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https://www.readbyqxmd.com/read/28719483/difficult-intubation-and-ventilation-in-an-infant-with-retropharyngeal-abscess-with-mediastinal-extension
#1
Michael A Bruno, Tomas Drabek, Mioara D Manole
A previously healthy 7-month-old male infant presented for evaluation of fever, deceased oral intake, and intermittent noisy breathing. Physical examination revealed neck tenderness. Soft tissue neck radiographs and computed tomography (CT) scan supported a diagnosis of retropharyngeal swelling with extension to the superior mediastinum. Surgical exploration was planned, and endotracheal intubation was performed in the operating room. Significant cardiorespiratory derangements developed immediately after the tracheal tube was inserted, including hypotension, hypoxia, and bradycardia with signs of cardiac ischemia...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28719384/anesthetic-management-of-an-infant-with-postnatally-diagnosed-tracheal-agenesis-undergoing-tracheal-reconstruction-a-case-report
#2
Brittany L Willer, Kayla G Bryan, Daiva E Parakininkas, Michael R Uhing, Susan R Staudt, Kathleen M Dominguez, Michael E McCormick, Michael E Mitchell, John C Densmore, Keith T Oldham, Richard J Berens
A term infant born cyanotic failed multiple intubation attempts and tracheostomy placement. After esophageal intubation resulted in the ability to ventilate, he was presumed to have tracheal agenesis and distal bronchoesophageal fistula. He was transferred to our institution where he was diagnosed with Floyd Type II tracheal agenesis. He underwent staged tracheal reconstruction. He was discharged to home at 4 months of age with a tracheostomy collar, cervical spit fistula, and gastrostomy tube. He represents the sole survivor-to-discharge of tracheal agenesis in the United States...
July 17, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28719368/change-is-in-the-air-what-you-need-to-know-about-pharmacy-ventilation-under-united-states-pharmacopeia-800
#3
Cheryl Laniewicz
On July 1, 2018, United States Pharmacopeia <800> takes effect in those states that adopt it, and the discussion within this article may be applicable to those states that develop their own standards. United States Pharmacopeia <800> changes requirements for storage and compounding of hazardous drugs. The new requirements have important implications for air management and ventilation in some pharmacies. This article discusses how United States Pharmacopeia <800> compares to United States Pharmacopeia <797>, how the changes impact room ventilation and pressurization requirements, and how high-performance airflow control systems that ensure compliance and safety are impacted...
July 2017: International Journal of Pharmaceutical Compounding
https://www.readbyqxmd.com/read/28719228/successful-use-of-noninvasive-ventilation-in-chronic-obstructive-pulmonary-disease-how-do-high-performing-hospitals-do-it
#4
Kimberly A Fisher, Kathleen M Mazor, Sarah Goff, Mihaela S Stefan, Penelope S Pekow, Lauren A Williams, Vida Rastegar, Michael B Rothberg, Nicholas S Hill, Peter K Lindenauer
RATIONALE: Noninvasive ventilation (NIV) is a cornerstone of treatment for patients with severe exacerbations of chronic obstructive pulmonary disease (COPD) where it has been shown to reduce the need for intubation, hospital length of stay, and mortality. Despite high quality evidence and strong recommendations in clinical guidelines, use of NIV varies widely across hospitals. OBJECTIVE: To identify approaches used by hospitals which have been successful in implementing NIV to treat patients with severe exacerbations of COPD...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28719069/inaccuracy-of-a-continuous-arterial-pressure-waveform-monitor-when-used-for-congenital-cardiac-catheterization
#5
Michael D Seckeler, Katri Typpo, Jendar Deschenes, Ruth Higgins, Ricardo Samson, Peter Lichtenthal
OBJECTIVE: To determine the accuracy of a continuous cardiac output monitor (FloTrac sensor) for measuring cardiac index in children with congenital heart disease undergoing cardiac catheterization. Cardiac index is a critical hemodynamic parameter measured during catheterizations in children with congenital heart disease. This has been challenging to measure accurately and many clinicians rely on predictive equations for calculating cardiac index. DESIGN: Prospective, nonrandomized trial...
July 18, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28718356/comparison-of-three-non-invasive-ventilation-strategies-nsippv-bipap-ncpap-for-rds-in-vlbw-infants
#6
Vincenzo Salvo, Gianluca Lista, Enrica Lupo, Alberto Ricotti, Luc J I Zimmermann, Antonio W D Gavilanes, Eloisa Gitto, Micaela Colivicchi, Valeria Ferraù, Diego Gazzolo
BACKGROUND: Noninvasive ventilation (NIV) significantly changed the management of respiratory distress syndrome (RDS) in preterm infants. Further perspectives for neonatologists regard the assessment of different NIV strategies in terms of availability, effectiveness and failure. OBJECTIVE: The aim of the present study is to evaluate the effectiveness of three different NIV strategies: nasal continuous pressure (N-CPAP), nasal synchronized intermittent positive pressure ventilation (N-SIPPV) and nasal bilevel CPAP (BiPAP), as first intention treatment for RDS in very low birth-weight infants (VLBW)...
