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Chronic ventilation

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https://www.readbyqxmd.com/read/28429628/relationship-of-steroid-dosing-and-duration-of-mechanical-ventilation-in-adult-patients-with-acute-exacerbations-of-chronic-obstructive-pulmonary-disease
#1
Jennifer McCann, Katherine Teare, Emily Cochard, Brent Toney
BACKGROUND: The optimal steroid dose for patients who require mechanical ventilation (MV) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is unknown. OBJECTIVE: The primary objective of the study is to describe the relationship between steroid doses prescribed and duration of MV. METHODS: This was a retrospective study of patients admitted between October 2013 and September 2014 who were prescribed steroids and received MV for ≥48 hours for AECOPD...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#2
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28421173/cerebral-autoregulation-brain-injury-and-the-transitioning-premature-infant
#3
REVIEW
Zachary A Vesoulis, Amit M Mathur
Improvements in clinical management of the preterm infant have reduced the rates of the two most common forms of brain injury, such as severe intraventricular hemorrhage and white matter injury, both of which are contributory factors in the development of cerebral palsy. Nonetheless, they remain a persistent challenge and are associated with a significant increase in the risk of adverse neurodevelopment outcomes. Repeated episodes of ischemia-reperfusion represent a common pathway for both forms of injury, arising from discordance between systemic blood flow and the innate regulation of cerebral blood flow in the germinal matrix and periventricular white matter...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#4
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#5
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28416020/patient-and-family-centered-performance-measures-focused-on-actionable-processes-of-care-for-persistent-and-chronic-critical-illness-protocol-for-a-systematic-review
#6
Louise Rose, Laura Istanboulian, Laura Allum, Lisa Burry, Craig Dale, Nicholas Hart, Claire Kydonaki, Pam Ramsay, Natalie Pattison, Bronwen Connolly
BACKGROUND: Approximately 5 to 10% of critically ill patients transition from acute critical illness to a state of persistent and in some cases chronic critical illness. These patients have unique and complex needs that require a change in the clinical management plan and overall goals of care to a focus on rehabilitation, symptom relief, discharge planning, and in some cases, end-of-life care. However, existing indicators and measures of care quality, and tools such as checklists, that foster implementation of best practices, may not be sufficiently inclusive in terms of actionable processes of care relevant to these patients...
April 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28415969/carbapenem-resistance-inappropriate-empiric-treatment-and-outcomes-among-patients-hospitalized-with-enterobacteriaceae-urinary-tract-infection-pneumonia-and-sepsis
#7
Marya D Zilberberg, Brian H Nathanson, Kate Sulham, Weihong Fan, Andrew F Shorr
BACKGROUND: Drug resistance among gram-negative pathogens is a risk factor for inappropriate empiric treatment (IET), which in turn increases the risk for mortality. We explored the impact of carbapenem-resistant Enterobacteriaceae (CRE) on the risk of IET and of IET on outcomes in patients with Enterobacteriaceae infections. METHODS: We conducted a retrospective cohort study in Premier Perspective database (2009-2013) of 175 US hospitals. We included all adult patients with community-onset culture-positive urinary tract infection (UTI), pneumonia, or sepsis as a principal diagnosis, or as a secondary diagnosis in the setting of respiratory failure, treated with antibiotics within 2 days of admission...
April 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28414607/cardiac-arrest-in-an-american-cocker-spaniel-during-a-deep-ear-flush-procedure
#8
Alexandra Gould, Fernando L Garcia-Pereira, W Dunbar Gram
CASE DESCRIPTION A 14-year-old spayed female American Cocker Spaniel with bilateral otitis media and no evidence of cardiovascular instability was anesthetized to allow performance of a deep ear flush. CLINICAL FINDINGS Otoscopic examination of the left ear revealed evidence of chronic inflammation; the ear was flushed with sterile saline (0.9% NaCl) solution. Examination of the right ear revealed more severe chronic inflammation than in the left ear, including a ruptured tympanum (timing of rupture unknown)...
