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Ventillator settings

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https://www.readbyqxmd.com/read/29777672/valvectomy-versus-replacement-for-the-surgical-treatment-of-tricuspid-endocarditis
#1
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#2
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29773355/pain-assessment-and-management-by-nurses-in-a-geriatric-setting-discrepancies-between-guidelines-and-documented-practice
#3
Irit Shahar, Gad Mendelson, Shlomit Gerbi, Merav Ben Natan
Pain is a common subjective symptom among older adults in general and among older adult residents in long-term geriatric facilities in particular. Pain diminishes older adults' quality of life and may impair their ability to recover from various illnesses. Therefore, the Israeli Ministry of Health has issued guidelines on effectively assessing and treating pain in this population. To examine discrepancies between the Ministry of Health's pain assessment guidelines and documented practice by nursing staff at a long-term geriatric care facility and whether these discrepancies correlate to characteristics of the nurses, the wards, and the patients' characteristics...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29773297/the-clinical-practice-of-high-flow-nasal-cannula-oxygen-therapy-in-adults-a-japanese-cross-sectional-multicenter-survey
#4
Jiro Ito, Kazuma Nagata, Susumu Sato, Akira Shiraki, Naoki Nishimura, Shinyu Izumi, Ryo Tachikawa, Takeshi Morimoto, Keisuke Tomii
BACKGROUND: High-flow nasal cannula oxygen therapy (HFNC) is widely used mainly in the acute care setting, but limited data are available on real-world practice in adults. The objective of this study was to describe HFNC practices in Japanese adults. METHODS: A retrospective cross-sectional multicenter survey of adult patients receiving HFNC from January through March 2015 was conducted in 33 participating hospitals in Japan. RESULTS: We obtained information on 321 patients (median age, 76; 218 men, 103 women; median estimated PaO2 /FI O2, 178 mm Hg) from 22 hospitals...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29773291/cost-utility-of-non-invasive-mechanical-ventilation-analysis-and-implications-in-acute-respiratory-failure-a-brief-narrative-review
#5
REVIEW
Antonello Nicolini, Sven Stieglitz, Pierre Bou-Khalil, Antonio Esquinas
The growing interest in the quality of patient care at the levels of the health care managers, insurance companies, and health professionals is evident. Further, the growing population requires good quality health services. In this review, we analyzed the cost-effectiveness of noninvasive ventilation (NIV) in an acute setting for the treatment of respiratory failure. The strength of this review is that it identified and summarized the most relevant studies regarding various aspects of the cost-utility of NIV in an acute setting...
May 2018: Respiratory Investigation
https://www.readbyqxmd.com/read/29769438/cytometry-tof-identifies-alveolar-macrophage-subtypes-in-acute-respiratory-distress-syndrome
#6
Eric D Morrell, Alice Wiedeman, S Alice Long, Sina A Gharib, T Eoin West, Shawn J Skerrett, Mark M Wurfel, Carmen Mikacenic
Studies in human peripheral blood monocyte-derived macrophages in vitro have shown clear evidence that multiple macrophage polarization states exist. The extent to which different alveolar macrophage (AM) polarization states exist in homeostasis or in the setting of severe injury such as acute respiratory distress syndrome (ARDS) is largely unknown. We applied single-cell cytometry TOF (CyTOF) to simultaneously measure 36 cell-surface markers on CD45+ cells present in bronchoalveolar lavage from healthy volunteers, as well as mechanically ventilated subjects with and without ARDS...
May 17, 2018: JCI Insight
https://www.readbyqxmd.com/read/29768111/effect-of-right-lateral-position-with-head-elevation-on-tracheal-aspirate-pepsin-in-ventilated-preterm-neonates-randomized-controlled-trial
#7
Safaa Shafik Imam, Dina Mohamed Shinkar, Nevine Ahmed Mohamed, Hebatallah Elhamy Mansour
OBJECTIVE: To evaluate the effect of right lateral positioning in comparison with supine positioning on tracheal aspirate pepsin levels as a marker of aspiration of gastric contents in ventilated preterm neonates. STUDY DESIGN: This randomized controlled trial was conducted on 60 ventilated preterm neonates <35 weeks; 30 neonates were nursed in right lateral position for 6 hours while the other 30 neonates were nursed in supine position for 6 hours. Tracheal aspirate sample was obtained from each neonate in both the groups just after the end of 6 hours and pepsin level was measured...
