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https://www.readbyqxmd.com/read/28550659/hyperoxia-provokes-a-time-and-dose-dependent-inflammatory-response-in-mechanically-ventilated-mice-irrespective-of-tidal-volumes
#1
Hendrik J F Helmerhorst, Laura R A Schouten, Gerry T M Wagenaar, Nicole P Juffermans, Joris J T H Roelofs, Marcus J Schultz, Evert de Jonge, David J van Westerloo
BACKGROUND: Mechanical ventilation and hyperoxia have the potential to independently promote lung injury and inflammation. Our purpose was to study both time- and dose-dependent effects of supplemental oxygen in an experimental model of mechanically ventilated mice. METHODS: Healthy male C57Bl/6J mice, aged 9-10 weeks, were intraperitoneally anesthetized and randomly assigned to the mechanically ventilated group or the control group. In total, 100 mice were tracheotomized and mechanically ventilated for either 8 or 12 h after allocation to different settings for the applied fractions of inspired oxygen (FiO2, 30, 50, or 90%) and tidal volumes (7...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28541863/danger-on-the-farm-a-comparison-of-agricultural-and-animal-related-injuries
#2
Jessica L Weaver, Charles W Kimbrough, Kimberly Broughton-Miller, Michelle Frisbie, Jodi Wojcik, Karina Pentecost, Matthew C Bozeman, Nicholas A Nash, Brian G Harbrecht
Animal-related injuries are common in rural areas. Agricultural workers can suffer severe injuries involving farm machinery or falls. The spectrum of injuries related to rural activities is poorly defined and characterizing these injuries will improve injury prevention efforts. Records for injured patients admitted between 2010 and 2013 were retrospectively reviewed. Patients with a mechanism of injury involving a large animal or with the injury site listed as "farm" were included. Patients with agricultural injuries (n = 85) were older with more multisystem injuries than patients injured by animals (n = 132) but the Injury Severity Score was equivalent...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28538644/validation-of-a-clinical-trial-composite-endpoint-for-patients-with-necrotizing-soft-tissue-infections
#3
Eileen M Bulger, Addison May, Wayne Dankner, Greg Maislin, Bryce Robinson, Anat Shirvan
OBJECTIVE: Our objective was to develop and validate a composite endpoint for patients with necrotizing soft tissue infections (NSTI) that incorporates: local tissue injury, systemic organ dysfunction, and mortality. METHODS: The Necrotizing Infection Clinical Composite Endpoint (NICCE) was defined as follows:(i) Alive at day 28 (ii) ≤3 debridements prior to day 14 (iii) No amputation beyond first debridement (iv) Modified SOFA score (mSOFA) at day 14 ≤1. To be considered a success, all individual criteria must be met...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28537997/where-are-we-heading-with-fluid-responsiveness-research
#4
Simon T Vistisen, Peter Juhl-Olsen
PURPOSE OF REVIEW: Fluid responsiveness prediction is not always possible with well established dynamic approaches such as passive leg raising or pulse pressure variation in the ICU. The purpose of the present review is to summarize emerging alternative techniques for fluid responsiveness prediction in adult critically ill patients and discuss their methodology and applicability. In addition, the future role of fluid responsiveness prediction in the ICU is discussed. RECENT FINDINGS: Several new dynamic techniques have been investigated and they all contribute to the applicability of fluid responsiveness techniques...
May 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28537938/should-all-massively-transfused-patients-be-treated-equally-an-analysis-of-massive-transfusion-ratios-in-the-nontrauma-setting
#5
Eric W Etchill, Sara P Myers, Lauren M McDaniel, Matthew R Rosengart, Jay S Raval, Darrell J Triulzi, Andrew B Peitzman, Jason L Sperry, Matthew D Neal
OBJECTIVES: Although balanced resuscitation has become integrated into massive transfusion practice, there is a paucity of evidence supporting the delivery of high ratios of plasma and platelet to RBCs in the nontrauma setting. This study investigated the administration of blood component ratios in the massively transfused nontrauma demographic. DESIGN: Retrospective analysis of a prospective, observational cohort of massively bleeding patients. SETTING: Surgical and critically ill patients at a tertiary medical center between 2011 and 2015...
