201 results match your criteria support decannulated


Tracheostomy in Pediatric Intensive Care Unit-A Two Decades of Experience.

Indian J Crit Care Med 2021 Jul;25(7):803-811

Department of Research, Sir Ganga Ram Hospital, New Delhi, India.

Aim And Objective: To study the profile, indications, related complications, and predictors of decannulation and mortality in patients who underwent tracheostomy in the pediatric intensive care unit (PICU).

Materials And Methods: Retrospective analysis of prospectively collected data of tracheostomies was done on patients admitted at PICU. Demographics, primary diagnosis, indication of tracheostomy, and durations of endotracheal intubation, mechanical ventilation, and tracheostomy cannulation were recorded. Read More

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Two Consecutive Runs of Veno-Venous Extracorporeal Membrane Oxygenation in a Peripartum Patient with COVID-19 Acute Respiratory Distress Syndrome.

Case Rep Crit Care 2021 9;2021:2032197. Epub 2021 Jul 9.

Department of Medicine (DIMED), Padua University School of Medicine, Italy.

Veno-venous extracorporeal membrane oxygenation (V-V ECMO) may be required to treat critically ill patients with COVID-19-associated severe acute respiratory distress syndrome (ARDS). We report the case of a 43-year-old peripartum patient, who underwent two sequential V-V ECMO runs. The first extracorporeal support was established for COVID-19 ARDS, as characterized by severe hypoxemia and hypercapnia (arterial partial pressure of oxygen to inspired oxygen fraction ratio 85 mmHg and arterial partial pressure of carbon dioxide 95 mmHg) and reduction of respiratory system static compliance to 25 mL/cmHO, unresponsive to mechanical ventilation and prone positioning. Read More

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Timely Use of Venous-Arterial ECMO to Treat Congenital Pediatric Junctional Ectopic Tachycardia: A Case Report.

J Investig Med High Impact Case Rep 2021 Jan-Dec;9:23247096211034045

University of California, Irvine, CA, USA.

Supraventricular tachycardia is the most common tachyarrhythmia in pediatrics. Although postoperative junctional ectopic tachycardia (JET) is a known complication of congenital heart surgery that is typically transient, congenital JET is rare and requires aggressive treatment to maintain hemodynamic stability. We describe the case of a 3-month-old, previously healthy female who presented with heart failure and cardiogenic shock secondary to congenital JET for whom extracorporeal membrane oxygenation (ECMO) provided time for selection of effective therapy. Read More

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Role of respiratory intermediate care units during the SARS-CoV-2 pandemic.

BMC Pulm Med 2021 Jul 13;21(1):228. Epub 2021 Jul 13.

Servei de Pneumologia i Al·lèrgia Respiratòria, Institut Clínic Respiratori, Hospital Clínic de Barcelona, Universitat de Barcelona, IDIBAPS, Barcelona, Spain.

Rationale: The SARS-CoV2 pandemic increased exponentially the need for both Intensive (ICU) and Intermediate Care Units (RICU). The latter are of particular importance because they can play a dual role in critical and post-critical care of COVID-19 patients. Here, we describe the setup of 2 new RICUs in our institution to face the SARS-CoV-2 pandemic and discuss the clinical characteristics and outcomes of the patients attended. Read More

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Outcomes of Extracorporeal Membrane Oxygenation in Patients with Severe Acute Respiratory Distress Syndrome Caused by COVID-19 versus Influenza.

Ann Thorac Surg 2021 Jun 14. Epub 2021 Jun 14.

Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, TX.

Background: Extracorporeal membrane oxygenation (ECMO) can be effective for refractory acute respiratory distress syndrome (ARDS) in patients with influenza, but its utility in patients with COVID-19 is uncertain. We compared outcomes of patients with refractory ARDS from COVID-19 and Influenza placed on ECMO.

Methods: We conducted a retrospective analysis of 120 patients with refractory ARDS due to COVID-19 or Influenza placed on ECMO at two referral centers from 1/2013 to 10/2020. Read More

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Morbidity and respiratory outcomes in infants requiring tracheostomy for severe bronchopulmonary dysplasia.

Pediatr Pulmonol 2021 Aug 18;56(8):2589-2596. Epub 2021 May 18.

Division of Neonatology and Pulmonary Biology, Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.

Objective: The decision for tracheostomy for bronchopulmonary dysplasia (BPD) is highly variable and often dictated by local practice. We aimed to characterize morbidity, mortality, and respiratory outcomes in preterm infants undergoing tracheostomy for severe BPD.

