31,881 results match your criteria Ventilator Management


Identification and Modulation of Microenvironment is Crucial for Effective MSC Therapy in Acute Lung Injury.

Am J Respir Crit Care Med 2018 Dec 6. Epub 2018 Dec 6.

The State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China, Critical Care Medicine, Guangzhou, Guangdong, China.

Rationale: There are controversial reports on applications of mesenchymal stromal cells (MSCs) in patients with acute respiratory distress syndrome (ARDS).

Objective: We hypothesized that lung microenvironment was the main determinant of beneficial versus detrimental effects of MSCs during ARDS.

Methods: Lung proteome was profiled in three models of injury induced by acid instillation and/or mechanical ventilation in mice. Read More

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December 2018
2 Reads

Weighing in on Ventilator Strategies.

Authors:
Jordan S Rettig

Pediatr Crit Care Med 2018 Dec;19(12):1179-1180

Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA.

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December 2018

Distribution and drug resistance of pathogenic bacteria in ventilator-associated pneumonia at a local hospital of North-eastern China.

Infect Drug Resist 2018 13;11:2249-2255. Epub 2018 Nov 13.

Department of Emergency, Shengjing Hospital Affiliated to China Medical University, Heping District, Shenyang, Liaoning Province 110004, People's Republic of China,

Purpose: To study the distribution of pathogenic bacteria in ventilator-associated pneumonia (VAP), and epidemiological characteristics of extended-spectrum β lactamase (ESBL)-producing bacteria.

Patients And Methods: Lower respiratory tract secretions from 156 patients with mechanical ventilation were collected using a protective specimen brush (PSB), with quantitative bacterial culture carried out and antibiotic sensitivity measured. ESBLs produced by Gram-negative bacilli were detected using the double disk diffusion method and monitored by plasmid profiles. Read More

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November 2018

Adult With Mutation and Late-Onset Congenital Central Hypoventilation Syndrome.

J Clin Sleep Med 2018 Nov 29. Epub 2018 Nov 29.

Abstract: 20/27 polyalanine repeat mutation (PARM) in patients with congenital central hypoventilation syndrome (CCHS) is generally associated with full-time ventilator dependence, Hirschsprung disease, and increased risk for cardiac asystole. We follow a 14-year-old boy with CCHS 20/27 PARM who is full-time ventilator dependent via tracheostomy and has Hirschsprung disease. His mother, age 52 years, has a history of prolonged recovery from anesthesia and an elevated serum bicarbonate level of 45 mEq/L discovered on routine blood chemistry. Read More

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November 2018

Didn't inhale? Time to reconsider aerosolized antibiotics in the treatment of ventilator-associated pneumonia.

Crit Care 2018 Dec 5;22(1):333. Epub 2018 Dec 5.

Division of Infectious Diseases, Department of Medicine, University of Nebraska Medical Center, 985400 Nebraska Medical Center, Omaha, NE, 68135, USA.

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December 2018

Detecting Early Markers of Ventilator-Associated Pneumonia by Analysis of Exhaled Gas.

Crit Care Med 2018 Nov 30. Epub 2018 Nov 30.

Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany.

Objectives: The detection of microbial volatile organic compounds or host response markers in the exhaled gas could give an earlier diagnosis of ventilator-associated pneumonia. Gas chromatography-ion mobility spectrometry enables noninvasive, rapid, and sensitive analysis of exhaled gas. Using a rabbit model of ventilator-associated pneumonia we determined if gas chromatography-ion mobility spectrometry is able to detect 1) ventilator-associated pneumonia specific changes and 2) bacterial species-specific changes in the exhaled gas. Read More

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November 2018

Nursing Oral Suction Intervention to Reduce Aspiration and Ventilator Events (NO-ASPIRATE): A Randomized Clinical Trial.

J Adv Nurs 2018 Dec 3. Epub 2018 Dec 3.

Orlando Health, Orlando, FL.

Aim: The primary aim of this study is to compare an oropharyngeal suction intervention versus usual care on microaspiration in intubated patients. Secondary aims are to evaluate the intervention on ventilator associated condition rates, time to occurrence and compare tracheal-oral α-amylase ratios between groups.