July 18, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28717966/association-between-aspirin-use-and-deep-venous-thrombosis-in-mechanically-ventilated-icu-patients
#7
Ena Gupta, Furqan S Siddiqi, Ryan Kunjal, Muhammad Faisal, Farah Al-Saffar, Abubakr A Bajwa, Lisa M Jones, Vandana Seeram, James D Cury, Adil Shujaat
Deep venous thrombosis (DVT) is common in intensive care unit (ICU) patients. It is often silent and may be complicated by pulmonary embolism and death. Thromboprophylaxis with heparin does not always prevent venous thromboembolism (VTE). Aspirin (ASA) reduces the risk of VTE in surgical and high-risk medical patients but it is unknown if ASA may prevent DVT in mechanically ventilated ICU patients. We performed a retrospective chart review of critically ill patients who received mechanical ventilation for >72 h and underwent venous ultrasonography for suspected DVT between Jan 2012 and Dec 2013...
July 17, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28717778/retention-of-cardiopulmonary-resuscitation-skills-after-hands-only-training-versus-conventional-training-in-novices-a-randomized-controlled-trial
#8
Young Joon Kim, Youngsuk Cho, Gyu Chong Cho, Hyun Kyung Ji, Song Yi Han, Jin Hyuck Lee
OBJECTIVE: Cardiopulmonary resuscitation (CPR) training can improve performance during simulated cardiac arrest; however, retention of skills after training remains uncertain. Recently, hands-only CPR has been shown to be as effective as conventional CPR. The purpose of this study is to compare the retention rate of CPR skills in laypersons after hands-only or conventional CPR training. METHODS: Participants were randomly assigned to 1 of 2 CPR training methods: 80 minutes of hands-only CPR training or 180 minutes of conventional CPR training...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28717524/anasarca-fever-thrombocytopenia-organomegaly-and-multiorgan-failure-in-a-24-year-old-pregnant-woman
#9
Guillaume Morel, Joy Mootien, Philippe Guiot, Khaldoun Kuteifan
TAFRO syndrome is a distinct idiopathic multicentric Castleman disease characterized by the association of thrombocytopenia, anasarca, fever, reticulin fibrosis, and organomegaly. We report the first case occurring in a Caucasian pregnant woman. At 34 weeks of gestation, our patient presented with all clinical and biological symptoms compatible with a TAFRO syndrome. Tough quick cesarean section was performed as symptoms got worse with onset of multiorgan failure requiring mechanical ventilation for acute respiratory distress, continuous renal replacement, and vasopressors...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28717510/post-obstructive-pulmonary-edema-from-aspirated-nuts
#10
Ahsan Bashir, Sabina Qureshi Ahmad, Joshua Silverman, Emily Concepcion, Haesoon Lee
OBJECTIVES: Post-obstructive pulmonary edema is thought to occur from hemodynamic changes secondary to forced inspiration against the closed airway due to acute or chronic airway obstruction. We report a case of a 13 month-old boy who developed pulmonary edema from aspirated foreign body, nuts. METHODS: He underwent emergency bronchoscopy to confirm the clinical diagnosis of aspirated nuts in the trachea and nuts were removed endoscopically. His trachea was then intubated and he was mechanically ventilated with oxygen...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28717088/long-term-effects-of-intravenous-cyclophosphamide-in-combination-with-mesna-provided-intravenously-and-via-bladder-perfusion-in-a-patient-with-severe-multifocal-motor-neuropathy
#11
Eri Iwasawa, Takuya Ohkubo, Tadashi Kanouchi, Takashi Kanda, Hidehiro Mizusawa, Takanori Yokota
A 25-year-old woman presenting with progressive muscle weakness in the distal extremities in the absence of sensory involvement for 2 years was diagnosed with multifocal motor neuropathy (MMN). Her disease was difficult to manage with various immunosuppressants, and the muscle weakness eventually progressed to involve the respiratory muscles, necessitating mechanical ventilation. Intravenous cyclophosphamide (CY) dramatically improved her symptoms, and she has since maintained her ambulatory status for 18 years with intermittent CY therapy...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28717052/withdrawal-of-tracheostomy-ventilation-in-motor-neurone-disease-implementing-advance-directives
#12
EDITORIAL
Christopher J McDermott, Christina Faull
No abstract text is available yet for this article.
July 17, 2017: Practical Neurology
https://www.readbyqxmd.com/read/28716663/time-course-of-plasma-inflammatory-mediators-in-a-rat-model-of-brain-death
#13
Majid Esmaeilzadeh, Mahmoud Sadeghi, Roland Galmbacher, Volker Daniel, Jürgen Knapp, Hans E Heissler, Joachim K Krauss, Arianeb Mehrabi
BACKGROUND: Brain death (BD) is a donor-associated risk factor that negatively affects transplantation outcome. The inflammation associated with BD appears to have a negative effect on organ quality. Complement activation, apoptosis, and pro-inflammatory cytokine and chemokine expression are significantly increased after BD. To better understand this process, we investigated plasma chemokine and cytokine levels for 8h after BD in a rodent model. METHODS: Thirteen healthy adult male Sprague Dawley rats were intubated and mechanically ventilated...
