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Respiration, circulation, ICU, intensive care

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https://www.readbyqxmd.com/read/26620118/secondary-stroke-in-patients-with-polytrauma-and-traumatic-brain-injury-treated-in-an-intensive-care-unit-karlovac-general-hospital-croatia
#1
M Belavić, E Jančić, P Mišković, A Brozović-Krijan, B Bakota, J Žunić
Traumatic brain injury (TBI) is divided into primary and secondary brain injury. Primary brain injury occurs at the time of injury and is the direct consequence of kinetic energy acting on the brain tissue. Secondary brain injury occurs several hours or days after primary brain injury and is the result of factors including shock, systemic hypotension, hypoxia, hypothermia or hyperthermia, intracranial hypertension, cerebral oedema, intracranial bleeding or inflammation. The aim of this retrospective analysis of a prospective database was to determine the prevalence of secondary stroke and stroke-related mortality, causes of secondary stroke, treatment and length of stay in the ICU and hospital...
November 2015: Injury
https://www.readbyqxmd.com/read/26148361/-effect-of-neonatal-respiratory-support-strategies-in-the-icu
#2
REVIEW
O E Mitkinov, V I Gorbachev
This review deals with the current trends in protective ventilation in newborns. Volumotrauma is the most common variant of ventilator-induced lung injury. The modern research is devoted to the study of biotrauma, which is the release of inflammatory mediators in response to mechanical ventilation. There is a correlation between the ventilator-induced lung injury and the development of chronic lung diseases in infants. Now we have the "new" form of bronchopulmonary dysplasia-parenchymal lung disease characterized by impaired growth and development of the alveoli and blood vessels of the pulmonary circulation...
March 2015: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/25790623/determinants-for-increased-resource-utilization-after-surgery-for-prosthetic-valve-endocarditis
#3
Herko Grubitzsch, Andreas Schäfer, Benamin Claus, Sascha Treskatsch, Michael Sander, Konertz Wolfgang
UNLABELLED: Mechanical circulatory support (11 intra-aortic balloon pump; two right ventricular assist device; one left ventricular assist device) was required in 14 patients (9.4%). At 30 days, mortality was 12.8% (n=17) and morbidity 78.5% (117 patients experienced at least one complication). At one, five and 10 years, the overall survival was 78.4 +/- 3.5%, 76.7 +/- 3.6% and 74.9 +/- 3.8%, respectively. The duration of postoperative MV was 8 +/- 20.7 days, while ICU and hospital stays were 11 +/- 20...
November 2014: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/25693354/-delayed-discharge-from-the-intensive-care-unit
#4
Nao Okuda, Yumiko Tsunano, Hisakazu Kohata, Emiko Nakataki, Taiga Itagaki, Mutsuo Onodera, Hideaki Imanaka, Masaji Nishimura
BACKGROUND: Delayed discharge from ICU to the general ward can exert an adverse effect. We researched whether patients are discharged smoothly from our ICU to the general ward. METHODS: We defined that patients were eligible for discharge if they are without administration of catecholamine, being assisted by mechanical ventilation and having blood purification therapy. RESULTS: Average time from actual discharge to the time patient was considered eligible for discharge was fifteen hours...
October 2014: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/24809262/-study-of-timing-of-invasive-and-noninvasive-sequential-ventilation-in-patients-with-acute-respiratory-distress-syndrome
#5
RANDOMIZED CONTROLLED TRIAL
Xiuyan Wang, Sicheng Xu, Guangming Liu, Shareli Caikai
OBJECTIVE: To investigate the timing and value of noninvasive ventilation (NIV) as a weaning tool immediately after early extubation in patients with acute respiratory distress syndrome (ARDS). METHODS: A prospective randomized controlled trial was conducted. The ARDS patients with surgical diseases admitted to Department of Respiratory Intensive Care Unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University were enrolled. The patients were randomly divided into sequential group and control group...
