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https://www.readbyqxmd.com/read/28448298/anesthetic-consideration-for-neuromuscular-diseases
#1
Jeffery A Katz, Glenn S Murphy
PURPOSE OF REVIEW: The aim of this review is to examine data relating to perioperative management of the patient with neuromuscular disorders RECENT FINDINGS: Patients with pre-existing neuromuscular disorders are at risk for a number of postoperative complications that are related to anesthetic drugs that are administered intraoperatively. Careful preoperative assessment is necessary to reduce morbidity and mortality. In particular, the risk of postoperative respiratory failure and need for long-term ventilation should be reviewed with patients...
April 26, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28446987/blunt-chest-trauma-is-there-a-place-for-rib-stabilization
#2
REVIEW
John D Mitchell
Rib fractures are a common and highly morbid finding in patients with blunt chest trauma. Over the past decade, a renewed interest in (and instrumentation for) rib fixation in this cohort has occurred. Stabilization of the chest wall in this setting, particularly when a flail segment is present, is associated with significant reductions in the rates of respiratory failure, pneumonia, ICU stay, and mortality. Thoracic surgeons should remain actively involved in this evolving area of our specialty to further optimize patient outcomes...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#3
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444072/chronic-obstructive-pulmonary-disease-exacerbation-in-the-intensive-care-unit-clinical-functional-and-quality-of-life-at-discharge-and-3-months-of-follow-up
#4
Renata Cristina Teixeira Pinto Viana, Mariangela Pimentel Pincelli, Emílio Pizzichini, André Pacheco Silva, Joice Manes, Tatiana Dias Marconi, Leila John Marques Steidle
Objective: The purpose of this study was to evaluate the clinical/functional aspects and quality of life of chronic obstructive pulmonary disease patients who were discharged after an intensive care unit admission for acute respiratory failure. Methods: This prospective study included chronic obstructive pulmonary disease patients who were admitted to two intensive care units between December of 2010 and August of 2011 and evaluated over three visits after discharge...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#5
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443680/periodic-breathing-during-incremental-exercise
#6
Piergiuseppe Agostoni, Ugo Corrà, Michele Emdin
Periodic breathing during incremental cardiopulmonary exercise testing is a regularly recurring waxing and waning of tidal volume due to oscillations in central respiratory drive. Periodic breathing is a sign of respiratory control system instability, which may occur at rest or during exercise. The possible mechanisms responsible of exertional periodic breathing might be related to any instability of the ventilatory regulation caused by: 1) increased circulatory delay (i.e., circulation time from the lung to the brain and chemoreceptors, due to reduced cardiac index leading to delay in information transfer), 2) increase in controller gain (i...
April 26, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28443390/an-integrative-index-for-predicting-extubation-outcomes-after-successful-completion-of-a-spontaneous-breathing-trial-in-an-adult-medical-intensive-care-unit
#7
Tsung-Ju Wu, Judith Shu-Chu Shiao, Hsin-Liang Yu, Ruay-Sheng Lai
BACKGROUND: Among respiratory predictors, rapid shallow breathing index (RSBI) has been a commonly used respiratory parameter to predict extubation outcomes. However, the outcome of prediction remains inconsistent. Regarding nonrespiratory predictors, serum albumin, hemoglobin, bicarbonate, and patients' alertness have been reported to be associated with successful weaning or extubation. We aimed to develop an integrative index combining commonly used predictors in the adult medical intensive care units (MICUs) and to compare the predictability of the index with RSBI...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28442772/discriminative-and-distinct-phenotyping-by-constrained-tensor-factorization
#8
Yejin Kim, Robert El-Kareh, Jimeng Sun, Hwanjo Yu, Xiaoqian Jiang
Adoption of Electronic Health Record (EHR) systems has led to collection of massive healthcare data, which creates oppor- tunities and challenges to study them. Computational phenotyping offers a promising way to convert the sparse and complex data into meaningful concepts that are interpretable to healthcare givers to make use of them. We propose a novel su- pervised nonnegative tensor factorization methodology that derives discriminative and distinct phenotypes. We represented co-occurrence of diagnoses and prescriptions in EHRs as a third-order tensor, and decomposed it using the CP algorithm...
