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Weaning failure

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https://www.readbyqxmd.com/read/29776707/unplanned-extubations-in-an-intensive-care-unit-findings-from-a-critical-incident-technique
#1
Matteo Danielis, Simona Chiaruttini, Alvisa Palese
BACKGROUND: Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. OBJECTIVES: To gain a greater understanding of the antecedents of unplanned extubations...
May 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29773665/hypersensitivity-pneumonitis-and-acute-respiratory-distress-syndrome-from-e-cigarette-use
#2
Casey G Sommerfeld, Daniel J Weiner, Andrew Nowalk, Allyson Larkin
Electronic cigarette (e-cigarette) use, or "vaping," is gaining widespread popularity as an alternative to conventional cigarettes among adolescents. Little is known of the health risks of e-cigarette use, especially in children and adolescents. We present a Case Report of a previously healthy 18-year-old woman who presented with dyspnea, cough, and pleuritic chest pain after e-cigarette use. She developed respiratory failure with hypoxia and was intubated, and ultimately met diagnostic criteria for acute respiratory distress syndrome...
May 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29771711/respiratory-muscle-effort-during-expiration-in-successful-and-failed-weaning-from-mechanical-ventilation
#3
Jonne Doorduin, Lisanne H Roesthuis, Diana Jansen, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29766320/weaning-from-prolonged-veno-venous-extracorporeal-membrane-oxygenation-ecmo-after-transfer-to-a-specialized-center-a-retrospective-study
#4
Frederik Seiler, Franziska C Trudzinski, Sabrina I Hörsch, Annegret Kamp, Carlos Metz, Monika Flaig, Mohammad Alqudrah, Holger Wehrfritz, Markus Kredel, Ralf M Muellenbach, Hendrik Haake, Robert Bals, Philipp M Lepper
Veno-venous extracorporeal membrane oxygenation (vvECMO) is increasingly used as rescue therapy in severe respiratory failure. In patients with pre-existent lung diseases or persistent lung injury weaning from vvECMO can be challenging. This study sought to investigate outcomes of patients transferred to a specialized ECMO center after prolonged ECMO therapy. We performed a retrospective analysis of all patients admitted to our medical intensive care unit (ICU) between 01/2013 and 12/2016 who were transferred from an external ICU after > 8 days on vvECMO...
May 15, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29762738/successful-treatment-of-suckling-red-angus-calves-for-bovine-respiratory-disease-is-not-associated-with-increased-mean-pulmonary-arterial-pressures-at-weaning
#5
J M Neary, D Church, N Reeves, R J Rathmann
The purposes of this study were to determine if the successful treatment of bovine respiratory disease (BRD) in suckling calves was associated with a long-term increase in mean pulmonary arterial pressure (mPAP) and, to screen for associations between blood leukogram variables and mPAP. A cohort of Red Angus calves (n = 74) were followed from birth to weaning at an altitude of 975 m. Calves were weaned at 172 ± 14 days when their mPAP was measured and whole blood collected. Thirty calves that had been treated for BRD (34 to 45 days prior) and 30 calves that had not required treatment for BRD were sampled...
May 12, 2018: Journal of Animal Science
https://www.readbyqxmd.com/read/29762383/starch-tolerance-and-the-short-bowel
#6
Jan de Laffolie, Hassan Y Naim, Silvia Rudloff, Klaus-Peter Zimmer
Short bowel syndrome with intestinal failure is a rare disease with a massive impairment in quality of life, requiring a multidisciplinary team approach to medical, surgical, and nutritional therapy. Current pharmacological and surgical therapeutic options are limited; an important cornerstone is enteral and parenteral nutrition. The changed physiology of carbohydrate digestion plays a major role in the adaptation process and can be a target for specific enteral nutrition interventions. An important prognostic factor is the preservation of at least portions of the colon in continuity with small bowel...
June 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29760926/diffuse-endobronchial-metastasis-from-sigmoid-carcinoma-presenting-as-wheezing-and-respiratory-failure
#7
Nattawat Jantarangsi, Poonchavist Chantranuwatana, Naricha Chirakalwasan
A 66-year-old Thai man with underlying asthma, history of traumatic right haemothorax, and sigmoid carcinoma with bladder invasion developed productive cough, whitish sputum, dyspnoea, and wheezing for 2 months. Physical examination showed generalized expiratory wheezing in both lungs. Computed tomography scan of the chest revealed diffuse thickening of bronchial wall, predominantly at lower lobes; several various sizes of pulmonary nodules; diffuse interlobular septal thickening; multiple enlarged mediastinal lymph nodes and hilar lymph nodes; and right pleural effusion...
