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This page shows you the most recent publications within this specialty of the MedWorm directory. This is page number 19.

Mobile-based asthma action plans for adolescents
Journal of Asthma, Ahead of Print. (Source: Journal of Asthma)
Source: Journal of Asthma - January 7, 2015 Category: Respiratory Medicine Tags: article Source Type: research

Furosemide versus ethacrynic acid in pediatric patients undergoing cardiac surgery: a randomized controlled trial
IntroductionClinical effects of Furosemide (F) and ethacrynic acid (EA) continuous infusion on urine output (UO), fluid balance and renal, cardiac, respiratory and metabolic function were compared in infants undergoing surgery for congenital heart diseases. Methods: A prospective randomized double-blinded study was conducted. Patients received either 0.2?mg/kg/h (up to 0.8?mg/kg/h) of F or EA. Results: In total 38 patients were enrolled in the F group and 36 in the EA group. No adverse reactions were recorded. UO at post-operative day (POD) 0 was significantly higher in the EA group, 6.9(3.3) ml/kg/h, compared to the F gro...
Source: Critical Care - January 7, 2015 Category: Intensive Care Authors: Zaccaria RicciRoberta HaibergerChiara PezzellaCristiana GaristoIsabella FaviaPaola Cogo Source Type: research

Findings of a Naloxone Database and its Utilization to Improve Safety and Education in a Tertiary Care Medical Center
ConclusionExamination of naloxone use can assist in the identification and stratification of patients at risk for opioid‐induced respiratory depression and oversedation and can serve as a driver for improvements in hospital patient safety. This information can also guide other institutions interested in similar improvements. (Source: Pain Practice)
Source: Pain Practice - January 7, 2015 Category: Anesthesiology Authors: David M. Rosenfeld, Jeffrey A. Betcher, Ruby A. Shah, Yu‐Hui H. Chang, Meng‐Ru Cheng, Efrain I. Cubillo, Julia M. Griffin, Terrence L. Trentman Tags: Original Article Source Type: research

A retrospective analysis of severe intraoperative respiratory compliance changes during ophthalmic arterial chemosurgery for retinoblastoma
ConclusionsHere, most patients experienced a severe respiratory compliance event during at least one of their procedures. Overall incidence was 29% and was more likely on subsequent procedures. A severe respiratory compliance event at the initial procedure was poorly predictive of its occurrence on subsequent procedures. No morbidity was associated with intraoperative severe respiratory compliance events. (Source: Pediatric Anesthesia)
Source: Pediatric Anesthesia - January 7, 2015 Category: Anesthesiology Authors: Meredith A. Kato, Nicole Green, Kelli O'Connell, Sean D. Till, Daniel J. Kramer, Mashael Al‐Khelaifi, Jung Hee Han, Kane O. Pryor, Yves‐Pierre Gobin, Alex Proekt Tags: Original Article Source Type: research

Intentional esophageal intubation to improve visualization during emergent endotracheal intubation in the context of massive vomiting: a case report
Impaired visualization during intubation due to vomitus of gastric contents is a potential cause of failed intubation. An 82-year-old woman was intubated emergently for respiratory distress secondary to aspiration of gastric contents. Her intubation was hindered by the presence of a massive amount of ongoing vomitus that impaired visualization and overwhelmed all suction capabilities. Intentional blind intubation of the esophagus with an endotracheal tube was performed with successful diversion of ongoing vomitus away from the airway. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - January 7, 2015 Category: Anesthesiology Authors: Khaled Sorour, Lucas Donovan Tags: Case Report Source Type: research

Comparison of Transthoracic Esophagectomy with Definitive Chemoradiotherapy as Initial Treatment for Patients with Esophageal Squamous Cell Carcinoma Who Could Tolerate Transthoracic Esophagectomy
Conclusions In locally advanced ESCC patients who could tolerate TTE, TTE extended 3-year OS, which might have been encouraged by utilizing local treatment after initial treatment failure. (Source: Annals of Surgical Oncology)
Source: Annals of Surgical Oncology - January 7, 2015 Category: Cancer & Oncology Source Type: research

