5,985 results match your criteria Ventilator Management


National Approach to Standardize and Improve Mechanical Ventilation.

Ann Thorac Med 2019 Apr-Jun;14(2):101-105

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

NASAM (National Approach to Standardize and Improve Mechanical Ventilation) is a national collaborative quality improvement project in Saudi Arabia. It aims to improve the care of mechanically ventilated patients by implementing evidence-based practices with the goal of reducing the rate of ventilator-associated events and therefore reducing mortality, mechanical ventilation duration and intensive care unit (ICU) length of stay. The project plans to extend the implementation to a total of 100 ICUs in collaboration with multiple health systems across the country. Read More

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http://www.thoracicmedicine.org/text.asp?2019/14/2/101/25552
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http://dx.doi.org/10.4103/atm.ATM_63_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6467017PMC
April 2019
3 Reads

Nutrition During Targeted Temperature Management After Cardiac Arrest: Observational Study of Neurological Outcomes and Nutrition Tolerance.

JPEN J Parenter Enteral Nutr 2019 Apr 22. Epub 2019 Apr 22.

Médecine Intensive Réanimation, University Hospital Centre, Nantes, France.

Background: Whether providing nutrition support is beneficial or deleterious during targeted temperature management (TTM) after cardiac arrest is unclear. We therefore performed a retrospective observational study to determine whether early nutrition was beneficial or deleterious during TTM.

Methods: We retrospectively studied patients admitted to our intensive care unit (ICU) between 2008 and 2014 after successfully resuscitated cardiac arrest. Read More

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http://dx.doi.org/10.1002/jpen.1596DOI Listing

Drug Prevention and Control of Ventilator-Associated Pneumonia.

Front Pharmacol 2019 28;10:298. Epub 2019 Mar 28.

Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, Xi'an, China.

Ventilator-associated pneumonia (VAP) is one of the most prevalent and serious complications of mechanical ventilation, which is considered a common nosocomial infection in critically ill patients. There are some great options for the prevention of VAP: (i) minimize ventilator exposure; (ii) intensive oral care; (iii) aspiration of subglottic secretions; (iv) maintain optimal positioning and encourage mobility; and (v) prophylactic probiotics. Furthermore, clinical management of VAP depends on appropriate antimicrobial therapy, which needs to be selected based on individual patient factors, such as previous antibacterial therapy, history of hospitalization or mechanical ventilation, and bacterial pathogens and antibiotic resistance patterns. Read More

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http://dx.doi.org/10.3389/fphar.2019.00298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6455059PMC

Early-Onset Ventilator-Associated Pneumonia in Severe Traumatic Brain Injury: is There a Relationship with Prehospital Airway Management?

J Emerg Med 2019 Apr 15. Epub 2019 Apr 15.

Division of Anesthesia, Intensive Care, and Prehospital Emergency, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.

Background: Prehospital airway management in severe traumatic brain injury (TBI) is widely recommended by international guidelines for the management of trauma. Early-onset ventilator-associated pneumonia (EOVAP) is a common occurrence in this population and can worsen mortality and functional outcome.

Objectives: In this retrospective observational study, we aimed to evaluate the association between different prehospital airway management variables and the occurrence of EOVAP. Read More

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http://dx.doi.org/10.1016/j.jemermed.2019.02.005DOI Listing
April 2019
1.175 Impact Factor

Etorphine-Ketamine Constant Rate Infusion for Maintenance of Anaesthesia in a Compromised White Rhinoceros ().

Case Rep Vet Med 2019 12;2019:4309043. Epub 2019 Mar 12.

Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort 0110, South Africa.

A subadult white rhinoceros bull presented for oesophageal endoscopic evaluation and foreign body removal under general anaesthesia. The animal had a history of nasal and oral regurgitation of water and ingesta with weight-loss for 6 days prior to the procedure and had been diagnosed with oesophageal obstruction caused by a bailing wire. Anaesthesia was induced with intramuscular etorphine and azaperone delivered remotely by dart, followed by an intravenous bolus of ketamine. Read More

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http://dx.doi.org/10.1155/2019/4309043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434309PMC

In vitro study of antimicrobial activity on Klebsiella Pneumoniae biofilms in endotracheal tubes.

J Chemother 2019 Apr 16:1-7. Epub 2019 Apr 16.

a Intensive Care Unit, Hospital Universitario y Politécnico La Fe , Valencia , Spain.

