Spontaneous Breathing Trial for Prediction of Extubation Success in Pediatric Patients Following Congenital Heart Surgery: A Randomized Controlled Trial*

Objectives: To evaluate the usefulness of a spontaneous breathing trial for predicting extubation success in pediatric patients in the postoperative period after cardiac surgery compared with a physician-led weaning. Study Design: Randomized, controlled trial. Setting: PICU of a tertiary-care university hospital. Patients: A population of pediatric patients following cardiac surgery for congenital heart disease. Interventions: Patients on mechanical ventilation for more than 12 hours after surgery who were considered ready for weaning were randomized to the spontaneous breathing trial group or the control group. The spontaneous breathing trial was performed on continuous positive airway pressure with the pressure support of 10 cmH2O, the positive end-expiratory pressure of 5 cmH2O, and the fraction of inspired oxygen less than or equal to 0.5 for 2 hours. Patients in the control group underwent ventilator weaning according to clinical judgment. Measurements and Main Results: The primary endpoint was extubation success defined as no need for reintubation within 48 hours after extubation. Secondary outcomes were PICU length of stay, hospital length of stay, occurrence rate of ventilator-associated pneumonia, and mortality. One hundred and ten patients with the median age of 8 months were included in the study: 56 were assigned to the spontaneous breathing trial group and 54 were assigned to the control group. Demographic and clinical data and Risk Adjustment fo...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

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Source: Medgadget - Category: Medical Devices Authors: Tags: Cardiology Critical Care Diagnostics Exclusive Informatics Medicine Public Health Source Type: blogs
This study is being conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran.ParticipantsBoth male and female patients with ≥18 years of age (≥ 35 kg of weight), admitted at the Shahid Mohammadi Hospital, Hormozgan University of Medical Sciences, Bandar Abbas for treatment, screened for the following criteria.Inclusion criteria:1. Confirmed diagnosis of SARS-CoV-2 infection (via polymerase chain reaction [PCR] and/or antibody test).2. Presenting as moderate COVID-19 pneumonia (via chest computed tomography (CT) and/or X-ray) requiring hospitalization.3. Hospitalized ≤48 hours.4. Signing informed consent and will...
Source: Trials - Category: Research Source Type: clinical trials
Abstract This retrospective study describes the epidemiology and identifies risk factors associated with severe complications in lower respiratory tract infection (LRTI) due to respiratory syncytial virus (RSV) in a population of infants hospitalized in a tertiary care hospital in a tropical region of Colombia. A severe complication in RSV LRTI was defined as the presence of SpO2 ≤ 90% in the emergency room and/or pneumonia and/or atelectasis and/or sepsis and/or respiratory failure during hospitalization. RSV was detected in 193 (46.3%) of 417 patients with LRTI. The average hospital stay lasted for 5.9 days. ...
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
Each year, approximately 0.8 million people are estimated to experience a new or recurrent stroke, according to the 2019 report of the American Heart Association.1 In Malaysia, stroke is the third leading cause of death after ischemic heart disease (IHD) and pneumonia.2 Both obesity and diabetes are considered as the established independent risk factors for ischemic stroke.3 Type 2 diabetes mellitus (T2DM) was also found to be associated with an increase in all-cause as well as cardiovascular mortality following the stroke,4,5 and in a meta-analysis of 18 studies, patients with diabetes had a higher stroke recurrence as co...
Source: Journal of Stroke and Cerebrovascular Diseases - Category: Neurology Authors: Source Type: research
Superficially, tissue hypoxia might look similar to Ischemia but differs in one important aspect. Though the hypoxic myocardium is short of oxygen, the respiratory excreta from cells ie Co2, lactic acid, and free radicles are promptly cleared and flushed as blood flow is normal. Hence, generally acute  Ischemia of tissues is more cell threatening than regional hypoxia at any organ level. How do you classify hypoxia? we need to go to physiology classes again.There are 4 types. Ischemic -Hypoxia, systemic hypoxia, Anemic hypoxia, Histo-toxic hypoxia.A good reference to read (Ošt’ádal B., Kol&aac...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: metabolic support of heart failure anerobic cardiac metabolism copd and lv dysfunction covid heart disease hypoxia and covid lv dysfunction hypoxia vs iscehmia ketone bodies ato heart lv dysfunction in congenital cyanotic heart disease met Source Type: blogs
Recently, Keech and his colleagues provided a clinical trial that High-intensity interval training (HIIT) could reduce the cardiovascular risk of coronary artery disease (CAD) patients during cardiac rehabilitation and may improve the quality of life of such patients in the long term [1].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Letter to the Editor Source Type: research
Infection with influenza viruses causes a substantial disease burden each year worldwide, especially for high-risk groups such as children and the elderly (Heo et al., 2018; Li et al., 2019; Wang et al., 2014). Most people recover within a week without requiring medical attention (World Health Organization, 2019), while a few cases have fatal complications such as primary viral and secondary bacterial pneumonia (Gran et al., 2010). The influenza epidemic has proven to have an increased mortality connection with many diagnoses of respiratory and circulatory diseases such as pneumonia, ischemic heart disease, and chronic obs...
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
Infection with influenza viruses causes substantial disease burden each year worldwide, especially for high-risk groups including children and the elderly(Heo et al., 2018, Li et al., 2019, Wang et al., 2014). Most people recover within a week without requiring medical attention, while few cases have fatal complications such as primary viral and secondary bacterial pneumonia(Gran et al., 2010). The influenza epidemic has proven to have a connection with increased mortality in many diagnoses of respiratory and circulatory diseases such as pneumonia, ischemic heart disease, and chronic obstructive pulmonary disease(Liu et al...
Source: International Journal of Infectious Diseases - Category: Infectious Diseases Authors: Source Type: research
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Source: Medical Science Monitor - Category: Research Tags: Med Sci Monit Source Type: research
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Source: Diabetes Research and Clinical Practice - Category: Endocrinology Authors: Source Type: research
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