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https://www.readbyqxmd.com/read/28551923/-extracorporeal-membrane-oxygenation-in-israel-6-5-years-of-experience-at-the-largest-ecmo-treatment-center-in-israel
#1
Philip Biderman, Uri Carmi, Michael Fainblut, Oren Bachar, Benny Medallion, Dan Aravot
AIMS: The primary purpose of the study is to evaluate the characteristics of the population treated with ECMO at Beilinson Hospital, the treatment results and a comparison of results with ECMO centers in the world. The treatment outcomes relative to the experience of the team during the years 2008-2014 were also examined. The secondary purpose of this article is to increase the awareness of the medical staff to ECMO as a treatment option for patients with appropriate indications, where indications have increased in recent years...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28537576/an-infant-and-mother-with-severe-b12-deficiency-vitamin-b12-status-assessment-should-be-determined-in-pregnant-women-with-anaemia
#2
A Sobczyńska-Malefora, R Ramachandran, D Cregeen, E Green, P Bennett, D J Harrington, H A Lemonde
The vitamin B12 status of infants depends on maternal B12 status during pregnancy, and during lactation if breastfed. We present a 9-month-old girl who was admitted to the metabolic unit for assessment of developmental delay. She was exclusively breastfed and the introduction of solids at 5 months was unsuccessful. Investigations revealed pancytopenia, undetectable B12 and highly elevated methylmalonic acid and homocysteine. Methylmalonic acid and homocysteine normalised following B12 injections. Marked catch-up of developmental milestones was noted after treatment with B12...
May 24, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28535136/eosinophilic-esophagitis-in-a-kitten
#3
Julie Pera, Douglas Palma, Taryn A Donovan
A 4 mo old intact male kitten was presented for chronic regurgitation and failure to thrive after weaning to dry food. Esophageal dilatation and severe diffuse proliferative lesions of the esophageal mucosa were found via radiography and esophagoscopy, respectively. Histopathologic examination revealed severe, chronic, diffuse, hyperplastic eosinophilic and mastocytic esophagitis. Eosinophilic infiltrates were prominent, with a mean of 29.8 eosinophils per high power field, supportive of eosinophilic esophagitis (EoE)...
May 23, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#4
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28526862/significant-clinical-factors-associated-with-long-term-mortality-in-critical-cancer-patients-requiring-prolonged-mechanical-ventilation
#5
Li-Ta Keng, Kuei-Pin Chung, Shu-Yung Lin, Sheng-Kai Liang, Jui-Chen Cheng, I-Chun Chen, Yen-Fu Chen, Hou-Tai Chang, Chia-Lin Hsu, Jih-Shuin Jerng, Hao-Chien Wang, Ping-Hung Kuo, Huey-Dong Wu, Jin-Yuan Shih, Chong-Jen Yu
Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6...
May 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28526379/the-polish-intestinal-failure-centres-consensus-on-the-use-of-teduglutide-for-the-treatment-of-short-bowel-syndrome
#6
Stanisław Klek, Marek Kunecki, Jacek Sobocki, Konrad Matysiak, Katarzyna Karwowska, Krystyna Urbanowicz
OBJECTIVE: Teduglutide is an active, glucagon-like peptide (GLP)-2 analog with proven clinical efficacy regarding intestinal adaptation in patients with short bowel syndrome (SBS). There are two factors that preclude its reimbursement, and thereby, its availability: its cost (reaching ∼$300,000/y)-which significantly exceeds the cost of home parenteral nutrition (HPN) in most countries-and the lack of clear guidelines. The aim of this study was to create evidence-based working criteria for the use of teduglutide that could be used in clinical settings...