Study Design: We retrospectively reviewed a single-center 4-year cohort of all infants born <33 weeks gestational age (GA) that required tracheostomy due to severe BPD. Read More

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Proposed Decannulation Criteria for COVID-19 Patients.

Am J Phys Med Rehabil 2021 08;100(8):730-732

From the Department of Cardiorespiratory Rehabilitation, Universidad Nacional de Asunción-Facultad de Ciencias Médicas, Hospital de Clinicas, San Lorenzo, Paraguay (GCG, MM-T); Department of Pediatrics, Universidad de Chile, Hospital Clínico San Borja Arriarán, Santiago, Chile (FJP); and Department of Physical Medicine and Rehabilitation, Rutgers University-New Jersey Medical School, Newark, New Jersey (JRB).

Abstract: A 66-yr-old man had been intubated for 21 days for severe COVID-19 infection. He then underwent tracheotomy, retained the tube for 2 mos, and then was discharged home on 10 liters of O2/min breathing via a tracheostomy collar. We were consulted for tracheostomy tube decannulation. Read More

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Prolonged Ventilatory Support for Patients Recovering From Guillain-Barré Syndrome.

Neurol Clin Pract 2021 Feb;11(1):18-24

Lane Fox Respiratory Service (MCFC, NH, MRBE, JES, RSH), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust; Lane Fox Clinical Respiratory Physiology Research Centre (MCFC, PBM, NH), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust; Department of Neurology (MRBE, JES), St. Thomas' Hospital, Guy's & St. Thomas' NHS (Foundation) Trust, London, United Kingdom; and Central Clinical School (MCFC), Faculty of Medicine and Health, University of Sydney, Australia.

Background: Recovery from Guillain-Barré syndrome (GBS) may be protracted, and patients may need prolonged ventilatory support. We present clinical data from a tertiary referral weaning center managing patients with GBS requiring prolonged ventilatory support.

Methods: A retrospective review of patients managed in a 34-bed specialist ventilator weaning facility in London, United Kingdom, between 2006 and 2017. Read More

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February 2021

ECMO POST-CARDIOTOMY, A SINGLE CENTRE EXPERIENCE.

Rev Port Cir Cardiotorac Vasc 2021 Apr 8;28(1):19-23. Epub 2021 Apr 8.

Cardiothoracic Surgery Department - Centro Hospitalar Universitário de São João, Portugal.

Objectives: Our objective was to examine the results of ECMO post cardiotomy in Centro Hospitalar Universitário S. João (CHUSJ).

Methods: Between 2011 and 2019, 13 patients were cannulated for refractory cardiogenic shock post-cardiotomy; 8 (61,5%) male and 5 (38,5%) female. Read More

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Escalation and Withdrawal of Treatment for Patients on Extracorporeal Membrane Oxygenation: A Qualitative Study.

Ann Surg 2021 Mar 4. Epub 2021 Mar 4.

Department of Anesthesia, Carver College of Medicine, University of Iowa, Iowa City, IA Department of Anesthesiology & Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Penn Center for Perioperative Outcomes Research and Transformation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA University of Pennsylvania Law School, Philadelphia, PA.

Objective: The aim of this study was to describe decisions about the escalation and withdrawal of treatment for patients on extracorporeal membrane oxygenation (ECMO).

Summary Background Data: Interventions premised on facilitating patient autonomy have proven problematic in guiding treatment decisions in intensive care units (ICUs). Calls have thus been made to better understand how decisions are made in critical care. Read More

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Two Hours of In Vivo Lung Perfusion Improves Lung Function in Sepsis-Induced Acute Respiratory Distress Syndrome.

Semin Thorac Cardiovasc Surg 2021 Mar 11. Epub 2021 Mar 11.

Department of Surgery, University of Virginia, Charlottesville, Virginia. Electronic address:

Sepsis is the leading cause of acute respiratory distress syndrome (ARDS) in adults and carries a high mortality. Utilizing a previously validated porcine model of sepsis-induced ARDS, we sought to refine our novel therapeutic technique of in vivo lung perfusion (IVLP). We hypothesized that 2 hours of IVLP would provide non-inferior lung rehabilitation compared to 4 hours of treatment. Read More

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Common carotid artery imaging after vessel sparing decannulation from Extracorporeal Membrane Oxygenation (ECMO) support.

J Pediatr Surg 2021 Feb 4. Epub 2021 Feb 4.

Department of Cardiovascular Surgery, Children's National Hospital, 111 Michigan Ave. NW, Washington, D.C. 20010, USA.

