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https://www.readbyqxmd.com/read/29222320/anticoagulation-with-vads-and-ecmo-walking-the-tightrope
#1
REVIEW
Leslie Raffini
The evolution of devices for mechanical circulatory support (MCS), including ventricular assist devices (VADs) for patients with heart failure and extracorporeal membrane oxygenation (ECMO) for patients with acute cardiac or respiratory failure, has improved survival for subsets of critically ill children and adults. The devices are intricate and complex, allowing blood to bypass the heart or lungs (or both). As blood flows through these artificial devices, normal hemostasis is disrupted, coagulation is promoted, and in the absence of anticoagulation, a thrombus may form in the device, resulting in device failure or embolic stroke...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221274/predictors-of-high-flow-nasal-cannula-failure-in-immunocompromised-patients-with-acute-respiratory-failure-due-to-non-hiv-pneumocystis-pneumonia
#2
Won-Young Kim, Heungsup Sung, Sang-Bum Hong, Chae-Man Lim, Younsuck Koh, Jin Won Huh
Background: To evaluate the predictors of high flow nasal cannula (HFNC) failure in pneumocystis pneumonia (PCP) patients with acute respiratory failure (ARF). Methods: Fifty-two non-HIV-related PCP subjects were divided into a HFNC success group (44%) and a HFNC failure group (who required mechanical ventilation (MV) despite HFNC application) (56%). The clinical characteristics and physiologic effects were retrospectively reviewed and compared between the groups...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29220699/hiv-1-tat-protein-induces-dna-damage-in-human-peripheral-blood-b-lymphocytes-via-mitochondrial-ros-production
#3
Rawan El-Amine, Diego Germini, Vlada V Zakharova, Tatyana Tsfasman, Eugene V Sheval, Ruy A N Louzada, Corinne Dupuy, Chrystèle Bilhou-Nabera, Aline Hamade, Fadia Najjar, Eric Oksenhendler, Marс Lipinski, Boris V Chernyak, Yegor S Vassetzky
Human immunodeficiency virus (HIV) infection is associated with B-cell malignancies in patients though HIV-1 is not able to infect B-cells. The rate of B-cell lymphomas in HIV-infected individuals remains high even under the combined antiretroviral therapy (cART) that reconstitutes the immune function. Thus, the contribution of HIV-1 to B-cell oncogenesis remains enigmatic. HIV-1 induces oxidative stress and DNA damage in infected cells via multiple mechanisms, including viral Tat protein. We have detected elevated levels of reactive oxygen species (ROS) and DNA damage in B-cells of HIV-infected individuals...
December 5, 2017: Redox Biology
https://www.readbyqxmd.com/read/29208754/proactive-use-of-high-flow-nasal-cannula-with-critically-ill-subjects
#4
Keith D Lamb, Sarah K Spilman, Trevor W Oetting, Julie A Jackson, Matthew W Trump, Sheryl M Sahr
INTRODUCTION: It has been suggested that use of a high-flow nasal cannula (HFNC) could be a first-line therapy for patients with acute hypoxic respiratory failure. The purpose of this study was to determine if protocolized use of HFNC decreases unplanned intubation and adverse outcomes in an ICU population. METHODS: The study was a prospective evaluation of 2 cohorts who received HFNC per protocol. Control groups were retrospective selections of subjects who received HFNC in the pre-protocol period...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29197078/cardiopulmonary-anomalies-in-incontinentia-pigmenti-patients
#5
Giuliana Onnis, Andrea Diociaiuti, Paola Zangari, Patrizia D'Argenio, Caterina Cancrini, Lorenzo Iughetti, May El Hachem
BACKGROUND: Incontinentia pigmenti (IP) is a rare inherited genodermatosis that usually involves the skin, and also teeth, oral cavity, central nervous system, eyes, blood with eosinophilia, and rarely skeletal system, breast, heart, and lungs. Skin lesions usually appear early, at birth or within the first 2 weeks of life, with four different phases tending to follow Blaschko lines that may overlap. CASE REPORT: We report a rare case of a neonate with transient reversible pulmonary hypertension that presented at day 9 of life...
