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https://www.readbyqxmd.com/read/28936968/-progress-of-pain-assessment-and-analgesia-strategy-for-mechanical-ventilation-patients
#1
Qingdong Li, Xianyao Wan
Standardized pain assessment is a precondition of appropriate analgesia for mechanical ventilation patients. However, routine pain assessment rates remain very low in intensive care unit (ICU). Behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) can be used to assess pain in mechanical ventilation patients who are unable to report pain by themselves. No matter what strategy we taken, analgesia-first sedation should be used in priority. Meanwhile, patient-centered and goal-directed sedation strategy should be adopted based on the individual condition...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936967/-effect-of-sedation-on-respiratory-function-of-patients-undergoing-mechanical-ventilation
#2
Jie Yang, Yan Kang
Sedation and analgesia for ventilated patients is an important treatment in intensive care unit (ICU). Patients receiving mechanical ventilation therapy comfortably and safely can improve patient-ventilator synchrony, reduce ventilation-related lung injury (VILI), improve compliance, decrease oxygen consumption and stress, prevent accidents, and reduce the incidence of complications and mortality in critical patients. Although sedation may protect lung function, it also has a greater impact on respiratory function...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936966/-progress-of-mechanical-ventilation-during-cardiopulmonary-resuscitation
#3
Cai Wen, Tao Yu, Lixiang Wang
Mechanical ventilation is regarded as an effective means of replacing artificial ventilation during cardiopulmonary resuscitation (CPR), and has been widely used in the treatment of cardiac arrest (CA) patients. However, there are still some controversial issues remaining to be settled, such as the assessment of the effectiveness of mechanical ventilation, the selection of the optimal oxygen concentration (FiO2), tidal volume (VT), respiratory frequency, and mode of ventilation during the CPR process. The pros and cons of positive pressure ventilation are also inconclusive...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936962/-evaluation-of-the-effect-of-a-new-fixation-tape-for-tracheal-catheter-in-intensive-care-patients
#4
Limin Chen, Ruihong Liu, Biyu Shen, Lingling Wang, Zhiming Cui, Guanhua Xu
OBJECTIVE: To evaluate the effect of a new type of fixation tape for tracheal catheter in intensive care patients. METHODS: A purposive sampling study was conducted. Ninety patients experienced oral tracheal intubation for mechanical ventilation, and admitted to respiratory intensive care unit (ICU) of the Second Affiliated Hospital of Nantong University from November 2015 to February 2017 were enrolled. All the patients were randomly (random number) divided into the control group and the observation group with 45 patients in each group...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#5
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936952/-application-of-injection-test-in-confirming-the-ideal-position-of-esophageal-balloon-catheter
#6
Han Chen, Ming Xu, Yanlin Yang, Xuan He, Jianxin Zhou
OBJECTIVE: To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter. METHODS: A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936951/-preliminary-evaluation-of-sequential-therapy-by-high-flow-nasal-cannula-oxygen-therapy-following-endotracheal-tube-extubation-in-mechanically-ventilated-patients
#7
Zhengfang Zhu, Yuhao Liu, Qixing Wang, Sheng Wang
OBJECTIVE: To evaluate the feasibility and effect of sequential treatment by the heated humidified high flow nasal cannula oxygen therapy (HFNC) in mechanically ventilated patients following endotracheal tube extubation. METHODS: A prospective randomized controlled trial was conducted. Forty-nine patients with the sequential treatment after tracheal intubation extraction admitted to Department of Critical Care Medicine of Shanghai Tenth People's Hospital from January 1st to December 31st 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936712/early-goal-directed-nutrition-versus-standard-of-care-in-adult-intensive-care-patients-the-single-centre-randomised-outcome-assessor-blinded-eat-icu-trial
#8
Matilde Jo Allingstrup, Jens Kondrup, Jørgen Wiis, Casper Claudius, Ulf Gøttrup Pedersen, Rikke Hein-Rasmussen, Mads Rye Bjerregaard, Morten Steensen, Tom Hartvig Jensen, Theis Lange, Martin Bruun Madsen, Morten Hylander Møller, Anders Perner
PURPOSE: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. METHODS: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936698/recommendations-for-mechanical-ventilation-of-critically-ill-children-from-the-paediatric-mechanical-ventilation-consensus-conference-pemvecc
#9
Martin C J Kneyber, Daniele de Luca, Edoardo Calderini, Pierre-Henri Jarreau, Etienne Javouhey, Jesus Lopez-Herce, Jürg Hammer, Duncan Macrae, Dick G Markhorst, Alberto Medina, Marti Pons-Odena, Fabrizio Racca, Gerhard Wolf, Paolo Biban, Joe Brierley, Peter C Rimensberger
PURPOSE: Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. METHODS: The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936695/early-application-of-airway-pressure-release-ventilation-may-reduce-the-duration-of-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#10
Yongfang Zhou, Xiaodong Jin, Yinxia Lv, Peng Wang, Yunqing Yang, Guopeng Liang, Bo Wang, Yan Kang
PURPOSE: Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936678/biomarker-based-strategy-for-early-discontinuation-of-empirical-antifungal-treatment-in-critically-ill-patients-a-randomized-controlled-trial
#11
Anahita Rouzé, Séverine Loridant, Julien Poissy, Benoit Dervaux, Boualem Sendid, Marjorie Cornu, Saad Nseir
