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Tracheostomy care

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https://www.readbyqxmd.com/read/29344689/early-versus-late-tracheostomy-in-trauma-patients-a-propensity-matched-cohort-study-of-5-years-data-at-a-single-institution-in-korea
#1
Byung Hee Kang, Jayun Cho, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: Although there have been many studies dealing with tracheostomy timing in trauma patients, the optimal timing is still being debated. This study aimed to compare outcomes between early tracheostomy (ET) and late tracheostomy (LT) in trauma populations to estimate the optimal timing of tracheostomy after intubation. METHODS: We retrospectively reviewed the 5 years' data of trauma patients who underwent tracheostomy during their acute intensive care unit (ICU) stay...
January 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29339536/length-of-stay-and-hospital-revisit-after-bacterial-tracheostomy-associated-respiratory-tract-infection-hospitalizations
#2
Christopher J Russell, Mary R Mamey, Joyce Y Koh, Sheree M Schrager, Michael N Neely, Susan Wu
OBJECTIVES: To identify factors associated with longer length of stay (LOS) and higher 30-day hospital revisit rates for children hospitalized with bacterial tracheostomy-associated respiratory tract infections (bTARTIs). METHODS: This was a multicenter, retrospective cohort study using administrative data from the Pediatric Health Information System database between 2007 and 2014 of patients 30 days to 17 years old with a principal discharge diagnosis of bTARTI or a principal discharge diagnosis of bTARTI symptoms with a secondary diagnosis of bTARTI...
January 16, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29337171/is-early-tracheostomy-better-for-severe-traumatic-brain-injury-a-meta-analysis
#3
Qin Lu, Yonglin Xie, Xunchen Qi, Xinwei Li, Shuxu Yang, Yirong Wang
OBJECTIVE: Tracheotomy have been proven to be benefit for the patients requiring prolonged mechanical ventilation. However, whether early tracheotomy (less than 10 days) could also improve the outcome of severe traumatic brain injury (TBI) patient (GCS≤8) remains controversial. The aim of this study was trying to clarify this question. METHODS: We searched four databases (PubMed, Web of Science, Elsevier and Cochrane Library) for articles comparing the outcome of early tracheostomy with late tracheostomy or prolonged intubation on the severe TBI patients...
January 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29329356/prognostic-factors-of-noninvasive-mechanical-ventilation-in-lung-cancer-patients-with-acute-respiratory-failure
#4
Wei-Chih Chen, Vincent Yi-Fong Su, Wen-Kuang Yu, Yen-Wen Chen, Kuang-Yao Yang
INTRODUCTION: Few studies have reported outcomes of lung cancer patients with acute respiratory failure (RF) using noninvasive positive pressure ventilation (NIPPV). The aim of this study was to investigate the prognostic factors in these patients. MATERIALS AND METHODS: This retrospective observational study included all hospitalized lung cancer patients who received NIPPV for acute RF. It was conducted at a tertiary medical center in Taiwan from 2005 to 2010. The primary outcome was all cause mortality at 28 days after the initiation of NIPPV...
2018: PloS One
https://www.readbyqxmd.com/read/29323630/fatal-innominate-artery-hemorrhage-in-a-patient-with-tetraplegia-case-report-and-literature-review
#5
Ahmad Zaheer Qureshi
Context Hemorrhage is one of the potentially fatal complications of tracheostomy. A rare but lethal cause of tracheostomy related bleeding is hemorrhage from the innominate artery. This occurs following tracheo-innominate artery fistula (TIF) formation, which is associated with a mortality rate of more than 85%. Here, we report the case of an individual with tetraplegia and a tracheostomy who died as a result of innominate artery hemorrhage. This case highlights the possible causes and interventions associated with this complication, and provides insight into tracheostomy related bleeding in patients with spinal cord injury (SCI)...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#6
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29304489/clinical-features-and-outcomes-of-tetanus-analysis-using-a-national-inpatient-database-in-japan
#7
Mikio Nakajima, Shotaro Aso, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
PURPOSE: This study was performed to elucidate the current clinical features and outcomes of tetanus using a national inpatient database in Japan. MATERIALS AND METHODS: We used the Japanese Diagnosis Procedure Combination inpatient database to retrospectively investigate patients with tetanus from July 2010 to March 2016. We examined the patients' characteristics; the proportions of patients requiring tracheal intubation, mechanical ventilation, and tracheostomy; and the discharge status...
