Search results for "Critical"
showing 10 items of 3024 documents
Repeated sugammadex reversal of muscle relaxation during lumbar spine surgery with intraoperative neurophysiological multimodal monitoring
2016
Intraoperative neurophysiological monitoring during spine surgery is usually acomplished avoiding muscle relaxants. A case of intraoperative sugammadex partial reversal of the neuromuscular blockade allowing adequate monitoring during spine surgery is presented. A 38 year-old man was scheduled for discectomy and vertebral arthrodesis throughout anterior and posterior approaches. Anesthesia consisted of total intravenous anesthesia plus rocuronium. Intraoperatively monitoring was needed, and the muscle relaxant reverted twice with low dose sugammadex in order to obtain adequate responses. The doses of sugammadex used were conservatively selected (0.1 mg/kg boluses increases, total dose neede…
Vitamin D serum levels in multiorgan failure critically ill patients undergoing continuous renal replacement therapies
2020
Introduction Severe vitamin D deficiency in critically ill patients is linked to mortality. There are no scientific data regarding vitamin D status in critically ill patients undergoing continuous renal replacement therapies. Material and methods We aimed to measure vitamin D serum levels in critically ill patients with multi-organ failure undergoing continuous renal replacement therapies. Vitamin D serum measurements in 12-hour time intervals were performed in 20 patients undergoing continuous renal replacement therapies through continuous veno-venous haemodiafiltration (the study group). The results were then compared with the historical control group (20 patients without renal replacemen…
Study-Related Work and Commuting Accidents among Students at the University of Mainz from 12/2012 to 12/2018: Identification of Potential Risk Groups…
2020
Background: Universities represent an important setting of everyday life for health promotion. The aim of the present study was to assess whether university students of specific disciplines might have an increased risk for having a study-related work accident and to analyze what types of study-related work accidents occur most frequently. Furthermore, knowledge regarding study-related commuting accidents will be provided by identifying places where study-related commuting accidents might occur most frequently and on potential types of commuting (walking vs. biking) which might be associated with an increased risk for having a study-related commuting accident. Methods: Retrospective analyses…
The novel video-assisted intubating laryngeal mask Totaltrack compared to the intubating laryngeal mask Fastrach - a controlled randomized manikin st…
2017
BACKGROUND The novel Totaltrack combines a supraglottic airway device with video laryngoscopic tracheal intubation. The intubation laryngeal mask Fastrach is an established device without visual control of intubation. We hypothesized that supraglottic ventilation success with Totaltrack would be similar to Fastrach, but intubation would be performed faster due to visual control of the procedure. METHODS Fifty-five anaesthesiologists were randomized into one of two study arms: Fastrach Totaltrack. After a standardized introduction, six consecutive attempts of supraglottic ventilation and intubation attempts with each of one of the devices were performed on an airway manikin. The combined pri…
Association between night-time extubation and clinical outcomes in adult patients
2021
Background: Whether night-time extubation is associated with clinical outcomes is unclear. Objective: The aim of this systematic review and meta-analysis was to evaluate the association between night-time extubation and the reintubation rate, mortality, ICU and in-hospital LOS in adult patients, compared with daytime extubation. Design: A systematic review and meta-analysis. Data sources: PubMed, EMBASE, CINAHL and Web of Science from inception to 2 January 2021 (PROSPERO registration - CRD42020222812). Eligibility criteria: Randomised, quasi and cluster randomised, and nonrandomised studies describing associations between adult patients' outcomes and time of extubation (daytime/night-time)…
High-flow nasal cannula versus non-invasive ventilation for acute hypercapnic respiratory failure in adults: a systematic review and meta-analysis of…
2022
Abstract Background Non-invasive ventilation (NIV) with bi-level positive pressure ventilation is a first-line intervention for selected patients with acute hypercapnic respiratory failure. Compared to conventional oxygen therapy, NIV may reduce endotracheal intubation, death, and intensive care unit length of stay (LOS), but its use is often limited by patient tolerance and treatment failure. High-flow nasal cannula (HFNC) is a potential alternative treatment in this patient population and may be better tolerated. Research question For patients presenting with acute hypercapnic respiratory failure, is HFNC an effective alternative to NIV in reducing the need for intubation? Methods We sear…
On the complementarity of holistic and analytic approaches to performance assessment scoring.
2019
BACKGROUND A holistic approach to performance assessment recognizes the theoretical complexity of multifaceted critical thinking (CT), a key objective of higher education. However, issues related to reliability, interpretation, and use arise with this approach. AIMS AND METHOD Therefore, we take an analytic approach to scoring students' written responses on a performance assessment. We focus on the complementarity of holistic and analytic approaches and on whether theoretically developed analytical scoring rubrics can produce sub-scores that may measure the 'whole' performance in a holistic assessment. SAMPLE We use data from the Wind Turbines performance assessment, developed in the iPAL p…
Impaired Cardiopulmonary Exercise Capacity in Patients With Hyperthyroidism
1996
Hyperthyroidism (H) has been implicated as a primary cause of decreased exercise tolerance. To our knowledge, analysis of respiratory gas exchange, an efficient noninvasive method in evaluating cardiopulmonary capacity, has not been performed in patients with H.Using cardiopulmonary exercise testing, 12 consecutive women with Graves' H were examined and controlled in euthyroidism (E). Eighteen women with E, in whom cardiac catheterization had ruled out heart disease, served as control subjects (C).The ventilatory anaerobic threshold was determined by means of the V-slope method. Ergometry was performed with patients in a semisupine position using a continuous ramp protocol of 20 W/min. Echo…
Sputum metalloproteinase-9/tissue inhibitor of metalloproteinase-1 ratio correlates with airflow obstruction in asthma and chronic bronchitis
1998
Asthma and chronic bronchitis are inflammatory diseases with extracellular matrix (ECM) remodeling and collagen deposition. Collagen homeostasis is controlled by metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). We evaluated MMP and TIMP balance in induced sputum of 10 control, 31 untreated asthmatic, and 16 chronic bronchitic subjects. We first performed zymographic analysis to identify the profile of MMPs. Zymography revealed a similar MMPs profile in all populations studied and that MMP-9 was the major enzyme released. We then measured, using enzyme immunoassay, the concentrations of MMP-9 and of its inhibitor TIMP-1 and evaluated whether airflow limitation m…
Increased Levels of Elastase and α1-Antitrypsin in Sputum of Asthmatic Patients
1998
Asthma and chronic bronchitis are inflammatory diseases associated with remodeling of the extracellular matrix (ECM). Elastin, a major component of the ECM in the airways, has been previously found to be disrupted in asthma and chronic bronchitis. This study was aimed at evaluating whether elastin disruption might be associated with an imbalance between elastase (active and total) and alpha1-proteinase inhibitor (alpha1-PI), the main inhibitor of elastase. We measured elastase and alpha1-PI in induced sputum obtained from 16 control subjects, 10 healthy smokers, 19 asthmatic patients, and 10 chronic bronchitis patients. We also assessed the possible origin of elastase, evaluating its levels…