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https://www.readbyqxmd.com/read/29325841/single-center-experience-with-venovenous-ecmo-for-influenza-related-ards
#1
Jessica Buchner, Michael Mazzeffi, Zachary Kon, Jay Menaker, Lewis Rubinson, Gregory Bittle, Chetan Pasrija, Daniel Herr
OBJECTIVES: This study was designed to determine whether venovenous extracorporeal membrane oxygenation (VV ECMO) reduced mortality in patients with influenza-related acute respiratory distress syndrome (ARDS). DESIGN: A retrospective cohort study was performed. Baseline characteristics of participants were compared and Kaplan-Meier survival analysis was used to compare survival at last medical center follow-up. Cox proportional hazards modeling also was performed to test for univariate associations between salient variables and mortality...
September 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29312748/acute-respiratory-distress-syndrome-in-traumatic-brain-injury-how-do-we-manage-it
#2
REVIEW
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29290518/enteral-nutrition-improves-clinical-outcome-and-reduces-costs-of-acute-mesenteric-ischaemia-after-recanalisation-in-the-intensive-care-unit
#3
Shuofei Yang, Jianming Guo, Qihong Ni, Jiaquan Chen, Xiangjiang Guo, Guanhua Xue, Meng Ye, Lan Zhang
BACKGROUND: Little data evaluate the enteral nutrition (EN) for patients with acute mesenteric ischaemia (AMI) in the intensive care unit (ICU). This study assessed the outcomes of EN for recanalised AMI patients in the ICU. METHODS: In this retrospective study, 183 AMI patients with mesenteric recanalisation admitted to two surgical ICUs were included. Patients were divided into EN (EN within first week, n = 95) and total parenteral nutrition (TPN) group (TPN in 1st week, n = 88)...
December 20, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29279787/acute-chest-syndrome-in-children-with-sickle-cell-disease
#4
REVIEW
Shilpa Jain, Nitya Bakshi, Lakshmanan Krishnamurti
Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
https://www.readbyqxmd.com/read/29279362/high-frequency-oscillatory-ventilation-use-and-severe-pediatric-ards-in-the-pediatric-hematopoietic-cell-transplant-recipient
#5
Courtney M Rowan, Ashley Loomis, Jennifer McArthur, Lincoln S Smith, Shira J Gertz, Julie C Fitzgerald, Mara E Nitu, Elizabeth As Moser, Deyin D Hsing, Christine N Duncan, Kris M Mahadeo, Jerelyn Moffet, Mark W Hall, Emily L Pinos, Robert F Tamburro, Ira M Cheifetz
INTRODUCTION: The effectiveness of high-frequency oscillatory ventilation (HFOV) in the pediatric hematopoietic cell transplant patient has not been established. We sought to identify current practice patterns of HFOV, investigate parameters during HFOV and their association with mortality, and compare the use of HFOV to conventional mechanical ventilation in severe pediatric ARDS. METHODS: This is a retrospective analysis of a multi-center database of pediatric and young adult allogeneic hematopoietic cell transplant patients requiring invasive mechanical ventilation for critical illness from 2009 through 2014...
