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management of ards

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https://www.readbyqxmd.com/read/29775606/ecmo-for-acute-respiratory-distress-syndrome-after-thoracoabdominal-aortic-aneurysm-repair
#1
Subhasis Chatterjee, William Mulvoy, Ourania A Preventza, Kim I de la Cruz, Scott A LeMaire, Joseph S Coselli
Acute respiratory distress syndrome (ARDS) after thoracoabdominal aortic aneurysm (TAAA) repair poses a formidable challenge. Despite conventional maneuvers in the operating room, perioperative ARDS may require extracorporeal membrane oxygenation (ECMO). We present 3 cases of successful ECMO for ARDS after TAAA repair and discuss management of anticoagulation and cerebrospinal fluid drains. Our experience suggests that ECMO is reasonable in selected patients after TAAA repair.
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29764555/-role-of-noninvasive-mechanical-ventilation-in-patients-with-severe-avian-influenza-a-h7n9-complicated-with-acute-respiratory-distress-syndrome
#2
Haili Luo, Shaohong Wang, Feng Shen, Tongmei Yuan, Xianguo Pan, Jingtao Liu, Ling Yao, Juncheng Wu, Xuemei Long
Human infection with avian influenza A (H7N9) is an acute contagious respiratory disease. Acute respiratory distress syndrome (ARDS) is a common complication in patients with severe avian influenza A (H7N9), for whom mechanical ventilation (MV) is an important supportive method. A patient, suffered from severe avian influenza A (H7N9) and complicated with ARDS, was admitted to the Second Affiliated Hospital of Guizhou Medical University in January 2017. With very intensive care for oxygenation, respiration and consciousness, and monitoring, she was successfully cured by comprehensive managements, among which noninvasive mechanical ventilation (NIV) was the major respiratory support method...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29753454/response-of-a-local-hospital-to-a-burn-disaster-contributory-factors-leading-to-zero-mortality-outcomes
#3
Eng-Kean Yeong, Ciaran P O'Boyle, Hui-Fu Huang, Hao-Chih Tai, Yen-Chun Hsu, Shu-Yang Chuang, Yu-Feng Wu, Che-Wei Chang, Tom J Liu, Hong-Shiee Lai
OBJECTIVE: To investigate the outcomes of a local healthcare system in managing a burn mass casualty incident (BMCI). METHODS: Thirty-three victims admitted to the National Taiwan University Hospital within 96h of the explosion were included in the study. Data were recorded on: patient demographics, Baux score, laboratory data, management response, treatment strategies, and outcomes. Case notes from June 27, 2015 to November 2015 were reviewed with a focus on fluid resuscitation, ventilation support, nutrition, infection control, sepsis treatment, and wound closure plan...
May 9, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29744088/sevoflurane-improves-respiratory-mechanics-and-gas-exchange-in-a-case-series-of-infants-with-severe-bronchiolitis-induced-acute-respiratory-distress-syndrome
#4
Mirco Nacoti, Jacopo Colombo, Oliviero Fochi, Daniele Bonacina, Francesco Fazzi, Giacomo Bellani, Ezio Bonanomi
This report describes the successful use of a new intervention to improve respiratory mechanics and gas exchange in a relatively homogeneous group of infants with severe bronchiolitis-induced PARDS after failure of conventional treatment. These results may open a new interesting area of research and management for PARDS patients.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29743094/feasibility-and-safety-of-low-flow-extracorporeal-co-2-removal-managed-with-a-renal-replacement-platform-to-enhance-lung-protective-ventilation-of-patients-with-mild-to-moderate-ards
#5
Matthieu Schmidt, Samir Jaber, Elie Zogheib, Thomas Godet, Gilles Capellier, Alain Combes
BACKGROUND: Extracorporeal carbon-dioxide removal (ECCO2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (Pplat ) (< 30 cmH2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS)...