May 2014: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/24776608/prospective-study-on-the-clinical-course-and-outcomes-in-transfusion-related-acute-lung-injury
#6
Mark R Looney, Nareg Roubinian, Ognjen Gajic, Michael A Gropper, Rolf D Hubmayr, Clifford A Lowell, Peter Bacchetti, Gregory Wilson, Monique Koenigsberg, Deanna C Lee, Ping Wu, Barbara Grimes, Philip J Norris, Edward L Murphy, Manish J Gandhi, Jeffrey L Winters, David C Mair, Randy M Schuller, Nora V Hirschler, Rosa Sanchez Rosen, Michael A Matthay, Pearl Toy
OBJECTIVE: Transfusion-related acute lung injury is the leading cause of transfusion-related mortality. A prospective study using electronic surveillance was conducted at two academic medical centers in the United States with the objective to define the clinical course and outcomes in transfusion-related acute lung injury cases. DESIGN: Prospective case study with controls. SETTING: University of California, San Francisco and Mayo Clinic, Rochester...
July 2014: Critical Care Medicine
https://www.readbyqxmd.com/read/24743042/mechanical-ventilation-induced-intrathoracic-pressure-distribution-and-heart-lung-interactions
#7
Benno Lansdorp, Charlotte Hofhuizen, Martijn van Lavieren, Henri van Swieten, Joris Lemson, Michel J A M van Putten, Johannes G van der Hoeven, Peter Pickkers
OBJECTIVE: Mechanical ventilation causes cyclic changes in the heart's preload and afterload, thereby influencing the circulation. However, our understanding of the exact physiology of this cardiopulmonary interaction is limited. We aimed to thoroughly determine airway pressure distribution, how this is influenced by tidal volume and chest compliance, and its interaction with the circulation in humans during mechanical ventilation. DESIGN: Intervention study. SETTING: ICU of a university hospital...
September 2014: Critical Care Medicine
https://www.readbyqxmd.com/read/24632426/the-influence-of-selective-pulmonary-perfusion-on-the-inflammatory-response-and-clinical-outcome-of-patients-with-chronic-obstructive-pulmonary-disease-undergoing-cardiopulmonary-bypass
#8
RANDOMIZED CONTROLLED TRIAL
Arndt-Holger Kiessling, Feng Wei Guo, Yildiz Gökdemir, Marlene Thudt, Christian Reyher, Mirela Scherer, Andres Beiras-Fernandez, Anton Moritz
OBJECTIVES: Patients undergoing cardiac surgery presenting with chronic obstructive pulmonary disease (COPD) have a higher 30-day mortality risk. In these patients, pulmonary dysfunction linked to an inflammatory response is frequent after cardiac operations using cardiopulmonary bypass (CPB), which causes pulmonary hypoperfusion. We hypothesize that selective pulmonary perfusion (sPP) of the lungs leads to a reduction of pulmonary inflammation and a better clinical outcome. METHODS: Fifty-nine COPD patients (forced expiratory volume in 1 s/vital capacity <70%) undergoing cardiac surgery procedures (coronary artery bypass grafting 64%, valve 14%) were block-randomized to sPP (venous blood, temperature 2°C, 4 l) or standard CPB (28/28)...
June 2014: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/23881507/minimally-invasive-versus-conventional-extracorporeal-circulation-in-minimally-invasive-cardiac-valve-surgery
#9
COMPARATIVE STUDY
Hardy Baumbach, Christian Rustenbach, Jens Michaelsen, Gernot Hipp, Markus Pressmar, Marco Leinweber, Ulrich Friedrich Wilhelm Franke
BACKGROUND: Minimally invasive extracorporeal circulation (MECC) technology was applied predominantly in coronary surgery. Data regarding the application of MECC in minimally invasive valve surgery are missing largely. PATIENTS AND METHODS: Patients undergoing isolated minimally invasive mitral or aortic valve procedures were allocated either to conventional extracorporeal circulation (CECC) group (n = 63) or MECC group (n = 105), and their prospectively generated data were analyzed...
February 2014: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/23615940/thrombocytopenia-in-the-critically-ill-prevalence-incidence-risk-factors-and-clinical-outcomes
#10
COMPARATIVE STUDY
David R Williamson, Olivier Lesur, Jean-Pierre Tétrault, Vincent Nault, Danielle Pilon
PURPOSE: The aim of this cohort study was to describe the prevalence, incidence, and risk factors for thrombocytopenia in the intensive care unit (ICU) and to evaluate the impact of thrombocytopenia on mortality with further comparisons amongst major diagnostic categories. METHODS: Patients admitted to the ICU from 1997-2011 for cardiac, medical, surgical, and trauma conditions were included. The presence of a platelet count < 100 × 10(9)·L(-1) on admission day or its appearance during ICU stay were considered as prevalent and incident thrombocytopenia, respectively...
