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https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#1
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#2
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29340765/orotracheal-tube-as-a%C3%A2-risk-factor-for-lower-respiratory-tract-infection-preliminary-data-from-a%C3%A2-randomised-trial
#3
Igor Muzlovic, Janja Perme, David Stubljar
PURPOSE: The aim of the study was to investigate whether polyurethane (PU) endotracheal tubes, continuous measurements of cuff pressure and aspiration of the subglottic space as a bundle of parameters could reduce patients' risk for developing ventilator associated pneumonia (VAP). METHODS: Two groups of patients that differed only in terms of endotracheal tubes and intubation intervention were compared. Group A was ventilated using PU tubes a with conical cuff; they also had continuous cuff pressure measurement and continuous subglottic aspiration...
January 16, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29338772/incidence-risk-factors-and-impact-of-protocolised-care-on-exposure-keratopathy-in-critically-ill-adults-a-two-phase-prospective-cohort-study
#4
Obaid Kousha, Zubaid Kousha, Jonathan Paddle
BACKGROUND: Exposure keratopathy (EK) has a high incidence in critically ill patients. We aimed to determine the rate of EK in patients admitted to our intensive care unit (ICU), identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. METHODS: We undertook a two-phase prospective cohort single-centre study in a general adult ICU. The first phase of the study was observational. In the second phase of the study an eye care protocol was introduced...
January 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29337172/organ-support-therapy-in-the-intensive-care-unit-and-return-to-work-in-out-of-hospital-cardiac-arrest-survivors-a-nationwide-cohort-study
#5
Signe Riddersholm, Kristian Kragholm, Rikke Nørmark Mortensen, Steen Moller Hansen, Mads Wissenberg, Freddy K Lippert, Christian Torp-Pedersen, Christian F Christiansen, Bodil Steen Rasmussen
AIM: With increased survival after out-of-hospital cardiac arrest (OHCA), impact of the post-resuscitation course has become important. Among 30-day OHCA survivors, we investigated associations between organ support therapy in the Intensive Care Unit (ICU) and return to work. METHODS: This Danish nationwide cohort-study included 30-day-OHCA-survivors who were employed prior to arrest. We linked OHCA data to information on in-hospital care and return to work. For patients admitted to an ICU and based on renal replacement therapy (RRT), cardiovascular support and mechanical ventilation, we assessed the prognostic value of organ support therapies in multivariable Cox regression models...
January 11, 2018: Resuscitation
https://www.readbyqxmd.com/read/29337171/is-early-tracheostomy-better-for-severe-traumatic-brain-injury-a-meta-analysis
#6
Qin Lu, Yonglin Xie, Xunchen Qi, Xinwei Li, Shuxu Yang, Yirong Wang
OBJECTIVE: Tracheotomy have been proven to be benefit for the patients requiring prolonged mechanical ventilation. However, whether early tracheotomy (less than 10 days) could also improve the outcome of severe traumatic brain injury (TBI) patient (GCS≤8) remains controversial. The aim of this study was trying to clarify this question. METHODS: We searched four databases (PubMed, Web of Science, Elsevier and Cochrane Library) for articles comparing the outcome of early tracheostomy with late tracheostomy or prolonged intubation on the severe TBI patients...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29336938/determination-of-the-energy-requirements-in-mechanically-ventilated-critically-ill-elderly-patients-in-different-bmi-groups-using%C3%A2-the-harris-benedict-equation
#7
Pi-Hui Hsu, Chao-Hsien Lee, Li-Kuo Kuo, Yu-Chung Kung, Wei-Ji Chen, Min-Su Tzeng
BACKGROUND: Due to studies on calorie requirement in mechanically ventilated critically ill elderly patients are few, and indirect calorimetry (IC) is not available in every intensive care unit (ICU). The aim of this study was to compare IC and Harris-Benedict (HB) predictive equation in different BMI groups. METHODS: A total of 177 mechanically ventilated critically ill elderly patients (≧65 years old) underwent IC for measured resting energy expenditure (MREE)...