Effective treatment approaches for biofilms in endotracheal tubes (ETTs) are lacking. In this study, we evaluated the in vitro effects of five antimicrobials against biofilms formed by Klebsiella pneumoniae in ETTs. K. Read More

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http://dx.doi.org/10.1080/1120009X.2019.1601801DOI Listing
April 2019
1 Read

Implementation of strategies to liberate patients from mechanical ventilation in a tertiary-level medical center.

Am J Infect Control 2019 Apr 12. Epub 2019 Apr 12.

Research Group of Surgery, Anesthesiology and Intensive Care, Medical Research Center Oulu, Oulu, Finland; Division of Intensive Care, Department of Anesthesiology, Oulu University Hospital, Oulu, Finland.

Background: Considerable discrepancies have been observed in the implementation of strategies to liberate patients from mechanical ventilation. The aim of this study was to describe critical care nurses' knowledge of and self-reported and documented adherence to lung-protective ventilation, daily sedation interruption, and daily assessment of readiness to extubate and evaluate how these practices differ between patients with and without ventilator-associated pneumonia and between survivors and nonsurvivors.

Methods: The survey was conducted in a tertiary-level hospital in Finland from October 2014 to June 2015. Read More

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http://dx.doi.org/10.1016/j.ajic.2019.03.010DOI Listing
April 2019
1 Read

Is hospital-acquired pneumonia different in transplant recipients?

Clin Microbiol Infect 2019 Apr 12. Epub 2019 Apr 12.

Infectious Diseases Department, Bellvitge University Hospital, IDIBELL, University of Barcelona, Spain; REIPI (Spanish Network for Research in Infectious Disease), Instituto de Salud Carlos III, Madrid, Spain. Electronic address:

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are serious complications in transplant patients.

Objectives: The aim of this review is to summarize the evidence regarding nosocomial pneumonia in transplant recipients, including HAP in non-ventilated patients and VAP, and to identify future directions for improvement.

Sources: A comprehensive literature search in the PubMed/MEDLINE database was performed. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S1198743X193015
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http://dx.doi.org/10.1016/j.cmi.2019.04.003DOI Listing
April 2019
2 Reads

Perioperative anesthesia management for pulmonary endarterectomy: Adopting an established European Protocol for the Asian Population.

Ann Card Anaesth 2019 Apr-Jun;22(2):169-176

Department of Anesthesiology, Singapore General Hospital, Singapore.

Background: Anesthesia for pulmonary endarterectomy (PEA) has always been one of the challenges of anesthesia. As one of the leading cardiothoracic institutions in Southeast Asia, our hospital has vast interest in this subject. A local multidisciplinary team was deployed to an expert center in the United Kingdom (UK), and the experience was then integrated to the care of our patients. Read More

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http://dx.doi.org/10.4103/aca.ACA_63_18DOI Listing
April 2019
1 Read

Barriers to the adoption of ventilator-associated events surveillance and prevention.

Authors:
Michael Klompas

Clin Microbiol Infect 2019 Apr 6. Epub 2019 Apr 6.

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA; Department of Medicine, Brigham and Women's Hospital, Boston, MA. Electronic address:

Background: The CDC expanded the purview of safety surveillance for ventilated patients from ventilator-associated pneumonia (VAP) to ventilator-associated events (VAE) in 2013. VAE definitions were created to simplify surveillance, increase objectivity, and broaden prevention efforts. Many U. Read More

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http://dx.doi.org/10.1016/j.cmi.2019.03.027DOI Listing
April 2019
1 Read

Influence of prevention of caffeine citrate on cytokine profile and bronchopulmonary dysplasia in preterm infants with apnea.

Minerva Pediatr 2019 Apr 5. Epub 2019 Apr 5.

Intensive Care Unit, Department of Neonatal, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China.

Background: This study aims to investigate the preventive effects of caffeine citrate on cytokine profile and bronchopulmonary dysplasia (BPD) in preterm infants with apnea.

Methods: Preterm infants with apnea who were born at less than 32 weeks of gestational age and Birth weight≤1500 g were randomly divided into caffeine citrate prevention group and caffeine citrate treatment group. Preterm infants in caffeine citrate prevention group who were at risk of developing recurrent apnea were given to caffeine citrate within 8 h after birth. Read More

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http://dx.doi.org/10.23736/S0026-4946.19.05428-8DOI Listing

The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol: a prospective, multi-center, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

Trials 2019 Apr 5;20(1):197. Epub 2019 Apr 5.

Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, USA.

