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Pulmonary

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https://www.readbyqxmd.com/read/27095241/paediatric-difficult-airway-management-what-every-anaesthetist-should-know
#1
EDITORIAL
N Jagannathan, L Sohn, J E Fiadjoe
No abstract text is available yet for this article.
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27203509/clinical-challenges-in-mechanical-ventilation
#2
REVIEW
Ewan C Goligher, Niall D Ferguson, Laurent J Brochard
Mechanical ventilation supports gas exchange and alleviates the work of breathing when the respiratory muscles are overwhelmed by an acute pulmonary or systemic insult. Although mechanical ventilation is not generally considered a treatment for acute respiratory failure per se, ventilator management warrants close attention because inappropriate ventilation can result in injury to the lungs or respiratory muscles and worsen morbidity and mortality. Key clinical challenges include averting intubation in patients with respiratory failure with non-invasive techniques for respiratory support; delivering lung-protective ventilation to prevent ventilator-induced lung injury; maintaining adequate gas exchange in severely hypoxaemic patients; avoiding the development of ventilator-induced diaphragm dysfunction; and diagnosing and treating the many pathophysiological mechanisms that impair liberation from mechanical ventilation...
April 30, 2016: Lancet
https://www.readbyqxmd.com/read/28258332/progress-in-difficult-airway-management
#3
EDITORIAL
Takashi Asai
No abstract text is available yet for this article.
March 3, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28235797/inhaled-corticosteroids-and-respiratory-infections-in-children-with-asthma-a-meta-analysis
#4
REVIEW
Cristine Cazeiro, Cristina Silva, Susana Mayer, Vanessa Mariany, Claire Elizabeth Wainwright, Linjie Zhang
CONTEXT: Inhaled corticosteroids (ICS) are associated with an increased risk of pneumonia in adult patients with chronic obstructive pulmonary disease. OBJECTIVE: To assess the association between ICS use and risk of pneumonia and other respiratory infections in children with asthma. DATA SOURCES: We searched PubMed from inception until May 2015. We also searched clinicaltrials.gov and databases of pharmaceutical manufacturers. STUDY SELECTION: We selected randomized trials that compared ICS with placebo for at least 4 weeks in children with asthma...
March 2017: Pediatrics
https://www.readbyqxmd.com/read/28096515/tonsillectomy-versus-watchful-waiting-for-recurrent-throat-infection-a-systematic-review
#5
REVIEW
Anna Morad, Nila A Sathe, David O Francis, Melissa L McPheeters, Sivakumar Chinnadurai
CONTEXT: The effectiveness of tonsillectomy or adenotonsillectomy ("tonsillectomy") for recurrent throat infection compared with watchful waiting is uncertain. OBJECTIVE: To compare sleep, cognitive, behavioral, and health outcomes of tonsillectomy versus watchful waiting in children with recurrent throat infections. DATA SOURCES: MEDLINE, Embase, and the Cochrane Library. STUDY SELECTION: Two investigators independently screened studies against predetermined criteria...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#6
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28085236/budesonide-reduces-hospital-admission-rates-in-preschool-children-with-acute-wheezing
#7
Cem Hasan Razi, Nazlı Cörüt, Nesibe Andıran
The object of this study was to determine whether high doses of inhaled budesonide provide additional benefits to a standardized treatment regimen that includes systemic steroids and salbutamol in preschool patients presented to the emergency department (ED) with acute wheezing attacks. Methods This randomized, double-blind, placebo-controlled, parallel group trial was conducted in children, 6 months-6 years with moderate or severe acute wheezing epizode, as determined based on a pulmonary index score (PIS) of 7-13 points...
January 13, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28114678/revisiting-the-definition-of-bronchopulmonary-dysplasia-effect-of-changing-panoply-of-respiratory-support-for-preterm-neonates
#8
Tetsuya Isayama, Shoo K Lee, Junmin Yang, David Lee, Sibasis Daspal, Michael Dunn, Prakesh S Shah
Importance: Several definitions of bronchopulmonary dysplasia are clinically used; however, their validity remains uncertain considering ongoing changes in the panoply of respiratory support treatment strategies used within neonatal units. Objective: To identify the optimal definition of bronchopulmonary dysplasia that best predicts respiratory and neurodevelopmental outcomes in preterm infants. Design, Setting, and Participants: Retrospective cohort study at tertiary neonatal intensive care units...