January 11, 2018: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29336389/a-randomized-controlled-trial-comparing-the-myocardial-protective-effects-of-isoflurane-with-propofol-in-patients-undergoing-elective-coronary-artery-bypass-surgery-on-cardiopulmonary-bypass-assessed-by-changes-in-n-terminal-brain-natriuretic-peptide
#8
Balaji Kuppuswamy, Kirubakaran Davis, Raj Sahajanandan, Manickam Ponniah
OBJECTIVE: The objective of the study is to compare the myocardial protective effects of isoflurane with propofol in patients undergoing elective coronary artery bypass surgery on cardiopulmonary bypass (CPB), the cardio protection been assessed by changes in N-terminal brain natriuretic peptide (NT proBNP). Methodology and Design: This study is designed as a participant blinded, prospective randomized clinical trial. SETTING: Christian Medical College Hospital, Vellore, India...
January 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29334927/dexmedetomidine-prevents-acute-kidney-injury-after-adult-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#9
Yang Liu, Bo Sheng, Suozhu Wang, Feiping Lu, Jie Zhen, Wei Chen
BACKGROUND: Dexmedetomidine has been shown to confer direct renoprotection by stabilizing the sympathetic system, exerting anti-inflammatory effects and attenuating ischemia/reperfusion (I/R) injury in preclinical studies. Results from clinical trials of dexmedetomidine on acute kidney injury (AKI) following adult cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed, and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the renal effect of dexmedetomidine versus placebo or other anesthetic drugs in adult patients undergoing cardiac surgery...
January 15, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#10
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29325842/use-of-dexmedetomidine-in-cardiothoracic-and-vascular-anesthesia
#11
REVIEW
Lucía Gallego-Ligorit, Marc Vives, Jorge Vallés-Torres, T Alberto Sanjuán-Villarreal, Azucena Pajares, Mario Iglesias
Dexmedetomidine is a highly selective α2-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus...
December 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#12
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29322062/increased-indoleamine-2-3-dioxygenase-activity-is-associated-with-poor-clinical-outcome-in-adults-hospitalized-with-influenza-in-the-insight-flu003plus-study
#13
Sarah L Pett, Ken M Kunisaki, Deborah Wentworth, Timothy J Griffin, Ioannis Kalomenidis, Raquel Nahra, Rocio Montejano Sanchez, Shane W Hodgson, Kiat Ruxrungtham, Dominic Dwyer, Richard T Davey, Chris H Wendt
Background: Indoleamine-2,3-dioxygenase (IDO) mediated tryptophan (TRP) depletion has antimicrobial and immuno-regulatory effects. Increased kynurenine (KYN)-to-TRP (KT) ratios, reflecting increased IDO activity, have been associated with poorer outcomes from several infections. Methods: We performed a case-control (1:2; age and sex matched) analysis of adults hospitalized with influenza A(H1N1)pdm09 with protocol-defined disease progression (died/transferred to ICU/mechanical ventilation) after enrollment (cases) or survived without progression (controls) over 60 days of follow-up...
January 2018: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/29320830/-a-multi-center-retrospective-study-of-clinical-characteristics-and-hospitalization-costs-of-patients-hospitalized-for-asthma-exacerbation-in-china-during-2013-2014
#14
J T Lin, B Xing, H P Tang, L Yang, Y D Yuan, Y H Gu, P Chen, X J Liu, J Zhang, H G Liu, C Z Wang, W Zhou, D J Sun, Y Q Chen, Z C Chen, M Huang, Q C Lin, C P Hu, X H Yang, J M Huo, X W Ye, X Zhou, P Jiang, W Zhang, Y J Huang, L M Dai, R Y Liu, S X Cai, J Y Xu, J Y Zhou
Objective: To study the characteristics of patients hospitalized for asthma exacerbation in 29 teaching hospitals in China and to evaluate the hospitalization costs of these patients. Methods: This was a retrospective study and involved patients hospitalized for asthma exacerbation in 29 hospitals throughout China during 2013-2014. Information about the demographic features, conditions before the admission, the outcome, the complications, and the costs was collected using the pre-designed case report form. The influencing factors of the hospitalization costs were analyzed...
