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Tracheostomy in icu

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https://www.readbyqxmd.com/read/28914429/a-systematic-review-of-patient-and-caregiver-experiences-with-a-tracheostomy
#1
REVIEW
Ivana Nakarada-Kordic, Niamh Patterson, Jill Wrapson, Stephen D Reay
BACKGROUND: A tracheostomy is a surgically created opening through the anterior neck tissues and the trachea, into which a tube is inserted. Despite its influence on basic human needs such as respiration, communication and nutrition, little is known about the impact of tracheostomy on patients and their caregivers or what could be done to enable better care and quality of life (QoL) for these individuals. OBJECTIVE: The aim of this review was to better understand the current knowledge related to the experience and QoL of adults living with a tracheostomy and their caregivers so as to be able to improve these experiences...
September 15, 2017: Patient
https://www.readbyqxmd.com/read/28902086/operative-stabilization-of-flail-chest-injuries-reduces-mortality-to-that-of-stable-chest-wall-injuries
#2
Niloofar Dehghan, Jeffrey M Mah, Emil H Schemitsch, Aaron Nauth, Milena Vicente, Michael D McKee
OBJECTIVE: To determine the prevalence, management and outcomes of patients with flail chest injuries, compared to patients without flail chest injuries (single rib fractures and multiple rib fractures without a flail segment). DESIGN: Retrospective cohort study SETTING:: Ontario, Canada PARTICIPANTS:: Ontario residents over the age of 16 who had been admitted to hospital with a chest wall injury from 2004 to 2015 were identified using administrative health care databases...
August 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28899526/association-between-severity-of-untreated-sleep-apnoea-and-postoperative-complications-following-major-cardiac-surgery-a-prospective-observational-cohort-study
#3
Martina Mason, Jules Hernández Sánchez, Alain Vuylsteke, Ian Smith
OBJECTIVE: To examine whether untreated sleep apnoea is associated with prolonged Intensive Care Unit (ICU) stay and increased frequency of postoperative ICU complications, in patients undergoing major cardiac surgery. PATIENTS/METHODS: Adult patients, undergoing elective coronary artery bypass grafting with or without cardiac valve surgery, between March 2013 and July 2014, were considered. We excluded patients participating in other interventional studies, those who had a tracheostomy before surgery, required emergency surgery or were due to be admitted on the day of surgery...
September 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28892951/outcomes-of-mechanically-ventilated-critically-ill-geriatric-patients-in-intensive-care-unit
#4
Vivek Aggarwal, Rajeshwar Singh, Jung Bahadur Singh, Jps Bawa, Nimish Gaur, Sandeep Kumar, I V Nagesh
INTRODUCTION: Increase in life expectancy across the globe has led to rise in geriatric population. Geriatric population is now living longer and healthier. This rise in geriatric population has also led to increase in the geriatric ailments leading to increased number of geriatric patients requiring intensive care including mechanical ventilation. Data on outcomes of geriatric patients requiring mechanical ventilation from India is scarce. AIM: To study the profile and outcome of geriatric patients more than equal to 60 years requiring mechanical ventilation in Intensive Care Unit (ICU)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28875324/-extreme-obesity-particular-aspect-of-invasive-and-noninvasive-ventilation
#5
REVIEW
M Deppe, P Lebiedz
The obesity rate is increasing worldwide and the percentage of obese patients in the intensive care unit (ICU) is rising concomitantly. Ventilatory support strategies in obese patients must take into account the altered pathophysiological conditions. Unfortunately, prospective randomized multicenter trials on this subject are lacking. Therefore, current strategies are based on the individual experiences of ICU physicians and single-center studies. Noninvasive ventilation (NIV) in critically ill patients with acute respiratory failure and obesity hypoventilation syndrome (OHS) is an efficient treatment option and should be provided as early as possible is an effort to avoid intubation...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28860781/adverse-outcomes-after-percutaneous-dilatational-tracheostomy-versus-surgical-tracheostomy-in-intensive-care-patients-case-series-and-literature-review
#6
Konrad Jarosz, Bartosz Kubisa, Agata Andrzejewska, Katarzyna Mrówczyńska, Zbigniew Hamerlak, Alicja Bartkowska-Śniatkowska
Tracheostomy is a routinely done procedure in the setting of intensive care unit (ICU) in patients requiring prolonged mechanical ventilation. There are two ways of making a tracheostomy: an open surgical tracheostomy and percutaneous dilatational tracheostomy. Percutaneous dilatational tracheostomy is associated with fewer complications than open tracheostomy. In this study, we would like to compare both techniques of performing a tracheostomy in ICU patients and to present possible complications, methods of diagnosing and treating and minimizing their risk...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28832908/pain-assessment-in-intensive-care-paint-an-observational-study-of-physician-documented-pain-assessment-in-45-intensive-care-units-in-the-united-kingdom
#7
H I Kemp, C Bantel, F Gordon, S J Brett, H C Laycock
Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines. This observational service evaluation considered all pain and analgesia-related entries in patients' records over a 24-h period, in 45 adult intensive care units (ICUs) in London and the South-East of England...
