scholarly journals A Case of Neonate with Vein of Galen Malformation Refractory to Weaning Attempts from Mechanical Ventilation Managed Successfully with Noninvasive Ventilation

2018 ◽  
Vol 05 (03) ◽  
pp. 198-200
Author(s):  
Ashutosh Kumar ◽  
Neeraja Ajayan ◽  
Manikandan Sethuraman ◽  
Ajay Prasad Hrishi
Keyword(s):  
Mechanical Ventilation ◽  
Noninvasive Ventilation ◽  
Cardiac Failure ◽  
Fluid Overload ◽  
Extubation Failure ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Successful Weaning ◽  
High Output

AbstractWeaning of patients with vein of Galen malformations (VOGM) from mechanical ventilation can be challenging in the postprocedure period due to underlying high-output cardiac failure and the fluid overload caused by the neurointervention procedure. We present the case of a neonate with VOGM who was refractory to multiple weaning attempts from mechanical ventilation and was successfully managed with noninvasive ventilation (NIV). NIV can be safely used as a method of weaning, post mechanical ventilation in this subset of patients. The use of NIV will facilitate successful weaning and reduce the incidence of extubation failure in neonates with VOGM in cardiac failure.

Vein of Galen Malformation and High-output Cardiac Failure

2016 ◽  
Vol 125 (3) ◽  
pp. 597-597 ◽  
Author(s):  
Ashley Smith ◽  
Todd Abruzzo ◽  
Mohamed Mahmoud
Keyword(s):  
Cardiac Failure ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
High Output

Successful Surgical and Anesthetic Management of Vein of Galen Aneurysm in a Neonate in Congestive Heart Failure

Neurosurgery ◽  
1988 ◽  
Vol 22 (5) ◽  
pp. 908-910 ◽  
Author(s):  
Jane Matjasko ◽  
Walker Robinson ◽  
Daniel Eudaily
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Failure ◽  
Growth And Development ◽  
Anesthetic Management ◽  
Vascular Supply ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Vein Of Galen Aneurysm

Abstract A 12-day-old infant in intractable cardiac failure due to a vein of Galen malformation was treated successfully with serial ligation of the majority of the vessels feeding the malformation. Despite some residual vascular supply to the malformation, the congestive heart failure has disappeared and growth and development have been normal over a 3-year follow-up period.

Vein of Galen aneurysmal malformations associated with high output cardiac failure: Report of three autopsy cases

2015 ◽  
Vol 09 (02) ◽  
pp. 227-232
Author(s):  
Reenu Malhotra ◽  
Luisa Florez ◽  
Dollett White ◽  
Sozos Papasozomenos ◽  
Michael Covinsky ◽  
...  
Keyword(s):  
Cardiac Failure ◽  
Vein Of Galen ◽  
High Output

scholarly journals Vein of Galen Aneurysmal Malformation Associated with High Output Cardiac Failure in Three Neonates

2007 ◽  
Vol 21 (5) ◽  
Author(s):  
Reenu Kapur Malhotra ◽  
Luisa Florez ◽  
Dollett White ◽  
Sozos Papasozomenos ◽  
Michael Covinsky ◽  
...  
Keyword(s):  
Cardiac Failure ◽  
Vein Of Galen ◽  
High Output

High Output Cardiovascular Physiology and Outcomes in Fetal Diagnosis of Vein of Galen Malformation

2021 ◽  
Author(s):  
Simone Jhaveri ◽  
Alejandro Berenstein ◽  
Shubhika Srivastava ◽  
Tomoyoshi Shigematsu ◽  
Miwa K. Geiger
Keyword(s):  
Cardiovascular Physiology ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Fetal Diagnosis ◽  
High Output

scholarly journals The effect of the physiological reserve surrogate characteristics on non-airway extubation failure in patients with pneumonia with high Burns wean assessment program scores

2021 ◽  
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Extubation Failure ◽  
Airway Extubation ◽  
Assessment Program ◽  
Increased Risk ◽  
Successful Weaning ◽  
History Of ◽  
Physiological Reserve ◽  
Baseline Characteristics

Objectives: A successful weaning prediction score could be a useful tool to predict non-airway extubation failure. However, it may carry some challenges without considering the effect of the physiological reserve on the sustainability of extubation. This study investigated the possible correlation between the physiological reserve surrogate characteristics including acute, baseline, and biochemical patients’ factors and non-airway extubation failure in patients with pneumonia. Methods: A retrospective cohort study at two academic teaching hospitals was conducted between January 2019 and January 2020 with patients with pneumonia requiring invasive mechanical ventilation and with Burns Wean Assessment Program (BWAP) scores equal to or exceeding 50. Acute clinical, biochemical, and baseline characteristics were collected for both successful and failed non-airway extubation patients. Results: Among 313 patients, the mean age was 63.63 ± 10.44 years and most of the patients were males (60.7%). The median invasive mechanical duration was 7 days [Interquartile range (IQR): 5–12], the median length of ICU stay was 12 [IQR: 6–23] and the in-hospital mortality was 16.9%. Among this cohort of patients with pneumonia, 37.7% had non-airway extubation failure. Multivariate logistic regression analyses showed that higher CURB-65 score, longer duration of invasive mechanical ventilation, hemodynamic instability, healthcare-associated pneumonia, older men, history of diabetes mellitus, history of cardiac disease, hypophosphatemia, hypocalcemia, and higher admission serum sodium were associated with increased risk of non-airway extubation failure in patients with pneumonia with high BWAP score. Conclusion: A distinct successful weaning score for patients with pneumonia that considers patients’ acute clinical, biochemical, and baseline characteristics may be effective, and these factors could be reflective of the underlying physiological reserve. Sustainability score from IMV rather than weaning score is needed and may be more predictive for the extubation outcome.