May 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#6
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29733073/a-50-a%C3%A3-os-de-la-descripci%C3%A3-n-del-s%C3%A3-ndrome-de-insuficiencia-respiratoria-aguda
#7
Raúl Carrillo-Esper, Gilberto Felipe Vázquez-De Anda, Cynthia Ivonne Mejía-Pérez, María Guadalupe Delaye-Aguilar, Ana Ivonne Pérez-Castañeda, Jesús Carlos Briones-Garduño, Manuel Antonio Díaz de León-Ponce
En 1967, Ashbaugh et al. publicaron en Lancet la descripción de una nueva entidad para la que acuñaron el nombre "síndrome de distress respiratorio del adulto". En ese artículo describieron minuciosamente a 12 enfermos que presentaban insuficiencia respiratoria, con infiltración pulmonar bilateral e hipoxemia resistente a oxigenoterapia. Para su manejo se hizo énfasis en la importancia de la intubación y la ventilación mecánica con presión positiva al final de la espiración. A 50 años de la publicación se han logrado grandes avances en el conocimiento de esta enfermedad, lo que ha influido en el manejo y supervivencia de los pacientes...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/29732188/weaning-from-veno-venous-extracorporeal-membrane-oxygenation-how-i-do-it
#8
REVIEW
Lars M Broman, Maximilian V Malfertheiner, Andrea Montisci, Federico Pappalardo
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a rescue treatment for acute respiratory distress syndrome (ARDS) failing protective mechanical ventilation. It temporarily provides proper gas exchange: hypoxia is treated by adjusting the blood flow rate and fraction in spired oxygen over the ventilator (FiO2 ) on the extracorporeal membrane oxygenation (ECMO) circuit while CO2 removal is regulated by the ECMO fresh gas flow. Therefore, ventilator settings can be gradually reduced allowing the lungs to rest and recover...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29732186/right-ventricular-dysfunction-during-acute-respiratory-distress-syndrome-and-veno-venous-extracorporeal-membrane-oxygenation
#9
REVIEW
Jeroen J H Bunge, Kadir Caliskan, Diederik Gommers, Dinis Reis Miranda
Severe ARDS can be complicated by right ventricular (RV) failure. The etiology of RV failure in ARDS is multifactorial. Vascular alterations, hypoxia, hypercapnia and effects of mechanical ventilation may play a role. Echocardiography has an important role in diagnosing RV failure in ARDS patients. Once extracorporeal membrane oxygenation (ECMO) is indicated in these patients, the right ECMO modus needs to be chosen. In this review, the etiology, diagnosis and management of RV failure in ARDS will be briefly outlined...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29727522/development-of-a-short-course-on-management-of-critically-ill-patients-with-acute-respiratory-infection-and-impact-on-clinician-knowledge-in-resource-limited-icus
#10
Janet V Diaz, Justin R Ortiz, Paula Lister, Nahoko Shindo, Neill K J Adhikari
BACKGROUND: The 2009 influenza A (H1N1) pandemic caused surges of patients in intensive care units (ICUs) in resource-limited settings. Several Ministries of Health requested clinical management guidance from the World Health Organization (WHO), which had not previously developed guidance regarding critically ill patients. OBJECTIVE: To assess the acceptability and impact on knowledge of a short course about the management of critically ill patients with acute respiratory infections complicated by sepsis or acute respiratory distress syndrome delivered to clinicians in resource-limited ICUs...
May 4, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29716909/survival-of-patients-with-severe-acute-respiratory-distress-syndrome-treated-without-extracorporeal-membrane-oxygenation
#11
Sarina K Sahetya, Roy G Brower, R Scott Stephens
BACKGROUND: Case series have reported favorable outcomes with extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory distress syndrome. However, those patients were generally young, with few comorbid conditions. OBJECTIVE: To characterize the clinical features and survival rates of patients with severe acute respiratory distress syndrome who met criteria for ECMO but were managed without it. METHODS: Patients who met the study criteria were identified prospectively...
May 2018: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29708916/venovenous-extracorporeal-membrane-oxygenation-to-prolong-pregnancy-a-case-report
#12
Omar Alyamani, Michael A Mazzeffi, Shobana Bharadwaj, Jessica H Galey, Ruofan Yao, Nirav G Shah, Andrew M Malinow
We report a gravida in fulminant acute respiratory distress syndrome, mechanically ventilated at 27 weeks estimated gestational age, who further deteriorated into severe combined hypercarbic, hypoxemic respiratory failure. At 30 weeks estimated gestational age, she was placed on venovenous extracorporeal membrane oxygenation (ECMO) because of refractory respiratory failure. Her physical status improved without fetal deterioration. She was managed expectantly in an effort to allow continued fetal maturation...
May 1, 2018: A&A practice
https://www.readbyqxmd.com/read/29705765/practice-of-ventilation-in-middle-income-countries-provent-imic-rationale-and-protocol-for-a-prospective-international-multicentre-observational-study-in-intensive-care-units-in-asia
#13
Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Reza Hashemian, Madiha Hashmi, Hisham Ahmed Imad, Kanishka Indraratna, Shivakumar Iyer, Gyan Kayastha, Bhuvana Krishna, Hassan Moosa, Behzad Nadjm, Rajyabardhan Pattnaik, Sriram Sampath, Louise Thwaites, Ni Ni Tun, Nor'azim Mohd Yunos, Salvatore Grasso, Frederique Paulus, Marcelo Gama de Abreu, Paolo Pelosi, Arjen M Dondorp, Marcus J Schultz
INTRODUCTION: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29691755/my-patient-has-received-fluid-how-to-assess-its-efficacy-and-side-effects
#14
REVIEW
Xavier Monnet, Jean-Louis Teboul
Many efforts have been made to predict, before giving fluid, whether it will increase cardiac output. Nevertheless, after fluid administration, it is also essential to assess the therapeutic efficacy and to look for possible adverse effects. Like for any drug, this step should not be missed. Basically, volume expansion is aimed at improving tissue oxygenation and organ function. To assess this final result, clinical signs are often unhelpful. The increase in urine output in case of acute kidney injury is a poor marker of the kidney perfusion improvement...