Design: Prospective randomized clinical trial. Read More

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December 2018

Unintentional endotracheal tube cuff deflation during routine checks: a simulation study.

Nurs Crit Care 2018 Dec 2. Epub 2018 Dec 2.

The Critical Care Department, The Queen Elizabeth Hospital, King's Lynn, UK.

Background: Endotracheal tube cuff pressures should be maintained between 20 and 30 cm H O to prevent the aspiration of subglottic secretions past the cuff. Guidance recommends regular monitoring of the cuff pressure, performed using a handheld manometer/inflator. Poor technique can lead to transient deflation of the cuff, leading to the bolus aspiration of upper respiratory tract secretions, tracheal colonization and, ultimately, ventilator-associated pneumonia. Read More

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December 2018

Outcomes after Lung Transplantation for Patients with Occupational Lung Diseases.

Clin Transplant 2018 Dec 2:e13460. Epub 2018 Dec 2.

Division of Lung Failure and Lung Transplantation, Lewis Katz School of Medicine at Temple University, Philadelphia, PA.

Occupational lung diseases (OLD) including silicosis, asbestosis, and pneumoconiosis progress to end stage lung disease requiring lung transplantation (LT). Prognosis and treatment of OLDs are poorly understood and a paucity of data exists regarding LT outcomes. Additionally, transplant operative complexity for patients with OLD is high. Read More

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December 2018
3 Reads

Functional status at listing predicts waitlist and post-transplant mortality in pediatric liver transplant candidates.

Am J Transplant 2018 Dec 1. Epub 2018 Dec 1.

Department of Medicine, UCSF, San Francisco, CA, USA.

Functional impairment is associated with mortality in adult liver transplant candidates. This has not been studied in pediatric liver transplant candidates. UNOS STAR files were used to investigate functional status, waitlist mortality, and post-transplant outcomes in children<18, listed 2006-16 for primary liver transplant. Read More

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December 2018

Unusual Case of Plastic Bronchitis Presenting with Pneumopericardium.

Am J Case Rep 2018 Dec 3;19:1434-1436. Epub 2018 Dec 3.

Department of Internal Medicine, Wayne State University, Rochester Hills, MI, USA.

BACKGROUND Lymphatic circulation in the thorax enters the systemic blood flow at the subclavian vein. Instances where diversion occurs leads to complications such as pleural effusion. A rare complication of lymphatic diversion results in fluid accumulation in the bronchial tree, causing plastic bronchitis. Read More

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December 2018

Phrenic nerve stimulation for diaphragmatic pacing in chronic ventilator-dependent patients.

Neurol India 2018 Nov-Dec;66(6):1834-1837

Department of Neurosurgery, Institute of Neurosciences, Medanta The Medicity, Gurugram, Haryana, India.

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December 2018

Interprofessional Approach to the Sustained in a Pediatric Intensive Care Unit.

Crit Care Nurse 2018 Dec;38(6):36-45

Cheryl Lynne McBeth is a nurse manager for the pediatric intensive care unit (PICU), pediatric cardiac intensive care unit (PCICU), and Critical Care Transport Team, University of California, Davis, Children's Hospital, Sacramento, California. Rosa Solis Montes is clinical nurse III, University of California, Davis, Children's Hospital. She has been the cochair or chair of the No VAP committee since 2010. Amy Powne is Fetal Care and Treatment Center registered nurse coordinator at University of California, Davis, Children's Hospital. Sopon Elizabeth North is clinical nurse III, University of California, Davis, Children's Hospital. She currently is chair of the PICU/PCICU Hospital-Acquired Infection Committee. JoAnne E. Natale is professor of clinical pediatrics, Pediatric Critical Care, Children's Hospital Quality & Safety, and director of quality and safety, University of California, Davis, Medical Center.

Background: Ventilator-associated pneumonia (VAP) increases morbidity, mortality, and health care costs.

Objective: To reduce the VAP rate in the pediatric/cardiac intensive care unit to fewer than 2 events per 1000 ventilator days within 2 years and to sustain a rate near 0 for the next 5 years.