PURPOSE: The aim of this study was to determine the impact of a biomarker-based strategy on early discontinuation of empirical antifungal treatment. METHODS: Prospective randomized controlled single-center unblinded study, performed in a mixed ICU. A total of 110 patients were randomly assigned to a strategy in which empirical antifungal treatment duration was determined by (1,3)-β-D-glucan, mannan, and anti-mannan serum assays, performed on day 0 and day 4; or to a routine care strategy, based on international guidelines, which recommend 14 days of treatment...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936675/reconnection-to-mechanical-ventilation-for-1%C3%A2-h-after-a-successful-spontaneous-breathing-trial-reduces-reintubation-in-critically-ill-patients-a-multicenter-randomized-controlled-trial
#12
M Mar Fernandez, Alejandro González-Castro, Monica Magret, M Teresa Bouza, Marcos Ibañez, Carolina García, Begoña Balerdi, Arantxa Mas, Vanesa Arauzo, José M Añón, Francisco Ruiz, José Ferreres, Roser Tomás, Marta Alabert, Ana Isabel Tizón, Susana Altaba, Noemi Llamas, Rafael Fernandez
BACKGROUND: Spontaneous breathing trials (SBT) can be exhausting, but the preventive role of rest has never been studied. This study aimed to evaluate whether reconnection to mechanical ventilation (MV) for 1 h after the effort of a successful SBT could reduce the need for reintubation in critically ill patients. METHODS: Randomized multicenter trial conducted in 17 Spanish medical-surgical intensive care units (Oct 2013-Jan 2015). Patients under MV for longer than 12 h who fulfilled criteria for planned extubation were randomly allocated after a successful SBT to direct extubation (control group) or reconnection to the ventilator for a 1-h rest before extubation (rest group)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936613/chronic-inflammatory-demyelinating-polyradiculoneuropathy-and-anesthesia-a-case-series
#13
Andrew R Mortenson, Juraj Sprung, James C Watson, P James B Dyck, Toby N Weingarten
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired autoimmune demyelinating polyneuropathy characterized by symmetrical diffuse weakness that also can rarely affect bulbar and respiratory muscles. The study objective was to describe perioperative outcomes of patients with CIDP who received general anesthesia. This retrospective observational study evaluated patients with active (diagnosed or treated within the previous year) CIDP who underwent general anesthesia at our institution between January 1, 2010, and December 31, 2015...
September 21, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/28936597/terminal-weaning-or-immediate-extubation-for-withdrawing-mechanical-ventilation-in-critically-ill-patients-the-arreve-observational-study
#14
René Robert, Amélie Le Gouge, Nancy Kentish-Barnes, Alice Cottereau, Bruno Giraudeau, Mélanie Adda, Djillali Annane, Juliette Audibert, François Barbier, Patrick Bardou, Simon Bourcier, Jeremy Bourenne, Alexandre Boyer, François Brenas, Vincent Das, Arnaud Desachy, Jérôme Devaquet, Marc Feissel, Frédérique Ganster, Maïté Garrouste-Orgeas, Guillaume Grillet, Olivier Guisset, Rebecca Hamidfar-Roy, Anne-Claire Hyacinthe, Sebastien Jochmans, Mercé Jourdain, Alexandre Lautrette, Nicolas Lerolle, Olivier Lesieur, Fabien Lion, Philippe Mateu, Bruno Megarbane, Sybille Merceron, Emmanuelle Mercier, Jonathan Messika, Paul Morin-Longuet, Bénédicte Philippon-Jouve, Jean-Pierre Quenot, Anne Renault, Xavier Repesse, Jean-Philippe Rigaud, Ségolène Robin, Antoine Roquilly, Amélie Seguin, Didier Thevenin, Patrice Tirot, Isabelle Vinatier, Elie Azoulay, Jean Reignier
PURPOSE: The relative merits of immediate extubation versus terminal weaning for mechanical ventilation withdrawal are controversial, particularly regarding the experience of patients and relatives. METHODS: This prospective observational multicentre study (ARREVE) was done in 43 French ICUs to compare terminal weaning and immediate extubation, as chosen by the ICU team. Terminal weaning was a gradual decrease in the amount of ventilatory assistance and immediate extubation was extubation without any previous decrease in ventilatory assistance...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28935558/immediate-interruption-of-sedation-compared-with-usual-sedation-care-in-critically-ill-postoperative-patients-sos-ventilation-a-randomised-parallel-group-clinical-trial
#15
Gerald Chanques, Matthieu Conseil, Claire Roger, Jean-Michel Constantin, Albert Prades, Julie Carr, Laurent Muller, Boris Jung, Fouad Belafia, Moussa Cissé, Jean-Marc Delay, Audrey de Jong, Jean-Yves Lefrant, Emmanuel Futier, Grégoire Mercier, Nicolas Molinari, Samir Jaber
BACKGROUND: Avoidance of excessive sedation and subsequent prolonged mechanical ventilation in intensive care units (ICUs) is recommended, but no data are available for critically ill postoperative patients. We hypothesised that in such patients stopping sedation immediately after admission to the ICU could reduce unnecessary sedation and improve patient outcomes. METHODS: We did a randomised, parallel-group, clinical trial at three ICUs in France. Stratified randomisation with minimisation (1:1 via a restricted web platform) was used to assign eligible patients (aged ≥18 years, admitted to an ICU after abdominal surgery, and expected to require at least 12 h of mechanical ventilation because of a critical illness defined by a Sequential Organ Failure Assessment score >1 for any organ, but without severe acute respiratory distress syndrome or brain injury) to usual sedation care provided according to recommended practices (control group) or to immediate interruption of sedation (intervention group)...
