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Prolonged mechanical ventilation

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https://www.readbyqxmd.com/read/29452598/7-versus-14-days-of-antibiotic-treatment-for-critically-ill-patients-with-bloodstream-infection-a-pilot-randomized-clinical-trial
#1
Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Pierre Aslanian, Sean M Bagshaw, Alex Carignan, Emmanuel Charbonney, Bryan Coburn, Deborah J Cook, Michael E Detsky, Peter Dodek, Richard Hall, Anand Kumar, Francois Lamontagne, Francois Lauzier, John C Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Wendy Sligl, Henry T Stelfox, M Elizabeth Wilcox, Robert A Fowler
BACKGROUND: Shorter-duration antibiotic treatment is sufficient for a range of bacterial infections, but has not been adequately studied for bloodstream infections. Our systematic review, survey, and observational study indicated equipoise for a trial of 7 versus 14 days of antibiotic treatment for bloodstream infections; a pilot randomized clinical trial (RCT) was a necessary next step to assess feasibility of a larger trial. METHODS: We conducted an open, pilot RCT of antibiotic treatment duration among critically ill patients with bloodstream infection across 11 intensive care units (ICUs)...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29451075/short-term-outcomes-of-preoperative-intra-aortic-balloon-pump-use-in-patients-undergoing-adjunctive-coronary-endarterectomy-a-retrospective-observational-study
#2
Liangshan Wang, Xing Hao, Xiaomeng Wang, Chengxiong Gu, Hong Wang, Xiaotong Hou
BACKGROUND: Coronary artery bypass grafting (CABG) combined with coronary endarterectomy (CE) can be associated with high operative mortality and morbidity. An intra-aortic balloon pump (IABP) has been the most widely used mechanical circulatory support device during perfusion treatment. However, the benefits of preoperative IABP in CABG combined with CE remain unknown. We conducted a retrospective observational study to evaluate the efficacy of preoperative IABP therapy in patients undergoing adjunctive right coronary artery (RCA) endarterectomy...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29447297/development-of-a-decision-aid-for-cardiopulmonary-resuscitation-and-invasive-mechanical-ventilation-in-the-intensive-care-unit-employing-user-centered-design-and-a-wiki-platform-for-rapid-prototyping
#3
Ariane Plaisance, Holly O Witteman, Annie LeBlanc, Jennifer Kryworuchko, Daren Keith Heyland, Mark H Ebell, Louisa Blair, Diane Tapp, Audrey Dupuis, Carole-Anne Lavoie-Bérard, Carrie Anna McGinn, France Légaré, Patrick Michel Archambault
BACKGROUND: Upon admission to an intensive care unit (ICU), all patients should discuss their goals of care and express their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. OBJECTIVES: To adapt an existing decision aid about CPR to create a wiki-based decision aid individually adapted to each patient's risk factors; and to document the use of a wiki platform for this purpose...
2018: PloS One
https://www.readbyqxmd.com/read/29444748/aortopulmonary-collaterals-in-neonates-with-d-transposition-of-the-great-arteries-clinical-significance-early-after-arterial-switch-operation
#4
Alexandra Wipf, Martin Christmann, Susanne Navarini-Meury, Hitendu Dave, Daniel Quandt, Walter Knirsch, Oliver Kretschmar
OBJECTIVES: Purpose of this study is to evaluate the clinical significance of major aortopulmonary collateral arteries (MAPCAs) during the early postoperative course after arterial switch operation (ASO) in d-transposition of the great arteries (dTGA). METHODS: Clinical data of 98 patients with simple dTGA between January 2007 and December 2016 at the University Children's Hospital Zurich, Switzerland were analyzed retrospectively. RESULTS: 37 from 98 patients (38%) required cardiac catheterization (CC) due to an early complicated postoperative course or difficult coronary transfer due to special coronary anatomy...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29444340/antipsychotics-delirium-and-acute-respiratory-distress-syndrome-what-is-the-link
#5
Heather Torbic, Abhijit Duggal
Acute respiratory distress syndrome (ARDS) is an acute inflammatory process that impairs the ability of the lungs to oxygenate and ultimately leads to respiratory failure. Patients who develop ARDS often have prolonged and complicated hospital courses putting them at risk for intensive care unit (ICU) delirium. Patients with ICU delirium often need chemical sedation, mechanical ventilation, prolonged duration of ICU and hospital stays, long-term cognitive impairment, and increased mortality. In a patient with ARDS, ICU delirium further complicates the hospital course and increases the risk of morbidly and mortality...
February 14, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29440830/impact-of-intensive-care-unit-attending-physician-training-background-on-outcomes-in-children-undergoing-heart-operations
#6
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29438568/haemodynamic-assessment-and-support-in-sepsis-and-septic-shock-in-resource-limited-settings
#7
David Misango, Rajyabardhan Pattnaik, Tim Baker, Martin W Dünser, Arjen M Dondorp, Marcus J Schultz
Background: Recommendations for haemodynamic assessment and support in sepsis and septic shock in resource-limited settings are largely lacking. Methods: A task force of six international experts in critical care medicine, all of them members of the Global Intensive Care Working Group of the European Society of Intensive Care Medicine and with extensive bedside experience in resource-limited intensive care units, reviewed the literature and provided recommendations regarding haemodynamic assessment and support, keeping aspects of efficacy and effectiveness, availability and feasibility and affordability and safety in mind...