Mitochondrial Neurogastrointestinal Encephalomyopathy Treated With Stem Cell Transplantation: A Case Report And Review Of Literature
Publication date: Available online 6 January 2015 Source:Hematology/Oncology and Stem Cell Therapy Author(s): Musthafa Chalikandy Peedikayil , Eje Ingvar Kagevi , Ehab Abufarhaneh , Moeenaldeen Dia Alsayed , Hazzaa Abdulla Alzahrani Mitochondrial neurogastrointestinal encephalomyopathy (MNGIE) is a rare autosomal recessive disorder. The mutation in the ECGF1 gene causes severe deficiency of thymidine phosphorylase (TP), which in turn increases thymidine and deoxyuridine in the blood, serum, and tissue. The toxic levels of these products cause malfunction of the mitochondrial respiratory chain and mitochondrial DNA. Commo...
Source: Hematology Oncology and Stem Cell Therapy - January 7, 2015 Category: Cancer & Oncology Source Type: research

Pilot study to detect airborne Mycobacterium tuberculosis exposure in a South African public healthcare facility outpatient clinic
Conclusion The use of air sampling coupled with quantitative real-time PCR is a simple and effective tool to demonstrate the risk of M. tuberculosis exposure. The findings provide an impetus for hospital management to strengthen infection prevention and control measures for tuberculosis. (Source: Journal of Hospital Infection)
Source: Journal of Hospital Infection - January 7, 2015 Category: Infectious Diseases Source Type: research

Lowbury Lecture 2014 Airborne transmission and precautions: facts and myths
Publication date: Available online 13 December 2014 Source:Journal of Hospital Infection Author(s): W.-H. Seto Airborne transmission occurs only when infectious particles of <5 μm, known as aerosols, are propelled into the air. The prevention of such transmission is expensive, requiring N95 respirators and negative pressure isolation rooms. This lecture first discussed whether respiratory viral infections are airborne with reference to published reviews of studies before 2008, comparative trials of surgical masks and N95 respirators, and relevant new experimental studies. However, the most recent experimental stu...
Source: Journal of Hospital Infection - January 7, 2015 Category: Infectious Diseases Source Type: research

A matched-group study protocol to evaluate the implementation of an Integrated Care Pathway programme for chronic obstructive pulmonary disease in Singapore
This study on the COPD-ICP programme is undertaken to determine the impact on processes of care, clinical outcomes and acute care utilisation. Methods and analysis This will be a retrospective, pre-post, matched-groups study to evaluate the effectiveness of the COPD-ICP programme in improving clinical outcomes and reducing healthcare costs. Programme enrolees (intervention group) and non-enrolees (comparator group) will be matched using propensity scores. Administratively, we set 30% as our target for proportion admission difference between programme and non-programme patients. A sample size of 62 patients in each group w...
Source: BMJ Open - January 7, 2015 Category: Journals (General) Authors: Wu, C. X., Tan, W. S., See, R. C. K., Yu, W., Kwek, L. S. L., Toh, M. P. H. S., Chee, T. G., Chua, G. S. W. Tags: Open access, Health economics, Health services research, Public health, Respiratory medicine Protocol Source Type: research

Outcome following physician supervised prehospital resuscitation: a retrospective study
Conclusions The present study demonstrates that anaesthesiologist administrated prehospital therapy increases the level of treatment modalities leading to an increased survival in relation to a prehospital system consisting of emergency medical technicians and paramedics alone and thus supports the concept of applying specialists in anaesthesiology in the prehospital setting especially when treating patients with cardiac arrest, patients in need of respiratory support and trauma patients. (Source: BMJ Open)
Source: BMJ Open - January 7, 2015 Category: Journals (General) Authors: Mikkelsen, S., Kruger, A. J., Zwisler, S. T., Brochner, A. C. Tags: Open access, Anaesthesia, Emergency medicine Research Source Type: research

