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RANDOMIZED CONTROLLED TRIAL
Shota Kubota, Hideki Hashimoto, Yurika Yoshikawa, Kengo Hiwatashi, Takahiro Ono, Masaki Mochizuki, Hiromu Naraba, Hidehiko Nakano, Yuji Takahashi, Tomohiro Sonoo, Kensuke Nakamura
BACKGROUND: Mechanical insufflation-exsufflation (MI-E) facilitates extubation. However, its potential to reduce the duration of ventilator use remains unclear. Therefore, the present study investigated whether the use of MI-E shortened the duration of mechanical ventilation in patients with high sputum retention. METHODS: A randomized open-label trial was conducted at a single intensive care unit (ICU) in Japan between November 2017 and June 2019. Ventilated subjects requiring suctioning at least once every hour due to sputum retention were randomly assigned to the MI-E group or conventional care group...
2024: PloS One
#42
MULTICENTER STUDY
Suman Kanungo, Uttaran Bhattacharjee, Aslesh O Prabhakaran, Rakesh Kumar, Prabu Rajkumar, Sumit Dutt Bhardwaj, Alok Kumar Chakrabarti, Girish Kumar C P, Varsha Potdar, Byomkesh Manna, Ritvik Amarchand, Avinash Choudekar, Giridara Gopal, Krishna Sarda, Kathryn E Lafond, Eduardo Azziz-Baumgartner, Siddhartha Saha, Lalit Dar, Anand Krishnan
BACKGROUND: Limited data exists regarding risk factors for adverse outcomes in older adults hospitalized with Community-Acquired Pneumonia (CAP) in low- and middle-income countries such as India. This multisite study aimed to assess outcomes and associated risk factors among adults aged ≥60 years hospitalized with pneumonia. METHODS: Between December 2018 and March 2020, we enrolled ≥60-year-old adults admitted within 48 hours for CAP treatment across 16 public and private facilities in four sites...
2024: PloS One
#43
JOURNAL ARTICLE
Hannah Littlecott, Shari Krishnaratne, Jacob Burns, Eva Rehfuess, Kerstin Sell, Carmen Klinger, Brigitte Strahwald, Ani Movsisyan, Maria-Inti Metzendorf, Petra Schoenweger, Stephan Voss, Michaela Coenen, Roxana Müller-Eberstein, Lisa M Pfadenhauer
BACKGROUND: More than 767 million coronavirus 2019 (COVID-19) cases and 6.9 million deaths with COVID-19 have been recorded as of August 2023. Several public health and social measures were implemented in schools to contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and prevent onward transmission. We built upon methods from a previous Cochrane review to capture current empirical evidence relating to the effectiveness of school measures to limit SARS-CoV-2 transmission...
May 2, 2024: Cochrane Database of Systematic Reviews
#44
JOURNAL ARTICLE
Alexandra H Ferguson, Kellie A Stockton, Sarah E Wright, Joanne M George, Tessa J Fulton, Christian Stocker, Debbie A Long
OBJECTIVES: To adapt and develop a reliable and easily administered outcome measure of physical and respiratory function in critically ill children in the PICU. DESIGN: Modified Delphi study to adapt the Chelsea Critical Care Physical Assessment (CPAx) tool for use in children 2-18 years old, with subsequent prospective testing in a single-center cohort. SETTING: Single-center tertiary PICU. SUBJECTS: Delphi process in 27 panelists (including physiotherapists, occupational therapists, and pediatric intensivists from seven countries from January 2018 to March 2018)...
May 1, 2024: Pediatric Critical Care Medicine
#45
REVIEW
Mohamed E Abdel-Latif, Olive Tan, Michelle Fiander, David A Osborn
BACKGROUND: Respiratory distress occurs in up to 7% of newborns, with respiratory support (RS) provided invasively via an endotracheal (ET) tube or non-invasively via a nasal interface. Invasive ventilation increases the risk of lung injury and chronic lung disease (CLD). Using non-invasive strategies, with or without minimally invasive surfactant, may reduce the need for mechanical ventilation and the risk of lung damage in newborn infants with respiratory distress. OBJECTIVES: To evaluate the benefits and harms of nasal high-frequency ventilation (nHFV) compared to invasive ventilation via an ET tube or other non-invasive ventilation methods on morbidity and mortality in preterm and term infants with or at risk of respiratory distress...
