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https://www.readbyqxmd.com/read/28538237/update-on-postnatal-steroids
#1
Henry L Halliday
Antenatal steroid treatment to enhance fetal lung maturity and surfactant treatment to prevent or treat respiratory distress syndrome have been major advances in perinatal medicine in the past 40 years contributing to improved outcomes for preterm infants. Use of postnatal steroids to prevent or treat chronic lung disease in preterm infants has been less successful and associated with adverse neurodevelopmental outcomes. Although early (in the first week of life) postnatal steroid treatment facilitates earlier extubation and reduces the risk of chronic lung disease, it is associated with adverse effects, such as hyperglycemia, hypertension, gastrointestinal bleeding and perforation, hypertrophic cardiomyopathy, growth failure, and cerebral palsy, and cannot be recommended...
2017: Neonatology
https://www.readbyqxmd.com/read/28531175/weekly-high-dose-liposomal-amphotericin-b-l-amb-in-critically-ill-septic-patients-with-multiple-candida-colonization-the-ambidex-study
#2
Elie Azoulay, Jean-François Timsit, Alexandre Lautrette, Stephane Legriel, Adeline Max, Stephane Ruckly, Benoit Misset, Yves Cohen, Michel Wolff
BACKGROUND: To demonstrate the feasibility and safety of weekly high-dose liposomal amphotericin B (L-AmB) (as a pre-emptive antifungal treatment) for 2 weeks in patients with septic shock and Candida colonization. METHODS: Pilot, multicentre, open-label, prospective study conducted in seven French ICUs. Non-immunocompromised patients, receiving mechanical ventilation were eligible if they presented ICU-acquired severe sepsis requiring newly administered antibacterial agents and Candida colonization in at least two sites...
2017: PloS One
https://www.readbyqxmd.com/read/28530332/-treatment-of-mechanically-ventilated-patients-in-an-internal-medicine-department-overview-2013
#3
Jacov Kogan, Alex Rodnitsky, Ornit Cohen, Svetlana Turkot, Yevgenia Tziba, Boris Golzman
BACKGROUND: Over recent years the number of mechanically ventilated patients in internal medicine departments has grown. These patients are elderly, mostly disabled and suffer from many chronic illnesses. Most of them require prolonged mechanical ventilation. OBJECTIVES: The study aimed to evaluate the population of mechanically ventilated patients in an internal department, the treatment and outcomes, particularly the morbidity in hospitalization and to identify the prognostic causes of death...
August 2016: Harefuah
https://www.readbyqxmd.com/read/28528140/maternal-and-neonatal-outcomes-of-respiratory-failure-during-pregnancy
#4
Chen-Yiu Hung, Han-Chung Hu, Li-Chung Chiu, Chih-Hao Chang, Li-Fu Li, Chung-Chi Huang, Chuan-Chi Kao, Po-Jen Cheng, Kuo-Chin Kao
BACKGROUND: Obstetric patients comprise a limited portion of intensive care unit patients, but they often present with unfamiliar conditions and exhibit the potential for catastrophic deterioration. This study evaluated the maternal and neonatal outcomes of respiratory failure during pregnancy. METHODS: Information on 71 patients at >25 weeks gestation in the ICU with respiratory failure was recorded between 2009 and 2013. The characteristics and outcomes of mothers and fetuses were determined through a retrospective chart review and evaluated using Student's t test, chi-square test, and Fisher's exact test...
May 17, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28526233/keratinocyte-growth-factor-for-the-treatment-of-the-acute-respiratory-distress-syndrome-kare-a-randomised-double-blind-placebo-controlled-phase-2-trial
#5
Daniel F McAuley, Lj Mark Cross, Umar Hamid, Evie Gardner, J Stuart Elborn, Kathy M Cullen, Ahilanandan Dushianthan, Michael Pw Grocott, Michael A Matthay, Cecilia M O'Kane
BACKGROUND: Data from in-vitro, animal, and human lung injury models suggest that keratinocyte growth factor (KGF) might be beneficial in acute respiratory distress syndrome (ARDS). The objective of this trial was to investigate the effect of KGF in patients with ARDS. METHODS: We did a double-blind, allocation concealed, randomised, placebo-controlled phase 2 trial in two intensive care units in the UK, involving patients fulfilling the American-European Consensus Conference Definition of ARDS...
