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https://www.readbyqxmd.com/read/28905470/outcomes-of-berlin-heart-excor-%C3%A2-pediatric-ventricular-assist-device-support-in-patients-with-restrictive-and-hypertrophic-cardiomyopathy
#1
Jennifer A Su, Jondavid Menteer
The outcomes of pediatric ventricular assist device support in patients with diastolic heart failure have not been well described. This study reviews the North American experience with Berlin Heart EXCOR(®) ventricular assist device implants in children with such physiology. The Berlin Heart clinical database was reviewed. Patients with primary diastolic dysfunction are included in this study. Twenty pediatric patients with restrictive cardiomyopathy (n = 13), hypertrophic cardiomyopathy (n = 3), or congenital heart disease with restrictive physiology (n = 4) who were supported with EXCOR(®) were identified...
September 14, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28905112/extracorporeal-membrane-oxygenation-in-spina-bifida-and-h1n1-induced-acute-respiratory-distress-syndrome
#2
Oliver Jansen, Oliver Kamp, Christian Waydhas, Valentin Rausch, Thomas Armin Schildhauer, Justus Strauch, Dirk Buchwald, Uwe Hamsen
Acute respiratory distress syndrome (ARDS) is characterized as an acute hypoxemic and/or hypercapnic respiratory failure seen in critically ill patients and is still, although decreased over the past few years, associated with high mortality. Furthermore, ARDS may be a life-threatening complication of H1N1 pneumonia. We report on a 45-year-old spina bifida patient with confirmed H1N1 influenza virus infection causing acute respiratory failure, who was successfully weaned from 42-day veno-venous extracorporeal membrane oxygenation (vv-ECMO) treatment with an excellent outcome...
September 13, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28904980/enterovirus-human-rhinovirus-a-rare-cause-of-acute-respiratory-distress-syndrome
#3
Parita Soni, Anand Rai, Nidhi Aggarwal, Stephan Kamholz, Taek Yoon, Yizhak Kupfer
A 22-year-old Asian woman presented with respiratory distress, cough, and wheezing for 1 week. Prior history included asthma and Turner syndrome. On presentation to the emergency department, the patient was hypotensive, tachycardic, tachypneic, with an oxyhemoglobin saturation in the mid 80% range while breathing ambient air. Chest radiograph revealed pulmonary vascular congestion and a left lower lobe infiltrate. Endotracheal intubation, mechanical ventilation, and vasopressors were initiated. Empiric therapy for community-acquired pneumonia was administered utilizing broad-spectrum intravenous antibiotics...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28904810/nasal-high-flow-treatment-in-preterm-infants
#4
REVIEW
Calum T Roberts, Kate A Hodgson
Nasal High Flow (HF) is a mode of 'non-invasive' respiratory support for preterm infants, with several potential modes of action, including generation of distending airway pressure, washout of the nasopharyngeal dead space, reduction of work of breathing, and heating and humidification of inspired gas. HF has several potential advantages over continuous positive airway pressure (CPAP), the most commonly applied form of non-invasive support, such as reduced nasal trauma, ease of use, and infant comfort, which has led to its rapid adoption into neonatal care...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28900041/predicting-extubation-outcome-by-cough-peak-flow-measured-using-a-built-in-ventilator-flow-meter
#5
Florent Gobert, Hodane Yonis, Romain Tapponnier, Raul Fernandez, Marie-Aude Labaune, Jean-François Burle, Jack Barbier, Bernard Vincent, Maria Cleyet, Jean-Christophe Richard, Claude Guérin
BACKGROUND: Successful weaning from mechanical ventilation depends on the patient's ability to cough efficiently. Cough peak flow (CPF) could predict extubation success using a dedicated flow meter but required patient disconnection. We aimed to predict extubation outcome using an overall model, including cough performance assessed by a ventilator flow meter. METHODS: This was a prospective observational study conducted from November 2014 to October 2015. Before and after a spontaneous breathing trial, subjects were encouraged to cough as strongly as possible before freezing the ventilator screen to assess CPF and tidal volume (VT) in the preceding inspiration...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28893673/extracorporeal-membrane-oxygenation-ecmo-as-salvage-treatment-for-pulmonary-echinococcus-granulosus-infection-with-acute-cyst-rupture
#6
Sören L Becker, Sebastian Fähndrich, Franziska C Trudzinski, Barbara Gärtner, Frank Langer, Torben K Becker, Robert Bals, Philipp M Lepper, Christian Lensch
Extracorporeal membrane oxygenation (ECMO) has been successfully used for the treatment of patients with respiratory failure due to severe infections. Though rare, parasites can also cause severe pulmonary disease. Tapeworms of the genus Echinococcus give rise to the development of cystic structures in the liver, lungs and other organs. Acute cyst rupture leads to potentially life-threatening infection, and affected patients may deteriorate rapidly. We describe the case of a young woman from Bulgaria who was admitted to hospital with severe dyspnoea, progressive chest pain and haemoptysis...