June 2017: Nutrition
https://www.readbyqxmd.com/read/28524029/-predictive-value-of-left-ventricular-diastolic-dysfunction-on-mechanical-ventilation-weaning
#7
Hui Wang, Ming Ma, Desheng Chen, Gang Li, Shupeng Wang, Jingen Xia, Jun Duan
OBJECTIVE: To investigate the predictive value of left ventricular diastolic function on mechanical ventilation weaning in patients with left ventricular ejection fraction (LVEF) > 0.50. METHODS: A retrospective case control study was conducted. Sixty-five patients with LVEF > 0.50 undergoing mechanical ventilation for more than 48 hours admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from June 2014 to December 2016 were enrolled...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28490869/pulmonary-infection-control-window-as-a-switching-point-for-sequential-ventilation-in-the-treatment-of-copd-patients-a-meta-analysis
#8
Yingying Lv, Qiurong Lv, Quanchao Lv, Tianwen Lai
PURPOSE: Choosing the appropriate time to switch to noninvasive positive-pressure ventilation (NPPV) plays a crucial role in promoting successful weaning. However, optimal timing for transitioning and weaning patients from mechanical ventilation (MV) to NPPV has not been clearly established. In China, the pulmonary infection control (PIC) window as a switching point for weaning from MV has been performed for many years, without definitive evidence of clinical benefit. This study aimed to summarize the evidence for NPPV at the PIC window for patients with respiratory failure from COPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28486624/ventricular-assist-device-support-in-patients-with-single-ventricles-the-melbourne-experience%C3%A2
#9
Chin L Poh, Roberto Chiletti, Diana Zannino, Christian Brizard, Igor E Konstantinov, Stephen Horton, Johnny Millar, Yves d'Udekem
OBJECTIVES: The capacity and limitations of ventricular assist device (VAD) support in single-ventricle physiology remains poorly understood. We aimed to review our experience in the use of VAD support in the single-ventricle circulation to determine its feasibility in this population. METHODS: We reviewed our experience with VAD support in patients with single ventricles over the past 25 years. Fifty-seven patients received 64 runs of VAD support between 1990 and 2015 at a median age of 13 days [interquartile range (IQR) 4...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28484823/-prolonged-weaning-during-early-neurological-and-neurosurgical-rehabilitation-s2k-guideline-published-by-the-weaning-committee-of-the-german-neurorehabilitation-society-dgnr
#10
REVIEW
J D Rollnik, J Adolphsen, J Bauer, M Bertram, J Brocke, C Dohmen, E Donauer, M Hartwich, M D Heidler, V Huge, S Klarmann, S Lorenzl, M Lück, M Mertl-Rötzer, T Mokrusch, D A Nowak, T Platz, L Riechmann, F Schlachetzki, A von Helden, C W Wallesch, D Zergiebel, M Pohl
Prolonged weaning of patients with neurological or neurosurgery disorders is associated with specific characteristics, which are taken into account by the German Society for Neurorehabilitation (DGNR) in its own guideline. The current S2k guideline of the German Society for Pneumology and Respiratory Medicine is referred to explicitly with regard to definitions (e.g., weaning and weaning failure), weaning categories, pathophysiology of weaning failure, and general weaning strategies. In early neurological and neurosurgery rehabilitation, patients with central of respiratory regulation disturbances (e...
May 8, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28470926/prevalence-of-hemolysis-and-metabolic-acidosis-in-patients-with-circulatory-failure-supported-with-extracorporeal-life-support-a-marker-for-survival
#11
Karla Lehle, Matthias Lubnow, Alois Philipp, Maik Foltan, Florian Zeman, York Zausig, Dirk Lunz, Christof Schmid, Thomas Müller
AIMS: Elevated levels of plasma free hemoglobin (fHb) indicate red blood cell (RBC) damage. The aim of this study was to analyze the prevalence of hemolysis and metabolic acidosis in patients on extracorporeal life support (ECLS) and to investigate whether it is a marker for outcome. METHODS AND RESULTS: This retrospective analysis included 215 adult patients with cardiac failure treated with ECLS. The cohort was divided into three groups: ECLS (1) during ongoing cardiopulmonary resuscitation (CPR, n = 110); (2) after CPR with return of spontaneous circulation and sustained cardiogenic shock (n = 45); (3) in severe cardiogenic shock without previous CPR (n = 60)...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28470920/a-rationale-for-early-extracorporeal-membrane-oxygenation-in-patients-with-postinfarction-ventricular-septal-rupture-complicated-by-cardiogenic-shock
#12
Daniel Rob, Rudolf Špunda, Jaroslav Lindner, Vilém Rohn, Jan Kunstýř, Martin Balík, Jan Rulíšek, Petr Kopecký, Michal Lipš, Ondřej Šmíd, Tomáš Kovárník, František Mlejnský, Aleš Linhart, Jan Bělohlávek
AIMS: Ventricular septal rupture (VSR) became a rare mechanical complication of myocardial infarction in the era of percutaneous coronary interventions but is associated with extreme mortality in patients who present with cardiogenic shock (CS). Promising outcomes have been reported with the use of circulatory support allowing haemodynamic stabilization, followed by delayed repair. Therefore, we analysed our experience with an early use of Veno-Arterial Extracorporeal Membrane Oxygenation (V-A ECMO) for postinfarction VSR...
May 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28459761/a-novel-weaning-protocol-for-high-flow-nasal-cannula-in-the-picu
#13
Kristina A Betters, Kiran B Hebbar, Courtney McCracken, David Heitz, Stephanie Sparacino, Toni Petrillo
OBJECTIVE: High-flow nasal cannula use in the PICU continues to increase; however, a protocol for weaning patients has yet to be published. This study aimed to create an efficient and safe protocol for weaning high-flow nasal cannula. DESIGN: A Respiratory Assessment Score was created using two validated scoring systems. A protocol was established for set "holidays" off high-flow nasal cannula, where nasal cannula flow was reduced to age-based low-flow nasal cannula rates if Respiratory Assessment Scores met certain criteria...
