Acute critical care最新文献_第10页

Outcomes among immunecompetent and immunocompromised and pneumonia and trachea-bronchitis in mechanical ventilation 免疫功能正常和免疫功能低下、肺炎和气管支气管炎机械通气的结局

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2277

Maria Augusta Costa deMoura, J. Moura, V. Moura, M. Moura, R. Stirbulov

引用次数: 0

Influencing factors on changes of ICU family members satisfaction ICU家庭成员满意度变化的影响因素

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4009

Dong Yon Kim, Sung-wook Kang, Hye Ri Choi, C. Choi, Y. Kim, H. Choi, Jung Mi Lee

引用次数: 0

Late Breaking Abstract - Effects of levosimendan on diaphragm contractile efficiency in patients weaning from mechanical ventilation 摘要-左西孟旦对机械通气患者膈肌收缩效率的影响

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4027

L. Roesthuis, H. V. D. Hoeven, C. Sinderby, T. Frenzel, C. Ottenheijm, L. Brochard, J. Doorduin, L. Heunks

{"title":"Late Breaking Abstract - Effects of levosimendan on diaphragm contractile efficiency in patients weaning from mechanical ventilation","authors":"L. Roesthuis, H. V. D. Hoeven, C. Sinderby, T. Frenzel, C. Ottenheijm, L. Brochard, J. Doorduin, L. Heunks","doi":"10.1183/13993003.congress-2019.pa4027","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4027","url":null,"abstract":"Introduction: Respiratory muscle weakness frequently develops in critically ill patients and is associated with difficult weaning from mechanical ventilation and increased mortality. No drug has been approved to improve respiratory muscle function. However, we have previously shown that the calcium sensitizer levosimendan improves contractility of diaphragm muscle fibers in vitro and diaphragm contractility in healthy subjects in vivo. Objectives: To investigate the effects of levosimendan on diaphragm contractile efficiency in mechanically ventilated patients. Methods: In a double-blind placebo-controlled trial mechanically ventilated patients (N=39) performed two continuous positive airway pressure (CPAP) trials for 30-minutes each with 5 hour interval. After the first CPAP trial, study medication (either levosimendan 0.2 µg/kg/min or placebo) was administered. During both trials electrical activity of the diaphragm (EAdi), transdiaphragmatic pressure (Pdi) and tidal volume (TV) were continuously measured. Neuromechanical efficiency (primary outcome parameter) was defined as ΔPdi/ΔEAdi. Results: Neuromechanical efficiency did not improve after levosimendan. However, ΔEAdi and tidal volume were higher after levosimendan administration (31% and 11%, respectively). P0.1, a measure for respiratory load, increased in the placebo group by 41%, while it remained constant in the levosimendan group. PaCO2 significantly decreased (44 mmHg vs 42 mmHg) in response to levosimendan administration. Conclusions: Although levosimendan did not improve diaphragm contractile efficiency, tidal volume increased, while P0.1 and PaCO2 decreased.","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80274626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characterization of patients with pneumonia and chronic structural lung disease admitted to an ICU ICU收治的肺炎和慢性结构性肺病患者的特征分析

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2287

Gil Gonçalves, M. Leitão, Luís Linhares, J. P. Baptista, P. Martins

引用次数: 0

Prognostic factors for extubation failure in high risk patients using high-flow nasal cannula 高危患者使用高流量鼻插管拔管失败的预后因素分析

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa4022

Paulina Ezcurra, M. Venuti, E. Gogniat, M. Ducrey, J. Dianti, A. Midley, S. Giannasi, E. S. Román, Nicolás Roux

{"title":"Prognostic factors for extubation failure in high risk patients using high-flow nasal cannula","authors":"Paulina Ezcurra, M. Venuti, E. Gogniat, M. Ducrey, J. Dianti, A. Midley, S. Giannasi, E. S. Román, Nicolás Roux","doi":"10.1183/13993003.congress-2019.pa4022","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa4022","url":null,"abstract":"Introduction: High flow nasal cannula (HFNC) is effective in preventing extubation respiratory failure in high risk patients. However there is a lack of information in which variables better predict which patients will not benefit from this intervention. Objective: Our goal is to identify variables that could predict which patients will not benefit with HFNC for extubation failure prevention. Methods: Prospective interventional single center study in an intensive care unit in Argentina. We included patients with at least one pre-specified risk factor who required invasive mechanical ventilation (IMV) for more than 48hs and passed a spontaneous breathing trial. HFNC was administered for the first 24hs following extubation. We divided extubation failure causes into those related with worsening of respiratory variables and non-respiratory related causes. Results: We include 165 patients. 40(24.2%) presented extubation failure, 18(10.9%) of which were for non-respiratory related causes and 22(13.3%) for worsening of respiratory variables. None of the pre-specified risk factors individually or combine between this were associated with extubation failure. The median of days of IMV prior to extubation was the only variable associated with extubation failure (5(3-6) vs 4(3-5), p=0.02) in the failure and success group respectively. Conclusions: Incidence of extubation failure in high risk patients receiving HFNC for extubation failure prevention was similar to that reported in previous trials. None of the pre-specified risk factors predicted extubation failure. Time of IMV prior to extubation was the only variable associated with extubation failure.","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76161443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Thirty-Day Readmission Among Patients With Acute Respiratory Distress Syndrome and Effects on Outcomes 急性呼吸窘迫综合征患者30天再入院及其对预后的影响

