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ventilation randomized controlled trial

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https://www.readbyqxmd.com/read/29770192/safety-and-efficacy-of-n-acetyl-cysteine-for-prophylaxis-of-ventilator-associated-pneumonia-a-randomized-double-blind-placebo-controlled-clinical-trial
#1
Mojtaba Sharafkhah, Ali Abdolrazaghnejad, Nader Zarinfar, Abolfazl Mohammadbeigi, Ali Massoudifar, Sahand Abaszadeh
Ventilator-associated-pneumonia (VAP) is characterized by morbidity, mortality, and prolonged length of stay in intensive care unit (ICU). The present study aimed to examine the effect of N-acetyl-cysteine (NAC) in preventing VAP in patients hospitalized in ICU. We performed a prospective, randomized, double-blind, placebo-controlled trial of 60 mechanically ventilated patients at high risk of developing VAP. NAC (600 mg/twice daily) and placebo (twice daily) were administered to NAC group ( n = 30) and control group ( n = 30), respectively, through the nasogastric tube in addition to routine care...
January 2018: Medical Gas Research
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
#2
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/29764722/middle-ear-disease-in-children-with-cleft-palate
#3
REVIEW
Tulasi Kota Karanth, Kenneth R Whittemore
OBJECTIVE: The objective of this review is to summarize all aspects of middle ear diseases in children with cleft palate (CP). METHODS: PubMed, Scopus, The Cumulative Index to Nursing and Allied Health Literature (CINAHL) and The Cochrane Library were searched for English-language randomized control trials (RCTs), meta-analyses, systematic reviews and observational studies published through 31st July 2017. RESULTS: Epidemiology and pathogenesis of middle ear diseases in children with cleft palate have been discussed in this review...
May 12, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29763777/incorporation-of-point-of-care-ultrasound-into-morning-round-is-associated-with-improvement-in-clinical-outcomes-in-critically-ill-patients-with-sepsis
#4
Zhonghua Chen, Yucai Hong, Junru Dai, Lifeng Xing
OBJECTIVES: Point-of-care ultrasound (POCUS) has been widely used in the intensive care unit (ICU). However, it is largely unknown whether the use of POCUS is associated with improved patient-important outcomes. The study aimed to investigate whether incorporation of POCUS during morning round on a routine basis was able to improve clinical outcomes in critically ill patients with sepsis. DESIGN: It was a prospective observational study. SETTING: A tertiary care emergency intensive care unit...
May 11, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#5
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#6
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29747662/progressive-mobility-program-and-technology-to-increase-the-level-of-physical-activity-and-its-benefits-in-respiratory-muscular-system-and-functionality-of-icu-patients-study-protocol-for-a-randomized-controlled-trial
#7
Debora Stripari Schujmann, Adriana Claudia Lunardi, Carolina Fu
BACKGROUND: Enhanced mobility in the Intensive Care Unit (ICU) could minimize the negative effects of critical illness, such as declines in cognitive, muscular, respiratory, and functional capacity. We aim to compare the functional status at ICU discharge of patients who underwent a progressive mobilization protocol versus patients who received conventional physiotherapy. We also examine the level of physical activity in the ICU, the degree of pulmonary and muscle function, and the length of stay to analyze correlations between these variables...
May 10, 2018: Trials
https://www.readbyqxmd.com/read/29746721/melatonin-for-the-promotion-of-sleep-in-adults-in-the-intensive-care-unit
#8
REVIEW
Sharon R Lewis, Michael W Pritchard, Oliver J Schofield-Robinson, Phil Alderson, Andrew F Smith
BACKGROUND: Patients in the intensive care unit (ICU) experience sleep deprivation caused by environmental disruption, such as high noise levels and 24-hour lighting, as well as increased patient care activities and invasive monitoring as part of their care. Sleep deprivation affects physical and psychological health, and patients perceive the quality of their sleep to be poor whilst in the ICU. Artificial lighting during night-time hours in the ICU may contribute to reduced production of melatonin in critically ill patients...
