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Airway simulation simulator

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https://www.readbyqxmd.com/read/29160160/ideal-particle-sizes-for-inhaled-steroids-targeting-vocal-granulomas-preliminary-study-using-computational-fluid-dynamics
#1
Elizabeth L Perkins, Saikat Basu, Guilherme J M Garcia, Robert A Buckmire, Rupali N Shah, Julia S Kimbell
Objectives Vocal fold granulomas are benign lesions of the larynx commonly caused by gastroesophageal reflux, intubation, and phonotrauma. Current medical therapy includes inhaled corticosteroids to target inflammation that leads to granuloma formation. Particle sizes of commonly prescribed inhalers range over 1 to 4 µm. The study objective was to use computational fluid dynamics to investigate deposition patterns over a range of particle sizes of inhaled corticosteroids targeting the larynx and vocal fold granulomas...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29159491/-algorithm-for-securing-an-unexpected-difficult-airway-user-analysis-on-a-simulator
#2
T Ott, K Truschinski, M Kriege, M Naß, S Herrmann, V Ott, S Sellin
BACKGROUND: Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29157220/combined-effects-of-leaks-respiratory-system-properties-and-upper-airway-patency-on-the-performance-of-home-ventilators-a-bench-study
#3
Kaixian Zhu, Claudio Rabec, Jésus Gonzalez-Bermejo, Sébastien Hardy, Sami Aouf, Pierre Escourrou, Gabriel Roisman
BACKGROUND: Combined effects of leaks, mechanical property of respiratory system and upper airway (UA) patency on patient-ventilator synchrony (PVA) and the level of clinically "tolerable" leaks are not well established in home ventilators. METHODS: We comparatively assessed on a bench model, the highest leak level tolerated without inducing significant asynchrony ("critical leak") in three home ventilators (Astral 150, Trilogy 100 and Vivo 60; noted as A150, T100 and V60 respectively) subjected to three simulated diseased respiratory conditions: chronic obstructive pulmonary disease (COPD), obesity hypoventilation (OHS) and neuromuscular disorders (NMD), with both open and closed UA...
November 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29155876/docking-analysis-and-the-possibility-of-prediction-efficacy-for-an-anti-il-13-biopharmaceutical-treatment-with-tralokinumab-and-lebrikizumab-for-bronchial-asthma
#4
Yutaka Nakamura, Aki Sugano, Mika Ohta, Yutaka Takaoka
Interleukin-13 (IL-13) is associated with allergic airway inflammation and airway remodeling. Our group found a variant with a single nucleotide polymorphism in the IL13 gene at position +2044G>A (rs20541) that was expected to result in the non-conservative replacement of a positively charged arginine (R) with a neutral glutamine (Q) at position 144. IL-13Q144 was associated with augmented allergic airway inflammation and bronchial asthma remodeling. There is some indication that anti-IL-13 monoclonal antibodies can demonstrate a positive effect on the clinical course of refractory asthmatic patients...
2017: PloS One
https://www.readbyqxmd.com/read/29144436/an-in-silico-subject-variability-study-of-upper-airway-morphological-influence-on-the-airflow-regime-in-a-tracheobronchial-tree
#5
Yu Feng, Jianan Zhao, Xiaole Chen, Jiang Lin
Determining the impact of inter-subject variability on airflow pattern and nanoparticle deposition in the human respiratory system is necessary to generate population-representative models, useful for several biomedical engineering applications. Thus, the overall research objective is to quantitatively correlate geometric parameters and coupled transport characteristics of air, vapor, and nanoparticles. Focusing on identifying morphological parameters that significantly influence airflow field and nanoparticle transport, an experimentally validated computational fluid-particle dynamics (CFPD) model was employed to simulate airflow pattern in three human lung-airway configurations...
November 16, 2017: Bioengineering
https://www.readbyqxmd.com/read/29140632/grain-entrapment-pressure-on-the-torso-can-you-breathe-while-buried-in-grain
#6
Kevin G Moore, Carol L Jones
The pressure applied to the chest and back of a simulated grain entrapment victim was measured. Pressure sensors were attached to the chest and back of a manikin that was buried in grain in the vertical position. Measurements were made in four grain types at four grain depths ranging from the top of the manikin's shoulders to 0.61 m (24 in.) over the head. The pressure ranged from 1.6 to 4.0 kPa (0.23 to 0.57 psi). Based on available physiological information, this amount of pressure is unlikely to limit the respiration of an otherwise healthy adult male victim...
