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    [A study on the effects and safety of sequential humidified high flow nasal cannula oxygenation therapy on the COPD patients after extubation].
    Zhonghua Yi Xue Za Zhi 2018 Jan;98(2):109-112
    Emergency Center, First Affiliated Hospital of Zhejiang University, Hangzhou 321000, China.
    Objective: To investigate and compare the effect and safety of nasal high-flow oxygen therapy (HFNCO) and noninvasive ventilation (NIV) therapy after extubation in patients with chronic obstructive pulmonary disease (COPD). Methods: All COPD patients subjected to mechanical ventilation in the Emergency Intensive Unit of the First Affiliated Hospital of Zhejiang University during January 2015 to June 2016 were included in the study. The patients were divided into two groups after extubation and HFNCO and NIV were adopted on each group respectively. Read More

    Dexmedetomidine as Single Continuous Sedative During Noninvasive Ventilation: Typical Usage, Hemodynamic Effects, and Withdrawal.
    Pediatr Crit Care Med 2018 Jan 16. Epub 2018 Jan 16.
    Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital & The Ohio State University College of Medicine, Columbus, OH.
    Objectives: Dexmedetomidine use in pediatric critical care is increasing. Its prolonged effects as a single continuous agent for sedation are not well described. The aim of the current study was to describe prolonged dexmedetomidine therapy without other continuous sedation, specifically the hemodynamic effects, discontinuation strategies, and risk factors for withdrawal. Read More

    Internal jugular vein variability predicts fluid responsiveness in cardiac surgical patients with mechanical ventilation.
    Ann Intensive Care 2018 Jan 16;8(1). Epub 2018 Jan 16.
    Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, Xuhui District, People's Republic of China.
    Background: To evaluate the efficacy of using internal jugular vein variability (IJVV) as an index of fluid responsiveness in mechanically ventilated patients after cardiac surgery.

    Methods: Seventy patients were assessed after cardiac surgery. Hemodynamic data coupled with ultrasound evaluation of IJVV and inferior vena cava variability (IVCV) were collected and calculated at baseline, after a passive leg raising (PLR) test and after a 500-ml fluid challenge. Read More

    Perioperative Implementation of Noninvasive Positive Airway Pressure Therapies.
    Respir Care 2018 Jan 16. Epub 2018 Jan 16.
    Division of Pulmonary, Critical Care and Sleep Medicine, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH.
    Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea. Read More

    Prognostic factors of noninvasive mechanical ventilation in lung cancer patients with acute respiratory failure.
    PLoS One 2018 12;13(1):e0191204. Epub 2018 Jan 12.
    Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
    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. Read More

    Effects of underwater bubble CPAP on very-low-birth-weight preterm newborns in the delivery room and after transport to the neonatal intensive care unit.
    J Child Health Care 2018 Jan 1:1367493517752500. Epub 2018 Jan 1.
    4 Augusto Motta University Center, Avenida Paris, Bonsucesso, Rio de Janeiro, Brazil.
    The development of less invasive ventilatory strategies in very-low-birth-weight (VLBW) preterm newborns has been a growing concern in recent decades. This study aimed to measure differences in the clinical progression of preterm newborns using two distinct periods in a university hospital: before and after using underwater bubble continuous positive airway pressure (ubCPAP). This is a retrospective study of VLBW preterm newborns with gestational ages less than or equal to 32 weeks admitted to the neonatal intensive care unit. Read More

    Supplemental oxygen in patients with stable chronic obstructive pulmonary disease: evidence from Nocturnal Oxygen Treatment Trial to Long-term Oxygen Treatment Trial.
    Curr Opin Pulm Med 2018 Jan 9. Epub 2018 Jan 9.
    Cleveland Clinic Lerner College of Medicine.
    Purpose Of Review: Oxygen therapy was the first treatment shown to prolong life in patients with chronic obstructive pulmonary disease (COPD) and has been joined by lung volume reduction surgery in selected patients with emphysema, smoking cessation, and potentially noninvasive ventilation in chronic hypercapneic respiratory failure. Although there is consensus around the survival-enhancing effect of supplemental oxygen (SupplO2) for patients with chronic severe hypoxemia at rest, the impact of SupplO2 for COPD patients with moderate hypoxemia and exertional desaturation had been less clear.