Introduction: In 2008, Children's National Hospital adopted a simple vessel sparing technique (VST) for neck extra corporeal membrane (ECMO) cannulation/decannulation that is technically simple and reproducible. In this study, we review a cohort of patients decannulated from venous-arterial (VA) ECMO using a VST with the goal of understanding flow dynamics and anatomic changes of the common carotid artery (CCA) after repair with a VST.

Methods: Patients supported with ECMO at a single, tertiary care center between 2008 and 2019 were identified. Read More

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February 2021

Extracorporeal Membrane Oxygenation as a Rescue Therapy for Postoperative Diastolic Dysfunction and Refractory Chylothorax.

ASAIO J 2021 05;67(5):e99-e101

Pediatric Cardiac Intensive Care Unit, Schneider Children's Medical Center of Israel, Petach Tikva, Israel.

This is the first published case, as far as we know, of a term neonate with refractory chylothorax secondary to diastolic dysfunction in the cardiac postoperative period, where extracorporeal membrane oxygenation (ECMO) was used to improve the physiologic derangements, thus allowing resolution of the chylous effusion. The infant was prenatally diagnosed with d-transposition of the great arteries. He was started on prostaglandin infusion and underwent balloon atrial septostomy followed by arterial switch operation. Read More

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A case of AL amyloidosis presenting with refractory ventricular fibrillation.

Respir Med Case Rep 2021 24;32:101349. Epub 2021 Jan 24.

Division of Cardiology, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.

A 66-year-old male with recent diagnosis of heart failure with reduced ejection fraction was referred to our institution for management of cardiogenic/vasodilatory shock. During his evaluation, he suffered a sudden cardiac arrest from refractory ventricular tachycardia/fibrillation (VT/VF) despite normal electrolytes and no evidence of prior ventricular arrhythmias. He was placed on rescue peripheral veno-arterial extracorporeal membrane oxygenation support (VA-ECMO) for 4 days and was decannulated without end-organ damage. Read More

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January 2021

Extracorporeal Life Support as a Treatment of Supraventricular Tachycardia in a Newborn.

Pediatr Emerg Care 2021 Feb;37(2):e75-e76

From the Critical Care Medicine, National Center for Child Health and Development, Setagaya, Tokyo, Japan.

Abstract: Supraventricular tachycardia (SVT) is the most common symptomatic tachyarrhythmia in children and requires medical treatment. Thus far, there have been few reports of the use of extracorporeal life support (ECLS) to provide cardiac support in children with low cardiac output resulting from arrhythmia. We present a case of a newborn in whom ECLS was used to provide support for cardiogenic shock secondary to intractable SVT. Read More

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February 2021

Utilization of Thromboelastogram and Inflammatory Markers in the Management of Hypercoagulable State in Patients with COVID-19 Requiring ECMO Support.

Case Rep Crit Care 2021 15;2021:8824531. Epub 2021 Jan 15.

Division of Cardiovascular Critical Care, Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.

The role of extracorporeal membrane oxygenation (ECMO) in the management of critically ill patients with COVID-19 is evolving. Extracorporeal support independently confers an increased predilection for thrombosis, which can be exacerbated by COVID-19-associated coagulopathy. We present the successful management of a hypercoagulable state in two patients who required venovenous ECMO for the treatment of COVID-19. Read More

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January 2021

Laryngeal lymphangioma as a cause of respiratory distress in an adult with Down's syndrome: an extremely rare presentation.

BMJ Case Rep 2021 Jan 27;14(1). Epub 2021 Jan 27.

ENT, Post Graduate Institute of Medical Education and Research, Chandigarh, India

A 32-year-old man with Down's syndrome was referred to the ear, nose and throat (ENT) department in view of failed attempts at extubation, and subsequently, at decannulation of tracheotomy tube. He had previously required ventilatory support and had history of intubation for 1 week. A flexible fibre-optic laryngoscopy showed a smooth mass covering the laryngeal inlet which moved with respiration. Read More

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January 2021

Extracorporeal Membrane Oxygenation for Primary Graft Dysfunction After Lung Transplantation.

ASAIO J 2021 Jan 11. Epub 2021 Jan 11.

From the Department of Cardiothoracic Surgery; University of Pittsburgh Medical Center Division of Pulmonary, Allergy and Critical Care Medicine; University of Pittsburgh Medical Center; Pittsburgh, Pennsylvania.

Extracorporeal membrane oxygenation (ECMO) is used as the last resort for primary graft dysfunction (PGD). The aim of this study is to explore the predictors and outcomes for early mortality in postlung transplant patients who required ECMO for PGD. Between January 2006 and December 2015, 1,049 cases of lung transplantation were performed at our center. Read More

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January 2021

Noninvasive ventilatory support in morbid obesity.