April 26, 2017: Journal of Agricultural Safety and Health
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#7
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136003/longitudinal-acquisition-of-endotracheal-intubation-skills-in-novice-physicians
#8
Shinya Takeuchi, Takashi Shiga, Yasuaki Koyama, Taizo Nakanishi, Yosuke Honma, Hiroshi Morita, Tadahiro Goto
Little is known about the acquisition of intubation skills among novice physicians during their one-year clinical training. Our primary objective was to determine the changes in the intubation skills of novice physicians between prior to the clinical training and after completion of the clinical training. We used data of a prospective longitudinal multicenter data registry developed to investigate factors associated with the improvement of intubation skills among novice physicians. The study participants included 90 postgraduate year 1 physicians in 2015-2016...
2017: PloS One
https://www.readbyqxmd.com/read/29135775/adjustment-for-variable-adherence-under-hierarchical-structure-instrumental-variable-modeling-through-compound-residual-inclusion
#9
Tyson H Holmes, Donna M Zulman, Clete A Kushida
BACKGROUND: Variable adherence to assigned conditions is common in randomized clinical trials. OBJECTIVES: A generalized modeling framework under longitudinal data structures is proposed for regression estimation of the causal effect of variable adherence on outcome, with emphasis upon adjustment for unobserved confounders. RESEARCH DESIGN: A nonlinear, nonparametric random-coefficients modeling approach is described. Estimates of local average treatment effects among compliers can be obtained simultaneously for all assigned conditions to which participants are randomly assigned within the trial...
December 2017: Medical Care
https://www.readbyqxmd.com/read/29131890/modeling-inspiratory-flow-in-a-porcine-lung-airway
#10
Peshala/P Thibotuwawa Gamage, Fardin Khalili, Md/Khurshidul Azad, Hansen/A Mansy
Inspiratory flow in a multi-generation pig lung airways was numerically studied at a steady inlet flow rate of 3.2×10-4 m3/s corresponding to a Reynolds number of 1150 in the trachea. The model was validated by comparing velocity distributions with previous measurements and simulations in simplified airway geometries. Simulation results provided detailed maps of the axial and secondary flow patterns at different cross sections of the airway tree. The vortex core regions in the airways were visualized using absolute helicity values and suggested the presence of secondary flow vortices where two counter rotating vortices were observed at the main bifurcation and in many other bifurcations...
November 13, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29129332/aerosol-deposition-predictions-in-computed-tomography-derived-skeletons-from-severe-asthmatics-a-feasibility-study
#11
REVIEW
Shinjiro Miyawaki, Eric A Hoffman, Sally E Wenzel, Ching-Long Lin
BACKGROUND: The authors numerically investigated the correlation between airway skeletons of severe asthmatic human subjects and predicted aerosol deposition to shed light on the effect of environmental factors on asthma risk. We hypothesized that there are asthmatic subjects whose airway skeletal structure can expose the subject to a risk of higher local aerosol deposition compared to subjects with a more common/normal branching pattern. METHODS: From a population of severe asthmatics studied at total lung capacity via computed tomography we randomly selected 8 subjects whose Forced Expiratory Volume in 1s, percent predicted fell below 45% predicted...
November 4, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29128524/numerical-study-of-the-airflow-structures-in-an-idealized-mouth-throat-under-light-and-heavy-breathing-intensities-using-large-eddy-simulation
#12
Xinguang Cui, Wenwang Wu, Eva Gutheil
An excellent understanding of the airflow structures is critical to enhance the efficiency of drug delivery via the human oral airway. The present paper investigates the characteristics of both steady and unsteady airflow structures in an idealized mouth-throat using large eddy simulation (LES). Representative inhalation flow rates of 15L/min at rest and 60L/min in exercise are considered. The study shows that there are more secondary vortices in the pharynx and the laryngeal jet is much longer and more concave in the steady flow field at 15L/min compared to the higher inspiration rate, which decreases the possibility of drug impinging on the wall...