March 1, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/27932390/official-american-thoracic-society-infectious-diseases-society-of-america-centers-for-disease-control-and-prevention-clinical-practice-guidelines-diagnosis-of-tuberculosis-in-adults-and-children
#9
David M Lewinsohn, Michael K Leonard, Philip A LoBue, David L Cohn, Charles L Daley, Ed Desmond, Joseph Keane, Deborah A Lewinsohn, Ann M Loeffler, Gerald H Mazurek, Richard J O'Brien, Madhukar Pai, Luca Richeldi, Max Salfinger, Thomas M Shinnick, Timothy R Sterling, David M Warshauer, Gail L Woods
BACKGROUND: Individuals infected with Mycobacterium tuberculosis (Mtb) may develop symptoms and signs of disease (tuberculosis disease) or may have no clinical evidence of disease (latent tuberculosis infection [LTBI]). Tuberculosis disease is a leading cause of infectious disease morbidity and mortality worldwide, yet many questions related to its diagnosis remain. METHODS: A task force supported by the American Thoracic Society, Centers for Disease Control and Prevention, and Infectious Diseases Society of America searched, selected, and synthesized relevant evidence...
January 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27117874/a-randomized-controlled-noninferiority-trial-of-single-dose-of%C3%A2-oral-dexamethasone-versus-5-days-of-oral-prednisone-in-acute%C3%A2-adult-asthma
#10
Matthew W Rehrer, Bella Liu, Marcela Rodriguez, Joseph Lam, Harrison J Alter
STUDY OBJECTIVE: Oral dexamethasone demonstrates bioavailability similar to that of oral prednisone but has a longer half-life. We evaluate whether a single dose of oral dexamethasone plus 4 days of placebo is not inferior to 5 days of oral prednisone in treatment of adults with mild to moderate asthma exacerbations to prevent relapse defined as an unscheduled return visit for additional treatment for persistent or worsening asthma within 14 days. METHODS: Adult emergency department patients (aged 18 to 55 years) were randomized to receive either a single dose of 12 mg of oral dexamethasone with 4 days of placebo or a 5-day course of oral prednisone 60 mg a day...
November 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27733360/antenatal-corticosteroids-for-maturity-of-term-or-near-term-fetuses-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Gabriele Saccone, Vincenzo Berghella
OBJECTIVE:  To evaluate the effectiveness of antenatal corticosteroids given at ≥34 weeks' gestation. DESIGN:  Systematic review with meta-analysis. DATA SOURCES:  Electronic databases were searched from their inception to February 2016. ELIGIBILITY CRITERIA FOR STUDY SELECTION:  Randomized clinical trials comparing antenatal corticosteroids with placebo or no treatment in women with a singleton pregnancy at ≥34 weeks' gestation...
October 12, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27521441/executive-summary-management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia-2016-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-and-the-american-thoracic-society
#12
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27456511/oxygen-targeting-in-extremely-low-birth-weight-infants
#13
James J Cummings, Richard A Polin
The use of supplemental oxygen plays a vital role in the care of the critically ill preterm infant, but the unrestricted use of oxygen can lead to unintended harms, such as chronic lung disease and retinopathy of prematurity. An overly restricted use of supplemental oxygen may have adverse effects as well. Ideally, continuous monitoring of tissue and cellular oxygen delivery would allow clinicians to better titrate the use of supplemental oxygen, but such monitoring is not currently feasible in the clinical setting...
August 2016: Pediatrics
https://www.readbyqxmd.com/read/27400909/treatment-of-ards-with-prone-positioning
#14
REVIEW
Eric L Scholten, Jeremy R Beitler, G Kim Prisk, Atul Malhotra
Prone positioning was first proposed in the 1970s as a method to improve gas exchange in ARDS. Subsequent observations of dramatic improvement in oxygenation with simple patient rotation motivated the next several decades of research. This work elucidated the physiological mechanisms underlying changes in gas exchange and respiratory mechanics with prone ventilation. However, translating physiological improvements into a clinical benefit has proved challenging; several contemporary trials showed no major clinical benefits with prone positioning...
