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https://www.readbyqxmd.com/read/27903130/risk-factors-and-mortality-in-the-carbapenem-resistant-klebsiella-pneumoniae-infection-case-control-study
#1
Fethiye Akgul, Ilkay Bozkurt, Mustafa Sunbul, Saban Esen, Hakan Leblebicioglu
Carbapenem-resistant Klebsiella pneumoniae (CRKP) has been known as a nosocomial pathogen, both for the last 10 years in Turkey and for 20 years worldwide. Due to limited treatment options and high mortality rates, despite improvements in the field of medicine at the present time, CRKP is still a big threat for public health. This study was carried out between the dates of January 2010 and September 2014. Patients ≥18 who were hospitalized for at least 72 h and who also had CRKP growth were included in the study as a case group...
December 1, 2016: Pathogens and Global Health
https://www.readbyqxmd.com/read/27899532/long-term-management-for-ventilator-assisted-children-in-hong-kong-2-decades-experience
#2
Shuk-Kuen Chau, Ada Wing-Yan Yung, So-Lun Lee
BACKGROUND: The population of children receiving long-term mechanical ventilation is growing worldwide, but only limited data exist in Asian regions. The objective of the study was to review the management of these children in Hong Kong over the past 2 decades. METHODS: This was a retrospective cohort study. Hospital records from subjects receiving mechanical ventilation for >3 months were retrieved. Demographic characteristics and medical information of subjects (≤21 y old) under the care of the ventilator program at the Duchess of Kent Children's Hospital between 1997 and 2015 were reviewed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27876258/normal-saline-instillation-before-suctioning-a-meta-analysis-of-randomized-controlled-trials
#3
Chia-Hui Wang, Jui-Chen Tsai, Shu-Fen Chen, Chien-Ling Su, Lawrence Chen, Chao-Chun Lin, Ka-Wai Tam
BACKGROUND: For airway management of intensive care unit (ICU) patients who are intubated, a 5-10-mL bolus of sterile normal saline (NS) solution is commonly instilled into an endotracheal or tracheostomy tube before suctioning. However, NS instillation has been associated with adverse events such as dyspnea, increasing heart rate, decreasing of oxygenation, blood pressure, and other vital parameters. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the necessity of NS instillation before suctioning in ICU patients...
November 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27872994/outcomes-of-tracheostomy-in-children-requiring-surgery-for-congenital-heart-disease
#4
Laura A Ortmann, Winston M Manimtim, Charisse I Lachica
Outcomes after discharge in children requiring tracheostomy after cardiac surgery have not been fully described. A retrospective, single-center study was performed on all children <18 years of age requiring both tracheostomy and surgery for congenital heart disease from January 2002 to May 2015. Forty-six tracheostomies were placed after surgery and four before. Single-ventricle anatomy was present in 12 (33%) patients. Incidence of tracheostomy after heart surgery increased from 0.8% the first half of the study period to 2% the second half...
November 21, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27865477/tracheostomy-among-infants-with-hypoplastic-left-heart-syndrome-undergoing-cardiac-operations-a-multicenter-analysis
#5
Parthak Prodhan, Amit Agarwal, Nahed O ElHassan, Elijah H Bolin, Brandon Beam, Xiomara Garcia, Michael Gaies, Xinyu Tang
BACKGROUND: Less than 2.7% of infants undergoing congenital heart disease operations have difficulty weaning from invasive mechanical ventilation. In such instances, clinicians may choose to perform tracheostomy. Limited literature has examined tracheostomy placement specifically in infants with hypoplastic left heart syndrome (HLHS). This study evaluated the risk factors for tracheostomy placement in infants with HLHS and examined the outcomes of these infants before their first hospital discharge...
November 16, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27864126/the-use-of-life-sustaining-procedures-in-the-last-month-of-life-is-associated-with-more-depressive-symptoms-in-surviving-spouses
#6
Katherine A Ornstein, Melissa D Aldridge, Melissa M Garrido, Rebecca Gorges, Evan Bollens-Lund, Albert L Siu, Kenneth M Langa, Amy S Kelley
CONTEXT: Family caregivers of individuals with serious illness who undergo intensive life-sustaining medical procedures at the end of life may be at risk of negative consequences including depression. OBJECTIVE: To determine the association between patients' use of life-sustaining procedures at the end of life and depressive symptoms in their surviving spouses. METHODS: We used data from the Health and Retirement Study, a longitudinal survey of U...