September 8, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28888648/evaluation-of-the-effect-of-a-porcine-reproductive-and-respiratory-syndrome-prrs-modified-live-virus-vaccine-on-sow-reproductive-performance-in-endemic-prrs-farms
#7
Jiwoon Jeong, Seeun Kim, Kee Hwan Park, Ikjae Kang, Su-Jin Park, Changhoon Park, Chanhee Chae
The efficacy of a porcine reproductive and respiratory syndrome (PRRS) modified-live virus vaccine in reproductive performance was evaluated under field conditions. Three PRRS endemic farms were selected based on their history of PRRS-associated reproductive failures. On each farm, a total of 40 sows were randomly allocated to either vaccinated (n=20) or unvaccinated (n=20) groups. Sows were vaccinated six weeks prior to breeding. Clinical data showed a significant improvement in reproductive performance in vaccinated sows...
September 2017: Veterinary Microbiology
https://www.readbyqxmd.com/read/28887931/extracorporeal-membrane-oxygenation-management-techniques-to-liberate-from-extracorporeal-membrane-oxygenation-and-manage-post-intensive-care-unit-issues
#8
REVIEW
Joseph B Zwischenberger, Harrison T Pitcher
Extracorporeal membrane oxygenation (ECMO) is a life-saving technique when patients require pulmonary and/or cardiac support for days to weeks for recovery, bridge to decision, or transplantation. Due to complications associated with ECMO, it is best to stay on ECMO as little time as necessary. Foremost is weaning from ECMO, but the post-ECMO period recapitulates the entire field of critical care. Identified issues include (1) potential for systemic inflammatory response syndrome post-decannulation; (2) post-ECMO complications, such as deep vein thrombosis, wounds, renal failure, and stroke; (3) delirium; (4) posttraumatic stress disorder; (5) rehabilitation; and (6) end of life...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28887927/cardiac-support-emphasis-on-venoarterial-ecmo
#9
REVIEW
Christopher S King, Aviral Roy, Liam Ryan, Ramesh Singh
Major advances have been made in mechanical circulatory support in recent years. Venoarterial (VA) extracorporeal membrane oxygenation (ECMO) provides both pulmonary and circulatory support for critically ill patients with hemodynamic compromise, serving as a bridge to recovery or definitive therapy in the form of transplant or a durable ventricular assist device. In the past, VA ECMO support was used in cases of cardiogenic shock or failure to wean from cardiopulmonary bypass; however, the technology is now being applied to an ever-expanding list of conditions, including massive pulmonary embolism, cardiac arrest, drug overdose, and hypothermia...
October 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28887708/long-term-clinical-results-of-acute-myocardial-infarction-at-the-left-main-trunk-requiring-percutaneous-cardiopulmonary-support
#10
Takashi Yamauchi, Takafumi Masai, Kenji Fujii, Yoshiki Sawa, Shinya Shirai, Mitsunori Kamigaki, Naofumi Itou
The clinical results of patients with acute myocardial infarction (AMI) at the left main trunk (LMT) remain unclear, especially in cases requiring percutaneous cardiopulmonary support (PCPS). Twenty seven cases of AMI at the LMT requiring emergent PCPS were retrospectively investigated. These 27 patients were aged 44-83 years (65.6 ± 8.6 years) and 20 (81.5%) were men. Peak creatine kinase (CK) leakage ranged from 538 to 34,010 IU/l (13,553 ± 7656 IU/l). Eight (29.6%) patients were discharged without mechanical support...
September 8, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28887110/percutaneous-decommissioning-of-left-ventricular-assist-device
#11
Jia-Lin Soon, Ju-Le Tan, Choon-Pin Lim, Teing-Ee Tan, Swee-Yaw Tan, Ka-Lee Kerk, Kheng-Leng David Sim, Cumaraswamy Sivathasan
BACKGROUND: The Left Ventricular Assist Device (LVAD) has revolutionised our treatment of advanced stage heart failure, giving debilitated patients a new lease on life. A small proportion of these LVAD patients can be bridged-to-recovery. The identification of these patients and decision to wean, however, can be challenging. METHODS: The need to fully explant the device upon recovery has evolved to a minimalist approach aiming to avoid injury to the 'recovered' heart...
