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https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#1
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28088804/monitoring-noninvasive-ventilation-in-patients-with-obesity-hypoventilation-syndrome-comparison-between-ventilator-built-in-software-and-respiratory-polygraphy
#2
Ramon Fernandez Alvarez, Claudio Rabec, Gemma Rubinos Cuadrado, Juan Alejandro Cascon Hernandez, Patricia Rodriguez, Marjolaine Georges, Pere Casan
BACKGROUND: Polygraphy (PG) remains the standard method of assessing noninvasive ventilation (NIV) effectiveness. Built-in software (BIS) of recent NIV equipment provides estimates of some ventilator parameters, but their usefulness is unclear. OBJECTIVES: To assess the reliability of BIS compared with PG in a cohort of obesity hypoventilation syndrome (OHS) patients on NIV. METHODS: Thirty stable OHS patients on NIV were evaluated in an outpatient setting with simultaneous PG and BIS recordings...
January 14, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28080292/effect-of-the-endoclear-%C3%A2-device-on-biofilm-in-endotracheal-tubes
#3
James M Bardes, Dana Gray, Alison Wilson
BACKGROUND: Organisms trapped in biofilms cause more than 80% of medical infections. Significant investments are being made to develop methods of removing these biofilms. The endOclear(®) device is reported to remove biofilm from endotracheal tubes (ETTs) and to decrease pneumonia rates and ventilator time. METHODS: This was an observational study performed at a university Level 1 trauma center intensive care unit. A series of 40 ETTs were collected at extubation, with half of the patients having been treated daily with the endOclear(®) device...
January 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28079851/corticosteroid-and-cyclophosphamide-in-acute-exacerbation-of-idiopathic-pulmonary-fibrosis-a-single-center-experience-and-literature-review
#4
Luca Novelli, Roberto Ruggiero, Federica De Giacomi, Alice Biffi, Paola Faverio, Luca Bilucaglia, Silvia Gamberini, Grazia Messinesi, Alberto Pesci
Acute Exacerbation (AEx) is a frequent and severe complication of Idiopathic Pulmonary Fibrosis (IPF). In the absence of consensus regarding treatment, studies evaluating the efficacy of specific therapies, such as corticosteroids and immunosuppresant agents, are needed. In this case series we evaluated the outcome in terms of survival of intravenous pulse doses of high-dose corticosteroid (methylprednisolone 1000 mg per day for 3 consecutive days) followed by montlhy cyclophosphamide administration (maximum 6 doses) in a cohort of patients with AEx-IPF referred to the Respiratory Unit, San Gerardo University Hospital, Monza, Italy, from 2009 to 2013...
December 23, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
https://www.readbyqxmd.com/read/28076295/convolutive-blind-source-separation-of-surface-emg-measurements-of-the-respiratory-muscles
#5
Eike Petersen, Herbert Buchner, Marcus Eger, Philipp Rostalski
Electromyography (EMG) has long been used for the assessment of muscle function and activity and has recently been applied to the control of medical ventilation. For this application, the EMG signal is usually recorded invasively by means of electrodes on a nasogastric tube which is placed inside the esophagus in order to minimize noise and crosstalk from other muscles. Replacing these invasive measurements with an EMG signal obtained non-invasively on the body surface is difficult and requires techniques for signal separation in order to reconstruct the contributions of the individual respiratory muscles...
January 11, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#6
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074800/effectiveness-of-ventilation-of-nondependent-lung-for-a-brief-period-in-improving-arterial-oxygenation-during-one-lung-ventilation-a-prospective-study
#7
Keerthi Chigurupati, Suneel Puthuvassery Raman, Unnikrishnan Koraparambil Pappu, Unnikrishnan Madathipat
BACKGROUND: Hypoxemia is common during one-lung ventilation(OLV), predominantly due to transpulmonary shunt. None of the strategies tried showed consistent results. We evaluated the effectiveness of ventilating the operated, non-dependent lung (NDL) with small tidal volumes in improving the oxygenation during OLV. METHODS: 30 ASA 1 and 2 patients undergoing elective, open thoracotomy were studied. After standard induction of anesthesia, lung seperation was acheived with left sided DLT...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28073993/daily-goals-formulation-and-enhanced-visualization-of-mechanical-ventilation-variance-improves-mechanical-ventilation-score
#8
Brian K Walsh, Craig Smallwood, Jordan Rettig, Robert Kacmarek, John Thompson, John H Arnold
BACKGROUND: The systematic implementation of evidence-based practice through the use of guidelines, checklists, and protocols mitigates the risks associated with mechanical ventilation, yet variation in practice remains prevalent. Recent advances in software and hardware have allowed for the development and deployment of an enhanced visualization tool that identifies mechanical ventilation goal variance. Our aim was to assess the utility of daily goal establishment and a computer-aided visualization of variance...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28068958/effects-of-ventilator-settings-nebulizer-and-exhalation-port-position-on-albuterol-delivery-during-non-invasive-ventilation-an-in-vitro-study
#9
Yuda Sutherasan, Lorenzo Ball, Pasquale Raimondo, Valentina Caratto, Elisa Sanguineti, Federico Costantino, Maurizio Ferretti, Robert M Kacmarek, Paolo Pelosi
BACKGROUND: Few studies have investigated the factors affecting aerosol delivery during non-invasive ventilation (NIV). Our aim was to investigate, using a bench-top model, the effect of different ventilator settings and positions of the exhalation port and nebulizer on the amount of albuterol delivered to a lung simulator. METHODS: A lung model simulating spontaneous breathing was connected to a single-limb NIV ventilator, set in bi-level positive airway pressure (BIPAP) with inspiratory/expiratory pressures of 10/5, 15/10, 15/5, and 20/10 cmH2O, or continuous positive airway pressure (CPAP) of 5 and 10 cmH2O...
