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Tracheostomy in icu

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https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28358176/early-versus-late-tracheostomy-in-pediatric-intensive-care-unit-does-it-matter-a-6-year-experience
#7
Alessandro Pizza, Enzo Picconi, Marco Piastra, Orazio Genovese, Daniele G Biasucci, Giorgio Conti
BACKGROUND: The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of Ventilator-Associated Pneumonia (VAP). METHODS: This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six year period...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28341953/giant-rhinophyma-a-rare-case-of-total-nasal-obstruction-and-restitutio-ad-integrum
#8
Andreas Wolter, Till Scholz, Jutta Liebau
Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment...
March 24, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#9
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28323727/experience-with-the-use-of-single-use-disposable-bronchoscope-in-the-icu-in-a-tertiary-referral-center-of-singapore
#10
Dominic C Marshall, Rucha S Dagaonkar, Chan Yeow, Anura T Peters, Siew Kin Tan, Dessmon Y H Tai, Soon Keng Gohs, Albert Y H Lim, Benjamin Ho, Sennen J W Lew, John Abisheganaden, Akash Verma
BACKGROUND: Flexible bronchoscopy is performed frequently in intensive care units (ICUs) for various indications using the reusable conventional bronchoscope (CB). Recently, "single-use disposable bronchoscope" (SB) was introduced into the health care industry. The purpose of this study was to compare the utility of SB with CB in ICU. METHODS: A retrospective review of medical records of patients undergoing flexible bronchoscopy in the ICUs in the year 2015. RESULTS: Ninety-three patients undergoing flexible bronchoscopy in the ICU were studied...
April 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28301956/the-effect-of-tracheostomy-performed-within-72%C3%A2-h-after-traumatic-brain-injury
#11
Keita Shibahashi, Kazuhiro Sugiyama, Hidenori Houda, Yuichi Takasu, Yuichi Hamabe, Akio Morita
The optimal timing of tracheostomy in patients with traumatic brain injury (TBI) remains unclear. The purpose of this study was to examine the effects of tracheostomy performed within 72 h after admission. In this retrospective cohort study, the authors reviewed the data for a series of 120 consecutive patients who underwent tracheostomy after suffering TBI with an Abbreviated Injury Scale (AIS) score of ≥4. The exclusion criteria were as follows: age <18 years, severe chest injury with an AIS score of ≥4, and a requirement for intubation because of upper airway obstruction...
March 16, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28295658/successful-closure-of-post-tracheostomy-large-chronic-trachea-esophageal-fistula-with-new-over-the-scope-clip
#12
P Rai, R Bhargava
Acquired tracheo-esophageal fistula mostly occurs secondary to malignancy, infection, ruptured diverticula, and injuries.(1) Among the benign conditions, prolonged mechanical ventilation is the most common (47%), followed by injury (17%), prior laryngectomy (17%), and prior esophagostomy (17%).(2) A 19 y male had a road traffic accident and was managed in an intensive care unit with ventilator support and had tracheostomy for 20 days. This article is protected by copyright. All rights reserved.
March 10, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28288027/cumulative-probability-and-time-to-reintubation-in-u-s-icus
#13
Andrea N Miltiades, Hayley B Gershengorn, May Hua, Andrew A Kramer, Guohua Li, Hannah Wunsch
OBJECTIVE: Reintubation after liberation from mechanical ventilation is viewed as an adverse event in ICUs. We sought to describe the frequency of reintubations across U.S. ICUs and to propose a standard, appropriate time cutoff for reporting of reintubation events. DESIGN AND SETTING: We conducted a cohort study using data from the Project IMPACT database of 185 diverse ICUs in the United States. PATIENTS: We included patients who received mechanical ventilation and excluded patients who received a tracheostomy, had a do-not-resuscitate order placed, or died prior to first extubation...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28284468/the-influence-of-tracheostomy-timing-on-outcomes-in-trauma-patients-a-meta-analysis
#14
Shi-Qi Cai, Jun-Wu Hu, Dong Liu, Xiang-Jun Bai, Jie Xie, Jia-Jun Chen, Fan Yang, Tao Liu
OBJECTIVE: This study aims to assess the influence of tracheostomy timing on outcomes among trauma patients, including mortality, medical resource utility and incidence of pneumonia. METHOD: A systematic review of the literature was conducted by internet search. Data were extracted from selected studies and analyzed using Stata to compare outcomes in trauma patients with early tracheostomy (ET) or late tracheostomy (LT)/prolonged intubation (PI). RESULT: 20 studies met our inclusion criteria with 3305 patients in ET group and 4446 patients in LT/PI group...
