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Tracheostomy care

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https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#1
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29120096/the-association-between-oral-health-status-and-respiratory-pathogen-colonization-with-pneumonia-risk-in-institutionalized-adults
#2
Chl Hong, M M Aung, K Kanagasabai, C A Lim, S Liang, K S Tan
OBJECTIVES: This study aimed to assess the oral health and the prevalence of pre-existing oral colonization with respiratory pathogens in dependent elderly, and whether these factors influence pneumonia development. MATERIALS AND METHODS: Participants residing in a long-term care facility received bedside oral examinations, and information on their oral health (caries status, calculus index and debris index) was obtained. Samples from the tongue and teeth were collected at baseline and at time of pneumonia development...
November 9, 2017: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/29111352/use-of-antibiotics-in-paediatric-long-term-care-facilities
#3
Meghan T Murray, Candace L Johnson, Bevin Cohen, Olivia Jackson, Laney K Jones, Lisa Saiman, Elaine L Larson, Natalie Neu
BACKGROUND: Adult long term care (LTC) have high rates of antibiotic use, raising concerns about antimicrobial resistance. Few studies have examined antibiotic use in paediatric LTC. AIM: We sought to describe antibiotic use in three paediatric LTC facilities and to describe the factors associated with use. METHODS: A retrospective cohort study was conducted September 2012 - December 2015 in three paediatric LTC facilities. Medical records were reviewed for demographics, healthcare-associated infections (HAI), antimicrobial use, and diagnostic testing...
October 27, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29110572/tracheostomy-as-a-comfort-measure-in-children-with-life-limiting-conditions
#4
Valerie Marshall, Francesca Holt, Suzanne Crowe
Palliative care for children who can expect only a short life has expanded over the last decade. Greater understanding of the measures required to ensure comfort and acceptable quality of life within the critical care environment has grown in tandem. Some more invasive interventions may be considered a "step too far" by some practitioners, including feeding gastrostomy, contracture release, and tracheostomy. Tracheostomy can facilitate a number of measures, which may enhance the brief life of the child and their family...
January 1, 2017: Journal of Palliative Care
https://www.readbyqxmd.com/read/29109556/management-of-mechanical-ventilation-in-patients-with-hospital-acquired-pneumonia-a-retrospective-observational-study
#5
Radovan Uvizl, Tomas Herkel, Katerina Langova, Petr Jakubec
BACKGROUND: Hospital-acquired pneumonia (HAP) in intensive care patients is a frequent reason for mechanical ventilation (MV). The management of MV and ventilator weaning vary, depending on the type of lung inflammation. This retrospective, observational study screened the data from all patients admitted to the intensive care unit (ICU) of the Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc between 2011 and 2016...
November 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29106315/the-paradox-of-end-of-life-hospital-treatment-intensity-among-black-patients-a-retrospective-cohort-study
#6
Amber E Barnato, Chung-Chou H Chang, Judith R Lave, Derek C Angus
OBJECTIVE: Black patients are more likely than white patients to die in the hospital with intensive care and life-sustaining treatments and less likely to use hospice. Regional concentration of high end-of-life (EOL) treatment intensity practice patterns may disproportionately affect black patients. We calculated and compared race-specific hospital-level EOL treatment intensity in Pennsylvania. METHODS: We conducted a retrospective cohort analysis of Pennsylvania acute care hospital admissions, 2001-2007, among black and white admissions ≥21 years old at high probability of dying (HPD) (≥15% predicted probability of dying at admission)...
November 6, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29097138/does-length-of-intubation-before-tracheostomy-affect-intensive-care-unit-length-of-stay
#7
Shaun R Young, Gary F Bouloux, Sebastian D Perez, Shelly Abramowicz
OBJECTIVE: The purpose of this study was to determine if length of intubation before tracheotomy (LIT) affects length of stay in the intensive care unit (ICU). STUDY DESIGN: This was a retrospective case series of patients who had open tracheotomies at Grady Memorial Hospital by the Oral and Maxillofacial Surgery (OMS) service. Medical records were reviewed to document patient demographic characteristics, etiology for ventilator dependence, and complications. The primary predictor variable was LIT and primary outcome variable was length of stay in ICU after tracheotomy...
