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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
#1
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
https://www.readbyqxmd.com/read/28419284/laser-thermal-ablation-for-metastases-failing-radiosurgery-a-multicentered-retrospective-study
#2
Tafadzwa L Chaunzwa, Di Deng, Eric C Leuthardt, Stephen B Tatter, Alireda M Mohammadi, Gene H Barnett, Veronica L Chiang
BACKGROUND: Radiosurgical failure following stereotactic radiosurgery for brain metastases can be attributed to tumor regrowth or radiation necrosis. MRI-guided laser thermal ablation (LTA) therapy has emerged as an option for treatment; however, previous literature demonstrates variable results across centers. OBJECTIVE: To assess the outcomes of LTA in the treatment of metastases failing radiosurgery across multiple centers and to determine if any treatment factors are predictive of outcome...
April 13, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#3
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28405460/provision-of-straw-by-a-foraging-tower-effect-on-tail-biting-in-weaners-and-fattening-pigs
#4
Carolin Holling, Elisabeth Grosse Beilage, Beatriz Vidondo, Christina Nathues
BACKGROUND: Straw is one of the most effective rooting materials to reduce tail biting in pigs. A so-called foraging-tower (FT) provides only small quantities of straw compatible with liquid manure systems. The focus of the present study was on the effect of providing straw by FT in order to prevent tail biting in tail docked pigs. Four consecutive batches of 160 pigs, randomly divided into a straw (SG) and a control group (CG) were followed up from weaning to slaughter. RESULTS: Tail wounds (Score ≥ 2) were detected in 104 out of 12,032 single observations (SG n = 48; CG n = 56) in 9 pens (SG n = 4/32; CG n = 5/32) mainly focused on the fattening period of batch 2 due to a failure in the ventilation system...
2017: Porcine Health Management
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#5
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28395275/tracheostomy-extubation-reintubation-airway-management-decisions-in-intubated-stroke-patients
#6
Corinna Steidl, Julian Boesel, Sonja Suntrup-Krueger, Silvia Schoenenberger, Faisal Al-Suwaidan, Tobias Warnecke, Jens Minnerup, Rainer Dziewas
BACKGROUND: Both delayed and premature extubation increase complication rate, the need for tracheostomy (TT), the duration of intensive care unit stay, and mortality. In this study, we therefore investigated factors associated with primary TT and predictors for extubation failure (EF) in a sample of severely affected ventilated stroke patients. METHODS: One hundred eighty five intubated stroke patients were prospectively analyzed in this observational study. Patients not meeting predefined clinical and respiratory extubation criteria received a TT...
April 11, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28394957/-intestinal-failure-due-to-short-bowel-syndrome-impact-of-a-multidisciplinary-intestinal-rehabilitation-program
#7
María Elena Molina, Felipe Bellolio, Julieta Klaassen, Javier Gómez, Constanza Villalón, Juan Francisco Guerra, Álvaro Zúñiga
BACKGROUND: In patients suffering intestinal failure due to short bowel, the goal of an Intestinal Rehabilitation Program is to optimize and tailor all aspects of clinical management, and eventually, wean patients off lifelong parenteral nutrition. AIM: To report the results of our program in patients suffering intestinal failure. PATIENTS AND METHODS: A registry of all patients referred to the Intestinal Failure unit between January 2009 and December 2015 was constructed...
November 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28381328/long-term-effect-of-a-chronic-low-protein-multideficient-diet-on-the-heart-hypertension-and-heart-failure-in-chronically-malnourished-young-adult-rats
#8
Luiza V P Mendes, Sabrina R Gonsalez, Leonardo M Oliveira-Pinto, Amaury Pereira-Acácio, Christina M Takiya, José H M Nascimento, Marcelo Einicker-Lamas, Adalberto Vieyra, Valéria M N Cunha, Lucienne S Lara
BACKGROUND: We investigated whether a chronic low-protein multideficient diet (BRD) from weaning turns on cardiovascular adaptive responses that could culminate in hypertension and heart failure. METHODS AND RESULTS: Systolic pressure (SP) and heart rate (HR) were determined in CTRL (normal diet) and BRD rats. Plasma albumin, plasma urea and urinary urea excretion decreased in BRD rats. In this group, echocardiography and the Langendorff technique showed: (i) increased HR and hypertension; (ii) decreased LVDP, dP/dtmax, dP/dtmin, cardiac output, ejection fraction, stroke volume and left ventricular diameter...
