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https://www.readbyqxmd.com/read/29041034/inhaled-versus-systemic-corticosteroids-for-preventing-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-neonates
#1
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains an important cause of mortality and morbidity in preterm infants and inflammation plays a significant role in its pathogenesis. The use of inhaled corticosteroids may modulate the inflammatory process without concomitant high systemic steroid concentrations and less risk of adverse effects. This is an update of a review published in 2012 (Shah 2012). We recently updated the related review on "Inhaled versus systemic corticosteroids for treating bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates"...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#2
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29036976/-comparison-of-perioperative-serum-thrombomodulin-levels-in-patients-underwent-off-pump-coronary-artery-bypass-grafting-with-and-without-cardiogenic-shock
#3
L Zhang, C Wang, T X Gu, C M Lu, Z W Wang
Objective: To observe the perioperative changes of serum thrombomodulin in patients with and without cardiogenic shock undergoing off-pump coronary artery bypass grafting surgery. Methods: A total of 66 patients with coronary artery disease who underwent off-pump coronary artery bypass grafting surgery between June and December 2015 in our hospital were included in this study.The patients were divided into non-cardiogenic shock group (n=51) and shock group (n=15) according to the absence or presence of cardiogenic shock...
September 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29036955/-comparision-of-risk-factors-and-pathogens-in-patients-with-early-and-late-onset-ventilator-associated-pneumonia-in-intensive-care-unit
#4
Y J Liang, Z L Li, L Wang, B Y Liu, R Y Ding, X C Ma
Objective: To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU). Methods: This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital, China Medical University from Jan 2012 to Jun 2016. Subjects were classified by ventilator status: early-onset VAP (< 5 d ventilation, E-VAP) or late-onset VAP (≥ 5 d ventilation, L-VAP)...
October 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29036732/predictors-of-poor-outcome-in-neonates-with-pyogenic-meningitis-in-a-level-three-neonatal-intensive-care-unit-of-developing-country
#5
Mala Kumar, Shalini Tripathi, Himanshu Kumar, S N Singh
Background: The mortality of neonatal pyogenic meningitis is reduced to 10-15%, but morbidity is unchanged. Methods: Primary objective is to determine the outcome, i.e. death or abnormal neurological examination (NE) at discharge and abnormal developmental quotient (DQ) at 3 months. Secondary objective is to find predictors of poor outcome. Results: In all, 89 neonates enrolled, 10 expired and 24 neonates had abnormal NE at discharge. A total of 59 neonates came for follow up, 13 had DQ < 70...
September 26, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29036310/baclofen-self-poisoning-in-the-era-of-changing-indication-multicentric-reports-to-a-french-poison-control-centre
#6
Maxime Léger, Marion Brunet, Gaël Le Roux, Nicolas Lerolle, David Boels
Aims: Baclofen has gained interest in treating alcohol use disorder patients. These patients are at risk of voluntary drug intoxications. Understanding the context of baclofen's widespread use for alcohol use disorder, a recent evaluation of the epidemiology, morbidity and mortality of baclofen self-poisoning episodes is necessary. Methods: All baclofen self-poisoning reported to the Western France Poison Control Centre between January 2008 and December 2015 were included for analysis in this retrospective study...
September 28, 2017: Alcohol and Alcoholism: International Journal of the Medical Council on Alcoholism
https://www.readbyqxmd.com/read/29035976/the-impact-of-obesity-on-mortality-and-other-outcomes-in-patients-with-nonvariceal-upper-gastrointestinal-hemorrhage-in-the-united-states
#7
Marwan S Abougergi, Heather Peluso, Chebli Mrad, John R Saltzman
GOALS: To quantify in patients with nonvariceal upper gastrointestinal hemorrhage (NVUGIH) the relationship between obesity and mortality, disease severity, treatment modalities, and resource utilization. BACKGROUND: NVUGIH is the most common gastrointestinal emergency. STUDY: Adults with a principal diagnosis of NVUGIH were selected from the 2014 National Inpatient Sample. The primary outcome was in-hospital mortality. Secondary outcomes were hemorrhagic shock, prolonged mechanical ventilation (PMV), upper endoscopy [esophagogastroduodenoscopy (EGD)], radiologic treatment, surgery, length of hospital stay (LOS), and total hospitalization costs and charges...
October 13, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29035701/does-sofa-predict-outcomes-better-than-sirs-in-brazilian-icu-patients-with-suspected-infection-a-retrospective-cohort-study
#8
Regis Goulart Rosa, Rafael Barberena Moraes, Thiago Costa Lisboa, Daniel Pretto Schunemann, Cassiano Teixeira
We compared the discriminatory capacity of the sequential organ failure assessment (SOFA) versus the systemic inflammatory response syndrome (SIRS) score for predicting ICU mortality, need for and length of mechanical ventilation (MV), ICU stay, and hospitalization in patients with suspected infection admitted to a mixed Brazilian ICU. We performed a retrospective analysis of a longitudinal ICU database from a tertiary hospital in Southern Brazil. Patients were categorized according to whether they met the criteria for sepsis according to SOFA (variation ≥2 points over the baseline clinical condition) and SIRS (SIRS score ≥2 points)...
