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"Mechanical Ventilation" AND "Emergency"

Paige M Garber, Christopher A Droege, Kristen E Carter, Nicole J Harger, Eric W Mueller
OBJECTIVE: Ketamine is an N-methyl-D-aspartate (NMDA) antagonist with emerging evidence assessing its use as a continuous infusion agent to provide concomitant analgesia and sedation. The role of ketamine as adjunctive therapy in mechanically ventilated patients is unclear. This study sought to investigate the impact of adjunctive continuous infusion ketamine on concomitant analgesic and sedative dosing while providing goal comfort in mechanically ventilated patients. METHODS: This retrospective, two-center, intrapatient comparison study included mechanically ventilated, adult ICU patients who received continuous infusion ketamine with at least one other analgesic or sedative infusion...
February 11, 2019: Pharmacotherapy
Jian Song, Qiang Zheng, Xiaochun Ma, Qian Zhang, Zhenqiang Xu, Chengwei Zou, Zhengjun Wang
The neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein (CRP) are emerging indirect blood markers to roughly reflect the inflammation level in our body while some pathological changes occurring in aortic valve tissue. Few recent studies demonstrated that NLR is related to calcific aortic valve disease (CAVD). However, the extent of the relationship between them and the impact of CRP on CAVD are not clear. This study aimed to investigate the diagnostic influence and surgical predictive effect of NLR and CRP on CAVD...
February 8, 2019: International Heart Journal
Elhaam Mesghali, Scott Fitter, Khaled Bahjri, Kayvan Moussavi
BACKGROUND: Hypertonic saline (HTS) and mannitol are frequently utilized in the emergency department (ED) to manage elevations in intracranial pressure (ICP). OBJECTIVE: The objective of this study was to compare the incidence of extravasation injury when HTS or mannitol was administered via peripheral i.v. line (PIV). METHODS: This retrospective cohort study evaluated adult and pediatric patients given either 3% HTS or mannitol via PIV while in the ED...
February 8, 2019: Journal of Emergency Medicine
Mohammad Bilal, Obada Tayyem, Hamzeh Saraireh, Monica Chowdhry, Praveen Guturu, Marwan S Abougergi
OBJECTIVE: Acute cholangitis (AC) and upper gastrointestinal hemorrhage (UGIH) are common emergencies encountered by gastroenterologists. We aimed to evaluate the impact of UGIH on in-hospital mortality, morbidity and resource utilization among patients with AC. PATIENTS AND METHODS: Adult admissions with a principal diagnosis of AC were selected from the National Inpatient Sample 2010-2014. The exposure of interest was significant UGIH (requiring red blood cell transfusion)...
February 7, 2019: European Journal of Gastroenterology & Hepatology
Tarun Pradhan, Pappu Rijal, Rubina Rai, Rabindra Dev Bhatta, Baburam Dixit Thapa, Mohan Chandra Regmi
BACKGROUND: Eclampsia is a multisystem disorder that may lead to deterioration of maternal condition, hypoxia and acidosis of fetus. Objective was to evaluate the risk factors associated with adverse maternal and fetal outcome in patients with eclampsia. METHODS: All patients with eclampsia were enrolled after informed consent from February 2013 to February 2014. Questions as per per-forma were asked to the patients and attendants about antenatal visits, parity, number of episodes of seizures, duration from onset of seizure to magnesium sulfate, then the patients were followed as per the hospital protocol, the mode of delivery, outcome of baby, post partum maternal condition and mortality were then noted...
January 28, 2019: Journal of Nepal Health Research Council
Hui Zhang, Xijie Wu, Guanhua Fang, Zhihuang Qiu, Liang-Wan Chen
OBJECTIVE: Open repair of acute type A aortic dissection frequently results in oozing from the suture lines. A modified fistula technique was developed to rapidly control oozing and allow closing the chest immediately and safely. The efficiency of this modified fistula technique in surgical repair of acute type A aortic dissection was evaluated. METHODS: This was a retrospective study. From January 2015 to December 2016, 172 patients with acute type A aortic dissection underwent emergency surgical repair in our center...
January 11, 2019: Journal of Thoracic and Cardiovascular Surgery
Esteban Araos-Baeriswyl, Teo Feuerhake, Manuel Mundaca, Bárbara Lara, Francisco Ortega, Nicolás Aeschlimann, Gonzalo Eymin
BACKGROUND: Medical emergencies (ME) in hospitalized patients (cardiac and respiratory arrest, suffocation, asphyxia, seizures, unconsciousness) are associated with high morbidity and mortality. Most of these patients have signs of physiological deterioration prior to the appearance of the emergency. Early detection of warning signs by rapid response teams (RRT) may provide an opportunity for the prevention of major adverse events. AIM: To identify clinical signs predicting death, need for mechanical ventilation, or transfer to a more complex unit during the 72 hours prior to the activation of the ME code...