Background: Sepsis accounts for 30% to 50% of all in-hospital deaths in the United States. Other than antibiotics and source control, management strategies are largely supportive with fluid resuscitation and respiratory, renal, and circulatory support. Intravenous vitamin C in conjunction with thiamine and hydrocortisone has recently been suggested to improve outcomes in patients with sepsis in a single-center before-and-after study. Read More

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http://dx.doi.org/10.1186/s13063-019-3254-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6451231PMC
April 2019
1 Read

Thromboelastography-guided therapy improves patient blood management and certain clinical outcomes in elective cardiac and liver surgery and emergency resuscitation: a systematic review and analysis.

J Thromb Haemost 2019 Apr 4. Epub 2019 Apr 4.

Department of Surgery, University of Colorado Denver, Denver, CO, USA.

Background: Thromboelastography (TEG 5000/6s Thrombelastograph Hemostasis Analyzer; Haemonetics , Braintree, MA) is a point-of-care system designed to monitor and analyze the entire coagulation process in real time. TEG -guided therapy has been shown to be valuable in a variety of surgical settings.

Objective: While guidelines recommend viscoelastic monitoring for the management of perioperative bleeding, there are no meta-analyses specifically evaluating the effects of TEG -guided transfusion on patient outcomes. Read More

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http://dx.doi.org/10.1111/jth.14447DOI Listing
April 2019
13 Reads

Thoracic trauma: a descriptive review of 4168 consecutive cases in East China.

Medicine (Baltimore) 2019 Apr;98(14):e14993

Department of Thoracic Surgery.

Thoracic trauma in China was scarcely reported. This study aimed to summarize the clinical profiles and to analyze the management approaches of patients with traumatic thoracic injury.Data for consecutive patients with thoracic trauma from January 2003 to January 2018 were retrospectively collected and analyzed. Read More

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http://dx.doi.org/10.1097/MD.0000000000014993DOI Listing
April 2019
3 Reads
5.723 Impact Factor

Requested withdrawal of mechanical ventilation in six patients with motor neuron disease.

BMJ Support Palliat Care 2019 Apr 3. Epub 2019 Apr 3.

Neurology, Royal Victoria Infirmary, Newcastle upon Tyne, UK.

Objectives: Mechanical ventilation (MV) has been shown to improve survival and quality of life in motor neuron disease (MND). However, during the progression of MND, there may come a point when MV is no longer felt appropriate. Association of Palliative Medicine Guidelines have been recently published to help clinicians withdraw MV at the request of patients with MND in a safe and compassionate manner to ensure that symptoms of distress and dyspnoea are minimised. Read More

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http://dx.doi.org/10.1136/bmjspcare-2017-001464DOI Listing
April 2019
4 Reads

Effect of Damage Control Laparotomy on Major Abdominal Complications and Lengths of Stay: a Propensity Score Matching and Bayesian Analysis.

J Trauma Acute Care Surg 2019 Apr 1. Epub 2019 Apr 1.

The University of Texas McGovern Medical School at Houston, Houston, Texas.

Background: In patients for whom surgical equipoise exists for damage control laparotomy (DCL) and definitive laparotomy (DEF), the effect of DCL and its associated resource utilization are unknown. We hypothesized that DEF would be associated with fewer abdominal complications and less resource utilization.

Methods: In 2016, 6 US Level 1 trauma centers performed a year-long, prospective, quality improvement project with the primary aim to safely decrease the use of DCL. Read More

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http://dx.doi.org/10.1097/TA.0000000000002285DOI Listing
April 2019
1 Read

Intravenous Iron Versus Placebo in the Management of Postoperative Functional Iron Deficiency Anemia in Patients Undergoing Cardiac Valvular Surgery: A Prospective, Single-Blinded, Randomized Controlled Trial.

J Cardiothorac Vasc Anesth 2019 Feb 8. Epub 2019 Feb 8.

Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.

Objective: To compare the efficacy of intravenous iron versus placebo to correct postoperative functional iron deficiency anemia in patients undergoing cardiac valvular surgery.

Design: A prospective, single-blinded, randomized controlled study.

Setting: National Center for Cardiovascular Diseases and a university hospital. Read More

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http://dx.doi.org/10.1053/j.jvca.2019.01.063DOI Listing
February 2019
2 Reads

Blunt trauma pelvic fracture-associated genitourinary and concomitant lower gastrointestinal injury: incidence, morbidity, and mortality.

World J Urol 2019 Mar 30. Epub 2019 Mar 30.

Department of Urology and Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Drive, 2nd floor, Chapel Hill, NC, USA.

Purpose: Limited data exist on the characteristics, risk factors, and management of blunt trauma pelvic fractures causing genitourinary (GU) and lower gastrointestinal (GI) injury. We sought to determine these parameters and elucidate independent risk factors.

