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https://www.readbyqxmd.com/read/28742783/end-expiratory-occlusion-test-predicts-fluid-responsiveness-in-patients-with-protective-ventilation-in-the-operating-room
#1
Matthieu Biais, Mathilde Larghi, Jeremy Henriot, Hugues de Courson, Musa Sesay, Karine Nouette-Gaulain
BACKGROUND: End-expiratory occlusion test (EEOT) has been proposed to predict fluid responsiveness in mechanically ventilated intensive care unit patients. The utility of this test during low-tidal-volume ventilation remains uncertain. This study aimed to determine whether hemodynamic variations induced by EEOT could predict the effect of volume expansion in patients with protective ventilation in the operating room. METHODS: Forty-one patients undergoing neurosurgery were included...
July 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742775/estimation-of-stroke-volume-and-stroke-volume-changes-by-electrical-impedance-tomography
#2
Fernando José da Silva Ramos, André Hovnanian, Rogério Souza, Luciano C P Azevedo, Marcelo B P Amato, Eduardo L V Costa
BACKGROUND: Electrical impedance tomography (EIT) is a noninvasive imaging method that identifies changes in air and blood volume based on thoracic impedance changes. Recently, there has been growing interest in EIT to measure stroke volume (SV). The objectives of this study are as follows: (1) to evaluate the ability of systolic impedance variations (ΔZsys) to track changes in SV in relation to a baseline condition; (2) to assess the relationship of ΔZsys and SV in experimental subjects; and (3) to identify the influence of body dimensions on the relationship between ΔZsys and SV...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#3
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742539/translating-evidence-into-practice-in-acute-respiratory-distress-syndrome-teamwork-clinical-decision-support-and-behavioral-economic-interventions
#4
Michael W Sjoding
PURPOSE OF REVIEW: Although the treatment of the acute respiratory distress syndrome (ARDS) with low tidal volume (LTV) mechanical ventilation improves mortality, it is not consistently administered in clinical practice. This review examines strategies to improve LTV and other evidence-based therapies for patients with ARDS. RECENT FINDINGS: Despite the well established role of LTV in the treatment of ARDS, a recent multinational study suggests it is under-utilized in clinical practice...
July 22, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28742524/early-postnatal-echocardiographic-assessment-of-pulmonary-blood-flow-in-newborns-with-congenital-diaphragmatic-hernia
#5
Florian Kipfmueller, Katrin Heindel, Lukas Schroeder, Christoph Berg, Oliver Dewald, Heiko Reutter, Peter Bartmann, Andreas Mueller
OBJECTIVE: Echocardiography is the most important tool to assess infants with congenital diaphragmatic hernia (CDH) for pulmonary hypertension (PH). The pattern of blood flow in the pulmonary artery [described as time to peak velocity (TPV)/right ventricular ejection time (RVET) ratio] provides distinct information about pulmonary arterial pressure. The aim of our study was to investigate the correlation of TPV/RVET measurements with the most commonly used classification system for PH in CDH newborns and the association of these measurements with outcome parameters...
July 25, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28742188/sp%C3%A3-dbarnsbotulism-%C3%A2-sk%C3%A3-l-att-inte-ge-honung-till-barn-under-ett-%C3%A3-r
#6
Sverre Wikström, Elisabet Holst
Infant botulism - why honey should be avoided for children up to one year Infant botulism means that Clostridium botulinum colonize and produce toxin in the infant gut, usually during the first year of life. Illness severity varies widely and the incidence may be under-estimated. Infant botulism should be considered in cases of acute muscle weakness or floppiness in infants, especially when accompanied by constipation or feeding difficulties. Respiratory failure and need for mechanical ventilation is common, but full recovery is gradually obtained...
July 24, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28742105/long-term-risk-of-dementia-after-acute-respiratory-failure-requiring-intensive-care-unit-admission
#7
Chih-Cheng Lai, Chung-Han Ho, Chin-Ming Chen, Shyh-Ren Chiang, Chien-Ming Chao, Wei-Lun Liu, Yu-Chieh Lin, Jhi-Joung Wang, Kuo-Chen Cheng
This retrospective, population-based cohort study aims to investigate the long-term risk of newly diagnosed dementia in patients discharged for acute respiratory failure that required mechanical ventilation (MV) and intensive care unit (ICU) admission. From the Taiwan National Health Insurance Research Database, first-time ICU patients using MV between June 1, 1998, and December 31, 2012, were enrolled, and they were followed-up until the earliest onset of one of our two endpoints: a new diagnosis of dementia (primary endpoint), or the end of the study...