December 2, 2017: International Journal of Dermatology
https://www.readbyqxmd.com/read/29187008/cost-effectiveness-analysis-of-the-use-of-high-flow-oxygen-through-nasal-cannula-in-intensive-care-units-in-nhs-england
#6
Emily Eaton Turner, Michelle Jenks
Objective To estimate the cost-effectiveness of Nasal High Flow (NHF) in the intensive care unit (ICU) compared with standard oxygen or non-invasive ventilation (NIV) from a UK NHS perspective. Methods Three cost-effectiveness models were developed to reflect scenarios of NHF use: first-line therapy (pre-intubation model); post-extubation in low-risk, and high-risk patients. All models used randomised control trial data on the incidence of intubation/re-intubation, events leading to intubation/re-intubation, mortality and complications...
November 30, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#7
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29177329/triphenylamine-flanked-furan-diketopyrrolopyrrole-for-multi-imaging-guided-photothermal-photodynamic-cancer-therapy
#8
Pingping Liang, Ya Wang, Peng Wang, Jianhua Zou, Hong Xu, Yewei Zhang, Weili Si, Xiaochen Dong
The combination of photodynamic therapy (PDT) and photothermal therapy (PTT) is highly desired to improve the cancer phototherapeutic effect. However, most reported multicomponent therapeutic agents need complex preparation processes and must be excited by using multiple light sources. Herein, triphenylamine flanked furan-diketopyrrolopyrrole (FDPP-TPA) with a donor-acceptor-donor structure has been synthesized and used as a sole-component agent for fluorescence, photoacoustic and photothermal imaging guided photodynamic and photothermal synergistic therapy...
November 27, 2017: Nanoscale
https://www.readbyqxmd.com/read/29174453/correlation-of-high-flow-nasal-cannula-outlet-area-with-gas-clearance-and-pressure-in-adult-upper-airway-replicas
#9
REVIEW
Charles P Moore, Ira M Katz, Georges Caillibotte, Warren H Finlay, Andrew R Martin
BACKGROUND: Primary benefits of high flow nasal cannula therapy include washout of carbon dioxide rich exhaled gas and increased airway pressures during tidal breathing. This work reports on the influence of high flow nasal cannula outlet area on upper airways gas clearance and tracheal pressures using measurements in five realistic adult nose-throat airway replicas. METHODS: Two commercial high flow nasal cannulas and one generic nasal cannula of varying size were compared...
November 11, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29171661/a-randomised-controlled-trial-comparing-high-flow-nasal-oxygen-with-standard-management-for-conscious-sedation-during-bronchoscopy
#10
N Douglas, I Ng, F Nazeem, K Lee, P Mezzavia, R Krieser, D Steinfort, L Irving, R Segal
Traditional conscious sedation for endobronchial ultrasound procedures places patients at risk of desaturation, and high-flow nasal oxygen may reduce the risk. We designed a parallel-group randomised controlled trial of high-flow nasal oxygen at a flow rate of 30-70 l.min(-1) via nasal cannulae, compared with standard oxygen therapy at 10 l.min(-1) via a bite block in adults planned for conscious sedation for endobronchial ultrasound. The primary outcome was the proportion of patients experiencing desaturation (defined as SpO2 < 90%)...
November 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29161401/the-evolution-of-airway-management-new-concepts-and-conflicts-with-traditional-practice
#11
A F McNarry, A Patel
In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29159034/hamman-rich-syndrome
#12
Arshiya Mastan, Nilaani Murugesu, Adil Hasnain, Terry O'Shaughnessy, Vladimir Macavei
INTRODUCTION: Acute interstitial pneumonia is a rare but important diagnosis, associated with a high mortality rate and important to identify early. CASE PRESENTATION: A 76 year-old individual presented to hospital with a two-week history of shortness of breath, fevers and a non-productive cough. Treatment initially was for lower respiratory tract infection but returned to hospital three days later as her shortness of breath and peripheral oedema was worsening despite diuretic treatment...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29149868/can-high-flow-nasal-cannula-reduce-the-rate-of-reintubation-in-adult-patients-after-extubation-a-meta-analysis
#13
Yue-Nan Ni, Jian Luo, He Yu, Dan Liu, Bin-Miao Liang, Rong Yao, Zong-An Liang
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients after extubation remain controversial. We aimed to further determine the effectiveness of HFNC in comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trails (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled study comparing HFNC with NIPPV and COT in adult patients after extubation...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149867/efficacy-and-safety-of-nasal-high-flow-oxygen-in-copd-patients
