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Tracheostomy in icu

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https://www.readbyqxmd.com/read/27922906/patient-outcomes-after-early-versus-late-tracheostomy-in-the-puerto-rico-trauma-hospital
#1
Ana M Romero Vázquez, Omar García Rodríguez, Ediel Ramos Meléndez, Pablo Rodríguez Ortiz
OBJECTIVE: This study aimed to evaluate the impact of early tracheostomy (ET, ≤7 days) versus that of late tracheostomy (LT, >7 days) on outcomes such as hospital length of stay (LOS), intensive care unit (ICU) days, mechanical ventilation (MV) days, and mortality ratio. METHODS: A historical cohort study was undertaken using charts of patients admitted to the Puerto Rico Trauma Hospital who required MV and underwent tracheostomies, from 2000 to 2013. A logistic regression was performed to evaluate the association between timing of tracheostomy and complications and mortality...
December 5, 2016: Journal of Patient Safety
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#2
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27916368/prognostic-indicators-for-early-mortality-after-tracheostomy-in-the-intensive-care-unit
#3
Afshin Parsikia, Matthew Goodwin, Zachary Wells, Zoe Gauthier, Molli Bascom, Moon Suh, Beth Meloro, Jorge Ortiz, Amit R T Joshi
BACKGROUND: Tracheostomy is indicated for patients requiring prolonged mechanical ventilation. The aim of this study is to identify prognostic indicators for early mortality after tracheostomy to potentially avoid futility in the intensive care unit. METHODS: Patients who underwent tracheostomy and died within 30 d of admission (futile group) were compared with patients who underwent tracheostomy and survived more than 30 d after admission (nonfutile group). Categorical data were analyzed using chi-square and Fisher's exact tests...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27909277/-complete-transection-of-the-cervical-trachea-caused-by-chest-blunt-trauma
#4
Masahiro Yamada, Masami Abiko
A 52-year-old man was injured when driving through the gate by a motorcycle without noticing the rope between the gateposts. He developed hoarseness, subcutaneous emphysema and dyspnea, and was transferred to our hospital by an ambulance. Chest X-ray and computed tomography showed subcutaneous and mediastinal emphysema, and complete transection of the cervical trachea. Since respiratory distress progressed rapidly, we performed tracheostomy in the intensive care unit, and the patient was carried to the operating room...
December 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#5
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27876258/normal-saline-instillation-before-suctioning-a-meta-analysis-of-randomized-controlled-trials
#6
Chia-Hui Wang, Jui-Chen Tsai, Shu-Fen Chen, Chien-Ling Su, Lawrence Chen, Chao-Chun Lin, Ka-Wai Tam
BACKGROUND: For airway management of intensive care unit (ICU) patients who are intubated, a 5-10-mL bolus of sterile normal saline (NS) solution is commonly instilled into an endotracheal or tracheostomy tube before suctioning. However, NS instillation has been associated with adverse events such as dyspnea, increasing heart rate, decreasing of oxygenation, blood pressure, and other vital parameters. OBJECTIVE: To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the necessity of NS instillation before suctioning in ICU patients...
November 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27867132/learning-curve-for-real-time-ultrasound-guided-percutaneous-tracheostomy
#7
Sandra Petiot, Pierre-Grégoire Guinot, Momar Diouf, Elie Zogheib, Hervé Dupont
OBJECTIVES: The objective of this study was to demonstrate and quantify the ultrasound-guided percutaneous tracheostomy (UPDT) learning curve in a single team since the first UPDT. STUDY DESIGN AND PATIENTS: This was a cohort of all consecutive patients undergoing UPDT in the Amiens teaching hospital surgical intensive care unit between 2010 and 2014. METHODS: The learning process was evaluated according to three aspects: duration of the various steps involved in UPDT, incidence of consecutive complications, and procedure difficulty...