May 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29745620/non-ventilatory-therapies-for-acute-respiratory-distress-syndrome
#9
Jérémy Bourenne, Sami Hraiech, Romain Rambaud, Jean-Marie Forel, Nicolas Persico, Christophe Guervilly, Laurent Papazian
Acute respiratory distress syndrome (ARDS) commonly affects intensive care unit patients and is associated with high mortality. In addition to etiologic treatment and protective ventilation, non-ventilatory therapies represent a significant part of ARDS care. Pharmacological treatments, extra corporeal devices and prone positioning are commonly grouped under this term. Studies have evaluated the individual effects of some of these non- ventilatory therapies in large randomized controlled trials. Recent advances concerning the beneficial use of neuromuscular blocking agents and prone positioning deserve attention...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29743101/individualized-perioperative-hemodynamic-goal-directed-therapy-in-major-abdominal-surgery-ipegasus-trial-study-protocol-for-a-randomized-controlled-trial
#10
Sandra Funcke, Bernd Saugel, Christian Koch, Dagmar Schulte, Thomas Zajonz, Michael Sander, Angelo Gratarola, Lorenzo Ball, Paolo Pelosi, Savino Spadaro, Riccardo Ragazzi, Carlo Alberto Volta, Thomas Mencke, Amelie Zitzmann, Benedikt Neukirch, Gonzalo Azparren, Marta Giné, Vicky Moral, Hans Otto Pinnschmidt, Oscar Díaz-Cambronero, Maria Jose Alberola Estelles, Marisol Echeverri Velez, Maria Vila Montañes, Javier Belda, Marina Soro, Jaume Puig, Daniel Arnulf Reuter, Sebastian Alois Haas
BACKGROUND: Postoperative morbidity and mortality in patients undergoing surgery is high, especially in patients who are at risk of complications and undergoing major surgery. We hypothesize that perioperative, algorithm-driven, hemodynamic therapy based on individualized fluid status and cardiac output optimization is able to reduce mortality and postoperative moderate and severe complications as a major determinant of the patients' postoperative quality of life, as well as health care costs...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29742145/effect-of-backpack-carrying-on-forced-vital-capacity-in-cystic-fibrosis-a-randomized-crossover-controlled-trial
#11
Yann Combret, Clement Medrinal, Guillaume Prieur, Aurora Robledo Quesada, Pascal Le Roux, Grégory Reychler
BACKGROUND: Backpack carrying impacts lung function in healthy children but the effect in children with cystic fibrosis (CF) is unknown. METHODS: Three backpack positions were tested: no backpack (NB), a 12.5% body-weight backpack carried bilaterally (BB) or unilaterally (UB), at rest and during a 10 minute walk. Primary outcome was forced vital capacity (FVC). Secondary outcomes included comparison of cardio-respiratory variables within and between groups. RESULTS: Nine children with CF (13...
2018: PloS One
https://www.readbyqxmd.com/read/29739430/relax-restricted-versus-liberal-positive-end-expiratory-pressure-in-patients-without-ards-protocol-for-a-randomized-controlled-trial
#12
Anna Geke Algera, Luigi Pisani, Dennis C J Bergmans, Sylvia den Boer, Corianne A J de Borgie, Frank H Bosch, Karina Bruin, Thomas G Cherpanath, Rogier M Determann, Arjen M Dondorp, Dave A Dongelmans, Henrik Endeman, Jasper J Haringman, Janneke Horn, Nicole P Juffermans, David M van Meenen, Nardo J van der Meer, Maruschka P Merkus, Hazra S Moeniralam, Ilse Purmer, Pieter Roel Tuinman, Mathilde Slabbekoorn, Peter E Spronk, Alexander P J Vlaar, Marcelo Gama de Abreu, Paolo Pelosi, Ary Serpa Neto, Marcus J Schultz, Frederique Paulus
BACKGROUND: Evidence for benefit of high positive end-expiratory pressure (PEEP) is largely lacking for invasively ventilated, critically ill patients with uninjured lungs. We hypothesize that ventilation with low PEEP is noninferior to ventilation with high PEEP with regard to the number of ventilator-free days and being alive at day 28 in this population.  METHODS/DESIGN: The "REstricted versus Liberal positive end-expiratory pressure in patients without ARDS" trial (RELAx) is a national, multicenter, randomized controlled, noninferiority trial in adult intensive care unit (ICU) patients with uninjured lungs who are expected not to be extubated within 24 h...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29728142/intermittent-fetal-heart-rate-monitoring-using-a-fetoscope-or-hand-held-doppler-in-rural-tanzania-a-randomized-controlled-trial
#13
Paschal Francis Mdoe, Hege L Ersdal, Estomih R Mduma, Jeffrey M Perlman, Robert Moshiro, Peter T Wangwe, Hussein Kidanto
BACKGROUND: Neonatal mortality is a global challenge, with an estimated 1.3 million intrapartum stillbirths in 2015. The majority of these were found in low resource settings with limited options to intrapartum fetal heart monitoring devices. This trial compared frequency of abnormal fetal heart rate (FHR) detection and adverse perinatal outcomes (i.e. fresh stillbirths, 24-h neonatal deaths, admission to neonatal care unit) among women intermittently assessed by Doppler or fetoscope in a rural low-resource setting...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#14
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#15
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29721817/the-impact-of-hyperoxia-on-outcomes-after-cardiac-surgery-a-systematic-review-and-narrative-synthesis
#16
Jeffrey Heinrichs, Carly Lodewyks, Christine Neilson, Ahmed Abou-Setta, Hilary P Grocott
PURPOSE: Historically, cardiac surgery patients have often been managed with supraphysiologic intraoperative oxygen levels to protect against the risks of cellular hypoxia inherent in the un-physiologic nature of surgery and cardiopulmonary bypass. This may result in excessive reactive oxygen species generation and exacerbation of ischemia-reperfusion injury. In this review, we synthesize all available data from randomized controlled trials (RCTs) to investigate the impact that hyperoxia has on postoperative organ dysfunction, length of stay, and mortality during adult cardiac surgery...
