Proning
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Proning
Proning or prone positioning is the placement of patients into a prone position so that they are lying on their front. This is used in the treatment of patients in intensive care with acute respiratory distress syndrome (ARDS). It has been especially tried and studied for patients on ventilators but, during the COVID-19 pandemic, it is being used for patients with oxygen masks and continuous positive airway pressure, CPAP as an alternative to ventilator, ventilation. Intensive care Prone positioning may be used for people suffering from acute respiratory distress syndrome (ARDS) to improve their breathing. If the patient is undergoing intensive care and sedated then this is a difficult procedure because lifting and turning the unconscious patient requires many staff or special equipment. If they are intubated then care has to be taken to manage the tangle of associated lines and tubes. A 2011 meta-analysis of 48 studies found that there were no negative effects on case fat ...
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Neonate With Electrical Impedance Tomography Electrodes
An infant or baby is the very young offspring of human beings. ''Infant'' (from the Latin word ''infans'', meaning 'unable to speak' or 'speechless') is a formal or specialised synonym for the common term ''baby''. The terms may also be used to refer to Juvenile (organism), juveniles of other organisms. A newborn is, in colloquial use, an infant who is only hours, days, or up to one month old. In medical contexts, a newborn or neonate (from Latin, ''neonatus'', newborn) is an infant in the first 28 days after birth; the term applies to Preterm birth, premature, Pregnancy#Term, full term, and Postterm pregnancy, postmature infants. Before birth, the offspring is called a fetus. The term ''infant'' is typically applied to very young children under one year of age; however, definitions may vary and may include children up to two years of age. When a human child learns to walk, they are called a toddler instead. Other uses In British English, an ''infant school'' is for children ...
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Surviving Sepsis Campaign
The Surviving Sepsis Campaign (SSC) is a global initiative to bring together professional organizations in reducing mortality from sepsis. The purpose of the SSC is to create an international collaborative effort to improve the treatment of sepsis and reduce the high mortality rate associated with the condition. The Surviving Sepsis Campaign and the Institute for Healthcare Improvement have teamed up to achieve a 25 percent reduction in sepsis mortality by 2009. The guidelines were updated in 2016 and again in 2021. Relevance Mortality associated with severe sepsis remains high at 30-50%. When shock is present, mortality is reported to be even higher at around 50-60%. Approximately 1400 people die from sepsis each day throughout the world. In the U.S. there are approximately 750,000 new sepsis cases each year, with at least 210,000 fatalities and this is reported to be same throughout Europe. As medicine becomes more advanced, with invasive procedures and immunosuppression, th ...
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Critical Care Medicine (journal)
''Critical Care Medicine'' is a peer-reviewed monthly medical journal in the field of intensive care medicine. The journal was established in 1973 with William C. Shoemaker as the founding editor. It is the official publication of the Society of Critical Care Medicine and is published by Lippincott Williams & Wilkins. The journal's editor-in-chief is Timothy G. Buchman. Abstracting and indexing The journal is abstracted and indexed in: According to the ''Journal Citation Reports'', the journal has a 2020 impact factor The impact factor (IF) or journal impact factor (JIF) of an academic journal is a scientometric index calculated by Clarivate that reflects the yearly mean number of citations of articles published in the last two years in a given journal, as ... of 7.598, ranking it 5th out of 82 journals in the category "‘Critical Care and Intensive Care Medicine". Editors * William C. Shoemaker, 1972-1991 * Bart Chernow, 1991-1997 * Joseph E. Parrillo, 1997-2014 * T ...
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Intensive Care Medicine (journal)
''Intensive Care Medicine'' is a monthly peer reviewed medical journal covering intensive care medicine, intensive care or critical care and emergency medicine. It was established in 1975 as the ''European Journal of Intensive Care Medicine'' and obtained its current name in 1977. It is the official journal of thEuropean Society of Intensive Care Medicine The editor-in-chief iGiuseppe Citerio(University of Milano Bicocca). It is published by Springer Science+Business Media. "Intensive Care Medicine" is the publication platform for communicating and exchanging current work and ideas in intensive care medicine. It is intended for all those who are involved in intensive medical care, physicians, anaesthetists, surgeons, paediatricians, as well as those concerned with pre-clinical subjects and medical sciences basic to these disciplines. The journal publishes: review articles reflecting the present state of knowledge in special areas or summarizing limited themes in which discussion has ...
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Supine Position
The supine position ( or ) means lying horizontally with the face and torso facing up, as opposed to the prone position, which is face down. When used in surgical procedures, it grants access to the peritoneal, thoracic and pericardial regions; as well as the head, neck and extremities. Using anatomical terms of location, the dorsal side is down, and the ventral side is up, when supine. Semi-supine In scientific literature "semi-supine" commonly refers to positions where the upper body is tilted (at 45° or variations) and not completely horizontal. Relation to sudden infant death syndrome The decline in death due to sudden infant death syndrome (SIDS) is said to be attributable to having babies sleep in the supine position. The realization that infants sleeping face down, or in a prone position, had an increased mortality rate re-emerged into medical awareness at the end of the 1980s when two researchers, Susan Beal in Australia and Gus De Jonge in the Netherlands, indep ...
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Recovery Position
In first aid, the recovery position (also called semi-prone) is one of a series of variations on a lateral recumbent or three-quarters prone position of the body, often used for unconscious but breathing casualties. An unconscious person, a person who is assessed on the Glasgow Coma Scale (GCS) at eight or below, in a supine position (on the back) may not be able to maintain an open airway as a conscious person would. This can lead to an obstruction of the airway, restricting the flow of air and preventing gaseous exchange, which then causes hypoxia, which is life-threatening. Thousands of fatalities occur every year in casualties where the cause of unconsciousness was not fatal, but where airway obstruction caused the patient to suffocate. This is especially true for unconscious pregnant women; once turned on to their left side, pressure is relieved on the inferior vena cava, and venous return is not restricted. The cause of unconsciousness can be any reason from trauma to i ...
