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https://www.readbyqxmd.com/read/29768512/infant-cpap-for-low-income-countries-an-experimental-comparison-of-standard-bubble-cpap-and-the-pumani-system
#1
Markus Falk, Snorri Donaldsson, Thomas Drevhammar
INTRODUCTION: Access to inexpensive respiratory support to newborn infants improves survival in low-income countries. Standard bubble continuous positive airway pressure (CPAP) has been extensively used worldwide for more than 30 years. One project aimed at providing affordable CPAP is the Pumani system developed by Rice 360°. Compared to standard bubble CPAP the system has an unconventional design. The aim was to compare the Pumani system with two traditional bubble CPAP systems, focusing on in-vitro performance and safety...
2018: PloS One
https://www.readbyqxmd.com/read/29766036/simulation-based-airway-management-training-for-anesthesiologists-a-brief-review-of-its-essential-role-in-skills-training-for-clinical-competency
#2
Nobuyasu Komasawa, Benjamin W Berg
In clinical practice, failure of proper airway management can lead to significant patient morbidity and mortality. Difficult airway management comprises a fundamental skill set for anesthesiologists and has long been recognized as one of the most challenging skills. Simulation-based training is an essential technique to establish and maintain technical and nontechnical skills for airway management. We review the evidence-based utility of simulation-based training for anesthesiologists to accquire technical and nontechnical airway mangement skills...
October 2017: Journal of Education in Perioperative Medicine: JEPM
https://www.readbyqxmd.com/read/29765004/a-comparison-of-the-adjustable-ranges-of-inspiratory-pressurization-during-pressure-controlled-continuous-mandatory-ventilation-of-5-icu-ventilators
#3
Yukiko Koyama, Akinori Uchiyama, Junko Yoshida, Takeshi Yoshida, Tomonori Yamashita, Yuji Fujino
BACKGROUND: Faster inspiratory pressurization can improve patient-ventilator synchrony and reduce the patient's work of breathing during pressure controlled continuous mandatory (PC-CMV) ventilation. The characteristics of the pressurization ramp settings are not standardized across ventilators from different manufacturers. We performed a bench test of 5 models of ICU ventilators to examine the effects of pressurization ramp settings on the actual pressurization. METHODS: A twin-bellows lung model was used, in which one bellow simulates inspiratory muscle activity and the other simulates an adult normal lung model...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29756207/quantification-of-tissue-engineered-trachea-performance-with-computational-fluid-dynamics
#4
Lauren Eichaker, Chengyu Li, Nakesha King, Victoria Pepper, Cameron Best, Ekene Onwuka, Eric Heuer, Kai Zhao, Jonathan Grischkan, Christopher Breuer, Jed Johnson, Tendy Chiang
OBJECTIVES/HYPOTHESIS: Current techniques for airway characterization include endoscopic or radiographic measurements that produce static, two-dimensional descriptions. As pathology can be multilevel, irregularly shaped, and dynamic, minimal luminal area (MLA) may not provide the most comprehensive description or diagnostic metric. Our aim was to examine the utilization of computational fluid dynamics (CFD) for the purpose of defining airway stenosis using an ovine model of tissue-engineered tracheal graft (TETG) implantation...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#5
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29728177/modeling-congenital-nasal-pyriform-aperture-stenosis-using-computational-fluid-dynamics
#6
Tirth R Patel, Chengyu Li, Jillian Krebs, Kai Zhao, Prashant Malhotra
OBJECTIVES: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of airway obstruction in the neonate. Computational airway modeling has not been done in neonates and young infants to understand the impact of stenosis on functional nasal airflow. In this study, we 1) applied computational fluid dynamics (CFD) model to the airway of a neonate with CNPAS and 2) compare airflow dynamics of a normal and CNPAS airway. METHODS: Three-dimensional models of the nasal airway of a normal neonate and a neonate with CNPAS were created using computed tomography scans of the facial bones...
June 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29721547/evaluation-of-the-pharyngeal-airway-using-computational-fluid-dynamics-in-patients-with-acromegaly
#7
Keika Mukaihara, Maiko Hasegawa-Moriyama, Tomonori Iwasaki, Youichi Yamasaki, Yuichi Kanmura
Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans-sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS. Methods: CT images of the nasopharyngeal airways of patients with acromegaly (n = 5) or nonfunctional pituitary adenoma (n = 6) undergoing TSS from April 2012 to January 2017 were used to construct these airways in three dimensions...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29721539/simulation-of-the-upper-airways-in-patients-with-obstructive-sleep-apnea-and-nasal-obstruction-a-novel-finite-element-method
#8
Mads Henrik Strand Moxness, Franziska Wülker, Bjørn Helge Skallerud, Ståle Nordgård
Objective: To evaluate the biomechanical properties of the soft palate and velopharynx in patients with obstructive sleep apnea (OSA) and nasal obstruction. Study design: Prospective experimental study. Materials and methods: Two finite element (FE) models of the soft palate were created in six patients undergoing nasal surgery, one homogeneous model based on CT images, and one layered model based on soft tissue composition. The influence of anatomy on displacement caused by a gravitational load and closing pressure were evaluated in both models...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29700102/-in-vitro-in-silico-and-in-vivo-study-challenges-the-impact-of-bronchial-thermoplasty-on-acute-airway-smooth-muscle-mass-loss
#9
Igor L Chernyavsky, Richard J Russell, Ruth M Saunders, Gavin E Morris, Rachid Berair, Amisha Singapuri, Latifa Chachi, Adel H Mansur, Peter H Howarth, Paddy Dennison, Rekha Chaudhuri, Stephen Bicknell, Felicity R A J Rose, Salman Siddiqui, Bindi S Brook, Christopher E Brightling
Bronchial thermoplasty is a treatment for asthma. Whether during thermoplasty the airway wall fraction exposed to temperatures necessary to affect cells is sufficient to explain its histopathological impact is unclear.Airway smooth muscle and bronchial epithelial cells were exposed to media (37-70°C) for 10 seconds to mimic thermoplasty. In silico we developed a mathematical model of airway heat distribution following thermoplasty. In vivo we determined airway smooth muscle mass and epithelial integrity pre- and post-thermoplasty in 14 severe asthmatics...