June 2017: Anaesthesia
https://www.readbyqxmd.com/read/28794882/interruption-of-enteral-nutrition-in-the-intensive-care-unit-a-single-center-survey
#8
Midori Uozumi, Masamitsu Sanui, Tetsuya Komuro, Yusuke Iizuka, Tadashi Kamio, Hiroshi Koyama, Hideyuki Mouri, Tomoyuki Masuyama, Kazuyuki Ono, Alan Kawarai Lefor
BACKGROUND: Interruption of enteral nutrition (EN) in the intensive care unit (ICU) occurs frequently for various reasons including feeding intolerance and the conduct of diagnostic and therapeutic procedures. However, few studies have investigated the details of EN interruption practices including reasons for and duration of interruptions. There is no standard protocol to minimize EN interruptions. METHODS: This is a retrospective review of 100 patients in the ICU staying more than 72 h and receiving EN in a 12-bed, medical/surgical ICU in a tertiary care center in 2013...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28793102/deaths-among-the-elderly-with-icu-infections
#9
Álvaro Francisco Lopes de Sousa, Artur Acelino Francisco Luz Nunes Queiroz, Layze Braz de Oliveira, Luana Kelle Batista Moura, Denise de Andrade, Evandro Watanabe, Maria Eliete Batista Moura
Objective: to evaluate the clinical outcome of elderly patients admitted to intensive care units who had nosocomial infection, correlating the findings with sociodemographic and clinical variables. Method: descriptive research, performed with 308 elderly patients. The collection was made from medical records and covers the years 2012 to 2015. Uni-/bivariate analyses were performed. Results: a statistical association was found between the clinical outcome types and the variables age, length of stay, presence of previous comorbidities, main diagnosis, respiratory and urinary tract infections, use of central venous and indwelling urinary catheters, mechanical ventilation, and tracheostomy...
July 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28774204/apache-ii-score-cannot-predict-successful-weaning-from-prolonged-mechanical-ventilation
#10
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62-77) years), hospitalized between 1 January 2012, and 31 December 2013...
August 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28770093/the-clinical-practice-guideline-for-the-management-of-ards-in-japan
#11
Satoru Hashimoto, Masamitsu Sanui, Moritoki Egi, Shinichiro Ohshimo, Junji Shiotsuka, Ryutaro Seo, Ryoma Tanaka, Yu Tanaka, Yasuhiro Norisue, Yoshiro Hayashi, Eishu Nango
BACKGROUND: The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. METHOD: The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan)...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28749714/risk-factors-for-carbapenem-resistant-klebsiella-pneumoniae-infection-a-meta-analysis
#12
Pin Liu, Xuan Li, Mei Luo, Xuan Xu, Kewen Su, Shuai Chen, Ying Qing, Yingli Li, Jingfu Qiu
AIMS: Carbapenem-resistant Klebsiella pneumoniae (CRKP) infection has been rapidly emerging as a life-threatening nosocomial disease in many countries. However, studies on the corresponding risk factors of CRKP infection showed inconsistent results. To resolve these inconsistencies, we conducted a meta-analysis of previous studies on the potential risk factors of CRKP infection. The results of this study could be used to develop CRKP infection prevention strategies. METHODS: Relevant works were systematically searched from five electronic databases up to September 2016...
July 27, 2017: Microbial Drug Resistance: MDR: Mechanisms, Epidemiology, and Disease
https://www.readbyqxmd.com/read/28744846/extubation-failure-and-tracheostomy-placement-in-children-with-acute-neurocritical-illness
#13
Ellen C Cohn, Tammy S Robertson, Stacey A Scott, Andre M Finley, Rong Huang, Darryl K Miles
BACKGROUND: There is a lack of data describing the risk factors for extubation failure (EF) or tracheostomy placement in pediatric neurocritical care (NCC) patients. METHODS: A retrospective chart review of children admitted to the pediatric intensive care unit who were intubated for >24 h with an acute neurocritical illness and had an extubation attempt. Bivariate and multivariate statistical analysis was performed to determine significant associations of demographic, neurologic, pulmonary, and clinical variables with EF and tracheostomy placement...