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Positional Asphyxia
Positional asphyxia, also known as postural asphyxia, is a form of asphyxia which occurs when someone's position prevents the person from breathing adequately. People may die from positional asphyxia accidentally, when the mouth and nose are blocked, or where the chest may be unable to fully expand. Background A 1992 article in ''The American Journal of Forensic Medicine and Pathology'' and a 2000 article in ''The American Journal of Forensic Medicine and Pathology'' said that multiple cases have been associated with the hogtie or hobble prone restraint position. The New York Police Department’s guidelines, explaining protocols for mitigating in-custody deaths, were published in a 1995 Department of Justice bulletin on "positional asphyxia." The NYPD recommended that, “ soon as the subject is handcuffed, get him off his stomach. Turn him on his side or place him in a seated position." A 1996 FBI bulletin said that many law enforcement and health personnel were being taught ...
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Ventilator-associated Pneumonia
Ventilator-associated pneumonia (VAP) is a type of lung infection that occurs in people who are on mechanical ventilation breathing machines in hospitals. As such, VAP typically affects critically ill persons that are in an intensive care unit (ICU) and have been on a mechanical ventilator for at least 48 hours.Cooper A.S. Oral hygiene care to prevent ventilator-associated pneumonia in critically ill patients. ''Crit. Care Nurs..'' 2021;41(4):80-82. doi:10.4037/ccn2021314 VAP is a major source of increased illness and death. Persons with VAP have increased lengths of ICU hospitalization and have up to a 20–30% death rate. The diagnosis of VAP varies among hospitals and providers but usually requires a new infiltrate on chest x-ray plus two or more other factors. These factors include temperatures of >38 °C or 12 × 109/ml, purulent secretions from the airways in the lung, and/or reduction in gas exchange. A different less studied infection found in mechanically ventilat ...
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Pulmonary Heart Disease
Pulmonary heart disease, also known as cor pulmonale, is the enlargement and failure of the right ventricle of the heart as a response to increased vascular resistance (such as from pulmonic stenosis) or high blood pressure in the lungs. Chronic pulmonary heart disease usually results in right ventricular hypertrophy (RVH), whereas acute pulmonary heart disease usually results in dilatation. Hypertrophy is an adaptive response to a long-term increase in pressure. Individual muscle cells grow larger (in thickness) and change to drive the increased contractile force required to move the blood against greater resistance. Dilatation is a stretching (in length) of the ventricle in response to acute increased pressure. To be classified as pulmonary heart disease, the cause must originate in the pulmonary circulation system; RVH due to a systemic defect is not classified as pulmonary heart disease. Two causes are vascular changes as a result of tissue damage (e.g. disease, hypoxic in ...
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Right Ventricle
A ventricle is one of two large chambers toward the bottom of the heart that collect and expel blood towards the peripheral beds within the body and lungs. The blood pumped by a ventricle is supplied by an atrium, an adjacent chamber in the upper heart that is smaller than a ventricle. Interventricular means between the ventricles (for example the interventricular septum), while intraventricular means within one ventricle (for example an intraventricular block). In a four-chambered heart, such as that in humans, there are two ventricles that operate in a double circulatory system: the right ventricle pumps blood into the pulmonary circulation to the lungs, and the left ventricle pumps blood into the systemic circulation through the aorta. Structure Ventricles have thicker walls than atria and generate higher blood pressures. The physiological load on the ventricles requiring pumping of blood throughout the body and lungs is much greater than the pressure generated by the atria t ...
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Ventilator-associated Lung Injury
Ventilator-associated lung injury (VALI) is an acute lung injury that develops during mechanical ventilation and is termed ventilator-induced lung injury (VILI) if it can be proven that the mechanical ventilation caused the acute lung injury. In contrast, ventilator-associated lung injury (VALI) exists if the cause cannot be proven. VALI is the appropriate term in most situations because it is virtually impossible to prove what actually caused the lung injury in the hospital. Cause It is generally regarded, based on animal models and human studies, that volutrauma is the most harmful aspect of mechanical ventilation. This may be regarded as the over-stretching of the airways and alveoli. During mechanical ventilation, the flow of gas into the lung will take the path of least resistance. Areas of the lung that are collapsed (atelectasis) or filled with secretions will be underinflated, while those areas that are relatively normal will be overinflated. These areas will become overdi ...
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Thoracic Diaphragm
The thoracic diaphragm, or simply the diaphragm ( grc, διάφραγμα, diáphragma, partition), is a sheet of internal Skeletal striated muscle, skeletal muscle in humans and other mammals that extends across the bottom of the thoracic cavity. The diaphragm is the most important Muscles of respiration, muscle of respiration, and separates the thoracic cavity, containing the heart and lungs, from the abdominal cavity: as the diaphragm contracts, the volume of the thoracic cavity increases, creating a negative pressure there, which draws air into the lungs. Its high oxygen consumption is noted by the many mitochondria and capillaries present; more than in any other skeletal muscle. The term ''diaphragm'' in anatomy, created by Gerard of Cremona, can refer to other flat structures such as the urogenital diaphragm or Pelvic floor, pelvic diaphragm, but "the diaphragm" generally refers to the thoracic diaphragm. In humans, the diaphragm is slightly asymmetric—its right half is h ...
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