#14
Helene Vogelsinger, Michael Halank, Silke Braun, Heinrike Wilkens, Thomas Geiser, Sebastian Ott, Armin Stucki, Christian M Kaehler
BACKGROUND: Nasal high-flow oxygen therapy (HFOT) is a novel treatment option for patients suffering from acute or chronic respiratory failure. Aim of our study was to compare safety and efficacy of HFOT with those of conventional oxygen treatment (COT) in normo- and hypercapnic COPD patients. METHODS: A single cohort of 77 clinically stable hypoxemic patients with an indication for long-term oxygen treatment (LTOT) with or without hypercapnia successively received COT and HFOT for 60 min each, including oxygen adaption and separated by a 30 min washout phase...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29144160/high-flow-nasal-cannula-oxygen-in-adults-an-evidence-based-assessment
#15
Matthew G Drake
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29129174/high-flow-or-titrated-oxygen-for-obese-medical-inpatients-a-randomised-crossover-trial
#16
Janine Pilcher, Michael Richards, Leonie Eastlake, Steven J McKinstry, George Bardsley, Sarah Jefferies, Irene Braithwaite, Mark Weatherall, Richard Beasley
OBJECTIVE: To compare the effects on transcutaneous carbon dioxide tension (Ptco2) of high concentration and titrated oxygen therapy in medical inpatients with morbid obesity who were not selected for a pre-existing diagnosis of obesity hypoventilation syndrome. DESIGN: A randomised, crossover trial undertaken between February and September 2015. SETTING: Internal medicine service, Wellington Regional Hospital, New Zealand. PARTICIPANTS: 22 adult inpatients, aged 16 years or more, with a body mass index exceeding 40 kg/m<sup>2</sup>...
November 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/29119848/management-of-community-acquired-pneumonia-in-immunocompetent-adults-updated-swedish-guidelines-2017
#17
Simon Athlin, Christer Lidman, Anders Lundqvist, Pontus Naucler, Anna C Nilsson, Carl Spindler, Kristoffer Strålin, Jonas Hedlund
Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation...
November 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29099420/predictors-of-intubation-in-patients-with-acute-hypoxemic-respiratory-failure-treated-with-a-noninvasive-oxygenation-strategy
#18
Jean-Pierre Frat, Stéphanie Ragot, Rémi Coudroy, Jean-Michel Constantin, Christophe Girault, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Keyvan Razazi, Jean-Baptiste Lascarrou, Jérôme Devaquet, Jean-Paul Mira, Laurent Argaud, Jean-Charles Chakarian, Muriel Fartoukh, Saad Nseir, Alain Mercat, Laurent Brochard, René Robert, Arnaud W Thille
OBJECTIVES: In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians to decide early. We aimed to identify factors associated with intubation in patients with acute hypoxemic respiratory failure treated with different noninvasive oxygenation techniques...
November 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29097988/hyperbaric-oxygen-therapy-can-induce-angiogenesis-and-regeneration-of-nerve-fibers-in-traumatic-brain-injury-patients
#19
Sigal Tal, Amir Hadanny, Efrat Sasson, Gil Suzin, Shai Efrati
Background: Recent clinical studies in stroke and traumatic brain injury (TBI) victims suffering chronic neurological injury present evidence that hyperbaric oxygen therapy (HBOT) can induce neuroplasticity. Objective: To assess the neurotherapeutic effect of HBOT on prolonged post-concussion syndrome (PPCS) due to TBI, using brain microstructure imaging. Methods: Fifteen patients afflicted with PPCS were treated with 60 daily HBOT sessions. Imaging evaluation was performed using Dynamic Susceptibility Contrast-Enhanced (DSC) and Diffusion Tensor Imaging (DTI) MR sequences...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29074620/the-natural-product-mensacarcin-induces-mitochondrial-toxicity-and-apoptosis-in-melanoma-cells
#20
Birte Plitzko, Elizabeth N Kaweesa, Sandra Loesgen
Mensacarcin is a highly oxygenated polyketide that was first isolated from soil-dwelling Streptomyces bacteria. It exhibits potent cytostatic properties (GI50: 0.2 μM) in almost all cell lines of the National Cancer Institute (NCI)-60 cell line screen and relatively selective cytotoxicity against melanoma cells. Moreover, its low COMPARE correlations with known standard antitumor agents indicate a unique mechanism of action. Effective therapies for managing melanoma are limited, so we sought to investigate mensacarcin's unique cytostatic and cytotoxic effects and its mode of action...
October 26, 2017: Journal of Biological Chemistry
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