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https://www.readbyqxmd.com/read/29902538/a-multicentre-observational-study-on-management-of-general-anaesthesia-in-elderly-patients-at-high-risk-of-postoperative-adverse-outcomes
#1
Serge Molliex, Sylvie Passot, Jerome Morel, Emmanuel Futier, Jean Yves Lefrant, Jean Michel Constantin, Yannick Le Manach, Bruno Pereira
INTRODUCTION: in elderly patients, goal directed haemodynamic therapy (GDHT), depth of anaesthesia monitoring and lung-protective ventilation have been shown to improve postoperative outcomes. The aim of this study was to evaluate current practices concerning strategies of anaesthesia optimisation in patients aged ≥ 75 years. PATIENTS AND METHODS: a multicentre observational study was performed from February to May 2015 in 23 French academic centres. On 30 consecutive days in each centre, patients ≥ 75 years with at least one major co-morbidity undergoing elective or emergency procedures (femoral-neck fractures surgery, intraperitoneal abdominal surgery or vascular surgery) were included...
June 11, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29878061/nutrient-enrichment-of-human-milk-with-human-and-bovine-milk-based-fortifiers-for-infants-born-weighing-1250-g-a-randomized-clinical-trial
#2
Deborah L O'Connor, Alex Kiss, Christopher Tomlinson, Nicole Bando, Ann Bayliss, Douglas M Campbell, Alan Daneman, Jane Francis, Kirsten Kotsopoulos, Prakesh S Shah, Simone Vaz, Brock Williams, Sharon Unger
Background: Human milk-based fortifiers (HMBFs) are being adopted in neonatal care to enrich the nutrients in human milk for very low birth weight (VLBW) infants despite being costly and there being limited efficacy data. No randomized clinical trial has evaluated the use of HMBF compared with bovine milk-based fortifiers (BMBFs) in the absence of formula feeding. Objective: To determine if HMBF compared with BMBF for routine nutrient enrichment of human milk improves feeding tolerance, reduces morbidity, reduces fecal calprotectin (a measure of gut inflammation), and supports the growth of infants <1250 g...
June 6, 2018: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29869957/interstitial-features-at-chest-ct-enhance-the-deleterious-effects-of-emphysema-in-the-copdgene-cohort
#3
Samuel Y Ash, Rola Harmouche, James C Ross, Alejandro A Diaz, Farbod N Rahaghi, Gonzalo Vegas Sanchez-Ferrero, Rachel K Putman, Gary M Hunninghake, Jorge Onieva Onieva, Fernando J Martinez, Augustine M Choi, Russell P Bowler, David A Lynch, Hiroto Hatabu, Surya P Bhatt, Mark T Dransfield, J Michael Wells, Ivan O Rosas, Raul San Jose Estepar, George R Washko
Purpose To determine if interstitial features at chest CT enhance the effect of emphysema on clinical disease severity in smokers without clinical pulmonary fibrosis. Materials and Methods In this retrospective cohort study, an objective CT analysis tool was used to measure interstitial features (reticular changes, honeycombing, centrilobular nodules, linear scar, nodular changes, subpleural lines, and ground-glass opacities) and emphysema in 8266 participants in a study of chronic obstructive pulmonary disease (COPD) called COPDGene (recruited between October 2006 and January 2011)...
