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Tracheostomy in icu

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https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#1
Karen F Watters
Over the last decade, tracheostomy has been increasingly performed in children, aligned with the improvements in neonatal and pediatric ICU care. Nowadays, the majority of children with tracheostomy represent a very complex cohort of patients with sustained reliance on tracheostomy and related medical technology for long-term survival. Tracheostomy is one of the most commonly performed procedures in the adult ICU. Contrary to adult practice, tracheostomy is a much less common procedure in the pediatric ICU, being performed in < 3% of patients...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28543108/complications-and-30-day-hospital-readmission-rates-of-patients-undergoing-tracheostomy-a-prospective-analysis
#2
Emily Spataro, Nedim Durakovic, Dorina Kallogjeri, Brian Nussenbaum
OBJECTIVE: To determine inpatient and outpatient tracheostomy complication rates and 30-day hospital readmission rates, and to assess patient and procedural risk factors associated with complications and readmissions. STUDY DESIGN: Prospective cohort study. METHODS: Adult patients undergoing tracheostomy at a single academic hospital performed by any service, for any indication, were enrolled in this study over the course of 1 year. All patients had complete 30-day follow-up after discharge to determine complication and hospital readmission rates...
May 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28532425/combined-pulmonary-and-left-ventricular-support-with-veno-pulmonary-ecmo-and-impella-5-0-for-cardiogenic-shock-after-coronary-surgery
#3
Sameh Sayed, Christoph Schimmer, Ina Shade, Rainer Leyh, Ivan Aleksic
BACKGROUND: Mechanical circulatory support is a common practice nowadays in the management of patients after cardiogenic shock due to myocardial infarction. The single or combined use of one or more devices for mechanical support depends not only on the advantage or disadvantage of these devices but also on the timing of use of these devices before the development of multi organ failure. In our case we used more than one tool for mechanical circulatory support during the prolonged and complicated course of our patient with postcardiotomy cardiogenic shock after coronary artery bypass surgery...
May 22, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28527564/prospective-comparison-of-perioperative-antibiotic-management-protocols-in-oncological-head-and-neck-surgery
#4
Alexander K Bartella, Mohammad Kamal, Jan Teichmann, Anita Kloss-Brandstätter, Timm Steiner, Frank Hölzle, Bernd Lethaus
OBJECTIVES: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. MATERIAL AND METHODS: In this prospective study 75 consecutive patients, who underwent major oncological head and neck surgery were included and divided in three groups, each containing 25 patients...
April 20, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28526500/pulmonary-function-tests-do-not-predict-mortality-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#5
Edo K S Bedzra, Todd F Dardas, Richard K Cheng, Jay D Pal, Claudius Mahr, Jason W Smith, Kent Shively, S Carolina Masri, Wayne C Levy, Nahush A Mokadam
OBJECTIVES: To investigate the effect of pulmonary function testing on outcomes after continuous flow left ventricular assist device implantation. METHODS: A total of 263 and 239 patients, respectively, had tests of forced expiratory volume in 1 second and diffusing capacity of the lungs for carbon monoxide preoperatively for left ventricular assist device implantations between July 2005 and September 2015. Kaplan-Meier analysis and multivariable Cox regressions were performed to evaluate mortality...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28511742/predictors-for-routine-admission-to-paediatric-intensive-care-for-post-supraglottoplasty-laryngomalacia-patients
#6
S Chan, G Siou, A Welch, S Powell
OBJECTIVES: Supraglottoplasty for the treatment of laryngomalacia has little current evidence regarding post-operative care. Our study aimed to: (1) retrospectively assess what proportion of patients required paediatric intensive care unit level of care; (2) identify pre-operative predictive factors common to these cases; and (3) report patient outcomes at six weeks' follow up. METHODS: A 10-year retrospective case series analysis was conducted of all patients diagnosed with laryngomalacia and subsequently treated with supraglottoplasty...
May 17, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28493197/risk-factors-for-ventilator-associated-pneumonia-among-patients-undergoing-major-oncological-surgery-for-head-and-neck-cancer
#7
Yutao Liu, Yaxia Di, Shuai Fu
Patients undergoing major oncological surgery for head and neck cancer (SHNC) have a particularly high risk of nosocomial infections. We aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients undergoing SHNC. The study included 465 patients who underwent SHNC between June 2011 and June 2014. The rate of VAP, risk factors for VAP, and biological aspects of VAP were retrospectively evaluated. The incidence of VAP was 19.6% (n = 95) in patients who required more than 48 h of mechanical ventilation...
May 11, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28483222/endoscopic-management-of-bilateral-vocal-fold-paralysis-in-newborns-and-infants
#8
Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28468263/an-evaluation-of-a-continuing-education-program-for-family-caregivers-of-ventilator-dependent-children-with-spinal-muscular-atrophy-sma
#9
Deborah S Boroughs
Until 25 years ago, there were limited options for long-term mechanical ventilation of children, and the majority of children were cared for in hospitals. However, with improving technology, the pediatric intensive care unit has moved from the hospital to a home setting, as children with increasingly complex healthcare needs are now often cared for by family members. One of the most complex care conditions involves ventilator and tracheostomy support. Advanced respiratory technologies that augment natural respiratory function prolong the lives of children with respiratory compromise; however, this care often comes with serious risks, including respiratory muscle impairment, respiratory failure, and chronic pulmonary disease...
