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Neuromuscular

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11 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27794082/impact-of-noninvasive-ventilation-on-lung-volumes-and-maximum-respiratory-pressures-in-duchenne-muscular-dystrophy
#1
Dante Brasil Santos, Isabelle Vaugier, Ghilas Boussaïd, David Orlikowski, Hélène Prigent, Frédéric Lofaso
BACKGROUND: Duchenne muscular dystrophy (DMD) is a sex-linked genetic disorder in which progressive impairment of skeletal muscle function eventually leads to severe respiratory failure requiring continuous noninvasive ventilation (NIV) at home. A current focus of debate is whether NIV may slow the decline in respiratory function or, on the contrary, worsen respiratory function when started early. Our objective here was to describe the effects of NIV on vital capacity (VC) and maximum respiratory pressures in DMD...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27793165/surviving-critical-illness-what-is-next-an-expert-consensus-statement-on-physical-rehabilitation-after-hospital-discharge
#2
M E Major, R Kwakman, M E Kho, B Connolly, D McWilliams, L Denehy, S Hanekom, S Patman, R Gosselink, C Jones, F Nollet, D M Needham, R H H Engelbert, M van der Schaaf
BACKGROUND: The study objective was to obtain consensus on physical therapy (PT) in the rehabilitation of critical illness survivors after hospital discharge. Research questions were: what are PT goals, what are recommended measurement tools, and what constitutes an optimal PT intervention for survivors of critical illness? METHODS: A Delphi consensus study was conducted. Panelists were included based on relevant fields of expertise, years of clinical experience, and publication record...
October 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27506902/respiratory-muscle-assessment-in-acute-guillain-barr%C3%A3-syndrome
#3
S Walterspacher, A Kirchberger, J Lambeck, D J Walker, A Schwörer, W D Niesen, W Windisch, F Hamzei, H J Kabitz
PURPOSE: Guillain-Barré Syndrome (GBS) is a life-threatening disease due to respiratory muscle involvement. This study aimed at objectively assessing the course of respiratory muscle function in GBS subjects within the first week of admission to an intensive care unit. METHODS: Medical Research Council Sum Score (MRC-SS), vigorimetry, spirometry, and respiratory muscle function tests (inspiratory/expiratory muscle strength: PImax/PEmax, sniff nasal pressure: SnPna) were assessed twice daily...
October 2016: Lung
https://www.readbyqxmd.com/read/27538676/tracheostomy-or-not-prediction-of-prolonged-mechanical-ventilation-in-guillain-barr%C3%A3-syndrome
#4
Christa Walgaard, Hester F Lingsma, Pieter A van Doorn, Mathieu van der Jagt, Ewout W Steyerberg, Bart C Jacobs
BACKGROUND: Respiratory insufficiency occurs in 20 % of Guillain-Barré syndrome (GBS) patients, and the duration of mechanical ventilation (MV) ranges widely. We identified predictors of prolonged MV to guide clinical decision-making on tracheostomy. METHODS: We analyzed prospectively collected data from 552 patients with GBS in the context of two clinical trials and three cohort studies in The Netherlands. Potential predictors for prolonged MV, defined as duration of ≥14 days, were considered using crosstabs...
August 18, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27521200/neuromuscular-disease-in%C3%A2-the-neurointensive-care-unit
#5
REVIEW
Veronica Crespo, Michael L Luke James
Neuromuscular diseases are syndromic disorders that affect nerve, muscle, and/or neuromuscular junction. Knowledge about the management of these diseases is required for anesthesiologists, because these may frequently be encountered in the intensive care unit, operating room, and other settings. The challenges and advances in management for some of the neuromuscular diseases most commonly encountered in the operating room and neurointensive care unit are reviewed.
