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Tracheostomy in icu

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https://www.readbyqxmd.com/read/29787876/risk-analysis-based-on-the-timing-of-tracheostomy-procedures-in-patients-with-spinal-cord-injury-requiring-cervical-spine-surgery
#1
Rita Galeiras, Mónica Mourelo, María Teresa Bouza, María Teresa Seoane, María Elena Ferreiro, Antonio Montoto, Sebastián Salvador, Leticia Seoane, David Freire
INTRODUCTION: To determine the optimal moment to carry out a tracheostomy in a patient requiring anterior cervical fixation. METHODS: A retrospective observational study was carried out over an 18-year period on 56 patients who had been admitted to the ICU with acute spinal cord injury (SCI), and who underwent a tracheostomy and surgical fixation. The sample was divided into two groups: An at-risk group (31 patients, who had undergone a tracheostomy prior to the cervical surgery or <4 days after the procedure), and a not at-risk group (25 patients, who had undergone a tracheostomy >4 day following the fixation surgery)...
May 19, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#2
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29756290/a-standardized-closed-loop-system-for-monitoring-pediatric-tracheostomy-related-adverse-events
#3
Mallory McKeon, Daphne Munhall, Brian K Walsh, Roger Nuss, Reza Rahbar, Mark Volk, Karen Watters
OBJECTIVES/HYPOTHESIS: Advancement in neonatal and pediatric intensive care has increased the need for chronic-care interventions, including tracheostomy. It is well established that children with a tracheostomy are at a high risk for adverse events, many of which are preventable. Despite this, there is no standardized method of monitoring tracheostomy-related adverse events (TRAEs). Our objective was to describe and assess a standardized, closed-loop system for monitoring TRAEs. STUDY DESIGN: Prospective Study...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29749260/effectiveness-safety-and-economic-comparison-of-inhaled-flolan-and-veletri-in-cardiothoracic-surgery-patients
#4
Jaclyn M Hawn, Matthew Wanek, Seth R Bauer, Mahmoud A Ammar, Steven Insler, Ahmad Adi, Heather Torbic
BACKGROUND: No previous studies exist examining inhaled Flolan compared with inhaled Veletri in a homogeneous cardiothoracic surgery patient population. OBJECTIVE: To compare the impact of inhaled Flolan and inhaled Veletri on the effectiveness, safety, or cost in cardiothoracic surgery patients. MATERIALS AND METHODS: This was a retrospective, noninferiority study comparing inhaled Flolan and inhaled Veletri in cardiothoracic surgery patients...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29735862/influence-of-visual-information-on-consent-for-invasive-procedures-in-intensive-care-unit
#5
E C Celik, M Ekinci, B Ciftci, B E Gölboyu, O Ö Kilinç
Objective: Patients hospitalized in Intensive Care Units (ICU) are critically ill. Sometimes informed consent for invasive procedures cannot be obtained from patients or relatives due to insufficient information. Methodology: Relatives of the patients who were being hospitalized in ICUs of state hospitals in 3 provinces in Eastern part of Turkey during year 2015, who were planned to undergo central venous catheter insertion, tracheostomy, and percutaneous gastroenterostomy (PGE) were asked to sign consent forms and these relatives were included in the study...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29730059/nasotracheal-intubation-the-preferred-airway-in-oral-cavity-microvascular-reconstructive-surgery
#6
Jordan Gigliotti, Godwin Cheung, Omar Suhaym, Ramanakumar V Agnihotram, Michel El-Hakim, Nicholas Makhoul
PURPOSE: We aimed to describe the safety and effectiveness of nasotracheal intubation (NTI) in a cohort of patients undergoing reconstruction of oral cavity defects with free tissue transfer (FTT). MATERIALS AND METHODS: We implemented a retrospective cohort study and enrolled a sample composed of consecutive patients undergoing FTT reconstruction of oral cavity, maxillary, or mandibular defects between 2013 and 2017. These patients were all subject to a newly developed enhanced recovery-after-surgery protocol...
April 11, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29709466/the-communication-experience-of-tracheostomy-patients-with-nurses-in-the-intensive-care-unit-a-phenomenological-study
#7
Angela Tolotti, Annamaria Bagnasco, Gianluca Catania, Giuseppe Aleo, Nicola Pagnucci, Lucia Cadorin, Milko Zanini, Gennaro Rocco, Alessandro Stievano, Franco A Carnevale, Loredana Sasso
OBJECTIVES: To describe the experience and sources of comfort and discomfort in tracheostomy patients, when they communicate with nurses in the Intensive Care Unit. RESEARCH METHODOLOGY/DESIGN: Benner's interpretive phenomenology. Data were collected through: a) semi-structured interviews conducted with the patients after leaving the intensive care unit; b) participant observation; c) situated interviews with intensive care nurses. SETTING: The intensive care unit of a hospital in Northern Italy...