May 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28536893/neurologic-recovery-after-cardiac-arrest-a-multifaceted-puzzle-requiring-comprehensive-coordinated-care
#6
REVIEW
Carolina B Maciel, Mary M Barden, David M Greer
Surviving cardiac arrest (CA) requires a longitudinal approach with multiple levels of responsibility, including fostering a culture of action by increasing public awareness and training, optimization of resuscitation measures including frequent updates of guidelines and their timely implementation into practice, and optimization of post-CA care. This clearly goes beyond resuscitation and targeted temperature management. Brain-directed physiologic goals should dictate the post-CA management, as accumulating evidence suggests that the degree of hypoxic brain injury is the main determinant of survival, regardless of the etiology of arrest...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28536282/predicting-survival-after-extracorporeal-membrane-oxygenation-for-ards-an-external-validation-of-resp-and-preserve-scores
#7
Jennifer Brunet, Xavier Valette, Dimitrios Buklas, Philippe Lehoux, Pierre Verrier, Bertrand Sauneuf, Calin Ivascau, Yves Dalibert, Amélie Seguin, Nicolas Terzi, Gérard Babatasi, Damien du Cheyron, Jean-Jacques Parienti, Cédric Daubin
BACKGROUND: We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. METHODS: All consecutive patients treated with ECMO for refractory ARDS, regardless of cause, in the Caen University Hospital in northwestern France over the last decade were included in a retrospective cohort study. The receiver operating characteristic curves of each score were plotted, and the area under the curve was computed to assess their performance in predicting mortality (c-index)...
May 23, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28535074/synchrotron-imaging-shows-effect-of-ventilator-settings-on-intra-breath-cyclic-changes-in-pulmonary-blood-volume
#8
Liisa Porra, Ludovic Broche, Loïc Dégrugilliers, Gergely Albu, Iliona Malaspinas, Camille Doras, Mats Wallin, Magnus Hallbäck, Walid Habre, Sam Bayat
RATIONALE: Despite the importance of dynamic changes in the regional distributions of gas and blood during the breathing cycle for lung function in the mechanically ventilated patient, no quantitative data on such cyclic changes is currently available. METHODS: We used a novel gated synchrotron CT-imaging to quantitatively image regional lung gas (Vg), tissue density and blood volume (Vb) in 6 anaesthetized, paralyzed and mechanically ventilated rabbits with normal lungs...
May 23, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#9
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528972/brand-variation-in-oxidant-production-in-mainstream-cigarette-smoke-carbonyls-and-free-radicals
#10
Samantha M Reilly, Reema Goel, Neil Trushin, Ryan J Elias, Jonathan Foulds, Joshua Muscat, Jason Liao, John P Richie
Oxidative stress/damage resulting from exposure to cigarette smoke plays a critical role in the development of tobacco-caused diseases. Carbonyls and free radicals are two major classes of oxidants in tobacco smoke. There is little information on the combined delivery of these oxidants across different cigarette brands; thus, we set out to measure and compare their levels in mainstream smoke from popular US cigarettes. Mainstream smoke from 28 different cigarette brands produced by smoking (FTC protocol) was analyzed for five important, abundant carbonyls, and levels were compared to previously determined free radical for the same brands...
