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    Committee Opinion No 689: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.
    • Authors:
    Obstet Gynecol 2017 Mar;129(3):e33-e34
    In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. Read More

    Committee Opinion No.689 Summary: Delivery of a Newborn With Meconium-Stained Amniotic Fluid.
    • Authors:
    Obstet Gynecol 2017 Mar;129(3):593-594
    In 2006, the American Academy of Pediatrics and the American Heart Association published the 2005 guidelines on neonatal resuscitation. Before the 2005 guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome in vigorous newborns. Read More

    Management of Hypoxaemic Respiratory Failure in a Respiratory High Dependency Unit.
    Intern Med J 2017 Feb 22. Epub 2017 Feb 22.
    Department of Respiratory and Sleep Medicine, Princess Alexandra Hospital, Ipswich Rd, WOOLLOONGABBA QLD 4102, AUSTRALIA.
    Background: There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-ICU settings.

    Aim: To assess outcomes in HRF (without multi-system disease and not requiring early intubation) directly admitted to a Respiratory High Dependency Unit (R-HDU).

    Methods: Retrospective, cohort study of HRF compared to Hypercapnic Respiratory Failure (HCRF) in a R-HDU (2007-2011). Read More

    Comparison of Short-Term Outcomes Between Open and Minimally Invasive Esophagectomy for Esophageal Cancer Using a Nationwide Database in Japan.
    Ann Surg Oncol 2017 Feb 21. Epub 2017 Feb 21.
    Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
    Purpose: This study aimed to compare short-term outcomes of minimally invasive esophagectomy (MIE) with those of open esophagectomy (OE) for thoracic esophageal cancer using a nationwide Japanese database.

    Methods: Overall, 9584 patients with thoracic esophageal cancer who underwent esophagectomy at 864 hospitals in 2011-2012 were evaluated. We performed one-to-one matching between the MIE and OE groups on the basis of estimated propensity scores for each patient. Read More

    Suspicion of respiratory tract infection with multidrug-resistant Enterobacteriaceae: epidemiology and risk factors from a Paediatric Intensive Care Unit.
    BMC Infect Dis 2017 Feb 21;17(1):163. Epub 2017 Feb 21.
    Dept. of Paediatrics, Pediatric Infectious Diseases, Immunology & Pneumology/Cystic fibrosis, University Children's Hospital Tübingen, Hoppe-Seyler Str. 1, Tübingen, 72076, Germany.
    Background: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. Read More

    Pulmonary outcomes following specialized respiratory management for acute cervical spinal cord injury: a retrospective analysis.
    Spinal Cord 2017 Feb 21. Epub 2017 Feb 21.
    Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA, USA.
    Study Design: Retrospective analysis.

    Objectives: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation.

    Setting: United States regional spinal cord injury (SCI) treatment center. Read More

    Noninvasive detection of alarming intracranial pressure changes by auditory monitoring in early management of brain injury: a prospective invasive versus noninvasive study.
    Crit Care 2017 Feb 21;21(1):35. Epub 2017 Feb 21.
    University Clermont Auvergne, Laboratory of Neurosensory Biophysics, UMR INSERM 1107, Clermont-Ferrand, France.
    Background: In brain-injured patients intracranial pressure (ICP) is monitored invasively by a ventricular or intraparenchymal transducer. The procedure requires specific expertise and exposes the patient to complications such as malposition, hemorrhage or infection. As inner-ear fluid compartments are connected to the cerebrospinal fluid space, ICP changes elicit subtle changes in the physiology of the inner ear. Read More

    Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis.
    BMC Nephrol 2017 Feb 20;18(1):69. Epub 2017 Feb 20.
    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
    Background: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. Read More

    A preliminary assessment of the LMA protector™ in non-paralysed patients.
    BMC Anesthesiol 2017 Feb 20;17(1):26. Epub 2017 Feb 20.
    Department of Women's Anaesthesia, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore, Singapore.
    Background: The LMA Protector™ is the latest CE marked single use supraglottic airway device. This airway device provides access and functional separation of the respiratory and digestive tracts. There are two ports (male, female ports) to provide suction in the laryngeal region and insertion of the gastric tube. Read More

