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Tracheostomy in icu

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https://www.readbyqxmd.com/read/28622012/tracheobronchomalacia-is-associated-with-increased-morbidity-in-bronchopulmonary-dysplasia
#1
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
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#2
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#3
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28610562/end-stage-renal-disease-a-risk-factor-of-deep-neck-infection-a-nationwide-follow-up-study-in-taiwan
#4
Geng-He Chang, Ming-Shao Tsai, Chia-Yen Liu, Meng-Hung Lin, Yao-Te Tsai, Cheng-Ming Hsu, Yao-Hsu Yang
BACKGROUND: Uremia is likely a risk factor for deep neck infection (DNI). However, only a few relevant cases have been reported, and evidence sufficient to support this hypothesis is lacking. The aim of the study is to investigate the effects of end-stage renal disease (ESRD) on DNI. METHODS: We used the database of the Registry for Catastrophic Illness Patients (RFCIP), a subset of the National Health Insurance Research Database (NHIRD) in Taiwan, to conduct a retrospective follow-up study...
June 13, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28594588/impact-of-bedside-tracheostomy-on-procalcitonin-kinetics-in-critically-ill-patients
#5
Koji Sato, Masaki Okajima, Toru Noda, Takumi Taniguchi
BACKGROUND: Critically ill patients are particularly vulnerable to invasive procedures and complications; however, tracheostomy is frequently performed in the intensive care unit (ICU). We analyzed the effects of tracheostomy on procalcitonin (PCT) kinetics and investigated whether PCT could reliably predict septic complications after tracheostomy. METHODS: We retrospectively identified 134 patients who underwent bedside tracheostomy during their ICU stay at a Japanese university hospital from October 2010 to December 2015...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28590308/perioperative-factors-related-to-the-severity-of-vocal-cord-paralysis-after-thoracic-cardiovascular-surgery-a-retrospective-review
#6
Hiroki Taenaka, Sho Carl Shibata, Kenta Okitsu, Takeshi Iritakenishi, Tatsuyuki Imada, Akinori Uchiyama, Yuji Fujino
BACKGROUND: Vocal cord paralysis (VCP) is a rare complication of thoracic cardiovascular surgery. In severe cases, life-threatening airway obstruction may occur. OBJECTIVE: To evaluate the incidence and severity of VCP among patients who underwent thoracic cardiovascular surgery and to identify possible risk factors. DESIGN: Single-centre retrospective review of adult patients. SETTING: Osaka University Hospital, Suita, Japan, from January 2013 to August 2015...
July 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28574532/association-between-opioid-and-benzodiazepine-use-and-clinical-deterioration-in-ward-patients
#7
Patrick G Lyons, Ashley Snyder, Sarah Sokol, Dana P Edelson, Babak Mokhlesi, Matthew M Churpek
BACKGROUND: Opioids and benzodiazepines are frequently used in hospitals, but little is known about outcomes among ward patients receiving these medications. OBJECTIVE: To determine the association between opioid and benzodiazepine administration and clinical deterioration. DESIGN: Observational cohort study. SETTING: 500-bed academic urban tertiary-care hospital. PATIENTS: All adults hospitalized on the wards from November 2008 to January 2016 were included...
June 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28546379/tracheostomy-in-infants-and-children
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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...
July 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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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