Methods: The National Trauma Data Bank for years 2010-2014 was queried for pelvic fractures by ICD-9-CM codes. Read More

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http://dx.doi.org/10.1007/s00345-019-02725-7DOI Listing
March 2019
4 Reads

Development and validation of a semi-automated surveillance system-lowering the fruit for non-ventilator-associated hospital-acquired pneumonia (nvHAP) prevention.

Clin Microbiol Infect 2019 Mar 25. Epub 2019 Mar 25.

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zürich, University of Zurich, Zurich, Switzerland.

Objectives: Conducting manual surveillance of non-ventilator-associated hospital-acquired pneumonia (nvHAP) using ECDC (European Centre for Disease Prevention and Control) surveillance criteria is very resource intensive. We developed and validated a semi-automated surveillance system for nvHAP, and describe nvHAP incidence and aetiology at our hospital.

Methods: We applied an automated classification algorithm mirroring ECDC definition criteria to distinguish patients 'not at risk' from patients 'at risk' for suffering from nvHAP. Read More

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http://dx.doi.org/10.1016/j.cmi.2019.03.019DOI Listing
March 2019
1 Read

Creation of a Robust and Generalizable Machine Learning Classifier for Patient Ventilator Asynchrony.

Methods Inf Med 2018 Sep 24;57(4):208-219. Epub 2018 Sep 24.

Background: As healthcare increasingly digitizes, streaming waveform data is being made available from an variety of sources, but there still remains a paucity of performant clinical decision support systems. For example, in the intensive care unit (ICU) existing automated alarm systems typically rely on simple thresholding that result in frequent false positives. Recurrent false positive alerts create distrust of alarm mechanisms that can be directly detrimental to patient health. Read More

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http://dx.doi.org/10.3414/ME17-02-0012DOI Listing
September 2018
2 Reads

PO oscillations induce lung injury and inflammation.

Crit Care 2019 Mar 27;23(1):102. Epub 2019 Mar 27.

Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background: Mechanical ventilation can lead to ventilator-induced lung injury (VILI). In addition to the well-known mechanical forces of volutrauma, barotrauma, and atelectrauma, non-mechanical mechanisms have recently been discussed as contributing to the pathogenesis of VILI. One such mechanism is oscillations in partial pressure of oxygen (PO) which originate in lung tissue in the presence of within-breath recruitment and derecruitment of alveoli. Read More

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http://dx.doi.org/10.1186/s13054-019-2401-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438034PMC
March 2019
1 Read

NIV in amyotrophic lateral sclerosis: The 'when' and 'how' of the matter.

Respirology 2019 Mar 25. Epub 2019 Mar 25.

INSERM, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France.

Non-invasive ventilation (NIV) has become an essential part of the treatment of amyotrophic lateral sclerosis (ALS) since 2006. NIV very significantly improves survival, quality of life and cognitive performances. The initial NIV settings are simple, but progression of the disease, ventilator dependence and upper airway involvement sometimes make long-term adjustment of NIV more difficult, with a major impact on survival. Read More

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http://dx.doi.org/10.1111/resp.13525DOI Listing
March 2019
1 Read

Innovative management of severe tracheobronchomalacia using anterior and posterior tracheobronchopexy.

Laryngoscope 2019 Mar 25. Epub 2019 Mar 25.

Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital, Boston, Massachusetts, U.S.A.

Objectives/hypothesis: Combined anterior and posterior tracheobronchopexy is a novel surgical approach for the management of severe tracheobronchomalacia (TBM). We present our institutional experience with this procedure. Our objective was to determine the utility and safety of anterior and posterior tracheopexy in the treatment of severe TBM. Read More

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https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.27938
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http://dx.doi.org/10.1002/lary.27938DOI Listing
March 2019
10 Reads

Computational Modeling of Primary Blast Lung Injury: Implications for Ventilator Management.

Mil Med 2019 03;184(Suppl 1):273-281

Department of Anesthesia, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA.

Primary blast lung injury (PBLI) caused by exposure to high-intensity pressure waves is associated with parenchymal tissue injury and severe ventilation-perfusion mismatch. Although supportive ventilation is often required in patients with PBLI, maldistribution of gas flow in mechanically heterogeneous lungs may lead to further injury due to increased parenchymal strain and strain rate, which are difficult to predict in vivo. In this study, we developed a computational lung model with mechanical properties consistent with healthy and PBLI conditions. Read More

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http://dx.doi.org/10.1093/milmed/usy305DOI Listing
March 2019
2 Reads

Incidence and treatment of snakebites in West Bengal, India.

