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Prolonged mechanical ventilation

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https://www.readbyqxmd.com/read/29049073/postoperative-outcomes-in-obstructive-sleep-apnea-patients-undergoing-cardiac-surgery-a-systematic-review-and-meta-analysis-of-comparative-studies
#1
Mahesh Nagappa, George Ho, Jayadeep Patra, Jean Wong, Mandeep Singh, Roop Kaw, Davy Cheng, Frances Chung
BACKGROUND: Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing cardiac surgery and may predispose patients to postoperative complications. The purpose of this meta-analysis is to determine the evidence of postoperative complications associated with OSA patients undergoing cardiac surgery. METHODS: A literature search of Cochrane Database of Systematic Reviews, Medline, Medline In-process, Web of Science, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and CINAHL until October 2016 was performed...
October 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29038746/influence-of-exercise-duration-on-cardiorespiratory-responses-energy-cost-and-tissue-oxygenation-within-a-6-hour-treadmill-run
#2
Hugo A Kerhervé, Scott McLean, Karen Birkenhead, David Parr, Colin Solomon
PURPOSE: The physiological mechanisms for alterations in oxygen utilization ([Formula: see text]) and the energy cost of running (Cr ) during prolonged running are not completely understood, and could be linked with alterations in muscle and cerebral tissue oxygenation. METHODS: Eight trained ultramarathon runners (three women; mean ± SD; age 37 ± 7 yr; maximum [Formula: see text] 60 ± 15 mL min(-1) kg(-1)) completed a 6 hr treadmill run (6TR), which consisted of four modules, including periods of moderate (3 min at 10 km h(-1), 10-CR) and heavy exercise intensities (6 min at 70% of maximum [Formula: see text], HILL), separated by three, 100 min periods of self-paced running (SP)...
2017: PeerJ
https://www.readbyqxmd.com/read/29038671/inspiratory-muscle-training-in-the-intensive-care-unit-a-new-perspective
#3
Rodrigo Marques Tonella, Ligia Dos Santos Roceto Ratti, Lilian Elisabete Bernardes Delazari, Carlos Fontes Junior, Paula Lima Da Silva, Aline Ribeiro Da Silva Herran, Daniela Cristina Dos Santos Faez, Ivete Alonso Bredda Saad, Luciana Castilho De Figueiredo, Rui Moreno, Desanka Dragosvac, Antonio Luis Eiras Falcao
BACKGROUND: Prolonged use of mechanical ventilation (MV) leads to weakening of the respiratory muscles, especially in patients subjected to sedation, but this effect seems to be preventable or more quickly reversible using respiratory muscle training. The aims of the study were to assess variations in respiratory and hemodinamic parameters with electronic inspiratory muscle training (EIMT) in tracheostomized patients requiring MV and to compare these variations with those in a group of patients subjected to an intermittent nebulization program (INP)...
November 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29036732/predictors-of-poor-outcome-in-neonates-with-pyogenic-meningitis-in-a-level-three-neonatal-intensive-care-unit-of-developing-country
#4
Mala Kumar, Shalini Tripathi, Himanshu Kumar, S N Singh
Background: The mortality of neonatal pyogenic meningitis is reduced to 10-15%, but morbidity is unchanged. Methods: Primary objective is to determine the outcome, i.e. death or abnormal neurological examination (NE) at discharge and abnormal developmental quotient (DQ) at 3 months. Secondary objective is to find predictors of poor outcome. Results: In all, 89 neonates enrolled, 10 expired and 24 neonates had abnormal NE at discharge. A total of 59 neonates came for follow up, 13 had DQ < 70...
September 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29035976/the-impact-of-obesity-on-mortality-and-other-outcomes-in-patients-with-nonvariceal-upper-gastrointestinal-hemorrhage-in-the-united-states
#5
Marwan S Abougergi, Heather Peluso, Chebli Mrad, John R Saltzman
GOALS: To quantify in patients with nonvariceal upper gastrointestinal hemorrhage (NVUGIH) the relationship between obesity and mortality, disease severity, treatment modalities, and resource utilization. BACKGROUND: NVUGIH is the most common gastrointestinal emergency. STUDY: Adults with a principal diagnosis of NVUGIH were selected from the 2014 National Inpatient Sample. The primary outcome was in-hospital mortality. Secondary outcomes were hemorrhagic shock, prolonged mechanical ventilation (PMV), upper endoscopy [esophagogastroduodenoscopy (EGD)], radiologic treatment, surgery, length of hospital stay (LOS), and total hospitalization costs and charges...