May 16, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28514310/development-and-validation-of-a-mortality-risk-model-for-pediatric-sepsis
#6
Mengshi Chen, Xiulan Lu, Li Hu, Pingping Liu, Wenjiao Zhao, Haipeng Yan, Liang Tang, Yimin Zhu, Zhenghui Xiao, Lizhang Chen, Hongzhuan Tan
Pediatric sepsis is a burdensome public health problem. Assessing the mortality risk of pediatric sepsis patients, offering effective treatment guidance, and improving prognosis to reduce mortality rates, are crucial.We extracted data derived from electronic medical records of pediatric sepsis patients that were collected during the first 24 hours after admission to the pediatric intensive care unit (PICU) of the Hunan Children's hospital from January 2012 to June 2014. A total of 788 children were randomly divided into a training (592, 75%) and validation group (196, 25%)...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28511469/clinical-profile-and-outcome-of-newborns-with-acute-kidney-injury-in-a-level-3-neonatal-unit-in-western-india
#7
Satvik Chaitanya Bansal, Archana Somashekhar Nimbalkar, Amit R Kungwani, Dipen Vasudev Patel, Ankur Rajinder Sethi, Somashekhar Marutirao Nimbalkar
INTRODUCTION: Acute Kidney Injury (AKI) is a serious condition in neonatal care. It complicates the management necessitating the restrictive use of medications. AIM: To evaluate clinical profile, identify associated and prog-nostic factors in newborns with AKI. MATERIALS AND METHODS: This was a case control study done between January 2008 to January 2010. Total 1745 newborns were admitted, of which 74 babies had AKI. It was defined as serum creatinine >1...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28508001/closing-a-tracheal-defect-with-an-omental-pedicled-gastric-flap-a-technical-note
#8
Holger Rupprecht, Marius Ghidau, Katharina Gaab
Due to an adenocarcinoma of the right upper lobe with infiltration of the main bronchus a 49-years-old female patient underwent an upper bilobectomy with sleeve resection. After two completed chemotherapy bouts and signs of sepsis another thoracotomy was inevitable.  As a complicating factor a supracarinal, necrotic and perforating lesion of the trachea appeared. The defect can be initially repaired with a suture and covered with azygos vein material. However surgical revision showed an enlargement of the tracheal necrosis...
April 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28505685/-weaning-unit-of-the-university-medicine-greifswald-institutional-structure-and-weaning-results-from-prolonged-ventilation-over-10-years
#9
A Müller-Heinrich, C Warnke, A Heine, T Bollmann, M Boesche, C Schäper, B Stubbe, S Friesecke, S B Felix, S Gläser, A Obst, R Ewert
The increasing importance of intensive care medicine including mechanical ventilation has been accompanied by the demand of weaning opportunities for patients undergoing prolonged mechanical ventilation. Consequently, specialised clinical institutions, focusing on the weaning from mechanical ventilation, have been established since the 1980 s.The present article illustrates the structural development and results of such a specialised institution at the University Medicine Greifswald, using data of 616 patients collected within the past ten years (2006 - 2015)...
May 15, 2017: Pneumologie
https://www.readbyqxmd.com/read/28491815/lethal-pulmonary-hemorrhage-syndrome-due-to-leptospira-infection-transmitted-by-pet-rat
#10
Bernd Ludwig, Viviane Zotzmann, Christoph Bode, Dawid L Staudacher, Stefan Zschiedrich
Human infection with Leptospira interrogans can be life-threatening. Multiple organ involvement frequently presents with liver and kidney failure, less commonly including severe hemolysis and pulmonary hemorrhage syndrome. Here, we present a fulminant case of leptospirosis presenting with hemolysis and pulmonary hemorrhage. A formerly healthy 34 year old patient presented to a rural hospital with dyspnea and hemoptysis after a week of influenza-like symptoms. Initial assessment revealed severe sepsis, acute kidney failure and severe hemolysis...