March 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#9
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28373296/a-proteomic-approach-to-identify-alterations-in-the-sumo-network-during-controlled-mechanical-ventilation-in-rat-diaphragm-muscle
#10
Arvind Venkat Namuduri, Gabriel Heras, Jia Mi, Nicola Cacciani, Katarina Hörnaeus, Anne Konzer, Sara Bergström Lind, Lars Larsson, Stefano Gastaldello
The Small Ubiquitin-like Modifier (SUMO) is as a regulator of many cellular functions by reversible conjugation to a broad number of substrates. Under endogenous or exogenous perturbations, the SUMO network becomes a fine sensor of stress conditions by alterations in the expression level of SUMO enzymes and consequently changing the status of SUMOylated proteins. The diaphragm is the major inspiratory muscle, which is continuously active under physiological conditions, but its structure and function is severely affected when passively displaced for long extents during mechanical ventilation (MV)...
April 3, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/28358849/extracorporeal-life-support-prior-to-left-ventricular-assist-device-implantation-leads-to-improvement-of-the-patients-intermacs-levels-and-outcome
#11
David Schibilsky, Christoph Haller, Bruno Lange, Barbara Schibilsky, Helene Haeberle, Peter Seizer, Meinrad Gawaz, Peter Rosenberger, Tobias Walker, Christian Schlensak
BACKGROUND: The objective of this study was to evaluate the outcome of left ventricular assist device (LVAD) implantation after initial extracorporeal life support (ECLS) in patients with cardiogenic shock and the incidence of post implantation right ventricular failure. METHODS & RESULTS: All patients on ECLS therapy for cardiogenic shock prior to LVAD implantation (n = 15) between October 2011 and January 2014 were analyzed. Baseline patient characteristics, as well as detailed pre-operative treatment and postoperative outcome data were collected retrospectively...
2017: PloS One
https://www.readbyqxmd.com/read/28355755/-predictors-of-in-hospital-mortality-in-adult-postcardiotomy-cardiacgenic-shock-patients-successfully-weaned-from-venoarterial-extracorporeal-membrane-oxygenation
#12
H X Xie, F Yang, C J Jiang, J H Wang, D B Hou, J G Wang, H Wang, X T Hou
Objective: To assess the factors associated with outcome of patients undergoing extracorporeal membrane oxygenation (ECMO) in a large ECMO center. Methods: Patients aged >18 years who received ECMO support for postcardiotomy cardiogenic shock were identified between January 2011 and December 2015. One hundred and seventy-seven patients (64.8%) successfully weaned from ECMO. These patients were divided into two groups depending on whether they could survive to hospital discharge: the survival group (group S, n=119) and death group (group D, n=58)...
March 28, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28353560/a-life-threatening-case-of-tafro-syndrome-with-dramatic-response-to-tocilizumab-rituximab-and-pulse-steroids-the-first-case-report-in-latin-america
#13
Fabio Freire José, Lucila Nassif Kerbauy, Guilherme Fleury Perini, Danielle Isadora Blumenschein, Denise da Cunha Pasqualin, Denise Maria Avancini Costa Malheiros, Guilherme de Carvalho Campos Neto, Fabio Pires de Souza Santos, Ronaldo Piovesan, Nelson Hamerschlak
RATIONALE: This is the report of the first case of TAFRO syndrome (Thrombocytopenia, Anasarca, myelofibrosis, Renal dysfunction, Organomegaly) in Latin America. PATIENT CONCERNS: The patient was a 61-year-old white woman of Ashkenazi Jewish descent, who presented with a history of 8 days of nausea, vomiting, and fever; severe pitting edema in both legs, ascites, splenomegaly, and palpable axillary lymph nodes. DIAGNOSES: Abdominal computed tomography (CT) showed bilateral pleural effusion and retroperitoneal lymph node enlargement...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#14
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28337083/continuous-infusion-etomidate-in-a-patient-receiving-extracorporeal-membrane-oxygenation
#15
Joseph M LaRochelle, Bonnie Desselle, Janet L Rossi
We describe a 16-year-old, 65-kg male deployed on extracorporeal membrane oxygenation (ECMO) for refractory respiratory failure secondary to ingestion of multiple substances. During his ECMO course, standard sedative and analgesic strategies failed and alternative medications were used. The patient received various dosages of fentanyl, morphine, hydromorphone, clonidine patches, dexmedetomidine, lorazepam, methadone, pentobarbital, olanzapine, and propofol. Despite administration of multiple agents, on day 29 of ECMO the patient experienced elevated blood pressures due to agitation, and continuous infusion etomidate was started...
January 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#16
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
#17
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
#18
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
#19
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
#20
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
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