January 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28067630/novel-swine-model-of-ricin-induced-acute-respiratory-distress-syndrome
#10
Shahaf Katalan, Reut Falach, Amir Rosner, Michael Goldvaser, Tal Brosh-Nissimov, Ayana Dvir, Avi Mizrachi, Orr Goren, Barak Cohen, Yoav Gal, Anita Sapoznikov, Sharon Ehrlich, Tamar Sabo, Chanoch Kronman
Pulmonary exposure to the plant toxin ricin, leads to respiratory insufficiency and death. To date, in-depth study of the functional disorders ensuing pulmonary intoxication, a prerequisite for establishing a clinically-relevant therapeutic protocol, is hampered by the lack of an appropriate animal model. To this end, we set up the pig, as a large animal model for the comprehensive study of the multifarious clinical manifestations of pulmonary ricinosis.Here we report for the first time, the monitoring of barometric whole body plethysmography for pulmonary function tests in non-anesthetized ricin-intoxicated pigs...
January 6, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28066609/association-between-post-sternotomy-tracheostomy-and-deep-sternal-wound-infection-a-retrospective-analysis
#11
Yi-Chin Tsai, Kevin Phan, Andrie Stroebel, Livia Williams, Lisa Nicotra, Lesley Drake, Elizabeth Ryan, James McGree, Peter Tesar, Kiran Shekar
BACKGROUND: Tracheostomy has traditionally been used as a means of facilitated mechanical ventilation in patients requiring respiratory management following cardiac surgery. However in the clinical setting, the advantages of tracheostomy has been questioned by concerns surrounding evidence of its association with increased risk of deep sternal wound infections (DSWI). The present study sought to evaluate retrospectively our experience with post-sternotomy tracheostomy among cardiac surgery patients and association with DSWI...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28060859/physiological-biochemical-and-biophysical-characterization-of-the-lung-lavaged-spontaneously-breathing-rabbit-as-a-model-for-respiratory-distress-syndrome
#12
Francesca Ricci, Chiara Catozzi, Xabier Murgia, Brenda Rosa, Davide Amidani, Luca Lorenzini, Federico Bianco, Claudio Rivetti, Silvia Catinella, Gino Villetti, Maurizio Civelli, Barbara Pioselli, Carlo Dani, Fabrizio Salomone
Nasal continuous positive airway pressure (nCPAP) is a widely accepted technique of non-invasive respiratory support in spontaneously-breathing premature infants with respiratory distress syndrome (RDS). Surfactant administration techniques compatible with nCPAP ventilation strategy are actively investigated. Our aim is to set up and validate a respiratory distress animal model that can be managed on nCPAP suitable for surfactant administration techniques studies. Surfactant depletion was induced by bronchoalveolar lavages (BALs) on 18 adult rabbits...
2017: PloS One
https://www.readbyqxmd.com/read/28059679/perioperative-outcomes-for-pediatric-neurosurgical-procedures-analysis-of-the-national-surgical-quality-improvement-program-pediatrics
#13
Benjamin J Kuo, Joao Ricardo N Vissoci, Joseph R Egger, Emily R Smith, Gerald A Grant, Michael M Haglund, Henry E Rice
OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform...