May 2, 2024: Cochrane Database of Systematic Reviews
#46
JOURNAL ARTICLE
Yi-Hsin Wu, Ching-Heng Hsiao, Yi-Ling Chen, Li-Yi Tsai, Shu-Chi Mu
BACKGROUND: Tracheal agenesis, or tracheal atresia, is a rare congenital anomaly. The presence of a tracheoesophageal fistula (TEF) can help with breathing for newborns with tracheal agenesis. In this article, we presented three unique cases and outcomes of neonates with tracheal agenesis along with a review of the literature. METHODS: This study consisted of a single center case series followed by a review of literature. Case reports were generated using both written and electronic medical records from a single hospital...
May 2, 2024: Pediatric Pulmonology
#47
REVIEW
Jia Yi Lim, Chin Jin Ker, Nai Ming Lai, Olga Romantsik, Michelle Fiander, Kenneth Tan
BACKGROUND: Dexmedetomidine is a selective alpha-2 agonist with minimal impact on the haemodynamic profile. It is thought to be safer than morphine or stronger opioids, which are drugs currently used for analgesia and sedation in newborn infants. Dexmedetomidine is increasingly being used in children and infants despite not being licenced for analgesia in this group. OBJECTIVES: To determine the overall effectiveness and safety of dexmedetomidine for sedation and analgesia in newborn infants receiving mechanical ventilation compared with other non-opioids, opioids, or placebo...
May 2, 2024: Cochrane Database of Systematic Reviews
#48
REVIEW
Lea Belackova, Jos H Verbeek, Jan L Hoving, Henk F van der Molen, Diana Gagliardi, Stefania Curti, Carel Tj Hulshof, Paul Tj Scheepers
BACKGROUND: Asbestos exposure can lead to asbestos-related diseases. The European Union (EU) has adopted regulations for workplaces where asbestos is present. The EU occupational exposure limit (OEL) for asbestos is 0.1 fibres per cubic centimetre of air (f/cm3 ) as an eight-hour average. Different types of personal protective equipment (PPE) are available to provide protection and minimise exposure; however, their effectiveness is unclear. OBJECTIVES: To assess the effects of personal protective equipment (PPE), including donning and doffing procedures and individual hygienic behaviour, compared to no availability and use of such equipment or alternative equipment, on asbestos exposure in workers in asbestos demolition and repair work...
May 2, 2024: Cochrane Database of Systematic Reviews
#49
JOURNAL ARTICLE
Esperanza Jiménez-Nogueira, Cristina Bueno-Rebollo, Beatriz García-Jerez, Elia Callejón-Fernández, Mateo Jesús Díaz-Torres, Yolanda González-Jiménez, David Lozano-Paniagua, Patricia Juárez-Marruecos, Bruno José Nievas-Soriano, Antonio Bonillo-Perales
INTRODUCTION: This work aimed to analyze whether breastfeeding is a predictive factor for admission to ICU or needing mechanical ventilation in children under 6 months with RSV+ respiratory infection. METHODS: A retrospective cohort study was performed in three hospitals. Binary and multiple logistic regression analyses were performed to evaluate the association of variables with admission to the ICU or receiving mechanical ventilation. RESULTS: We analyzed 414 admissions, of which 293 (70...
May 2, 2024: Pediatric Pulmonology
#50
COMPARATIVE STUDY
Gerson Gatass Orro de Campos, Leandro Steinhorst Goelzer, Tiago Rodrigues de Lemos Augusto, Gisele Walter Barbosa, Gaspar R Chiappa, Erik H van Iterson, Paulo T Muller
BACKGROUND: Currently, excess ventilation has been grounded under the relationship between minute-ventilation/carbon dioxide output ( V ˙ E - V ˙ CO 2 ). Alternatively, a new approach for ventilatory efficiency ( η E V ˙ ) has been published. OBJECTIVE: Our main hypothesis is that comparatively low levels of η E V ˙ between chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) are attainable for a similar level of maximum and submaximal aerobic performance, conversely to long-established methods ( V ˙ E - V ˙ CO 2 slope and intercept)...