July 14, 2017: Transplant Immunology
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#14
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as PaO2/FIO2 < 150 mm Hg (i.e., severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4-8 mL/kg predicted body weight (PBW) with plateau pressure ≤30 cm H2O, and initial PEEP of 10 - 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 - 3 cm, provided plateau pressure remains ≤30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28716593/the-critical-care-literature-2016
#15
REVIEW
Michael E Winters, Joseph P Martinez, Haney Mallemat, William J Brady
An emergency physician (EP) is often the first health care provider to evaluate, resuscitate, and manage a critically ill patient. Between 2001 and 2009, the annual hours of critical care delivered in emergency departments (EDs) across the United States increased >200%! (Herring et al., 2013). This trend has persisted since then. In addition to seeing more critically ill patients, EPs are often tasked with providing critical care long beyond the initial resuscitation period. In fact, >33% of critically ill patients who are brought to an ED remain there for >6h (Herring et al...
July 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28716451/multidrug-resistant-pseudomonas-aeruginosa-lower-respiratory-tract-infections-in-the-intensive-care-unit-prevalence-and-risk-factors
#16
Trang D Trinh, Evan J Zasowski, Kimberly C Claeys, Abdalhamid M Lagnf, Shravya Kidambi, Susan L Davis, Michael J Rybak
Intensive care unit (ICU) admission is a risk for multidrug-resistant (MDR) Pseudomonas aeruginosa, but factors specific to critically ill pneumonia patients are not fully characterized. Objective was to determine risk factors associated with MDR P. aeruginosa pneumonia among ICU patients. This was a retrospective case-control study of P. aeruginosa pneumonia in the ICU; cystic fibrosis and colonizers were excluded. Risk factors included comorbid conditions and prior healthcare exposure (anti-pseudomonal antibiotics, hospitalizations, nursing home, P...
June 19, 2017: Diagnostic Microbiology and Infectious Disease
https://www.readbyqxmd.com/read/28716018/prediction-of-extubation-readiness-in-extremely-preterm-infants-by-the-automated-analysis-of-cardiorespiratory-behavior-study-protocol
#17
Wissam Shalish, Lara J Kanbar, Smita Rao, Carlos A Robles-Rubio, Lajos Kovacs, Sanjay Chawla, Martin Keszler, Doina Precup, Karen Brown, Robert E Kearney, Guilherme M Sant'Anna
BACKGROUND: Extremely preterm infants (≤ 28 weeks gestation) commonly require endotracheal intubation and mechanical ventilation (MV) to maintain adequate oxygenation and gas exchange. Given that MV is independently associated with important adverse outcomes, efforts should be made to limit its duration. However, current methods for determining extubation readiness are inaccurate and a significant number of infants fail extubation and require reintubation, an intervention that may be associated with increased morbidities...
July 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28715363/decompressive-craniectomy-vs-craniotomy-only-for-intracranial-hemorrhage-evacuation-a-propensity-matched-study
#18
Faisal Jehan, Asad Azim, Peter Rhee, Muhammad Khan, Lynn Gries, Terence OʼKeeffe, Narong Kulvatunyou, Andrew Tang, Bellal Joseph
BACKGROUND: Decompressive craniectomy (DC) is often performed in conjunction with evacuation of intracranial hemorrhage (ICH) to control intracranial pressure (ICP) in patients with a traumatic brain injury (TBI). The efficacy of DC in lowering ICP is well established, however, its effect on clinical outcomes remains controversial. The aim of our study is to assess outcomes in TBI patients undergoing decompressive craniectomy (DC) vs. craniotomy only (CO) for the evacuation of intracranial hemorrhage...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28715324/electrical-impedance-tomography-tissue-properties-to-image-measures
#19
Andy Adler, Alistair Boyle
Electrical Impedance Tomography (EIT) uses electrical stimulation and measurement at the body surface to image the electrical properties of internal tissues. It has the advantage of non-invasiveness and high temporal resolution but suffers from poor spatial resolution and sensitivity to electrode movement and contact quality. EIT can be useful to applications where there are conductive contrasts between tissues, fluids or gasses, such as imaging of cancerous or ischemic tissue or functional monitoring of breathing, blood flow, gastric motility and neural activity...
July 17, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28715240/the-effect-of-inspiratory-muscle-training-on-respiratory-variables-in-a-patient-with-ankylosing-spondylitis-a-case-report
#20
Marlon L Wong, Rachael G Anderson, Kelsey Garcia, Elissa M Housmann, Erin McHale, Gregory S Goldberger, Lawrence P Cahalin
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION: A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES: At baseline, the patient presented with a resting respiratory rate (RR) of 14...
July 17, 2017: Physiotherapy Theory and Practice
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