Methods: An evidence-based VAP prevention bundle was developed and implemented by an interprofessional team using the Six Sigma Define, Measure, Analyze, Improve, Control methodology. Read More

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December 2018

Health, Physical Growth, and Neurodevelopmental Outcomes in Preterm Infants of Women With Hypertensive Disorders of Pregnancy.

J Obstet Gynecol Neonatal Nurs 2018 Nov 28. Epub 2018 Nov 28.

Objective: To compare the health, physical growth, and developmental outcomes in preterm infants of women with and without hypertensive disorders of pregnancy (HDP).

Design: Cross-sectional analysis of health outcomes; physical growth (head circumference, height, and weight) collected at birth and 2 months, corrected for prematurity; and cognitive, language, and motor skills of preterm infants of women with and without HDP.

Setting: Four NICUs in the United States. Read More

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November 2018

The Effects of Missed Doses of Antibiotics on Hospitalized Patient Outcomes.

J Surg Res 2019 Jan 4;233:276-283. Epub 2018 Sep 4.

Division of Acute Care Surgery, Center for Translational Injury Research, Department of Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas. Electronic address:

Background: Missing doses of antibiotics in hospitalized patients is a well-described but inadequately recognized issue. We hypothesized that missing doses of antibiotics decreases quality of care.

Methods: Retrospective study on patients admitted to the Shock Trauma ICU from February to June 2015. Read More

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January 2019
2 Reads

Extracorporeal membrane oxygenation with prone position ventilation successfully rescues infantile pertussis: a case report and literature review.

BMC Pediatr 2018 Nov 30;18(1):377. Epub 2018 Nov 30.

Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University, No.355 Luding Road, Putuo District, Shanghai, 200062, China.

Background: Bordetella pertussis can cause fatal illness with severe acute respiratory distress syndrome (ARDS) and pulmonary hypertension (PHT).

Case Presentation: A 6-month-old non-vaccinated boy with B. pertussis infection who developed ARDS was treated by extracorporeal membrane oxygenation (ECMO). Read More

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November 2018

Components of the antepartum, intrapartum, and postpartum exposome impact on distinct short-term adverse neonatal outcomes of premature infants: A prospective cohort study.

PLoS One 2018 5;13(12):e0207298. Epub 2018 Dec 5.

Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, Connecticut, United states of America.

We aimed to test the hypothesis that determinants of the perinatal clinical exposome related to the underlying etiology of premature birth (PTB) impact differently on select neonatal outcomes. We conducted a prospective longitudinal study of 377 singleton preterm neonates [gestational age (GA) at birth: 23-34 weeks] separated into three distinct contemporaneous newborn cohorts: i) spontaneous PTB in the setting of intra-amniotic infection/inflammation (yes-IAI, n = 116); ii) spontaneous PTB in the absence of IAI (no-IAI, n = 130), and iii) iatrogenic PTB for preeclampsia (iPTB-PE, n = 131). Newborns (n = 372) were followed until death or discharge. Read More

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December 2018
1 Read

Critical Care of Neuromuscular Disorders.

Continuum (Minneap Minn) 2018 Dec;24(6):1753-1775

Purpose Of Review: Weakness is a common reason patients are seen in neurologic consultation. This article reviews the differential diagnosis of neuromuscular disorders in the intensive care unit (ICU), discusses the intensive care needs and evaluation of respiratory failure in patients with neuromuscular disorders, and provides a practical guide for management.

Recent Findings: Although primary neuromuscular disorders used to be the most common cause for weakness from peripheral nervous system disease in the ICU, a shift toward ICU-acquired weakness is observed in today's clinical practice. Read More

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December 2018
1 Read

Recent advances in venovenous extracorporeal membrane oxygenation for severe acute respiratory distress syndrome.

Curr Opin Crit Care 2018 Nov 30. Epub 2018 Nov 30.

Sorbonne Université, INSERM, UMRS_1166-ICAN, Institute of Cardiometabolism and Nutrition.

Purpose Of Review: To summarize results of the most recent trials on venovenous extracorporeal membrane oxygenation (VV-ECMO) in severe acute respiratory distress syndrome (ARDS) and to elaborate on the unmet needs regarding VV-ECMO management in this setting.