May 18, 2017: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/28528348/effect-of-home-noninvasive-ventilation-with-oxygen-therapy-vs-oxygen-therapy-alone-on-hospital-readmission-or-death-after-an-acute-copd-exacerbation-a-randomized-clinical-trial
#11
Patrick B Murphy, Sunita Rehal, Gill Arbane, Stephen Bourke, Peter M A Calverley, Angela M Crook, Lee Dowson, Nicholas Duffy, G John Gibson, Philip D Hughes, John R Hurst, Keir E Lewis, Rahul Mukherjee, Annabel Nickol, Nicholas Oscroft, Maxime Patout, Justin Pepperell, Ian Smith, John R Stradling, Jadwiga A Wedzicha, Michael I Polkey, Mark W Elliott, Nicholas Hart
Importance: Outcomes after exacerbations of chronic obstructive pulmonary disease (COPD) requiring acute noninvasive ventilation (NIV) are poor and there are few treatments to prevent hospital readmission and death. Objective: To investigate the effect of home NIV plus oxygen on time to readmission or death in patients with persistent hypercapnia after an acute COPD exacerbation. Design, Setting, and Participants: A randomized clinical trial of patients with persistent hypercapnia (Paco2 >53 mm Hg) 2 weeks to 4 weeks after resolution of respiratory acidemia, who were recruited from 13 UK centers between 2010 and 2015...
May 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28526060/comparison-of-the-effect-of-oral-care-with-four-different-antiseptics-to-prevent-ventilator-associated-pneumonia-in-adults-protocol-for-a-network-meta-analysis
#12
Zhigang Zhang, Yuying Hou, Jun Zhang, Bo Wang, Juxia Zhang, Ailing Yang, Ge Li, Jinhui Tian
BACKGROUND: Ventilator-associated pneumonia (VAP) is defined as the occurrence of pneumonia in patients receiving mechanical ventilation for more than 48 h after endotracheal intubation. The implementation of effective oral care with antiseptics may reduce the incidence of ventilator-associated pneumonia. However, previous studies have been unclear about the best antiseptic for this purpose. Therefore, present protocol proposed to perform a network meta-analysis to evaluate the efficacy of different antiseptics to prevent ventilator-associated pneumonia...
May 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28525509/analgesic-choice-in-management-of-rib-fractures-paravertebral-block-or-epidural-analgesia
#13
Mahdi Malekpour, Ammar Hashmi, James Dove, Denise Torres, Jeffrey Wild
BACKGROUND: Rib fractures are commonly encountered in the setting of trauma. The aim of this study was to assess the association between the clinical outcome of rib fracture and epidural analgesia (EA) versus paravertebral block (PVB) using the National Trauma Data Bank (NTDB). METHODS: Using the 2011 and 2012 versions of the NTDB, we retrieved completed records for all patients above 18 years of age who were admitted with rib fractures. Primary outcome was in-hospital mortality...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28524808/determination-of-safe-and-critical-nanoparticles-exposure-to-welders-in-a-workshop
#14
J F Gomes, R M Miranda
The present study examined consequences of "safe" versus "critical" exposure to nanoparticles (NP) released during welding operations. With this aim in mind, a set of measurements regarding NP emissions was undertaken in a workshop during welding by metal active gas of carbon steel using different mixtures of argon (Ar) and carbon dioxide (CO2) as well as different process parameters which might influence emission of (NP). If these measurements were conducted in several locations away from the welding sources, the graphical representation of the obtained observations with time enabled definition of "safe" and "critical" regions within a welding workshop in terms of welder's exposure...
May 19, 2017: Journal of Toxicology and Environmental Health. Part A
https://www.readbyqxmd.com/read/28522770/current-practice-of-closed-loop-mechanical-ventilation-modes-on-intensive-care-units-a-nationwide-survey-in-the-netherlands
#15
E F E Wenstedt, A J R De Bie Dekker, A N Roos, J J M Verberne, H H M Korsten, M J Schultz, A J G H Bindels
BACKGROUND: The most recent modes for mechanical ventilation are closed-loop modes, which are able to automatically adjust certain respiratory settings. Although closed-loop modes have been investigated in various clinical trials, it is unclear to what extent these modes are actually used in clinical practice. The aim of this study was to determine closed-loop ventilation practice on intensive care units (ICUs) in the Netherlands, and to explore reasons for not applying closed-loop ventilation...
