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https://www.readbyqxmd.com/read/29161297/prognostic-performance-of-mr-pro-adrenomedullin-in-patients-with-community-acquired-pneumonia-in-the-emergency-department-compared-to-clinical-severity-scores-psi-and-curb
#1
Jacopo Maria Legramante, Maria Mastropasqua, Beniamino Susi, Ottavia Porzio, Marta Mazza, Grazia Miranda Agrippino, Cartesio D Agostini, Antonella Brandi, Germano Giovagnoli, Vito Nicola Di Lecce, Sergio Bernardini, Marilena Minieri
AIM: (i) evaluate the performance of MR-pro-ADM in reflecting the outcome and risk for CAP patients in the emergency department, and (ii) compare the prognostic performance of MR-pro-ADM with that of clinical scores PSI and CURB65. METHODS: Observational prospective, single-center study in patients with suspected community acquired pneumonia (CAP). Eighty one patients underwent full clinical and laboratory assessment as by protocol, and were followed up a 28 days...
2017: PloS One
https://www.readbyqxmd.com/read/29160424/effect-of-prophylactic-non-invasive-mechanical-ventilation-on-functional-capacity-after-heart-valve-replacement-a-clinical-trial
#2
Amaro Afrânio de Araújo-Filho, Manoel Luiz de Cerqueira-Neto, Lucas de Assis Pereira Cacau, Géssica Uruga Oliveira, Telma Cristina Fontes Cerqueira, Valter Joviniano de Santana-Filho
OBJECTIVE: During cardiac surgery, several factors contribute to the development of postoperative pulmonary complications. Non-invasive ventilation is a promising therapeutic tool for improving the functionality of this type of patient. The aim of this study is to evaluate the functional capacity and length of stay of patients in a nosocomial intensive care unit who underwent prophylactic non-invasive ventilation after heart valve replacement. METHOD: The study was a controlled clinical trial, comprising 50 individuals of both sexes who were allocated by randomization into two groups with 25 patients in each group: the control group and experimental group...
October 2017: Clinics
https://www.readbyqxmd.com/read/29160128/hospital-utilization-for-patients-with-amyotrophic-lateral-sclerosis-in-saskatoon-canada
#3
Adrianna Gunton, Gregory Hansen, Kerri Lynn Schellenberg
OBJECTIVE: This retrospective study reviewed hospital and intensive care unit (ICU) admissions for patients with amyotrophic lateral sclerosis (ALS) in Saskatoon, Canada, between 2005 and 2017. The purpose was to understand hospital utilization and admission patterns for patients with ALS in the absence of coordinated multidisciplinary care. METHODS: Hospital/ICU admissions were detected at two hospitals in Saskatoon using the International Classification of Diseases (ICD-10) coding for ALS...
November 21, 2017: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29156920/supportive-palliative-interventions-in-motor-neurone-disease-what-we-know-from-current-literature
#4
Hon Wai Benjamin Cheng, Kwok Ying Chan, Yuen Kwan Judy Chung, Chun Wai Choi, Chun Hung Chan, Shuk Ching Cheng, Wan Hung Chan, Koon Sim Fung, Kar Yin Wong, Oi Man Iman Chan, Ching Wah Man
Although there is no cure for motor neurone disease (MND), the advent of supportive interventions including multidisciplinary care (MDC) has improved treatment interventions and enhanced quality of life (QOL) for MND patients and their carers. Our integrative review showed evidence-based MDC, respiratory management and disease-modifying therapy that have improved the outcomes of patients diagnosed with MND. Supportive approaches to nutritional maintenance and optimization of symptomatic treatments, including management of communication and neuropsychiatric issues, improve the QOL for MND patients...
October 31, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29156917/advance-care-planning-for-patients-with-advanced-neurology-diseases
#5
Ka-Chi Cheung, Vikki Wai-Kee Lau, Ka-Chun Un, Man-Sheung Wong, Kwok-Ying Chan
BACKGROUND: Advanced neurology diseases including motor neuron disease (MND) are usually progressive life-limiting illness and could be devastating for patients, families and caregivers. Although medical technologies, such as enteral feeding and non-invasive ventilation, may prolong life expectancy of the patients, their utilization prompts important ethical questions in regard to their quality of life (QoL). Little attention had been paid on how ACP practice would practically help with patients suffering from different neurology diseases...
October 13, 2017: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/29151423/-guiding-significance-of-diaphragm-function-evaluation-in-ventilation-weaning
#6
Jieying Luo, Xiaotong Han, Maiying Fan, Hui Wen, Jing Xu, Yanfang Pei, Ying Huang
Diaphragm dysfunction is common in clinical work, which is a frequently important cause of ventilation weaning failure ignored by clinicians. Assessing diaphragmatic function while weaning helps early detection and prevention of weaning failure, so as to improve the clinical outcome of patients on mechanical ventilation (MV). Reviewing studies of diaphragmatic function evaluation in weaning, we can find that assessing diaphragmatic function during weaning can help guide weaning. Weaning predictors including pressure index, electrophysiological index and morphological index, among which bedside ultrasound as a morphological index is widely used in intensive care unit (ICU), which is simple, non-invasive, and easy to operate...