    Genome-resolved metagenomics of a bioremediation system for degradation of thiocyanate in mine water containing suspended solid tailings.
    Microbiologyopen 2017 Feb 19. Epub 2017 Feb 19.
    Department of Earth and Planetary Sciences, University of California, Berkeley, CA, USA.
    Thiocyanate (SCN(-) ) is a toxic compound that forms when cyanide (CN(-) ), used to recover gold, reacts with sulfur species. SCN(-) -degrading microbial communities have been studied, using bioreactors fed synthetic wastewater. The inclusion of suspended solids in the form of mineral tailings, during the development of the acclimatized microbial consortium, led to the selection of an active planktonic microbial community. Read More

    The Burden of Respiratory Disease in Very-Low-Birth-Weight Infants: Changes in Perinatal Care and Outcomes in a Decade in Spain.
    Neonatology 2017 Feb 18;112(1):30-39. Epub 2017 Feb 18.
    Division of Neonatology, CHUI Materno-Infantil, Las Palmas de Gran Canaria, Spain.
    Background: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease.

    Objectives: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). Read More

    Effects of salvage logging on soil properties and vegetation recovery in a fire-affected Mediterranean forest: A two year monitoring research.
    Sci Total Environ 2017 Feb 14. Epub 2017 Feb 14.
    Department of Applied Biology, University Miguel Hernández, Avda. de la Universidad s/n, Elche, 03202, Alicante, Spain.
    Post-fire management can have an additional impact on the ecosystem; in some cases, even more severe than the fire. Salvage logging (SL) is a common practice in most fire-affected areas. The management of burnt wood can determine microclimatic conditions and seriously affect soil properties. Read More

    Clinical manifestations of severe enterovirus 71 infection and early assessment in a Southern China population.
    BMC Infect Dis 2017 Feb 17;17(1):153. Epub 2017 Feb 17.
    Dongguan Taiping People's Hospital, Dongguan, 523905, China.
    Background: Enterovirus 71 (EV-A71) shows a potential of rapid death, but the natural history of the infection is poorly known. This study aimed to examine the natural history of EV-A71 infection.

    Methods: This was a prospective longitudinal observational study performed between January 1(st) and October 31(st), 2012, at three hospitals in Guangdong, China. Read More

    Relationship between pre-anesthetic and intra-anesthetic airway resistance in patients undergoing general anesthesia: A prospective observational study.
    PLoS One 2017 17;12(2):e0172421. Epub 2017 Feb 17.
    Department of Anesthesiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
    Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. Read More

    Depth-specific fluctuations of gene expression and protein abundance modulate the photophysiology in the seagrass Posidonia oceanica.
    Sci Rep 2017 Feb 17;7:42890. Epub 2017 Feb 17.
    CCMAR, University of Algarve, Faro, Portugal.
    Here we present the results of a multiple organizational level analysis conceived to identify acclimative/adaptive strategies exhibited by the seagrass Posidonia oceanica to the daily fluctuations in the light environment, at contrasting depths. We assessed changes in photophysiological parameters, leaf respiration, pigments, and protein and mRNA expression levels. The results show that the diel oscillations of P. Read More

    Comparison of four techniques on facility of two-hand Bag-valve-mask (BVM) ventilation: E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (non-dominant hand) and Thenar Eminence (non-dominant hand) - E-C (dominant hand).
    J Cardiovasc Thorac Res 2016 27;8(4):147-151. Epub 2016 Dec 27.
    Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
    Introduction: Bag-valve-mask (BVM) ventilation is the first and important part of the airway management. The aim of present study was to evaluate the quality of four different BVM ventilation techniques - E-C, Thenar Eminence, Thenar Eminence (Dominant hand)-E-C (Non dominant hand), and Thenar Eminence (Non dominant hand)-E-C (Dominant hand) - among two novice and experienced groups. Methods: In a case-control and mannequin based study that was conducted in Tabriz University of medical sciences, 120 volunteers were recruited and divided into two groups. Read More