Birth History Is Forever: Implications for Family Medicine
The rapidly growing number of adult survivors of preterm birth has necessitated and made possible for the first time large-scale investigations of long-term outcomes of preterm birth. Large epidemiologic studies have shown that the long-term sequelae are wide-ranging, including metabolic disorders, cardiovascular and respiratory disease, psychiatric disorders, and increased mortality risk. Clinicians should now recognize preterm birth as a long-term, multidisease risk factor in adults. These research findings contribute to a growing body of evidence of early life programming for chronic disease, which in turn supports a "l...
Source: Journal of the American Board of Family Medicine - January 7, 2015 Category: Primary Care Authors: Crump, C. Tags: Special Communication Source Type: research

Structural biology: Cold drug fits in virus's pocket
Nature 517, 7533 (2015). doi:10.1038/517124c An antiviral drug developed for the common cold could be effective against another virus that affected more than 1,000 US children in 2014.An enterovirus called EV-D68 caused respiratory illness, sometimes severe, in an outbreak last August. Michael Rossmann and his colleagues at Purdue University (Source: Nature)
Source: Nature - January 7, 2015 Category: Research Tags: Research Highlights Source Type: research

First you have to row a little boat
(Source: Respirology)
Source: Respirology - January 7, 2015 Category: Respiratory Medicine Authors: Jennifer R. Honda, Richard J. Wallace, Edward D. Chan Tags: Editorial Source Type: research

Let’s keep dancing
Looking back over my career, it is clear that my major preoccupation, pleasure and productivity has been to increase the breadth and depth of things that I don’t know. While some of this stuff has filtered down into facts – in the form of peer-reviewed publications – these often feel like a sad betrayal of the fleeting, exciting moments of insight that preceded them. I find myself leaning towards a Groucho Marx view that any fact that I know is not worth knowing. My heart sinks when I have to list publications as a measure of my professional activities. (Source: Tuberculosis)
Source: Tuberculosis - January 7, 2015 Category: Respiratory Medicine Authors: Douglas Young Source Type: research

TLR9 Gene Region Polymorphisms and Susceptibility to Tuberculosis in Vietnam
Humans exposed to Mycobacterium tuberculosis (Mtb) show variation in susceptibility to infection and differences in tuberculosis (TB) disease outcome. Toll-like receptor 9 (TLR9) is a pattern recognition receptor that mediates recognition of Mtb and modulates Mtb-specific T-cell responses. Using a case-population design, we evaluated whether single nucleotide polymorphisms (SNPs) in the TLR9 gene region are associated with susceptibility to pulmonary or meningeal TB as well as neurologic presentation and mortality in the meningeal TB group. (Source: Tuberculosis)
Source: Tuberculosis - January 7, 2015 Category: Respiratory Medicine Authors: A.D. Graustein, D.J. Horne, M. Arentz, N.D. Bang, T.T.H. Chau, G.E. Thwaites, M. Caws, N.T.T. Thuong, S.J. Dunstan, T.R. Hawn Tags: Host Genetics of Susceptibility Source Type: research

CD4+ T cell polyfunctional profile in HIV-TB coinfection are similar between individuals with latent and active TB infection
We examined a cohort of HIV-infected anti-retroviral naïve individuals in Kampala, Uganda, a TB endemic area using multiparametric flow cytometry analysis to determine IFN-γ, IL-2, IL-17, and TNF-α production in CD4+ memory T cell subsets. (Source: Tuberculosis)
Source: Tuberculosis - January 7, 2015 Category: Respiratory Medicine Authors: David H. Canaday, Sankar Sridaran, Puja Van Epps, Htin Aung, Christopher J. Burant, Mary Nserko, Harriet Mayanja-Kizza, Michael R. Betts, Zahra Toossi Tags: Mechanisms of Pathogenesis Source Type: research

