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https://www.readbyqxmd.com/read/29656607/expert-agreement-in-the-interpretation-of-lung-ultrasound-studies-performed-on-mechanically-ventilated-patients
#1
Scott J Millington, Robert T Arntfield, Robert Jie Guo, Seth Koenig, Pierre Kory, Vicki Noble, Haney Mallemat, Jordan R Schoenherr
OBJECTIVES: Although lung ultrasound (US) has been shown to have high diagnostic accuracy in patients presenting with acute dyspnea, its precision in critically ill patients is unknown. We investigated common areas of agreement and disagreement by studying 6 experts as they interpreted lung US studies in a cohort of intensive care unit (ICU) patients. METHODS: A previous study by our group asked experts to rate the quality of 150 lung US studies performed by 10 novices in a population of mechanically ventilated patients...
April 15, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29656287/respiratory-management-of-extremely-preterm-infants-an-international-survey
#2
Marc Beltempo, Tetsuya Isayama, Máximo Vento, Kei Lui, Satoshi Kusuda, Liisa Lehtonen, Gunnar Sjörs, Stellan Håkansson, Mark Adams, Akihiko Noguchi, Brian Reichman, Brian A Darlow, Naho Morisaki, Dirk Bassler, Simone Pratesi, Shoo K Lee, Abhay Lodha, Neena Modi, Kjell Helenius, Prakesh S Shah
BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration...
April 13, 2018: Neonatology
https://www.readbyqxmd.com/read/29652870/surveillance-for-the-identification-of-cases-of-acute-respiratory-infection-by-enterovirus-d68-in-children-in-a-tertiary-level-care-hospital-during-2014-2016
#3
Ana Estela Gamiño-Arroyo, José Luis Sánchez-Huerta, Alicia Elhaín de la Garza-López, Israel Parra-Ortega, Noé Escobar-Escamilla, Edgar Mendieta-Condado, Fabiola Garcés-Ayala, Gisela Barrera-Badillo, José Ernesto Ramírez-González, José Alberto Díaz-Quiñonez, Daniela de la Rosa-Zamboni
Background: The reemergence of enterovirus D68 (EV-D68) infections in the United States was reported from August-October 2014 (691 cases). In Mexico, an outbreak at the National Institute of Respiratory Diseases was reported (24 cases). The results of epidemiological surveillance of Enterovirus sp. (EV) and other respiratory viruses in a national pediatric tertiary care level hospital are presented. Methods: Following the alert issued by the reemergence of EV-D68 in 2014, epidemiological surveillance -which only detected respiratory viruses by PCR in patients with influenza-like illness using nasopharyngeal swabs- expanded to include children with asthma exacerbation or acute respiratory distress...
2018: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29652280/relationship-between-maximum-clot-firmness-in-rotem-%C3%A2-and-postoperative-bleeding-after-coronary-artery-bypass-graft-surgery-in-patients-using-clopidogrel
#4
Rasoul Azarfarin, Fereidoon Noohi, Majid Kiavar, Ziae Totonchi, Avaz Heidarpour, Amir Hendiani, Zahra Sadat Koleini, Saeid Rahimi
Background: The aim of the present study was to investigate the relationship between maximum clot firmness (MCF) in rotational thromboelastometry (ROTEM® ) and postoperative bleeding in patients on clopidogrel after emergency coronary artery bypass graft surgery (CABG). Methods: This observational study recruited 60 patients posted for emergency CABG following unsuccessful primary percutaneous coronary intervention (PCI) while on 600 mg of clopidogrel. The study population was divided into 2 groups on the basis of their MCF in the extrinsically activated thromboelastometric (EXTEM) component of the (preoperative) ROTEM® test: patients with MCF <50 mm (n = 16) and those with MCF ≥50 mm (n = 44)...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29652241/bacterial-burden-in-critically-injured-ventilated-patients-does-not-correlate-with-progression-to-pneumonia
#5
Bradley M Dennis, Richard D Betzold, Daryl Patton, Herbert A Hopper, Judith Jenkins, Chris Fonnesbeck, Wonder Drake, Addison K May
BACKGROUND: Ventilator-associated pneumonia (VAP) is common in critically injured patients. The pathogenesis of VAP is not completely understood. We hypothesized that mechanically ventilated trauma patients who develop pneumonia have a progressive increase in pathogen burden over the course of ventilation until a threshold for symptomatic pneumonia is reached, leading to clinical suspicion of VAP. METHODS: Critically injured adults ventilated for more than two successive days were enrolled...