2017: PloS One
https://www.readbyqxmd.com/read/28741665/remote-ischemic-preconditioning-and-clinical-outcomes-in-on-pump-coronary-artery-bypass-grafting-a-meta-analysis-of-14-randomized-controlled-trials
#8
Bin Yi, Jianhui Wang, Dingwu Yi, Yanling Zhu, Yumei Jiang, Yi Li, Shaoyan Mo, Yi Liu, Jian Rong
The purpose of this article is to perform the first pooled analysis on remote ischemic preconditioning (RIPC) used for the improvement of clinical outcomes of patients only undergoing on-pump coronary artery bypass grafting (CABG) in randomized controlled trials (RCTs). A systematic search was performed using PubMed, the Cochrane Library, and the Web of Science to identify studies that described the effect of RIPC on postoperative mortality in patients only undergoing on-pump CABG. The outcomes included postoperative mortality, postoperative morbidity (including incidence of myocardial infarction, atrial fibrillation, stroke, acute kidney injury, and renal replacement therapy), mechanical ventilation (MV), intensive care unit length of stay (ICU LOS), and hospital length of stay (HLOS)...
July 25, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28741335/cardiopulmonary-bypass-time-every-minute-counts
#9
Sudharsan Madhavan, Siew-Pang Chan, Wei-Chuan Tan, Jolane Eng, Bowen Li, Hai-Dong Luo, Leok-Kheng K Teoh
BACKGROUND: This study was conducted to examine the impact of CPB times on post-operative outcomes. We sought to determine the optimum cut-offs of CPB per graft time and cumulative CPB time and their predictive accuracy for mortality in conjunction with EuroSCORE II. METHODS: The de-identified data of 1,960 patients who had undergone isolated on-pump CABG from 2009 to 2014 were analyzed. The risk strata of CPB/graft and cumulative CPB times, identified with a decision tree, were added into an augmented model for predicting short- and intermediate-term post-operative clinical events...
July 24, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28741229/inhaled-antimicrobials-for-ventilator-associated-pneumonia-practical-aspects
#10
Garyphallia Poulakou, Dimitrios K Matthaiou, David P Nicolau, Georgios Siakallis, George Dimopoulos
Positive experience with inhaled antibiotics in pulmonary infections of patients with cystic fibrosis has paved the way for their utilization in mechanically ventilated, critically ill patients with lower respiratory tract infections. A successful antibiotic delivery depends upon the size of the generated particle and the elimination of drug impaction in the large airways and the ventilator circuit. Generated droplet size is mainly affected by the type of the nebulizer employed. Currently, jet, ultrasonic, and vibrating mesh nebulizers are marketed; the latter can deliver optimal antibiotic particle size...
July 24, 2017: Drugs
https://www.readbyqxmd.com/read/28741217/effects-of-non-invasive-ventilation-in-patients-with-acute-respiratory-failure-excluding-post-extubation-respiratory-failure-cardiogenic-pulmonary-edema-and-exacerbation-of-copd-a-systematic-review-and-meta-analysis
#11
Yutaka Kondo, Junji Kumasawa, Atsushi Kawaguchi, Ryutaro Seo, Eishu Nango, Satoru Hashimoto
BACKGROUND: This meta-analysis compared the effects of non-invasive ventilation (NIV) with invasive mechanical ventilation (InMV) and standard oxygen (O2) therapy on mortality and rate of tracheal intubation in patients presenting acute respiratory failure (ARF). METHODS: We searched the MEDLINE, EMBASE and Cochrane Central Register of clinical trials databases between 1949 and May 2015 to identify randomized trials of NIV for ARF. We excluded the ARF caused by extubation, cardiogenic pulmonary edema, and COPD...
July 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28740714/aortic-valve-replacement-in-patients-with-a-left-ventricular-ejection-fraction-%C3%A2-35-performed-via-a-minimally-invasive-right-thoracotomy
#12
Orlando Santana, Steve Xydas, Roy F Williams, Angelo La Pietra, Maurice Mawad, Vicente Behrens, Esteban Escolar, Christos G Mihos
BACKGROUND: We evaluated the outcomes of patients with aortic valve pathology in the setting of a left ventricular ejection fraction ≤35% who underwent minimally invasive aortic valve replacement (AVR), with or without concomitant mitral valve (MV) surgery. METHODS: All minimally invasive AVR in patients with a left ventricular ejection fraction ≤35%, performed via a right thoracotomy for aortic stenosis or regurgitation between January 2009 and March 2013, were retrospectively evaluated...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740710/percutaneous-coronary-intervention-followed-by-minimally-invasive-valve-surgery-compared-with-median-sternotomy-coronary-artery-bypass-graft-and-valve-surgery-in-patients-with-prior-cardiac-surgery
#13
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Jason C Wigley, Nirat Beohar, Christos G Mihos
BACKGROUND: In patients with prior cardiac surgery requiring re-operative coronary and valve surgery, a hybrid approach of percutaneous coronary intervention followed by minimally invasive valve surgery (PCI + MIVS) may be an alternative to the standard median sternotomy coronary artery bypass and valve surgery (CABG + valve). METHODS: The outcomes of patients with prior cardiac surgery, presenting with coronary artery and valvular disease, who underwent PCI + MIVS (N=39) were retrospectively compared with those who underwent CABG + valve (N=28) via a repeat median sternotomy, between February 2009 and April 2014...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740640/effects-of-early-administration-of-acetazolamide-on-the-duration-of-mechanical-ventilation-in-patients-with-chronic-obstructive-pulmonary-disease-still-far-from-the-truth
#14
EDITORIAL
Mabrouk Bahloul, Rania Ammar, Abir Bouattour, Samar Bellil, Hedi Chelly, Anis Chaari, Mounir Bouaziz
No abstract text is available yet for this article.