Recent Findings: Although it was terminated early for futility (i.e. Read More

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November 2018

Maxillofacial Fractures Associated With Laryngeal Injury: A Craniofacial Surgeon Should be Alert.

Ann Plast Surg 2018 Dec 3. Epub 2018 Dec 3.

From the Departments of Plastic and Reconstructive Surgery and.

Objective: Maxillofacial fractures with concomitant laryngeal injuries put both the quality and maintenance of life in jeopardy. Because of its low incidence, it is often overlooked in the clinical setting. The purpose of this study is to review the incidence, clinical presentations, managements, and outcomes of these patients. Read More

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December 2018

Predicting Patient-ventilator Asynchronies with Hidden Markov Models.

Sci Rep 2018 Dec 4;8(1):17614. Epub 2018 Dec 4.

Critical Care Center, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain.

In mechanical ventilation, it is paramount to ensure the patient's ventilatory demand is met while minimizing asynchronies. We aimed to develop a model to predict the likelihood of asynchronies occurring. We analyzed 10,409,357 breaths from 51 critically ill patients who underwent mechanical ventilation >24 h. Read More

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December 2018
1 Read

Invasive Mechanical Ventilation.

South Med J 2018 Dec;111(12):746-753

From the Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Invasive mechanical ventilation is a potentially lifesaving intervention for acutely ill patients. The goal of this review is to provide a concise, clinically focused overview of basic invasive mechanical ventilation for the many clinicians who care for mechanically ventilated patients. Attention is given to how common ventilator modes differ in delivering a mechanical breath, evaluation of respiratory system mechanics, how to approach acute changes in airway pressure, and the diagnosis of auto-positive end-expiratory pressure. Read More

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December 2018
4 Reads

Home Health Care Availability and Discharge Delays in Children With Medical Complexity.

Pediatrics 2018 Dec 3. Epub 2018 Dec 3.

Children's Minnesota, Minneapolis, Minnesota.

: media-1vid110.1542/5849572914001PEDS-VA_2018-1951 BACKGROUND: An increasing proportion of pediatric hospital days are attributed to technology-dependent children. The impact that a pediatric home care nursing (HCN) shortage has on increasing length of hospital stay and readmissions in this population is not well documented. Read More

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December 2018
7 Reads

Devising negative pressure within intercuff space reduces microaspiration.

BMC Anesthesiol 2018 Dec 3;18(1):181. Epub 2018 Dec 3.

Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.

Background: Microaspiration past the tracheal tube cuffs causes ventilator-associated pneumonia. The objective of the current study was to evaluate whether creating negative pressure between the tracheal double cuffs could block the fluid passage past the tracheal tube cuffs.

Methods: A new negative pressure system was devised between the double cuffs through a suction hole in the intercuff space. Read More

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December 2018

Effectiveness of intrahospital transportation of mechanically ventilated patients in medical intensive care unit by the rapid response team: A cohort study.

Medicine (Baltimore) 2018 Nov;97(48):e13490

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine.

Critically ill patients could experience various risks including life-threatening events during intrahospital transportation (IHT), with a global incidence of 20% to 79.8%. Evidence on the clinical benefits of the presence of specialized intensive care members such as the rapid response team (RRT) during their transportation is limited. Read More

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November 2018
2 Reads

Mesalazine-related lung disease in a patient with ulcerative colitis: A case report.

Medicine (Baltimore) 2018 Nov;97(48):e13242

Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital.

Rationale: Mesalazine is widely used to treat inflammatory bowel disease (IBD). However, discriminating between pulmonary manifestations of IBD and drug-related lung disease remains a challenge. There were few case reports of mesalazine-related organizing pneumonia so far. Read More

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November 2018
1 Read

Crystalloid fluid administration was associated with outcomes in pediatric patients with severe sepsis or septic shock.

Medicine (Baltimore) 2018 Nov;97(48):e12663

Department of Pediatric General Surgery and Liver Transplantation.

Intravenous fluid prescription plays an important role in sepsis management, which may be associated with patient prognosis. The objective of the present study was to determine if the administration of crystalloid fluids is associated with clinical outcome for patients with severe sepsis and septic shock.The medical records of 79 patients with severe sepsis or septic shock at an academic tertiary care hospital between 2011 and 2016 were reviewed retrospectively. Read More

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November 2018

High-intensity non-invasive ventilation in stable hypercapnic COPD: Evidence of efficacy and practical advice.