October 13, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29035425/inhaled-versus-systemic-corticosteroids-for-the-treatment-of-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-infants
#9
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: This is an update of a review published in 2012. A related review "Inhaled versus systemic corticosteroids for preventing bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates" has been updated as well. Bronchopulmonary dysplasia (BPD) is a serious and common problem among very low birth weight infants, despite the use of antenatal steroids and postnatal surfactant therapy to decrease the incidence and severity of respiratory distress syndrome. Due to their anti-inflammatory properties, corticosteroids have been widely used to treat or prevent BPD...
October 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29035085/lung-microbiota-is-related-to-smoking-status-and-to-development-of-ards-in-critically-ill-trauma-patients
#10
Ariane R Panzer, Susan V Lynch, Chaz Langelier, Jason D Christie, Kathryn McCauley, Mary Nelson, Christopher K Cheung, Neal L Benowitz, Mitchell J Cohen, Carolyn S Calfee
RATIONALE: Cigarette smoking is associated with increased risk of acute respiratory distress syndrome (ARDS) in patients following severe trauma; however, mechanisms underlying this association are unknown. OBJECTIVES: To determine whether cigarette smoking contributes to ARDS development following trauma by altering community composition of the lung microbiota Methods: We studied lung microbiota of mechanically ventilated patients admitted to the intensive care unit (ICU) following severe blunt trauma using 16S rRNA gene amplicon sequencing of endotracheal aspirate (ETA) samples obtained upon ICU admission (n=74) and at 48 hours post-admission (n=30)...
October 16, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29034711/electromagnetically-guided-bedside-placement-of-post-pyloric-feeding-tubes-in-critical-care
#11
Danielle E Bear, Alice Champion, Katie Lei, Luigi Camporota, Nicholas A Barrett
Post-pyloric feeding is recommended in critically ill patients with gastro-intestinal intolerance. However, traditional placement methods are logistically difficult and carry potential risks. The authors retrospectively compared the position of post-pyloric feeding tubes (PPFTs) using an electromagnetic device that demonstrated by X-ray and analysed the complication rates, proportion of lung placements avoided and the time taken to establish enteral feeding. Forty placements in 37 mechanically ventilated patients were analysed; there was a success rate of 87...
October 12, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29033719/epidemiology-and-characteristics-of-nosocomial-infections-in-critically-ill-patients-in-a-tertiary-care-intensive-care-unit-of-northern-india
#12
Anirban Hom Choudhuri, Mitali Chakravarty, Rajeev Uppal
BACKGROUND AND AIMS: The prevalence of nosocomial infection is higher in the Intensive Care Unit (ICU) than other areas of the hospital. The present observational study was undertaken to describe the epidemiology and characteristics of nosocomial infections acquired in a tertiary care ICU and the impact of the various risk factors in their causation. MATERIALS AND METHODS: A retrospective study was conducted on the prospectively collected data of 153 consecutive patients admitted in a tertiary care ICU between July 2014 and December 2015...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033344/a-prospective-study-of-ketamine-as-primary-therapy-for-prehospital-profound-agitation
#13
Jon B Cole, Lauren R Klein, Paul C Nystrom, Johanna C Moore, Brian E Driver, Brandon J Fryza, Justin Harrington, Jeffrey D Ho
OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...
October 7, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29032753/halogenated-agents-and-cardiovascular-surgery-has-mortality-really-decreased
#14
Giovanni Landoni, Juan Carlos Lopez-Delgado, Chiara Sartini, Simona Tamà, Alberto Zangrillo
Halogenated anesthetic agents (desflurane, isoflurane and sevoflurane) may have cardioprotective properties at therapeutic doses against myocardial intraoperative ischemia-reperfusion injury. Cardioprotection mechanisms are related to mitochondrial and anti-apoptotic signaling pathways. Experimental and human studies have proven that their use may reduce morbidity and mortality in the setting of cardiac surgery, including a reduction in myocardial infarct size and mechanical ventilation needs. On the contrary, total intra-venous propofol based anesthesia may be detrimental...
October 10, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29032602/muscle-specific-differences-in-expression-and-phosphorylation-of-the-janus-kinase-2-signal-transducer-and-activator-of-transcription-3-following-long-term-mechanical-ventilation-and-immobilization-in-rats
#15
Heba Salah, Wen Fury, Jesper Gromada, Yu Bai, Tamar Tchkonia, James L Kirkland, Lars Larsson
AIM: Muscle wasting is one of the factors most strongly predicting mortality and morbidity in critically ill intensive care unit (ICU). This muscle wasting affects both limb and respiratory muscles but the understanding of underlying mechanisms and muscle-specific differences remains incomplete. This study aims at investigating the temporal expression and phosphorylation of the Janus kinase / signal transducer and activator of transcription (JAK/STAT) pathway in muscle wasting associated with the ICU condition in order to characterize the JAK/STAT proteins and the related changes leading or responding to their activation during exposure to the ICU condition...