September 27, 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/29095187/defining-the-role-of-free-flaps-for-transoral-robotic-surgery
#8
Kyle M Hatten, Robert M Brody, Gregory S Weinstein, Jason G Newman, Andres M Bur, Ara A Chalian, Bert W OʼMalley, Christopher H Rassekh, Steven B Cannady
BACKGROUND: Transoral surgical techniques for oropharyngeal tumors have been widely accepted, yet often results in a significant functional deficit. Current reports on the safety, feasibility, and swallowing performance after microvascular reconstruction are limited to small volume case series. MATERIALS AND METHODS: Retrospective review of 42 consecutive patients, between December 2013 and May 2016, who underwent transoral robotic surgery oropharyngectomy followed by microvascular reconstruction...
October 31, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/29091036/a-prospective-descriptive-study-to-assess-nursing-staff-perceptions-of-and-interventions-to-prevent-medical-device-related-pressure-injury
#9
Ayişe Karadag, Seval C Hanönü, Evrim Eyikara
Nurses play an important role in identifying patients at risk for medical device-related (MDR) pressure injuries and preventing their occurrence. A prospective, descriptive study was conducted across 6 hospitals in Ankara, Turkey between December 2014 and June 2015 to assess nursing perceptions about and interventions used for the pre- vention of MDR pressure ulcers. A questionnaire was used to collect demographic information and data on experience with MDR pressure ulcers; in addition, participants completed a Nursing Interventions Form that included 10 statements regarding basic nursing interventions to prevent MDR pressure ulcers; answer options were I perform, I partly perform, I do not perform...
October 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29089699/tracheostomy-in-patients-who-need-mechanical-ventilation-early-or-late-surgical-or-percutaneous-a-prospective-study-in-iran
#10
Hamidreza Hemmati, Mohammad Forozeshfard, Babak Hosseinzadeh, Sahar Hemmati, Majid Mirmohammadkhani, Razieh Bandari
Tracheostomy can be performed surgically or by percutaneous (percutaneous dilatory tracheostomy, PDT) methods, and it may be used early or late. In a 3-month follow-up, all patients who underwent tracheostomy in Semnan in 2013 were evaluated for complications of tracheostomy considering the method used and the timing of operation. A total of 55 patients underwent tracheostomy (26 cases surgery, 29 cases PDT, 30 cases early, and 25 cases late based on 14 days reference). The mean durations of operation were 19...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29084116/role-of-swallowing-function-of-tracheotomised-patients-in-major-head-and-neck-cancer-surgery
#11
Alexander K Bartella, Mohammad Kamal, Sean Berman, Timm Steiner, Dirk Frölich, Frank Hölzle, Bernd Lethaus
INTRODUCTION: Tracheotomy is a frequent procedure in extended head and neck cancer surgery and known to be a risk factor for prolonged hospitalization. The authors hypothesized that the clinical course and delayed decannulation of patients are not only influenced by airway narrowing, but also by a compromised postoperative swallowing function. MATERIAL AND METHODS: The investigators implemented a retrospective cohort study. The sample was composed of a tertiary care center patients who underwent major head and neck cancer surgery, each receiving a tracheostomy...
October 27, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29076779/cigarette-smoking-and-outcomes-after-aneurysmal-subarachnoid-hemorrhage-a-nationwide-analysis
#12
Hormuzdiyar H Dasenbrock, Robert F Rudy, Pui Man Rosalind Lai, Timothy R Smith, Kai U Frerichs, William B Gormley, M Ali Aziz-Sultan, Rose Du
OBJECTIVE Although cigarette smoking is one of the strongest risk factors for cerebral aneurysm development and rupture, there are limited data evaluating the impact of smoking on outcomes after aneurysmal subarachnoid hemorrhage (SAH). Additionally, two recent studies suggested that nicotine replacement therapy was associated with improved neurological outcomes among smokers who had sustained an SAH compared with smokers who did not receive nicotine. METHODS Patients who underwent endovascular or microsurgical repair of a ruptured cerebral aneurysm were extracted from the Nationwide Inpatient Sample (NIS, 2009-2011) and stratified by cigarette smoking...