April 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29686542/factors-among-patients-receiving-prone-positioning-for-the-acute-respiratory-distress-syndrome-found-useful-for-predicting-mortality-in-the-intensive-care-unit
#15
Ariel M Modrykamien, Yahya Daoud
Optimal mechanical ventilation management in patients with the acute respiratory distress syndrome (ARDS) involves the use of low tidal volumes and limited plateau pressure. Refractory hypoxemia may not respond to this strategy, requiring other interventions. The use of prone positioning in severe ARDS resulted in improvement in 28-day survival. To determine whether mechanical ventilation strategies or other parameters affected survival in patients undergoing prone positioning, a retrospective analysis was conducted of a consecutive series of patients with severe ARDS treated with prone positioning...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29685050/factors-influencing-the-caregiving-performance-of-mothers-of-hospitalized-toddlers-with-acute-respiratory-diseases-a-path-analysis
#16
Han Hye-Yul, Kim Shin-Jeong, Ellis Kevin Wayne, Kang Kyung-Ah
Studies on the management of respiratory diseases in children have focused on family members' participation and caregivers' needs. However, evidence-based data on the effectiveness of mothers' management of acute respiratory diseases (ARDs) in toddlers are lacking. This study aimed to examine the factors influencing the caregiving performance of mothers of toddlers hospitalized for an ARD and to test a hypothetical causal model based on the Caregiving Effectiveness Model (CEM). A cross-sectional design was used, and participants included 291 mothers of toddlers aged 12-36 months who were hospitalized for an ARD...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29681395/chugging-in-patients-on-veno-venous-extracorporeal-membrane-oxygenation-an-under-recognized-driver-of-intravenous-fluid-administration-in-patients-with-acute-respiratory-distress-syndrome
#17
James M Walter, Chitaru Kurihara, Thomas C Corbridge, Ankit Bharat
BACKGROUND: Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized in the management of severe acute respiratory distress syndrome (ARDS). Providers who care for patients on VV-ECMO should be familiar with common circuit complications. OBJECTIVES: To provide an example of a common complication, circuit "chugging," and suggest a management algorithm which aims to avoid excessive fluid administration to patients with ARDS. METHODS: We use a clinical case to illustrate chugging and discuss potential management strategies...
April 19, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29680410/influence-of-entrapment-on-prehospital-management-and-the-hospital-course-in-polytrauma-patients-a-retrospective-analysis-in-air-rescue
#18
Christian Macke, Marika Sarakintsis, Marcel Winkelmann, Philipp Mommsen, Mohamed Omar, Christian Schröter, Christian Krettek, Christian Zeckey
BACKGROUND: Entrapment is a challenging and crucial factor in the prehospital setting. Few studies have addressed whether entrapment has an influence on on-scene treatment or on the following hospital course. OBJECTIVES: Here we aimed to investigate the influence of entrapment on prehospital management and on the hospital course of polytrauma patients. METHODS: We performed a retrospective analysis of consecutive patients with an Injury Severity Score ≥16 and aged 16-65 years that were admitted between 2005 and 2013 to a Level I trauma center...
April 18, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29666710/acute-chest-syndrome-progressing-to-ards-in-a-patient-of-25-week-gestation
#19
Jefferson Chambers, Nichole Smith, Matthew Sehring, Subramanyam Chittivelu
Acute chest syndrome is a complication of sickle cell disease and represents the highest cause of mortality in those afflicted with the disorder. Pregnancy represents an increased risk for complications of sickle cell disease in both the mother and fetus. We present a case of a 20-year-old patient with known sickle cell disease who was at 25-week gestation and developed acute chest syndrome refractory to conventional therapies and requiring emergency cesarean section. Following delivery, the patient developed acute respiratory distress syndrome (ARDS) requiring extracorporeal membrane oxygenation (ECMO)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29664034/incidence-prognosis-of-acute-kidney-injury-in-individuals-of-snakebite-in-a-tertiary-care-hospital-in-india
#20
Ramulu Pulimaddi, Amruth Rao Parveda, Balkishan Brahmanpally, Paul Marx Kalakanda, K Ramakrishna, Venkata Ramana Devi Chinnapaka
Background & objectives: The snakebites are considered to be an occupational hazard in agriculture workers and the snake handlers, resulting in a considerable morbidity, mortality and economical implications. This study was conducted to determine the incidence, clinical presentation, renal injury and clinical outcome in snakebite victims who developed acute kidney injury (AKI). Methods: This hospital-based prospective, observational study was done on 100 cases who were admitted for the management of snakebite and found to develop AKI in a tertiary care hospital at Hyderabad, India...
December 2017: Indian Journal of Medical Research
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