Respirology 2018 Nov 30. Epub 2018 Nov 30.

Department of Pulmonary Diseases/Home Mechanical Ventilation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Patients with end-stage chronic obstructive pulmonary disease (COPD) frequently develop chronic hypercapnic respiratory failure (CHRF), with disabling symptoms and poor survival. The use of long-term nocturnal non-invasive ventilation (NIV) to treat CHRF in COPD has long been subject of debate due to conflicting evidence. However, since the introduction of high-intensity NIV (HI-NIV) in COPD, physiological and clinical benefits have been shown. Read More

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November 2018

The Effects of Oral Care Protocol on the Incidence of Ventilation-Associated Pneumonia in Selected Intensive Care Units in Jordan.

Dimens Crit Care Nurs 2019 Jan/Feb;38(1):5-12

Mahmoud Ali Alja'afreh, RN, PhD, is an assistant professor, vice dean, and head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Mutah, Karak, Jordan. His research interest is focused on four major areas: (1) studying of patient and family satisfaction in acute and critical care settings; (2) use of local resources to develop student center knowledge about disaster education; (3) development of patient safety guidelines for pressure ulcers patients, mechanically ventilated patients, and critical care practices issues; and (4) reshaping and enforcement of structures, processes, and outcomes of risk assessment, and management of pressure ulcers patients and critical care/cancer patients. Sultan Mosleh, RN, PhD, is an associate professor and a former head of the Adult Health Nursing Department, Faculty of Nursing, Mutah University, Jordan. His research interest is focused on four major areas: (1) critical care environment issues for patients and staff; (2) palliative care and end-of-life care of cancer patients; (3) clinical cardiac patients' rehabilitation; and (4) patient and nursing education. Sakhaa S. Habashneh, RN, MsN, is a lecturer at the Department of Adult Health Nursing, Faculty of Nursing, University of Mutah, Mutah, Karak, Jordan. Her research interest is focused on four major areas: (1) clinical critical nursing issues; (2) knowledge and compliances of critical care units' staff; and (3) patient and nursing education.

Purpose: This study aims to evaluate the effects of oral care protocol on the incidence of ventilator-associated pneumonia (VAP) at selected intensive care units (ICUs) in Jordan using clinical pulmonary infection score.

Methods: A quasi-experimental design was used, and 1 large teaching hospital from the Jordanian capital, along with 2 hospitals from the southern region, was selected. A total of 218 patients participated, among which VAP risk in 2 independent groups was evaluated through the Clinical Pulmonary Infection Score sheet. Read More

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December 2018
3 Reads

Validation of a new WIND classification compared to ICC classification for weaning outcome.

Ann Intensive Care 2018 Nov 29;8(1):115. Epub 2018 Nov 29.

Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Republic of Korea.

Background: Although the WIND (Weaning according to a New Definition) classification based on duration of ventilation after the first separation attempt has been proposed, this new classification has not been tested in clinical practice. The objective of this cohort study was to evaluate the clinical relevance of WIND classification and its association with hospital mortality compared to the International Consensus Conference (ICC) classification.

Methods: All consecutive medical ICU patients who were mechanically ventilated for more than 24 h between July 2010 and September 2013 were prospectively registered. Read More

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November 2018
3 Reads

Comparison of branded rugby headguards on their effectiveness in reducing impact on the head.

BMJ Open Sport Exerc Med 2018 25;4(1):e000361. Epub 2018 Oct 25.

Institute of Motion Analysis Research (IMAR), Department of Orthopaedic and Trauma Surgery, TORT Centre, Ninewells Hospital & Medical School, University of Dundee, Dundee, Scotland.

Aim: To compare the available brands of rugby headguards and evaluate their impact attenuation properties at various locations on the cranium, with regard to concussion prevention.

Methods: Seven different branded headguards were fitted onto a rigid headform and drop-tested in three different positions. An accelerometer measured the linear acceleration the headform experienced on impact with the ground. Read More

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October 2018

Clinico-microbiological profile of healthcare associated pneumonia in critically ill patients at level-I trauma centre of India.