Toxicol Rep 2019 1;6:239-243. Epub 2019 Mar 1.

Department of Human Physiology with Community Health, Vidyasagar University, Paschim Medinipur, 721102, West Bengal, India.

Objective: Snake envenomation is a major cause of death and disability in the developing countries. In India and neighboring countries, the four venomous snakes of concern include - Indian cobra(, Common Krait (); Russell's Viper (); Saw Scaled Viper (). We describe the management protocol for snakebite treatment in a tertiary care hospital of district, West Bengal based on case reports of subjects admitted and treated in Ghatal Subdivisional Hospital(GSH) during 2013-2016. Read More

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http://dx.doi.org/10.1016/j.toxrep.2019.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6409390PMC
March 2019
2 Reads

A Case of Pneumomediastinum and Pneumoperitoneum with Concurrent Massive Subcutaneous Emphysema due to Repositioning of a Tracheostomy Tube.

Cureus 2019 Jan 14;11(1):e3881. Epub 2019 Jan 14.

Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.

Tracheostomy is a common procedure seen in critically ill patients that require long term ventilatory support. As with all airway access procedures, tracheotomy with prolonged tracheal tube placement comes with possible risks such as tracheal scarring, tracheal rupture, pneumothorax, tracheoesophageal fistula among others. Another possible complication, though rare, is escape of free air into the surrounding tissue, as well as pneumomediastinum (PM). Read More

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http://dx.doi.org/10.7759/cureus.3881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420328PMC
January 2019
1 Read

ABCDE and ABCDEF care bundles: A systematic review protocol of the implementation process in intensive care units.

Medicine (Baltimore) 2019 Mar;98(11):e14792

Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo.

Background: The awakening and breathing coordination of daily sedation and ventilator removal trials, delirium monitoring and management, and early mobility and exercise (ABCDE) and assessment, prevent and manage pain, both spontaneous awakening and spontaneous breathing trials, choice of analgesia and sedation, assess, prevent and manage delirium, early mobility and exercise, family engagement (ABCDEF) bundles are part of the science of the liberation of the intensive care unit (ICU). There are not enough studies that have evaluated the effectiveness and safety of the implementation of these bundles. This study will analyze the implementation process, estimate their effectiveness and safety, and identify barriers, facilitators and attitudes that have influenced the implementation process. Read More

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http://Insights.ovid.com/crossref?an=00005792-201903150-0003
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http://dx.doi.org/10.1097/MD.0000000000014792DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426482PMC
March 2019
10 Reads

Effect of Neurally Adjusted Ventilatory Assist on Patient-Ventilator Interaction in Mechanically Ventilated Adults: A Systematic Review and Meta-Analysis.

Crit Care Med 2019 Mar 15. Epub 2019 Mar 15.

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

Objectives: Patient-ventilator asynchrony is common among critically ill patients undergoing mechanical ventilation and has been associated with adverse outcomes. Neurally adjusted ventilatory assist is a ventilatory mode that may lead to improved patient-ventilator synchrony. We conducted a systematic review to determine the impact of neurally adjusted ventilatory assist on patient-ventilator asynchrony, other physiologic variables, and clinical outcomes in adult patients undergoing invasive mechanical ventilation in comparison with conventional pneumatically triggered ventilatory modes. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003719DOI Listing
March 2019
1 Read

Role of Critical Care Medicine Training in the Cardiovascular Intensive Care Unit: Survey Responses From Dual Certified Critical Care Cardiologists.

J Am Heart Assoc 2019 Mar;8(6):e011721

1 Critical Care Medicine Department National Institutes of Health Clinical Center Bethesda MD.

Background Cardiovascular intensive care units ( CICUs ) have evolved from coronary care wards into distinct units for critically ill patients with primary cardiac diseases, often suffering from illnesses that cross multiple disciplines. Mounting evidence has demonstrated improved survival with the incorporation of dedicated CICU providers with expertise in critical care medicine ( CCM ). This is the first study to systematically survey dual certified physicians in order to assess the relevance of CCM training to contemporary CICU care. Read More

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http://dx.doi.org/10.1161/JAHA.118.011721DOI Listing
March 2019
3 Reads
2.882 Impact Factor

The advantages of adding rib fixations during VATS for retained hemothorax in serious blunt chest trauma - A prospective cohort study.

Int J Surg 2019 Mar 14;65:13-18. Epub 2019 Mar 14.