May 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28521346/real-time-magnetic-resonance-imaging-guided-biopsy-using-smartframe%C3%A2-stereotaxis-in-the-setting-of-a-conventional-diagnostic-magnetic-resonance-imaging-suite
#16
Justin K Scheer, Thomas Hamelin, Leon Chang, Brian Lemkuil, Bob S Carter, Clark C Chen
BACKGROUND: Real-time magnetic resonance imaging (MRI) visualization during stereotactic needle biopsies affords several valuable benefits to the neurosurgeon, including the opportunity to visually confirm the biopsy site at the time of surgery. Until now, reported experiences with this technique have been limited to the setting of intraoperative MRI or dedicated procedural MRI suites with modified ventilation systems. OBJECTIVE: To describe our experience with 11 consecutive patients who underwent real-time MRI-guided biopsy performed using SmartFrame® stereotaxis (MRI Interventions, Irvine, California) in the setting of a conventional diagnostic MRI suite...
June 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28516821/pseudomonas-aeruginosa-outbreak-in-a-neonatal-intensive-care-unit-attributed-to-hospital-tap-water
#17
Cara Bicking Kinsey, Samir Koirala, Benjamin Solomon, Jon Rosenberg, Byron F Robinson, Antonio Neri, Alison Laufer Halpin, Matthew J Arduino, Heather Moulton-Meissner, Judith Noble-Wang, Nora Chea, Carolyn V Gould
OBJECTIVE To investigate an outbreak of Pseudomonas aeruginosa infections and colonization in a neonatal intensive care unit. DESIGN Infection control assessment, environmental evaluation, and case-control study. SETTING Newly built community-based hospital, 28-bed neonatal intensive care unit. PATIENTS Neonatal intensive care unit patients receiving care between June 1, 2013, and September 30, 2014. METHODS Case finding was performed through microbiology record review. Infection control observations, interviews, and environmental assessment were performed...
May 18, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28516043/quantification-of-regional-deformation-of-the-lungs-by-non-rigid-registration-of-three-dimensional-contrast-enhanced-magnetic-resonance-imaging
#18
Jiaxin Shao, Peng Hu
BACKGROUND: Assessment of lung function is vital for the diagnosis of a variety of pathological conditions. Research has been proposed to study pulmonary mechanics and kinematics using two-dimensional (2D) magnetic resonance imaging (MRI). This allows estimation of regional lung tissue mechanics but is limited to 2D information. An approach based on three-dimensional (3D) contrast-enhanced MR angiogram of pulmonary blood vessels and a non-rigid image registration technique is proposed for quantification of lung regional deformations, which can potentially be used for assessment of pulmonary parenchymal mechanics and regional ventilation for disease diagnosis without ionizing radiation...
April 2017: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28515969/application-of-selective-bronchial-intubation-versus-neurally-adjusted-ventilatory-assist-in-the-management-of-unilateral-pulmonary-interstitial-emphysema-an-illustrative-case-and-the-literature-review
#19
Shing-Yan Robert Lee
In the treatment of left-sided pulmonary interstitial emphysema (PIE) in a 23-week neonate, we used two ventilatory strategies: selective bronchial intubation from day 10 to 15 and neurally adjusted ventilatory assist (NAVA) from day 18 to 26. We compared the effects and adverse effects of these two strategies. On selective bronchial intubation, desaturation was frequent. Fentanyl infusion was required. There was an episode of carbon dioxide retention coupled with hypotension. On NAVA, the neonate was clinically stable without the requirement of sedation...
April 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28510504/cardiopulmonary-exercise-testing-basics-of-methodology-and-measurements
#20
Alessandro Mezzani
Cardiopulmonary exercise testing adds measurement of ventilation and volume of oxygen uptake and exhaled carbon dioxide to routine physiological and performance parameters obtainable from conventional exercise testing, furnishing an all-round vision of the systems involved in both oxygen transport from air to mitochondria and its utilization during exercise. Peculiarities of cardiopulmonary exercise testing methodology are the use of ramp protocols and calibration procedures for flow meters and gas analyzers...
May 16, 2017: Annals of the American Thoracic Society
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