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https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#1
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28682893/burden-on-caregivers-of-ventilator-dependent-patients-a-cross-sectional-study
#2
Jui-Fang Liu, Man-Chi Lu, Tien-Pei Fang, Hong-Ren Yu, Hui-Ling Lin, Der-Long Fang
Caring for prolonged mechanical ventilation (PMV) patients imposes heavy psychological, physical, social, and financial burdens on caregivers. Currently, studies regarding the burden on caregivers of PMV patients are scant; therefore, the present study investigated the burden on caregivers of PMV patients.This cross-sectional study was approved by the Institutional Review Board of Zuoying Armed Forces General Hospital. A survey was conducted among the caregivers of PMV patients who were admitted to a chronic respiratory care ward (RCW) or were receiving home care from June to December 2010...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28677019/-acute-respiratory-distress-syndrome-basic-principles-and-treatment
#3
P M Spieth, A Güldner, M Gama de Abreu
Even after many years of intensive research acute respiratory distress syndrome (ARDS) is still associated with a high mortality. Epidemiologically, ARDS represents a central challenge for modern intensive care treatment. The multifactorial etiology of ARDS complicates the clear identification and evaluation of new therapeutic interventions. Lung protective mechanical ventilation and adjuvant therapies, such as the prone position and targeted extracorporeal lung support are of particular importance in the treatment of ARDS, depending on the severity of the disease...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28639944/clinical-impact-and-efficacy-of-bedside-echocardiography-on-patient-management-in-pediatric-intensive-care-units-picus-a-prospective-study
#4
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş
OBJECTIVE: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children. METHODS: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28625234/-effect-of-global-end-diastolic-volume-index-guidance-fluid-resuscitation-in-elderly-patients-with-septic-shock
#5
Shuang Ma, Rumin Zhang, Shifu Wang, Meiling Zhao, Lei Wang, Yun Zhang
OBJECTIVE: To evaluate the effect of global end diastolic volume index (GEDVI) on fluid resuscitation in elderly patients with septic shock. METHODS: A prospective randomized controlled trial (RCT) was conducted. Septic shock patients over 65 years admitted to intensive care unit (ICU) of Shandong Province, Zibo Central Hospital from January 2013 to December 2015 were enrolled. The patients were randomly divided into control group and observation group, 20 cases in each group...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622477/an-examination-of-factors-affecting-the-length-of-stay-in-a-palliative-care-center
#6
Metin Dincer, Kadriye Kahveci, Cihan Doger
BACKGROUND: With the increase in elderly population, life-threatening chronic diseases are increasing, simultaneously increasing the need for palliative care centers (PCCs). OBJECTIVES: To evaluate the factors affecting the length of stay (LOS) and discharge of patients from a PCC. METHODS: A retrospective scan was made of the records of patients followed up in the PCC between January 2013 and March 2016. A record was made of patient age, gender, diagnosis, conditions/comorbidities, Glasgow Coma Scale, Karnofsky Performance Scale, LOS, prognosis (exitus or surviving), percutaneous endoscopic gastrostomy (PEG), tracheostomy, mechanical ventilator, nutrition (total parenteral nutrition [TPN] or enteral nutrition), and the results of cultures taken during stay in PCCs (blood, tracheal aspirate, urine, rectal swab, wound)...
June 16, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28571104/a-review-of-the-burns-caseload-of-a-physician-based-helicopter-emergency-medical-service
#7
Karina Hall, Brian Burns
OBJECTIVES: The aim of this study was to describe patient demographics, injuries, physiology and interventions performed by retrieval physicians in the care of burns patients in both a pre-hospital and interhospital setting. METHODS: A retrospective review of patient records from a large Australian Helicopter Emergency Medical Service was conducted. Demographics, injury, burn type, physiology and intervention data were extracted into a database for statistical analysis...
August 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28535026/tetanus-%C3%A2-n%C3%A3-stan-bortgl%C3%A3-md-men-allvarlig-sjukdom-%C3%A3-ldre-kvinnor-%C3%A3-r-en-riskgrupp-diagnosen-kan-vara-en-utmaning
#8
Bernhard Hozgraefe, Akad Koria, Victoria Sem, Joak Johansson
Tetanus, an almost forgotten but serious disease Tetanus is the systemic consequence of a local infection with Clostridium tetani, that produces toxin which spreads in the systemic circulation. In developed countries, it is extremely rare. Women born before 1950 are a group at risk due to lower prevalence of immunisation. This report describes a case of tetanus. The patient is a previously healthy 82-year-old woman. She presented to primary care with a complaint of stiffness in the neck and jaw. A physical exam and basic laboratory tests were normal apart from a slightly increased blood pressure...
