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https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#1
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Parth Solanki, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
BACKGROUND: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients. METHODS: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28329284/contemporary-outcome-of-unplanned-right-ventricular-assist-device-for-severe-right-heart-failure-after-continuous-flow-left-ventricular-assist-device-insertion
#2
Daisuke Yoshioka, Hiroo Takayama, Reshad A Garan, Veli K Topkara, Jiho Han, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: The timely use of a right ventricular assist device (RVAD) becomes necessary for severe right heart failure (RHF) after left ventricular assist device (LVAD) insertion. This study evaluates outcomes in patients who required unplanned RVAD support early after continuous-flow (CF) LVAD insertion. METHODS: We retrospectively reviewed 305 patients who underwent HeartMate II/HeartWare CF-LVAD insertion between 2009 and 2014. Twenty-seven (9%) patients required unplanned RVAD for severe RHF early after LVAD insertion...
March 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#3
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28326202/venovenous-extracorporeal-membrane-oxygenation-as-a-treatment-for-obesity-hypoventilation-syndrome
#4
Nao Umei, Shingo Ichiba
The mortality rate for respiratory failure resulting from obesity hypoventilation syndrome is high if it requires ventilator management. We describe a case of severe acute respiratory failure resulting from obesity hypoventilation syndrome (BMI, 60.2 kg/m(2)) successfully treated with venovenous extracorporeal membrane oxygenation (VV-ECMO). During ECMO management, a mucus plug was removed by bronchoscopy daily and 18 L of water was removed using diuretics, resulting in weight loss of 24 kg. The patient was weaned from ECMO on day 5, extubated on day 16, and discharged on day 21...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28293000/-endobronchial-watanabe-spigot-in-treating-pleural-empyema-with-fistula
#5
Atsushi Sekimura, Takashi Yoshimatsu, Naoki Yamashita, Hanae Higa, Takeaki Miyata, Daigo Kawano, Tetsuya So
For pleural empyema with fistula, fenestration and subsequent omental plombage, and thoracoplasty are frequently necessary. A 57-year-old man was transported by ambulance because of impaired consciousness and septic shock due to pleural empyema on the right caused by a ruptured lung abscess. We performed empyema curettage urgently, drained 800 ml of purulent pleural effusion, and inserted 3 chest tubes. Postoperative air leakage from the ruptured lung abscess of the middle lobe was noted, and respiratory failure was prolonged...
March 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28289791/-predictors-of-cognitive-outcome-in-ventilated-early-rehabilitation-patients
#6
M-D Heidler, L Bidu, H Völler, A Salzwedel
BACKGROUND: After weaning failure, patients who are transferred from intensive care units to early rehabilitation centers (ERC) not only suffer from motor deficits but also from cognitive deficits. It is still uncertain which patient factors have an impact on cognitive outcome at the end of early rehabilitation. OBJECTIVE: Investigation of predictors of cognitive performance for initially ventilated early rehabilitation patients. METHODS: A total of 301 patients (mean age 68...
March 13, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28288543/renal-function-weaning-and-survival-in-patients-with-ventilator-dependent-respiratory-failure
#7
Debapriya Datta, Raymond J Foley, Rong Wu, James Grady, Paul Scalise
BACKGROUND: Acute kidney injury in acute critical illness has been associated with poor weaning and survival outcomes. The relation between renal dysfunction as defined by creatinine clearance (CrCl) and weaning from prolonged mechanical ventilation (PMV) is not known. The objective of this study was to determine the relation of measured CrCl to weaning and survival in patients on PMV. METHODS: We retrospectively studied 167 patients on PMV admitted to a long-term acute care facility for weaning over a 3-year period...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28286047/effects-of-early-administration-of-acetazolamide-on-the-duration-of-mechanical-ventilation-in-patients-with-chronic-obstructive-pulmonary-disease-or-obesity-hypoventilation-syndrome-with-metabolic-alkalosis-a-randomized-trial
#8
G Rialp Cervera, J M Raurich Puigdevall, I Morán Chorro, M C Martín Delgado, G Heras la Calle, A Mas Serra, I Vallverdú Perapoch
BACKGROUND: Metabolic alkalosis (MA) inhibits respiratory drive and may delay weaning from mechanical ventilation (MV). MA is common in CO2-retainer patients that need MV. Acetazolamide (ACTZ) decreases serum bicarbonate concentration and stimulates respiratory drive. This study evaluated the effects of ACTZ on the duration of MV in patients with MA and COPD or obesity hypoventilation syndrome (OHS) intubated with acute respiratory failure. METHODS: Multicenter, randomized, controlled, double-blind study, with COPD or OHS patients with MV < 72 h and initial bicarbonate >28 mmol/L and pH > 7...