January 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28056816/optimization-of-pressure-settings-during-adaptive-servo-ventilation-support-using-real-time-heart-rate-variability-assessment-initial-case-report
#14
Teruhiko Imamura, Daisuke Nitta, Koichiro Kinugawa
BACKGROUND: Adaptive servo-ventilation (ASV) therapy is a recent non-invasive positive pressure ventilation therapy that was developed for patients with heart failure (HF) refractory to optimal medical therapy. However, it is likely that ASV therapy at relatively higher pressure setting worsens some of the patients' prognosis compared with optimal medical therapy. Therefore, identification of optimal pressure settings of ASV therapy is warranted. CASE PRESENTATION: We present the case of a 42-year-old male with HF, which was caused by dilated cardiomyopathy, who was admitted to our institution for evaluating his eligibility for heart transplantation...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28055066/association-between-antipsychotic-agents-and-risk-of-acute-respiratory-failure-in-patients-with-chronic-obstructive-pulmonary-disease
#15
Meng-Ting Wang, Chen-Liang Tsai, Chen Wei Lin, Chin-Bin Yeh, Yun-Han Wang, Hui-Lan Lin
Importance: Acute respiratory failure (ARF) is a life-threatening event that has been linked in case reports to antipsychotic use, but this association lacks population-based evidence. Particular attention should be focused on patients with chronic obstructive pulmonary disease (COPD) regarding this drug safety concern because these patients are prone to ARF and are commonly treated with antipsychotics. Objective: To determine whether the use of antipsychotics is associated with an increased risk of ARF in patients with COPD...
January 4, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28051988/ultraportable-oxygen-concentrator-use-in-u-s-army-special-operations-forward-area-surgery-a-proof-of-concept-in-multiple-environments
#16
Michael Rybak, Lynn C Huffman, Richard Nahouraii, John Loden, Marcos Gonzalez, Ramey Wilson, Paul D Danielson
INTRODUCTION: A limitation to surgical care in an austere environment is the supply of oxygen to support mechanical ventilation and general anesthesia. Portable oxygen concentrators (OCs) offer an alternative to traditional compressed oxygen tanks. OBJECTIVES: We set out to demonstrate that a low-pressure OC system could supply the mechanical ventilation needs in an austere operating environment. METHODS: An ultraportable OC (SAROS Model 3000, SeQual Technologies, Ball Ground, Georgia) was paired with an Impact 754 ventilator (Impact Instrumentation, West Caldwell, New Jersey) to evaluate the delivered fraction of inspired oxygen (FiO2) to a test lung across a range of minute ventilations and at altitudes of 1,200 and 6,500 feet above sea level...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28048542/we-ab-bra-06-4dct-ventilation-a-novel-imaging-modality-for-thoracic-surgical-evaluation
#17
Y Vinogradskiy, M Jackson, L Schubert, B Jones, R Castillo, E Castillo, T Guerrero, J Mitchell, B Kavanagh, M Miften
PURPOSE: The current standard-of-care imaging used to evaluate lung cancer patients for surgical resection is nuclear-medicine ventilation. Surgeons use nuclear-medicine images along with pulmonary function tests (PFT) to calculate percent predicted postoperative (%PPO) PFT values by estimating the amount of functioning lung that would be lost with surgery. 4DCT-ventilation is an emerging imaging modality developed in radiation oncology that uses 4DCT data to calculate lung ventilation maps...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043267/-investigation-of-emergency-capacities-for-occupational-hazard-accidents-in-silicon-solar-cell-producing-enterprises
#18
D D Yang, J N Xu, B L Zhu
Objective: To investigate and analyze the influential factors of occupational hazard acci-dents, emergency facilities and emergency management in Silicon solar cell producing enterprises, then to pro-vide scientific strategies. Methods: The methods of occupationally healthy field investigating, inspecting of ven-tilation effectiveness, setup of emergency program and wearing chemical suit were used. Results: The mainly occupational hazard accidents factors in the process of Silicon solar cell producing included poisoning chemi-cals, high temperature, onizing radiation and some workplaces...
November 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28042370/review-of-critical-illness-myopathy-and-neuropathy
#19
Starane Shepherd, Ayush Batra, David P Lerner
Critical illness myopathy (CIM) and neuropathy are underdiagnosed conditions within the intensive care setting and contribute to prolonged mechanical ventilation and ventilator wean failure and ultimately lead to significant morbidity and mortality. These conditions are often further subdivided into CIM, critical illness polyneuropathy (CIP), or the combination-critical illness polyneuromyopathy (CIPNM). In this review, we discuss the epidemiology and pathophysiology of CIM, CIP, and CIPNM, along with diagnostic considerations such as detailed clinical examination, electrophysiological studies, and histopathological review of muscle biopsy specimens...
January 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28040224/household-air-pollution-following-replacement-of-traditional-open-fire-with-an-improved-rocket-type-cookstove
#20
Caroline Ochieng, Sotiris Vardoulakis, Cathryn Tonne
Cooking with biomass fuel is an important source of household air pollution (HAP) in developing countries, and a leading risk factor for ill-health. Although various designs of "improved cookstoves" (ICS) have been promoted as HAP interventions in these settings, few of them have undergone in-field evaluation, partly due to the challenge of conducting field measurements in remote settings. In this study we assessed the change in carbon monoxide (CO) exposure following the replacement of the traditional three-stone stove with a popular ICS in 49 homes in Western Kenya...
December 28, 2016: Science of the Total Environment
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