Tag: oxygenation

Upvote Story 5
Prediction scoring systems for coronary artery bypass grafting (CABG) patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have not yet been reported. This study was designed to develop a predictive score for in-hospital mortality for cardiogenic shock patients who received VA-ECMO after isolated CABG. The REMEMBER score might help clinicians at bedside to predict in-hospital mortality for patients receiving VA-ECMO after isolated CABG for refractory cardiogenic... Read More | Comment
Upvote Story 6
Oxygen desaturation was more commonly observed during tracheal intubation in children with cyanotic versus noncyanotic heart disease. However, hemodynamic tracheal intubation associated event rates were similar. In both groups, oxygen desaturation greater than or equal to 30% was significantly associated with increased occurrence of hemodynamic tracheal intubation associated events. Our exposure of interest was oxygen desaturation measured by a fall in pulse oximetry from baseline... Read More | Comment
Upvote Story 14
Nurses handle supplementary oxygen to intensive care unit (ICU) patients as part of their daily practice. To secure patients of optimal and safe care, knowledge of nurses’ perception of this practice, including influencing factors for adjusting oxygenation levels is essential. This study aimed to explore intensive care nurses’ perception of handling oxygenation and of factors that govern and influence this practice. A mixed methods approach... Read More | Comment
Upvote Story 9
A high-flow nasal cannula (HFNC) is a high-flow oxygen supply device developed in recent years and is increasingly being used to treat acute hypoxemic respiratory failure (AHRF) in intensive care unit (ICU). Patients with pre-existing chronic lung disease (CLD) often develop AHRF and require ICU admission. HFNC therapy is also used for these patients in clinical practice, although few studies have examined its efficacy. We... Read More | Comment
Upvote Story 7
Extracorporeal membrane oxygenation (ECMO) has been in clinical use for some 40 years, but it is only in the past decade that its application in the treatment of life-threatening circulatory and respiratory failure has truly flourished. This book presents a comprehensive overview of both pathophysiological and practical aspects of circulatory and respiratory extracorporeal support. The basics of ECMO, including its history, the “ECMO team”, cannulation,... Read More | Comment
Upvote Story 9
Critical care transport of prone acute respiratory distress syndrome (ARDS) patients is a feasible and cost-effective intervention that will help prevent treatment delays and interruptions. A nonphysician critical care transport team (registered nurse and paramedic) can initiate prone positioning before transport. We report the case of a non-physician based critical care transport team (registered nurse and paramedic) that successfully initiated prone positioning of a severe... Read More | Comment
Upvote Story 13
Cerebral auto-regulation was altered in half of the patients with sepsis and was associated with the development of SABD. These findings support the concept that cerebral hypoxia could contribute to the development of sepsis-associated brain dysfunction (SABD). Mxa was 0.29. Cerebral autoregulation (CAR) was impaired in 50 patients (50%). In a multiple linear regression analysis, low mean arterial pressure, history of chronic kidney disease and... Read More | Comment
Upvote Story 10
Hemoglobin is important for cerebral oxygenation and strategies to minimize anemia should be undertaken. Although higher hemoglobin levels are associated with less cerebral ischemia and better clinical outcome, whether this remains true whenever red blood cell transfusion is used to achieve this result remains unclear. Hemoglobin is a key component in oxygen delivery, and thus cerebral oxygenation. Higher hemoglobin levels and red blood cell transfusion... Read More | Comment
Upvote Story 9
Among critically ill immunocompromised patients with acute respiratory failure (ARF), high-flow oxygen therapy did not significantly decrease day-28 mortality compared with standard oxygen therapy. Of 778 randomized patients (median age, 64 [IQR, 54-71] years; 259 [33.3%] women), 776 (99.7%) completed the trial. The primary outcome was day-28 mortality. Secondary outcomes included intubation and mechanical ventilation by day 28, Pao2:Fio2 ratio over the 3 days after... Read More | Comment
Upvote Story 5
Is emergency medicine on the verge of “the dawn of a new golden age of resuscitation?” That’s the bold prediction from CPR innovator Keith Lurie, MD, a professor of internal and emergency medicine at the University of Minnesota, a director of the CentraCare Heart and Vascular Center and the founder of Minnesota Resuscitation Solutions. Emergency physicians, EMS personnel, and other experts from around the world... Read More | Comment
Upvote Story 11
There were both similarities and differences in tracheal intubation practice and outcomes across international PICUs. Fewer adverse tracheal intubation–associated events were reported from International versus North American PICUs. International PICUs used cuffed endotracheal tube less often and had higher proportion of endotracheal tube change. Adverse tracheal intubation–associated events and desaturation occurrence (oxygen saturation < 80%) were evaluated. A total of 1,134 and 9,376 TIs from... Read More | Comment
Upvote Story 9
The majority of respondents reported targeting moderate to deep sedation following cannulation, with the use of sedative and opioid infusions. There is considerable variability surrounding early physical therapy and mobilization goals for patients with acute respiratory failure (ARF) supported by venovenous extracorporeal membrane oxygenation. We analyzed responses from 209 respondents (53%), mostly from academic centers (63%); 41% respondents provide venovenous extracorporeal membrane oxygenation to adults... Read More | Comment
Upvote Story 5
Multi-system organ failure is ubiquitous but treatable with adequate hemodynamic support. Neurologic recovery was prolonged requiring delayed prognostication. Immediate 24/7 availability of surgical and medical specialty expertise was required to achieve 48% functionally intact survival. Of 100 appropriately transported patients, 83 achieved CICU admission. 40/83 (48%) discharged functionally intact. Multi-system organ failure occurred in all patients. Cardiac, pulmonary, renal, and liver injury improved within 3-4... Read More | Comment
Upvote Story 4
Implementing a systematic respiratory mechanics test leads to frequent individual adaptations of ventilator settings and allows improvement in oxygenation indexes and reduction of the risk of overdistention at the same time. Sixty-one consecutive patients with ARDS were enrolled. Esophageal pressure was measured in 53 patients (86.9%). In 41 patients (67.2%), ventilator settings were changed after the measurements, often by reducing positive end-expiratory pressure or by... Read More | Comment
Upvote Story 10
The proportion of pediatric patients undergoing percutaneous extracorporeal membrane oxygenation cannulation is increasing. Mechanical and physiologic complications occur with both methods of cannulation, but percutaneous cannulation appears safe in this cohort. Further analysis is needed to evaluate long-term outcomes with this technique. Of 3,501 patients identified, 77.2% underwent open cannulation, with the frequency of open cannulation decreasing over the study period from approximately 80% to... Read More | Comment