    Hot topics from the Assemblies.
    • Authors:
    Breathe (Sheff) 2016 Dec;12(4):378-379
    Cowie et al. present the results of the international, multicentre, randomised, parallel-group SERVE-HF (Treatment of sleep-disordered breathing with predominant central sleep apnea by adaptive servo ventilation in patients with heart failure) trial, which investigated the effects of adding adaptive servo-ventilation (ASV) to guideline based medical management on survival and cardiovascular outcomes in patients with heart failure defined as reduced ejection fraction (<45%) and predominant central sleep apnoea (CSA). Read More

    Telemedicine in chronic obstructive pulmonary disease.
    Breathe (Sheff) 2016 Dec;12(4):350-356
    Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Lumezzane, Italy.
    : Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. Read More

    Effectiveness of new sedation and rehabilitation methods for critically ill patients receiving mechanical ventilation.
    J Phys Ther Sci 2017 Jan 30;29(1):138-143. Epub 2017 Jan 30.
    Department of Critical Care Medical Center, Hakodate Municipal Hospital, Japan.
    [Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a "control group" and an "intervention group", respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation. Read More

    Contributing Factors for Morbidity and Mortality in Patients with Organophosphate Poisoning on Mechanical Ventilation: A Retrospective Study in a Teaching Hospital.
    J Clin Diagn Res 2016 Dec 1;10(12):UC18-UC20. Epub 2016 Dec 1.
    Postgraduate Student, Department of Anaesthesiology, Mahadevappa Rampure Medical College/Rajiv Gandhi University of Health Sceinces , Kalaburagi, Karnataka, India .
    Introduction: One of the most common causes of poisoning in agricultural based developing countries like India is due to Organophosphorus (OP) compound. Its widespread use and easy availability has increased the likelihood of poisoning with these compounds.

    Aim: To study the morbidity and mortality in patients with acute OP poisoning requiring mechanical ventilation. Read More

    Acute respiratory distress syndrome and chemical burns after exposure to chlorine-containing bleach: a case report.
    J Thorac Dis 2017 Jan;9(1):E17-E20
    Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea.
    Chlorine-containing bleach can cause acute respiratory distress syndrome (ARDS) and chemical burns. However, simultaneous occurrence of the two conditions caused by this agent is very rare. We describe the case of a 74-year-old female who presented with shortness of breath and hemoptysis following accidental exposure to chlorine-containing bleach. Read More

    Burden and treatment patterns of invasive fungal infections in hospitalized patients in the Middle East: real-world data from Saudi Arabia and Lebanon.
    Infect Drug Resist 2017 2;10:35-41. Epub 2017 Feb 2.
    Real-world Evidence/Data Analytics Center of Excellence, Pharmerit International, Bethesda, MD, USA.
    Objectives: The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to Candida and Aspergillus species in Saudi Arabia and Lebanon.

    Methods: A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to Candida or Aspergillus, which was culture proven or suspected based on clinical criteria. Read More

    Intraabdominal Surgery and Anesthesia Management.
    Anesthesiology 2017 Mar;126(3):543-546
    From the David S. Sheridan Professorship in Anaesthesia and Respiratory Therapy, Harvard University, Boston, Massachusetts.
    Inspired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation: A Concept of Atelectasis. By Bendixen HH, Hedley-Whyte J, and Laver MB. New Engl J Med 1963; 269:991-996. Read More

    Patient and Hospital Characteristics Associated with Inter-hospital Transfer for Adults with Ventilator Dependent Respiratory Failure.
    Ann Am Thorac Soc 2017 Feb 15. Epub 2017 Feb 15.
    Medical University of South Carolina, Pulmonary and Critical Care Medicine , 96 Jonathan Lucas Dr. , Suite 812 CSB , Charleston, South Carolina, United States , 29425 ;
    Rationale: Patients with ventilator-dependent respiratory failure have improved outcomes at centers with greater expertise, yet most patients are not treated in such facilities. Efforts to align care for respiratory failure and hospital capability would necessarily require inter-hospital transfer.