September 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27509100/randomized-trial-of-thymectomy-in-myasthenia-gravis
#6
RANDOMIZED CONTROLLED TRIAL
Gil I Wolfe, Henry J Kaminski, Inmaculada B Aban, Greg Minisman, Hui-Chien Kuo, Alexander Marx, Philipp Ströbel, Claudio Mazia, Joel Oger, J Gabriel Cea, Jeannine M Heckmann, Amelia Evoli, Wilfred Nix, Emma Ciafaloni, Giovanni Antonini, Rawiphan Witoonpanich, John O King, Said R Beydoun, Colin H Chalk, Alexandru C Barboi, Anthony A Amato, Aziz I Shaibani, Bashar Katirji, Bryan R F Lecky, Camilla Buckley, Angela Vincent, Elza Dias-Tosta, Hiroaki Yoshikawa, Márcia Waddington-Cruz, Michael T Pulley, Michael H Rivner, Anna Kostera-Pruszczyk, Robert M Pascuzzi, Carlayne E Jackson, Guillermo S Garcia Ramos, Jan J G M Verschuuren, Janice M Massey, John T Kissel, Lineu C Werneck, Michael Benatar, Richard J Barohn, Rup Tandan, Tahseen Mozaffar, Robin Conwit, Joanne Odenkirchen, Joshua R Sonett, Alfred Jaretzki, John Newsom-Davis, Gary R Cutter
BACKGROUND: Thymectomy has been a mainstay in the treatment of myasthenia gravis, but there is no conclusive evidence of its benefit. We conducted a multicenter, randomized trial comparing thymectomy plus prednisone with prednisone alone. METHODS: We compared extended transsternal thymectomy plus alternate-day prednisone with alternate-day prednisone alone. Patients 18 to 65 years of age who had generalized nonthymomatous myasthenia gravis with a disease duration of less than 5 years were included if they had Myasthenia Gravis Foundation of America clinical class II to IV disease (on a scale from I to V, with higher classes indicating more severe disease) and elevated circulating concentrations of acetylcholine-receptor antibody...
August 11, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27427990/respiratory-failure-because-of-neuromuscular-disease
#7
Robin S Howard
PURPOSE OF REVIEW: Understanding the mechanisms and abnormalities of respiratory function in neuromuscular disease is critical to supporting the patient and maintaining ventilation in the face of acute or chronic progressive impairment. RECENT FINDINGS: Retrospective clinical studies reviewing the care of patients with Guillain-Barré syndrome and myasthenia have shown a disturbingly high mortality following step-down from intensive care. This implies high dependency and rehabilitation management is failing despite evidence that delayed improvement can occur with long-term care...
October 2016: Current Opinion in Neurology
https://www.readbyqxmd.com/read/27354681/daytime-mouthpiece-for-continuous-noninvasive-ventilation-in-individuals-with-amyotrophic-lateral-sclerosis
#8
Marie-Eve Bédard, Douglas A McKim
BACKGROUND: Noninvasive ventilation (NIV) is commonly used to provide ventilatory support for individuals with amyotrophic lateral sclerosis (ALS). Once 24-h ventilation is required, the decision between invasive tracheostomy ventilation and palliation is often faced. This study describes the use and outcomes of daytime mouthpiece ventilation added to nighttime mask ventilation for continuous NIV in subjects with ALS as an effective alternative. METHODS: This was a retrospective study of 39 subjects with ALS using daytime mouthpiece ventilation over a 17-y period...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27330037/long-term-non-invasive-ventilation-in-muscular-dystrophy-trends-in-use-over-25-years-in-a-home-ventilation-unit
#9
W Kinnear, J Colt, L Watson, P Smith, L Johnson, S Burrows, M Sovani, A Khanna, P Maddison, A Wills
Long-term non-invasive ventilation (NIV) was introduced in the 1980s, initially mainly for patients with poliomyelitis, muscular dystrophy (MD) or scoliosis. The obesity-hypoventilation syndrome has since become the commonest reason for referral to most centres providing home-NIV. Patients with MD are numerically a much smaller part of the workload, but as their disease progresses the need for ventilatory support changes and they require regular comprehensive assessment of their condition. We have examined the trend in MD use of home-NIVin our unit over the last 25 years...
June 21, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/26872323/noninvasive-ventilation-for-neuromuscular-respiratory-failure-when-to-use-and-when-to-avoid
#10
Alejandro A Rabinstein
PURPOSE OF REVIEW: Neuromuscular respiratory failure can occur from a variety of diseases, both acute and chronic with acute exacerbation. There is often a misunderstanding about how the nature of the neuromuscular disease should affect the decision on how to ventilate the patient. This review provides an update on the value and relative contraindications for the use of noninvasive ventilation in patients with various causes of primary neuromuscular respiratory failure. RECENT FINDINGS: Myasthenic crisis represents the paradigmatic example of the neuromuscular condition that can be best treated with noninvasive ventilation...
April 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26636518/early-use-of-non-invasive-ventilation-in-patients-with-amyotrophic-lateral-sclerosis-what-benefits
#11
C Terzano, S Romani
OBJECTIVE: The aim of this study was to analyze the efficacy of an early start of NIV in ALS patients, evaluating respiratory and ventilatory parameters. PATIENTS AND METHODS: Functional respiratory parameters and arterial blood gas analysis were evaluated in forty-six patients. All patients were informed about the benefits and possible adverse effects of therapeutic support with NIV and divided in two groups based on the compliance to early start therapy with NIV (Group A) or not (Group B)...
November 2015: European Review for Medical and Pharmacological Sciences
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