Division of Thoracic Surgery, Department of Surgery, Kaohsiung-Veterans General Hospital, Kaohsiung, Taiwan; Division of Trauma, Department of Emergency, Kaohsiung-Veterans General Hospital, Kaohsiung, Taiwan; Department of Cosmetic Science, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan. Electronic address:

Background: Serious blunt chest trauma usually induces hemothorax, pneumothorax, and rib fracture. Early video-assisted thoracoscopic surgery (VATS) to evacuate retained hemothorax is one commonly used treatment. In this study, a new strategy was implemented to combine VATS with fractured rib fixation simultaneously. Read More

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http://dx.doi.org/10.1016/j.ijsu.2019.02.022DOI Listing
March 2019
1 Read

Pulmonary infections prime the development of subsequent ICU-acquired pneumonia in septic shock.

Ann Intensive Care 2019 Mar 15;9(1):39. Epub 2019 Mar 15.

Service de médecine intensive-réanimation, Hôpital Cochin, Hôpitaux Universitaires Paris-Centre, Assistance Publique - Hôpitaux de Paris, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.

Purpose: To investigate the determinants and the prognosis of intensive care unit (ICU)-acquired pneumonia in patients with septic shock.

Methods: This single-center retrospective study was conducted in a medical ICU in a tertiary care center from January 2008 to December 2016. All consecutive patients diagnosed for septic shock within the first 48 h of ICU admission were included. Read More

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http://dx.doi.org/10.1186/s13613-019-0515-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420540PMC
March 2019
1 Read

[Thoracoscopic clipping of patent ductus arteriosus: position of surgery in the era of transcatheter procedures].

Khirurgiia (Mosk) 2019(2):5-12

Meshalkin National Medical Research Center of Healthcare Ministry of the Russian Federation, Novosibirsk, Russia.

Aim: To describe single-center evolution of the procedure and to evaluate the results of thoracoscopic clipping of patent ductus arteriosus (PDA) with diameter over 3,0 mm in term infants weighting over 4,0 kg.

Material And Methods: Thoracoscopic clipping of PDA has been performed in 140 patients for the period from March 2012 to March 2018 in Meshalkin National Medical Research Center. Mean age was 4. Read More

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http://dx.doi.org/10.17116/hirurgia20190215DOI Listing
January 2019
1 Read

Misdiagnosis: Acute Chest Syndrome That Evolved into Acute Respiratory Distress Syndrome in a Patient without a Documented History of Hemoglobinopathy.

Case Rep Med 2019 3;2019:2893056. Epub 2019 Feb 3.

Program Director, Pulmonary and Critical Care Fellowship, Newark Beth Israel Medical Center, Newark, NJ, USA.

Acute chest syndrome (ACS) is a feared complication of sickle cell disease. Here is a case of a patient who presented with symptoms suggestive of acute chest syndrome yet had a delayed diagnosis presumably due to the lack of documented history of sickle cell disease of the patient, consequently evolving into acute respiratory distress syndrome (ARDS). He was subsequently diagnosed with heterozygous sickle cell SC disease on hemoglobin electrophoresis. Read More

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http://dx.doi.org/10.1155/2019/2893056DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6378019PMC
February 2019
2 Reads

Chlorhexidine-Related Mortality Rate in Critically Ill Subjects in Intensive Care Units: A Systematic Review and Meta-Analysis.

Respir Care 2019 Mar;64(3):337-349

Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.

Background: This meta-analysis aimed to explore the chlorhexidine-related mortality rate for subjects on mechanical ventilation and in an ICU when compared with subjects who received standard ICU care.

Methods: We searched a number of medical literature databases and the first 100 results in an internet search. Two of us independently reviewed the titles and abstracts of the identified articles. Read More

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http://dx.doi.org/10.4187/respcare.06434DOI Listing
March 2019
2 Reads

A cohort study of intranasal fentanyl for procedural pain management in neonates.

Paediatr Child Health 2018 Dec 24;23(8):e170-e175. Epub 2018 May 24.

Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.

Objectives: The objective of this cohort study was to document experience with intranasal (IN) fentanyl analgesia for procedural pain management in neonates in a surgical neonatal intensive care unit. A consecutive sample of 23 neonates without intravenous access treated with IN fentanyl was included.

Methods: Data were extracted from medical charts, including infant characteristics, indication for IN fentanyl, dose, physiologic parameters (heart rate, respiratory rate, oxygen saturation, blood pressure) and pain scores. Read More

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http://dx.doi.org/10.1093/pch/pxy060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241873PMC
December 2018

A Short History of Medical Expert Guidelines and How They Pertain to Tracheostomy Tubes and Physical Medicine and Rehabilitation.

Authors:
John R Bach

Am J Phys Med Rehabil 2019 Feb 27. Epub 2019 Feb 27.