November 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#15
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29317840/an-antibiotic-stewardship-exercise-in-the-icu-building-a-treatment-algorithm-for-the-management-of-ventilator-associated-pneumonia-based-on-local-epidemiology-and-the-2016-infectious-diseases-society-of-america-american-thoracic-society-guidelines
#16
Lyn S Awad, Dania I Abdallah, Anas M Mugharbil, Tamima H Jisr, Nabila S Droubi, Nabila A El-Rajab, Rima A Moghnieh
Introduction: Management of ventilator-associated pneumonia (VAP), the most common infection in patients on mechanical ventilation, should be tailored to local microbiological data. The aim of this study was to determine susceptibility patterns of organisms causing VAP to develop a treatment algorithm based on these findings and evidence from the literature. Materials and methods: This is a retrospective analysis of the microbiological etiology of VAP in the intensive care unit (ICU) of a Lebanese tertiary care hospital from July 2015 to July 2016...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29315332/clinical-profile-and-outcomes-of-acute-cardiorenal-syndrome-type-5-in-sepsis-an-eight-year-cohort-study
#17
Saraschandra Vallabhajosyula, Ankit Sakhuja, Jeffrey B Geske, Mukesh Kumar, Rahul Kashyap, Kianoush Kashani, Jacob C Jentzer
BACKGROUND: To evaluate the clinical features and outcomes of acute cardiorenal syndrome type-5 in patients with severe sepsis and septic shock. METHODS: Historical cohort study of all adult patients with severe sepsis and septic shock admitted to the intensive care units (ICU) at Mayo Clinic Rochester from January 1, 2007 through December 31, 2014. Patients with prior renal or cardiac dysfunction were excluded. Patients were divided into groups with and without cardiorenal syndrome type-5...
2018: PloS One
https://www.readbyqxmd.com/read/29315320/association-of-day-4-cumulative-fluid-balance-with-mortality-in-critically-ill-patients-with-influenza-a-multicenter-retrospective-cohort-study-in-taiwan
#18
Wen-Cheng Chao, Chien-Hua Tseng, Ying-Chun Chien, Chau-Chyun Sheu, Ming-Ju Tsai, Wen-Feng Fang, Yu-Mu Chen, Kuo-Chin Kao, Han-Chung Hu, Wann-Cherng Perng, Kuang-Yao Yang, Wei-Chih Chen, Shinn-Jye Liang, Chieh-Liang Wu, Hao-Chien Wang, Ming-Cheng Chan
BACKGROUND: Fluid balance is a fundamental management of patients with sepsis, and this study aimed to investigate the impact of cumulative fluid balance on critically ill patients with influenza admitted to an intensive care unit (ICU). METHODS: This multicenter retrospective cohort study was conducted by the Taiwan Severe Influenza Research Consortium (TSIRC) which includes eight medical centers. Patients with virology-proven influenza infection admitted to ICUs between October 2015 and March 2016 were included for analysis...
2018: PloS One
https://www.readbyqxmd.com/read/29312706/hemorrhage-under-veno-venous-extracorporeal-membrane-oxygenation-in-acute-respiratory-distress-syndrome-patients-a-retrospective-data-analysis
#19
Stefan Kreyer, Thomas Muders, Nils Theuerkauf, Juliane Spitzhüttl, Torsten Schellhaas, Jens-Christian Schewe, Ulf Guenther, Hermann Wrigge, Christian Putensen
Background: Despite being still invasive and challenging, technical improvement has resulted in broader and more frequent application of extracorporeal membrane oxygenation (ECMO), to prevent hypoxemia and to reduce invasiveness of mechanical ventilation (MV). Heparin-coated ECMO-circuits are currently standard of care, in addition to heparin based anticoagulation (AC) regimen guided by activated clotting time (ACT) or activated partial thromboplastin time (aPTT). Despite these advances, a reliable prediction of hemorrhage is difficult and the risk of hemorrhagic complication remains unfortunately high...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310390/takotsubo-cardiomyopathy-caused-by-acute-respiratory-stress-from-extubation-a-case-report
#20
Kohei Taniguchi, Syogo Takashima, Ryo Iida, Koshi Ota, Masahiko Nitta, Kazushi Sakane, Tomohiro Fujisaka, Nobukazu Ishizaka, Osamu Umegaki, Kazuhisa Uchiyama, Akira Takasu
RATIONAL: Takotsubo cardiomyopathy (TCM) is a transient systolic dysfunction of the left ventricular apex without stenosis of coronary arteries and is induced by various psychological and physical factors. TCM sometimes causes lethal complications such as arrhythmia, thrombogenesis, and even cardiac rupture, and thus it should be diagnosed appropriately and managed carefully. Intensive care unit (ICU) patients are exposed to overstress during the treatment process and therefore can are at potential risk for TCM...
December 2017: Medicine (Baltimore)
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