    Objectives: To characterize the prevalence and patient and hospital factors associated with inter-hospital transfer of adults residing in Florida with ventilator-dependent respiratory failure. Read More

    The success of pre-hospital tracheal intubation by different pre-hospital providers: a systematic literature review and meta-analysis.
    Crit Care 2017 Feb 14;21(1):31. Epub 2017 Feb 14.
    London Air Ambulance, Royal London Hospital, Whitechapel Road, London, E1 1BB, UK.
    Background: Pre-hospital basic airway interventions can be ineffective at providing adequate oxygenation and ventilation in some severely ill or injured patients, and advanced airway interventions are then required. Controversy exists regarding the level of provider required to perform successful pre-hospital intubation. A previous meta-analysis reported pre-hospital intubation success rates of 0. Read More

    Safe treatment of ethmoid sinusitis utilizing minimally invasive ethmoid punch sinusotomy (EPS) in chronic rhinosinusitis without polyposis (CRSsNP) patients.
    Laryngoscope 2017 Feb 14. Epub 2017 Feb 14.
    Division of Rhinology, Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, U.S.A.
    Objectives/hypothesis: Current rhinologic practice is devoid of minimally invasive procedures dedicated to the treatment of ethmoid sinusitis to improve ventilation and topical drug delivery. We have recently described a handheld spiral punch to create minimally invasive ethmoid punch sinusotomy (EPS) sites into the ethmoid bulla and basal lamella, which significantly increased irrigant access to the ethmoid sinuses in cadaver models. Here, we conducted a clinical feasibility study to determine the initial safety evaluation of EPS in chronic rhinosinusitis without polyposis (CRSsNP) patients with active ethmoid disease. Read More

    Risk factors and prognosis of pain events during mechanical ventilation: a retrospective study.
    J Intensive Care 2017 8;5:17. Epub 2017 Feb 8.
    0000 0001 0667 4960grid.272458.eDepartment of Anesthesiology, Kyoto Prefectural University of Medicine, Kajiicho 465, Kamigyo-Ku, Kyoto 602-8566 Japan.
    Background: Pain assessment is highly recommended in patients receiving mechanical ventilation. However, pain intensity and its impact on outcomes in these patients remain obscure. We collected the results of routine pain assessments, utilizing the behavioral pain scale (BPS), from 151 patients receiving mechanical ventilation. Read More

    Fat, oil and grease reduction in commercial kitchen ductwork: A novel biological approach.
    Waste Manag 2017 Feb 9. Epub 2017 Feb 9.
    School of Construction Management and Engineering, University of Reading, Whiteknights, Reading RG6 6AY, UK. Electronic address:
    Recent research has characterised emissions upon cooking a variety of foods in a commercial catering environment in terms of volume, particle size and composition. However, there has been limited focus on the deposition of solid grease in commercial kitchen ductwork, the sustainability of these systems and their implications on the heat recovery potential of kitchen ventilation extract air. This paper reviews the literature concerning grease, commonly referred to as Fat, Oils and Grease (FOG) abatement strategies and finds that many of these systems fall short of claimed performances. Read More

    Neurologic complications of polytrauma.
    Handb Clin Neurol 2017 ;141:633-655
    Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address:
    Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Read More

    Intelligent volume-assured pressured support (iVAPS) for the treatment of congenital central hypoventilation syndrome.
    Sleep Breath 2017 Feb 11. Epub 2017 Feb 11.
    Division of Respiratory Medicine, The Hospital for Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada.
    Purpose: Congenital central hypoventilation syndrome (CCHS) is characterized by ventilatory insensitivity to hypercapnia and hypoxemia during sleep and/or wakefulness. Management of CCHS includes a long-term ventilation. However, ventilation can be challenging given differences in the control of breathing during different sleep stages. Read More