May 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28413775/an-interesting-case-of-mycoplasma-pneumonia-associated-multisystem-involvement-and-diffuse-alveolar-hemorrhage
#9
Rashmi Mishra, Edison Cano, Sindhaghatta Venkatram, Gilda Diaz-Fuentes
Severe mycoplasma pneumonia is a rare entity with only 0.5-2% of cases having a fulminant course. We present a 74-year-old woman with hypertension, diabetes mellitus and remote history of marginal zone B-cell lymphoma admitted with abdominal pain and diarrhea of 1-2 days associated with body-aches, dyspnea, dry cough and weight loss for 2-3 weeks. On physical exam, she was febrile, tachypneic, tachycardic and hypoxic on room air. Chest examination revealed diffuse crackles and end-expiratory wheezes. Laboratory tests showed anemia, acute-on-chronic kidney injury and hyaline casts and epithelial cells in the urine analysis...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28413497/antibiotic-de-escalation-principle-in-elderly-patients-with-chronic-obstructive-pulmonary-disease-complicated-with-severe-pneumonia
#10
Baohong Xiao, Mei Wang, Xiaoling Hu, Jinfeng Li, Fangfang Wang, Jiaxing Sun
The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram-positive (G+) and Gram-negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412688/clinical-research-of-treating-tuberculous-respiratory-failure-by-sequential-mechanical-ventilation
#11
Chengqun Ge, Tao Zhang, Houcui Fan
Tuberculosis is kind of common chronic infectious disease, of which the pathogenic bacterium is mainly Mycobacterium tuberculosis (MTB). One who is suffering severe tuberculosis may be ended with cardio-pulmonary function damage or cardio-pulmonary failure. This disease is of higher risks of complications or even high death rate, which is seriously challenging people's health and life. When a tuberculosis patient is accompanied with respiratory failure, which means the disease has developed into the late stage, on this occasion the optimal treatment program is to use mechanical ventilation to improve the respiratory failure condition...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28410001/respiratory-pattern-and-tidal-volumes-differ-for-pressure-support-and-volume-assured-pressure-support-in-amyotrophic-lateral-sclerosis
#12
Trevor T Nicholson, Sean B Smith, Teepu Siddique, Robert Sufit, Senda Ajroud-Driss, John M Coleman, Lisa F Wolfe
RATIONALE: Amyotrophic Lateral Sclerosis is a progressive neuromuscular disease resulting in respiratory failure and death. Use of non-invasive ventilation (NIV) improves survival. However, use of Volume-Assured Pressure Support (VAPS) has not been extensively studied in ALS. OBJECTIVES: To explore the clinical utility of a detailed evaluation of device-recorded NIV data in the management of chronic respiratory failure in ALS. To determine if there are differences in efficacy between patients using VAPS or PS...
April 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28408931/drug-induced-pneumonitis-secondary-to-treatment-with-paritaprevir-ritonavir-ombitasvir-and-dasabuvir-viekira-pak%C3%A2-for-chronic-hepatitis-c-case-report-of-an-unexpected-life-threatening-adverse-reaction
#13
Shih Yea Sylvia Wu, Bridget Faire, Edward Gane
VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28408814/non-invasive-ventilation-with-intelligent-volume-assured-pressure-support-versus-pressure-controlled-ventilation-effects-on-the-respiratory-event-rate-and-sleep-quality-in-copd-with-chronic-hypercapnia
#14
Georg Nilius, Nato Katamadze, Ulrike Domanski, Maik Schroeder, Karl-Josef Franke
BACKGROUND: COPD patients who develop chronic hypercapnic respiratory failure have a poor prognosis. Treatment of choice, especially the best form of ventilation, is not well known. OBJECTIVES: This study compared the effects of pressure-controlled (spontaneous timed [ST]) non-invasive ventilation (NIV) and NIV with intelligent volume-assured pressure support (IVAPS) in chronic hypercapnic COPD patients regarding the effects on alveolar ventilation, adverse patient/ventilator interactions and sleep quality...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28406813/effects-of-hypercapnia-and-hypercapnic-acidosis-on-hospital-mortality-in-mechanically-ventilated-patients