April 27, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#8
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29699834/respiratory-muscle-strength-and-state-of-consciousness-values-measured-prior-to-the-decanulation-in-different-levels-of-complexity-a-longitudinal-prospective-case-series-study
#9
L Diaz-Ballve, D Villalba, M Andreu, M Escobar, G Morel-Vulliez, J Lebus, E Rositi
OBJECTIVE: To describe the variables related to effective cough capacity and the state of consciousness measured prior to decannulation and compare their measured values between the different areas of care such as the Intensive Care Unit (ICU), General ward and Mechanical Ventilation Weaning and Rehabilitation Centers (MVWRC). Secondarily analyze the evolution of patients once decannulated. DESIGN: Case series, longitudinal and prospective. SCOPE: Multicentric 31 ICUs (polyvalent) and 5 MVWRC...
April 23, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29681109/safety-and-efficacy-of-noncardiac-surgical-procedures-in-the-management-of-patients-with-trisomy-13-a-single-institution-based-detailed-clinical-observation
#10
Soichi Shibuya, Yuichiro Miyake, Shigeru Takamizawa, Eriko Nishi, Katsumi Yoshizawa, Tomoko Hatata, Kazuki Yoshizawa, Kenya Fujita, Masahiko Noguchi, Jun Ohata, Takehiko Hiroma, Tomohiko Nakamura, Tomoki Kosho
Intensive treatment including surgery for patients with trisomy 13 (T13) remains controversial. This study aimed to evaluate the safety and efficacy of noncardiac surgical intervention for T13 patients. Medical records of patients with karyotypically confirmed T13 treated in the neonatal intensive care unit in Nagano Children's Hospital from January 2000 to October 2016 were retrospectively reviewed, and data from patients who underwent noncardiac surgery were analyzed. Of the 20 patients with T13, 15 (75%) underwent a total of 31 surgical procedures comprising 15 types, including tracheostomy in 10 patients and gastrostomy in 4...
May 2018: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/29678147/protocol-based-evaluation-for-feasibility-of-extubation-compared-to-clinical-scoring-systems-after-major-oral-cancer-surgery-safely-reduces-the-need-for-tracheostomy-a-retrospective-cohort-study
#11
Axel Schmutz, Rolf Dieterich, Johannes Kalbhenn, Pit Voss, Torsten Loop, Sebastian Heinrich
BACKGROUND: Despite risks, complications and negative impact to quality of life, tracheostomy is widely used to bypass upper airway obstruction after major oral cancer surgery (MOCS). Decision to tracheostomy is frequently based on clinical scoring systems which mainly have not been validated by different cohorts. Delayed extubation in the Intensive Care Unit (ICU) may be a suitable alternative in selected cases. We hypothesize that delayed routine ICU extubation after MOCS instead of scoring system based tracheostomy is safe, feasible and leads to lower tracheostomy rates...
April 20, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29673728/infrahyoid-involvement-may-be-a-high-risk-factor-in-the-management-of-non-odontogenic-deep-neck-infection-retrospective-study
#12
Hui Yuan, Rong Gao
OBJECTIVES: This study sought to investigate the impact of involvement of the infrahyoid neck space on the management of non-odontogenic DNI. METHOD: Eighty-one patients treated for non-odontogenic DNI over 5 years were retrospectively recruited into this study. Demographics, etiology, radiology results, treatments, duration/cost of hospital stay, and complications were recorded. Differences between DNIs with and without infrahyoid involvement, as defined based on an anatomical chart, were analyzed...
March 16, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29616357/preliminary-experience-on-the-safety-and-tolerability-of-mechanical-insufflation-exsufflation-in-subjects-with-artificial-airway
#13
Miguel Sánchez-García, Passio Santos, Gema Rodríguez-Trigo, Fernando Martínez-Sagasti, Tomás Fariña-González, Ángela Del Pino-Ramírez, Carlos Cardenal-Sánchez, Beatriz Busto-González, Mónica Requesens-Solera, Mercedes Nieto-Cabrera, Francisco Romero-Romero, Antonio Núñez-Reiz
BACKGROUND: Catheter suctioning of respiratory secretions in intubated subjects is limited to the proximal airway and associated with traumatic lesions to the mucosa and poor tolerance. "Mechanical insufflation-exsufflation" exerts positive pressure, followed by an abrupt drop to negative pressure. Potential advantages of this technique are aspiration of distal airway secretions, avoiding trauma, and improving tolerance. METHODS: We applied insufflation of 50 cmH2 O for 3 s and exsufflation of - 45 cmH2 O for 4 s in patients with an endotracheal tube or tracheostomy cannula requiring secretion suctioning...