Professor of Physical Medicine and Rehabilitation Department of PM&R, Professor of Neurology, Department of Neurology, Medical Director of the Center for Ventilator Management Alternatives and Pulmonary Rehabilitation of the University Hospital, of the Rutgers New Jersey Medical School, Newark, New Jersey, USA.

Continuous noninvasive ventilatory support (CNVS) and mechanical insufflation exsufflation (MIE) have been used since 1953 to spare patients with ventilatory pump failure from ever requiring tracheostomy tubes for ventilatory support or secretion management. Today there are patients with spinal muscular atrophy type 1 who are 25 years old and CNVS dependent since 4 months or age, post-polio survivors CNVS dependent for 64 years, Duchenne muscular dystrophy patients over age 45 CNVS dependent for over 25 years, high level spinal cord injured patients CNVS dependent for over 20 years, and even lung disease patients dependent on CNVS. All these patients, although unweanable from ventilatory support and with little or no measurable vital capacity, can also be extubated to CNVS and MIE without resort to tracheotomies when necessary to continue CNVS. Read More

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http://dx.doi.org/10.1097/PHM.0000000000001172DOI Listing
February 2019
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2.012 Impact Factor

Acute Colonic Pseudo-Obstruction Caused by Dexmedetomidine: A Case Report and Literature Review.

Am J Case Rep 2019 Mar 3;20:278-284. Epub 2019 Mar 3.

Department of Internal Medicine, BronxCare Health System, Bronx, NY, USA.

BACKGROUND Acute colonic pseudo-obstruction (ACPO) is an infrequent entity characterized by non-toxic, non-mechanical, abrupt, functional dilation of the colon. Clinically patients present with abdominal distention, anxiety, severe abdominal pain, nausea, and vomiting. This rare entity can lead to a fatal outcome if not recognized early. Read More

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http://dx.doi.org/10.12659/AJCR.913645DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6410604PMC
March 2019
3 Reads

Cerebellar hemorrhage: a 10-year evaluation of risk factors.

J Matern Fetal Neonatal Med 2019 Mar 1:1-9. Epub 2019 Mar 1.

a Department of Pediatrics, Division of Newborn Medicine , Washington University School of Medicine , St. Louis , MO , USA.

Background: While cerebellar hemorrhage (CH) has been linked with adverse neurodevelopmental outcome in preterm infants, it remains under-recognized and the underlying mechanisms are not fully understood.

Objective: To determine risk factors for CH in premature infants.

Methods: A retrospective cohort study included all inborn infants ≤ 30 weeks EGA admitted to the NICU from 2007 to 2016. Read More

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http://dx.doi.org/10.1080/14767058.2019.1583729DOI Listing
March 2019
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Intrathecal Immunoglobulin for treatment of adult patients with tetanus: A randomized controlled 2x2 factorial trial.

Wellcome Open Res 2018 5;3:58. Epub 2018 Nov 5.

Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.

Despite long-standing availability of an effective vaccine, tetanus remains a significant problem in many countries. Outcome depends on access to mechanical ventilation and intensive care facilities and in settings where these are limited, mortality remains high. Administration of tetanus antitoxin by the intramuscular route is recommended treatment for tetanus, but as the tetanus toxin acts within the central nervous system, it has been suggested that intrathecal administration of antitoxin may be beneficial. Read More

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https://wellcomeopenresearch.org/articles/3-58/v2
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http://dx.doi.org/10.12688/wellcomeopenres.14587.2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372971PMC
November 2018
5 Reads

Ventilator autotriggering : An underestimated phenomenon in the determination of brain death.

Anaesthesist 2019 Mar;68(3):171-176

Division of Anaesthesiology for Cardiovascular and Thoracic Surgery and Intensive Care Medicine of Department of Anaesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria.

Background: Ventilator autotriggering (VAT) may induce uncertainty in diagnosing brain death because it may falsely suggest a central respiratory drive in brain-dead patients where no intrinsic respiratory efforts exist. Since the lack of international standardization of brain death criteria contributes to the loss of potential donor organs, it is important to be aware of this phenomenon, which is a not well-known confounder in the process of diagnosing brain death.

Methods: The national official recommendations or guidelines for the determination of brain death and organ transplantation of 15 selected European countries (including all 8 member states of the Eurotransplant network) were evaluated with respect to VAT. Read More

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http://dx.doi.org/10.1007/s00101-019-0555-5DOI Listing
March 2019
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The Top-100 Highly Cited Original Articles on Drug Therapy for Ventilator-Associated Pneumonia.

Front Pharmacol 2019 12;10:108. Epub 2019 Feb 12.