June 5, 2018: Radiology
https://www.readbyqxmd.com/read/29862030/pre-edit-protocol-for-a-randomised-feasibility-trial-of-elastance-directed-intrapleural-catheter-or-talc-pleurodesis-edit-in-malignant-pleural-effusion
#4
Geoffrey A Martin, Selina Tsim, Andrew C Kidd, John E Foster, Philip McLoone, Anthony Chalmers, Kevin G Blyth
Introduction: Non-expansile lung (NEL) is a common cause of talc pleurodesis (TP) failure in malignant pleural effusion (MPE), but is often occult prior to drainage. Reliable detection of NEL would allow patients to be allocated between intrapleural catheter (IPC) and TP. High pleural elastance (PEL ) has been associated with NEL in observational studies. Pre-EDIT is a randomised feasibility trial of elastance-directed IPC or TP (EDIT) management using a novel, purpose-built digital pleural manometer (Rocket Medical, UK)...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29844216/acute-effects-of-mechanical-insufflation-exsufflation-on-the-breathing-pattern-in-stable-subjects-with-duchenne-muscular-dystrophy
#5
Ambra Cesareo, Antonella LoMauro, Marika Santi, Emilia Biffi, Maria G D'Angelo, Andrea Aliverti
BACKGROUND: Duchenne muscular dystrophy (DMD) is characterized by progressive degeneration, wasting, and weakness of skeletal musculature, including respiratory muscles. Cough is also compromised with disease progression. Among cough-augmentation techniques, mechanical insufflation-exsufflation (MI-E) has demonstrated several clinical benefits in patients with chronic airway secretion obstruction and muscular weakness. In clinical practice, the use of MI-E in DMD patients is also suggested when they are stable with no airway infections...
May 29, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29797071/phenotypes-of-copd-in-an-austrian-population-national-data-from-the-pope-study
#6
Gabriele Reiger, Ralf Zwick, Bernd Lamprecht, Christian Kähler, Otto Chris Burghuber, Arschang Valipour
BACKGROUND: Chronic obstructive pulmonary disease (COPD) represents a major global health problem; however, there are no data regarding clinical phenotypes of these patients in Austria. METHODS: This was an analysis from the Austrian cohort of the cross-sectional Phenotypes of COPD in Central and Eastern Europe (POPE) study, which was offered to patients with stable COPD in a real-life setting. Patients were recruited at 5 different outpatient facilities in 3 different provinces in Austria...
May 24, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29794540/closing-knowledge-gaps-to-optimize-patient-outcomes-and-advance-precision-medicine
#7
Kathy Giusti, Anne Quinn Young, Kerri Lehrhaupt
Realizing the promise of precision medicine requires patient engagement at the key decision points throughout the cancer journey. Previous research has shown that patients who make the "right" decisions, such as being treated at a high-volume academic medical center, for example, have better outcomes. An online survey was conducted to understand awareness of and barriers to these decision points among patients with multiple myeloma and pancreatic, lung, prostate, and metastatic breast cancers. Survey respondents were identified by 5 participating foundations (multiple myeloma: n = 86, pancreatic: n = 108, lung: n = 56, prostate: n = 50, metastatic breast: n = 86) and recruited by an e-mail or social media invitation...
May 2018: Cancer Journal
https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#8
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#9
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29731862/synergistic-anti-tumor-effects-of-dasatinib-and-dendritic-cell-vaccine-on-metastatic-breast-cancer-in-a-mouse-model
#10
Ningning Song, Hulin Guo, Jia Ren, Suhong Hao, Xinchao Wang
Immunotherapy is currently considered as one of the major anti-tumor modalities, but its efficacy is limited. Dasatinib could improve the expansion and recruitment of cluster of differentiation (CD) 8+ T cells and natural killer (NK) cells to the tumor microenvironment. The present study aimed to evaluate the synergistic anti-tumor effects of dasatinib with dendritic cell (DC) vaccine in metastatic breast cancer. Dasatinib with DC vaccine was administered to mice inoculated with 4T1 breast cancer cells. Thereafter, tumor volume was measured every other day...
May 2018: Oncology Letters
https://www.readbyqxmd.com/read/29709437/the-effects-of-an-open-lung-approach-during-one-lung-ventilation-on-postoperative-pulmonary-complications-and-driving-pressure-a-descriptive-multicenter-national-study
#11
Javier Belda, Carlos Ferrando, Ignacio Garutti
OBJECTIVE: Thoracic surgical procedures are associated with an increased risk of postoperative pulmonary complications (PPCs), which seem to be related directly to intraoperative driving pressure. The authors conducted this study to describe the incidence of PPCs in patients in whom an individualized open-lung approach was applied during one-lung ventilation. DESIGN: This was a prospective, multicenter, national descriptive study. SETTING: Thoracic surgery patients undergoing one-lung ventilation...