July 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29755073/-beating-mitral-valve-replacement-for-functional-mitral-regurgitation-after-cardiac-resynchronization-therapy-report-of-a-case
#8
Hiroshi Kumano, Keisuke Shuntoh, Akimitsu Yamaguchi
A 72-year-old man was admitted to our hospital because of dyspnea. He had a history of cardiac resynchronization therapy for congestive heart failure due to dilated cardiomyopathy 6 months previously. Echocardiography revealed severe functional mitral regurgitation which had been mild 6 months before. Because medical treatment was ineffective, on-pump beating mitral valve replacement using a bioprosthesis was performed to prevent reperfusion injury. The patient was easily weaned from cardiopulmonary bypass with low-dose inotropic support and scheduled intra-aortic balloon pump...
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29753617/patient-factors-associated-with-prolonged-postoperative-opioid-use-after-total-knee-arthroplasty
#9
Robert S Namba, Anshuman Singh, Elizabeth W Paxton, Maria C S Inacio
BACKGROUND: Pain persists in a moderate proportion of patients after total knee arthroplasty (TKA). Identifying patient factors that are associated with persistent pain may lead to improved care. PURPOSE: The purpose of the study was to identify preoperative factors associated with increased opioid prescriptions after TKA. METHODS: A retrospective cohort study of TKAs in an integrated health-care system (January 2008-December 2011) was conducted...
April 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29748076/comparison-of-levosimendan-and-milrinone-for-ecls-weaning-in-patients-after-cardiac-surgery-a-retrospective-before-and-after-study
#10
Annina Jacky, Alain Rudiger, Bernard Krüger, Markus J Wilhelm, Sebastian Paal, Burkhardt Seifert, Donat R Spahn, Dominique Bettex
OBJECTIVES: Pharmacodynamics suggests that levosimendan might be a valuable inotrope for weaning from extracorporeal life support (ECLS). As there is a paucity of evidence regarding the effectiveness and safety of such an approach, the aim was to report the authors' experiences in ECLS weaning before and after the implementation of levosimendan in clinical practice. DESIGN: Retrospective before-and-after study. SETTING: Cardiac intensive care unit of a university hospital...
April 6, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29746522/changes-in-quality-of-life-and-health-status-in-patients-with-extracorporeal-life-support-a-prospective-longitudinal-study
#11
Kang-Hua Chen, Yu-Ting Chen, Shu-Ling Yeh, Li-Chueh Weng, Feng-Chun Tsai
BACKGROUND: Extracorporeal life support (ECLS) provides emergency pulmonary and cardiac assistance for patients in respiratory or cardiac failure. Most studies evaluate the success of ECLS based on patients' survival rate. However, the trajectory of health status and quality of life (QOL) should also be important considerations. The study's aim was to explore changes in health status and QOL in adult patients weaned from ECLS who survived to hospital discharge over a one-year period. STUDY DESIGN: A prospective longitudinal study was conducted from April 2012 to September 2014...
2018: PloS One
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#12
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29741919/efficacy-of-acupuncture-treatment-for-improving-the-respiratory-status-in-patients-receiving-prolonged-mechanical-ventilation-in-intensive-care-units-a-retrospective-observational-study
#13
Jun Matsumoto-Miyazaki, Hiroaki Ushikoshi, Kodai Suzuki, Nagisa Miyazaki, Takahide Nawa, Hideshi Okada, Shozo Yoshida, Ichijiro Murata, Shinji Ogura, Shinya Minatoguchi
BACKGROUND AND OBJECTIVE: Patients in critical care settings often require prolonged mechanical ventilation (MV) therapy and, occasionally, they cannot be weaned from MV. The authors evaluated the efficacy of acupuncture treatment for improving the respiratory status and promoting successful weaning from prolonged MV in patients at intensive care units (ICUs). DESIGN: Retrospective observational study. SETTING: Gifu University Hospital, Gifu, Japan...