April 29, 2017: Children
https://www.readbyqxmd.com/read/28465381/two-year-follow-up-after-percutaneous-dilatational-tracheostomy-in-a-surgical-icu
#10
Maria Theresa Voelker, Marcus Wiechmann, Andreas Dietz, Sven Laudi, Sven Bercker
BACKGROUND: The modalities of tracheostomy for critically ill patients are still controversially discussed. Although the use of percutaneous dilatational tracheostomy (PDT) is generally accepted to be a safe procedure, it is still not considered to be suitable for patients requiring a permanent tracheostomy. METHODS: This was an observational cohort study investigating long-term outcome parameters of PDT. All patients having received a PDT at the interdisciplinary ICU at the University of Leipzig between October 2008 and August 2009 that survived to discharge were asked for consent to participate (n = 103)...
May 2, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28461543/predictive-associations-of-music-anxiety-and-sedative-exposure-on-mechanical-ventilation-weaning-trials
#11
Breanna Hetland, Ruth Lindquist, Craig R Weinert, Cynthia Peden-McAlpine, Kay Savik, Linda Chlan
BACKGROUND: Weaning from mechanical ventilation requires increased respiratory effort, which can heighten anxiety and later prolong the need for mechanical ventilation. OBJECTIVES: To examine the predictive associations of music intervention, anxiety, sedative exposure, and patients' characteristics on time to initiation and duration of weaning trials of patients receiving mechanical ventilation. METHODS: A descriptive, correlational design was used for a secondary analysis of data from a randomized trial...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28460120/post-neonatal-tetanus-in-a-picu-of-a-developing-economy-intensive-care-needs-outcome-and-predictors-of-mortality
#12
Suresh Kumar Angurana, Muralidharan Jayashree, Arun Bansal, Sunit Singhi, Karthi Nallasamy
Objectives: To evaluate pediatric intensive care unit (PICU) needs, outcome and predictors of mortality in post-neonatal tetanus. Materials and methods: Review of 30 consecutive post-neonatal tetanus cases aged 1 months to 12 years admitted to a PICU in north India over a period of 10 years (January 2006 to December 2015). Results: Chronic suppurative otitis media was the commonest portal of entry. All received tetanus toxoid, human tetanus immunoglobulin (HTIG) and appropriate antibiotics; 7 (23...
April 27, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28459406/-application-of-modified-percutaneous-rotating-dilative-tracheostomy-with-fiberoptic-bronchoscope-in-critical-patients-of-icu-a-control-study-for-four-kinds-of-tracheostomy
#13
Hong Zhang, Yanmin Xu, Haihong Li, Yao Zhang, Lunmeng Cui, Linlin Zhao, Qinghuan Yao, Fengjie Xie
OBJECTIVE: To investigate the clinical application of modified percutaneous rotating dilative tracheostomy with fiberoptic bronchoscope (MPRDT-FOB) in critical patients of intensive care unit (ICU) by comparing it with percutaneous dilative tracheostomy (PDT), modified percutaneous dilative tracheostomy (MPDT), and percutaneous dilative tracheostomy with fiberoptic bronchoscope (PDT-FOB). METHODS: A prospective control study was conducted. 240 critical patients underwent tracheotomy admitted to ICU of Mudanjiang Medical University Hongqi Hospital from February 2011 to November 2016 were enrolled, and they were randomly divided into four groups with 60 patients in each group...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#14
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#15
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#16
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28417683/tracheostomy-for-severe-pediatric-obstructive-sleep-apnea-indications-and-outcomes
#17
Christopher J Rizzi, Julian D Amin, Amal Isaiah, Tulio A Valdez, Anita Jeyakumar, Suzanne E Smart, Kevin D Pereira
Objectives (1) To describe characteristics of pediatric patients undergoing tracheostomy for obstructive sleep apnea (OSA). (2) To highlight perioperative events and outcomes of the procedure. Study Design Case series with chart review. Setting Four tertiary care academic children's hospitals. Subjects and Methods Twenty-nine children aged <18 years from January 1, 2010, to December 31, 2015, who underwent tracheostomy for severe OSA, defined as an apnea-hypopnea index (AHI) >10, were included in the study...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#18
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28395275/tracheostomy-extubation-reintubation-airway-management-decisions-in-intubated-stroke-patients
#19
Corinna Steidl, Julian Boesel, Sonja Suntrup-Krueger, Silvia Schoenenberger, Faisal Al-Suwaidan, Tobias Warnecke, Jens Minnerup, Rainer Dziewas
BACKGROUND: Both delayed and premature extubation increase complication rate, the need for tracheostomy (TT), the duration of intensive care unit stay, and mortality. In this study, we therefore investigated factors associated with primary TT and predictors for extubation failure (EF) in a sample of severely affected ventilated stroke patients. METHODS: One hundred eighty five intubated stroke patients were prospectively analyzed in this observational study. Patients not meeting predefined clinical and respiratory extubation criteria received a TT...
April 11, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28389026/national-survey-on-the-indicators-of-quality-in-bioethics-of-the-semicyuc-in-the-departments-of-intensive-care-medicine-in-spain
#20
V López Camps, M A García García, M C Martín Delgado, J M Añón Elizalde, N Masnou Burrallo, O Rubio Sanchiz, A Estella García, J L Monzón Marín
INTRODUCTION: Multiple interventions are performed in critical patients admitted to Intensive Care Units (ICUs). This study explores the presence in the daily practice of ICUs of elements related to the 6 bioethics quality indicators of the Spanish Society of Intensive and Critical Care Medicine and Coronary Units, and the participation of their members in the hospital ethics committees. MATERIALS AND METHODS: A multicenter observational study was carried out, using a survey exploring descriptive aspects of the ICUs, with 25 questions related to bioethics quality indicators, and assessing the participation of ICU members in the hospital ethics committees...
April 4, 2017: Medicina Intensiva
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