October 27, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29066907/role-of-the-multidisciplinary-team-in-the-care-of-the-tracheostomy-patient
#13
REVIEW
Barbara Bonvento, Sarah Wallace, James Lynch, Barry Coe, Brendan A McGrath
Tracheostomies are used to provide artificial airways for increasingly complex patients for a variety of indications. Patients and their families are dependent on knowledgeable multidisciplinary staff, including medical, nursing, respiratory physiotherapy and speech and language therapy staff, dieticians and psychologists, from a wide range of specialty backgrounds. There is increasing evidence that coordinated tracheostomy multidisciplinary teams can influence the safety and quality of care for patients and their families...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/29057504/speech-language-pathology-care-and-short-and-long-term-outcomes-of-oropharyngeal-cancer-treatment-in-the-elderly
#14
Kimberly T Webster, Donna Tippett, Marissa Simpson, Rina Abrams, Kristine Pietsch, Robert J Herbert, David W Eisele, Christine G Gourin
OBJECTIVE: To examine associations between speech-language pathology (SLP) care and pretreatment variables, short-term and long-term swallowing and airway impairment, and survival in elderly patients treated for oropharyngeal squamous cell cancer (SCCA). STUDY DESIGN: Retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data. METHODS: We evaluated longitudinal data from 666 patients diagnosed with oropharyngeal SCCA from 2004 to 2007 using cross-tabulations, multivariate logistic regression, and survival analysis...
October 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29048709/comparison-of-percutaneous-dilatational-tracheostomy-guided-by-ultrasound-and-bronchoscopy-in-critically-ill-obese-patients
#15
Jieqiong Song, Lizhen Xuan, Wei Wu, Duming Zhu, Yijun Zheng
OBJECTIVES: This study aimed to compare the efficacy and safety of percutaneous dilatational tracheostomy (PDT) with ultrasound (US) or bronchoscopic guidance for critically ill patients, notably obese patients. METHODS: This work was a retrospective study. The study included mechanically ventilated patients who underwent PDT from August 2013 to July 2015 in the Department of Critical Care Medicine of Zhongshan Hospital. The patients were classified according to the different guidance methods during tracheotomy and their body mass index in the following 4 groups: normal bronchoscopy group, normal US group, obese bronchoscopy group, and obese US group...
October 19, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29046086/the-provision-of-surgical-tracheostomies-by-maxillofacial-surgeons-in-the-uk-time-for-a-dedicated-tracheostomy-team
#16
P Chohan, R Elledge, M K Virdi, G M Walton
Surgical tracheostomy is a commonly provided service by surgical teams for patients in intensive care where percutaneous dilatational tracheostomy is contraindicated. A number of factors may interfere with its provision on shared emergency operating lists, potentially prolonging the stay in intensive care. We undertook a two-part project to examine the factors that might delay provision of surgical tracheostomy in the intensive care unit. The first part was a prospective audit of practice within the University Hospital Coventry...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29042707/the-effect-of-subglottic-secretion-drainage-on-the-incidence-of-ventilator-associated-pneumonia
#17
Marta Walaszek, Agnieszka Gniadek, Malgorzata Kolpa, Zdzislaw Wolaka, Alicja Kosiarska
BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs). AIM: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU. METHODS: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014)...
October 17, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29026472/clinical-features-and-antimicrobial-resistance-of-bacterial-agents-of-ventilator-associated-tracheobronchitis-in-hamedan-iran
#18
Seyyed Hamid Hashemi, Naeimeh Hashemi, Farzaneh Esna-Ashari, Abbas Taher, Arash Dehghan
OBJECTIVES: Ventilator-associated tracheobronchitis (VAT) is a common cause of mortality and morbidity in patients admitted to intensive care units (ICUs). This study was conducted to evaluate the clinical course, etiology, and antimicrobial resistance of bacterial agents of VAT in ICUs in Hamedan, Iran. METHODS: During a 12-month period, all patients with VAT in a medical and a surgical ICU were included. The criteria for the diagnosis of VAT were fever, mucus production, a positive culture of tracheal secretions, and the absence of lung infiltration...
September 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29025380/early-tracheostomy-reduces-time-of-mechanical-ventilation-in-respiratory-high-risk-patients-after-liver-transplant
#19
Sebastian Cammann, Kai Timrott, Florian W R Vondran, Harald Schrem, Frank Lehner, Jürgen Klempnauer, Wolfgang Knitsch, Moritz Kleine
OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...
October 12, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29020869/a-review-of-four-health-procedures-that-school-nurses-may-encounter
#20
Rebecca Toothaker, Pamela Cook
The school nurse plays a vital role in providing care and meeting the health needs of students in the school setting. Students attend school with chronic conditions and complex medical problems such as quadriplegia, cerebral palsy, spina bifida, and muscular dystrophy. It is the responsibility of the school nurse to provide appropriate assessment, early intervention, and care for children in the school environment. The purpose of this article is to review and discuss the knowledge and skills the school nurse needs to care for students with central venous lines, gastrostomy tubes, altered urinary elimination, and tracheostomies...
October 1, 2017: NASN School Nurse
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