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https://www.readbyqxmd.com/read/29352361/the-modified-ravitch-approach-for-the-management-of-severe-anterior-flail-chest-with-bilateral-sternochondral-dislocations-a-case-report
#1
Gabriel Estremera, Ellen Chieko Omi, Eduardo Smith-Singares
The management of flail chest continues to evolve as scientific evidence and surgical experience accumulates. Flail chest injuries that span the sternum present a rare and complicated injury pattern that can be challenging to manage both medically and surgically. Our patient is a 69-year-old involved in a high-speed motor vehicle crash with respiratory failure secondary to an anterior flail chest. Tomographic examination confirmed a sternal fracture with bilateral sternochondral dislocations and multiple rib fractures...
January 19, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29335475/discontinuous-ventilator-weaning-of-patients-with-acute-sci
#2
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29334565/reversal-of-intestinal-failure-in-children-with-tufting-enteropathy-supported-with-parenteral-nutrition-at-home
#3
Iona Ashworth, Alexander Wilson, Samuel Aquilina, Raymond Parascandalo, Victor Mercieca, Jurgen Gerada, Sarah Macdonald, Venetia Simchowitz, Susan Hill
OBJECTIVES: To review long-term outcome of Intestinal Epithelial Dysplasia(IED)/tufting enteropathy(TE) patients treated with parenteral nutrition(PN) at home managed by an intestinal failure(IF) rehabilitation service METHODS:: Infants presenting from 1986-2010 with IF, and TE histology were retrospectively reviewed for up to 30 years. Data collected included: outcome, presentation, nutrition(parenteral/enteral), country of residence, race, EpCAM gene, growth, bone age, occupation. RESULTS: 13 patients (6 male) in Malta and the UK with TE histology were established on home PN...
January 13, 2018: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29332614/serelaxin-for-infant-heart-failure-in-congenital-dilated-cardiomyopathy
#4
Patrick O Myers, Alice Bordessoule, Cécile Tissot
Serelaxin has been studied in trials in adults with acute heart failure, but not in children. We report the first compassionate use of serelaxin in an infant. A 6-month-old girl with dilated cardiomyopathy was placed on extracorporeal membrane oxygenation following cardiac arrest unresponsive to medical treatment. Extracorporeal membrane oxygenation weaning failed despite maximal ino-dilator therapy. During the 48-hour infusion of serelaxin, we observed marked improvement in brain natriuretic peptide, left ventricular systolic function, and dilatation...
January 15, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29330683/cardiac-function-during-weaning-failure-the-role-of-diastolic-dysfunction
#5
Ferran Roche-Campo, Alexandre Bedet, Emmanuel Vivier, Laurent Brochard, Armand Mekontso Dessap
BACKGROUND: Cardiac dysfunction is a common cause of weaning failure. Weaning shares some similarities with a cardiac stress test and may challenge active phases of the cardiac cycle-like ventricular contractility and relaxation. This study aimed at assessing systolic and diastolic function during the weaning process and scrutinizing their dynamics during weaning trials. METHODS: Echocardiography was performed during baseline ventilator settings to assess cardiac function at the initiation of the weaning process and at the start and the end of consecutive weaning trials (performed at day-1, day-2, and before extubation if applicable) to explore the evolution of left ventricle contractility and relaxation in a subset of patients...
January 9, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29329356/prognostic-factors-of-noninvasive-mechanical-ventilation-in-lung-cancer-patients-with-acute-respiratory-failure
#6
Wei-Chih Chen, Vincent Yi-Fong Su, Wen-Kuang Yu, Yen-Wen Chen, Kuang-Yao Yang
INTRODUCTION: Few studies have reported outcomes of lung cancer patients with acute respiratory failure (RF) using noninvasive positive pressure ventilation (NIPPV). The aim of this study was to investigate the prognostic factors in these patients. MATERIALS AND METHODS: This retrospective observational study included all hospitalized lung cancer patients who received NIPPV for acute RF. It was conducted at a tertiary medical center in Taiwan from 2005 to 2010. The primary outcome was all cause mortality at 28 days after the initiation of NIPPV...
2018: PloS One
https://www.readbyqxmd.com/read/29280162/managing-traps-and-pitfalls-during-initial-steps-of-an-ecmo-retrieval-program-using-a-miniaturized-portable-system-what-have-we-learned-from-the-first-two-years
#7
Anton Sabashnikov, Ilja Djordjevic, Antje-Christin Deppe, Elmar W Kuhn, Julia Merkle, Carolyn Weber, Dirk Sindhu, Kaveh Eghbalzadeh, Mohamed Zeriouh, Oliver J Liakopoulos, Parwis B Rahmanian, Ferdinand Kuhn-Régnier, Yeong-Hoon Choi, Navid Madershahian, Thorsten Wahlers
The aim of this study was to provide early and mid-term results of the newly established extracorporeal membrane oxygenation (ECMO) retrieval service in a tertiary cardiothoracic center using the miniaturized portable Cardiohelp System (Maquet, Rastatt, Germany). A particular attention was paid to organizational and logistic specifics as well as challenges and pitfalls associated with initial phase of the program. From January 2015 until January 2017 a heterogenic group of 28 consecutive patients underwent ECMO implantation in distant hospitals for acute cardiac, pulmonary or combined failure as a bridge-to-decision and were subsequently transported to our institution...