November 8, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29125918/in-vitro-characterization-of-the-eflow-closed-system-nebulizer-with-glycopyrrolate-inhalation-solution
#13
Stephen Pham, Gary T Ferguson, Edward Kerwin, Thomas Goodin, Alistair Wheeler, Andrea Bauer
BACKGROUND: Glycopyrrolate administered by a novel, investigational eFlow(®) Closed System (CS) nebulizer (eFlow CS) is being evaluated for the maintenance treatment of chronic obstructive pulmonary disease (COPD). The eFlow CS is a hand-held, vibrating membrane nebulizer optimized to deliver 1 mL of glycopyrrolate solution into the lung in <3 minutes. Clinical studies have shown improvements in lung function of subjects treated with nebulized glycopyrrolate. METHODS: The aerosol performance of the eFlow CS nebulizer was characterized by delivered dose, aerodynamic droplet size distribution and nebulization time...
November 10, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/29123902/influence-of-body-position-during-heimlich-maneuver-to-relieve-supralaryngeal-obstruction-a-manikin-study
#14
Michitaro Ichikawa, So Oishi, Katsunori Mochizuki, Kenichi Nitta, Kazufumi Okamoto, Hiroshi Imamura
Aim: HASH(0x5087f80) To study the most effective body position for Heimlich maneuver. Methods: A choking simulation manikin was connected to a laryngeal model of a child or an adult, and a differential pressure transducer recorded the airway pressure and waveform during the maneuver. A konjac jelly was placed on the larynx to mimic complete supralaryngeal obstruction. The maneuver (five successive compressions) was carried out six times each in standing, prone, and supine positions...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121299/gender-power-and-leadership-the-effect-of-a-superior-s-gender-on-respiratory-therapists-ability-to-challenge-leadership-during-a-life-threatening-emergency
#15
N Pattni, M D Bould, M A Hayter, D McLuckie, L M K Noble, A Malavade, Z Friedman
Background: Effective communication within teams is crucial, especially in crisis situations. Hierarchy gradients between team members can contribute to communication failures and are influenced by many factors. The effect of gender on team performance has not been well studied. The objective of this study was to examine the effect of the physician's gender on respiratory therapists' ability to effectively challenge clearly incorrect clinical decisions during a life-threatening crisis...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#16
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29113010/comparison-of-four-methods-of-endotracheal-tube-passage-in-simulated-airways-there-is-room-for-improved-techniques
#17
Kirsten Kingma, Ross Hofmeyr, Irene Suilan Zeng, Christin Coomarasamy, Andrew Brainard
OBJECTIVE: Endotracheal intubation requires laryngoscopy followed by passage of the endotracheal tube (ETT). Tube passage can be difficult, but there is little evidence to support which adjunct for tube passage is most effective. METHODS: The four tube passage adjuncts tested were the naked ETT, stylet ETT, railroaded bougie and preloaded bougie. Participants completed pre- and post-test surveys identifying demographics, experience and method preference. After instruction, participants completed eight intubations on manikins with 'easy' and 'difficult' airways...
November 7, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29105007/simulation-of-the-human-airways-using-virtual-topology-tools-and-meshing-optimization
#18
A Fernández-Tena, A C Marcos, R Agujetas, C Ferrera
A method is proposed to improve the quality of the three-dimensional airway geometric models using a commercial software, checking the number of elements, meshing time, and aspect ratio and skewness parameters. The use of real and virtual topologies combined with patch-conforming and patch-independent meshing algorithms results in four different models being the best solution the combination of virtual topology and patch-independent algorithm, due to an excellent aspect ratio and skewness of the elements, and minimum meshing time...
November 5, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29103789/an-in-situ-simulation-based-educational-outreach-project-for-pediatric-trauma-care-in-a-rural-trauma-system
#19
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29101894/computational-fluid-dynamics-evaluation-of-excessive-dynamic-airway-collapse
#20
Shahab Taherian, Hamid Rahai, Bernardo Gomez, Thomas Waddington, Farhad Mazdisnian
BACKGROUND: Excessive dynamic airway collapse, which is often caused by the collapse of the posterior membrane wall during exhalation, is often misdiagnosed with other diseases; stents can provide support for the collapsing airways. The standard pulmonary function tests do not necessarily show change in functional breathing condition for evaluation of these type of diseases. METHODS: Flow characteristics through a patient's airways with excessive dynamic airway collapse have been numerically investigated...
November 1, 2017: Clinical Biomechanics
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