March 7, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28282408/the-renal-phenotype-of-allopurinol-treated-hprt-deficient-mouse
#9
Cristina Zennaro, Federica Tonon, Paola Zarattini, Milan Clai, Alessandro Corbelli, Michele Carraro, Marialaura Marchetti, Luca Ronda, Gianluca Paredi, Maria Pia Rastaldi, Riccardo Percudani
Excess of uric acid is mainly treated with xanthine oxidase (XO) inhibitors, also called uricostatics because they block the conversion of hypoxanthine and xanthine into urate. Normally, accumulation of upstream metabolites is prevented by the hypoxanthine-guanine phosphoribosyltransferase (HPRT) enzyme. The recycling pathway, however, is impaired in the presence of HPRT deficiency, as observed in Lesch-Nyhan disease. To gain insights into the consequences of purine accumulation with HPRT deficiency, we investigated the effects of the XO inhibitor allopurinol in Hprt-lacking (HPRT-/-) mice...
2017: PloS One
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#10
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28274657/bone-health-of-children-with-intestinal-failure-measured-by-dual-energy-x-ray-absorptiometry-and-digital-x-ray-radiogrammetry
#11
Esther Neelis, Noortje Rijnen, Johanna Sluimer, Joanne Olieman, Dimitris Rizopoulos, René Wijnen, Edmond Rings, Barbara de Koning, Jessie Hulst
BACKGROUND & AIMS: Children with intestinal failure (IF) receiving long-term parenteral nutrition (PN) are at risk of developing low bone mineral density (BMD). Next to the dual energy X-ray absorptiometry (DXA) method, digital X-ray radiogrammetry (DXR) using the BoneXpert software has become available to obtain the Bone Health Index (BHI) in hand radiographs. In this study we 1) evaluated the prevalence of low BMD in children with IF using DXA and DXR, 2) compared DXA and DXR results, and 3) aimed to identify factors associated with low BMD...
February 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28264702/duration-of-veno-arterial-extracorporeal-life-support-va-ecmo-and-outcome-an-analysis-of-the-extracorporeal-life-support-organization-elso-registry
#12
Myles Smith, Alexander Vukomanovic, Daniel Brodie, Ravi Thiagarajan, Peter Rycus, Hergen Buscher
BACKGROUND: Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is an effective rescue therapy for severe cardiorespiratory failure, but morbidity and mortality are high. We hypothesised that survival decreases with longer VA ECMO treatment. We examined the Extracorporeal Life Support Organization (ELSO) registry for a relationship between VA ECMO duration and in-hospital mortality, and covariates including indication for support. METHODS: All VA runs from the ELSO database from 2002 to 2012 were extracted...
March 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28251431/48%C3%A2-h-cessation-of-mechanical-ventilation-during-venovenous-extracorporeal-membrane-oxygenation-in-severe-trauma-a-case-report
#13
Justyna Swol, Yann Fülling, Christopher Ull, Matthias Bechtel, Thomas A Schildhauer
A 32-year-old motorcyclist who was hit by a tram subsequently presented with blunt force thoracic trauma, a pelvic fracture and a penetrating injury to the left lower extremity. Coagulopathy persisted following surgery of the leg and pelvic vascular intervention. Bedside thoracotomy was performed to treat pneumothorax and pneumopericardium. Severe hypoxemia secondary to lung failure ensued, which required venovenous extracorporeal membrane oxygenation (VV ECMO) support. On the third day after the trauma, ultra-protective mechanical ventilation was not possible due to non-existent lung compliance; thus, the ventilator was disconnected, and the T-piece was connected to the blocked tracheal tube left in the airway...
March 1, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28244947/intermediate-acting-nondepolarizing-neuromuscular-blocking-agents-and-risk-of-postoperative-30-day-morbidity-and-mortality-and-long-term-survival
#14
Michael R Bronsert, William G Henderson, Terri G Monk, Joshua S Richman, Jennifer D Nguyen, John T Sum-Ping, Michael P Mangione, Binh Higley, Karl E Hammermeister
BACKGROUND: Nondepolarizing neuromuscular blocking drugs (NNMBDs) are commonly used as an adjunct to general anesthesia. Residual blockade is common, but its potential adverse effects are incompletely known. This study was designed to assess the association between NNMBD use with or without neostigmine reversal and postoperative morbidity and mortality. METHODS: This is a retrospective observational study of 11,355 adult patients undergoing general anesthesia for noncardiac surgery at 5 Veterans Health Administration (VA) hospitals...