    Recent Findings: The recently published Long-term Oxygen Treatment Trial (LOTT) showed no benefit of SupplO2 for the composite outcome of survival and all-cause hospitalizations, or for component outcomes, severe COPD exacerbations, or quality of life in COPD patients with moderate resting hypoxemia or room air normoxemia with exercise desaturation. Read More

    Noninvasive ventilation-neurally adjusted ventilator assist for management of acute exacerbation of chronic obstructive pulmonary disease.
    Lung India 2018 Jan-Feb;35(1):62-65
    Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India.
    Patient-ventilator asynchrony is common with noninvasive ventilation (NIV) used for management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Neurally adjusted ventilator assist (NAVA) is a mode of ventilatory support which can minimize the patient-ventilator asynchrony. Delivering NIV with NAVA (NIV-NAVA) during acute exacerbation of COPD seems a logical approach and may be useful in reducing patient-ventilator asynchrony. Read More

    Pyomyositis in the setting of complicated diverticulitis: case report.
    Int J Gen Med 2018 22;11:11-14. Epub 2017 Dec 22.
    Department of Surgery, Richmond University Medical Center, Staten Island, NY, USA.
    Pyomyositis is typically thought of as a disease of the tropics. However, it is becoming more prevalent in temperate regions, and may be underdiagnosed. Here, pyomyositis is encountered as a complication of perforated diverticulitis, which has not been previously reported. Read More

    Noninvasive Ventilation During Endoscopic Procedures: Rationale, Clinical Use, and Devices.
    J Cardiothorac Vasc Anesth 2017 Sep 27. Epub 2017 Sep 27.
    Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy.
    Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself. Read More

    [Noninvasive ventilation in acute respiratory insufficiency].
    Med Klin Intensivmed Notfmed 2018 Jan 8. Epub 2018 Jan 8.
    Medizinische Klinik I - Sektion Pneumologie, Universitätsklinikum RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
    The use of noninvasive ventilation reduces ventilator-associated complications. Thus, the outcome of patients suffering from acute hypercapnic respiratory insufficiency as well as cardiogenic lung edema can be improved. For the use of noninvasive ventilation to be successful and safe, its correct application is pivotal. Read More

    High-Velocity Nasal Insufflation in the Treatment of Respiratory Failure: A Randomized Clinical Trial.
    Ann Emerg Med 2018 Jan 5. Epub 2018 Jan 5.
    Vapotherm, Inc, Exeter, NH; Sidney Kimmel Medical College, Philadelphia, PA.
    Study Objective: We compare high-velocity nasal insufflation, a form of high-flow nasal cannula, with noninvasive positive-pressure ventilation in the treatment of undifferentiated respiratory failure with respect to therapy failure, as indicated by requirement for endotracheal intubation or cross over to the alternative therapy.

    Methods: This was a multicenter, randomized trial of adults presenting to the emergency department (ED) with respiratory failure requiring noninvasive positive-pressure ventilation. Patients were randomly assigned to high-velocity nasal insufflation (initial flow 35 L/min; temperature 35°C (95°F) to 37°C (98. Read More

    Tropical Fevers in Indian Intensive Care Units: A Prospective Multicenter Study.
    Indian J Crit Care Med 2017 Dec;21(12):811-818
    Professor Emeritus Pathology, PGIMS, Rohtak, Haryana, India.
    Background And Aims: Infections in tropics often present as undifferentiated fevers with organ failures. We conducted this nationwide study to identify the prevalence, profile, resource utilization, and outcome of tropical fevers in Indian Intensive Care Units (ICUs).