November 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29149690/a-modified-montpellier-protocol-for-intubating-intensive-care-unit-patients-is-associated-with-an-increase-in-first-pass-intubation-success-and-fewer-complications
#7
Keith A Corl, Christopher Dado, Ankita Agarwal, Nader Azab, Tim Amass, Sarah J Marks, Mitchell M Levy, Roland C Merchant, Jason Aliotta
BACKGROUND: The Montpellier protocol for intubating patients in the intensive care unit (ICU) is associated with a decrease in intubation-related complications. We sought to determine if implementation of a simplified version of the Montpellier protocol that removed selected components and allowed for a variety of pre-oxygenation modalities increased first-pass intubation success and reduced intubation-related complications. METHODS: A prospective pre/post-comparison of a modified Montpellier protocol in two medical and one medical/surgical/cardiac ICU within a hospital system...
November 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29146865/echocardiographic-changes-with-non-invasive-ventilation-and-cpap-in-obesity-hypoventilation-syndrome
#8
Jaime Corral, Maria Victoria Mogollon, M-Ángeles Sánchez-Quiroga, Javier Gómez de Terreros, Auxiliadora Romero, Candela Caballero, Joaquin Teran-Santos, María L Alonso-Álvarez, Teresa Gómez-García, Mónica González, Soledad López-Martínez, Pilar de Lucas, José M Marin, Odile Romero, Trinidad Díaz-Cambriles, Eusebi Chiner, Carlos Egea, Roberto M Lang, Babak Mokhlesi, Juan F Masa
RATIONALE: Despite a significant association between obesity hypoventilation syndrome (OHS) and cardiac dysfunction, no randomised trials have assessed the impact of non-invasive ventilation (NIV) or CPAP on cardiac structure and function assessed by echocardiography. OBJECTIVES: We performed a secondary analysis of the data from the largest multicentre randomised controlled trial of OHS (Pickwick project, n=221) to determine the comparative efficacy of 2 months of NIV (n=71), CPAP (n=80) and lifestyle modification (control group, n=70) on structural and functional echocardiographic changes...
November 16, 2017: Thorax
https://www.readbyqxmd.com/read/29144160/high-flow-nasal-cannula-oxygen-in-adults-an-evidence-based-assessment
#9
Matthew G Drake
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29143501/-the-place-of-balloon-pulmonary-angioplasty-in-the-management-of-chronic-thromboembolic-pulmonary-hypertension
#10
Aileen Kharat, Béatrice Duxbury, Anne-Lise Hachull, Stéphane Noble, Hélène Bouvaist, Paola M Soccal, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) is uncommon. Its diagnosis should not be delayed as its prognosis is poor if not treated. In most cases, an acute pulmonary embolism is found in the medical history of the patient. Once suspected, a specific work-up should be performed in a pulmonary hypertension (PH) center. The ventilation/perfusion scan has a central role in this workup but the emergence of non invasive imaging technologies provides morphological and functional information which take part in the therapeutic decision making, such as operability...
November 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#11
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#12
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29132057/predictors-of-hemodynamic-derangement-during-intubation-in-the-critically-ill-a-nested-case-control-study-of-hemodynamic-management-part-ii
#13
Nathan J Smischney, Mohamed O Seisa, Katherine J Heise, Robert A Wiegand, Kyle D Busack, Jillian L Deangelis, Theodore O Loftsgard, Darrell R Schroeder, Daniel A Diedrich
PURPOSE: Our primary aim was to identify predictors of immediate hemodynamic decompensation during the peri-intubation period. METHODS: We conducted a nested case-control study of a previously identified cohort of adult patients needing intubation admitted to a medical-surgical ICU during 2013-2014. Hemodynamic derangement was defined as cardiac arrest and/or the development of systolic blood pressure <90mmHg and/or mean arterial pressure <65mmHg 30min following intubation...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29131536/non-invasive-ventilation-use-in-status-asthmaticus-16%C3%A2-years-of-experience-in-a-tertiary-intensive-care
#14
Kirsten Rl Bond, Carl Ae Horsley, Anthony B Williams
OBJECTIVE: To describe the use of non-invasive ventilation (NIV) in adults presenting with status asthmaticus to Middlemore Hospital Critical Care Complex (CCC, South Auckland, New Zealand) from 2000 to 2015. METHOD: Retrospective review of all adult asthma admissions to the Hospital CCC between 2000 and 2015. Demographic, physiological, treatment data and blood gas results were recorded. RESULTS: There were 265 asthma admissions to Middlemore Hospital CCC during the study period...