November 17, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27842947/extracorporeal-support-during-bilateral-sequential-lung-transplantation-in-patients-with-pulmonary-hypertension-risk-factors-and-outcomes
#8
Pranav R Shah, Michael L Boisen, Daniel G Winger, Jose Marquez, Christian A Bermudez, Jay K Bhama, Norihisa Shigemura, Jonathan D'Cuhna, Kathirvel Subramaniam
OBJECTIVE: To identify preoperative predictors of extracorporeal support in patients with pulmonary hypertension (PH) undergoing bilateral sequential lung transplantation (LTx), and to examine outcomes associated with the use of extracorporeal support. DESIGN: Retrospective, observational study. SETTING: Single organ transplantation and tertiary care university medical center. PARTICIPANTS: Adults with PH (preoperative mean pulmonary artery pressure (mPAP)≥25 mmHg) who underwent primary bilateral sequential LTx during 2007 to 2013...
August 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27842753/the-changing-role-for-tracheostomy-in-patients-requiring-mechanical-ventilation
#9
REVIEW
Kamran Mahmood, Momen M Wahidi
Tracheostomy is performed in patients who require prolonged mechanical ventilation or have upper airway instability. Percutaneous tracheostomy with Ciaglia technique is commonly used and rivals the surgical approach. Percutaneous technique is associated with decreased risk of stomal inflammation, infection, and bleeding along with reduction in health resource utilization when performed at bedside. Bronchoscopy and ultrasound guidance improve the safety of percutaneous tracheostomy. Early tracheostomy decreases the need for sedation and intensive care unit stay but may be unnecessary in some patients who can be extubated later successfully...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27811559/rib-fractures-in-trauma-patients-does-operative-fixation-improve-outcome
#10
Peter Majak, Pål A Næss
PURPOSE OF REVIEW: Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. RECENT FINDINGS: Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively...
December 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27806150/patterns-of-care-in-hospitalized-vascular-surgery-patients-at-end-of-life
#11
Dale G Wilson, Sheena K Harris, Heidi Peck, Kyle Hart, Enjae Jung, Amir F Azarbal, Erica L Mitchell, Gregory J Landry, Gregory L Moneta
Importance: There is limited literature reporting circumstances surrounding end-of-life care in vascular surgery patients. Objective: To identify factors driving end-of-life decisions in vascular surgery patients. Design, Setting, and Participants: In this cohort study, medical records were reviewed for all vascular surgery patients at a tertiary care university hospital who died during their hospitalization from 2005 to 2014. Main Outcomes and Measures: Patient, family, and hospitalization variables potentially important to influencing end-of-life decisions...
November 2, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27756433/communicating-with-conscious-and-mechanically-ventilated-critically-ill-patients-a-systematic-review
#12
S Ten Hoorn, P W Elbers, A R Girbes, P R Tuinman
BACKGROUND: Ventilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently used in ICU patients. We summarized the current evidence on communication methods with mechanically ventilated patients in the ICU. Secondly, we developed an algorithm for communication with these patients based on current evidence. METHODS: We performed a systematic review...
October 19, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27755248/the-combination-of-sat-and-sbt-protocols-may-help-reduce-the-incidence-of-ventilator-associated-pneumonia-in-the-burn-intensive-care-unit
#13
Yann-Leei Larry Lee, Kaci D Sims, Charles C Butts, M Amin Frotan, Steven Kahn, Sidney B Brevard, Jon D Simmons
There are few published reports on the unique nature of burn patients using a paired spontaneous awakening and spontaneous breathing protocol. A combined protocol was implemented in our burn intensive care unit (ICU) on January 1, 2012. This study evaluates the impact of this protocol on patient outcomes in a burn ICU. We performed a retrospective review of our burn registry over 4 years, including all patients placed on mechanical ventilation. In the latter 2 years, patients meeting criteria underwent daily spontaneous awakening trial; if successful, spontaneous breathing trial was performed...