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.oa3297

K. Ho, J. Sheehan, J. Salonia

引用次数: 2

Possible microRNA-mediated alterations of gene expression in lipoteichoic acid-stimulated neutrophils 微rna介导的脂壁酸刺激中性粒细胞基因表达的可能改变

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2268

Po-Lin Kuo, M. Yen, Shu-Fang Jian, M. Tsai

引用次数: 0

Survival after intensive care for COPD exacerbation in patients with and without long-term oxygen therapy: a nationwide cohort study 接受和不接受长期氧疗的COPD加重患者重症监护后的生存率:一项全国性队列研究

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2184

H. Nyström, J. Berkius, M. Ekström, S. Walther, M. Inghammar

引用次数: 0

A preliminary clinical evaluation of a new portable life support ventilator with invasively ventilated home users 一种新型便携式生命支持呼吸机与有创通气家庭用户的初步临床评价

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2278

J. Yarascavitch, C. Vogler, S. Cannon-Bailey

{"title":"A preliminary clinical evaluation of a new portable life support ventilator with invasively ventilated home users","authors":"J. Yarascavitch, C. Vogler, S. Cannon-Bailey","doi":"10.1183/13993003.congress-2019.pa2278","DOIUrl":"https://doi.org/10.1183/13993003.congress-2019.pa2278","url":null,"abstract":"Background: Trilogy Evo (Philips Respironics, Murrysville PA) is a new life support ventilator that provides invasive and non-invasive ventilation to adult and pediatric patients with a minimum weight of 2.5kg. Aims: To evaluate the performance of the Trilogy Evo ventilator compared to parameters from user’s current ventilator. Methods: Patients treated with invasive mechanical ventilation via tracheostomy tube (IPAP 15.9 ± 3.2cmH2O, EPAP 5.3 ± 1.6cmH2O, and tidal volume 263 ± 166ml) were enrolled. At baseline, users were monitored on their current ventilator (LTV or Trilogy) for 15 minutes then were set-up on the Trilogy Evo for at least 15 minutes with one or more of the following circuits: Passive, ActivePAP, Active Flow and Dual Limb. Pulse oximetry (SpO2) and End Tidal CO2 (EtCO2) were recorded. Results: Thirteen participants (7 males, age 11.3 ± 10.1) completed the study. Modes utilized were SIMV-VC (n=9), S/T (n=3), and A/C-PC (n=1). Trilogy Evo passive circuit settings were IPAP 15.4 ± 3.7 cmH2O, EPAP 5.2 ± 1.5 cmH2O, and tidal volume 236 ± 166 ml. No clinical difference in EtCO2 mmHg (baseline 31.6 ± 6.3 vs Trilogy Evo 29.7 ± 6.9) or SpO2% (baseline 97.3 ± 1.8 vs Trilogy Evo 97.6 ± 1.2) were detected. In users with significant leaks around their trach tubes, the tidal volume and/or pressure settings needed to be decreased to match baseline therapy due to leak compensation algorithms with the passive circuit on Trilogy Evo. Conclusion: In this group of patients, Trilogy Evo provided effective ventilation based on SpO2 and EtCO2 values. The leak compensation capabilities may offer benefits to patients with airway leak issues.","PeriodicalId":7201,"journal":{"name":"Acute critical care","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88122618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Plasma level of TNF related apoptosis inducing ligand is associated with severity of disease in patients with sepsis and septic shock 脓毒症和感染性休克患者血浆TNF相关凋亡诱导配体水平与疾病严重程度相关

Acute critical care Pub Date : 2019-09-28 DOI: 10.1183/13993003.congress-2019.pa2272

H. Yoo, Jin Young Lee, Junehee Park, J. Song, S. Zo, K. Jeon

引用次数: 0