    Materials And Methods: This was a multicenter prospective observational study done in 34 ICUs across India (July 2013-September 2014). Read More

    Five-Year Follow-Up and Outcomes of Noninvasive Ventilation in Subjects With Neuromuscular Diseases.
    Respir Care 2018 Jan 3. Epub 2018 Jan 3.
    Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, South Korea.
    Introduction: The purpose of this study was to investigate the 5-year outcomes of noninvasive ventilation (NIV) application in different neuromuscular disease (NMD) groups.

    Methods: We categorized 180 subjects who had initiated NIV between March 2001 and August 2009 into 4 groups and followed them for > 5 y. The NIV maintenance rate and average duration, applying time, and forced vital capacity (FVC) were investigated at the time NIV was initiated and 5 y after NIV initiation in each group. Read More

    A Hybrid Form of Telemedicine: A Unique Way to Extend Intensive Care Service to Neonates in Medically Underserved Areas.
    Telemed J E Health 2018 Jan 3. Epub 2018 Jan 3.
    Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma.
    Background: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU. Read More

    Biomarkers for Pulmonary Inflammation and Fibrosis and Lung Ventilation Function in Chinese Occupational Refractory Ceramic Fibers-Exposed Workers.
    Int J Environ Res Public Health 2017 Dec 27;15(1). Epub 2017 Dec 27.
    National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, No. 29 Nanwei Road, Xicheng District, Beijing 100050, China.
    Refractory ceramic fibers (RCFs) can cause adverse health effects on workers' respiratory system, yet no proper biomarkers have been used to detect early pulmonary injury of RCFs-exposed workers. This study assessed the levels of two biomarkers that are related to respiratory injury in RCFs-exposed workers, and explored their relations with lung function. The exposure levels of total dust and respirable fibers were measured simultaneously in RCFs factories. Read More

    Upfront triple combination therapy-induced pulmonary edema in a case of pulmonary arterial hypertension associated with Sjogren's syndrome.
    Respir Med Case Rep 2018 7;23:55-59. Epub 2017 Dec 7.
    Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
    Clinical efficacy of combination therapy using vasodilators for pulmonary arterial hypertension (PAH) is well established. However, information on its safety are limited. We experienced a case of primary Sjogren's syndrome associated with PAH where the patient developed pulmonary edema immediately after the introduction of upfront triple combination therapy. Read More

    Early Identification of Acute Respiratory Distress Disorder in the Absence of Positive Pressure Ventilation: Implications for Revision of the Berlin Criteria for Acute Respiratory Distress Syndrome.
    Crit Care Med 2017 Dec 21. Epub 2017 Dec 21.
    CHU de Poitiers, Service de Réanimation Médicale, Poitiers, France.
    Objectives: To assess whether patients breathing spontaneously under standard oxygen could be recognized early as acute respiratory distress syndrome patients according to the current Berlin definition.

    Design: A post hoc analysis from two prospective studies.

    Setting: Twenty-three French ICUs. Read More

    Pulmonary Hypertension and Its Response to Treatment in a Patient With Kyphosis-related Alveolar Hypoventilation.
    Intern Med 2017 Dec 21. Epub 2017 Dec 21.
    South Miyagi Medical Center, Japan.
    Pulmonary hypertension (PH) with kyphoscoliosis-related alveolar hypoventilation is uncommon, so little is known about the effectiveness of treatments for this condition. A 66-year-old man with kyphosis who had been treated with nocturnal noninvasive positive-pressure ventilation developed PH with a mean pulmonary arterial pressure (PAP) of 32 mmHg and a pulmonary vascular resistance (PVR) of 5.95 Wood units. Read More

    Real-life feasibility and effectiveness of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease requiring medical equipment.
    Int J Chron Obstruct Pulmon Dis 2017 12;12:3549-3556. Epub 2017 Dec 12.
    FormAction Santé, Pérenchies, France.
    Background: Pulmonary rehabilitation (PR) is a key treatment of chronic obstructive pulmonary disease (COPD) but studies are still needed to identify the most pertinent criteria to personalize this intervention and improve its efficacy.