October 6, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27752627/upper-airway-obstruction-resulting-from-acute-mucosal-injury-induced-by-direct-ingestion-of-sodium-picosulfate-magnesium-citrate-powder
#14
Gyeong Bo Kim, Sung Yeon Hwang, Tae Gun Shin, Tae Rim Lee, Won Chul Cha, Min Seob Sim, Ik Joon Jo, Keun Jeong Song, Joong Eui Rhee, Yeon Kwon Jeong
A 59-year-old man presented to the emergency department with a chief complaint of sore throat after swallowing sodium picosulfate/magnesium citrate powder for bowel preparation, without first dissolving it in water. The initial evaluation showed significant mucosal injury involving the oral cavity, pharynx, and epiglottis. Endotracheal intubation was performed for airway protection in the emergency department, because the mucosal swelling resulted in upper airway compromise. After conservative treatment in the intensive care unit, he underwent tracheostomy because stenosis of the supraglottic and subglottic areas was not relieved...
June 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/27748723/seizures-and-epileptiform-discharges-in-patients-with-acute-subdural-hematoma
#15
Sebastian Pollandt, Bichun Ouyang, Thomas P Bleck, Katharina M Busl
PURPOSE: Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH). METHODS: Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between 01/2009 and 03/2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy (PEG) placement and length of stay (LOS) were assessed...
June 20, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/27743430/prevalence-and-outcomes-of-diaphragmatic-dysfunction-assessed-by-ultrasound-technology-during-acute-exacerbation-of-copd-a-pilot-study
#16
Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27740854/tracheostomy-risk-factors-and-outcomes-after-severe-traumatic-brain-injury
#17
Stephen S Humble, Laura D Wilson, John W McKenna, Taylor C Leath, Yanna Song, Mario A Davidson, Jesse M Ehrenfeld, Oscar D Guillamondegui, Pratik P Pandharipande, Mayur B Patel
OBJECTIVE: To determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. METHODS: This retrospective cohort study compared adult trauma patients with severe TBI (n = 583) who did and did not receive tracheostomy. A multivariable logistic regression model assessed the associations between age, sex, race, insurance status, admission GCS, AIS (Head, Face, Chest) and tracheostomy placement...
October 14, 2016: Brain Injury: [BI]
https://www.readbyqxmd.com/read/27737432/evaluation-of-medical-devices-in-thoracic-radiograms-in-intensive-care-unit-time-to-pay-attention
#18
Ana Sofia Linhares Moreira, Maria da Graça Alves Afonso, Mónica Ribeiro Dos Santos Alves Dinis, Maria Cristina Granja Teixeira Dos Santos
OBJECTIVE: To identify and evaluate the correct positioning of the most commonly used medical devices as visualized in thoracic radiograms of patients in the intensive care unit of our center. METHODS: A literature search was conducted for the criteria used to evaluate the correct positioning of medical devices on thoracic radiograms. All the thoracic radiograms performed in the intensive care unit of our center over an 18-month period were analyzed. All admissions in which at least one thoracic radiogram was performed in the intensive care unit and in which at least one medical device was identifiable in the thoracic radiogram were included...
September 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27729153/successful-conservative-management-of-a-rare-complication-of-tracheostomy-extensive-posterior-tracheal-false-pouch
#19
Jennifer F Ha, Waseem Ostwani, Glenn Green
INTRODUCTION: With the advent of improved neonatal and pediatric intensive care management, tracheostomy is increasingly performed in children requiring prolonged ventilation. Even though tracheostomy is generally a safe procedure, there remains mortality and morbidity associated with it. OBJECTIVE: We report a rare complication of a tracheostomy tube resulting in extensive erosion and posterior tracheal false pouch secondary to a large tracheostomy tube and high positive end expiratory pressure in a 12-month-old infant...
November 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/27720369/extubation-failure-in-neonates-after-cardiac%C3%A2-surgery-prevalence-etiology-and%C3%A2-risk-factors
#20
Shinya Miura, Nao Hamamoto, Masaki Osaki, Satoshi Nakano, Chisato Miyakoshi
BACKGROUND: The purpose of this study was to explore the prevalence, etiology, and risk factors of extubation failure (EF) in post-cardiac surgery neonates. METHODS: Neonates (30 days old or younger) who underwent cardiac surgery and were admitted to the cardiac intensive care unit between September 2010 and February 2016 were included. The prevalence and etiology of EF, defined as reintubation within 48 hours, were reviewed. Demographic, operative, and perioperative data were retrospectively collected...
October 6, 2016: Annals of Thoracic Surgery
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