December 29, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29290748/therapeutic-drug-monitoring-of-prolonged-infusion-aztreonam-for-multi-drug-resistant-pseudomonas-aeruginosa-a-case-report
#8
Jeffrey J Cies, Richard J LaCoursiere, Wayne S Moore, Arun Chopra
Aztreonam, a broad-spectrum monobactam, is typically reserved for multidrug resistant (MDR) infections. Pharmacokinetic (PK) data to guide dosing in children, however, are limited to healthy volunteers or nonintensive care unit (ICU) patients. Impaired antibiotic delivery into tissue remains a major concern and may explain the high morbidity and mortality associated with MDR infections. Therefore, evaluating the PK changes in pediatric ICU patients is necessary to elucidate the most appropriate antimicrobial regimen...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29287880/revisits-after-pediatric-tracheotomy-airway-concerns-result-in-returns
#9
Sophie Shay, Nina L Shapiro, Neil Bhattacharyya
OBJECTIVES: Children undergoing tracheotomy represent a medically vulnerable patient population, and understanding the reasons for revisiting the hospital setting following tracheotomy is critical for improving the quality of care for these patients. This study aims to investigate the incidence and characteristics of revisits following pediatric tracheotomy. METHODS: Cross-sectional, population-based study using state databases. The State Inpatient Databases and State Emergency Department Databases for California, Florida, Iowa and New York 2010-11 were linked and examined for cases of pediatric tracheotomy (patients < 18...
January 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29284882/guidewire-migrating-into-murphy-s-eye-of-endotracheal-tube-an-unusual-complication-of-percutaneous-dilational-tracheostomy
#10
Rohini Arora, Sandeep Kumar, Sumit Sachan
Percutaneous dilational tracheostomy (PDT) is a frequently carried out bedside procedure in a critical care setting. It is usually performed under fiberoptic endoscopic guidance. Studies with PDT performed with endoscopic guidance have reported lower complication rates than studies performed with "blind" PDT. We report a case where PDT was performed without endoscopic assistance and the j-shaped guidewire got stuck in the Murphy's eye of endotracheal tube causing difficulty in railroading of tracheostomy tube (TT)...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284857/to-compare-the-effect-of-two-different-doses-of-dexmedetomidine-on-the-attenuation-of-airway-and-pressor-response-during-tracheostomy-tube-change-in-traumatic-brain-injury-patients
#11
Abdul Alim Khan, Neeraj Kumar, Yashpal Singh, Atul Kumar Singh, Sharad Kumar Mathur
Background: Tracheostomy tube (TT) change is the common procedure in trauma Intensive Care Unit (ICU) and almost always associated with cough reflex, increase in blood pressure, and heart rate. Dexmedetomidine (DEX) is a selective α2-adrenergic receptor agonist well studied for the prevention of pressor response during laryngoscopy and extubation, but literature on prevention of pressor response during TT change is lacking. Aims: The aim of this study is to compare two doses (0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284841/a-retrospective-analysis-on-anesthetic-management-during-rigid-bronchoscopy-in-children-with-foreign-body-aspiration-propofol-and-sevoflurane-with-controlled-ventilation
#12
Rashmi Venkatesh Annigeri, Rashmi Suresh Patil
Background: Bronchoscopic removal of foreign body in the airway is one of the important life-saving procedure and demands skill and expertise on the part of the surgeon and anesthesiologist. Aim: To study the outcome of controlled ventilation during rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: A review of fifty cases of foreign body in the bronchi, from January 2014 to December 2015 was undertaken in Vittal Institute of Child Care Hospital, Dharwad, through patient case records...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29282535/percutaneous-versus-surgical-strategy-for-tracheostomy-a-systematic-review-and-meta-analysis-of-perioperative-and-postoperative-complications
#13
Rosa Klotz, Pascal Probst, Marlene Deininger, Ulla Klaiber, Kathrin Grummich, Markus K Diener, Markus A Weigand, Markus W Büchler, Phillip Knebel
PURPOSE: Tracheostomy is one of the most frequently performed procedures in intensive care medicine. The two main approaches are open surgical tracheostomy (ST) and percutaneous dilatational tracheostomy (PDT). This systematic review summarizes and analyzes the existing evidence regarding perioperative and postoperative parameters of safety. METHODS: A systematic literature search was conducted in the Cochrane Library, EMBASE, LILACS, and MEDLINE to identify all randomized controlled trials (RCTs) comparing complications of ST and PDT and to define the strategy with the lower risk of potentially life-threatening events...
December 27, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29279248/primary-surgical-management-with-radial-forearm-free-flap-reconstruction-in-t4-oropharyngeal-cancer-complications-and-functional-outcomes
#14
John R Sims, Eric J Moore
PURPOSE: Functional outcomes and complication rates after open surgery for advanced-stage oropharyngeal cancers are rarely reported. These measures are critical for choice of treatment modality and patient counseling. We describe the long term functional outcomes and associated complications of primary surgical management of T4 oropharyngeal cancers reconstructed with radial forearm free flaps. MATERIALS AND METHODS: A retrospective review was performed of 40 patients with T4 oropharyngeal cancers treated between 2005 and 2015 at a tertiary care center...