February 9, 2018: Transactions of the Royal Society of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29433716/percutaneous-dilational-tracheostomy
#8
REVIEW
Andrew D Lerner, Lonny Yarmus
Tracheostomy tubes can be inserted surgically or percutaneously via percutaneous dilational tracheostomy (PDT). Tracheostomy is performed for upper airway obstruction, though more often to allow prolonged mechanical ventilation in place of endotracheal tubes. Preparation, performance, and postoperative management for PDT are best provided by a multidisciplinary team. Although PDT is a safe procedure in the hands of experienced operators, both early and late complications can arise. Caution must also be taken during early tracheostomy tube exchange given that immaturity of the stomal tract can risk loss of the airway...
March 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29430408/using-bronchoscopy-to-detect-acquired-tracheoesophageal-fistula-in-mechanically-ventilated-patients
#9
Michael S Green, Johann J Mathew, Lia J Michos, Parmis Green, Mansoor M Aman
Introduction: An acquired Tracheoesophageal fistula (TEF) is commonly caused by a malignancy or trauma, with pulmonary infection or aspiration being the presenting symptom. However, in the critical care setting the presentation can be subtle and may present with difficult ventilation. High endotracheal tube cuff pressures can lead to tracheal erosions and thus increasing the chances for developing a TEF. Prolonged intubation in the presence of other risk factors like poor general state of health, episodic hypotension, nasogastric tubes, and repeated intubations can increase the likelihood of developing an acquired TEF...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29422291/a-case-control-study-on-the-clinical-impact-of-ventilator-associated-tracheobronchitis-in-adult-patients-who-did-not-develop-ventilator-associated-pneumonia
#10
María Luisa Cantón-Bulnes, María Ascensión González-García, Manuela García-Sánchez, Ángel Arenzana-Seisdedos, José Garnacho-Montero
OBJECTIVES: The main objective was to determine whether ventilator-associated tracheobronchitis (VAT) is related to increased length of ICU stay. Secondary endpoints included prolongation of hospital stay, as well as, ICU and hospital mortality. DESIGN: A retrospective matched case-control study. Each case was matched with a control for duration of ventilation (± 2 days until development of ventilator-associated tracheobronchitis), disease severity (Acute Physiology and Chronic Health Evaluation II) at admission ± 3, diagnostic category and age ±10 years...
February 5, 2018: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/29413508/weaning-failure-and-respiratory-muscle-function-what-has-been-done-and-what-can-be-improved
#11
REVIEW
Paulo A F Magalhães, Carlos A Camillo, Daniel Langer, Lívia B Andrade, Maria do Carmo M B Duarte, Rik Gosselink
INTRODUCTION: Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Inspiratory muscle training (IMT) has been described as an important contributor to the treatment of respiratory muscle dysfunction in critically ill patients. Its effectiveness is however yet controversial. OBJECTIVE: To discuss evidence for assessment of readiness and the effectiveness of interventions for liberation from MV, with special attention to the role of IMT...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29404795/prolonged-extracorporeal-membrane-oxygenation-for-pediatric-necrotizing-pneumonia-due-to-streptococcus-pneumonia-and-influenza-h1n1-co-infection-how-long-should-we-wait-for-native-lung-recovery
#12
Gerard Cortina, Christian Niederwanger, Uwe Klingkowski, Corinna Velik-Salchner, Nikolaus Neu
Most children with severe respiratory failure require extracorporeal membrane oxygenation (ECMO) for 7-10 days. However, some may need prolonged duration ECMO (> 14 days). To date, no consensus exists on how long to wait for native lung recovery. Here we report the case of a 3-year-old boy who developed severe necrotizing pneumonia requiring venovenous (VV) ECMO after 19 days of mechanical ventilation. In the first 4 weeks of his ECMO run, he showed no lung aeration, requiring total extracorporeal support...
February 5, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29402358/-effect-of-early-mobilization-on-diaphragmatic-function-in-patients-with-mechanical-ventilation-a-prospective-randomized-controlled-study
#13
Shengqiang Yang, Jinggang Liu, Wenbao Yang, Jiyin Yuan, Suqiu Meng, Maoling Liang, Qibiao Shi
OBJECTIVE: To investigate the effect of early mobilization on diaphragmatic function in patients with mechanical ventilation (MV). METHODS: Sixty chronic obstructive pulmonary disease with acute exacerbation (AECOPD) patients with respiratory failure (RF) and underwent MV admitted to intensive care unit (ICU) of Huxi Affiliated Hospital of Jining Medical College from January 2016 to January 2017 were enrolled. The patients were divided into treatment group (n = 30) and control group (n = 30) by randomly number table method...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29394231/red-cell-transfusion-and-prolonged-mechanical-ventilation-the-perpetrator-finally-identified-or-guilt-by-association-again
#14
James A DiNardo
No abstract text is available yet for this article.