October 15, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/29032021/clinical-characteristics-and-survival-outcomes-of-terminally-ill-patients-undergoing-withdrawal-of-mechanical-ventilation
#16
Yu-Shin Hung, Shu-Hui Lee, Chia-Yen Hung, Chao-Hui Wang, Chen-Yi Kao, Hung-Ming Wang, Wen-Chi Chou
BACKGROUND: Withdrawal of mechanical ventilation is an important, but rarely explored issue in Asia during end-of-life care. This study aimed to describe the clinical characteristics and survival outcomes of terminally ill patients undergoing withdrawal of mechanical ventilation in Taiwan. METHODS: One-hundred-thirty-five terminally ill patients who had mechanical ventilation withdrawn between 2013 and 2016, from a medical center in Taiwan, were enrolled. Patients' clinical characteristics and survival outcomes after withdrawal of mechanical ventilation were analyzed...
October 11, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/29031433/risk-factors-for-health-care-associated-infection-in-hospitalized-adults-systematic-review-and-meta-analysis
#17
REVIEW
Alba Luz Rodríguez-Acelas, Miriam de Abreu Almeida, Bruna Engelman, Wilson Cañon-Montañez
BACKGROUND: Health care-associated infections (HAIs) are a public health problem that increase health care costs. This article aimed to systematically review the literature and meta-analyze studies investigating risk factors (RFs) independently associated with HAIs in hospitalized adults. METHODS: Electronic databases (MEDLINE, Embase, and LILACS) were searched to identify studies from 2009-2016. Pooled risk ratios (RRs) or odds ratios (ORs) or mean differences (MDs) and 95% confidence intervals (CIs) were calculated and compared across the groups...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29031327/respiratory-variation-in-aortic-blood-peak-velocity-and-caudal-vena-cava-diameter-can-predict-fluid-responsiveness-in-anaesthetised-and-mechanically-ventilated-dogs
#18
M Bucci, R Rabozzi, C Guglielmini, P Franci
BACKGROUND AND M&MS: Dynamic preload indices, such as systolic pressure variation (SPV), aortic flow peak velocity variation (ΔVpeak) and distensibility index of the caudal vena cava (CVCDI), are reliable indices for predicting fluid responsiveness in humans. This study aimed to investigate the ability of these indices to predict fluid response in 24 healthy dogs undergoing general anaesthesia and mechanical ventilation. Aortic flow peak velocity variation (∆Vpeak), CVCDI, and SPV were calculated before volume expansion (5mL/kg bolus of lactated Ringer's solution)...
September 2017: Veterinary Journal
https://www.readbyqxmd.com/read/29031240/colonization-of-oropharynx-and-lower-respiratory-tract-in-critical-patients-risk-of-ventilator-associated-pneumonia
#19
Ivany Machado de Carvalho Baptista, Frederico Canato Martinho, Gustavo Giacomelli Nascimento, Carlos Eduardo da Rocha Santos, Renata Falchete do Prado, Marcia Carneiro Valera
OBJECTIVE: To investigate the microbial diversity existing in oral cavity and respiratory tract samples (from mini-bronchoalveolar lavage (BAL), endotracheal aspirate, and orotracheal tube) of patients on mechanical ventilation by using the checkerboard DNA-DNA hybridisation. Also, the study aimed to evaluate whether the microbial profile in the oral cavity is found in respiratory tract samples, at different periods of mechanical ventilation time (12h, 48h, 96h) in attempt to identification of relationship between VAP (ventilator-associated pneumonia) and bacterial species studied...
October 2, 2017: Archives of Oral Biology
https://www.readbyqxmd.com/read/29030937/changes-in-blood-volume-indicators-and-dynamic-indicators-measured-with-transpulmonary-ultrasound-velocity-during-blood-depletion-and-repletion-in-a-neonatal-swine-model
#20
Manuel Martin-Flores, Alvaro F Cisternas, Robin D Gleed
BACKGROUND: Dynamic indicators such as pulse pressure and stroke volume variations can be measured to track changes in preload during hemorrhage, and evaluate fluid therapy. However, these dynamic indicators require mechanical ventilation, and might be affected by cardiac dysrhythmias and changes in vascular tone. Blood volume indicators may offer alternatives for assessing changes in volume status. AIMS: The aims of this study were to measure changes in blood volume indicators and dynamic indicators during removal of blood in two stages and subsequent blood replacement in anesthetized, mechanically ventilated, neonatal pigs...
November 2017: Paediatric Anaesthesia
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