2017: IDCases
https://www.readbyqxmd.com/read/28488955/reporting-transfusion-related-acute-lung-injury-by-clinical-and-preclinical-disciplines
#11
Anna L Peters, Emma K Van De Weerdt, Eline J Goudswaard, Jan M Binnekade, Jaap J Zwaginga, Erik A M Beckers, Sacha S Zeerleder, Marian G J Van Kraaij, Nicole P Juffermans, Alexander P J Vlaar
BACKGROUND: Disciplines involved in diagnosing transfusion-related acute lung injury (TRALI) report according to a "one-hit" theory. However, studies showed that patients with an underlying condition are at increased risk of the development of TRALI. We investigated whether accumulating evidence on the "two-hit" theory has changed the practice of reporting TRALI. MATERIALS AND METHODS: Departments of haematology, haemovigilance, transfusion medicine, intensive care and anaesthesiology from all Dutch hospitals with at least five beds equipped for mechanical ventilation were invited to participate in an online survey...
April 5, 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28486866/the-predictive-value-of-coefficient-of-pct-%C3%A3-bg-for-anastomotic-leak-in-esophageal-carcinoma-patients-with-ards-after-esophagectomy
#12
Huan Li, Daofeng Wang, Wenxiao Wei, Lamei Ouyang, Ning Lou
Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Early recognition and intervention treatment of anastomotic leak may alleviate complication and improve outcome...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28486385/validation-of-the-vasoactive-inotropic-score-in-pediatric-sepsis
#13
Amanda M McIntosh, Suhong Tong, Sara J Deakyne, Jesse A Davidson, Halden F Scott
OBJECTIVES: To assess the validity of Vasoactive-Inotropic Score as a scoring system for cardiovascular support and surrogate outcome in pediatric sepsis. DESIGN: Secondary retrospective analysis of a single-center sepsis registry. SETTING: Freestanding children's hospital and tertiary referral center. PATIENTS: Children greater than 60 days and less than 18 years with sepsis identified in the emergency department between January 2012 and June 2015 treated with at least one vasoactive medication within 48 hours of admission to the PICU...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28484052/chronic-critical-illness-from-sepsis-is-associated-with-an-enhanced-tcr-response
#14
Farina Borken, Robby Markwart, Robert P Requardt, Katja Schubert, Michal Spacek, Miroslav Verner, Stefan Rückriem, André Scherag, Frank Oehmichen, Frank M Brunkhorst, Ignacio Rubio
Sepsis is characterized by a disproportionate host response to infection that often culminates in multiple organ failure. Current concepts invoke a deregulated immune reaction involving features of hyperinflammation, as well as protracted immune suppression. However, owing to the scarcity of human data, the precise origin of a long-term suppression of adaptive immunity remains doubtful. We report on an explorative clinical study of chronic critical illness (CCI) patients aimed at assessing the long-term consequences of sepsis on T cell function...