January 2017: Chest
https://www.readbyqxmd.com/read/27251312/advances-in-neonatal-pulmonary-hypertension
#15
Robin H Steinhorn
Persistent pulmonary hypertension of the newborn (PPHN) is a surprisingly common event in the neonatal intensive care unit, and affects both term and preterm infants. Recent studies have begun to elucidate the maternal, fetal and genetic risk factors that trigger PPHN. There have been numerous therapeutic advances over the last decade. It is now appreciated that oxygen supplementation, particularly for the goal of pulmonary vasodilation, needs to be approached as a therapy that has risks and benefits. Administration of surfactant or inhaled nitric oxide (iNO) therapy at a lower acuity of illness can decrease the risk of extracorporeal membrane oxygenation/death, progression of disease and duration of hospital stay...
2016: Neonatology
https://www.readbyqxmd.com/read/27251453/synchronized-nasal-intermittent-positive-pressure-ventilation-of-the-newborn-technical-issues-and-clinical-results
#16
Corrado Moretti, Camilla Gizzi, Francesco Montecchia, Caterina Silvia Barbàra, Fabio Midulla, Manuel Sanchez-Luna, Paola Papoff
Although mechanical ventilation via an endotracheal tube has undoubtedly led to improvement in neonatal survival in the last 40 years, the prolonged use of this technique may predispose the infant to development of many possible complications including bronchopulmonary dysplasia. Avoiding mechanical ventilation is thought to be a critical goal, and different modes of noninvasive respiratory support beyond nasal continuous positive airway pressure, such as nasal intermittent positive pressure ventilation and synchronized nasal intermittent positive pressure ventilation, are also available and may reduce intubation rate...
2016: Neonatology
https://www.readbyqxmd.com/read/27370268/diagnosis-and-management-of-asthma-statement-on-the-2015-gina-guidelines
#17
Fritz Horak, Daniel Doberer, Ernst Eber, Elisabeth Horak, Wolfgang Pohl, Josef Riedler, Zsolt Szépfalusi, Felix Wantke, Angela Zacharasiewicz, Michael Studnicka
This statement was written by a group of pulmonologists and pediatric pulmonologists belonging to the corresponding professional associations ÖGP (Austrian Society for Pulmonology) and ÖGKJ (Austrian Society for pediatric and adolescent medicine) to provide a concise overview of the latest updates in the 2015 GINA Guidelines and to include aspects that are specific to Austria.
August 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27410761/neutrophil-infiltration-and-activation-in-bronchiolitic-airways-are-independent-of-viral-etiology
#18
Elena C Cavallaro, Kar-Kate Liang, Mark D Lawrence, Kevin D Forsyth, Dani-Louise Dixon
BACKGROUND: Hospitalization with bronchiolitis is linked to the development of early childhood chronic wheeze and asthma. Viral etiology and severity of inflammation are potential contributing factors. Previously we observed reduced airway neutrophil infiltration in breastfed bronchiolitic infants, with a corresponding reduction in disease severity. This study aimed to examine whether respiratory viral etiology and co-infection alters the pattern of neutrophil influx, and the inflammatory mediator profile, resulting in epithelial damage in bronchiolitis...
February 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/26479975/the-pathogenesis-of-pulmonary-hypertension-an-update
#19
REVIEW
Lars C Huber, Hannah Bye, Matthias Brock
Elevation of the mean pulmonary arterial pressure to ≥25 mm Hg within the low-pressure system of the pulmonary circulation is defined as pulmonary hypertension. Pulmonary hypertension may be the consequence of various clinical and pathophysiological entities. Many of these conditions, however, result in a final common pathway of pathogenesis. This pathway is characterised by the triad of excessive vasoconstriction, microthrombosis and remodelling of pulmonary arteries. Remodelling is arguably the most important factor: its complex pathogenesis is not completely understood and no specific treatment directly targets vascular remodelling...
2015: Swiss Medical Weekly
https://www.readbyqxmd.com/read/26707546/assessment-and-causes-of-stridor
#20
REVIEW
Andreas Pfleger, Ernst Eber
Stridor is a variably pitched respiratory sound, caused by abnormal air passage during breathing and often is the most prominent sign of upper airway obstruction. It is usually heard on inspiration (typically resulting from supraglottic or glottic obstruction) but also can occur on expiration (originating from obstruction at or below glottic level and/or severe upper airway obstruction). Stridor due to congenital anomalies may exist from birth or may develop within days, weeks or months. Various congenital and acquired disorders prevail in neonates, infants, children, and adolescents, and have to be distinguished...
March 2016: Paediatric Respiratory Reviews
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