Vitamin D deficiency is associated with pulmonary dysfunction in cystic fibrosis
Vitamin D deficiency is common in CF. Whether vitamin D affects pulmonary function in CF is unknown. (Source: Journal of Cystic Fibrosis)
Source: Journal of Cystic Fibrosis - January 7, 2015 Category: Respiratory Medicine Authors: William P. Sexauer, Anas Hadeh, Pamela A. Ohman-Strickland, Robert L. Zanni, Laurie Varlotta, Douglas Holsclaw, Stanley Fiel, Gavin R. Graff, Arthur Atlas, Dorothy Bisberg, Denis Hadjiliadis, Suzanne H. Michel, Daria Mintz, Rebanta Chakraborty, Bridget Ma Tags: Original Article Source Type: research

Innovative Approach Using Interprofessional Simulation to Educate Surgical Residents in Technical and Nontechnical Skills in High-Risk Clinical Scenarios
ImportanceThe Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained.ObjectiveTo educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations.Design, Setting, and ParticipantsSimMan 3GS was used to simulate high-risk clinical s...
Source: JAMA Surgery - January 7, 2015 Category: Sports Medicine Source Type: research

A Global Health Elective for US Medical Students: The 35 Year Experience of the State University of New York, Downstate Medical Center, School of Public Health
Abstract The School of Public Health at the State University of New York, Downstate Medical Center has sponsored a 6–8 week global health elective for fourth year medical students since 1980. The purpose of this elective is to provide students with an opportunity to observe the health care and public health delivery systems in low-income countries, provide medical service and have a cross-cultural experience. Over the course of the past 35 years, 388 students have participated in this global health elective in more than 41 low-income countries. The most popular sites include the Dominican Republic, Guatemala, ...
Source: Journal of Community Health - January 7, 2015 Category: Global & Universal Source Type: research

Noncommunicable Diseases
Semin Reprod Med 2015; 33: 035-040DOI: 10.1055/s-0034-1395277Noncommunicable diseases (NCDs), long considered diseases of little significance to global health, represent the greatest threat to economic development and human health. The main NCDs—diabetes, cancer, cardiovascular disease, and chronic respiratory disease—are the world's number one killer and bear the greatest burden on the poor. On September 19–20, 2011, the United Nations General Assembly (UNGA) convened a high-level meeting (HLM) on the Prevention and Control of Non-Communicable Diseases. The only other HLM held on a health issue in the past had been ...
Source: Seminars in Reproductive Medicine - January 7, 2015 Category: Reproduction Medicine Authors: Marrero, ShannonAdashi, Eli Y. Source Type: research

Mid-term results of aortic valve surgery in redo scenarios in the current practice: results from the multicentre European RECORD (REdo Cardiac Operation Research Database) initiative [ADULT CARDIAC]
CONCLUSIONS RAVR achieves overall satisfactory results. Baseline risk factors and perioperative complications strongly affect outcomes and mandate improvements in perioperative management. New emerging strategies might be considered in selected high-risk cases. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - January 7, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Onorati, F., Biancari, F., De Feo, M., Mariscalco, G., Messina, A., Santarpino, G., Santini, F., Beghi, C., Nappi, G., Troise, G., Fischlein, T., Passerone, G., Heikkinen, J., Faggian, G. Tags: Basic research vascular ADULT CARDIAC Source Type: research

Emergency open surgery for aorto-oesophageal and aorto-bronchial fistulae after thoracic endovascular aortic repair: a single-centre experience [AORTIC SURGERY]
CONCLUSIONS AOF and ABF represent uncommon but fatal complications—if treated conservatively—after TEVAR that may occur during short- and mid-term follow-up. Surgery for AOF/ABF requires early diagnosis and should be performed promptly and in a radical fashion to totally excise all infected tissues in these high-risk patients. (Source: European Journal of Cardio-Thoracic Surgery)
Source: European Journal of Cardio-Thoracic Surgery - January 7, 2015 Category: Cardiovascular & Thoracic Surgery Authors: Luehr, M., Etz, C. D., Nozdrzykowski, M., Garbade, J., Lehmkuhl, L., Schmidt, A., Misfeld, M., Borger, M. A., Mohr, F.-W. Tags: Cerebral protection, Pericardium AORTIC SURGERY Source Type: research