July 2013: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/23407696/normothermic-cardiopulmonary-bypass-increases-cerebral-tissue-oxygenation-during-combined-valve-surgery-a-single-centre-randomized-trial
#11
RANDOMIZED CONTROLLED TRIAL
Andrey I Lenkin, Viktor I Zaharov, Pavel I Lenkin, Alexey A Smetkin, Lars J Bjertnaes, Mikhail Y Kirov
OBJECTIVES: In cardiac surgery, the choice of temperature regimen during cardiopulmonary bypass (CPB) remains a subject of debate. Hypothermia reduces tissue metabolic demands, but may impair the autoregulation of cerebral blood flow and contribute to neurological morbidity. The aim of this study was to evaluate the effect of two different temperature regimens during CPB on the systemic oxygen transport and the cerebral oxygenation during surgical correction of acquired heart diseases...
May 2013: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/23199212/the-trauma-patient-in-hemorrhagic-shock-how-is-the-c-priority-addressed-between-emergency-and-icu-admission
#12
Sigune Peiniger, Thomas Paffrath, Manuel Mutschler, Thomas Brockamp, Matthew Borgmann, Philip C Spinella, Bertil Bouillon, Marc Maegele
BACKGROUND: Trauma is the leading cause of death in young people with an injury related mortality rate of 47.6/100,000 in European high income countries. Early deaths often result from rapidly evolving and deteriorating secondary complications e.g. shock, hypoxia or uncontrolled hemorrhage. The present study assessed how well ABC priorities (A: Airway, B: Breathing/Ventilation and C: Circulation with hemorrhage control) with focus on the C-priority including coagulation management are addressed during early trauma care and to what extent these priorities have been controlled for prior to ICU admission among patients arriving to the ER in states of moderate or severe hemorrhagic shock...
2012: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/23096426/volatile-isoflurane-sedation-in-cerebrovascular-intensive-care-patients-using-anaconda-%C3%A2-effects-on-cerebral-oxygenation-circulation-and-pressure
#13
Julian Bösel, Jan C Purrucker, Frank Nowak, Julian Renzland, Petra Schiller, Eva Benveniste Pérez, Sven Poli, Benjamin Brunn, Werner Hacke, Thorsten Steiner
PURPOSE: The anesthetic-conserving device AnaConDa(®), a miniature vaporizer, allows volatile sedation in the intensive care unit (ICU). We investigated the effects of isoflurane sedation on cerebral and systemic physiology parameters in neuromonitored ICU stroke patients. METHODS: Included in the study were 19 consecutive ventilated patients with intracerebral hemorrhage (12), subarachnoid hemorrhage (4), and ischemic stroke (3) who were switched from intravenous propofol or midazolam to inhalative isoflurane sedation for an average of 3...
December 2012: Intensive Care Medicine
https://www.readbyqxmd.com/read/22777898/associations-between-the-use-of-critical-care-procedures-and-change-in-functional-status-at-discharge
#14
Kazuaki Kuwabara, Shinya Matsuda, Kiyohide Fushimi, Koichi B Ishikawa, Hiromasa Horiguchi, Kenji Fujimori
Quality improvement initiatives in intensive care units (ICUs) have increased survival rates. Changes in functional status following ICU care have been studied, but results are inconclusive because of insufficient consideration of the combinations of critical care procedures used. Using the Japanese administrative database including the Barthel Index (BI) at admission and discharge, we measured the changes in functional status among the adult patients and determined whether longer ICU stay or use of various critical care procedures was associated with functional deterioration...
September 2013: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/22331959/vitamin-d-deficiency-is-associated-with-poor-outcomes-and-increased-mortality-in-severely-ill-patients
#15
Y Arnson, I Gringauz, D Itzhaky, H Amital
BACKGROUND: Vitamin D plays a seminal role in many homeostatic mechanisms. In this study, we assessed the correlation between circulating vitamin D levels and mortality rates in critically ill patients. METHODS: All patients admitted to the intensive care units (ICUs) and internal medicine wards in a university-based hospital that required mechanical ventilation were admitted. Data collected included the underlying disease, basic hematological and biochemical blood test results, APACHE II scores and serum 25-hydroxyvitamin D [25(OH)D] levels...
