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Prolonged mechanical ventilation

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https://www.readbyqxmd.com/read/29221974/criteria-for-postoperative-mechanical-ventilation-after-thymectomy-in-patients-with-myasthenia-gravis-a-retrospective-analysis
#1
Keerthi Chigurupati, Shrinivas Gadhinglajkar, Rupa Sreedhar, Muraleedharan Nair, Madathipat Unnikrishnan, Manjusha Pillai
OBJECTIVE: To determine the criteria for postoperative mechanical ventilation after thymectomy in patients with Myasthenia Gravis. DESIGN: Retrospective study. SETTING: Teritiary care centre. PARTICIPANTS: 77 Myasthenia gravis patients operated for thymectomy were studied. INTERVENTIONS: After obtaining clearance from Institutional ethics committee, medical records of 77 patients with MG, who were operated for thymectomy between January 2005 and December 2015 were reviewed in a retrospective manner...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29217969/severity-of-hyperoxia-as-a-risk-factor-in-patients-undergoing-on-pump-cardiac-surgery
#2
Gabrielius Jakutis, Ieva Norkienė, Donata Ringaitienė, Tomas Jovaiša
Background: Hyperoxia has long been perceived as a desirable or at least an inevitable part of cardiopulmonary bypass. Recent evidence suggest that it might have multiple detrimental effects on patient homeostasis. The aim of the study was to identify the determinants of supra-physiological values of partial oxygen pressure during on-pump cardiac surgery and to assess the impact of hyperoxia on clinical outcomes. Materials and methods: Retrospective data analysis of the institutional research database was performed to evaluate the effects of hyperoxia in patients undergoing elective cardiac surgery with cardiopulmonary bypass, 246 patients were included in the final analysis...
2017: Acta Medica Lituanica
https://www.readbyqxmd.com/read/29213205/hypercapnic-ventilatory-response-in-the-weaning-of-patients-with-prolonged-mechanical-ventilation
#3
Chung-Shu Lee, Ning-Hung Chen, Li-Pang Chuang, Chih-Hao Chang, Li-Fu Li, Shih-Wei Lin, Hsiung-Ying Huang
Objective: To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [[Formula: see text]] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2 ]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods: A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29210786/selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-are-not-associated-with-bleeding-or-transfusion-in-cardiac-surgical-patients
#4
Mark M Smith, Bradford B Smith, Brian D Lahr, Gregory A Nuttall, William J Mauermann, Timothy J Weister, Joseph A Dearani, David W Barbara
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is known to alter platelet activation and aggregation leading to impairment in hemostasis. Previous studies are ambiguous with regard to bleeding, transfusion, and perioperative complications in patients undergoing cardiac surgery. The purpose of this study was to evaluate the risk of perioperative bleeding, transfusion, morbidity, and mortality in cardiac surgical patients taking SSRI/SNRIs compared with propensity-matched controls...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29207322/identification-of-a-vte-rich-population-in-pediatrics-critically-ill-children-with-central-venous-catheters
#5
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
November 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29206492/intravenous-controlled-release-hydrogen-sulfide-protects-against-ventilator-induced-lung-injury
#6
Lifeng Wang, Hao Yu, Yana Zhang, Caiyu Dong, Bo Liu
BACKGROUND: Despite its critical utility in providing life support to patients with impaired respiratory functions, prolonged mechanical ventilation has been found to cause a series of pathological changes in the lung that are collectively referred to as ventilator-induced lung injury (VILI). This study aims to investigate the therapeutic effects of mesoporous silica nanoparticles (DATS-MSN), which is capable of releasing H2S in a slow and controlled manner, on VILI. METHODS: A murine VILI model was generated...
December 5, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29202432/validation-of-the-prognosis-for-prolonged-ventilation-provent-score-in-patients-receiving-14days-of-mechanical-ventilation
#7
Won-Young Kim, Eun-Jung Jo, Jung Seop Eom, Jeongha Mok, Mi-Hyun Kim, Ki Uk Kim, Hye-Kyung Park, Min Ki Lee, Kwangha Lee
PURPOSE: To evaluate the performance of the Prognosis for Prolonged Ventilation (ProVent) 14 score in patients requiring prolonged mechanical ventilation (PMV). MATERIALS AND METHODS: Data were obtained from 366 patients receiving at least 14days of MV between January 2011 and December 2015 at a university-affiliated tertiary care hospital in Korea. ProVent 14 scores were assessed using the six standard variables. Model discrimination was assessed with the area under the receiver operating characteristic curve...