    Mechanical ventilation in patients subjected to extracorporeal membrane oxygenation (ECMO).
    Med Intensiva 2017 Feb 7. Epub 2017 Feb 7.
    Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España. Electronic address:
    Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury. Read More

    Hydrotherapy for the long term ventilated patient: A case study and implications for practice.
    Aust Crit Care 2017 Feb 7. Epub 2017 Feb 7.
    Royal Brisbane and Women's Hospital, C/- Physiotherapy Department, Level 2 Ned Hanlon Building, Butterfield St and Bowen Bridge Rd, Herston, Brisbane, 4029 Queensland, Australia. Electronic address:
    Hydrotherapy of mechanically ventilated patients has been shown to be safe and feasible in both the acute stages of critical illness and in those requiring long term mechanical ventilation. This case study describes the hydrotherapy sessions of a 36 year old female, who after suffering complications of pneumococcal meningitis, became an incomplete quadriplegic and required long term mechanical ventilation. When implementing hydrotherapy with patients on mechanical ventilation a number of factors should be considered. Read More

    Management of acute neuromuscular disorders.
    Handb Clin Neurol 2017 ;140:229-237
    Division of Critical Care Neurology, Mayo Clinic and Neurosciences Intensive Care Unit, Mayo Clinic Campus, Saint Marys Hospital, Rochester, MN, USA. Electronic address:
    Imminent neuromuscular respiratory failure is recognized by shortness of breath, restlessness, and tachycardia and is often followed by tachypnea, constantly interrupting speech, asynchronous breathing and sometimes paradoxical breathing and use of scalene and sternocleidomastoid muscles. Once a patient presents with such a constellation of signs, there are some difficult decisions to be made and include assessment of the severity of respiratory failure and in particular when to intubate. Failure of the patient to manage secretions as a result of oropharyngeal weakness rather than neuromuscular respiratory weakness may be another reason for acute intubation. Read More

    Airway management and mechanical ventilation in acute brain injury.
    Handb Clin Neurol 2017 ;140:15-32
    Department of Neurology, University of Heidelberg, Heidelberg, Germany.
    Patients with acute neurologic disease often develop respiratory failure, the management of which profoundly affects brain physiology and long-term functional outcomes. This chapter reviews airway management and mechanical ventilation of patients with acute brain injury, offering practical strategies to optimize treatment of respiratory failure and minimize secondary brain injury. Specific concerns that are addressed include physiologic changes during intubation and ventilation such as the effects on intracranial pressure and brain perfusion; cervical spine management during endotracheal intubation; the role of tracheostomy; and how ventilation and oxygenation are utilized to minimize ischemia-reperfusion injury and cerebral metabolic distress. Read More

    Management of the comatose patient.
    Handb Clin Neurol 2017 ;140:117-129
    Division of Critical Care Neurology, Mayo Clinic and Neurosciences Intensive Care Unit, Mayo Clinic Campus, Saint Marys Hospital, Rochester, MN, USA. Electronic address:
    Coma has many causes but there are a few urgent ones in clinical practice. Management must start with establishing the cause and an attempt to reverse or attenuate some of the damage. This may include early neurosurgical intervention, efforts to reduce brain tissue shift and raised intracranial pressure, correction of markedly abnormal laboratory abnormalities, and administration of available antidotes. Read More

    Acute pulmonary embolism detection with ventilation/perfusion SPECT combined with full dose CT: What is the best option?
    Rev Esp Med Nucl Imagen Mol 2017 Feb 6. Epub 2017 Feb 6.
    Department of Internal Medicine, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
    Aim: To compare diagnostic accuracy of Ventilation/Perfusion (V/P) single-photon emission computed tomography (SPECT) combined with simultaneous full-dose CT with a hybrid SPECT/CT scanner versus planar ventilation/perfusion (V/P) SPECT and CT angiography (CTA) in patients suspected with acute pulmonary embolism (PE).