May 8, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28483623/perioperative-infections-after-open-abdominal-aortic-aneurysm-repair-lead-to-increased-risk-of-subsequent-complications
#15
Su Yeon Lee, Matthew R Peacock, Alik Farber, Nishant K Shah, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Sevan Komshian, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing open abdominal aortic aneurysm (AAA) repair are at risk of perioperative infections that can lead to subsequent complications. Our goal was to understand how an initial infectious complication influences the risk of subsequent complications in this cohort of patients. METHODS: Using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database (2005 to 2012), we evaluated the relationship between three index infectious complications after open elective AAA repair (pneumonia, deep/organ surgical site infection, and urinary tract infection) and subsequent complications...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28482715/hearing-loss-among-high-risk-newborns-admitted-to-a-tertiary-neonatal-intensive-care-unit
#16
May Ahmed Khairy, Walaa Alsharany Abuelhamed, Radwa Sayed Ahmed, Hedayet El Sayed El Fouly, Ismail Mohamed Elhawary
PURPOSE: The aim of this work is to identify the most significant risk factors for hearing impairment in high risk neonates hospitalized at our Neonatal Intensive Care Unit (NICU) and to assess the sensitivity of hearing screening tests. METHODS: This study involved 260 neonates admitted to a tertiary NICU; they were classified into 2 groups; 150 preterm and 110 full terms with risk factors for hearing loss. The hearing screening tests performed were transient evoked otoacoustic emissions (TEOAES) and the automated auditory brain stem response (AABR)...
May 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28472969/perforated-acute-appendicitis-with-no-peritonitis-in-a-premature-baby-a-case-report
#17
Fayza Haider, Barrak Ayoub, Mariam Al Kooheji, Mona Al Juffairi, Safa Al-Shaikh
BACKGROUND: Acute appendicitis in a neonate and premature baby is still considered a rare entity as diagnosis is always made after surgical exploration for acute abdominal findings mimicking necrotizing enterocolitis. Our reported case is a premature baby who had a perforated appendix with no evidence of peritonitis. CASE PRESENTATION: We describe the case of a premature Bahraini girl born at 29 weeks of gestation by spontaneous vaginal delivery to a 39-year-old G6P5 mother...
May 5, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28460565/early-simultaneous-esophagopleural-and-bronchopleural-fistula-after-right-pneumonectomy
#18
Marek Szkorupa, Josef Chudacek, Olga Klementová, Cestmir Neoral, Martin Stasek
BACKGROUND: Esophagopleural and bronchopleural fistulas represent a rare, but life-threatening complication after lung resections, most often after a right pneumonectomy. CASE STUDY: A 64 years old woman was indicated for right pulmectomy for local recurrence of initially stage IIB lung cancer treated by lower lobectomy. On the postoperative day 34, an esophagopleurobronchial fistula occurred. Further course required thoracostomy with closure of the bronchial stump and vacuum-assisted closure therapy and two-phase esophagectomy with 6 weeks interval to the esophageal reconstruction...
May 2, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28456514/respiratory-distress-in-term-neonates-in-low-resource-settings
#19
REVIEW
Sindhu Sivanandan, Ramesh Agarwal, Amanpreet Sethi
Most neonatal deaths worldwide occur in low- and middle-income countries (LMICs). Respiratory distress is an important cause of neonatal morbidity and mortality. The epidemiology of respiratory distress among term neonates who constitute the vast majority of births is under reported. The scarcely available data from LMICs suggest an incidence of 1.2% to 7.2% among term live births and greater morbidity compared to that in high-income countries. Pneumonia and meconium aspiration syndrome are the predominant causes among outborn neonates, but next only to transient tachypnea among inborn neonates...
April 26, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28450933/retrospective-analysis-of-fosfomycin-combinational-therapy-for-sepsis-caused-by-carbapenem-resistant-klebsiella-pneumoniae
#20
Yun Liao, Guang-Hui Hu, Yun-Fei Xu, Jian-Ping Che, Ming Luo, Hai-Min Zhang, Bo Peng, Xu-Dong Yao, Jun-Hua Zheng, Min Liu
The aim of the present study was to compare the efficacy and safety of fosfomycin combinational therapy with other antibiotics for the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae (CRKP). This retrospective cohort study examined 104 cases of sepsis caused by CRKP occurring between January 2012 and November 2014 in Shanghai Tenth People's Hospital. Three categories of patient outcome were assessed: Survival/mortality, duration of intensive care unit stays and duration of medical ventilation...
March 2017: Experimental and Therapeutic Medicine
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