May 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29765932/fluid-overload-and-renal-angina-index-at-admission-are-associated-with-worse-outcomes-in-critically-ill-children
#8
Sidharth K Sethi, Veena Raghunathan, Shilpi Shah, Maninder Dhaliwal, Pranaw Jha, Maneesh Kumar, Sravanthi Paluri, Shyam Bansal, Maroun J Mhanna, Rupesh Raina
Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29765004/a-comparison-of-the-adjustable-ranges-of-inspiratory-pressurization-during-pressure-controlled-continuous-mandatory-ventilation-of-5-icu-ventilators
#9
Yukiko Koyama, Akinori Uchiyama, Junko Yoshida, Takeshi Yoshida, Tomonori Yamashita, Yuji Fujino
BACKGROUND: Faster inspiratory pressurization can improve patient-ventilator synchrony and reduce the patient's work of breathing during pressure controlled continuous mandatory (PC-CMV) ventilation. The characteristics of the pressurization ramp settings are not standardized across ventilators from different manufacturers. We performed a bench test of 5 models of ICU ventilators to examine the effects of pressurization ramp settings on the actual pressurization. METHODS: A twin-bellows lung model was used, in which one bellow simulates inspiratory muscle activity and the other simulates an adult normal lung model...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29764824/achieving-full-neurological-recovery-in-snakebite-using-best-supportive-care
#10
Sally Wright, Genevieve Haddock
A 29-year-old woman presented to a community hospital in Sierra Leone 2 hours after being bitten by an unknown snake. On arrival, she was agitated though alert, however deteriorated into respiratory arrest. There was no local availability of antivenom. The patient remained in respiratory arrest undergoing best supportive care in a low-resource setting for 2 hours 55 minutes before returning to spontaneous ventilation. She went on to make a full neurological recovery. Though spontaneous recovery following snakebite envenoming is rare, this case showcases that good communication and basic manoeuvres can have a hugely positive impact on patient outcome...
May 14, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29763713/practice-of-mechanical-ventilation-in-cardiac-arrest-patients-and-effects-of-targeted-temperature-management-a-substudy-of-the-targeted-temperature-management-trial
#11
Matthew B A Harmon, David M P van Meenen, Annelou L I P van der Veen, Jan M Binnenkade, Josef Dankiewicz, Florian Ebner, Niklas Nielsen, Paolo Pelosi, Marcus J Schultz, Janneke Horn, Hans Friberg, Nicole P Juffermans
AIMS: Mechanical ventilation practices in patients with cardiac arrest are not well described. Also, the effect of temperature on mechanical ventilation settings is not known. The aims of this study were 1) to describe practice of mechanical ventilation and its relation with outcome 2) to determine effects of different target temperatures strategies (33 °C versus 36 °C) on mechanical ventilation settings. METHODS: This is a substudy of the TTM-trial in which unconscious survivors of a cardiac arrest due to a cardiac cause were randomized to two TTM strategies, 33 °C (TTM33) and 36 °C (TTM36)...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29758884/the-impact-of-urban-open-space-and-lift-up-building-design-on-building-intake-fraction-and-daily-pollutant-exposure-in-idealized-urban-models
#12
Chenyuan Sha, Xuemei Wang, Yuanyuan Lin, Yifan Fan, Xi Chen, Jian Hang
Sustainable urban design is an effective way to improve urban ventilation and reduce vehicular pollutant exposure to urban residents. This paper investigated the impacts of urban open space and 'lift-up' building design on vehicular CO (carbon monoxide) exposure in typical three-dimensional (3D) urban canopy layer (UCL) models under neutral atmospheric conditions. The building intake fraction (IF) represents the fraction of total vehicular pollutant emissions inhaled by residents when they stay at home. The building daily CO exposure (Et ) means the extent of human beings' contact with CO within one day indoor at home...
August 15, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29757824/improvements-in-key-cardiopulmonary-exercise-testing-variables-following-cardiac-rehabilitation-in-patients-with-coronary-artery-disease
#13
Dejana Popovic, Nikhil Kumar, Sundeep Chaudhry, Akshay Bagai, Ross Arena, Naresh Kumar
PURPOSE: Improvements in cardiorespiratory fitness (VO2peak) post-cardiac rehabilitation (post-CR) are used to gauge therapeutic efficacy. The aim of the present study was to assess the effect of supervised CR on other cardiopulmonary exercise testing (CPX) variables, specifically those that reflect ventilatory efficiency and VO2 changes in relation to changes in work rate (WR). METHODS: Patients (n = 142; mean age 63 ± 9 y; 23% female) with coronary artery disease (CAD) participated in supervised CR for 3 to 6 mo completing 60 ± 17 sessions (range: 32-96 sessions), with intensity derived from the baseline CPX...