Ornithinibacillus composti sp. nov., isolated from sludge compost and emended description of the genus Ornithinibacillus.
Abstract A Gram-stain positive, aerobic, motile, endospore-forming and rod-shaped bacterium, designated GSS05(T), was isolated from a sludge compost sample and was characterized by means of a polyphasic taxonomic approach. Growth was observed to occur with 0-3 % (w/v) NaCl (optimum 1 %), at pH 5.5-10 (optimum pH 7.5) and at 15-50 °C (optimum 37 °C). According to the results of a phylogenetic analysis, strain GSS05(T) was found to belong to the genus Ornithinibacillus and to be related most closely to the type strains of Ornithinibacillus halotolerans and Ornithinibacillus contaminans (96.5 and 95.1 % 16S rRN...
Source: Antonie van Leeuwenhoek - January 7, 2015 Category: Microbiology Authors: Lu Q, Yuan H, Li J, Zhao Y, Zhou S Tags: Antonie Van Leeuwenhoek Source Type: research

A retrospective analysis of severe intraoperative respiratory compliance changes during ophthalmic arterial chemosurgery for retinoblastoma.
CONCLUSIONS: Here, most patients experienced a severe respiratory compliance event during at least one of their procedures. Overall incidence was 29% and was more likely on subsequent procedures. A severe respiratory compliance event at the initial procedure was poorly predictive of its occurrence on subsequent procedures. No morbidity was associated with intraoperative severe respiratory compliance events. PMID: 25565164 [PubMed - as supplied by publisher] (Source: Paediatric Anaesthesia)
Source: Paediatric Anaesthesia - January 7, 2015 Category: Anesthesiology Authors: Kato MA, Green N, O'Connell K, Till SD, Kramer DJ, Al-Khelaifi M, Han JH, Pryor KO, Gobin Y, Proekt A Tags: Paediatr Anaesth Source Type: research

Continuous positive airway pressure (CPAP) for acute bronchiolitis in children.
CONCLUSIONS: The effect of CPAP in children with acute bronchiolitis is uncertain due to the limited evidence available. Larger trials with adequate power are needed to evaluate the effect of CPAP in children with acute bronchiolitis. PMID: 25563827 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - January 7, 2015 Category: Journals (General) Authors: Jat KR, Mathew JL Tags: Cochrane Database Syst Rev Source Type: research

Bronchiolitis.
Authors: Abstract Essential facts Bronchiolitis is the most common disease that affects the lower respiratory tract. Around one in five babies will develop the condition in their first year of life and it can become a serious illness in a small minority of children. It is caused by a viral infection where small airways in the lungs, known as bronchioles, become inflamed. This inflammation reduces the amount of air entering the lungs and causes breathing difficulties. Up to 3 per cent of children with bronchiolitis will need hospital care. In 2011-12, there were 30,451 secondary care admissions for bronchiolitis in...
Source: Nursing Standard - January 7, 2015 Category: Nursing Tags: Nurs Stand Source Type: research

Let's keep dancing
Looking back over my career, it is clear that my major preoccupation, pleasure and productivity has been to increase the breadth and depth of things that I don't know. While some of this stuff has filtered down into facts – in the form of peer-reviewed publications – these often feel like a sad betrayal of the fleeting, exciting moments of insight that preceded them. I find myself leaning towards a Groucho Marx view that any fact that I know is not worth knowing. My heart sinks when I have to list publications as a measure of my professional activities. (Source: Tuberculosis)
Source: Tuberculosis - January 7, 2015 Category: Respiratory Medicine Authors: Douglas Young Source Type: research