October 13, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29033719/epidemiology-and-characteristics-of-nosocomial-infections-in-critically-ill-patients-in-a-tertiary-care-intensive-care-unit-of-northern-india
#6
Anirban Hom Choudhuri, Mitali Chakravarty, Rajeev Uppal
BACKGROUND AND AIMS: The prevalence of nosocomial infection is higher in the Intensive Care Unit (ICU) than other areas of the hospital. The present observational study was undertaken to describe the epidemiology and characteristics of nosocomial infections acquired in a tertiary care ICU and the impact of the various risk factors in their causation. MATERIALS AND METHODS: A retrospective study was conducted on the prospectively collected data of 153 consecutive patients admitted in a tertiary care ICU between July 2014 and December 2015...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29031240/colonization-of-oropharynx-and-lower-respiratory-tract-in-critical-patients-risk-of-ventilator-associated-pneumonia
#7
Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
OBJECTIVE: To investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied...
October 2, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29030928/pharmacokinetics-of-s-ketamine-during-prolonged-sedation-at-the-pediatric-intensive-care-unit
#8
Robert B Flint, Carole N M Brouwer, Anne S C Kränzlin, Loraine Lie-A-Huen, Albert P Bos, Ron A A Mathôt
BACKGROUND: S-ketamine is the S(+)-enantiomer of the racemic mixture ketamine, an anesthetic drug providing both sedation and analgesia. In clinical practice, significant interpatient variability in drug effect of S-ketamine is observed during long-term sedation. AIMS: The aim of this study was to evaluate the pharmacokinetic variability of S-ketamine in children aged 0-18 years during long-term sedation. Twenty-five children (median age: 0.42 years, range: 0...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29027126/etiology-and-risk-factors-determining-poor-outcome-of-severe-pneumonia-in-under-five-children
#9
Suresh Kumar Jakhar, Mukul Pandey, Dheeraj Shah, V G Ramachandran, Rumpa Saha, Natasha Gupta, Piyush Gupta
OBJECTIVES: To determine the etiology of severe pneumonia (pneumonia with chest indrawing) in under-five children, and to study the risk factors for poor outcomes viz., 'treatment failure', 'need for change in antibiotics', 'prolonged hospital stay', 'need for mechanical ventilation' and 'mortality.' METHODS: Children (age 2 mo to 5 y) with pneumonia and chest drawing were enrolled prospectively from October 2012 through September 2013. Clinical history was recorded, and examination, anthropometry and investigations (including chest X-ray, blood culture and nasopharyngeal swab culture) were performed...
October 13, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29025380/early-tracheostomy-reduces-time-of-mechanical-ventilation-in-respiratory-high-risk-patients-after-liver-transplant
#10
Sebastian Cammann, Kai Timrott, Florian W R Vondran, Harald Schrem, Frank Lehner, Jürgen Klempnauer, Wolfgang Knitsch, Moritz Kleine
OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#11
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28991116/incidence-and-operative-factors-associated-with-discretional-postoperative-mechanical-ventilation-after-general-surgery
#12
Juliet J Ray, Meredith Degnan, Krishnamurti A Rao, Jonathan P Meizoso, Charles A Karcutskie, Danielle B Horn, Luis Rodriguez, Richard P Dutton, Carl I Schulman, Roman Dudaryk
BACKGROUND: Mechanical ventilation after general surgery is associated with worse outcomes, prolonged hospital stay, and increased health care cost. Postoperatively, patients admitted to the intensive care unit (ICU) may be categorized into 1 of 3 groups: extubated patients (EXT), patients with objective medical indications to remain ventilated (MED), and patients not meeting these criteria, called "discretional postoperative mechanical ventilation" (DPMV). The objectives of this study were to determine the incidence of DPMV in general surgery patients and identify the associated operative factors...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28988400/left-ventricle-assist-devices-and-driveline-s-infection-incidence-a-single-centre-experience
#13
Jonida Bejko, Francesca Toto, Dario Gregori, Gino Gerosa, Tomaso Bottio
Different left ventricular assist devices (LVADs) are provided of different driveline exit sites: HeartWare HVAD presents abdominal power-cable-supply, while the Jarvik 2000 LVAD is powered by a retroauricular driveline. We analyzed 93 LVAD-implanted patients from January-2009 to October-2016 (41 HeartWare and 52 Jarvik 2000), hypothesizing a different incidence of infection, according to driveline exit site. The two populations were propensity matched for the demographic data and preoperative variables, and the outcomes were further analyzed...
October 7, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28985401/clinical-characteristics-of-nosocomial-bloodstream-infections-in-neonates-in-two-hospitals-china
#14
Shanmei Wang, Sheng Chen, Wei Feng, Fengjun Sun, Qian Wang, Ke Zhu, Jie Song
Background: The improvement of medical condition requires prolonged hospital stays, which increase the risk of nosocomial bloodstream infections (BSIs). Methods: All nosocomial BSI newborns in two hospitals were included, and the demographic and clinical characteristics of bacteremia patients were obtained from the information systems. Isolates were identified by biochemical assays. Antimicrobial susceptibility was determined using disk diffusion method. Results: Except for three same risk factors, intubation with mechanical ventilation was a risk factor in Chongqing, while low birth weight was a risk factor in Henan...