May 22, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28524029/-predictive-value-of-left-ventricular-diastolic-dysfunction-on-mechanical-ventilation-weaning
#9
Hui Wang, Ming Ma, Desheng Chen, Gang Li, Shupeng Wang, Jingen Xia, Jun Duan
OBJECTIVE: To investigate the predictive value of left ventricular diastolic function on mechanical ventilation weaning in patients with left ventricular ejection fraction (LVEF) > 0.50. METHODS: A retrospective case control study was conducted. Sixty-five patients with LVEF > 0.50 undergoing mechanical ventilation for more than 48 hours admitted to surgery intensive care unit (ICU) of China-Japan Friendship Hospital from June 2014 to December 2016 were enrolled...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28482805/management-of-potentially-life-threatening-emergencies-at-74-primary-level-hospitals-in-mongolia-results-of-a-prospective-observational-multicenter-study
#10
Naranpurev Mendsaikhan, Davaa Gombo, Ganbold Lundeg, Christian Schmittinger, Martin W Dünser
BACKGROUND: While the capacities to care for and epidemiology of emergency and critically ill patients have been reported for secondary and tertiary level hospitals in Mongolia, no data exist for Mongolian primary level hospitals. METHODS: In this prospective, observational multicenter study, 74 primary level hospitals of Mongolia were included. We determined the capacities of these hospitals to manage medical emergencies. Furthermore, characteristics of patients presenting with potentially life-threatening emergencies to these hospitals were evaluated during a 6 month period...
May 8, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#11
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28401600/involvement-of-patients-perspectives-on-treatment-with-non-invasive-ventilation-in-patients-with-copd-a-qualitative-study
#12
Helle Marie Christensen, Lotte Huniche, Ingrid L Titlestad
AIMS AND OBJECTIVES: To clarify COPD patients' perspectives on treatment with non-invasive ventilation and develop management strategies for the treatment based on these perspectives. BACKGROUND: The effect of treating COPD patients with non-invasive ventilation is well documented, as is the problem of patient difficulties in tolerating the treatment. Knowledge of how patients with COPD experience and evaluate treatment with non-invasive ventilation is limited; therefore, more information of patient perspectives is needed to develop treatment practices in respiratory medicine...
April 12, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#13
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28291809/impact-of-a-structured-icu-training-programme-in-resource-limited-settings-in-asia
#14
Rashan Haniffa, Yoel Lubell, Ben S Cooper, Sanjib Mohanty, Shamsul Alam, Arjun Karki, Rajya Pattnaik, Ahmed Maswood, R Haque, Raju Pangeni, Marcus J Schultz, Arjen M Dondorp
OBJECTIVE: To assess the impact on ICU performance of a modular training program in three resource-limited general adult ICUs in India, Bangladesh, and Nepal. METHOD: A modular ICU training programme was evaluated using performance indicators from June 2009 to June 2012 using an interrupted time series design with an 8 to 15 month pre-intervention and 18 to 24 month post-intervention period. ICU physicians and nurses trained in Europe and the USA provided training for ICU doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28273238/evaluation-of-self-perception-of-mechanical-ventilation-knowledge-among-brazilian-final-year-medical-students-residents-and-emergency-physicians
#15
Fernando Sabia Tallo, Simone de Campos Vieira Abib, Alexandre Jorgi de Andrade Negri, Paulo Cesar, Renato Delascio Lopes, Antônio Carlos Lopes
OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil...
February 1, 2017: Clinics
https://www.readbyqxmd.com/read/28196506/the-success-of-pre-hospital-tracheal-intubation-by-different-pre-hospital-providers-a-systematic-literature-review-and-meta-analysis
#16
K Crewdson, D J Lockey, J Røislien, H M Lossius, M Rehn
BACKGROUND: Pre-hospital basic airway interventions can be ineffective at providing adequate oxygenation and ventilation in some severely ill or injured patients, and advanced airway interventions are then required. Controversy exists regarding the level of provider required to perform successful pre-hospital intubation. A previous meta-analysis reported pre-hospital intubation success rates of 0.849 for non-physicians versus 0.991 for physicians. The evidence base on the topic has expanded significantly in the last 10 years...
February 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28187795/management-of-the-comatose-patient
#17
REVIEW
E F M Wijdicks
Coma has many causes but there are a few urgent ones in clinical practice. Management must start with establishing the cause and an attempt to reverse or attenuate some of the damage. This may include early neurosurgical intervention, efforts to reduce brain tissue shift and raised intracranial pressure, correction of markedly abnormal laboratory abnormalities, and administration of available antidotes. Supporting the patient's vital signs, susceptible to major fluctuations in a changing situation, remains the most crucial aspect of management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28144686/-new-technical-developments-for-inhaled-sedation
#18
A Meiser, H Bomberg, T Volk, H V Groesdonk
The circle system has been in use for more than 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. In the circle system, all breathing gas is rebreathed after carbon dioxide absorption. A reflector, on the other hand, with the breathing gas flowing to and fro, specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. A high reflection efficiency (number of molecules resupplied/number of molecules exhaled, RE 80-90%) decreases consumption...
January 31, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28138763/-haemoptysis-intensive-care-management-of-pulmonary-hemorrhage
#19
J H Ficker, W M Brückl, J Suc, A Geise
There is a wide spectrum of severities in patients with pulmonary bleeding with a range from mild haemoptysis to severe bleeding with an acute risk of asphyxiation. For the management of acute pulmonary haemorrhage, it is essential to identify the underlying cause in order to initiate a target-oriented or causal therapy. The most common causes of localized pulmonary bleeding are lung cancer as well as infections, anticoagulant therapy or bronchiectasis. Diffuse alveolar haemorrhage is mostly due to pulmonary vasculitis or connective tissue disease, but may also occur in pulmonary metastasis, congestive heart failure, coagulation disorders and from many other causes...
March 2017: Der Internist
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#20
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
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