August 19, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28870355/mechanical-ventilation-state-of-the-art
#12
REVIEW
Tài Pham, Laurent J Brochard, Arthur S Slutsky
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28869234/weaning-difficulty-in-a-near-hanging-patient-an-unusual-cause
#13
Animesh Ray, Vikas Sharma, Ashif Ali, Shantanu Kumar Das
Suicidal hanging causes damage to the airways, neck blood vessels as well as soft tissue injuries. We report the development of tracheo-esophageal fistula in such a patient. Recurrent soiling of the airways and the resultant lung infection led to weaning failure. We highlight the approach to diagnosis and appropriate management in such a patient.
September 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28860265/official-ers-ats-clinical-practice-guidelines-noninvasive-ventilation-for-acute-respiratory-failure
#14
Bram Rochwerg, Laurent Brochard, Mark W Elliott, Dean Hess, Nicholas S Hill, Stefano Nava, Paolo Navalesi, Massimo Antonelli, Jan Brozek, Giorgio Conti, Miquel Ferrer, Kalpalatha Guntupalli, Samir Jaber, Sean Keenan, Jordi Mancebo, Sangeeta Mehta, Suhail Raoof
Noninvasive mechanical ventilation (NIV) is widely used in the acute care setting for acute respiratory failure (ARF) across a variety of aetiologies. This document provides European Respiratory Society/American Thoracic Society recommendations for the clinical application of NIV based on the most current literature.The guideline committee was composed of clinicians, methodologists and experts in the field of NIV. The committee developed recommendations based on the GRADE (Grading, Recommendation, Assessment, Development and Evaluation) methodology for each actionable question...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#15
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28852969/recovery-from-very-long-aortic-cross-clamping-in-redo-complex-aortic-surgery
#16
Shoichi Suehiro, Koji Shimizu, Megumi Ito, Hayato Nakata, Kazuhiro Akeho, Teiji Oda
A 68-year-old man had undergone ascending aortic replacement for acute type A aortic dissection. Three months later, he had a new aortic dissection with an ulcer-like projection located in the aortic arch with suspected graft infection. An emergent redo total aortic arch and root replacement was performed because of the coexistence of a fragile aortic root wall. The extensive redo procedure necessitated a very long aortic cross-clamping time (516 min). After 25 min of assisted circulation, he was easily weaned from the cardiopulmonary bypass...
August 29, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28839998/high-rate-of-arterial-complications-in-patients-supported-with-extracorporeal-life-support-for-drug-intoxication-induced-refractory-cardiogenic-shock-or-cardiac-arrest
#17
Matteo Pozzi, Catherine Koffel, Camelia Djaref, Daniel Grinberg, Jean Luc Fellahi, Elisabeth Hugon-Vallet, Cyril Prieur, Jacques Robin, Jean François Obadia
BACKGROUND: Cardiac failure is still a leading cause of death in drug intoxication. Extracorporeal life support (ECLS) could be used as a rescue therapeutic option in patients developing refractory cardiogenic shock or cardiac arrest. The aim of this report is to present our results of ECLS in the setting of poisoning from cardiotoxic drugs. METHODS: We included in this analysis consecutive patients who received an ECLS for refractory cardiogenic shock or in-hospital cardiac arrest due to drug intoxication...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28839496/use-of-nasal-non-invasive-ventilation-with-a-ram-cannula-in-the-outpatient-home-setting
#18
Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera
BACKGROUND: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings. OBJECTIVE: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure...
2017: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/28832706/behavior-of-lung-ultrasound-findings-during-spontaneous-breathing-trial
#19
Ana Carolina Peçanha Antonio, Cassiano Teixeira, Priscylla Souza Castro, Augusto Savi, Juçara Gasparetto Maccari, Roselaine Pinheiro Oliveira, Marli Maria Knorst
Objective: We aimed to investigate a potential association between B-lines and weaning failure. Methods: Fifty-seven subjects eligible for ventilation liberation were enrolled. Patients with tracheostomy were excluded. Lung ultrasound assessments of six thoracic zones were performed immediately before and at the exnd of the spontaneous breathing trial. B-predominance was defined as any profile with anterior bilateral B-pattern. Patients were followed up to 48 hours after extubation...
August 21, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#20
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
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