Fusobacterium nucleatum: a commensal-turned pathogen.
This article reviews its implication in adverse pregnancy outcomes (chorioamnionitis, preterm birth, stillbirth, neonatal sepsis, preeclampsia), GI disorders (colorectal cancer, inflammatory bowel disease, appendicitis), cardiovascular disease, rheumatoid arthritis, respiratory tract infections, Lemierre's syndrome and Alzheimer's disease. The virulence mechanisms involved in the diseases are discussed, with emphasis on its colonization, systemic dissemination, and induction of host inflammatory and tumorigenic responses. The FadA adhesin/invasin conserved in F. nucleatum is a key virulence factor and a potential diagnosti...
Source: Current Opinion in Microbiology - January 7, 2015 Category: Microbiology Authors: Han YW Tags: Curr Opin Microbiol Source Type: research

[Obstructive sleep apnea syndrome and ischemic heart disease. Evidence of their relationship.]
We present epidemiological data on the respiratory disorder and its association with ischemic cardiopathy, as well as common cardiovascular risk factors, physiopathological interactions between both conditions, clinical evolution and impact of treatment on prognosis. PMID: 25577551 [PubMed - as supplied by publisher] (Source: Archivos de Cardiologia de Mexico)
Source: Archivos de Cardiologia de Mexico - January 7, 2015 Category: Cardiology Authors: González-Pliego JA, Hernández-Gordillo D, Castañeda-Barragán E, García-Lamas L, Guzmán-Sánchez CM Tags: Arch Cardiol Mex Source Type: research

Assessment of Montelukast, Doxofylline, and Tiotropium With Budesonide for the Treatment of Asthma: Which Is the Best Among the Second-Line Treatment? A Randomized Trial.
This study aimed to compare the efficacy and safety of montelukast, doxofylline, and tiotropium with a low-dose budesonide in patients with mild to moderate persistent asthma. METHODS: Patients, all of whom were concurrently using inhaled budesonide (400 µg), were treated for 6 months with formoterol (12 µg), montelukast (10 mg), doxofylline (400 mg), or tiotropium (18 µg). Outcomes included forced expiratory volume in 1 second (FEV1), Saint George Respiratory Questionnaire (SGRQ) scores, asthma symptom scores (daytime and nighttime), and assessment of tolerability and rescue medication use. FINDINGS: A total of...
Source: Clinical Therapeutics - January 7, 2015 Category: Drugs & Pharmacology Authors: Rajanandh MG, Nageswari AD, Ilango K Tags: Clin Ther Source Type: research

Long-term follow-up of distal intestinal obstruction syndrome in cystic fibrosis.
CONCLUSION: CF patients with DIOS suffer from recurrent hospitalizations and airway pathogen acquisition. Although recurrence of DIOS is common, conservative treatment is successful in most patients. PMID: 25574107 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)
Source: World Journal of Gastroenterology : WJG - January 7, 2015 Category: Gastroenterology Authors: Lavie M, Manovitz T, Vilozni D, Levy-Mendelovich S, Sarouk I, Weintraubv I, Shoseyov D, Cohen-Cymberknoh M, Rivlin J, Efrati O Tags: World J Gastroenterol Source Type: research

Expression and Functional Activity of the Bitter Taste Receptors TAS2R1 and TAS2R38 in Human Keratinocytes
Recent studies have shown that human bitter taste receptors (TAS2Rs) are not only expressed in mucous epithelial cells of the tongue, but also in epithelial cells of the colon, stomach and upper respiratory tract. These cell types come in close contact with external bitter compounds by ingestion or breathing. In the present work we addressed the question whether bitter taste receptors might also be expressed in cornified epithelial cells of the skin. Here, we show for the first time the expression of TAS2R1 and TAS2R38 in human skin. Double staining of HaCaT cells and primary keratinocytes demonstrated the colocalization o...
Source: Skin Pharmacology and Physiology - January 6, 2015 Category: Dermatology Source Type: research