April 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28441237/noninvasive-ventilation-in-acute-hypoxemic-nonhypercapnic-respiratory-failure-a-systematic-review-and-meta-analysis
#9
Xiu-Ping Xu, Xin-Chang Zhang, Shu-Ling Hu, Jing-Yuan Xu, Jian-Feng Xie, Song-Qiao Liu, Ling Liu, Ying-Zi Huang, Feng-Mei Guo, Yi Yang, Hai-Bo Qiu
OBJECTIVE: To evaluate the effectiveness of noninvasive ventilation in patients with acute hypoxemic nonhypercapnic respiratory failure unrelated to exacerbation of chronic obstructive pulmonary disease and cardiogenic pulmonary edema. DATA SOURCES: PubMed, EMBASE, Cochrane library, Web of Science, and bibliographies of articles were retrieved inception until June 2016. STUDY SELECTION: Randomized controlled trials comparing application of noninvasive ventilation with standard oxygen therapy in adults with acute hypoxemic nonhypercapnic respiratory failure were included...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441236/the-new-mirus-system-for-short-term-sedation-in-postsurgical-icu-patients
#10
Stefano Romagnoli, Cosimo Chelazzi, Gianluca Villa, Giovanni Zagli, Francesco Benvenuti, Paola Mancinelli, Giulio Arcangeli, Stefano Dugheri, Alessandro Bonari, Lorenzo Tofani, Andrea Belardinelli, A Raffaele De Gaudio
OBJECTIVES: To evaluate the feasibility and safety of the MIRUS system (Pall International, Sarl, Fribourg, Switzerland) for sedation with sevoflurane for postsurgical ICU patients and to evaluate atmospheric pollution during sedation. DESIGN: Prospective interventional study. SETTING: Surgical ICU. February 2016 to December 2016. PATIENTS: Postsurgical patients requiring ICU admission, mechanical ventilation, and sedation...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28440911/unnoticed-aspiration-of-palate-plate-impression-material-in-a-neonate-diagnosis-therapy-outcome
#11
Friedrich Reichert, Peter Amrhein, Frank Uhlemann
A 7 week old infant was admitted with respiratory failure. Chest X-ray showed an atelectatic right upper lobe, herniation of right middle and lower lobe into the left thorax, and compression-atelectasis of the left lung. Thoracic CT showed complete occlusion of the right superior bronchus with a radiopaque foreign material. Six weeks prior, an impression for a palate plate using polyvinylsiloxane was taken. The material was removed with a rigid endoscopy, in readiness of extracorporeal oxygenation in case of tracheal obstruction or bronchial rupture...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28440124/perspectives-on-advance-care-planning-among-patients-recently-requiring-non-invasive-ventilation-for-acute-respiratory-failure-a-qualitative-study-using-thematic-analysis
#12
Tracy A Smith, Rebecca T Disler, Christine R Jenkins, Jane M Ingham, Patricia M Davidson
BACKGROUND: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. AIM: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. DESIGN: Qualitative research using thematic analysis...
June 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28439949/weight-gain-and-supplemental-o2-risk-factors-during-the-hematopoietic-cell-transplant-admission-in-pediatric-patients
#13
Courtney M Rowan, Mara E Nitu, Elizabeth A S Moser, Nancy L Swigonski, Jamie L Renbarger
BACKGROUND: Respiratory failure in the pediatric hematopoietic cell transplant (HCT) recipient is the leading cause for admission to the intensive care unit and carries a high mortality rate. The objective of this study is to investigate the association of clinical risk factors with the development of respiratory failure in the pediatric allogeneic HCT recipient. PROCEDURES: This is a single-center, retrospective review of allogeneic pediatric HCT from 2008 to 2014...
April 25, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28439268/alveolar-fluid-clearance-in-pathologically-relevant-conditions-in-vitro-and-in-vivo-models-of-acute-respiratory-distress-syndrome
#14
REVIEW
Laura A Huppert, Michael A Matthay
Critically ill patients with respiratory failure from acute respiratory distress syndrome (ARDS) have reduced ability to clear alveolar edema fluid. This reduction in alveolar fluid clearance (AFC) contributes to the morbidity and mortality in ARDS. Thus, it is important to understand why AFC is reduced in ARDS in order to design targeted therapies. In this review, we highlight experiments that have advanced our understanding of ARDS pathogenesis, with particular reference to the alveolar epithelium. First, we review how vectorial ion transport drives the clearance of alveolar edema fluid in the uninjured lung...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28439196/clinical-differences-of-influenza-subspecies-among-hospitalized-children
#15
Manolya Acar, Murat Sütçü, Hacer Aktürk, Selda Hançerli Törün, Metin Uysalol, Sevim Meşe, Nuran Salman, Ayper Somer
AIM: Clinical findings, mortality, and morbidity rates differ among influenza subspecies. Awareness of these differences will lead physicians to choose the proper diagnostic and therapeutic strategies and to foresee possible complications. The aim of this study was to evaluate the clinical differences of influenza subspecies among hospitalized children. MATERIAL AND METHODS: Hospitalized children with proven influenza infection by polymerase chain reaction on nasopharyngeal swab specimens in our clinic, between December 2013 and March 2016, were enrolled...