July 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28743722/bedside-tracheostomy-on-pediatric-icu-subjects-supported-by-extracorporeal-membrane-oxygenation
#14
Stephanie P Schwartz, Desiree Bonadonna, Matthew G Hartwig, Ira M Cheifetz
BACKGROUND: Tracheostomy facilitates ambulatory extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation in patients with respiratory failure, yet data on this procedure in this population are lacking. This report describes a series of pediatric ICU patients who had a bedside tracheostomy performed while being supported on ECMO and examines the potential impact of this procedure on active rehabilitation and sedation requirements. METHODS: This retrospective case series reviews all patients in the pediatric ICU who received a tracheostomy while being supported on ECMO at a single tertiary care center for the past 3 y...
July 25, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28685809/follow-up-after-intensive-care-treatment-a-questionnaire-survey-of-intensive-care-aftercare-in-denmark
#15
C K W Kjer, S Estrup, L M Poulsen, O Mathiesen
BACKGROUND: Rehabilitation efforts after treatment in the intensive care unit (ICU) are termed intensive care aftercare. It includes both early in-hospital follow-up after ICU-discharge and late follow-up after hospital discharge. This study aims to investigate the current ICU-aftercare activities in Denmark. METHODS: We conducted an electronic questionnaire survey, which was distributed by e-mail to the heads of all 31 general ICUs in Denmark. Specialized ICUs were not included...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28666781/evaluation-of-sedation-related-medication-errors-in-contact-isolation-patients-in-the-icu
#16
Randi Searcy, Donald Johnson, Christopher Jankowski, Jason Ferreira
BACKGROUND: Patients in the intensive care unit (ICU), may be placed in contact isolation (CI) for meticillin-resistant Staphylococcus aureus (MRSA) colonization to prevent transmission. Prior studies suggest that isolated patients may receive substandard care compared to patients not on isolation. An optimal level of sedation is required to facilitate mechanical ventilation (MV) and to minimize adverse outcomes. AIM: To determine if patients on MV and isolated for MRSA colonization are at an increased risk of inappropriate over-sedation compared to patients not on CI...
June 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28658904/elective-tracheostomy-in-head-and-neck-surgery-our-experience
#17
Venkatesh S Anehosur, Pallavi Karadiguddi, Vajendra K Joshi, Basavraj C Lakkundi, Rajarshi Ghosh, Gopalkrishnan Krishnan
INTRODUCTION: Tracheostomy is commonly used to secure the airway during the immediate postoperative period in maxillofacial oncological operations. We conducted a study to review the utility of elective tracheostomy in head and neck surgery. AIM: To review the incidence of intraoperative, perioperative and postoperative complications and its management in elective tracheostomy and to analyse its utility in head and neck surgery. MATERIALS AND METHODS: The study included review of 50 patients, who were treated for head and neck cancers in the Department of Oral And Maxillofacial Surgery of our centre between January 2011 to December 2014...
May 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28658198/professional-responsibility-consensus-and-conflict-a-survey-of-physician-decisions-for-the-chronically-critically-ill-in-neonatal-and-pediatric-intensive-care-units
#18
Miriam C Shapiro, Pamela K Donohue, Sapna R Kudchadkar, Nancy Hutton, Renee D Boss
OBJECTIVE: To describe neonatologist and pediatric intensivist attitudes and practices relevant to high-stakes decisions for children with chronic critical illness, with particular attention to physician perception of professional duty to seek treatment team consensus and to disclose team conflict. DESIGN: Self-administered online survey. SETTING: U.S. neonatal ICUs and PICUs. SUBJECTS: Neonatologists and pediatric intensivists...
September 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28648671/late-complications-of-percutaneous-tracheostomy-using-the-balloon-dilation-technique
#19
J B Araujo, J M Añón, A García de Lorenzo, A M García-Fernandez, M Esparcia, J Adán, S Relanzon, D Quiles, V de Paz, A Molina
OBJECTIVE: The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. DESIGN: A prospective, observational cohort study was carried out. SCOPE: Two medical-surgical intensive care units (ICU). PATIENTS: All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy...
June 22, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28622012/tracheobronchomalacia-is-associated-with-increased-morbidity-in-bronchopulmonary-dysplasia
#20
Erik B Hysinger, Nicholas L Friedman, Michael A Padula, Russell T Shinohara, Huayan Zhang, Howard B Panitch, Steven M Kawut
RATIONALE: Tracheobronchomalacia is a common comorbidity in neonates with bronchopulmonary dysplasia. However, the effect of tracheobronchomalacia on the clinical course of bronchopulmonary dysplasia is not well-understood. OBJECTIVE: We sought to assess the impact of tracheobronchomalacia on outcomes in neonates with bronchopulmonary dysplasia in a large, multi-center cohort. METHODS: We preformed a cohort study of 974 neonates with bronchopulmonary dysplasia admitted to 27 neonatal intensive care units participating in the Children's Hospital Neonatal Database who had undergone bronchoscopy...
June 16, 2017: Annals of the American Thoracic Society
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