The effect of mechanical ventilator settings during ventilator hyperinflation techniques: a bench-top analysis
Ventilator hyperinflations are used by physiotherapists for the purpose of airway clearance in intensive care. There is limited data to guide the selection of mechanical ventilator modes and settings that may achieve desired flow patterns for ventilator hyperinflation. A mechanical ventilator was connected to two lung simulators and a respiratory mechanics monitor. Peak inspiratory (PIFR) and expiratory flow rates (PEFR) were measured during manipulation of ventilator modes (pressure support ventilation [PSV], volume-controlled synchronised intermittent mandatory ventilation [VC-SIMV] and pressure-controlled synchronised i...
Source: Anaesthesia and Intensive Care - January 6, 2015 Category: Anesthesiology Source Type: research

A review on airway biomarkers: exposure, effect and susceptibility
Expert Review of Respiratory Medicine, Ahead of Print. (Source: Expert Review of Respiratory Medicine)
Source: Expert Review of Respiratory Medicine - January 6, 2015 Category: Respiratory Medicine Tags: article Source Type: research

The effect of parental social support and acculturation on childhood asthma control
Journal of Asthma, Ahead of Print. (Source: Journal of Asthma)
Source: Journal of Asthma - January 6, 2015 Category: Respiratory Medicine Tags: article Source Type: research

A Comparative Study of Bronchoscopic Microsample Probe versus Bronchoalveolar Lavage in Patients with Burns-Related Inhalational Injury, Acute Lung Injury and Chronic Stable Lung Disease
Conclusions: The BMS probe safely collects ELF with higher equivalent inflammatory cytokine concentrations than via BAL from patients with both acute and chronic lung disease and can be an alternative to saline BAL. Variations in cytokine concentrations between BMS and BAL and sampling-site differences warrant further study. (Source: Respiration)
Source: Respiration - January 6, 2015 Category: Respiratory Medicine Source Type: research

The Forgotten Species
Respiration (Source: Respiration)
Source: Respiration - January 6, 2015 Category: Respiratory Medicine Source Type: research

Prevention of acute respiratory distress syndrome
Purpose of review: The paucity of effective therapeutic interventions in patients with the acute respiratory distress syndrome (ARDS) combined with overwhelming evidence on the importance of timely implementation of effective therapies to critically ill patients has resulted in a recent shift in ARDS research. Increasingly, efforts are being directed toward early identification of patients at risk with a goal of prevention and early treatment, prior to development of the fully established syndrome. The focus of the present review is on the prevention of ARDS in patients without this condition at the time of their healthcar...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Discontinuation of ventilatory support: new solutions to old dilemmas
Purpose of review: Weaning from mechanical ventilation implies two separate but closely related aspects of care, the discontinuation of mechanical ventilation and removal of artificial airway, which implies routine clinical dilemmas. Extubation delay and extubation failure are associated with poor clinical outcomes. We sought to summarize recent evidence on weaning. Recent findings: Tolerance to an unassisted breathing does not require routine use of weaning predictors and can be addressed using weaning protocols or by implementing automatic weaning methods. Spontaneous breathing trial can be performed on low levels of pre...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