March 27, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29708892/continuous-negative-abdominal-pressure-reduces-ventilator-induced-lung-injury-in-a-porcine-model
#12
Takeshi Yoshida, Doreen Engelberts, Gail Otulakowski, Bhushan Katira, Martin Post, Niall D Ferguson, Laurent Brochard, Marcelo B P Amato, Brian P Kavanagh
BACKGROUND: In supine patients with acute respiratory distress syndrome, the lung typically partitions into regions of dorsal atelectasis and ventral aeration ("baby lung"). Positive airway pressure is often used to recruit atelectasis, but often overinflates ventral (already aerated) regions. A novel approach to selective recruitment of dorsal atelectasis is by "continuous negative abdominal pressure." METHODS: A randomized laboratory study was performed in anesthetized pigs...
April 27, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29691422/pulmonary-effects-of-adjusting-tidal-volume-to-actual-or-ideal-body-weight-in-ventilated-obese-mice
#13
Elise Guivarch, Guillaume Voiriot, Anahita Rouzé, Stéphane Kerbrat, Jeanne Tran Van Nhieu, Philippe Montravers, Bernard Maitre, Armand Mekontso Dessap, Mathieu Desmard, Jorge Boczkowski
Obese patients could be more susceptible to mechanical ventilation (MV)-induced lung injury than non-obese patients due to weight-dependent changes in lung properties. The aim of this study was therefore to evaluate the pulmonary effects of 2 hours low VT MV in a diet-induced obese mice model, with VT calculated on either the actual body weight (VT aw) or the ideal body weight (VT iw) . First, we hypothesized that a MV with VT aw would be associated with altered lung mechanics and an increased lung inflammation...
April 24, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29670346/prediction-of-severe-exacerbations-and-mortality-in-copd-the-role-of-exacerbation-history-and-inspiratory-capacity-total-lung-capacity-ratio
#14
João Cardoso, Ricardo Coelho, Carla Rocha, Constança Coelho, Luísa Semedo, A Bugalho Almeida
Background: Severe exacerbations and mortality are major outcomes in COPD, and risk factors for these events are actively searched for. Several predictors of mortality have been identified in COPD. The inspiratory capacity/total lung capacity (IC/TLC) ratio has been shown to be a strong predictor of all cause and respiratory mortality in patients with COPD. The major objectives of this study were to analyze which clinical parameters, including lung volumes, were the best predictors of the 5-year cumulative risk of hospital admissions or death and the 5-year risk of exacerbations, in stable COPD patients...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29652760/influence-of-disease-severity-and-exercise-limitation-on-exercise-training-intensity-and-load-and-health-benefits-from-pulmonary-rehabilitation-in-patients-with-copd-an-exploratory-study
#15
Virginia C Huynh, Desi P Fuhr, Bradley W Byers, Anne-Marie Selzler, Linn E Moore, Michael K Stickland
PURPOSE: Some patients with chronic obstructive pulmonary disease (COPD) fail to achieve health benefits with pulmonary rehabilitation (PR). Exercise intensity and load represent stimulus for adaptation but it is unclear whether inappropriate exercise intensity and/or load are affected by severity of COPD, which may affect health benefits. The purpose was to determine whether COPD severity and/or the severity of pulmonary limitation to exercise (PLE) impacted exercising intensity or load and whether resultant intensity/load affected health outcomes derived from PR...