May 2, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29719126/randomized-controlled-trial-comparing-the-supraglottic-airway-to-use-of-an-endotracheal-tube-in-sinonasal-surgery
#17
Austin S Adams, Todd J Wannemuehler, Benjamin Hull, Jeffanie Wu, Rakesh K Chandra, Kate VonWahlde, Matthew S Shotwell, Stephen Harvey, Michael Higgins, Kelly McQueen, Justin H Turner
BACKGROUND: The supraglottic airway (SGA) represents an alternative to endotracheal intubation (endotracheal tube [ETT]) in many types of ambulatory surgery. Adoption of the SGA has progressed slowly in sinonasal surgery due to concerns about airway protection. The purpose of this study was to compare quality of life measures and indices of airway protection between patients undergoing sinonasal surgery who were ventilated via an SGA or ETT. METHODS: Patients undergoing outpatient sinonasal surgery were enrolled into a randomized, single-blind study in which patients would be ventilated with either an SGA or ETT...
May 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29718143/the-association-between-empirical-antibiotic-treatment-and-mortality-in-severe-infections-caused-by-carbapenem-resistant-gram-negative-bacteria-a-prospective-study
#18
Yael Zak-Doron, Yael Dishon Benattar, Iris Pfeffer, George L Daikos, Anna Skiada, Anastasia Antoniadou, Emanuele Durante-Mangoni, Roberto Andini, Giusi Cavezza, Leonard Leibovici, Dafna Yahav, Noa Elyakim-Raz, Yehuda Carmeli, Amir Nutman, Mical Paul
Background: Empirical colistin should be avoided. We aimed to evaluate the association between covering empirical antibiotics (EAT) and mortality for infections caused by carbapenem-resistant Gram-negative bacteria (CRGNB). Methods: Secondary analysis of a randomized-controlled trial, including adults with bloodstream infections (BSI), pneumonia or urosepsis caused by CRGNB. All patients received EAT followed by covering targeted therapy. The exposure variable was covering EAT in the first 48 hours...
April 27, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29712500/effects-of-fentanyl-for-pain-control-and-neuroprotection-in-very-preterm-newborns-on-mechanical-ventilation
#19
Jie Qiu, Li Zhao, Yang Yang, Jing-Han Zhang, Yun Feng, Rui Cheng
OBJECTIVE: This study aimed to evaluate the cerebral protection effect of fentanyl infusion in very preterm infants in the first 72 h of mechanical ventilation. METHODS: In this double-blind, randomized, controlled trial, mechanically ventilated newborns (< 32 weeks' gestational age) were randomized to fentanyl (continuous infusion of fentanyl) or placebo (continuous infusion of glucose, controls) in the first 72 h of the mechanical ventilation period. The premature infant pain profile (PIPP), cerebral blood flow velocity, neuron-specific enolase (NSE) concentrations in plasma samples, and cerebral function monitoring (CFM) recordings were evaluated...
April 30, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29709502/is-the-venner-pneux-endotracheal-tube-system-a-cost-effective-option-for-post-cardiac-surgery-care
#20
Lazaros Andronis, Raymond A Oppong, Na'ngono Manga, Eshan Senanayake, Shameer Gopal, Susan Charman, Ramesh Giri, Heyman Luckraz
BACKGROUND: Ventilator-associated pneumonia (VAP) is common and costly. In a recent randomized controlled trial, the Venner-PneuX (VPX) endotracheal tube system was found to be superior to standard endotracheal tubes (SET) in preventing VAP. However, VPX is considerably more expensive. We evaluated the costs and benefits of VPX to determine whether replacing SET with VPX is a cost-effective option for intensive care units. METHODS: We developed a decision analytic model to compare intubation with VPX or SET for patients requiring mechanical ventilation post cardiac surgery...
April 27, 2018: Annals of Thoracic Surgery
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