April 3, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29557596/severe-asthma-in-pediatrics-outcomes-of-the-implementation-of-a-special-health-care-protocol
#14
Verónica Giubergia, María J Ramirez Farías, Verónica Pérez, Adriana González, Nancy Crespi, Nora Fridman, Claudio Castaños
INTRODUCTION: Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). OBJECTIVE: To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. METHODS: Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29554066/an-algorithm-for-airway-management-in-patients-with-pierre-robin-sequence
#15
Katherine E Hicks, Kathleen R Billings, Chad A Purnell, John M Carter, Bharat Bhushan, Arun K Gosain, Dana M Thompson, Jeffrey C Rastatter
PURPOSE: Airway management in neonates with Pierre Robin sequence (PRS) can be challenging. The goal was to describe the algorithm developed by the authors over the past 8 years. METHODS: A retrospective case series analyzing airway management in neonates with PRS admitted to the neonatal intensive care unit at a tertiary care pediatric hospital was performed. The utility of the proposed algorithm for airway management incorporating more consistent use of polysomnography (PSG), and airway assessment was assessed...
March 16, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29551223/quality-of-life-improves-for-tracheostomy-patients-with-return-of-voice-a-mixed-methods-evaluation-of-the-patient-experience-across-the-care-continuum
#16
Amy L Freeman-Sanderson, Leanne Togher, Mark Elkins, Belinda Kenny
OBJECTIVES: A tracheostomy tube can profoundly impact ability to communicate. The impact of this on patients' self-esteem and quality of life in the care continuum from the intensive care unit to after decannulation has not been reported. Therefore, the aim was to investigate the patient-reported experience regarding change in communication function, communication-related self-esteem and quality of life. RESEARCH DESIGN: A mixed methods approach was utilised. Quantitative data were obtained using validated measures of self-esteem related to communication-related quality of life and general health...
March 15, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29550510/elevated-red-blood-cell-distribution-width-at-icu-discharge-is-associated-with-readmission-to-the-intensive-care-unit
#17
Tiago Antonio Tonietto, Marcio Manozzo Boniatti, Thiago Costa Lisboa, Marina Verçoza Viana, Moreno Calcagnotto Dos Santos, Carla Silva Lincho, José Augusto Santos Pellegrini, Josi Vidart, Jeruza Lavanholi Neyeloff, Gustavo Adolpho Moreira Faulhaber
BACKGROUND: Red blood cell distribution width (RDW) is a predictor of mortality in critically ill patients. Our objective was to investigate the association between the RDW at ICU discharge and the risk of ICU readmission or unexpected death in the ward. METHODS: A secondary analysis of prospectively collected data study was conducted including patients discharged alive from the ICU to the ward. The target variable was the RDW collected at ICU discharge. Elevated RDW was defined as an RDW > 16%...
May 2018: Clinical Biochemistry
https://www.readbyqxmd.com/read/29549119/the-case-for-early-use-of-rapid-whole-genome-sequencing-in-management-of-critically-ill-infants-late-diagnosis-of-coffin-siris-syndrome-in-an-infant-with-left-congenital-diaphragmatic-hernia-congenital-heart-disease-and-recurrent-infections
#18
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29544581/percutaneous-tracheostomy-by-physician-intensivists
#19
Asad Zaman Khan, Aslam Khan, Arshad Naseem
OBJECTIVE: To assess the safety of percutaneous tracheostomy when performed by physician intensivists. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Adult Medical ICU in the Department of Critical Care Medicine, Military Hospital, Rawalpindi, Pakistan, from September 2013 to August 2016. METHODOLOGY: Departmental record for percutaneous tracheostomies, performed by physician intensivifts, was evaluated...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29521796/a-selective-placement-strategy-for-surgical-feeding-tubes-benefits-trauma-patients
#20
Joseph Marcotte, Joshua Hazelton, Chirag Arya, Michael Dalton, Amber Batool, John Gaughan, Linh Nguyen, John Porter, Nicole Fox
BACKGROUND: The indications for surgical feeding tube (SFT) placement in trauma patients are poorly defined. Patient selection is critical as complications from SFTs have been reported in up to 70% of patients. A previous analysis by our group determined that 25% of the SFTs we placed were unnecessary and that older patients, patients with head and spinal cord injuries, and patients who needed a tracheostomy were more likely to require long term SFTs. Following this study, we modified our institutional guidelines for SFT placement...
March 8, 2018: Journal of Trauma and Acute Care Surgery
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