September 2018: Revista Médica de Chile
Rachel Yaffa Zisk-Rony, Charles Weissman, Yoram G Weiss
BACKGROUND: Mechanical ventilation is a life supporting modality increasingly utilized when caring for severely ill patients. Its increasing use has extended the survival of the critically ill leading to increasing healthcare expenditures. We examined changes in the hospital-wide use of mechanical ventilation over 20 years (1997-2016) in two Israeli hospitals to determine whether there were specific patterns (e.g. seasonality, weekday vs. weekend) and trends (e.g. increases or decreases) among various hospital departments and units...
February 1, 2019: Israel Journal of Health Policy Research
Yong-Xing Yao, Jia-Teng Wu, Wei-Liu Zhu, Sheng-Mei Zhu
RATIONALE: Ventilator-associated complications comprise important fatal aetiologies during heart transplantation. Ultra-fast anesthesia might provide the most effective measure to prevent this type of complication. Immediate extubation after heart transplantation (IEAHT) has recently been reported in adult patients. However, IEAHT in children is much more challenging due to limitations in anesthesia protocols. Recently, we managed to perform an ultra-fast anesthesia protocol combined with IEAHT during a heart transplant operation in a child, who had an excellent postoperative outcome...
February 2019: Medicine (Baltimore)
Kana R Jat, Joseph L Mathew
BACKGROUND: Acute bronchiolitis is one of the most frequent causes of emergency department visits and hospitalisation in children. There is no specific treatment for bronchiolitis except for supportive treatment, which includes ensuring adequate hydration and oxygen supplementation. Continuous positive airway pressure (CPAP) aims to widen the lungs' peripheral airways, enabling deflation of overdistended lungs in bronchiolitis. Increased airway pressure also prevents the collapse of poorly supported peripheral small airways during expiration...
January 31, 2019: Cochrane Database of Systematic Reviews
Gunchan Paul, Birinder Singh Paul, Parshotum Lal Gautam, G Singh, S Kaushal
Objective: To analyze the frequency, causes, and outcomes of admission to the Intensive Care Unit (ICU) among Parkinson's disease (PD) population so that preventive measures can be developed. Methods: We prospectively observed patients with diagnosis of PD admitted to ICU from January 2014 to December 2016. Based on etiology for hospital admission, they were divided into two groups - related to PD (further divided into direct or indirect) or not associated with PD at all...
January 2019: Annals of Indian Academy of Neurology
Amelia C Nelson, Joy Kehoe, Jeffrey Sankoff, David Mintzer, Julie Taub, Kevin A Kaucher
INTRODUCTION: Alcohol withdrawal treatment varies widely. Benzodiazepines are the standard of care, with rapid onset and long durations of action. Recent drug shortages involving IV benzodiazepines have required incorporation of alternative agents into treatment protocols. Phenobarbital has similar pharmacokinetics to select benzodiazepines frequently used for alcohol withdrawal. The objective of this study is to describe the effectiveness and safety of our institutional protocols during three time periods utilizing benzodiazepines and barbiturates for the acute treatment of alcohol withdrawal in the emergency department...
January 3, 2019: American Journal of Emergency Medicine
Mazen J El Sayed, Hani Tamim, Aurelie Mailhac, N Clay Mann
Prehospital use of ventilators by emergency medical services (EMS) during 911 calls is increasing. This study described the impact of prehospital mechanical ventilation on prehospital time intervals and on mortality.This retrospective matched-cohort study used 4 consecutive public releases of the US National Emergency Medical Services Information System dataset (2011-2014). EMS activations with recorded ventilator use were randomly matched with activations without ventilator use (1 to 1) on age (range ± 2 years), gender, provider's primary impression, urbanicity, and level of service...
January 2019: Medicine (Baltimore)
Ronan McKenna, Lindsay Joseph, Philip Sargent, Meryta May, Sarah Tozer, Seweryn Bialasiewicz, Claire Heney, Luregn J Schlapbach, Julia E Clark
AIM: The human parechovirus (HPeV) has emerged as a pathogen causing sepsis-like presentations in young infants, but there is a lack of data on HPeV presentations requiring intensive care support. We aimed to characterise the clinical presentation, disease severity, management and outcome of a population-based cohort of children with microbiologically confirmed HPeV infection requiring admission to paediatric intensive care units (PICUs) in Queensland, Australia during a recent outbreak...