Pulmonology 2021 Jan 11. Epub 2021 Jan 11.

Pulmonology Department, University Hospital of São João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.

Background: In the conventional management of the morbidly obese that normalizes the apnea-hypopnea index (AHI), CO2 levels often remain elevated.

Methods: A retrospective review of morbidly obese patients using volume preset settings up to 1800ml to positive inspiratory pressures (PIPs) of 25-55cm H2O, or pressure control at 25-50cm H2O pressure via noninvasive interfaces up to continuously (CNVS).

Results: Twenty-six patients, mean 55. Read More

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January 2021

Venovenous extracorporeal membrane oxygenation for patients with refractory coronavirus disease 2019 (COVID-19): Multicenter experience of referral hospitals in a large health care system.

J Thorac Cardiovasc Surg 2020 Dec 1. Epub 2020 Dec 1.

Department of Cardiothoracic Surgery, Baylor University Medical Center, Dallas, Tex.

Background: The benefit of extracorporeal membrane oxygenation (ECMO) for patients with severe acute respiratory distress from coronavirus disease 2019 refractory to medical management and lung-protective mechanical ventilation has not been adequately determined.

Methods: We reviewed the clinical course of 37 patients with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection supported by venovenous ECMO at 4 ECMO referral centers within a large health care system. Patient characteristics, progression of hemodynamics and inflammatory markers, and clinical outcomes were evaluated. Read More

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December 2020

Long-term Outcomes of Juvenile Onset Recurrent Respiratory Papillomatosis with Pulmonary Involvement.

Laryngoscope 2021 07 7;131(7):EE2277-E2283. Epub 2021 Jan 7.

Department of Otolaryngology Head and Neck Surgery. Beijing Tongren Hospital, Capital Medical University, Key Laboratory of Otolaryngology Head and Neck Surgery (Ministry of Education of China), Beijing, China.

Objective: To investigate the clinical characteristics and long-term outcomes of juvenile onset recurrent respiratory papillomatosis (JORRP) with or without pulmonary involvement.

Methods: A group of patients with JORRP who had clinical course over an extended period of time (at least 5 years) in the Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital were included in this retrospective study. Lung/bronchus involvement was revealed by lung imaging. Read More

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Extracorporeal Membrane Oxygenation for COVID-19-Associated Multisystem Inflammatory Syndrome in a 5-year-old.

Am Surg 2020 Dec 29:3134820983198. Epub 2020 Dec 29.

Division of Pediatric Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC, USA.

Severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) is associated with multisystem inflammatory syndrome in children (MIS-C) that ranges from mild symptoms to cardiopulmonary collapse. A 5-year-old girl presented with shock and a rapid decline in left ventricular function requiring intubation. SARS-CoV-2 was diagnosed by viral Polymerase Chain Reaction (PCR), and she received remdesivir and COVID-19 convalescent plasma. Read More

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December 2020

A Prospective Study of Voice, Swallow, and Airway Outcomes Following Tracheostomy for COVID-19.

Laryngoscope 2021 06 28;131(6):E1918-E1925. Epub 2020 Dec 28.

National Centre for Airway Reconstruction, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, U.K.

Objective: The COVID-19 pandemic has led to unprecedented demands on healthcare with many requiring intubation. Tracheostomy insertion has often been delayed and the enduring effects of this on voice, swallow, and airway outcomes in COVID-19 tracheostomy patients are unknown. The aim of this study was to prospectively assess these outcomes in this patient cohort following hospital discharge. Read More

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Tracheostomy in the pediatric trisomy 21 population.

Int J Pediatr Otorhinolaryngol 2021 Jan 1;140:110540. Epub 2020 Dec 1.

Division of Otolaryngology, Children's Mercy Hospital-Kansas City, Kansas City, MO, USA; Department of Surgery, University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA. Electronic address:

Introduction: Tracheostomy in children is often performed to alleviate airway obstruction (AO) or to facilitate long-term ventilator support due to respiratory failure of various etiologies, such as heart failure, and postoperative respiratory failure. Although many of these pathologies are common among trisomy 21 patients, tracheostomy rates among this population have not previously been reported. The aim of our study was to determine the incidence of trisomy 21 patients undergoing tracheostomy. Read More

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January 2021

The Prolonged Use of VV ECMO Support in COVID-19: A Case Report.

J Crit Care Med (Targu Mures) 2020 Oct 7;6(4):224-230. Epub 2020 Nov 7.