scholarly journals Fluid overload and length of mechanical ventilation in pediatric sepsis

2019 ◽  
Vol 59 (4) ◽  
pp. 211-6
Author(s):  
Winda Paramitha ◽  
Rina Triasih ◽  
Desy Rusmawatiningtyas
Keyword(s):  
Mechanical Ventilation ◽  
Fluid Overload ◽  
Secondary Data ◽  
Pediatric Intensive Care ◽  
Extubation Failure ◽  
Critically Ill Children ◽  
Inclusion Criteria ◽  
Mechanically Ventilated ◽  
Mechanical Ventilation Duration ◽  
Pediatric Sepsis

Background Children with sepsis often experience hemodynamic failure and would benefit from fluid resuscitation. On the other hand, critically ill children with sepsis have a higher risk of fluid accumulation due to increased capillary hydrostatic pressure and permeability. Therefore, fluid overload may result in higher morbidity and mortality during pediatric intensive care unit (PICU) hospitalization. Objective To evaluate the correlation between fluid overload and the length of mechanical ventilation in children with sepsis admitted to the PICU. Methods Our retrospective cohort study included children aged 1 month-18 years with sepsis who were admitted to the PICU between January 2013 and June 2018 and mechanically-ventilated. Secondary data was extracted from subjects’ medical records. Data analyses used were independent T-test and survival analysis. Results Of 444 children admitted to the PICU, 166 initially met the inclusion criteria. Of those, 17 children were excluded due to congenital heart disease. Subjects’ median age was 19 months and median PELOD-2 score was 8. Eighteen children (12.1%) had positive fluid balance in the first 48 hours. Median mechanical ventilation duration was 5 days. Fluid overload was significantly correlated with length of mechanical ventilation (P=0.01) and PICU mortality (RR=2.06; 95%CI 2.56 to 166; P=0.001). Neither length of PICU stay nor extubation failure were significantly correlated to fluid overload. Conclusion Fluid overload was significantly correlated with length of mechanical ventilation and may be a predictor of mortality in children with sepsis in the PICU.

A Newborn with Cardiac Failure Secondary to a Large Vein of Galen Malformation

2004 ◽  
Vol 97 (5) ◽  
pp. 516-518 ◽  
Author(s):  
Sergio G. Golombek ◽  
Shamiza Ally ◽  
Paul K. Woolf
Keyword(s):  
Cardiac Failure ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Large Vein

scholarly journals Application of bedside ultrasound in predicting the outcome of weaning from mechanical ventilation in elderly patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shigang Li ◽  
Zhe Chen ◽  
Weifeng Yan
Keyword(s):  
Mechanical Ventilation ◽  
Elderly Patients ◽  
Extubation Failure ◽  
Bedside Ultrasound ◽  
Weaning From Mechanical Ventilation ◽  
Rapid Shallow Breathing Index ◽  
Diaphragm Function ◽  
Successful Weaning ◽  
Shallow Breathing ◽  
Weaning Outcome

Abstract Background With the increased ageing of society, more and more elderly people are admitted to the intensive care unit, How to accurately predict whether elderly patients can successfully wean from the ventilator is more complicated. Diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) were measured by bedside ultrasound to assess diaphragm function. The lung ultrasound score (LUS) and the rapid shallow breathing index (RBSI) were used as indices of diaphragm function to predict the outcome of weaning from mechanical ventilation. The aim of this study was to examine the clinical utility of these parameters in predicting extubation success. Methods This prospective study included 101 consecutive elderly patients undergoing a trial of extubation in the ICU of Haidian Hospital between June 2017 and July 2020. Patients were divided into the successful weaning group (n = 69) and the failed weaning group (n = 32). Baseline characteristics, including RSBI, were recorded. Measurements of DE, DTF and LUS were made using ultrasound within 24 h before extubation. Results Median DE was greater in patients with extubation success than in those with extubation failure (1.64 cm vs. 0.78 cm, p = 0.001). Patients with extubation success had a greater DTF than those with extubation failure (49.48% vs. 27.85%, p = 0.001). The areas under the receiver operating curves for the RSBI, LUS, DE and DFT were 0.680, 0.764, 0.831 and 0.881, respectively. The best cut-off values for predicting successful weaning were DTF ≥ 30%, DE ≥ 1.3 cm, LUS ≤ 11, and RSBI ≤ 102. The specificity of DTF (84%) in predicting weaning outcome was higher than that of RBSI (53%), that of LUS (55%), and that of DE (62%). The sensitivity of DTF (94%) was greater than that of RBSI (85%), that of LUS (71%), and that of DE (65%). The combination of RSBI, LUS, DE, and DTF showed the highest AUC (AUC = 0.919), with a sensitivity of 96% and a specificity of 89%. Conclusions DTF has higher sensitivity and specificity for the prediction of successful weaning in elderly patients than the other parameters examined. The combination of RSBI, LUS, DE and DFT performed well in predicting weaning outcome. This has potentially important clinical application and merits further evaluation.

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