November 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#8
Young-Bin Choi, Juyoung Lee, Jisun Park, Yong Hoon Jun
OBJECTIVE: To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. STUDY DESIGN: A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. RESULTS: The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less...
November 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29197632/crosstalk-between-autophagy-and-oxidative-stress-regulates-proteolysis-in-the-diaphragm-during-mechanical-ventilation
#9
Ashley J Smuder, Kurt J Sollanek, W Bradley Nelson, Kisuk Min, Erin E Talbert, Andreas N Kavazis, Matthew B Hudson, Marco Sandri, Hazel H Szeto, Scott K Powers
Mechanical ventilation (MV) results in the rapid development of ventilator-induced diaphragm dysfunction (VIDD). While the mechanisms responsible for VIDD are not fully understood, recent data reveal that prolonged MV activates autophagy in the diaphragm, which may occur as a result of increased cellular reactive oxygen species (ROS) production. Therefore, we tested the hypothesis that 1) accelerated autophagy is a key contributor to VIDD; and that 2) oxidative stress is required to increase the expression of autophagy genes in the diaphragm...
November 29, 2017: Free Radical Biology & Medicine
https://www.readbyqxmd.com/read/29197340/clinical-significance-and-risk-factors-for-new-onset-and-recurring-atrial-fibrillation-following-cardiac-surgery-a-retrospective-data-analysis
#10
Hristo Todorov, Inka Janssen, Stefanie Honndorf, Daniela Bause, Antje Gottschalk, Silke Baasner, Thomas Volkert, Valentin Faerber, John F Stover, Martin Westphal, Björn Ellger
BACKGROUND: Although mortality after cardiac surgery has significantly decreased in the last decade, patients still experience clinically relevant postoperative complications. Among others, atrial fibrillation (AF) is a common consequence of cardiac surgery, which is associated with prolonged hospitalization and increased mortality. METHODS: We retrospectively analyzed data from patients who underwent coronary artery bypass grafting, valve surgery or a combination of both at the University Hospital Muenster between April 2014 and July 2015...
December 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29194281/rbc-transfusions-are-associated-with-prolonged-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#11
Michael E Zubrow, Neal J Thomas, David F Friedman, Nadir Yehya
OBJECTIVES: Blood products are often transfused in critically ill children, although recent studies have recognized their potential for harm. Translatability to pediatric acute respiratory distress syndrome is unknown given that hypoxemia has excluded pediatric acute respiratory distress syndrome patients from clinical trials. We aimed to determine whether an association exists between blood product transfusion and survival or duration of ventilation in pediatric acute respiratory distress syndrome...
November 30, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189669/measurement-of-dead-space-fraction-upon-icu-admission-predicts-length-of-stay-and-clinical-outcomes-following-bidirectional-cavopulmonary-anastomosis
#12
Claire L Cigarroa, Sarah J van den Bosch, Xiaoqi Tang, Kimberlee Gauvreau, Christopher W Baird, James A DiNardo, John Nagi Kheir
OBJECTIVES: Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis...
November 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189283/effects-of-increasing-airway-pressures-on-the-pressure-of-the-endotracheal-tube-cuff-during-pelvic-laparoscopic-surgery
#13
Eric B Rosero, Esra Ozayar, Javier Eslava-Schmalbach, Abu Minhajuddin, Girish P Joshi
BACKGROUND: Tracheal tube cuff pressures exceeding the perfusion pressures of the tracheal mucosa have been associated with complications such as sore throat, tracheal mucosa ulcers, tracheal rupture, and subglottic stenosis. Despite appropriate inflation, many factors can increase the tracheal cuff pressure during mechanical ventilation. This prospective observational cohort study was designed to test the hypothesis that during a clinical model of decreasing respiratory compliance, the pressure within the endotracheal tube cuff will rise in direct relationship to increases in the airway pressures...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29184454/sleep-quality-and-circadian-rhythm-disruption-in-the-intensive-care-unit-a-review
#14
REVIEW
Yuliya Boyko, Poul Jennum, Palle Toft
Sleep and circadian rhythm are reported to be severely abnormal in critically ill patients. Disturbed sleep can lead to the development of delirium and, as a result, can be associated with prolonged stay in the intensive care unit (ICU) and increased mortality. The standard criterion method of sleep assessment, polysomnography (PSG), is complicated in critically ill patients due to the practical challenges and interpretation difficulties. Several PSG sleep studies in the ICU reported the absence of normal sleep characteristics in many critically ill patients, making the standard method of sleep scoring insufficient in this patient group...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/29174288/-update-on-the-respiratory-management-of-patients-with-chronic-neuromuscular-disease
#15
REVIEW
P Priou, W Trzepizur, N Meslier, F Gagnadoux
BACKGROUND: Neuromuscular diseases include a wide range of conditions that may involve potentially life-threatening respiratory complications (infection, respiratory failure). SURVEILLANCE AND PULMONARY FUNCTION TESTS: For patients with neuromuscular diseases, clinical assessment of respiratory function and regular pulmonary function tests are needed to screen for nocturnal respiratory disorders, weakness of the diaphragm and potential restrictive disorders and/or chronic hypercapnic respiratory insufficiency, possibly with couch deficiency...