J Lab Physicians 2018 Oct-Dec;10(4):406-409

Division of Trauma Surgery and Critical Care, JPNATC, AIIMS, New Delhi, India.

Introduction: Device-associated infections constitute the majority of health-care infections in Intensive Care Units (ICUs). Trauma patients are more prone to acquire such infections; ventilator-associated pneumonia (VAP) being the most common Health care associated infections (HAI) in ICU has serious implications such as increased morbidity, prolonged hospital stay, and mortality. This study aims to compare the clinicomicrobiological profile of VAP and non-VAP trauma patients at Level I trauma center. Read More

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December 2018

Mitigating respiratory motion in radiotherapy: rapid, shallow, non-invasive mechanical ventilation for internal thoracic targets.

Int J Radiat Oncol Biol Phys 2018 Nov 26. Epub 2018 Nov 26.

Department of Radiotherapy Physics, Northern Centre for Cancer Care, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.

Purpose: Reducing respiratory motion during the delivery of radiotherapy reduces the volume of healthy tissues irradiated and may decrease radiation induced toxicity. The purpose of this study was to assess the potential for rapid shallow non-invasive mechanical ventilation to reduce internal anatomy motion for radiotherapy purposes.

Material And Methods: Ten healthy volunteers (age 22-54years; mean 38years; 6 female and 4 male) were scanned on an MR scanner during normal breathing and at 2 ventilator induced frequencies; 20 and 25 breaths per minute for 3 minutes. Read More

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November 2018
1 Read

Longitudinal assessment of cerebral perfusion and vascular response to hypoventilation in a bigenic mouse model of Alzheimer's disease with amyloid and tau pathology.

NMR Biomed 2018 Nov 29:e4037. Epub 2018 Nov 29.

Biomedical MRI/MoSAIC, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium.

Alzheimer's disease is the most common neurodegenerative disease, and many patients also present with vascular dysfunction. In this study, we aimed to assess cerebral blood flow (CBF) and cerebrovascular response (CVR) as early, pre-symptomatic (3 months of age), imaging markers in a bigenic model of Alzheimer's disease (APP.V717IxTau. Read More

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November 2018

Interventions for preventing intensive care unit delirium in adults.

Cochrane Database Syst Rev 2018 Nov 23;11:CD009783. Epub 2018 Nov 23.

The Neuroscience Centre, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark, 2100.

Background: Delirium is defined as a disturbance in attention, awareness and cognition with reduced ability to direct, focus, sustain and shift attention, and reduced orientation to the environment. Critically ill patients in the intensive care unit (ICU) frequently develop ICU delirium. It can profoundly affect both them and their families because it is associated with increased mortality, longer duration of mechanical ventilation, longer hospital and ICU stay and long-term cognitive impairment. Read More

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November 2018
4 Reads

Congenital diaphragmatic hernia repair in patients on extracorporeal membrane oxygenation: How early can we repair?

J Pediatr Surg 2018 Oct 5. Epub 2018 Oct 5.

Baylor College of Medicine, Michael E. DeBakey Department of Surgery, Houston, TX, USA; Texas Children's Hospital, Department of Pediatric Surgery, Houston, TX, USA. Electronic address:

Background: The benefits to early repair (<72 h postcannulation) of infants with congenital diaphragmatic hernia (CDH) on extracorporeal membrane oxygenation (ECMO) are increasingly recognized. Yet it is not known if even earlier repair (<24 h) results in comparable or improved patient outcomes. The goal of this study was to compare "super-early" (<24 h) to early repair (24-72 h) of CDH patients on ECMO. Read More

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October 2018

Comparison of non-invasive to invasive oxygenation ratios for diagnosing acute respiratory distress syndrome following coronary artery bypass graft surgery: a prospective derivation-validation cohort study.

J Cardiothorac Surg 2018 Nov 27;13(1):123. Epub 2018 Nov 27.

Department of Emergency Medicine, Vident Medical Center, East Carolina University Brody School of Medicine, 600 Moye Blvd, Greenville, NC, 27834, USA.

