by acute onset of hypoxemia, bilateral patchy pulmonary infiltrates and non-cardiogenic pulmonary edema. Human studies have provided us with valuable information about the physiological and inflammatory changes in the lung caused by ARDS, which has led to various hypotheses about the underling mechanisms...
February 26, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28264670/examining-the-quality-of-childhood-tuberculosis-diagnosis-in-cambodia-a-cross-sectional-study
#12
Julia B Frieze, Rajendra-Prasad Yadav, Khann Sokhan, Song Ngak, Team Bak Khim
BACKGROUND: Cambodia is one of the 22 countries with the highest TB burden. While childhood TB is estimated to make up 10-20% of total TB cases in high-burden settings, this proportion ranges from 1.3 to 39.4% throughout Cambodia's provinces, suggesting potential under- and over-diagnosis of childhood TB, subnationally. The proportion of case notifications classified as extrapulmonary TB out of total TB case notifications in children is 87%, greatly exceeding the expected global range of 20-30%...
March 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28262529/effects-of-combined-prokinetic-administration-on-gastric-emptying-in-critically-ill-patients
#13
Afshin Gholipour Baradari, Mohammad Reza Khajavi, Abolfazl Firouzian, Abbas Alipour, Hojatallah Daneshpour, Yunes Panahi, Amirhossein Sahebkar
BACKGROUND AND STUDY AIMS: Combination of prokinetic drugs with different mechanisms of action is frequently used when feeding intolerance is not improved with a single agent. In this study, we evaluated the effect of combined infusion of neostigmine and metoclopramide on gastric passage in critically ill patients in the intensive care unit (ICU). PATIENTS AND METHODS: This study is a randomized double-blind controlled trial in 90 patients between 20 and 60years of age who were under mechanical ventilation and had gastric residual volumes (GRVs) >120mL 3h after the last lavage...
March 2, 2017: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/28255548/rapunzel-syndrome-is-not-just-a-mere-surgical-problem-a-case-report-and-review-of-current-management
#14
Obinna Obinwa, David Cooper, Faraz Khan, James M O'Riordan
Recurrent Rapunzel syndrome (RRS) is a rare clinical presentation with fewer than six cases reported in the PubMed literature. A report of RRS and literature review is presented. A 25-year-old female was admitted to hospital with a 4-wk history of epigastric pain and swelling. She had a known history of trichophagia with a previous admission for Rapunzel syndrome requiring a laparotomy nine years earlier, aged 16. Psychological treatment had been successfully achieved for nine years with outpatient hypnotherapy sessions only, but she defaulted on her last session due to stressors at home...
February 16, 2017: World Journal of Clinical Cases
https://www.readbyqxmd.com/read/28244948/safety-of-large-volume-same-day-oral-bowel-preparations-during-deep-sedation-a-prospective-observational-study
#15
Kanwarpreet Tandon, Charl Khalil, Fernando Castro, Alison Schneider, Mosaab Mohameden, Seifeldin Hakim, Kinchit Shah, Chau To, Colin O'Rourke, Jeffrey Jacobs
BACKGROUND: Colonoscopy quality is directly related to the bowel preparation. It is well established that bowel preparations are improved when at least part of the laxative is ingested on the day of the procedure. However, there is concern that this can result in higher gastric residual volumes (GRV) and increase the risk of pulmonary aspiration. The aim of this study is to evaluate GRV and gastric pH in patients who received day-before bowel preparation versus those ingesting their laxative on the day of colonoscopy under anesthesiologist-directed propofol deep sedation...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28219359/congenital-tuberculosis-in-an-extremely-preterm-infant-conceived-after-in-vitro-fertilization-case-report
#16
Veronica Samedi, Stephen K Field, Essa Al Awad, Gregory Ratcliffe, Kamran Yusuf
BACKGROUND: Congenital tuberculosis is a rare manifestation of tuberculosis. The diagnosis is often delayed, especially in preterm neonates because of the non-specific clinical presentation and the lack of awareness of maternal disease prior to pregnancy. CASE PRESENTATION: We report a case of congenital tuberculosis in an infant born at 24 weeks of gestation to a mother who presented with uncontrolled seizures during preterm labor. Maternal diagnosis was initially made by placental pathology, and later confirmed by isolation of Mycobacterium tuberculosis in urine, gastric aspirates and sputum...
February 20, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28214603/the-impact-of-reduced-gastric-acid-secretion-on-dissolution-of-salts-of-weak-bases-in-the-fasted-upper-gastrointestinal-lumen-data-in-biorelevant-media-and-in-human-aspirates
#17
Chara Litou, Maria Vertzoni, Wei Xu, Filippos Kesisoglou, Christos Reppas
PURPOSE: To propose media for simulating the intragastric environment under reduced gastric acid secretion in the fasted state at three levels of simulation of the gastric environment and evaluate their usefulness in evaluating the intragastric dissolution of salts of weak bases. To evaluate the importance of bicarbonate buffer in biorelevant in vitro dissolution testing when using Level II biorelevant media simulating the environment in the fasted upper small intestine, regardless of gastric acid secretions...
February 15, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28210705/gastric-esd-may-be-useful-as-accurate-staging-and-decision-of-future-therapeutic-strategy
#18
Ai Fujimoto, Osamu Goto, Toshihiro Nishizawa, Yasutoshi Ochiai, Joichiro Horii, Tadateru Maehata, Teppei Akimoto, Satoshi Kinoshita, Seiji Sagara, Motoki Sasaki, Toshio Uraoka, Naohisa Yahagi
Background and study aims We sometimes perform gastric endoscopic submucosal dissection (ESD) for total pathologic diagnosis when preoperative diagnosis is difficult. In the present study we analyzed the treatment outcomes and adverse events of diagnostic ESD for early gastric cancer (EGC). Patients and methods We conducted a retrospective analysis of 18 consecutive cases of EGC in 18 patients with a suspected out-of-indication diagnosis who underwent diagnostic ESD, between June 2010 and November 2014...
February 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28202056/normal-gastric-emptying-time-of-a-carbohydrate-rich-drink-in-elderly-patients-with-acute-hip-fracture-a-pilot-study
#19
Per M Hellström, Bodil Samuelsson, Amer N Al-Ani, Margareta Hedström
BACKGROUND: Guidelines for fasting in elderly patients with acute hip fracture are the same as for other trauma patients, and longer than for elective patients. The reason is assumed stress-induced delayed gastric emptying with possible risk of pulmonary aspiration. Prolonged fasting in elderly patients may have serious negative metabolic consequences. The aim of our study was to investigate whether the preoperative gastric emptying was delayed in elderly women scheduled for surgery due to acute hip fracture...
February 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28188978/split-dose-bowel-preparation-with-polyethylene-glycol-for-colonoscopy-performed-under-propofol-sedation-is-there-an-optimal-timing
#20
Alaa Alghamry, Sureshkumar K Ponnuswamy, Aditya Agarwal, Hadi Moattar, Stephanie T Yerkovich, Ann E Vandeleur, James Thomas, John Croese, Tony Rahman, Ruth Hodgson
AIM: Aspiration risk, especially with propofol sedation, remains a concern with split-dose bowel preparation using polyethylene glycol, which involves up to one liter of preparation intake close to the procedure time. We aim to identify the ideal timing of bowel preparation that achieves optimal colon cleansing with no increased risk of aspiration in all patients undergoing combined esophagogastroduodenoscopy (EGD) and colonoscopy with propofol sedation. METHODS: We prospectively recruited 892 consecutive patients undergoing simultaneous EGD and colonoscopy...
February 11, 2017: Journal of Digestive Diseases
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