    Methods: Between 2009 and 2011, consecutive patients suspected of acute PE were referred for V/P SPECT/CT (reviewed board approved study). A contrast agent was administered to patients who had no contraindications. Read More

    Comparison of the macintosh and airtraq laryngoscopes in morbidly obese patients: a randomized and prospective study.
    J Clin Anesth 2017 Feb 2;36:136-141. Epub 2016 Dec 2.
    Service of Anesthesiology, Reanimation and Pain Therapy, University General Hospital of Cartagena, Murcia, Spain. Electronic address:
    Study Objective: Morbid obesity is associated with a difficult management of the airway. There is no agreement on these patients being difficult to intubate, but if they are difficult to ventilate with facial mask, then the fast control of their airway becomes a priority. This study compares the quickness and success in tracheal intubation, glottic view, hemodynamic response, and complications from the use of the Macintosh and Airtraq laryngoscopes in morbidly obese patients for scheduled surgery. Read More

    Airway management for glossopexy in infants with micrognathia and obstructive breathing.
    J Clin Anesth 2017 Feb 1;36:127-132. Epub 2016 Dec 1.
    Department of Dental Anesthesiology, Graduate School of Dentistry, Osaka University, 1-8, Yamadaoka, Suita, Osaka 565-0871, Japan.
    Study Objectives: To identify airway management and tracheal intubation techniques for glossopexy in infants with preexisting airway obstruction under general anesthesia.

    Design: Retrospective, observational study.

    Settings: Operating room of a university hospital between January 2003 and March 2015. Read More

    Management of continuous positive airway pressure treatment compliance using telemonitoring in obstructive sleep apnoea.
    Eur Respir J 2017 Feb 8;49(2). Epub 2017 Feb 8.
    Group of Translational Research in Respiratory Medicine, Hospital Universitari Arnau de Vilanova and Santa Maria, IRBLleida, Lleida, Spain.
    Continuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnoea (OSA), but treatment compliance is often unsatisfactory. This study investigated the efficacy and cost-effectiveness of telemonitoring for improving CPAP compliance.100 newly diagnosed OSA patients requiring CPAP (apnoea-hypopnoea index >15 events·h(-1)) were randomised to standard management or a telemonitoring programme that collected daily information about compliance, air leaks and residual respiratory events, and initiated patient contact to resolve issues. Read More

    Fermentation products as feed additives mitigate some ill-effects of heat stress in pigs.
    J Anim Sci 2017 Jan;95(1):279-290
    Heat stress (HS) may result in economic losses to pig producers across the USA and worldwide. Despite significant advancements in management practices, HS continues to be a challenge. In this study, an in-feed antibiotic (carbadox, CBX) and antibiotic alternatives ( [XPC], and [SGX] fermentation products) were evaluated in a standard pig starter diet as mitigations against the negative effects of HS in pigs. Read More

    Respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation.
    Minerva Pediatr 2017 Feb 7. Epub 2017 Feb 7.
    Pediatric Gastroenterology Unit, Puerta del Mar University Hospital, Cadiz, Spain.
    Background: There is no evidence of the need for oxygen supplementation during upper digestive endoscopies under Ketamine sedation in children, and the latest recommendations specifically state that it is not mandatory for the procedure. The aim of our study is to assess the incidence of respiratory adverse events during upper digestive endoscopies in children under Ketamine sedation when performed without oxygen supplementation, in accordance with the latest recommendations.

    Methods: 88 children undergoingketamine sedation for programmed upper digestive endoscopy at our Pediatric Intensive Care Unit were included. Read More

    Fluid restriction for treatment of preterm infants with chronic lung disease.
    Cochrane Database Syst Rev 2017 Feb 8;2:CD005389. Epub 2017 Feb 8.
    Université de Montréal, Montreal, ON, Canada.
    Background: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD).