December 27, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29259784/prospective-cohort-study-to-assess-rates-of-contagious-disease-in-pre-weaned-uk-dairy-heifers-management-practices-passive-transfer-of-immunity-and-associated-calf-health
#8
Kate F Johnson, Natalie Chancellor, Charlotte C Burn, D Claire Wathes
Dairy calves are vulnerable to infectious diseases, particularly diarrhoea and bovine respiratory disease (BRD), causing mortality and reducing welfare and growth. A prospective cohort study was performed on 11 UK dairy farms to determine the underlying causes for calf disease. This first paper describes the incidence, timing and duration of infectious disease, mortality rates, passive transfer of immunity and key management practices that may contribute to disease incidence. Heifer calves were recruited in the first week of life (n=492) and a blood sample taken to measure IgG and total protein (TP)...
2017: Veterinary Record Open
https://www.readbyqxmd.com/read/29244782/efficacy-of-blunt-force-trauma-a-novel-mechanical-cervical-dislocation-device-and-a-non-penetrating-captive-bolt-device-for-on-farm-euthanasia-of-pre-weaned-kits-growers-and-adult-commercial-meat-rabbits
#9
Jessica L Walsh, Aaron Percival, Patricia V Turner
The commercial meat rabbit industry is without validated on-farm euthanasia methods, potentially resulting in inadequate euthanasia protocols. We evaluated blunt force trauma (BFT), a mechanical cervical dislocation device (MCD), and a non-penetrating captive bolt device (NPCB) for euthanasia of pre-weaned kits, growers, and adult rabbits. Trials were conducted on three commercial meat rabbit farms using 170 cull rabbits. Insensibility was assessed by evaluating absence of brainstem and spinal reflexes, rhythmic breathing, and vocalizations...
December 15, 2017: Animals: An Open Access Journal From MDPI
https://www.readbyqxmd.com/read/29233766/use-of-the-perceval-sutureless-valve-in-active-prosthetic-aortic-valve-endocarditis
#10
Elena Roselló-Díez, Gregorio Cuerpo, Francisco Estévez, C Christian Muñoz-Guijosa, Manel Tauron, José J Cuenca, Ángel Pinto, Josep María Padró
BACKGROUND: Surgical treatment of active prosthetic aortic valve endocarditis presents a challenge for cardiac surgeons because of tissue friability and destruction caused by infection. Sutureless prostheses, such as the Perceval S® (LivaNova, Saluggia, Italy), have emerged as an option among the different surgical approaches for these complicated cases. METHODS: This study presents data from nine patients who underwent aortic valve re-replacement with the Perceval S® due to active prosthetic aortic valve endocarditis, between January 2014 and August 2016...
December 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29232299/the-axillary-intra-aortic-balloon-pump-as-a-bridge-to-recovery-allows-early-ambulation-in-long-term-use-case-series-and-literature-review
#11
Nnamdi Nwaejike, Andre Y Son, Chetan B Patel, Jacob N Schroder, Carmelo A Milano, Mani A Daneshmand
We evaluated the feasibility, tolerability, and efficacy of a strategy for transaxillary artery intra-aortic balloon pump placement for extended mechanical circulatory support of patients with postcardiotomy shock as a bridge to recovery. Patients requiring prolonged intra-aortic balloon pump support for postcardiotomy heart failure were identified. Intra-aortic balloon pump was tunneled through a 6-mm Dacron graft anastomosed to the right axillary artery. The intra-aortic balloon pump catheter is advanced under fluoroscopic guidance into the descending thoracic aorta...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29225976/intensive-care-in-a-patient-with-toxic-epidermal-necrolysis
#12
J Wallenborn, M Fischer
Toxic epidermal necrolysis (TEN) is a serious adverse drug reaction with high lethality, which usually requires intensive-medical care. A 44-year-old man developed generalized exanthema with increasing exfoliation and mucosal involvement after taking allopurinol, ibuprofen, and etoricoxib. The clinical diagnosis of TEN was histologically confirmed. Prednisolone therapy with 3 mg/kg body weight (BW) was not able to prevent further progress to finally 80% of the body surface, and infliximab 5 mg/kg BW was given as a single dose...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29221294/using-m-mode-ultrasonography-to-assess-diaphragm-dysfunction-and-predict-the-success-of-mechanical-ventilation-weaning-in-elderly-patients
#13
Daozheng Huang, Huan Ma, Wenzhao Zhong, Xiaoting Wang, Yan Wu, Tiehe Qin, Shouhong Wang, Ning Tan