Objective: To determine if non-invasive oxygenation indices, namely peripheral capillary oxygen saturation (SO)/fraction of inspired oxygen (FO) and partial pressure of alveolar oxygen (PO)/FO may be used as effective surrogates for the partial pressure of arterial oxygen (PO)/FO. Also, to determine the SO/FO and PO/FO values that correspond to PO/FO thresholds for identifying acute respiratory distress syndrome (ARDS) in patients following coronary artery bypass graft (CABG) surgery.

Methods: A prospective derivation-validation cohort study in the Open-Heart ICU of an academic teaching hospital. Read More

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November 2018
1.020 Impact Factor

A Comparison of Early, Late, and No Treatment of Intensive Care Unit Delirium With Antipsychotics: A Retrospective Cohort Study.

Prim Care Companion CNS Disord 2018 Nov 15;20(6). Epub 2018 Nov 15.

Brigham and Women's Hospital, Boston, Massachusetts, USA.

Objective: To investigate the effect of early versus late versus no antipsychotic administration on intensive care unit (ICU) delirium.

Methods: This retrospective cohort study was conducted in 2 adult medical ICUs at a single tertiary care center in Boston, Massachusetts, from October 1, 2015, to May 31, 2016. The study included 322 patients stratified into those who first received antipsychotics < 48 hours after first positive or unscorable (due to sedation) modified Confusion Assessment Method (CAM-ICU-m) (early), > 48 hours after first positive or unscorable CAM-ICU-m (late), and never received antipsychotics. Read More

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November 2018
2 Reads

Differences in hospital outcomes following traumatic injury for patients experiencing immediate transfer to a level I trauma facility versus resuscitation at a critical access hospital (CAH).

Am J Surg 2018 Nov 14. Epub 2018 Nov 14.

Department of Surgery, The University of Kansas School of Medicine - Wichita, Wichita, KS, USA; Trauma Services, Via Christi Hospital Saint Francis, Wichita, KS, USA. Electronic address:

Background: Critical access hospitals (CAH) serve a key role in providing medical care to rural patients. The purpose of this study was to assess effectiveness of CAHs in initial care of trauma patients.

Methods: A 5-year retrospective review was conducted of all adult trauma patients who were transported directly to a level I trauma facility or were transported to a CAH then transferred to a level I trauma facility after initial resuscitation. Read More

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November 2018

Intrapulmonary pharmacokinetics of antibiotics used to treat nosocomial pneumonia caused by gram-negative bacilli: a systematic review.

Int J Antimicrob Agents 2018 Nov 22. Epub 2018 Nov 22.

Centre for Translational Anti-Infective Pharmacodynamics, School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland 4006, Australia.

Background: . Knowledge of antibiotic concentrations achievable in the epithelial lining fluid (ELF) will help guide antibiotic dosing for treating patients with gram-negative bacillary ventilator-associated pneumonia (VAP).

Objective: . Read More

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November 2018
4 Reads

Polymyxin B hemoperfusion in endotoxemic septic shock patients without extreme endotoxemia: a post hoc analysis of the EUPHRATES trial.

Intensive Care Med 2018 Dec 23;44(12):2205-2212. Epub 2018 Nov 23.

Fondazione Policlinico Universitario A. Gemelli IRCCS-Universitá Cattolica del Sacro Cuore, Rome, Italy.

Purpose: The EUPHRATES trial examined the impact of polymyxin B hemoperfusion (PMX) on mortality in patients with septic shock and endotoxemia, defined as EAA ≥ 0.60. No difference was found in 28-day all-cause mortality. Read More

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December 2018
9 Reads

Risk factors and Associated Complications with Symptomatic Venous Thromboembolism in Patients with Craniotomy for Meningioma.

World Neurosurg 2018 Nov 20. Epub 2018 Nov 20.

Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY. Electronic address:

Objective: Patients undergoing surgical resection of meningioma are at increased risk for developing venous thromboembolism (VTE). The primary aim of this study was to assess the occurrence of VTE in patients who underwent surgery to remove their meningioma, and to determine the risk factors and associated complications with VTE.