    Objectives: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes.

    Search Methods: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016). Read More

    Cervical spine arteriovenous fistula associated with hereditary haemorrhagic telangiectasia.
    BMJ Case Rep 2017 Feb 7;2017. Epub 2017 Feb 7.
    Department of Neurology, St Vincent's University Hospital, Dublin, Ireland.
    Reported is a case of a man aged 55 years who presented with progressive spastic paraparesis. Examination demonstrated multiple cutaneous telangiectases. Subsequent development of upper limb weakness, acute urinary retention and eventual respiratory compromise resulted in the requirement for intensive care unit admission and mechanical ventilation. Read More

    Patient Characteristics, Management, and Predictors of Outcome from Severe Community-Onset Staphylococcal Sepsis in Northeast Thailand: A Prospective Multicenter Study.
    Am J Trop Med Hyg 2017 Feb 6. Epub 2017 Feb 6.
    Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
    Staphylococcus aureus infection is a persistent threat in resource-restricted settings in southeast Asia but informative data about this disease remain limited. We analyzed characteristics, management, and predictors of outcome in severely septic patients with community-onset S. aureus infection in northeast Thailand. Read More

    A psychological intervention to promote acceptance and adherence to non-invasive ventilation in people with chronic obstructive pulmonary disease: study protocol of a randomised controlled trial.
    Trials 2017 Feb 6;18(1):59. Epub 2017 Feb 6.
    Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy.
    Background: People with chronic obstructive pulmonary disease (COPD) sometimes experience anxiety, depression and comorbid cognitive deficits. Rather than being merely a consequence of symptom-related physical impairments these additional problems may be part of the clinical course of the condition. The relationship between the physical and psychological aspects of the condition is illustrated by the patterns of use of non-invasive ventilation (NIV); NIV is often rejected or used inappropriately, resulting in clinical deterioration and an increase in health care costs. Read More

    Effectiveness of hands-on tutoring and guided self-directed learning versus self-directed learning alone to educate critical care fellows on mechanical ventilation - a pilot project.
    Med Educ Online 2016 Jan;21(1):32727
    a Division of Pulmonary and Critical Care Medicine Mayo Clinic, Rochester , MN , USA.
    Background Physicians require extensive training to achieve proficiency in mechanical ventilator (MV) management of the critically ill patients. Guided self-directed learning (GSDL) is usually the method used to learn. However, it is unclear if this is the most proficient approach to teaching mechanical ventilation to critical care fellows. Read More

    Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study.
    Pediatr Crit Care Med 2017 Feb;18(2):120-127
    1Sorbonne Universités, UPMC Paris 06, Groupe PEPITE, Paris, France.2AP-HP, HUEP, hôpital Trousseau, service des Urgences Pédiatriques, Paris, France.3AP-HP, HUEP, hôpital Trousseau, Service Hématologie et Oncologie pédiatrique, Paris, France.
    Objectives: To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team.

    Design: Randomized controlled study.

    Setting: Children's hospital at a tertiary care academic medical center. Read More

    Update on traumatic acute spinal cord injury. Part 2.
    Med Intensiva 2017 Feb 1. Epub 2017 Feb 1.
    Unidad de Cuidados Intensivos, Complexo Hospitalario Universitario de A Coruña, A Coruña, España. Electronic address:
    The aim of treatment in acute traumatic spinal cord injury is to preserve residual neurologic function, avoid secondary injury, and restore spinal alignment and stability. In this second part of the review, we describe the management of spinal cord injury focusing on issues related to short-term respiratory management, where the preservation of diaphragmatic function is a priority, with prediction of the duration of mechanical ventilation and the need for tracheostomy. Surgical assessment of spinal injuries based on updated criteria is discussed, taking into account that although the type of intervention depends on the surgical team, nowadays treatment should afford early spinal decompression and stabilization. Read More

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