April 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28453795/closing-the-gap-in-paediatric-ventricular-assist-device-therapy-with-the-berlin-heart-excor%C3%A2-15-ml-pump%C3%A2
#14
Fabrizio De Rita, Massimo Griselli, Eugen Sandica, Oliver Miera, Ann Karimova, Yves d'Udekem, Ranny Goldwasser, Katarzyna Januszewska, Antonio Amodeo, Nadine Jurrmann, Simon Ersel, Ares K Menon
OBJECTIVES: The Berlin Heart EXCOR ® (EXCOR) paediatric ventricular assist device is used worldwide for mechanical support of infants and small children with end-stage heart failure. A clinically important gap between the smallest EXCOR blood pump (10 ml) and the next larger size (25 ml) limited the choice of pump size in patients with a body surface area (BSA) between 0.33 and 0.5 m 2 . We present the first clinical experience from the early product surveillance (EPS) of the new EXCOR 15-ml blood pump...
May 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28449477/continuous-administration-of-recombinant-human-b-type-natriuretic-peptide-can-improve-heart-and-renal-function-in-patients-after-cardiopulmonary-bypass-surgery
#15
Shiguan Le, Jian Xiao, Wei Li, Jing Wang, Qing Wang, Wang Xi, Jibin Xu, Zhinong Wang
BACKGROUND: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#16
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443527/an-investigation-into-the-effects-of-maternal-supplementation-with-excess-iodine-on-the-mechanisms-and-impacts-of-reduced-igg-absorption-in-the-lamb-postpartum
#17
F M McGovern, T Sweeney, M T Ryan, S Lott, F P Campion, T M Boland
An experiment was conducted to determine: (1) the effect of excess maternal I supplementation on the thyroid hormone status of the ewe and her progeny; (2) potential mechanisms underpinning the failure of passive transfer associated with excess I and (3) the growing lambs' response to natural gastrointestinal infection. Twin-bearing ewes received one of two treatments (n 32/treatment group): basal diet (C) or C plus 26·6 mg of iodine/ewe per d (I), supplied as calcium iodate. Ewes were individually fed from day 119 of gestation to parturition...
April 26, 2017: British Journal of Nutrition
https://www.readbyqxmd.com/read/28443390/an-integrative-index-for-predicting-extubation-outcomes-after-successful-completion-of-a-spontaneous-breathing-trial-in-an-adult-medical-intensive-care-unit
#18
Tsung-Ju Wu, Judith Shu-Chu Shiao, Hsin-Liang Yu, Ruay-Sheng Lai
BACKGROUND: Among respiratory predictors, rapid shallow breathing index (RSBI) has been a commonly used respiratory parameter to predict extubation outcomes. However, the outcome of prediction remains inconsistent. Regarding nonrespiratory predictors, serum albumin, hemoglobin, bicarbonate, and patients' alertness have been reported to be associated with successful weaning or extubation. We aimed to develop an integrative index combining commonly used predictors in the adult medical intensive care units (MICUs) and to compare the predictability of the index with RSBI...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28438191/continuous-diphenhydramine-infusion-and-imatinib-for-kit-d816v-negative-mast-cell-activation-syndrome-a-case-report
#19
Faizan Malik, Naveed Ali, Syed Imran Mustafa Jafri, Ali Ghani, Mohsin Hamid, Margot Boigon, Christian Fidler
BACKGROUND: We present the first full case report of the treatment of mast cell activation syndrome with continuous diphenhydramine infusion, which resulted in the improvement of anaphylactic reactions and a decrease in hospital readmission. Furthermore, the patient received imatinib in the absence of the KIT-D816V mutation, which led to further improvement of quality of life. Currently, we are trying to wean this patient off diphenhydramine; if successful, this attempt will represent the first reported case...
April 24, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28430296/effect-of-body-mass-index-on-the-outcome-of-surgical-patients-receiving-extracorporeal-devices-vv-ecmo-pecla-for-respiratory-failure
#20
Justyna Swol, Dirk Buchwald, Justus T Strauch, Thomas A Schildhauer, Christopher Ull
INTRODUCTION: To determine whether obese surgical patients are at a significant disadvantage in terms of outcomes after extracorporeal device (ECD) support, such as veno-venous extracorporeal membrane oxygenation (VV ECMO) or pumpless extracorporeal lung assist (pECLA), for respiratory failure, the relationship between body mass index (BMI) and hospital outcomes was analyzed. METHODS: This retrospective study included data on patients who were supported with an ECD between January 1, 2008 and December 31, 2014...
April 20, 2017: International Journal of Artificial Organs
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