How to ventilate patients without acute respiratory distress syndrome?
Purpose of review: There is convincing evidence for benefit from lung-protective mechanical ventilation with lower tidal volumes in patients with the acute respiratory distress syndrome (ARDS). It is uncertain whether this strategy benefits critically ill patients without ARDS also. The present article summarizes the background and clinical evidence for ventilator settings that have the potential to protect against ventilator-induced lung injury. Recent findings: There has been a paradigm shift from treating ARDS to preventing ARDS. In surgical patients, anesthesiologists should consider ventilating patients with a tidal v...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Neurally adjusted ventilatory assist
Purpose of review: Compared with the conventional forms of partial support, neurally adjusted ventilatory assist was repeatedly shown to improve patient–ventilator synchrony and reduce the risk of overassistance, while guaranteeing adequate inspiratory effort and gas exchange. A few animal studies also suggested the potential of neurally adjusted ventilatory assist in averting the risk of ventilator-induced lung injury. Recent work adds new information on the physiological effects of neurally adjusted ventilatory assist. Recent findings: Compared with pressure support, neurally adjusted ventilatory assist has been shown ...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Selecting the ‘right’ positive end-expiratory pressure level
Purpose of review: To compare the positive end-expiratory pressure selection aiming either to oxygenation or to the full lung opening. Recent findings: Increasing positive end-expiratory pressure in patients with severe hypoxemia is associated with better outcome if the oxygenation response is greater and positive end-expiratory pressure tests may be performed in a few minutes. The oxygenation response to recruitment maneuvers was associated with better outcome in patients with acute respiratory distress syndrome from influenza A (H1N1). If, after recruitment maneuver, the recruitment is not sustained by sufficient positiv...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Stem cells for respiratory failure
Purpose of review: The prognosis of patients with respiratory failure in the ICU remains poor, while current therapeutic approaches are aimed at minimizing ventilator-induced lung injury. Stem cell-based therapies have the potential to transform respiratory failure treatment by achieving lung repair. The purpose of this article is to critically review the large body of clinical and experimental work performed with respect to the use of stem/progenitor cells in respiratory failure, and to discuss current challenges and future directions. Recent findings: Since the initial report of cell therapy for lung injury in 2005, nume...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Balancing neuromuscular blockade versus preserved muscle activity
Purpose of review: Acute respiratory distress syndrome (ARDS) is still associated with a high mortality. The best way to ensure mechanical ventilation in ARDS patients is still debated, recent data arguing for a muscle paralysis and a controlled ventilation whereas other elements being in favor of a preserved spontaneous breathing. The purpose of this review is to discuss the benefits and the disadvantages of both strategies. Recent findings: Randomized controlled trials have brought the evidence that at the acute phase of ARDS, a 48-h administration of cisatracurium is associated with a decrease in mortality for the most ...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Monitoring and preventing diaphragm injury
Purpose of review: The present review summarizes developments in the field of respiratory muscle monitoring, in particular in critically ill patients. Recent findings: Patients admitted to the ICU may develop severe respiratory muscle dysfunction in a very short time span. Among other factors, disuse and sepsis have been associated with respiratory muscle dysfunction in these patients. Because weakness is associated with adverse outcome, including prolonged mechanical ventilation and mortality, it is surprising that respiratory muscle dysfunction largely develops without being noticed by the clinician. Respiratory muscle m...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Novel approaches to minimize ventilator-induced lung injury
Purpose of review: To discuss the mechanisms of ventilator-induced lung injury and the pro and cons of the different approaches proposed by literature to minimize its impact in patients with acute respiratory distress syndrome. Recent findings: Mechanical ventilation is indispensable to manage respiratory failure. The evolution of knowledge of the physiological principles and of the clinical implementation of mechanical ventilation is characterized by the shift of interest from its capability to restore ‘normal gas exchange’ to its capability of causing further lung damage and multisystem organ failure. Summary: If one...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Extracorporeal life support for severe acute respiratory distress syndrome
Purpose of review: To provide a summary of the recent literature on extracorporeal membrane oxygenation (ECMO) in adults with severe acute respiratory distress syndrome (ARDS), focusing on advances in equipment, current conventional and unconventional indications, complications, and future applications. Recent findings: ECMO use has increased during the past 5 years. Advances in cannulation, circuit design, and patient selection have made it a safer therapeutic option in severe ARDS, and its use has become more widespread for nonconventional indications. Summary: High-quality evidence for the routine use of ECMO for manage...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research

Noninvasive ventilation for acute respiratory failure
This article reviews the use of noninvasive ventilation (NIV) in patients with acute respiratory failure (ARF), with a critical review of the most recent literature in this setting. Recent findings: The efficacy of NIV is variable depending on the cause of the episode of ARF. In community-acquired pneumonia, NIV is often associated with poor response, with better response in patients with preexisting cardiac or respiratory disease. In patients with pandemic influenza H1N1 and severe ARF, NIV has been associated with high failure rates but relatively favorable mortality. In acute respiratory distress syndrome, NIV should be...
Source: Current Opinion in Critical Care - January 6, 2015 Category: Nursing Tags: RESPIRATORY SYSTEM: Edited by Niall D. Ferguson Source Type: research