March 2017: Türk Pediatri Arşivi
https://www.readbyqxmd.com/read/28438369/independent-prognostic-importance-of-respiratory-instability-and-sympathetic-nerve-activity-in-patients-with-chronic-heart-failure
#16
Hidetsugu Asanoi, Daisuke Harada, Yoshitaka Oda, Hiroshi Ueno, Junya Takagawa, Hisanari Ishise, Yukiko Goso, Shuji Joho, Hiroshi Inoue
BACKGROUND: Respiratory instability in chronic heart failure (CHF) is characterized by irregularly rapid respiration or non-periodic breathing rather than by Cheyne-Stokes respiration. We developed a new quantitative measure of respiratory instability (RSI) and examined its independent prognostic impact upon CHF. METHODS: In 87 patients with stable CHF, respiratory flow and muscle sympathetic nerve activity (MSNA) were simultaneously recorded. RSI was calculated from the frequency distribution of respiratory spectral components and very low frequency components...
April 21, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28438080/guillain-barr%C3%A3-syndrome-in-pregnancy-a-case-report
#17
Misai Hukuimwe, Tawanda T Matsa, Muchabayiwa F Gidiri
Guillain-Barré syndrome is a rare condition in pregnancy which is characterised by symmetrical progressive ascending polyneuropathy. A case of a 16-year-old nulliparous woman who presented with rapidly progressive limb paralysis following an upper respiratory tract infection a week prior to presentation is discussed. She was intubated as she had developed respiratory failure and managed in the intensive care unit by a multidisciplinary team. Plasma exchange and intravenous immunoglobulin were not readily available so she was managed conservatively...
April 1, 2017: Women's Health
https://www.readbyqxmd.com/read/28437378/risk-factors-for-pediatric-extubation-failure-the-importance-of-respiratory-muscle-strength
#18
Robinder G Khemani, Tro Sekayan, Justin Hotz, Rutger C Flink, Gerrard F Rafferty, Narayan Iyer, Christopher J L Newth
OBJECTIVE: Respiratory muscle weakness frequently develops during mechanical ventilation, although in children there are limited data about its prevalence and whether it is associated with extubation outcomes. We sought to identify risk factors for pediatric extubation failure, with specific attention to respiratory muscle strength. DESIGN: Secondary analysis of prospectively collected data. SETTING: Tertiary care PICU. PATIENTS: Four hundred nine mechanically ventilated children...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437374/icu-patients-requiring-renal-replacement-therapy-initiation-fewer-survivors-and-more-dialysis-dependents-from-80-years-old
#19
Morgane Commereuc, Emmanuel Guérot, Anais Charles-Nelson, Adrien Constan, Sandrine Katsahian, Frédérique Schortgen
OBJECTIVES: To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. DESIGN: Retrospective pooled analysis of prospectively collected data. SETTING: ICUs of two teaching hospitals in Paris area, France. SUBJECTS: One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. INTERVENTIONS: None...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28434776/a-patient-who-made-an-impact-on-how-i-practice-severe-leptospirosis-presenting-as-ards-in-the-icu
#20
Evangelia S Panagiotidou, Sofia V Akritidou, Seraphim T Kotoulas, Evdokia K Sourla, Basilis G Mpikos, Basilis P Bagalas, Ioannis T Stanopoulos, Katalin M Fekete, Athanasia D Pataka
Severe leptospirosis can be a rare cause of acute respiratory distress syndrome (ARDS) and multiorgan failure. A patient who made an impact on how I practice was a case of severe leptospirosis (Weil's disease) that presented as ARDS in the ICU. Leptospirosis is an under-reported infectious disease worldwide and should be considered as a cause of ARDS especially in patients with exposure history complicated with diffuse alveolar bleeding (DAH), icteric hepatitis and renal deterioration. Empiric treatment should be recommended before confirmation of laboratory tests as serological diagnosis is time consuming...
April 20, 2017: Journal of Infection and Public Health
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