2024: Arquivos Brasileiros de Cardiologia
#51
Fabio Eiti Nishibe Minamoto, Mariana Rodrigues Cremonese, Eduardo de Campos Werebe, Victor Nudelman, Helio Minamoto
A female newborn presented with respiratory distress at birth and was diagnosed with congenital tracheal stenosis. The stenosis was positioned at the distal trachea and compromised the carina and the right and left bronchi. She underwent surgical treatment using circulatory life support with veno-arterial peripheral extracorporeal membrane oxygenation, and the airway was reconstructed using the slide tracheoplasty technique to build a neocarina. The patient had an excellent postoperative course, was successfully weaned from extracorporeal membrane oxygenation and invasive ventilation, and was discharged...
2024: Einstein
#52
JOURNAL ARTICLE
Lauren Freedman, Anna Varughese, Binu Koirala, Vinciya Pandian
BACKGROUND AND PURPOSE: Tonsillectomy procedures are commonly performed worldwide. At our academic tertiary care facility, we perform approximately 1000 tonsillectomy procedures annually. We have found inconsistent pain management strategies in pediatric tonsillectomy patients have contributed to variability in postoperative complications and the number and types of postoperative pain medications required in the Post Anesthesia Care Unit (PACU). This project aimed to assess the impact of implementing a standardized perioperative pain management protocol on reducing postoperative complications in pediatric patients who underwent a tonsillectomy procedure...
May 2, 2024: Paediatric Anaesthesia
#53
JOURNAL ARTICLE
Randa Elsheikh, Abdelrahman M Makram
The global increasing spread of multidrug-resistant organisms (MRDOs) is threatening the control of various infections in vulnerable populations and patient groups. One of the most affected groups is burn patients, who are prone to hyperinfection as they suffer from a hypermetabolic state and weakened immune barriers. Those patients also share the infection risk of patients hospitalized for a long time, including ventilator-associated pneumonia and urinary tract infections. While some preventative and therapeutic management styles are still controversial, there are some consensuses that we discuss here...
May 2, 2024: Journal of Burn Care & Research: Official Publication of the American Burn Association
#54
REVIEW
Luigi Vetrugno, Cristian Deana, Nicolas Colaianni-Alfonso, Fabrizio Tritapepe, Carmen Fierro, Salvatore Maurizio Maggiore
The application of preoperative noninvasive respiratory support (NRS) has been expanding with increasing recognition of its potential role in this setting as a physiological optimization for patients with a high risk of developing atelectasis and postoperative pulmonary complications (PPC). The increased availability of high-performance anesthesia ventilator machines providing an easy way for NRS support in patients with reduced lung function should not be under-evaluated. This support can reduce hypoxia, restore lung volumes and theoretically reduce atelectasis formation after general anesthesia...
2024: Frontiers in Medicine
#55
JOURNAL ARTICLE
Xiaofeng Wang, Shuo Li, Da Huo, Zhiyuan Zhu, Wenlong Wang, Hongxia He, Qian Zhang, Jiantao Li, Xu Wang
PURPOSE: Infection prevention and control (IPC) has a significant impact on the prognosis after pediatric cardiac surgery. This study aimed to provide surveillance data on the incidence and density of various infections during the COVID-19 epidemic and explore the influence of multi-drug resistant organisms (MDRO) on in-hospital prognosis after congenital heart disease surgery. METHODS: This single-center retrospective study included pediatric patients who underwent cardiac surgery between 2021 and 2022...
2024: Infection and Drug Resistance
#56
JOURNAL ARTICLE
Abdulraouf M Z Jijeh, Anis Fatima, Mohammad A Faraji, Hussam K Hamadah, Ghassan A Shaath
OBJECTIVES: This prospective cohort study aimed to investigate changes in intracranial pressure (ICP) and cerebral hemodynamics in infants with congenital heart disease undergoing the Glenn procedure, focusing on the relationship between superior vena cava pressure and estimated ICP. DESIGN: A single-center prospective cohort study. SETTING: The study was conducted in a cardiac center over 4 years (2019-2022). PATIENTS: Twenty-seven infants with congenital heart disease scheduled for the Glenn procedure were included in the study, and detailed patient demographics and primary diagnoses were recorded...