November 15, 2016: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/27852959/percutaneous-dilatational-tracheostomy-in-ankylosing-spondylitis-bechterew-disease-is-feasible-and-not-associated-with-higher-complication-rates
#7
Uwe Hamsen, Oliver Kamp, Chris Kaczmarek, Mirko Aach, Christian Waydhas, Thomas A Schildhauer, Oliver Jansen
BACKGROUND: Ankylosing spondylitis (AS) is a common disease with an incidence of approximately 0.5% in Europe, causing severe limitations of axial spine mobility and cervical kyphosis. Deformities of the cervical spine and the temporomandibular joints could increase the risk of complications while performing an intubation or tracheostomy. The percutaneous dilatational tracheostomy (PDT) is a standard procedure in intensive care medicine. However, the combination of cervical kyphosis and osteoporosis makes patient positioning challenging...
November 15, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27837046/c1-esterase-inhibitor-berinert-for-ace-inhibitor-induced-angioedema-two-case-reports
#8
Maria Leibfried, Alexandra Kovary
OBJECTIVE: To describe 2 cases of angiotensin-converting enzyme inhibitor (ACEI)-induced angioedema treated with C1 esterase inhibitor (human) [Berinert]. SUMMARY: Case 1 is a 60-year-old Caucasian male with angioedema from lisinopril. He was initially treated with a conventional regimen of an antihistamine, methylprednisolone, epinephrine, and fresh frozen plasma. When symptoms did not resolve, intravenous C1 peptide esterase inhibitor (C1INH) was administered, with clinical improvement...
November 11, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27833492/submandibular-intubation-in-awake-patient-of-panfacial-trauma
#9
S K Kamra, H K Khandavilli, P Banerjee
Maxillofacial trauma patients present with airway problems. Submandibular intubation is an effective means of intubation to avoid tracheostomy for operative procedures. Airway is secured with oral endotracheal intubation in paralyzed patient and tube is then transplaced in sub mental or submandibular region. However there may be instances when paralyzing such trauma patients is not safe and short term tracheostomy is the only airway channel available for conduction of anesthesia. We report a case of submandibular intubation in awake patient of maxillofacial trauma with anticipated intubation problems...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27833343/distraction-osteogenesis-for-management-of-severe-osa-in-pierre-robin-sequence-an-approach-to-elude-tracheostomy-in-infants
#10
N K Sahoo, I D Roy, Shamsher Dalal, Amit Bhandari
BACKGROUND: Severe obstructive sleep apnoea (OSA) is a life threatening condition associated with Pierre Robin sequence (PRS) due to mandibular micrognathia and glossoptosis. Often these patients require tracheostomy at an early age which has high morbidity. Distraction osteogenesis (DO) is an accepted method of treatment for patients with hypoplastic mandible to achieve mandibular lengthening without need for a bone graft. It has also been used in respiratory distressed neonates and infants to avoid tracheostomy...
December 2016: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/27828898/pediatric-ventilator-associated-infections-the-ventilator-associated-infection-study
#11
Douglas F Willson, Michelle Hoot, Robinder Khemani, Christopher Carrol, Aileen Kirby, Adam Schwarz, Rainer Gedeit, Sholeen T Nett, Simon Erickson, Heidi Flori, Spencer Hays, Mark Hall
OBJECTIVE: Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes. DESIGN: Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia...
November 8, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27807115/subclassification-of-gmfcs-level-5-cerebral-palsy-as-a-predictor-of-complications-and-health-related-quality-of-life-after-spinal-arthrodesis
#12
Amit Jain, Paul D Sponseller, Suken A Shah, Amer Samdani, Patrick J Cahill, Burt Yaszay, Dolores B Njoku, Mark F Abel, Peter O Newton, Michelle C Marks, Unni G Narayanan
BACKGROUND: The Gross Motor Function Classification System (GMFCS) of cerebral palsy categorizes patients by mobility. Patients at GMFCS level 5 are considered the most disabled and at high risk of hip and spine problems, yet they represent a wide spectrum of function. Our aim was to subclassify patients at GMFCS level 5 who underwent spinal arthrodesis on the basis of central neuromotor impairments and to assess whether subclassification predicted postoperative complications and changes in health-related quality of life...
November 2, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27785098/single-shot-lamina-thoracic-paravertebral-block-with-ketofol-for-modified-radical-mastectomy
#13
Ambrose Rukewe, Oludolapo O Afuwape, Austin Ugheoke, Akinola A Fatiregun
We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB...