Methods: The American College of Surgeons(ACS) National Surgical Quality Improvement Project (NSQIP) database from 2012-2015 was reviewed for patients who had undergone meningioma resection according to their primary Current Procedural Terminology codes and International Classification of Diseases, Ninth Revision. Read More

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November 2018
3 Reads
2.420 Impact Factor

Pediatric continuity care intensivist: A randomized controlled trial.

Contemp Clin Trials 2018 Nov 20;76:72-78. Epub 2018 Nov 20.

Children's Hospital of Philadelphia, Philadelphia, PA, United States.

Introduction: Long-stay critically ill patients in the Pediatric Intensive Care Unit (PICU) may be at risk for inconsistencies in treatment plan, delay in plan progression, and patient/family dissatisfaction with communication. This article describes the development and evaluation of an intervention designed to improve continuity and communication delivered by continuity PICU attendings.

Methods And Analysis: A randomized controlled trial of an intervention in one PICU that was randomized at the patient level. Read More

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November 2018
1 Read

Effects of Human Interleukin-10 on Ventilator-Associated Lung Injury in Rats.

Inflammation 2018 Nov 22. Epub 2018 Nov 22.

Department of Anesthesiology, the First Hospital of Fujian Medical University, Fuzhou, 350005, China.

Ventilator-induced lung injury (VILI) is one of the most serious complications of mechanical ventilation (MV) and can increase the mortality of patients with acute respiratory distress syndrome (ARDS). This work aimed to test the hypothesis that the anti-inflammatory properties of human interleukin-10 (hIL-10) can reduce VILI. Thirty-six healthy male Sprague-Dawley rats were randomly assigned into three groups (n = 12) as follows: a control group, a VILI group, and a hIL-10 group. Read More

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November 2018
4 Reads

Supportive Care of Patients on Mechanical Ventilation.

Respir Care 2018 Dec;63(12):1567-1574

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

The paradigm of supportive care of patients who are critically ill has changed significantly over the past 20 years. Patients on mechanical ventilation are no longer heavily sedated; the goal is a comfortable patient who can interact with health-care professionals and with their family members. Systematic, regular assessment of the patient for pain, anxiety, and sleep deprivation allows early recognition of these distressing symptoms. Read More

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December 2018
12 Reads

A New Formula for Predicting the Fraction of Delivered Oxygen During Low-Flow Oxygen Therapy.

Respir Care 2018 Dec;63(12):1528-1534

Institut de Recherche Experimentale et Clinique (IREC), Pole de Pneumologie, ORL & Dermatologie, Service de Pneumologie, Universite Catholique de Louvain, Brussels, Belgium.

Background: During O therapy at low flow in patients who breathe spontaneously, the fraction of delivered O (F ) is unknown. In recent years, F prediction formulas have been proposed. However, they do not take into account the effect of inspiratory flow (V̇) on the F . Read More

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December 2018
1 Read

Minimally invasive drainage in critically ill patients with severe necrotizing pancreatitis is associated with better outcomes: an observational study.

Crit Care 2018 Nov 22;22(1):321. Epub 2018 Nov 22.

Sorbonne University, Department of Anesthesiology and Critical Care Medicine, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.

Background: Infected pancreatic necrosis, which occurs in about 40% of patients admitted for acute necrotizing pancreatitis, requires combined antibiotic therapy and local drainage. Since 2010, drainage by open surgical necrosectomy has been increasingly replaced by less invasive methods such as percutaneous radiological drainage, endoscopic necrosectomy, and laparoscopic surgery, which proved effective in small randomized controlled trials in highly selected patients. Few studies have evaluated minimally invasive drainage methods used under the conditions of everyday hospital practice. Read More

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November 2018
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ECMO improves survival following cardiogenic shock due to carbon monoxide poisoning - an experimental porcine model.

Scand J Trauma Resusc Emerg Med 2018 Nov 22;26(1):103. Epub 2018 Nov 22.

Department of Cardiothoracic Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.

Background: Severe intoxication with carbon monoxide (CO) is extremely lethal and causes numerous deaths due to cardiac or respiratory failure. Conventional intensive treatment may not be sufficient. The aim of this study was to investigate the treatment effect of extracorporeal veno-arterial extracorporeal membrane oxygenation (ECMO) following severe CO poisoning in an experimental porcine model. Read More

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November 2018
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