February 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28244284/nosocomial-infection-in-adult-patients-undergoing-veno-arterial-extracorporeal-membrane-oxygenation
#15
Gwan Sic Kim, Kyo Seon Lee, Choung Kyu Park, Seung Ku Kang, Do Wan Kim, Sang Gi Oh, Bong Suk Oh, Yochun Jung, Seok Kim, Ju Sik Yun, Sang Yun Song, Kook Joo Na, In Seok Jeong, Byoung Hee Ahn
Data on the frequency of nosocomial infections during extracorporeal membrane oxygenation (ECMO) in adult populations remain scarce. We investigated the risk factors for nosocomial infections in adult patients undergoing venoarterial ECMO (VA-ECMO) support. From January 2011 to December 2015, a total of 259 patients underwent ECMO. Of these, patients aged 17 years or less and patients undergoing ECMO for less than 48 hours were excluded. Of these, 61 patients diagnosed with cardiogenic shock were evaluated...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28219811/stress-echocardiography-in-patients-who-experienced-mechanical-ventilation-weaning-failure
#16
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana Castillo-Rivera, María Dolores Pola-Gallego-de-Guzmán, Antonio Cárdenas-Cruz, Antonio Martínez-Amat, María Sevilla-Martínez, Clara Hernández-Caballero
INTRODUCTION: Critically ill patients may suffer varying degrees of temporary myocardial dysfunction during respiratory weaning that could play an important role in weaning failure. OBJECTIVES: In this study, we tried to assess the existence of temporary diastolic dysfunction during respiratory weaning. METHODS: Inclusion period is from 2006 to 2015. In this study, we included 181 ventilated patients with cardiogenic shock that were being weaned from mechanical ventilation...
January 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28216201/intratracheal-milrinone-bolus-administration-during-acute-right-ventricular-dysfunction-after-cardiopulmonary-bypass
#17
Caroline Eva Gebhard, Georges Desjardins, Cathérine Gebhard, Paul Gavra, André Y Denault
OBJECTIVE: To evaluate intratracheal milrinone (tMil) administration for rapid treatment of right ventricular (RV) dysfunction as a novel route after cardiopulmonary bypass. DESIGN: Retrospective analysis. SETTING: Single-center study. PARTICIPANTS: The study comprised 7 patients undergoing cardiac surgery who exhibited acute RV dysfunction after cardiopulmonary bypass. INTERVENTIONS: After difficult weaning caused by cardiopulmonary bypass-induced acute RV dysfunction, milrinone was administered as a 5-mg bolus inside the endotracheal tube...
November 22, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28203417/clinical-factors-associated-with-weaning-failure-in-patients-requiring-prolonged-mechanical-ventilation
#18
Hong-Joon Shin, Jin-Sun Chang, Seong Ahn, Tae-Ok Kim, Cheol-Kyu Park, Jung-Hwan Lim, In-Jae Oh, Yu-Il Kim, Sung-Chul Lim, Young-Chul Kim, Yong-Soo Kwon
BACKGROUND: For patients requiring prolonged mechanical ventilation (PMV), weaning is difficult and mortality is very high. PMV has been defined recently, by consensus, as constituting ≥21 consecutive days of mechanical ventilation (MV) for ≥6 hours per day. This study aimed to evaluate the clinical factors predicting weaning failure in patients undergoing PMV in medical intensive care unit (ICU). METHODS: We retrospectively reviewed the clinical and laboratory characteristics of 127 patients who received MV for more than 21 days in the medical ICU at Chonnam National University Hospital in South Korea between January 2005 and December 2014...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28198753/mechanical-ventilation-weaning-practices-and-decision-making-in-european-picus
#19
Lyvonne N Tume, Martin C J Kneyber, Bronagh Blackwood, Louise Rose
OBJECTIVES: This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making. DESIGN: Cross-sectional electronic survey...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28193535/the-utility-of-nurse-managed-extracorporeal-life-support-in-an-adult%C3%A2-cardiac-intensive-care-unit
#20
Amy E Hackmann, Luke M Wiggins, Glenn P Grimes, Richard M Fogel, Felicia A Schenkel, Mark L Barr, Michael E Bowdish, Mark J Cunningham, Vaughn A Starnes
BACKGROUND: The use of extracorporeal life support (ECLS) worldwide has increased exponentially since 2009. The patient requiring ECLS demands an investment of hospital resources, including personnel. Educating bedside nurses to manage ECLS circuits broadens the availability of trained providers. METHODS: Experienced cardiothoracic intensive care unit (CTICU) nurses underwent training to manage ECLS circuits, including volume assessment, treatment of arterial blood gas values, the physiology of ECLS, and recognition of common emergencies...
February 10, 2017: Annals of Thoracic Surgery
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