July 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28982219/mechanical-ventilation-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#15
REVIEW
Aleksandar Radunovic, Djillali Annane, Muhammad K Rafiq, Ruth Brassington, Naveed Mustfa
BACKGROUND: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease, is a fatal neurodegenerative disease. Neuromuscular respiratory failure is the most common cause of death, which usually occurs within two to five years of the disease onset. Supporting respiratory function with mechanical ventilation may improve survival and quality of life. This is the second update of a review first published in 2009. OBJECTIVES: To assess the effects of mechanical ventilation (tracheostomy-assisted ventilation and non-invasive ventilation (NIV)) on survival, functional measures of disease progression, and quality of life in ALS, and to evaluate adverse events related to the intervention...
October 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28970664/diabetic-ketoacidosis-with-extreme-hypernatremia-in-a-4-year-old-girl
#16
Manish Kumar Arya, Sheikh Minhaj Ahmed, Krishnakumar N Shah, Uma S Ali
A 4-year-old girl admitted with altered mental status, new-onset diabetes mellitus, and diabetic ketoacidosis (DKA) had a rapid rise in serum sodium from 158 mEq/L (corrected sodium 165 mEq/L) at the admission to 204 mEq/L within 18 hours of admission despite standard fluid and insulin therapy recommended for the treatment of DKA. During her illness, she developed arterial and deep vein thrombosis (DVT), bloodstream infection with Candida species, and extensive skin blistering and denudation. The child needed mechanical ventilation, insulin infusion, careful fluid titration to bring down the sodium gradually, and low-molecular weight heparin for her DVT...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28970661/hospital-acquired-hyponatremia-in-pediatric-intensive-care-unit
#17
Anil Sachdev, Nagaraj Pandharikar, Dhiren Gupta, Neeraj Gupta, Suresh Gupta, Shekhar T Venkatraman
OBJECTIVE: The objective of the study was to evaluate the etiology of hospital-acquired hyponatremia (HAH) and its effects on morbidity and mortality in the Pediatric Intensive Care Unit (PICU) patients. DESIGN: This study design was a prospective observational case-control study. SETTING: this study was conducted at tertiary care PICU. MATERIALS AND METHODS: All consecutive cases admitted with at least one measured serum sodium (PNa) value were evaluated...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28966007/risk-factors-and-outcomes-of-severe-acute-respiratory-failure-requiring-invasive-mechanical-ventilation-in-cancer-patients-a-retrospective-cohort-study
#18
F D Martos-Benítez, A Gutiérrez-Noyola, M Badal, N A Dietrich
OBJECTIVES: To determine the risk factors for severe acute respiratory failure requiring invasive mechanical ventilation (SARF-MV) and its effect upon clinical outcomes in critically ill cancer patients. DESIGN: A retrospective cohort study was carried out. SETTING: A 12-bed oncological intensive care unit (ICU) from January 2014 to December 2015. PATIENTS: A total of 878 consecutive cancer patients were included. Patients with an ICU stay of ≤1 day were excluded...
September 28, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28965157/the-effect-of-listening-to-holy-quran-recitation-on-weaning-patients-receiving-mechanical-ventilation-in-the-intensive-care-unit-a-pilot-study
#19
Mohammad Yadak, Khalid Aziz Ansari, Hatem Qutub, Hajed Al-Otaibi, Omar Al-Omar, Nawal Al-Onizi, Faraz Ahmed Farooqi
Mechanical ventilation (MV) causes high level of stress in hospitalized patients. Weaning is the gradual process of decreasing ventilator support that in turn lead to termination of MV and increased respiratory effort, which may exacerbate symptoms and prolong MV. This study aimed to investigate the effect of listening to Holy Quran recitation (HQR) as a non-pharmacological intervention in patients during weaning from mechanical ventilation. This is a randomized controlled trial in which 55 patients admitted in the intensive care unit (ICU) and on mechanical ventilation were recruited...
September 30, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28964315/pediatric-tracheotomy-a-comparison-of-outcomes-and-lengths-of-hospitalization-between-different-indications
#20
Che-Yi Lin, Te-Tien Ting, Tzu-Yu Hsiao, Wei-Chung Hsu
OBJECTIVES: To assess outcomes of pediatric tracheotomy and duration of associated hospital stay according to indications. SUBJECTS AND METHODS: In this retrospective study, subjects were 142 consecutive pediatric patients (<18 years old) who underwent tracheotomy at a tertiary referral medical center, National Taiwan University Hospital, in 1997-2012. Age, sex, indications, pre-operative status (oxygen demand, number of repeated intubations), and post-operative status (duration of weaning, length of hospital stay, mortality) were analyzed...
October 2017: International Journal of Pediatric Otorhinolaryngology
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