May 2024: Critical care explorations
#57
JOURNAL ARTICLE
Alexander J Beagle, Priya A Prasad, Colin C Hubbard, Sven Walderich, Sandra Oreper, Yumiko Abe-Jones, Margaret C Fang, Kirsten N Kangelaris
OBJECTIVES: To evaluate the relationship between early IV fluid volume and hospital outcomes, including death in-hospital or discharge to hospice, in septic patients with and without heart failure (HF). DESIGN: A retrospective cohort study using logistic regression with restricted cubic splines to assess for nonlinear relationships between fluid volume and outcomes, stratified by HF status and adjusted for propensity to receive a given fluid volume in the first 6 hours...
May 2024: Critical care explorations
#58
JOURNAL ARTICLE
Hassan Ashktorab, Antonio Pizuorno, Lakshmi Gayathri Chirumamilla, Folake Adeleye, Maryam Mehdipour Dalivand, Zaki A Sherif, Gholamreza Oskrochi, Suryanarayana Reddy Challa, Boubini Jones-Wonni, Sheldon Rankine, Chiamaka Ekwunazu, Abigail Banson, Rachel Kim, Chandler Gilliard, Elizabeth Ekpe, Nader Shayegh, Constance Nyaunu, Chidi Martins, Ashley Slack, Princess Okwesili, Malachi Abebe, Yashvardhan Batta, Do Ly, Ogwo Valarie, Tori Smith, Kyra Watson, Oluwapelumi Kolawole, Sarine Tahmazian, Sofiat Atoba, Myra Khushbakht, Gregory Riley, Warren Gavin, Areeba Kara, Manuel Hache-Marliere, Leonidas Palaiodimos, Vishnu R Mani, Aleksandr Kalabin, Vijay Reddy Gayam, Pavani Reddy Garlapati, Joseph Miller, Fatimah Jackson, John M Carethers, Vinod Rustgi, Hassan Brim
BACKGROUND AND AIM: Identifying clinical characteristics and outcomes of different ethnicities in the US may inform treatment for hospitalized COVID-19 patients. Aim of this study is to identify predictors of mortality among US races/ethnicities. DESIGN SETTING AND PARTICIPANTS: We retrospectively analyzed de-identified data from 9,873 COVID-19 patients who were hospitalized at 15 US hospital centers in 11 states (March 2020-November 2020). Main Outcomes and Measures: The primary outcome was to identify predictors of mortality in hospitalized COVID-19 patients...
2024: Arch Intern Med Res
#59
JOURNAL ARTICLE
Avisham, Anurag Agrawal, Abhishek Gupta
BACKGROUND AND OBJECTIVES: Hospital-acquired pneumonia (HAP) is a life-threatening hospital-acquired infection contributing to poor outcomes and mortality. Though the prevalence is comparable, the burden of comorbidities and malnutrition further worsens the scenario in developing countries. Infective agents responsible for these infections vary between regions due to the variables involved. There is a dearth of data on clinico-microbiological correlates of HAP from Northern India...
December 2023: Curēus
#60
JOURNAL ARTICLE
Ahmed Abushahin, Sara G Hamad, Amal Sabouni, Sufwan Alomar, Anoop Sudarsanan, Hiba Kammouh, Prem Chandra
Background As the most common chronic lung disease (CLD) related to premature birth, bronchopulmonary dysplasia (BPD) is associated with long-term lung disease along with cardiovascular and neurodevelopmental disorders. However, data on the incidence and predictors of BPD in Qatar are lacking. Objectives In this study, we aimed to determine the incidence of BPD among infants born at ≤ 32 weeks gestational age (GA) at our neonatal unit, and identify risk factors for the development of BPD and moderate-severe BPD...
April 2024: Curēus
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