November 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29126689/the-feasibility-and-impact-of-routine-combined-limited-transthoracic-echocardiography-and-lung-ultrasound-on-diagnosis-and-management-of-patients-admitted-to-icu-a-prospective-observational-study
#15
Kavi Haji, Darsim Haji, David J Canty, Alistair G Royse, Dhaksha Tharmaraj, Meor Azraee, Lynda Hopkins, Collin F Royse
OBJECTIVES: Limited transthoracic echocardiography (TTE) and lung ultrasound increasingly is performed in the intensive care unit (ICU), though used in a goal-directed rather than routine manner. DESIGN: Prospective observational study. SETTINGS: Tertiary ICU. PARTICIPANTS: Ninety-three critically ill participants within 24 hours of admission to ICU. METHODS: A treating intensivist documented a clinical diagnosis and management plan before and after combined limited TTE and lung ultrasound...
August 18, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29126451/acceleration-sensors-in-abdominal-wall-position-as-a-non-invasive-approach-to-detect-early-breathing-alterations-induced-by-intolerance-of-increased-airway-resistance
#16
Thomas Breuer, Christian S Bruells, Rolf Rossaint, Henning Steffen, Catherine Disselhorst-Klug, Michael Czaplik, Norbert Zoremba
BACKGROUND: Early detection of respiratory overload is crucial to mechanically ventilated patients, especially during phases of spontaneous breathing. Although a diversity of methods and indices has been established, there is no highly specific approach to predict respiratory failure. This study aimed to evaluate acceleration sensors in abdominal and thoracic wall positions to detect alterations in breathing excursions in a setting of gradual increasing airway resistance. METHODS: Twenty-nine healthy volunteers were committed to a standardized protocol of a two-minutes step-down spontaneous breathing on a 5 mm, 4 mm and then 3 mm orally placed endotracheal tube...
November 10, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29122894/dyspnoea-in-lupus
#17
Jeremy Fleri Soler, Andrew Borg, Cecilia Mercieca
A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal apart from reduced air entry at the lung bases.Arterial blood gases showed hypoxaemia and chest X-ray revealed raised hemidiaphragms without any pleural effusions. Lung function showed a restrictive pathology while high-resolution chest CT and CT pulmonary angiogram were negative. Echocardiography showed normal ventricular diameters and no pericardial effusion...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29119848/management-of-community-acquired-pneumonia-in-immunocompetent-adults-updated-swedish-guidelines-2017
#18
Simon Athlin, Christer Lidman, Anders Lundqvist, Pontus Naucler, Anna C Nilsson, Carl Spindler, Kristoffer Strålin, Jonas Hedlund
Based on expert group work, Swedish recommendations for the management of community-acquired pneumonia in adults are here updated. The management of sepsis-induced hypotension is addressed in detail, including monitoring and parenteral therapy. The importance of respiratory support in cases of acute respiratory failure is emphasized. Treatment with high-flow oxygen and non-invasive ventilation is recommended. The use of statins or steroids in general therapy is not found to be fully supported by evidence. In the management of pleural infection, new data show favourable effects of tissue plasminogen activator and deoxyribonuclease installation...
November 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29118858/characteristics-and-predictors-of-mortality-of-patients-with-hematologic-malignancies-requiring-invasive-mechanical-ventilation
#19
Hasan M Al-Dorzi, Haya Al Orainni, Faten Al Eid, Haytham Tlayjeh, Abedalrahman Itani, Ayman Al Hejazi, Yaseen M Arabi
RATIONALE: Acute respiratory failure (ARF) may complicate the course of hematologic malignancies (HMs). Our objective was to study the characteristics, outcomes and predictors of mortality of patients with HMs who required intubation for ARF. METHODS: This retrospective cohort study evaluated all patients with HMs who were admitted to the Intensive Care Unit (ICU) of King Abdul-Aziz Medical City-Riyadh between 2008 and 2013 and required invasive mechanical ventilation...
October 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/29116173/incidence-and-prognostic-relevance-of-cardiopulmonary-failure-in-takotsubo-cardiomyopathy
#20
Ibrahim El-Battrawy, Siegfried Lang, Uzair Ansari, Katherine Sattler, Michael Behnes, Katja Schramm, Christian Fastner, Erol Tülümen, Xiaobo Zhou, Ursula Hoffmann, Martin Borggrefe, Ibrahim Akin
Recent studies have indicated that patients with takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. There is a distinct possibility that TTC could be associated with adverse life-threatening complications like cardiopulmonary failure. Our institutional database constituted a collective of 114 patients diagnosed with TTC. The frequency, determinants and predictors of cardiopulmonary failure were assessed. The patients were subsequently classified into two groups based on the presence (n = 44, 38...
November 7, 2017: Scientific Reports
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