April 11, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29628587/effects-of-preoxygenation-with-tidal-volume-breathing-followed-by-apneic-oxygenation-with-and-without-continuous-positive-airway-pressure-on-duration-of-safe-apnea-time-and-arterial-blood-gases
#16
Sunil Rajan, Nandhini Joseph, Pulak Tosh, Jerry Paul, Lakshmi Kumar
Background: Application of continuous positive airway pressure (CPAP) helps to recruit collapsed areas of the lung, which improves the oxygen reserve. Aim of the Study: To compare the time to desaturate to 90% during apnea following preoxygenation and apneic ventilation with tidal volume breathing for 3 min with and without the application of CPAP. Settings and Design: This prospective randomized study was conducted in a tertiary care institution...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29617006/relevance-of-b-lines-on-lung-ultrasound-in-volume-overload-and-pulmonary-congestion-clinical-correlations-and-outcomes-in-patients-on-hemodialysis
#17
Marc M Saad, Jeanne Kamal, Elias Moussaly, Boutros Karam, Wissam Mansour, Emad Gobran, Saqib Hussen Abbasi, Ahmed Mahgoub, Puja Singh, Ross Hardy, Devjani Das, Cara Brown, Monica Kapoor, Seleshi Demissie, Morton J Kleiner, Elie El Charabaty, Suzanne E El Sayegh
BACKGROUND: Volume overload in patients on hemodialysis (HD) is an independent risk factor for cardiovascular mortality. B-lines detected on lung ultrasound (BLUS) assess extravascular lung water. This raises interest in its utility for assessing volume status and cardiovascular outcomes. METHODS: End-stage renal disease patients on HD at the Island Rehab Center being older than 18 years were screened. Patients achieving their dry weight (DW) had a lung ultrasound in a supine position...
2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29615226/effect-of-long-term-exposure-to-fine-particulate-matter-on-lung-function-decline-and-risk-of-chronic-obstructive-pulmonary-disease-in-taiwan-a-longitudinal-cohort-study
#18
Cui Guo, Zilong Zhang, Alexis K H Lau, Chang Qing Lin, Yuan Chieh Chuang, Jimmy Chan, Wun Kai Jiang, Tony Tam, Eng-Kiong Yeoh, Ta-Chien Chan, Ly-Yun Chang, Xiang Qian Lao
BACKGROUND: Information on the effects of long-term exposure to fine particulate matter with an aerodynamic diameter of 2·5 μm or less (PM2·5 ) on lung health is scarce. We aimed to investigate the associations between long-term exposure to PM2·5 , lung function, and chronic obstructive pulmonary disease (COPD) in a large-scale longitudinal cohort. METHODS: We included 285 046 participants aged 20 years or older from the Taiwan MJ Health Management Institution cohort, who were recruited between 2001 and 2014 and had spirometric tests during the medical examination visit...
March 2018: Lancet. Planetary Health
https://www.readbyqxmd.com/read/29609563/the-association-between-circulating-adiponectin-levels-lung-function-and-adiposity-in-subjects-from-the-general-population-data-from-the-akershus-sleep-apnea-project
#19
Nina F Caspersen, Helge Røsjø, Allan Flyvbjerg, Mette Bjerre, Anna Randby, Harald Hrubos-Strøm, Torbjørn Omland, Gunnar Einvik
BACKGROUND: Circulating adiponectin (ADPN) levels are inversely associated with disease severity in patients with chronic obstructive pulmonary disease (COPD), while studies assessing the relationship between ADPN and lung function in subjects from the general population have shown diverging results. Accordingly, we hypothesized that ADPN would be associated with lung function in a population-based sample and tested how abdominal adiposity, metabolic syndrome, and systemic inflammation influenced this association...
April 2, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29596290/use-of-recruitment-maneuvers-in-patients-with-acute-respiratory-distress-syndrome
#20
Angela Nguyen
Acute respiratory distress syndrome (ARDS) is a deadly complication in critically ill patients that causes significant morbidity and mortality. Patients with ARDS are seen across intensive care unit settings, with treatment being largely supportive involving techniques through mechanical ventilation. Using low-tidal-volume ventilation is a standard of practice for patients with ARDS, as a lung protection strategy; however, alveolar decruitment may occur. Recruitment maneuvers can recruit collapsed alveoli and promote oxygenation...
May 2018: Dimensions of Critical Care Nursing: DCCN
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