December 18, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29278917/experiences-with-unregulated-respite-care-among-family-caregivers-of-children-dependent-on-respiratory-technologies
#15
Krista Keilty, David Nicholas, Enid Selkirk
Increasingly, children with respiratory conditions who are dependent on medical technology (e.g. ventilators and tracheostomies) are cared for at home by family caregivers who are at risk for significant health, financial and social burdens. In many jurisdictions, access to quality respite is varied and often the availability of regulated (nursing) providers is insufficient. Rather than go without, some families have secured alternative and unregulated providers to supplement formal home care systems. The purpose of this study was to explore the experiences of family caregivers of children dependent on respiratory technologies who have used unregulated providers for in-home respite care...
January 1, 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29278008/oral-health-status-of-hospitalized-amyotrophic-lateral-sclerosis-patients-a-single-centre-observational-study
#16
Rena Nakayama, Akira Nishiyama, Chiharu Matsuda, Yuki Nakayama, Chiyoko Hakuta, Masahiko Shimada
OBJECTIVE: To assess the intraoral conditions and oral function of patients with amyotrophic lateral sclerosis (ALS). MATERIAL AND METHODS: This single-centre, cross-sectional observational study included 50 ALS patients, who were treated with tracheostomy positive-pressure ventilation (TPPV) while hospitalized. The disease duration, TPPV duration, current number of teeth, number of occlusal units, number of decayed/missing/filled teeth, community periodontal index, bleeding on probing, dental calculus, maximum mouth opening, salivation rate, tongue anomalies (atrophy or hypertrophy) and tongue coating were determined for each patient...
December 26, 2017: Acta Odontologica Scandinavica
https://www.readbyqxmd.com/read/29274212/drug-susceptibility-of-fungi-isolated-from-icu-patients
#17
Barbara D Modrzewska, Anna J Kurnatowska,, Katarzyna Khalid
Candida species can be a reason of infections associated with high morbidity and mortality. The risk of invasive candidosis for patients admitted to intensive care units (ICUs) is increased due to immunosuppressive states, prolonged length of stay, broad-spectrum antibiotics and Candida colonization. The aim of the study was to determine selected properties of fungi isolated from patients treated in the ICUs of hospitals in Lodz. The materials were collected from the oral cavity, the tracheostomy or endotracheal tube and urine from 16 children and 35 adult...
2017: Annals of Parasitology
https://www.readbyqxmd.com/read/29262440/who-is-safe-to-extubate-in-the-neuroscience-intensive-care-unit
#18
Julian Bösel
Patients admitted to the neuroscience intensive care unit (NICU) may have respiratory compromise from either central or peripheral neurological pathology, and may hence require intubation and mechanical ventilation for very diverse reasons. Liberation from invasive ventilation, that is, extubation, at the earliest possible time is a widely accepted principle in intensive care. For this, classic extubation criteria have been established in the general critical care setting, mainly targeting pulmonary function and cooperativeness of the patient...
December 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29247265/end-of-life-care-pathway-of-head-and-neck-cancer-patients-single-institution-experience
#19
T Heinonen, V Loimu, K Saarilahti, T Saarto, A Mäkitie
BACKGROUND: Studies on palliative care of head and neck cancer (HNC) patients are scarce although the affected patient population is quite large. OBJECTIVE: To evaluate the role of a specialised palliative-care pathway of HNC patients. PATIENTS AND METHODS: Data on all HNC patients who were treated at the Helsinki University Hospital Palliative Care Center during 1 year were retrospectively reviewed. The analysis comprised 60 patients (49 males; mean age 67 years; range 28-88)...
December 15, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29229347/post-operative-stridor-and-acute-respiratory-failure-after-parkinson-s-disease-deep-brain-stimulator-placement-a-case-report-and-review-of-literature
#20
Mi Wang, Wael Saasouh, Thomas Botsford, Allen Keebler, Andrew Zura, Michael S Benninger, Rafi Avitsian
BACKGROUND: Parkinson's disease (PD), a neurodegenerative disorder characterized by loss of dopaminergic neurons in the substantia nigra of the midbrain is commonly thought of as a motion disorder, but it can have significant effect on the respiratory system. Respiratory failure is the most common cause of death in these patients, but it can also affect laryngeal function causing dysphonia, dysphagia, and dysarthric speech.. Acute upper airway obstruction is a very rare finding in PD, especially in the perioperative settings...
December 8, 2017: World Neurosurgery
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