September 18, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28935428/predictive-factors-for-the-outcome-of-high-flow-nasal-cannula-therapy-in-a-pediatric-intensive-care-unit-is-the-spo2-fio2-ratio-useful
#16
Fulya Kamit Can, Ayşe Berna Anil, Murat Anil, Neslihan Zengin, Fatih Durak, Caner Alparslan, Zeynep Goc
OBJECTIVES: To determine the predictive factors for the outcome of high-flow nasal cannula (HFNC) therapy in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: We prospectively included all patients with acute respiratory distress/failure aged 1month to 18years who were admitted to the PICU between January 2015 and May 2016 and treated with HFNC as a primary support and for postextubation according to our pre-established protocol. HFNC failure was defined as the need for escalation to non-invasive ventilation (NIV) or invasive mechanical ventilation (MV)...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28933178/-nosocomial-pneumonia
#17
Jana Skřičková
Nosocomial pneumonia (hospital-acquired pneumonia - HAP) is the form of pneumonia the symptoms of which present after more than 2 days (> 48 hours) of admission to hospital or as late as 14 days of discharge from hospital. The HAP pneumonias represent 13-18 % of all nosocomial infections. Incidence of HAP is the most frequent in mechanically ventilated patients. The type and representation of HAP agents primarily depends on the length of a patients stay in hospital and on their condition and character of treatment...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28932567/respiratory-support-with-venovenous-extracorporeal-membrane-oxygenation-during-stent-placement-for-the-palliation-of-critical-airway-obstruction-case-series-analysis
#18
Jung-Hoon Park, Ji Hoon Shin, Kun Yung Kim, Ju Yong Lim, Pyeong Hwa Kim, Jiaywei Tsauo, Min Tae Kim, Ho-Young Song
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV ECMO) is used to support gas transfer of patients suffering from respiratory failure during various procedures. The purpose of this study was to evaluate the technical feasibility and safety of fluoroscopic stent placement under respiratory support with VV ECMO in patients with critical airway obstructions. METHODS: We reviewed the records of 17 patients (14 male and 3 female; mean age: 63 years; range, 30-82 years) who underwent self-expandable metallic stent (SEMS) placement under VV ECMO respiratory support for critical airway obstruction caused by malignant (n=16) or benign (n=1) etiology...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28932552/chylothorax-after-pediatric-cardiac-surgery-complicates-short-term-but-not-long-term-outcomes-a-propensity-matched-analysis
#19
Nikoletta R Czobor, György Roth, Zsolt Prodán, Daniel J Lex, Erzsébet Sápi, László Ablonczy, Mihály Gergely, Edgar A Székely, János Gál, Andrea Székely
BACKGROUND: The occurrence of postoperative chylothorax in children with congenital heart disease is a rare and serious complication in cardiac intensive care units (ICUs). The aim of our study was to identify the perioperative characteristics, treatment options, resource utilization and long term complications of patients having chylothorax after a pediatric cardiac surgery. METHODS: Patients were retrospectively assessed for the presence of chylothorax between January 2002 and December 2012 in a tertiary national cardiac center...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931718/solar-powered-ventilation-of-african-termite-mounds
#20
Samuel A Ocko, Hunter King, David Andreen, Paul Bardunias, J Scott Turner, Rupert Soar, L Mahadevan
How termite mounds function to facilitate climate control is still only partially understood. Recent experimental evidence in the mounds of a single species, the south Asian termite Odontotermes obesus, suggests that the daily oscillations of radiant heating associated with diurnal insolation patterns drive convective flow within them. How general this mechanism is remains unknown. To probe this, we consider the mounds of the African termite Macrotermes michaelseni, which thrives in a very different environment...
September 15, 2017: Journal of Experimental Biology
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