November 21, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29172756/the-experience-of-parents-of-adult-sons-with-duchenne-muscular-dystrophy-regarding-their-prolonged-roles-as-primary-caregivers-a-serial-qualitative-study
#16
Miku Yamaguchi, Etsuyo Sonoda, Machiko Suzuki
PURPOSE: Mechanical ventilation has allowed a greater number of patients with Duchenne muscular dystrophy (DMD) to transition into adulthood. However, the role of a child's parent as a caregiver lasts throughout the child's lifetime. We explored parents' experiences of prolonged caregiving using serial interviews, analyzed using constructivist grounded theory. MATERIALS AND METHODS: Fourteen parents (average age 53.9 years) with sons with DMD (average age 23.2 years) were interviewed two to four times, over a 3-year period...
November 26, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29167575/nutritional-assessment-of-critically-ill-patients-validation-of-the-modified-nutric-score
#17
Manon Ch de Vries, Wac Kristine Koekkoek, Marieke H Opdam, Dick van Blokland, Arthur Rh van Zanten
BACKGROUND/OBJECTIVES: In order to identify critically ill patients with high nutritional risk the modified NUTrition Risk in the Critically ill (mNUTRIC)-score was developed. This score aims to identify patients that will benefit from nutritional interventions. Few data are available on its validity. In The Netherlands, the MUST-score, a nutritional assessment tool for non-ICU patients, is commonly used in the ICU. To validate the mNUTRIC-score in Dutch ICU patients and compare its prognostic performance with the MUST-score...
November 23, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29166261/pressure-injury-risk-factors-in-adult-critical-care-patients-a-review-of-the-literature
#18
Jill Cox
Critically ill patients require complex care in a technologically sophisticated environment where they are highly vulnerable to pressure-related injuries. However, pressure injury (PI) development remains a multifactorial phenomenon in critically ill persons; true risk is both pervasive and elusive. The purpose of this comprehensive review of the empirical literature was to examine the risk factors associated with PIs among adult patients admitted to contemporary intensive care units (ICUs). Inclusion criteria stipulated publications were to be peer-reviewed, quantitative studies with a focus on pressure ulcer (PU) risk factors in adult critical care patients published between 2010 and 2016 in which statistical analysis involved multivariate analysis using PU development as the outcome variable...
November 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29164549/-improving-the-accuracy-rate-of-analgesics-and-sedatives-administration-in-an-intensive-care-unit
#19
Hsiu-Chuan Lai, Ya-Huei Chen, Yi-Jene Li, Hui-Mei Huang, Chien-Hua Tseng, Ming-Cheng Chan
BACKGROUND: Patients with respiratory failure needing mechanical ventilation are common in the intensive care unit. These patients often require sedative and analgesic agents to alleviate their discomfort and to avoid causing associated safety issues. However, prolonged post-awakening confusion and changes in perception after withdrawal from sedatives and analgesic agents are common in daily practice. Thus, the optimal use of sedative and analgesic agents remains an important issue in the intensive care unit...
December 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29161667/pre-hospital-frailty-and-hospital-outcomes-in-adults-with-acute-respiratory-failure-requiring-mechanical-ventilation
#20
Aluko A Hope, Oriade Adeoye, Elizabeth H Chuang, S J Hsieh, Hayley B Gershengorn, Michelle N Gong
PURPOSE: We aimed to estimate the independent effect of pre-hospital frailty (PHF) on hospital mortality and prolonged hospital length of stay (pLOS) while adjusting for other patient level factors. METHODS: This is a cohort study of hospitalized adults with acute respiratory failure (ARF) who required invasive mechanical ventilation for ≥24h in 2013. We used inpatient/outpatient claims from a list of diagnoses from the year before index hospital admission to define PHF...
November 11, 2017: Journal of Critical Care
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