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ventilator-associated pneumonia

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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
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
https://www.readbyqxmd.com/read/28228576/ten-year-temporal-trends-in-medical-complications-after-acute-intracerebral-hemorrhage-in-the-united-states
#2
Fadar Oliver Otite, Priyank Khandelwal, Amer M Malik, Seemant Chaturvedi, Ralph L Sacco, Jose G Romano
BACKGROUND AND PURPOSE: Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States. METHODS: A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Weighted complication risks were computed by sex and mechanical ventilation status...
February 22, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28224111/attributable-cost-of-a-nosocomial-infection-in-the-intensive-care-unit-a-prospective-cohort-study
#3
Binila Chacko, Kurien Thomas, Thambu David, Hema Paul, Lakshmanan Jeyaseelan, John Victor Peter
AIM: To study the impact of hospital-acquired infections (HAIs) on cost and outcome from intensive care units (ICU) in India. METHODS: Adult patients (> 18 years) admitted over 1-year, to a 24-bed medical critical care unit in India, were enrolled prospectively. Treatment cost and outcome data were collected. This cost data was merged with HAI data collected prospectively by the Hospital Infection Control Committee. Only infections occurring during ICU stay were included...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#4
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#5
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#6
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28221200/pathogenic-link-between-postextubation-pneumonia-and-ventilator-associated-pneumonia-an-experimental-study
#7
Emanuele Rezoagli, Alberto Zanella, Massimo Cressoni, Lorenzo De Marchi, Theodor Kolobow, Lorenzo Berra
BACKGROUND: The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours...
February 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28216354/outcomes-of-endovascular-and-open-surgical-repair-of-ruptured-abdominal-aortic-aneurysms-in-elderly-patients
#8
Tze-Woei Tan, Mohammad Eslami, Denis Rybin, Gheorghe Doros, Wayne W Zhang, Alik Farber
BACKGROUND: Endovascular aneurysm repair (EVAR) is becoming the preferred treatment modality for patients with a ruptured abdominal aortic aneurysm (rAAA). Although the survival advantage of EVAR over open aortic repair (OAR) has been shown in some studies, it is unclear whether this benefit extends to elderly patients. We sought to evaluate the outcomes of rAAA repair in octogenarians. METHODS: We reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data set (2005-2014) to identify patients older than 80 years who were treated with EVAR and OAR for rAAA...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28216018/prospective-randomised-controlled-study-evaluating-early-modification-of-oral-microbiota-following-admission-to-the-intensive-care-unit-and-oral-hygiene-with-chlorhexidine
#9
Felipe Francisco Tuon, Oleg Gavrilko, Saulo de Almeida, Eigi Ricardo Sumi, Thiago Alberto, Jaime Luis Rocha, Edvaldo Antonio Rosa
OBJECTIVES: Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. METHODS: This was a prospective, randomised, controlled, double-blind study in patients (n=16) under MV who were mouth-rinsed with either CHX or placebo...
February 18, 2017: Journal of Global Antimicrobial Resistance
https://www.readbyqxmd.com/read/28215171/oral-colonization-by-nosocomial-pathogens-during-hospitalization-in-invasive-care-unit-and-prevention-strategies
#10
Hossein Kazemian, Samane Bourbour, Maryam Beheshti, Abbas Bahador
BACKGROUND: Critically ill patients are very susceptible to a variety of disorders and infections during hospitalization in Intensive Care Units (ICU). Among these problems, nosocomial infections are major causes of morbidity and mortality. METHODS: Nosocomial pneumonias, specifically ventilator associated pneumonias have become a major health care issue. The implication of oral care in hospital presents challenges that can prevent or reduce the risk of nosocomial pneumonias in ICU...
February 15, 2017: Recent Patents on Anti-infective Drug Discovery
https://www.readbyqxmd.com/read/28212478/-risk-factors-related-with-ventilator-associated-pneumonia-in-a-neonatal-intensive-care-therapy
#11
Juan Pablo Romo-Gamboa, Bertha Alicia Sandoval-Pérez, Ana Bertha Rodríguez-López, Marco Antonio Torres-González, Juan Carlos Barrera-de León
BACKGROUND: Ventilator-associated pneumonia (VAP) represents the second cause of nosocomial infections and it is associated with greater morbility, duration of mechanical ventilation (MV), and hospital stay. The objective was to determine factors related with VAP in neonates. METHODS: Analytical transversal study including newborns admitted already intubated with at least 48 hours of MV or who were intubated in Neonatal Therapy. VAP was defined according to the criteria of the Centers for Disease Control and Prevention: "those patients submitted to MV during at least 48 hours"...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28209197/accuracy-and-generalizability-of-using-automated-methods-for-identifying-adverse-events-from-electronic-health-record-data-a-validation-study-protocol
#12
Christian M Rochefort, David L Buckeridge, Andréanne Tanguay, Alain Biron, Frédérick D'Aragon, Shengrui Wang, Benoit Gallix, Louis Valiquette, Li-Anne Audet, Todd C Lee, Dev Jayaraman, Bruno Petrucci, Patricia Lefebvre
BACKGROUND: Adverse events (AEs) in acute care hospitals are frequent and associated with significant morbidity, mortality, and costs. Measuring AEs is necessary for quality improvement and benchmarking purposes, but current detection methods lack in accuracy, efficiency, and generalizability. The growing availability of electronic health records (EHR) and the development of natural language processing techniques for encoding narrative data offer an opportunity to develop potentially better methods...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28208972/ventilator-associated-pneumonia-in-paediatric-intensive-care-unit
#13
Anirban Mandal, Amitabh Singh, Puneet Kaur Sahi, Bhavika Rishi
No abstract text is available yet for this article.