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29384944/epidemiologic-characteristics-and-outcomes-of-major-trauma-patients-requiring-prolonged-mechanical-ventilation
#15
Shu-Chen Kung, Wei-Ting Lin, Tsung-Chih Tsai, Ming-Hsiu Lin, Chia-Hao Chang, Chih-Cheng Lai, Chien-Ming Chao
The epidemiologic characteristics and outcomes of severe trauma patients requiring prolonged mechanical ventilation (PMV) remain unclear. This retrospective study aims to investigate the outcomes of PMV in this specific group. All patients with major trauma admitted to the respiratory care center (RCC) requiring PMV (duration ≥21 days between January 2014 and December 2016) were enrolled. A total of 36343 trauma patients visited our emergency department for management, and 1388 (3.82%) were admitted to the intensive care unit (ICU) after initial resuscitation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383943/complications-of-surgery-for-infectious-lung-cavities
#16
Gildardo Cortés-Julián, Luis C Valencia, Silviano Ríos-Pascual, Marco A de la Rosa-Abarroa, Enrique Guzmán-de Alba
Background Infectious lung cavities are a common entity for the respiratory physician. Sometimes these lesions require surgical treatment, but surgery is challenging, and complications are common. Methods Patients with infectious lung cavities amenable to surgical treatment were included in a case-control study. The control group included patients with no complications. The cases group comprised patients with any of the following complications up to 90 days after surgery: death, persistence of hemoptysis, empyema, operative blood loss > 500 mL, vascular lesion requiring repair, massive transfusion (>5 units of packed red blood cells per 48 h) or reoperation for bleeding, postoperative mechanical ventilation, intensive care unit stay > 48 h, prolonged air leak, and persistent atelectasis...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29382792/prolonged-mechanical-ventilation-as-a-predictor-of-mortality-after-cardiac-surgery
#17
Maria Dolores Fernandez-Zamora, Antonio Gordillo-Brenes, Esther Banderas-Bravo, José Andrés Arboleda-Sánchez, Rafael Hinojosa-Pérez, Eduardo Aguilar-Alonso, Ángel Herruzo-Aviles, Emilio Curiel-Balsera, Ángel Sánchez-Rodríguez, Ricardo Rivera-Fernández
BACKGROUND: Mortality among the small percentage of cardiac surgery patients receiving prolonged mechanical ventilation is high, but this issue appears to be inadequately addressed in guidelines. METHODS: This study is a retrospective analysis of prospective, multi-center, and observational study in Spain including all adults undergoing cardiac surgery in 3 Andalusian hospitals between June 2008 and December 2012. RESULTS: The study included 3,588 adults with mean ± SD age of 63...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29373223/factors-associated-with-pulmonary-dysfunction-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-use-of-intra-aortic-balloon-pump
#18
Helena Amaral Gonçalves Fusatto, Luciana Castilho de Figueiredo, Ana Paula Ragonete Dos Anjos Agostini, Melissa Sibinelli, Desanka Dragosavac
OBJECTIVE: The aim of this study was to identify pulmonary dysfunction and factors associated with prolonged mechanical ventilation, hospital stay, weaning failure and mortality in patients undergoing coronary artery bypass grafting with use of intra-aortic balloon pump (IABP). METHODS: This observational study analyzed respiratory, surgical, clinical and demographic variables and related them to outcomes. RESULTS: We analyzed 39 patients with a mean age of 61...
January 16, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29371107/advance-directive-utilization-is-associated-with-less-aggressive-end-of-life-care-in-patients-undergoing-allogeneic-hematopoietic-cell-transplantation
#19
Kathryn Cappell, Vandana Sundaram, Annie Park, Parveen Shiraz, Ridhi Gupta, Patricia Jenkins, Vyjeyanthi S J Periyakoil, Lori Muffly
Background Allogeneic hematopoietic cell transplantation (HCT) is associated with significant morbidity and mortality, making advance care planning (ACP) and management especially important in this patient population. A paucity of data exists on the utilization of ACP amongst allogeneic HCT recipients, and the relationship between ACP and intensity of health care utilization in these patients. Methods We performed a retrospective review of patients receiving allogeneic HCT at our institution from 2008 to 2015 who had subsequently died following HCT...
January 22, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29367411/ards-challenges-in-patient-care-and-frontiers-in-research
#20
Lieuwe D Bos, Ignacio Martin-Loeches, Marcus J Schultz
This review discusses the clinical challenges associated with ventilatory support and pharmacological interventions in patients with acute respiratory distress syndrome (ARDS). In addition, it discusses current scientific challenges facing researchers when planning and performing trials of ventilatory support or pharmacological interventions in these patients.Noninvasive mechanical ventilation is used in some patients with ARDS. When intubated and mechanically ventilated, ARDS patients should be ventilated with low tidal volumes...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
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