    Objective: This real-life retrospective study compared the effects of home-based PR on exercise tolerance, anxiety, depression, and health-related quality of life (HRQoL) in COPD patients, according to their medical equipment.

    Methods: Exercise tolerance, anxiety, depression, and HRQoL were evaluated in 109 patients equipped with long-term oxygen therapy (LTOT), 84 patients with noninvasive ventilation (NIV), 25 patients with continuous positive airway pressure (CPAP), and 80 patients with no equipment (NE), before, just after, and 6 and 12 months after PR. Read More

    Low minute ventilation episodes during anesthesia recovery following intraperitoneal surgery as detected by a non-invasive respiratory volume monitor.
    J Clin Monit Comput 2017 Dec 20. Epub 2017 Dec 20.
    Department of Anesthesia and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA.
    An electrical impedance-based noninvasive respiratory volume monitor (RVM) accurately reports minute volume, tidal volume and respiratory rate. Here we used the RVM to quantify the occurrence of and evaluate the ability of clinical factors to predict respiratory depression in the post-anesthesia care unit (PACU). RVM generated respiratory data were collected from spontaneously breathing patients following intraperitoneal surgeries under general anesthesia admitted to the PACU. Read More

    Looking under the bonnet of patient-ventilator asynchrony during noninvasive ventilation: does it add value?
    ERJ Open Res 2017 Oct 14;3(4). Epub 2017 Dec 14.
    St James's University Hospital, Leeds, UK.
    During noninvasive ventilation it is reasonable to try to abolish clinically apparent patient-ventilator asynchronies but the use of more invasive tests to detect subtle asynchronies cannot be justified Read More

    Alterations in the Masticatory System in Patients with Amyotrophic Lateral Sclerosis.
    J Oral Facial Pain Headache 2017 Dec 15. Epub 2017 Dec 15.
    Aims: To determine the effect of amyotrophic lateral sclerosis (ALS) on aspects of masticatory function and to assess the relationship between ALS and the prevalence of traumatic mucosal lesions caused by oral self-injury.

    Methods: A total of 153 ALS patients and 23 control subjects participated in this cross-sectional study. Clinical characteristics including site of onset, medication, type of feeding, and use of noninvasive mechanical ventilation were recorded. Read More

    [Research advances in neonatal nasal intermittent positive pressure ventilation].
    Zhongguo Dang Dai Er Ke Za Zhi 2017 Dec;19(12):1301-1305
    Department of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
    Nasal intermittent positive pressure ventilation (NIPPV) can augment nasal continuous positive airway pressure (nCPAP) by delivering intermittent positive pressure ventilation in a noninvasive way and can provide a new option for neonatal noninvasive respiratory support. NIPPV has an advantage over nCPAP in primary and post-extubation respiratory support. Moreover, it can reduce severe apnea of prematurity. Read More

    The relationship between right ventricular outflow tract fractional shortening and Pulmonary Embolism Severity Index in acute pulmonary embolism.
    Turk Kardiyol Dern Ars 2017 Dec;45(8):709-714
    Department of Cardiology, Atatürk Chest Disease and Thorasic Surgery Training and Research Hospital, Ankara Turkey.
    Objective: Right ventricular (RV) functions are clinically important in acute pulmonary embolism (APE). Measurement of systolic function of the right ventricular outflow tract (RVOT) with echocardiography is a simple method to evaluate RV function. The aim of this study was to determine the relationship between RVOT systolic function and the Pulmonary Embolism Severity Index (PESI). Read More

    Improving patient safety during procedural sedation via respiratory volume monitoring: A randomized controlled trial.
    J Clin Anesth 2017 Dec 7. Epub 2017 Dec 7.
    University of Vermont Larner College of Medicine, Department of Anesthesiology, 111 Colchester Avenue, West Pavilion, Level 2, Burlington, VT 05401, United States. Electronic address:
    Study Objective: Assess the utility of a respiratory volume monitor (RVM) to reduce the incidence of low minute ventilation events in procedural sedation.