#15
Ravindranath Tiruvoipati, David Pilcher, Hergen Buscher, John Botha, Michael Bailey
OBJECTIVES: Lung-protective ventilation is used to prevent further lung injury in patients on invasive mechanical ventilation. However, lung-protective ventilation can cause hypercapnia and hypercapnic acidosis. There are no large clinical studies evaluating the effects of hypercapnia and hypercapnic acidosis in patients requiring mechanical ventilation. DESIGN: Multicenter, binational, retrospective study aimed to assess the impact of compensated hypercapnia and hypercapnic acidosis in patients receiving mechanical ventilation...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403904/pre-existing-chronic-interstitial-pneumonia-is-a-poor-prognostic-factor-of-goodpasture-s-syndrome-a-case-report-and-review-of-the-literature
#16
Hiroki Tashiro, Koichiro Takahashi, Yuki Ikeda, Saori Uchiumi, Makoto Fukuda, Miyazono Motoaki, Shinya Kimura, Naoko Sueoka-Aragane
BACKGROUND: Goodpasture's syndrome is a rare disease that is characterized by rapidly progressive glomerulonephritis and diffuse alveolar hemorrhage. CASE PRESENTATION: A 71-year-old Japanese man who had chronic interstitial pneumonia was diagnosed as having Goodpasture's syndrome. Both anti-glomerular basement membrane antibody and myeloperoxidase anti-neutrophil cytoplasmic antibody were increased. Despite intensive treatments, including mechanical ventilation, he died from respiratory failure...
April 13, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#17
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403118/validation-of-intensive-care-and-mechanical-ventilation-codes-in-medicare-data
#18
Hannah Wunsch, Andrew Kramer, Hayley B Gershengorn
OBJECTIVES: To assess the reliability of codes relevant to critically ill patients in administrative data. DESIGN: Retrospective cohort study linking data from Acute Physiology and Chronic Health Evaluation Outcomes, a clinical database of ICU patients with data from Medicare Provider Analysis and Review. We linked data based on matching for sex, date of birth, hospital, and date of admission to hospital. SETTING: Forty-six hospitals in the United States participating in Acute Physiology and Chronic Health Evaluation Outcomes...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28402551/a-risk-prediction-score-for-acute-kidney-injury-in-the-intensive-care-unit
#19
Rakesh Malhotra, Kianoush B Kashani, Etienne Macedo, Jihoon Kim, Josee Bouchard, Susan Wynn, Guangxi Li, Lucila Ohno-Machado, Ravindra Mehta
Background.: Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. Early identification of high-risk patients provides an opportunity to develop strategies for prevention, early diagnosis and treatment of AKI. Methods.: We undertook this multicenter prospective cohort study to develop and validate a risk score for predicting AKI in patients admitted to an intensive care unit (ICU). Patients were screened for predictor variables within 48 h of ICU admission...
April 10, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28402103/patient-derived-airway-secretion-dissociation-technique-to-isolate-and-concentrate-immune-cells-using-closed-loop-inertial-microfluidics
#20
Hyunryul Ryu, Kyungyong Choi, Yanyan Qu, Taehong Kwon, Janet S Lee, Jongyoon Han
Assessment of airway secretion cells, both for research and clinical purposes, is a highly desired goal in patients with acute and chronic pulmonary diseases. However, lack of proper cell isolation and enrichment techniques hinder downstream evaluation and characterization of cells found in airway secretions. Here, we demonstrate a novel enrichment method to capture immune-related cells from clinical airway secretions using closed-loop separation of spiral inertial microfluidics (C-sep). By recirculating the output focusing stream back to the input reservoir and running continuously with a high flow processing rate, one can achieve optimal concentration, recovery and purity of airway immune cells from a large volume of diluent, which was not readily possible in the single-pass operation...
April 21, 2017: Analytical Chemistry
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