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208857/emergence-of-hospital-acquired-carbapenem-resistant-non-fermenters-in-teaching-institute
#14
Hariom Sharan, Neeraj Katare, Aparna Pandey, Ganesh Shivmurti Bhatambare, Trupti Bajpai
INTRODUCTION: Non-Fermenting Gram Negative Bacilli (NFGNB) are emerging now-a-days because of their tendency to colonize various surfaces and inherent resistance to commonly used disinfectants. They are responsible for multi-drug resistant hospital acquired infections. Detection of carbapenem resistance mechanisms is essential for treatment and infection control purpose as can spread to other organisms causing hospital outbreaks. AIM: To characterize non-fermenters from various clinical samples and to detect different carbapenem resistance mechanisms in meropenem resistant isolates...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207437/lack-of-association-between-preoperative-statin-use-and-respiratory-and-neurologic-complications-after-cardiac-surgery
#15
Ryu Komatsu, Huseyin Oguz Yilmaz, Jing You, C Allen Bashour, Shobana Rajan, Edward G Soltesz, Daniel I Sessler, Alparslan Turan
BACKGROUND: Statins may reduce the risk of pulmonary and neurologic complications after cardiac surgery. METHODS: The authors acquired data for adults who had coronary artery bypass graft, valve surgery, or combined procedures. The authors matched patients who took statins preoperatively to patients who did not. First, the authors assessed the association between preoperative statin use and the primary outcomes of prolonged ventilation (more than 24 h), pneumonia (positive cultures of sputum, transtracheal fluid, bronchial washings, and/or clinical findings consistent with the diagnosis of pneumonia), and in-hospital all-cause mortality, using logistic regressions...
February 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28201768/first-reported-case-of-ventilator-associated-pneumonia-and-sepsis-caused-by-cedecea-lapagei-in-a-brazilian-neonatal-intensive-care-unit
#16
Charbell Miguel Haddad Kury, Aline Azevedo Yabrudi, Thyara Boechat de Souza, Elisa Carvalhal de Souza, Ludmyla Tavares E Silva Costa, Charles Bruno Soares, Gabrielle Assumpção Calixto, Mariana Rodrigues Gramático
No abstract text is available yet for this article.
February 14, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28198727/new-guidelines-for-nosocomial-pneumonia
#17
Mark L Metersky, Andre C Kalil
PURPOSE OF REVIEW: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) remain important causes of morbidity and mortality in hospitalized patients. New evidence-based guidelines for the diagnosis and treatment of these entities were released by the Infectious Diseases Society of America and the American Thoracic Society in 2016. This review summarizes the recommendations contained within these guidelines and their supporting rationale. RECENT FINDINGS: With respect to diagnosis of HAP and VAP, the guidelines suggest using semiquantitative cultures of noninvasively obtained respiratory samples instead of quantitative cultures of invasively obtained samples...
February 13, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#18
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28197049/zinc-supplementation-in-adult-mechanically-ventilated-trauma-patients-is-associated-with-decreased-occurrence-of-ventilator-associated-pneumonia-a-secondary-analysis-of-a-prospective-observational-study
#19
Farshad Hasanzadeh Kiabi, Abbas Alipour, Hadi Darvishi-Khezri, Aily Aliasgharian, Amir Emami Zeydi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a type of lung infection that typically affects critically ill patients undergoing mechanical ventilation (MV) in the Intensive Care Unit (ICU). The aim of this analysis is to determine potential association between zinc supplementation with the occurrence of VAP in adult mechanically ventilated trauma patients. SUBJECTS AND METHODS: This secondary analysis of a prospective observational study was carried out over a period of 1 year in ICUs of one teaching hospital in Iran...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28193455/assessment-of-the-effectiveness-of-a-ventilator-associated-pneumonia-prevention-bundle-that-contains-endotracheal-tube-with-subglottic-drainage-and-cuff-pressure-monitorization
#20
Ozlem Akdogan, Yasemin Ersoy, Ciğdem Kuzucu, Ender Gedik, Turkan Togal, Funda Yetkin
The effectiveness of prevention bundles on the occurrence and mortality of ventilator associated pneumonia (VAP) was evaluated in many studies. However, the effectiveness of endotracheal tube with subglottic secretion drainage (ETT-SD) and cuff pressure monitorization in VAP bundles have not been adequately assessed. In this study, we aimed to evaluate the effectiveness of VAP bundle containing ETT-SD and cuff pressure monitorization. This was a prospective, controlled study that was carried out between March 2011 and April 2012 including intubated patients...
February 10, 2017: Brazilian Journal of Infectious Diseases
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