    Design: Randomized control trial SETTING: Endoscopy suite PATIENTS: Seventy-three total patients (ASA Physical Status 1-3) undergoing upper endoscopies were analyzed.

    Intervention: Patients were randomized into two groups using a computer generated randomization table: Control (n=41): anesthesia provider was unable to see the screen of the RVM; RVM (n=32): anesthesia provider had access to RVM data to assist with management of the case. Read More

    VATS Plication of the Diaphragm: A Descriptive Observational 10-Year Southampton Experience.
    Innovations (Phila) 2017 Nov/Dec;12(6):398-405
    From the Cardiovascular & Thoracic Centre, Southampton General Hospital, Southampton, UK.
    Objective: The aim of the study was to report the safety and efficacy of video-assisted thoracoscopic (VATS) plication of the diaphragm at our institution between 2006 and 2016.

    Methods: Adult patients selected on etiology and combination of investigations including plain chest x-ray, computed tomography of chest and abdomen, lung functions in supine and sitting positions, radiological/ultrasonic screening for diaphragmatic movement, and phrenic nerve conduction studies. We incorporated a triportal VATS and Endostitch device for plication, using CO2 insufflation to maximum 12 mm Hg. Read More

    Novel magnetic resonance technique for functional imaging of cystic fibrosis lung disease.
    Eur Respir J 2017 Dec 7;50(6). Epub 2017 Dec 7.
    Pediatric Respiratory Medicine, Dept of Pediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
    Lung function tests are commonly used to monitor lung disease in cystic fibrosis (CF). While practical, they cannot locate the exact origin of functional impairment. Contemporary magnetic resonance imaging (MRI) techniques provide information on the location of disease but the need for contrast agents constrains their repeated application. Read More

    Which Nebulizer Position Should Be Avoided? An Extended Study of Aerosol Delivery and Ventilator Performance during Noninvasive Positive Pressure Ventilation.
    Respiration 2017 Dec 6. Epub 2017 Dec 6.
    Background: Research on the effect of nebulizer location on aerosol delivery during noninvasive ventilation has reached inconsistent conclusions.

    Objective: To investigate the effects of nebulizer position on aerosol delivery efficiency and ventilator performance during noninvasive ventilation.

    Methods: The Active Servo Lung 5000 respiratory simulation system (ASL5000) was used to simulate a COPD patient. Read More

    Respiratory Volume Monitoring Reduces Hypoventilation and Apnea in Subjects Undergoing Procedural Sedation.
    Respir Care 2017 Dec 5. Epub 2017 Dec 5.
    The University of Texas Medical Branch at Galveston, Galveston, Texas.
    Introduction: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group. Read More

    Neurally Adjusted Ventilatory Assist After Pediatric Cardiac Surgery: Clinical Experience and Impact on Ventilation Pressures.
    Respir Care 2017 Dec 5. Epub 2017 Dec 5.
    Pediatric Intensive Care Unit, CHU Sainte-Justine, Université de Montréal, Montréal, Québec, Canada.
    Introduction: After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. Read More

    Home Mechanical Ventilation: A 12-Year Population-Based Retrospective Cohort Study.
    Respir Care 2017 Dec 5. Epub 2017 Dec 5.
    Institute for Clinical Evaluative Sciences, the Department of Medicine, Sunnybrook Health Sciences Centre, and the Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
    Background: Increasing numbers of individuals are being initiated on home mechanical ventilation, including noninvasive (bi-level) and invasive mechanical ventilation delivered via tracheostomy due to chronic respiratory failure to enable symptom management and promote quality of life. Given the high care needs of these individuals, a better understanding of the indications for home mechanical ventilation, and health-care utilization is needed.