May 9, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29735126/results-of-bracing-for-juvenile-idiopathic-scoliosis
#14
Nanjundappa S Harshavardhana, John E Lonstein
STUDY DESIGN: Retrospective comparative therapeutic clinical study evaluating the results of bracing for juvenile idiopathic scoliosis (JIS). OBJECTIVES: To evaluate if bracing has a role in treatment of JIS and, if so, to report its success rate and factors associated with successful bracing. SUMMARY OF BACKGROUND DATA: Patients with JIS have higher mortality and morbidity in comparison to those with adolescent idiopathic scoliosis (AIS) or general population...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29735027/intestinal-failure-and-rehabilitation
#15
REVIEW
Alan L Buchman
The rendering of proper care for the patient with intestinal failure requires the provider to have a functional understanding of digestion and absorption, nutrient requirements, and intestinal adaptation. Inherent in those concepts is that not only is nutritional absorption compromised, but medication absorption is as well. The principles of the management of home parenteral nutrition must be mastered and then proper and controlled weaning of parenteral nutrition may be commenced by use of dietary and pharmacologic means with appropriate clinical outcome measures followed...
June 2018: Gastroenterology Clinics of North America
https://www.readbyqxmd.com/read/29732176/oxygenator-performance-and-artificial-native-lung-interaction
#16
REVIEW
Francesco Epis, Mirko Belliato
During extracorporeal membrane oxygenation (ECMO), oxygen (O2 ) transfer (V'O2 ) and carbon dioxide (CO2 ) removal (V'CO2 ) are partitioned between the native lung (NL) and the membrane lung (ML), related to the patient's metabolic-hemodynamic pattern. The ML could be assimilated to a NL both in a physiological and a pathological way. ML O2 transfer (V'O2 ML) is proportional to extracorporeal blood flow and the difference in O2 content between each ML side, while ML CO2 removal (V'CO2 ML) can be calculated from ML gas flow and CO2 concentration at sweep gas outlet...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29727818/efficacy-and-safety-of-ketogenic-diet-for-treatment-of-pediatric-convulsive-refractory-status-epilepticus
#17
Ravindra Arya, Katrina Peariso, Marina Gaínza-Lein, Jessica Harvey, Ann Bergin, J Nicholas Brenton, Brian T Burrows, Tracy Glauser, Howard P Goodkin, Yi-Chen Lai, Mohamad A Mikati, Iván Sánchez Fernández, Dmitry Tchapyjnikov, Angus A Wilfong, Korwyn Williams, Tobias Loddenkemper
PURPOSE: To describe the efficacy and safety of ketogenic diet (KD) for convulsive refractory status epilepticus (RSE). METHODS: RSE patients treated with KD at the 6/11 participating institutions of the pediatric Status Epilepticus Research Group from January-2011 to December-2016 were included. Patients receiving KD prior to the index RSE episode were excluded. RSE was defined as failure of ≥2 anti-seizure medications, including at least one non-benzodiazepine drug...
April 27, 2018: Epilepsy Research
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#18
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29721672/outcomes-of-patients-requiring-extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-implantation-a-clinical-case-series
#19
Ryosuke Higuchi, Tetsuya Tobaru, Kenichi Hagiya, Mike Saji, Itaru Takamisawa, Jun Shimizu, Nobuo Iguchi, Shuichiro Takanashi, Morimasa Takayama, Mitsuaki Isobe
Transcatheter aortic valve implantation (TAVI) has been established as a low-invasive therapy for aortic stenosis, but circulatory collapse necessitating mechanical circulatory support could occur during TAVI due to procedure itself or procedural complications. The purpose of this study is to describe the outcomes of patients requiring extracorporeal membrane oxygenation (ECMO) in TAVI. Among 384 consecutive patients undergoing TAVI from April 2010 to July 2017 in Sakakibara Heart Institute, we evaluated seven patients (1...
May 2, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29721319/successful-ventilator-weaning-following-vascular-bypass-in-patient-with-vascular-tracheobronchial-compression
#20
Kei Sonehara, Toshitaka Shomura, Masanori Yasuo, Atsuhito Ushiki, Hiroshi Yamamoto, Masayuki Hanaoka
A 74-year-old man, who had undergone thoracoplasty for tuberculous sequelae 54 years earlier, was referred to our hospital with a chief complaint of dyspnea. He had recently received mechanical ventilation due to pneumonia. However, although the pneumonia had improved, extubation was prevented by the presence of hypercapnic respiratory failure with tracheal stenosis due to compression of the right aortic arch and the left common carotid artery. Bypass surgery was performed, during which the left subclavian artery was placed over the left common carotid artery...
July 2018: Respirology Case Reports
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