Westmead Hospital, Westmead, Sydney, New South Wales, Australia.

COVID-19 has resulted in unprecedented global health and economic challenges. The reported mortality in patients with COVID-19 requiring mechanical ventilation is high. VV ECMO may serve as a lifesaving rescue therapy for a minority of patients with COVID-19; however, its impact on overall survival of these patients is unknown. Read More

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October 2020

COVID-19 Pulmonary Failure and Extracorporeal Membrane Oxygenation: First Experience from Three European Extracorporeal Membrane Oxygenation Centers.

Thorac Cardiovasc Surg 2021 04 13;69(3):259-262. Epub 2020 Nov 13.

Department of Anaesthesiology and Intensive Care Medicine, University Hospital Wurzburg, Wurzburg, Bayern, Germany.

On April 17, 2020, a coronavirus disease 2019 (COVID-19) webinar was held by selected international experts in the field of intensive care and specialized respiratory ECMO centers from Germany, Italy, Spain, and the United Kingdom, which was hosted by the German Heart Centre Berlin/Charité. The experts shared their experience about the treatment of 42 patients with severe acute respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV-ECMO). Patients were predominantly male (male-to-female ratio: 3:1), with a mean age of 51 years (range: 25-73 years). Read More

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Percutaneous Tracheostomy in COVID-19 Patients: A Four-step Safe Protocol.

Indian J Crit Care Med 2020 Sep;24(9):832-834

Department of Critical Care Medicine, NMC Specialty Hospital, Dubai, United Arab Emirates.

Background: Coronavirus disease-2019 (COVID-19) pandemic has inundated healthcare systems globally especially resources in intensive care units (ICUs). Tracheostomy may be required in critically ill COVID-19 patients to facilitate weaning and to optimize resources like ventilator and ICU beds. Percutaneous tracheostomy (PCT) has become the standard of care globally in ICUs; however, it is considered a high-risk procedure in COVID-19 patients because of the inherent risk of aerosol generation. Read More

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September 2020

The successful use of extracorporeal carbon dioxide removal as a rescue therapy in a patient with severe COVID-19 pneumonitis.

Anaesth Rep 2020 Jul-Dec;8(2):e12072. Epub 2020 Sep 25.

Royal Oldham Hospital Oldham UK.

We present a patient with severe COVID-19 pneumonitis; poor respiratory compliance; dangerously high ventilator pressures; and hypercapnia refractory to conventional treatment including low tidal volume ventilation, neuromuscular blockade and prone position ventilation. Extracorporeal carbon dioxide removal was used as a rescue therapy to facilitate safer ventilator pressures and arterial partial pressures of carbon dioxide. After 6 days of treatment, the patient had improved to the extent that the extracorporeal support was able to be weaned and the patient was decannulated from the device. Read More

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September 2020

The First 60 Days: Physical Therapy in a Neurosurgical Center Converted Into a COVID-19 Center in Brazil.

Phys Ther 2020 12;100(12):2120-2126

Department of Physical Therapy, Instituto Estadual do Cérebro Paulo Niemeyer.

Objective: The purpose of this case report was to describe the role of physical therapists in a neurosurgical center that was converted into a COVID-19 center for critically ill patients.

Methods (case Description): On March 16, 2020, the state government of Rio de Janeiro, Brazil, determined that a neurosurgical center with 44 ICU beds equipped with mechanical ventilators should immediately transfer all patients with neurological conditions to other institutions and prepare for patients who were critically ill with COVID-19. The staff, including physical therapists, were trained to handle patients with COVID-19, many of whom were developing acute respiratory distress syndrome (ARDS) with complex and multifactorial ventilatory support needs. Read More

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December 2020

Incidence of healthcare-associated infections in patients with fever during the first 48 hours after decannulation from veno-venous extracorporeal membrane oxygenation.

Perfusion 2021 May 21;36(4):421-428. Epub 2020 Aug 21.

Departments of Surgery, Surgical Critical Care, Trauma Surgery, Cardiac Surgery, R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA.

Introduction: Fevers following decannulation from veno-venous extracorporeal membrane oxygenation often trigger an infectious workup; however, the yield of this workup is unknown. We investigated the incidence of post-veno-venous extracorporeal membrane oxygenation decannulation fever as well as the incidence and nature of healthcare-associated infections in this population within 48 hours of decannulation.

Methods: All patients treated with veno-venous extracorporeal membrane oxygenation for acute respiratory failure who survived to decannulation between August 2014 and November 2018 were retrospectively reviewed. Read More

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