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740479/non-ischemic-cerebral-energy-dysfunction-at-the-early-brain-injury-phase-following-aneurysmal-subarachnoid-hemorrhage
#15
Laurent Carteron, Camille Patet, Daria Solari, Mahmoud Messerer, Roy T Daniel, Philippe Eckert, Reto Meuli, Mauro Oddo
BACKGROUND: The pathophysiology of early brain injury following aneurysmal subarachnoid hemorrhage (SAH) is still not completely understood. OBJECTIVE: Using brain perfusion CT (PCT) and cerebral microdialysis (CMD), we examined whether non-ischemic cerebral energy dysfunction may be a pathogenic determinant of EBI. METHODS: A total of 21 PCTs were performed (a median of 41 h from ictus onset) among a cohort of 18 comatose mechanically ventilated SAH patients (mean age 58 years, median admission WFNS score 4) who underwent CMD and brain tissue PO2 (PbtO2) monitoring...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28738709/nebulized-hypertonic-saline-to-prevent-ventilator-associated-pneumonia-in-premature-infants-a-randomized-trial
#16
Zahra Ezzeldin, Yasmeen Mansi, Mervat Gaber, Rania Zakaria, Rehab Fawzy, Mohamed A Mohamed
BACKGROUND/OBJECTIVES: Ventilator associated pneumonia (VAP) is a leading cause of death. Nebulized hypertonic saline solution (HSS) has been used to improve pulmonary clearance and reduce infection in intubated patients. This study examines whether nebulized HSS may reduce VAP in intubated premature infants. METHODS: We analyzed results of 100 intubated premature infants who completed the study. Infants were divided into the "Control" group where VAP prevention protocol was implemented and the "Intervention" group where nebulized HSS twice daily was added to the package of care...
July 24, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#17
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737191/-stress-in-parents-of-hospitalized-newborns-in-a-neonatal-intensive-care-unit
#18
Elisa Palma I, Fernanda Von Wussow K, Ignacia Morales B, Javier Cifuentes R, Sergio Ambiado T
The birth of a child that requires hospitalization in a Neonatal Intensive Care Unit (NICU) can be very stressful for parents. OBJECTIVE: To determine the stress level of parents of newborns (NB) hospitalized in a level III NICU in Santiago, and its association with clinical and sociodemographic variables. PATIENTS AND METHOD: Descriptive cross-sectional study. 373 admissions were evaluated. The sampling was non-probabilistic and included parents of RN admitted to the UPCN between 7 and 21 days of hospitalization...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28737047/the-role-of-mucoactive-agents-in-the-mechanically-ventilated-patient-a-review-of-the-literature
#19
Bradley L Icard, Edmundo Rubio
The management of airway secretions in the mechanically ventilated patient is a routine task throughout all intensive care units. The current treatment strategies are primarily based on anecdotal experiences rather than statistical evidence. Areas Covered: This review article evaluates the data from published trials surrounding mucoactive agents and their use in the critically ill patient population. We completed an extensive search through PUBMED and CINAHL via EBSCO, along with the Cochran library to find all trials using mucoactive agents in the critically ill patient population...
July 24, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28736528/linking-ventilator-injury-induced-leak-across-the-blood-gas-barrier-to-derangements-in-murine-lung-function
#20
Bradford J Smith, Elizabeth Bartolak-Suki, Bela Suki, Gregory S Roy, Katharine L Hamlington, Chantel M Charlebois, Jason H T Bates
Mechanical ventilation is vital to the management of acute respiratory distress syndrome, but it frequently leads to ventilator-induced lung injury (VILI). Understanding the pathophysiological processes involved in the development of VILI is an essential prerequisite for improving lung-protective ventilation strategies. The goal of this study was to relate the amount and nature of material accumulated in the airspaces to biomarkers of injury and the derecruitment behavior of the lung in VILI. Forty-nine BALB/c mice were mechanically ventilated with combinations of tidal volume and end-expiratory pressures to produce varying degrees of overdistension and atelectasis while lung function was periodically assessed...
2017: Frontiers in Physiology
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