February 24, 2017: Injury
https://www.readbyqxmd.com/read/28263440/a-decade-of-pediatric-tracheostomies-indications-outcomes-and-long-term-prognosis
#15
Mona L McPherson, Lara Shekerdemian, Michelle Goldsworthy, Charles G Minard, Cynthia S Nelson, Fernando Stein, Jeanine M Graf
OBJECTIVE: To define the mortality and long-term outcomes of children undergoing tracheostomy. DESIGN: Retrospective chart and Texas Department of Health Bureau of Vital Statistics review of patients admitted to a Pediatric Intensive Care Unit who underwent a tracheostomy between 2001 and 2011. Mortality and decannulation rates were compared based on tracheostomy indication and age. SUBJECTS: A total of 426 patients admitted to a Pediatric Intensive Care Unit in a large tertiary children's hospital...
March 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28254541/an-experience-with-traumatic-brain-injury-is-early-tracheostomy-associated-with-better-prognosis
#16
Hosseinali Khalili, Shahram Paydar, Rasool Safari, Peyman Arasteh, Amin Niakan, Amin Abolhasani Foroughi
OBJECTIVE: In this study we compared the effects of early tracheostomy (ET) versus late tracheostomy (LT) on traumatic brain injury (TBI) related outcomes and prognosis. PATIENTS AND METHODS: Data on 152 TBI patients with a Glasgow coma scale (GCS) of ≤8, admitted to Rajaee hospital, between March 1, 2014 and August 23, 2015, were collected. Rajaee hospital is the main referral trauma center in southern Iran and is affiliated to Shiraz University of Medical Sciences...
February 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28252524/development-and-prospective-validation-of-tools-to-accurately-identify-neurosurgical-and-critical-care-events-in-children-with-traumatic-brain-injury
#17
Tellen D Bennett, Peter E DeWitt, Rebecca R Dixon, Cory Kartchner, Yamila Sierra, Diane Ladell, Rajendu Srivastava, Jay Riva-Cambrin, Allison Kempe, Desmond K Runyan, Heather T Keenan, J Michael Dean
OBJECTIVE: To develop and validate case definitions (computable phenotypes) to accurately identify neurosurgical and critical care events in children with traumatic brain injury. DESIGN: Prospective observational cohort study, May 2013 to September 2015. SETTING: Two large U.S. children's hospitals with level 1 Pediatric Trauma Centers. PATIENTS: One hundred seventy-four children less than 18 years old admitted to an ICU after traumatic brain injury...
March 1, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28250751/traumatic-brain-injury-and-palliative-care-a-retrospective-analysis-of-49-patients-receiving-palliative-care-during-2013-2016-in-turkey
#18
Kadriye Kahveci, Metin Dinçer, Cihan Doger, Ayse Karhan Yaricı
Traumatic brain injury (TBI), which is seen more in young adults, affects both patients and their families. The need for palliative care in TBI and the limits of the care requirement are not clear. The aim of this study was to investigate the length of stay in the palliative care center (PCC), Turkey, the status of patients at discharge, and the need for palliative care in patients with TBI. The medical records of 49 patients with TBI receiving palliative care in PCC during 2013-2016 were retrospectively collected, including age and gender of patients, the length of stay in PCC, the cause of TBI, diagnosis, Glasgow Coma Scale score, Glasgow Outcome Scale score, Karnofsky Performance Status score, mobilization status, nutrition route (oral, percutaneous endoscopic gastrostomy), pressure ulcers, and discharge status...
January 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/28241903/adult-epiglottitis-a-case-series
#19
Benjamin Lindquist, Sybil Zachariah, Anita Kulkarni
INTRODUCTION: Emergency Departments are inundated by patients with respiratory illness during the winter months. Emergency physicians are required to quickly identify critically ill patients among the large volume of patients with mild upper respiratory illness. Among these life-threatening conditions is acute epiglottitis. CASE PRESENTATION: We report a rare series of four adult patients who presented to our Emergency Department during a period of only one week in April 2015 and were ultimately diagnosed with acute epiglottitis...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#20
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
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