Background: Ultrasonography (US) is a non-invasive and commonly available bedside diagnostic tool. The aim of this study was to assess the utility of M-mode US on ventilator weaning outcomes in elderly patients. Methods: This was a single center, prospective, observational study in patients aged 80 years or older who were in the medical intensive care unit, had undergone mechanical ventilation for >48 hours, and met the criteria for a spontaneous breathing trial (SBT)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29213205/hypercapnic-ventilatory-response-in-the-weaning-of-patients-with-prolonged-mechanical-ventilation
#14
Chung-Shu Lee, Ning-Hung Chen, Li-Pang Chuang, Chih-Hao Chang, Li-Fu Li, Shih-Wei Lin, Hsiung-Ying Huang
Objective: To investigate whether hypercapnic ventilatory response (defined as the ratio of the change in minute ventilation [[Formula: see text]] to the change in end-tidal partial pressure of carbon dioxide [ΔPETCO2 ]) is a predictor of successful weaning in patients with prolonged mechanical ventilation (PMV) and to determine a reference value for clinical use. Methods: A hypercapnic challenge test was performed on 32 PMV subjects (average age: 74.3 years ± 14...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29212551/extracorporeal-membrane-oxygenation-for-life-threatening-asthma-refractory-to-mechanical-ventilation-analysis-of-the-extracorporeal-life-support-organization-registry
#15
Hye Ju Yeo, Dohyung Kim, Doosoo Jeon, Yun Seong Kim, Peter Rycus, Woo Hyun Cho
BACKGROUND: The use of extracorporeal membrane oxygenation (ECMO) in cases of near-fatal asthma (NFA) has increased, but the benefits and potential complications of this therapy have yet to be fully investigated. METHODS: Cases were extracted from the Extracorporeal Life Support Organization Registry between March 1992 and March 2016. All patients with a diagnosis of asthma (according to the International Classification of Diseases 9th edition), who also received ECMO, were extracted...
December 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29201833/in-reply-successful-extubation-after-weaning-failure-by-non-invasive-ventilation-in-patients-with-neurmuscular-disease-do-we-appreciate-the-bigger-picture
#16
Sun Mi Kim, Yu Hui Won, Seong-Woong Kang
No abstract text is available yet for this article.
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29201832/letter-to-the-editor-successful-extubation-after-weaning-failure-by-noninvasive-ventilation-in-patients-with-neuromuscular-disease-do-we-appreciate-the-bigger-picture
#17
COMMENT
Alastair J Glossop, Antonio M Esquina
No abstract text is available yet for this article.
October 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29195690/completed-fda-feasibility-trial-of-surgically-placed-temporary-diaphragm-pacing-electrodes-a-promising-option-to-prevent-and-treat-respiratory-failure
#18
Raymond P Onders, Alan Markowitz, Vanessa P Ho, Jeff Hardacre, Yuri Novitsky, Christopher Towe, MaryJo Elmo, Cindy Kaplan, Robert Schilz
BACKGROUND: Etiologies contributing to failure to wean from mechanical ventilation (MV) are multiple, resulting in morbid and costly outcomes. Diaphragm pacing (DP) is used in spinal cord injury to replace MV. Temporary DP could be utilized in acute respiratory failure to reduce MV. METHODS: A prospective FDA feasibility trial evaluated temporary DP electrodes implanted in each hemi-diaphragm during a subject's primary procedure. Objectives included: ability to provide ventilation, stability analysis with diaphragm electromyography, and adverse event monitoring...
November 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29193160/multicenter-experience-with-mechanical-circulatory-support-using-a-new-diagonal-pump-in-233-children
#19
Brigitte Stiller, Robert Jan Houmes, André Rüffer, Matthias Kumpf, Andreas Müller, Florian Kipfmüller, Harald Köditz, Susanne Herber Jonat, Claudia Schmoor, Christoph Benk, Dick Tibboel, Thilo Fleck
Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients...
November 29, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29191205/different-effects-of-cardiac-and-diaphragm-function-assessed-by-ultrasound-on-extubation-outcomes-in-difficult-to-wean-patients-a-cohort-study
#20
Ling Luo, Yidan Li, Xiukai Chen, Bing Sun, Wenxiong Li, Wei Gu, Shuo Wang, Song Zhao, Yanwei Lv, Mulei Chen, Jingen Xia, Feng Sui, Xue Mei, Huanzhong Shi, Zhaohui Tong
BACKGROUND: Ultrasound is a convenient tool to evaluate cardiac and diaphragm function. The ratio (E/Ea) of mitral Doppler inflow velocity to annular tissue Doppler wave velocity by transthoracic echocardiography (TTE) and diaphragmatic excursion (DE) by diaphragm ultrasound have been confirmed in predicting extubation outcomes independently, however their different roles in the weaning process have not been determined until now. METHODS: We designed a cohort study to preform diaphragm ultrasound and TTE before and after the spontaneous breathing trial (SBT) in difficult-to-wean patients...
December 1, 2017: BMC Pulmonary Medicine
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