January 24, 2019: Journal of Paediatrics and Child Health
Byeong-Ho Jeong, Soo Jin Na, Dae-Sang Lee, Chi Ryang Chung, Gee Young Suh, Kyeongman Jeon
BACKGROUND: Intensive care unit (ICU) readmission is generally associated with increased hospital stays and increased mortality. However, there are limited data on ICU readmission in critically ill cancer patients. METHOD: We conducted a retrospective cohort study based on the prospective registry of all critically ill cancer patients admitted to the oncology medical ICU between January 2012 and December 2013. After excluding patients who were discharged to another hospital or decided to end-of-life care, we divided the enrolled patients into four groups according to the time period from ICU discharge to unexpected events (ICU readmission or ward death) as follows: no (without ICU readmission or death, n = 456), early (within 2 days, n = 42), intermediate (between 2 and 7 days, n = 64), and late event groups (after 7 days of index ICU discharge, n = 129)...
2019: PloS One
Jih-Shuin Jerng, Chao-Hsiun Tang, Rhoda Wen-Yi Cheng, Michael Yao-Hsien Wang, Kuan-Yu Hung
OBJECTIVE: Although disease-related malnutrition has prognostic implications for patients with chronic obstructive pulmonary disease (COPD), its health-economic impact and clinical burdens are uncertain. We conducted a population-level study to investigate these questions. METHODS: We excerpted data relevant to malnutrition, prolonged mechanical ventilation, and medications from claims by 1,197,098 patients which were consistent with COPD and registered by the Taiwan National Health Insurance Administration between 2009 and 2013...
January 24, 2019: Current Medical Research and Opinion
Osama M El-Asheer, Emad E M Hammad, Ismail L Mohamad, Khaled Saad, Nancy A Aziz
BACKGROUND: Scorpion envenomation and its consequences represented a serious healthcare problem in Upper Egypt and considered to be an important cause of life-threatening emergency particularly in children. METHODS: One hundred patients presented to the emergency department of Assiut University Children Hospital with a history of scorpion sting aged less than 18 years were included in our randomized comparative trial during 2016. Two groups of patients were randomly categorized according to the route of administration of scorpion antivenom; intramuscular and intravenous with 50 patients in each group...
January 18, 2019: Toxicon: Official Journal of the International Society on Toxinology
Laura Baumgartner, Kalvin Lam, Jonathan Lai, Mitch Barnett, Ashley Thompson, Kendall Gross, Amanda Morris
STUDY OBJECTIVE: Intensive care unit (ICU) delirium is an acute brain dysfunction that has been associated with increased mortality, prolonged ICU and hospital lengths of stay, and development of post-ICU cognitive impairment. Melatonin may help to restore sleep and reduce the occurrence of ICU delirium. The purpose of this study was to evaluate the effectiveness of melatonin for the prevention of ICU delirium in critically ill adults. DESIGN: Retrospective, observational cohort study...
January 21, 2019: Pharmacotherapy
Fermín López-Rivera, Hector R Cintrón Martínez, Christian Castillo LaTorre, Alexis Rivera González, Jose Gabriel Rodríguez Vélez, Vanessa Fonseca Ferrer, Omar F Méndez Meléndez, Edgar J Vázquez Vargas, Hernán A González Monroig
BACKGROUND Pulmonary edema is the accumulation of fluid in the lung secondary to increased hydrostatic pressure. Hypertensive cardiogenic pulmonary edema presents with a sudden onset of severe dyspnea, tachycardia, and tachypnea, and can occur when the systolic blood pressure exceeds 160 mmHg in association with acute decompensated congestive cardiac failure (CCF). A case is presented of hypertensive cardiogenic pulmonary edema treated with high-dose nitroglycerin and includes a review of the literature. CASE REPORT A 63-year-old Hispanic male with a medical history of hypertension, coronary artery disease, heart failure with a reduced ejection fraction of 35%, chronic kidney disease (CKD) and diabetes mellitus, presented as an emergency with acute, severe dyspnea...
January 21, 2019: American Journal of Case Reports
Steven J Baumrucker, Matt Stolick, Laura Hutchinson, Angela Eastridge, Lawrence Devereux, Russell W Adkins, Gregory T Carter
MC is a 42-year-old female who was in a motor vehicle accident and suffered multiple contusions as well as a fracture of the left femur, pelvic ramus, and left orbit. Due to contusion of the brain, MC has been comatose for over a week and is on mechanical ventilation to protect her airway. There is no written declaration of surrogacy. During the admission, surgery to repair the left femoral fracture was performed and was complicated by severe blood loss. Currently, MC's hematocrit is 24% with a hemoglobin of 7...
January 16, 2019: American Journal of Hospice & Palliative Care
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