December 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29276594/prolonged-circulatory-support-with-an-impella-assist-device-in-the-management-of-cardiogenic-shock-associated-with-takotsubo-syndrome-severe-sepsis-and-acute-respiratory-distress-syndrome
#6
Edward D Foley, Ricardo Diaz, Manuel R Castresana
Severe sepsis has been known to trigger for takotsubo syndrome which is associated with profound physical or emotional stress. Severe sepsis is also associated with sepsis-induced cardiomyopathy, a reversible myocardial depression. We report a case in which a patient with takotsubo syndrome, cardiogenic shock, severe sepsis, and adult respiratory distress syndrome was managed with an Impella Cardiac Power circulatory support device for 108 h (4.5 days) because of sustained hemodynamic compromise. To the best of our knowledge, this represents the longest reported use of the Impella Cardiac Power device for the management of cardiogenic shock in a patient with takotsubo syndrome and severe sepsis...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/29224660/postpartum-hemorrhage
#7
Janice Newsome, Jonathan G Martin, Zachary Bercu, Jay Shah, Haris Shekhani, Gail Peters
Interventional radiologists are often called for emergent control of abnormal uterine bleeding. Bleeding, even heavy bleeding as a result of uterine fibroids is not a common emergent procedure; instead, pregnancy and pregnancy related conditions, trauma and malignancy associated with bleeding can be the source of many interventional radiology on call events or procedures. Postpartum hemorrhage (PPH) is the most common cause, and is defined as blood loss of 500mL after vaginal delivery or 1000mL after cesarean section...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29218772/signals-for-identifying-cows-at-risk-of-subacute-ruminal-acidosis-in-dairy-veterinary-practice
#8
REVIEW
E Humer, J R Aschenbach, V Neubauer, I Kröger, R Khiaosa-Ard, W Baumgartner, Q Zebeli
Controlling rumen disorders is critical to ensure successful dairy herd health management. Lactation diets of dairy cows are commonly rich in concentrates and low in physically effective fibre. Feeding of these diets increases the risk of rumen disorders with far-reaching consequences for cattle health, welfare and sustainability of dairy production. The term subacute ruminal acidosis or SARA is often used as a synonym for poor rumen health. Being subclinical, SARA lacks of clear symptoms and is therefore difficult to diagnose and to control in the practice...
December 8, 2017: Journal of Animal Physiology and Animal Nutrition
https://www.readbyqxmd.com/read/29216950/-effect-of-early-enteral-nutrition-standardized-treatment-on-blood-glucose-and-prognosis-in-acute-respiratory-distress-syndrome-patients-with-mechanical-ventilation
#9
Chunmiao Zhong, Chaohui Ji, Zhuquan Dai, Kai Fu, Xiaohong Wen, Huibin Pan
OBJECTIVE: To study the effect of early entreat nutrition (EN) standardized treatment on optimization of blood glucose control and prognosis in acute respiratory distress syndrome (ARDS) patients with mechanical ventilation (MV). METHODS: Forty-two patients with MV of ARDS admitted to Huzhou First Municipal People's Hospital from April 2015 to March 2017 were enrolled. April 1st, 2016 was taken as the time node, the patients treated from April 1st, 2015 to March 31st, 2016 were assigned in the control group (n = 20), while the patients treated from April 1st, 2016 to March 31st, 2017 were included in the experimental group (n = 22)...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#10
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29207669/breath-analysis-by-gas-chromatography-mass-spectrometry-and-electronic-nose-to-screen-for-pleural-mesothelioma-a-cross-sectional-case-control-study
#11
Kevin Lamote, Paul Brinkman, Lore Vandermeersch, Matthijs Vynck, Peter J Sterk, Herman Van Langenhove, Olivier Thas, Joris Van Cleemput, Kristiaan Nackaerts, Jan P van Meerbeeck
Rationale: Malignant pleural mesothelioma (MPM) is mainly caused by previous exposure to asbestos fibers and has a poor prognosis. Due to a long latency period between exposure and diagnosis, MPM incidence is expected to peak between 2020-2025. Screening of asbestos-exposed individuals is believed to improve early detection and hence, MPM management. Recent developments focus on breath analysis for screening since breath contains volatile organic compounds (VOCs) which reflect the cell's metabolism...
October 31, 2017: Oncotarget
https://www.readbyqxmd.com/read/29206477/acute-eosinophilic-pneumonia-causes-diagnosis-and-management
#12
Federica De Giacomi, Robert Vassallo, Eunhee S Yi, Jay H Ryu
Acute eosinophilic pneumonia is an uncommon acute respiratory illness of varying severity that includes presentation as acute respiratory distress syndrome with fatal outcome. Acute eosinophilic pneumonia may be idiopathic but identifiable causes include smoking and other inhalational exposures, medications and infections. The pathogenesis of acute eosinophilic pneumonia is poorly understood but likely varies depending on the underlying cause. Airway epithelial injury, endothelial injury and release of interleukin-33 are early events that subsequently promote eosinophil recruitment to the lung; eosinophilic infiltration and degranulation appear to mediate subsequent lung inflammation and associated clinical manifestations...