July 2012: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/22032811/effects-of-bag-mask-versus-advanced-airway-ventilation-for-patients-undergoing-prolonged-cardiopulmonary-resuscitation-in-pre-hospital-setting
#16
Tomoyuki Nagao, Kosaku Kinoshita, Atsushi Sakurai, Junko Yamaguchi, Makoto Furukawa, Akira Utagawa, Takashi Moriya, Takeo Azuhata, Katsuhisa Tanjoh
BACKGROUND: There is no evidence that the advanced airway ventilation (AAV) method improves patient outcome in the pre-hospital cardiac arrest setting. OBJECTIVE: The aim of this study was to estimate the effectiveness of AAV vs. bag-mask ventilation (BMV) for cardiopulmonary arrest (CPA) patients, when administered by a licensed emergency medical technician in the pre-hospital setting. METHODS: The study used the database of patients who suffered out-of-hospital cardiogenic CPA from 2006 to 2007 in our hospital...
February 2012: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/21906758/increasing-duration-of-circulatory-arrest-but-not-antegrade-cerebral-perfusion-prolongs-postoperative-recovery-after-neonatal-cardiac-surgery
#17
COMPARATIVE STUDY
Selma O Algra, Verena N N Kornmann, Ingeborg van der Tweel, Antonius N J Schouten, Nicolaas J G Jansen, Felix Haas
OBJECTIVE: Deep hypothermic circulatory arrest (DHCA) and antegrade cerebral perfusion (ACP) are 2 cardiopulmonary bypass techniques applied in aortic arch repair. In recent literature, cerebral effects of both techniques have received most attention, whereas the consequences for other organs have not been thoroughly investigated. Therefore, in this study, the impact of duration of DHCA and ACP on postoperative recovery was analyzed in a cohort of neonates undergoing aortic arch reconstruction...
February 2012: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/21854091/j-shaped-versus-median-sternotomy-for-aortic-valve-replacement-with-minimal-extracorporeal-circuit
#18
COMPARATIVE STUDY
Alaaddin Yilmaz, Jelena Sjatskig, Wim J van Boven, Frans G Waanders, Johannes C Kelder, Uday Sonker, Geoffrey T L Kloppenburg
OBJECTIVES: Minimal access aortic valve replacement (AVR) has been demonstrated to have beneficial effects over median sternotomy. Minimal extracorporeal circulation (MECC) has been shown to have less deleterious effects than conventional cardiopulmonary bypass. We describe for the first time AVR via upper J-shaped partial sternotomy compared to median sternotomy using MECC. METHODS: Prospectively collected pre-operative, intra-operative, post-operative and follow-up data from 104 consecutive patients who underwent minimal access AVR were compared to 72 consecutive patients undergoing median sternotomy using MECC during the same period (January 2007 to December 2009)...
December 2011: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/21818012/risk-factors-associated-with-early-reintubation-in-trauma-patients-a-prospective-observational-study
#19
COMPARATIVE STUDY
Carlos V R Brown, Jacob B Daigle, Kelli H Foulkrod, Brandee Brouillette, Adam Clark, Clea Czysz, Marnie Martinez, Hassie Cooper
BACKGROUND: After mechanical ventilation, extubation failure is associated with poor outcomes and prolonged hospital and intensive care unit (ICU) stays. We hypothesize that specific and unique risk factors exist for failed extubation in trauma patients. The purpose of this study was to identify the risk factors in trauma patients. METHODS: We performed an 18-month (January 2008-June 2009) prospective, cohort study of all adult (8 years or older) trauma patients admitted to the ICU who required mechanical ventilation...
July 2011: Journal of Trauma
https://www.readbyqxmd.com/read/21411266/-efficacy-safety-and-cost-of-sedation-with-sevoflurane-in-intensive-care-unit
#20
M Bisbal, J-M Arnal, A Passelac, M Sallée, D Demory, S-Y Donati, I Granier, G Corno, J Durand-Gasselin
OBJECTIVES: To study efficacy, systemic and cerebral haemodynamic, and cost of sedation with sevoflurane after midazolam failure. STUDY DESIGN: Prospective observational study in a mixed intensive care unit. PATIENTS AND METHODS: Mechanically ventiled patients in whom deep sedation failed (Ramsay score<5 despite midazolam 10mg/h and fentanyl 400μg/h) were enrolled. Sedation with sevoflurane and fentanyl (200μg/h) was performed during 48 hours...
April 2011: Annales Françaises D'anesthèsie et de Rèanimation
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