May 11, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29756744/monitoring-the-oxygen-reserve-index-can-contribute-to-the-early-detection-of-deterioration-in-blood-oxygenation-during-one-lung-ventilation
#14
Wakana Koishi, Motoi Kumagai, Shohei Ogawa, Shuhei Hongo, Kenji Suzuki
BACKGROUND: Hypoxemia can occur during one-lung ventilation (OLV), but monitoring blood oxygenation using percutaneous oxygen saturation (SpO2) can be limited by detection latency, and SpO2 sometimes does not change during OLV. The Oxygen Reserve Index (ORiTM) is a novel index reported to detect impending desaturation before this is observed with SpO2 monitoring. This study assessed whether the ORi decreased earlier than SpO2 during OLV and evaluated its correlation with the partial pressure of arterial oxygen (PaO2) during OLV...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29756065/the-effects-of-mechanical-ventilation-on-the-quality-of-sleep-of-hospitalised-patients-in-the-intensive-care-unit
#15
REVIEW
Hana Locihová, Katarína Žiaková
Aim: To examine the effects of mechanical ventilation on the quality of sleep in patients in the intensive care unit (ICU) using recent and relevant literature. Methods: To verify the examined objective, the results of the analysis of available original scientific works have been used including defined inclusion/exclusion criteria and search strategy. Appropriate works found were analysed further. The applied methodology was in line with the general principles of Evidence-Based Medicine...
April 2018: Romanian journal of anaesthesia and intensive care
https://www.readbyqxmd.com/read/29755626/the-impact-of-admission-serum-creatinine-on-major-adverse-clinical-events-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention
#16
Poornima Vinod, Taylor Kann, Shyam Polaconda, Alibel Bello, Mohamed Khayata, Fernando Munoz, Vinod Krishnappa, Rupesh Raina
Background: Impaired renal function has been shown in previous studies to be an independent predictor of cardiovascular adverse events amongst patients admitted for percutaneous coronary intervention (PCI) following ST-segment elevation myocardial infarction (STEMI). This study investigates the impact of admission serum creatinine (SCr) on major cardiovascular outcomes among STEMI patients undergoing PCI. Methods: A retrospective study of patients admitted for PCI following STEMI was conducted using the National Cardiovascular Database Action Registry (NCDR) at Cleveland Clinic Akron General (CCAG) Hospital...
April 2018: Cardiology Research
https://www.readbyqxmd.com/read/29754942/dead-space-analysis-at-different-levels-of-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-patients
#17
Emiliano Gogniat, Marcela Ducrey, José Dianti, Matías Madorno, Nicolás Roux, Alejandro Midley, Julio Raffo, Sergio Giannasi, Eduardo San Roman, Fernando Suarez-Sipmann, Gerardo Tusman
PURPOSE: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr /VT) in patients with acute respiratory distress syndrome (ARDS). MATERIAL AND METHODS: Fourteen ARDS patients under lung protective ventilation settings were submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH2 O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step. RESULTS: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (∆P˃15% , n = 7, p = ...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29754749/comparison-of-oral-and-axillary-temperatures-in-intubated-pediatric-patients
#18
Danielle Wood, Mary Heitschmidt, Louis Fogg
PURPOSE: Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures...
May 10, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29750636/outcomes-of-very-elderly-treated-with-dialysis-for-acute-kidney-injury
#19
Ezra Gabbay, Yehudit Zangi, Alon Bnayah, Jawad Atrash, Itzchak Slotki, Linda Shavit
BACKGROUND: The factors that determine prognosis in elderly patients with dialysis-requiring acute kidney injury (AKI-D) is uncertain. The purpose of this study was to examine predictors of in-hospital mortality in these patients. MATERIALS AND METHODS: A retrospective, single-center study of hospitalized patients ≥ 70 years old with AKI-D. Clinical and demographic variables were compared between survivors and non-survivors, independent predictors of hospital mortality were identified by logistic regression...
May 11, 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/29746613/aging-effects-on-alveolar-sacs-under-mechanical-ventilation
#20
Parya Aghasafari, Rebeca L Heise, Angela Reynolds, Ramana Pidaparti
Alveolar sacs are primarily responsible for gas exchange in the human respiratory system and lose their functionality with aging. Three-dimensional (3D) models of young and old human alveolar sacs were constructed and fluid-solid interaction (FSI) was employed to investigate the contribution of age-related changes to decline in alveolar sacs function under mechanical ventilation (MV). Simulations results illustrated that compliance and pressure reduced in the alveolar sacs of the elderly, and they have to work harder to breathe...
May 9, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
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