March 13, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#6
Chuong Ngo, Stephan Dahlmanns, Thomas Vollmer, Berno Misgeld, Steffen Leonhardt
BACKGROUND AND OBJECTIVE: This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS: Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29649932/optimal-tube-length-of-orotracheal-intubation-for-mice
#7
Nobuyuki Nosaka, Timothy R Crother, Shuang Chen, Moshe Arditi, Kenichi Shimada
Endotracheal tube (ETT) management is an essential technique in handling mice with mechanical ventilators. Malposition into bronchi causes not only lethal complications for them but also less efficient mechanical ventilation. However, in general, it is difficult to know whether the ETT is placed with appropriate depth into the trachea of mice. We measured the distance from incisors to the bifurcation of trachea of multiple mice, and created a new estimation formula to obtain the suitable ETT length for mice with a body weight range from 17 g to 25 g: length (mm) = 0...
January 1, 2018: Laboratory Animals
https://www.readbyqxmd.com/read/29649556/is-there-a-relationship-between-airborne-and-surface-microbes-in-the-critical-care-environment
#8
J Smith, C A Adams, M F King, C J Noakes, C Robertson, S J Dancer
OBJECTIVE: This study attempted firstly to correlate environmental contamination of air and surfaces in the intensive care unit (ICU); and secondly, to examine any association between environmental contamination and ICU-acquired staphylococcal infection. DESIGN: We screened patients, air and surfaces on 10 sampling days in a mechanically ventilated 10-bed ICU during 10 months. METHODS: Near-patient hand-touch sites (n=500) and air (n=80) were screened for total colony count and Staphylococcus aureus using dipslides, settle plates (passive air sampling) and an MAS-100 slit-sampler (active air sampling)...
April 9, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29644893/activation-of-the-nfkb-pathway-alters-the-phenotype-of-mscs-in-the-tracheal-aspirates-of-preterm-infants-with-severe-bpd
#9
Tobias Reicherzer, Susanne Häffner, Tayyab Shahzad, Judith Gronbach, Josef Mysliwietz, Christoph Huebener, Uwe Hasbargen, Jan Gertheiss, Andreas Schulze, Saverio Bellusci, Rory E Morty, Anne Hilgendorff, Harald Ehrhardt
Mesenchymal stromal cells (MSCs) are released into the airways of preterm infants following lung injury. These cells display a pro-inflammatory phenotype and are associated with development of severe bronchopulmonary dysplasia (BPD). We aimed to characterize the functional properties of MSCs obtained from tracheal aspirates of 50 preterm infants who required invasive ventilation. Samples were separated by disease severity. The increased proliferative capacity of MSCs was associated with longer duration of mechanical ventilation and higher severity of BPD...
April 12, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29644580/on-the-efficacy-of-cardio-pulmonary-resuscitation-and-epinephrine-following-cyanide-and-h-2-s-intoxication-induced-cardiac-asystole
#10
Annick Judenherc-HaouzI, Takashi Sonobe, Vikhyat S Bebarta, Philippe Haouzi
This study was aimed at determining the efficacy of epinephrine, followed by chest compressions, in producing a return of spontaneous circulation (ROSC) during cyanide (CN)- or hydrogen sulfide (H2 S)-induced toxic cardiac pulseless electrical activity (PEA) in the rat. Thirty-nine anesthetized rats were exposed to either intravenous KCN (n = 27) or H2 S solutions (n = 12), at a rate that led to a PEA within less than 10 min. In the group intoxicated by CN, 20 rats were mechanically ventilated and received either epinephrine (0...
April 11, 2018: Cardiovascular Toxicology
https://www.readbyqxmd.com/read/29644564/semi-quantitative-cough-strength-score-as-a-predictor-for-extubation-outcome-in-traumatic-brain-injury-a-prospective-observational-study
#11
Abdelrady S Ibrahim, Mohamed G Aly, Khaled A Abdel-Rahman, Mona A Mohamed, Mogedda M Mehany, Eman M Aziz
BACKGROUND: Between 25 and 40% of extubated patients with traumatic brain injury (TBI) in the intensive care unit at our hospital (Assiut University Hospital-Assiut-Egypt) require reintubation. This reflects the importance of developing better criteria for predicting successful extubation in TBI. We evaluated the accuracy of semi-quantitative cough strength score (SCSS) and Glasgow coma scale (GCS) in predicting extubation outcomes in TBI. METHODS: This prospective observational study included patients (18-65 years), with TBI on mechanical ventilation more than 24 h who were ready to be weaned off...