    Methods: We performed a retrospective cohort study using provincial health administrative data from Ontario, Canada (population ∼13,000,000). Read More

    Face mask leak with nasal cannula during noninvasive positive pressure ventilation: A randomized crossover trial.
    Am J Emerg Med 2017 Dec 2. Epub 2017 Dec 2.
    Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, Fort Sam Houston, TX, United States.
    Background: Nasal cannula can achieve apneic oxygenation during emergency intubation. However, pre-procedure nasal cannula placement may be difficult in patients undergoing non-invasive positive pressure ventilation (NPPV) prior to intubation. Our objective was to compare mask leak during NPPV with versus without simultaneous application of nasal cannula. Read More

    Standardization of Pediatric Interfacility Transport Handover: Measuring the Development of a Shared Mental Model.
    Pediatr Crit Care Med 2017 Dec 4. Epub 2017 Dec 4.
    Division of Pediatric Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL.
    Objectives: To determine if standardization of pediatric interfacility transport handover is associated with the development of a prototypical shared mental model between healthcare providers.

    Design: A single center, prepost, retrospective cohort study.

    Settings: A 259-bed, tertiary care, pediatric referral center. Read More

    Electrical impedance tomography in children with community acquired pneumonia: preliminary data.
    Respir Med 2017 Sep 4;130:9-12. Epub 2017 Jul 4.
    Pediatric Emergency Department, IRCCS Foundation Cà Granda, Ospedale Maggiore Policlinico, Clinica De Marchi, University of Milan, Italy.
    Background: Electrical impedance tomography (EIT) is a noninvasive pulmonary function test that provides spatial and temporal information of changes in regional lung ventilation. We aimed to assess the feasibility of EIT as a supplementary tool in the evaluation of community acquired pneumonia in children. Furthermore, we performed a prospective evaluation of regional lung ventilation changes during a six-month follow-up period. Read More

    Risk Trajectories of Readmission and Death in the First Year Following Hospitalization for COPD.
    Am J Respir Crit Care Med 2017 Dec 5. Epub 2017 Dec 5.
    Yale University School of Medicine, 12228, Internal Medicine, New Haven, Connecticut, United States.
    Rationale Characterizing the dynamic nature of post-hospital risk in COPD is needed to provide counseling and plan clinical services. Objectives To analyze risk of readmission and death among Medicare beneficiaries >=65 years following discharge for COPD, and to determine the association between ventilator support and risk trajectory. Methods We computed daily absolute risks of hospital readmission and death for one year after discharge for COPD, stratified by ventilator support. Read More

    Perioperative management of gastrostomy tube placement in Duchenne muscular dystrophy adolescent and young adult patients: A role for a perioperative surgical home.
    Paediatr Anaesth 2018 Feb 5;28(2):127-133. Epub 2017 Dec 5.
    Department of Anesthesiology, Pain and Perioperative Medicine, Boston Children's Hospital, Boston, MA, USA.
    Background: In past decades, Duchenne muscular dystrophy patients have been living longer and as the disease advances, patients experience multisystemic deterioration. Older patients often require gastrostomy tube placement for nutritional support. For optimizing the perioperative care, a practice of multidisciplinary team can better anticipate, prevent, and manage possible complications and reduce the overall perioperative morbidity and mortality. Read More

    Efficacy of ventilator waveform observation for detection of patient-ventilator asynchrony during NIV: a multicentre study.
    ERJ Open Res 2017 Oct 4;3(4). Epub 2017 Oct 4.
    Dept of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
    The objective of this study was to assess ability to identify asynchronies during noninvasive ventilation (NIV) through ventilator waveforms according to experience and interface, and to ascertain the influence of breathing pattern and respiratory drive on sensitivity and prevalence of asynchronies. 35 expert and 35 nonexpert physicians evaluated 40 5-min NIV reports displaying flow-time and airway pressure-time tracings; identified asynchronies were compared with those ascertained by three examiners who evaluated the same reports displaying, additionally, tracings of diaphragm electrical activity. We determined: 1) sensitivity, specificity, and positive and negative predictive values; 2) the correlation between the double true index (DTI) of each report (i. Read More

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