Department of General Surgery, Huaihe Hospital of Henan University, Kaifeng, China.

In recent decades, research on drug therapy for ventilator-associated pneumonia (VAP) remains one of the major hot-spots in the field of critical care medicine, but relevant data are not satisfactory. Our aim was to assess the status and trends of the most cited articles on drug therapy for VAP through bibliometric approaches. The Institute for Scientific Information (ISI) Web of Science core collection database was searched for the VAP-related articles. Read More

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http://dx.doi.org/10.3389/fphar.2019.00108DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379351PMC
February 2019
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An Early Tailored Approach Is the Key to Effective Rehabilitation in the Intensive Care Unit.

Arch Phys Med Rehabil 2019 Feb 21. Epub 2019 Feb 21.

Department of Experimental and Clinical Medicine, Neurorehabilitation Clinic, Marche Polytechnic University, Ancona, Italy.

Objective: To investigate the effectiveness, feasibility, and safety of an evidence-based rehabilitation care pathway in the intensive care unit (ICU) in different patient populations.

Design: Observational prospective cohort study, with retrospective controls.

Setting: ICUs of a university hospital. Read More

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http://dx.doi.org/10.1016/j.apmr.2019.01.015DOI Listing
February 2019
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Use of home telemedicine for critical illness rehabilitation: an Indian success story.

BMJ Case Rep 2019 Feb 21;12(2). Epub 2019 Feb 21.

Department of Oncology, HealthCare Global Enterprises Ltd, Bangalore, Karnataka, India.

One-fifth of healthcare beneficiaries in developed nations get discharged from hospitals to physician supervised skilled nursing care facilities. In low-income and middle-income countries like India, postdischarge skilled nursing facilities are at a very nascent stage and largely underequipped in terms of infrastructure, skilled nursing and physician staff to manage complicated patients. Hence the responsibility of management of such patients lies largely with their families. Read More

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http://dx.doi.org/10.1136/bcr-2018-227779DOI Listing
February 2019
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Implementation of infection prevention and control in acute care hospitals in Mainland China - a systematic review.

Antimicrob Resist Infect Control 2019 11;8:32. Epub 2019 Feb 11.

Infection Control Program and WHO Collaborating Centre on Patient Safety, University of Geneva Hospitals and Faculty of Medicine, Rue Gabrielle Perret-Gentil 4, 1211 Geneva 14, Switzerland.

Background: Healthcare-associated infections (HAIs) and antimicrobial resistance (AMR) affect patients in acute-care hospitals worldwide. No systematic review has been published on adoption and implementation of the infection prevention and control (IPC) key components. The objective of this systematic review was to assess adoption and implementation of the three areas issued by the "National Health Commission of the People's Republic of China" in acute-care hospitals in Mainland China, and to compare the findings with the key and core components on effective IPC, issued by the European Centre for Disease Prevention and Control (ECDC) and the World Health Organization (WHO). Read More

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http://dx.doi.org/10.1186/s13756-019-0481-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371478PMC
February 2019
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Safety and feasibility of above cuff vocalisation for ventilator-dependant patients with tracheostomies.

J Intensive Care Soc 2019 Feb 28;20(1):59-65. Epub 2018 Mar 28.

Acute Intensive Care Unit, University Hospital South Manchester, Manchester, UK.

Introduction: Temporary tracheostomy is commonly used in patients admitted to intensive care units. Cuffed tubes prevent laryngeal airflow, preventing vocalisation. Sub-glottic suction tubes such as the 'Blue Line Ultra ' are used primarily to remove sub-glottic secretions, but retrograde gas flows via the suction port can facilitate above cuff vocalisation. Read More

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http://dx.doi.org/10.1177/1751143718767055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6376581PMC
February 2019
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Variations in Physician Orders for Life-Sustaining Treatment Program across the Nation: Environmental Scan.

J Palliat Med 2019 Feb 21. Epub 2019 Feb 21.

1 Center for Health Policy and Center for Improving Palliative Care for Vulnerable Adults with Multiple Chronic Conditions, Columbia University School of Nursing, New York, New York.

Background: Physician Orders for Life-Sustaining Treatment (POLST) is an advance care planning tool that is designed to document end-of-life (EoL) care wishes of those living with limited life expectancies. Although positive impacts of POLST program has been studied, variations in state-specific POLST programs across the nation remain unknown.

Objective: Identify state variations in POLST forms and determine if variations are associated with program maturity status. Read More

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http://dx.doi.org/10.1089/jpm.2018.0626DOI Listing
February 2019
1 Read