December 5, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#13
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29201914/acute-right-ventricular-dysfunction-in-intensive-care-unit
#14
REVIEW
Juan C Grignola, Enric Domingo
The role of the left ventricle in ICU patients with circulatory shock has long been considered. However, acute right ventricle (RV) dysfunction causes and aggravates many common critical diseases (acute respiratory distress syndrome, pulmonary embolism, acute myocardial infarction, and postoperative cardiac surgery). Several supportive therapies, including mechanical ventilation and fluid management, can make RV dysfunction worse, potentially exacerbating shock. We briefly review the epidemiology, pathophysiology, diagnosis, and recommendations to guide management of acute RV dysfunction in ICU patients...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29194057/approaches-and-techniques-to-avoid-development-or-progression-of-acute-respiratory-distress-syndrome
#15
François Beloncle, Alain Mercat
PURPOSE OF REVIEW: Despite major improvement in ventilation strategies, hospital mortality and morbidity of the acute respiratory distress syndrome (ARDS) remain high. A lot of therapies have been shown to be ineffective for established ARDS. There is a growing interest in strategies aiming at avoiding development and progression of ARDS. RECENT FINDINGS: Recent advances in this field have explored identification of patients at high-risk, nonspecific measures to limit the risks of inflammation, infection and fluid overload, prevention strategies of ventilator-induced lung injury and patient self-inflicted lung injury, and pharmacological treatments...
February 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29179699/gastrointestinal-tuberculosis-following-renal-transplantation-accompanied-with-septic-shock-and-acute-respiratory-distress-syndrome-a-survival-case-presentation
#16
Andrea Cikova, Diana Vavrincova-Yaghi, Peter Vavrinec, Anna Dobisova, Andrea Gebhardtova, Zora Flassikova, Mark A Seelen, Robert H Henning, Aktham Yaghi
BACKGROUND: Post-transplant tuberculosis (PTTB) is a serious opportunistic infection in renal graft recipients with a 30-70 fold higher incidence compared to the general population. PTTB occurs most frequently within the first years after transplantation, manifesting as pulmonary or disseminated TB. Gastrointestinal TB (GITB) is a rare and potentially lethal manifestation of PTTB and may show delayed onset in renal transplant recipients due to the use of lower doses of immunosuppressants...
November 28, 2017: BMC Gastroenterology
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in%C3%A2-ards-a-narrative-review
#17
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung-protective ventilation (LPV) has become the cornerstone of management in patients with ARDS. A subset of patients is unable to tolerate LPV without significant CO2 elevation. In these patients, permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated CO2 levels have significant physiological effects. In this narrative review, we highlight clinically relevant end-organ effects in both animal models and clinical studies. We also explore the association between elevated CO2, acute cor pulmonale, and ICU mortality...
November 22, 2017: Chest
https://www.readbyqxmd.com/read/29175085/ventilator-management-and-respiratory-care-after-cardiac-arrest-oxygenation-ventilation-infection-and-injury
#18
REVIEW
Nicholas J Johnson, David J Carlbom, David F Gaieski
Return of spontaneous circulation after cardiac arrest results in a systemic inflammatory state called the post-cardiac arrest syndrome, characterized by oxidative stress, coagulopathy, neuronal injury, and organ dysfunction. Perturbations in oxygenation and ventilation may exacerbate secondary injury after cardiac arrest, and have been shown to be associated with poor outcome. Further, patients who suffer cardiac arrest are at risk for a number of other pulmonary complications. Up to 70% of patients experience early infection after cardiac arrest, and the respiratory tract is the most common source...
November 21, 2017: Chest
https://www.readbyqxmd.com/read/29173964/outcomes-after-resection-versus-non-resection-management-of-penetrating-grade-iii-and-iv-pancreatic-injury-a-trauma-quality-improvement-tqip-databank-analysis
#19
Shahin Mohseni, Jeremy Holzmacher, Gabriel Sjolin, Rebecka Ahl, Babak Sarani
BACKGROUND: High-grade traumatic pancreatic injuries are associated with significant morbidity and mortality. Non-resection management is associated with fewer complications in pediatric patients. The present study evaluates outcomes following resection versus non-resection management of severe pancreatic injury caused by penetrating trauma. METHODS: A retrospective study of the Trauma Quality Improvement Program (TQIP) database was performed from 1/2010 to 12/2014...
November 21, 2017: Injury
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#20
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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