2016: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/27780384/predicting-feeding-tube-and-tracheotomy-dependence-in-laryngeal-cancer-patients
#14
John Patrick Lavo, David Ludlow, Matt Morgan, Gloria Caldito, Cherie-Ann Nathan
CONCLUSIONS: The two scales reliably measure laryngeal edema and dysfunction in laryngeal cancer patients. The eight categories from these scales, and abnormal pharyngeal squeeze, can be used to form a new rating scale intended to help clinicians identify and circumvent swallowing complications after chemo-irradiation. OBJECTIVES: The objectives were to compare two laryngeal edema rating scales in laryngeal cancer patients and determine if post-radiation +/- chemotherapy edema predicts dependence on a feeding tube and/or tracheostomy...
October 26, 2016: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/27776743/open-airway-reconstruction-in-adults-outcomes-and-prognostic-factors
#15
Marianne Abouyared, Mikhaylo Szczupak, Eric Barbarite, Zoukaa B Sargi, David E Rosow
PURPOSE: The purpose was to assess the success of open tracheal resection and re-anastomosis for non-malignant tracheal stenosis in adults. Successful operations were defined as T-tube or tracheostomy-free status by 6months post-operatively. MATERIALS AND METHODS: Retrospective chart review was performed and data were recorded in a de-identified manner. The primary outcome was T-tube or tracheostomy-free status by 6months following tracheal resection. Clinical and demographic characteristics were evaluated as potential prognostic variables...
September 7, 2016: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/27768853/retrospective-analysis-of-factors-leading-to-tracheostomy-decannulation-failure-a-single-institution-experience
#16
Anuja Bandyopadhyay, A Ioana Cristea, Stephanie D Davis, Veda L Ackerman, James E Slaven, Hasnaa E Jalou, Deborah C Givan, Ameet Daftary
RATIONALE: There is a lack of evidence regarding factors associated with failure of tracheostomy decannulation. OBJECTIVES: We aimed to identify characteristics of pediatric patients who fail a tracheostomy decannulation challenge Methods: A retrospective review was performed on all patients who had a decannulation challenge at a tertiary care center from June 2006 to October 2013. Tracheostomy decannulation failure was defined as reinsertion of the tracheostomy tube within 6 months of the challenge...
October 21, 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27766714/clinical-significance-of-differentiating-post-intubation-and-post-tracheostomy-tracheal-stenosis
#17
Beomsu Shin, Kang Kim, Byeong-Ho Jeong, Jung Seop Eom, Won Jun Song, Hyung Koo Kang, Hojoong Kim
BACKGROUND AND OBJECTIVE: Post-intubation tracheal stenosis (PITS) and post-tracheostomy tracheal stenosis (PTTS) are serious complications in mechanically ventilated patients. Although the aetiologies and mechanisms of PITS and PTTS are quite different, little is known about the clinical impact of differentiating one from the other. METHODS: We retrospectively conducted a chart review of 117 patients with PITS and 88 patients with PTTS who were treated with interventional bronchoscopy at Samsung Medical Center between January 2004 and December 2013...
October 21, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27763701/alternative-methods-of-lung-isolation-in-cases-of-pediatric-bilateral-thoracoscopic-surgery
#18
Mark Wigginton, Laura Lehrian
We compare airway management and lung isolation methods in two pediatric cases of congenital central hypoventilation syndrome undergoing bilateral throacoscopic phrenic-nerve-stimulator surgery. One child received lung isolation using a 7Fr bronchial blocker in conjunction with a 6.0 cuffed endotracheal tube; and the second received a technique of endobronchial intubation using a 3.5 microcuffed tube via the tracheostomy stoma in conjunction with 5.0 cuffed endotracheal intubation; a technique previously undescribed in pediatric patients...
December 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27759914/a-retrospective-case-series-of-318-tracheostomy-related-adverse-events-over-6-years-a-scottish-context
#19
Harriet Mortimer, Haytham Kubba
The National Confidential Enquiry into Patient Outcome and Death recently conducted a large, robust study investigating tracheostomy care for patients in England, Wales and Northern Ireland. They found up to 31% of tracheostomy patients experience a complication at some stage in their care, many of which were serious. This study aims to explore the nature of adverse events and complications affecting tracheostomy patients across the diverse hospitals of NHS Greater Glasgow and Clyde (NHSGGC) including both adult and paediatric populations over a 6-year period between 2008 and 2014...
October 19, 2016: Clinical Otolaryngology
https://www.readbyqxmd.com/read/27756433/communicating-with-conscious-and-mechanically-ventilated-critically-ill-patients-a-systematic-review
#20
S Ten Hoorn, P W Elbers, A R Girbes, P R Tuinman
BACKGROUND: Ventilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently used in ICU patients. We summarized the current evidence on communication methods with mechanically ventilated patients in the ICU. Secondly, we developed an algorithm for communication with these patients based on current evidence. METHODS: We performed a systematic review...
October 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
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