April 11, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29644402/-a-case-of-sole-supportive-care-of-severe-neuroparalytic-foodborne-botulism-due-to-homemade-pesto
#12
M Kuratle, R Baldinger, B Lienhardt Nobbe, P Dreessen, B Yuen
In this article, a case of severe foodborne botulism in a 78-year-old man due to homemade pesto is presented. His initial symptoms were gastrointestinal problems. Later he suffered of cranial nerve palsies, muscle weakness of the upper extremities and respiratory failure, so he had to be admitted to the intensive care unit for mechanical ventilation. The botulism was confirmed by serology and culture. Because of spontaneously improving neurological deficits, we decided not to treat with the botulism antitoxin and the patient had complete clinical remission...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29644297/negative-pressure-in-treatment-of-persistent-post-traumatic-subcutaneous-emphysema-with-respiratory-failure-case-report-and-literature-review
#13
Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29643948/central-venous-oxygen-saturation-as-a-predictor-of-a-successful-spontaneous-breathing-trial-from-mechanical-ventilation-a-prospective-nested-case-control-study
#14
Ioannis Georgakas, Afroditi K Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Kristina Matei, Paraskevi Argyropoulou, Ioannis Stanopoulos
Background: Weaning from mechanical ventilation is a key element in the care of critically ill patients, and Spontaneous Breathing Trial (SBT) is a crucial step in this procedure. This nested case-control study aimed to evaluate whether central oxygen saturation (ScvO2 ) values and their changes could independently predict the SBT outcome among mechanically ventilated patients. Methods: A prospective cohort of patients who were mechanically ventilated for at least 48hours and fulfilled the criteria of readiness to wean constituted the study population...
2018: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/29643922/an-investigation-of-the-psychological-experiences-of-patients-under-mechanical-ventilation-following-open-heart-surgery
#15
Yousef Aslani, Reyhaneh Niknejad, Maryam Moghimian, Jaefar Maghaddasi, Mohammad Akbari
BACKGROUND: Breathing and living on mechanical ventilation develops a different feeling in patients. Most of such feelings and experiences are not pleasant and can lead to psychiatric disorders in the patients after they are detached from the ventilator. The aim of this study is to explore the psychological experiences of patients under mechanical ventilation. METHODS: This qualitative study was conducted according to an interpretive epistemological approach in 2016...
November 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#16
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#17
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29643089/physicians-political-preferences-and-the-delivery-of-end-of-life-care-in-the-united-states-retrospective-observational-study
#18
Anupam B Jena, Andrew R Olenski, Dhruv Khullar, Adam Bonica, Howard Rosenthal
OBJECTIVES: To compare the delivery of end of life care given to US Medicare beneficiaries in hospital by internal medicine physicians with Republican versus Democrat political affiliations. DESIGN: Retrospective observational study. SETTING: US Medicare. PARTICIPANTS: Random sample of Medicare beneficiaries, who were admitted to hospital in 2008-12 with a general medical condition, and died in hospital or shortly thereafter...
April 11, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29643066/early-ambulation-among-hospitalized-heart-failure-patients-is-associated-with-reduced-length-of-stay-and-30-day-readmissions
#19
Lisa M Fleming, Xin Zhao, Adam D DeVore, Paul A Heidenreich, Clyde W Yancy, Gregg C Fonarow, Adrian F Hernandez, Robb D Kociol
BACKGROUND: Early ambulation (EA) is associated with improved outcomes for mechanically ventilated and stroke patients. Whether the same association exists for patients hospitalized with acute heart failure is unknown. We sought to determine whether EA among patients hospitalized with heart failure is associated with length of stay, discharge disposition, 30-day post discharge readmissions, and mortality. METHODS AND RESULTS: The study population included 369 hospitals and 285 653 patients with heart failure enrolled in the Get With The Guidelines-Heart Failure registry...
April 2018: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#20
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
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