April 26, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29687674/intubation-through-2-supraglottic-airway-device-in-cervical-spine-immobilization-a-randomized-trial-of-residents-use-of-the-intubating-laryngeal-mask-airway-and-the-intubating-laryngeal-tube-in-manikins
#10
Dawid Aleksandrowicz, Tomasz Gaszyński
OBJECTIVES: The aim of this study was to compare the intubating laryngeal mask (iLM) airway and the new intubating laryngeal tube (iLTS-D) in use by residents with minimal previous intubation experience during simulated conditions of reduced cervical spine mobility. MATERIAL AND METHODS: Thirty first-year residents in anesthesiology participated in the study (18 women). All participants had minimal intubation experience (fewer than 10 previously performed intubations) and were novices in the specialty...
June 2018: Emergencias: revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29686383/the-il-33-pin1-irak-m-axis-is-critical-for-type-2-immunity-in-il-33-induced-allergic-airway-inflammation
#11
Morris Nechama, Jeahoo Kwon, Shuo Wei, Adrian Tun Kyi, Robert S Welner, Iddo Z Ben-Dov, Mohamed S Arredouani, John M Asara, Chun-Hau Chen, Cheng-Yu Tsai, Kyle F Nelson, Koichi S Kobayashi, Elliot Israel, Xiao Zhen Zhou, Linda K Nicholson, Kun Ping Lu
Interleukin 33 (IL-33) is among the earliest-released cytokines in response to allergens that orchestrate type 2 immunity. The prolyl cis-trans isomerase PIN1 is known to induce cytokines for eosinophil survival and activation by stabilizing cytokines mRNAs, but the function of PIN1 in upstream signaling pathways in asthma is unknown. Here we show that interleukin receptor associated kinase M (IRAK-M) is a PIN1 target critical for IL-33 signaling in allergic asthma. NMR analysis and docking simulations suggest that PIN1 might regulate IRAK-M conformation and function in IL-33 signaling...
April 23, 2018: Nature Communications
https://www.readbyqxmd.com/read/29679678/characterisation-of-40-mg-ml-and-100-mg-ml-tobramycin-formulations-for-aerosol-therapy-with-adult-mechanical-ventilation
#12
Jayesh A Dhanani, Patrician Tang, Steven C Wallis, Suzanne L Parker, Preeti Pandey, John F Fraser, Jeremy Cohen, Adrian Barnett, Jason R Roberts, Hak-Kim Chan
BACKGROUND: Preservative-free tobramycin is commonly used as aerosolized therapy for ventilator associated pneumonia. The comparative delivery profile of the formulations of two different concentrations (100 mg/ml and 40 mg/ml) is unknown. This study aims to evaluate the aerosol characteristics of these tobramycin formulations in a simulated adult mechanical ventilation model. METHODS: Simulated adult mechanical ventilation set up and optimal settings were used in the study...
April 18, 2018: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29675732/bias-flow-rate-and-ventilation-efficiency-during-adult-high-frequency-oscillatory-ventilation-a-lung-model-study
#13
Osamu Nagano, Tetsuya Yumoto, Atsunori Nishimatsu, Shunsuke Kanazawa, Takahisa Fujita, Sunao Asaba, Hideo Yamanouchi
BACKGROUND: Bias flow (BF) is essential to maintain mean airway pressure (MAP) and to washout carbon dioxide (CO2 ) from the oscillator circuit during high-frequency oscillatory ventilation (HFOV). If the BF rate is inadequate, substantial CO2 rebreathing could occur and ventilation efficiency could worsen. With lower ventilation efficiency, the required stroke volume (SV) would increase in order to obtain the same alveolar ventilation with constant frequency. The aim of this study was to assess the effect of BF rate on ventilation efficiency during adult HFOV...
April 19, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29672467/concepts-for-the-simulation-community-development-of-the-international-simulation-data-registry
#14
Aaron William Calhoun, Vinay Nadkarni, Carla Venegas-Borsellino, Marjorie Lee White, Matt Kurrek
The past several decades have seen tremendous growth in our understanding of best practices in simulation-based healthcare education. At present, however, there is limited infrastructure available to assist programs in translation of these best practices into more standardized educational approaches, higher quality of care, and ultimately improved outcomes. In 2014, the International Simulation Data Registry (ISDR) was launched to address this important issue. The existence of such a registry has important implications not just for educational practice but also for research...
April 18, 2018: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29668295/unravelling-a-clinical-paradox-why-does-bronchial-thermoplasty-work-in-asthma
#15
Graham M Donovan, John G Elliot, Francis H Y Green, Alan L James, Peter B Noble
Rationale Bronchial thermoplasty is a relatively new but effective treatment in asthmatic subjects who do not respond to conventional therapy. While the favoured mechanism is ablation of the airway smooth muscle layer, because bronchial thermoplasty treats only a small number of central airways, there is ongoing debate regarding its precise method of action. Objectives Elucidate the underlying method of action behind bronchial thermoplasty. Methods We employ a combination of extensive human lung specimens and novel computational methods...
April 18, 2018: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29658053/flow-and-air-conditioning-simulations-of-computer-turbinectomized-nose-models
#16
J Pérez-Mota, F Solorio-Ordaz, J Cervantes-de Gortari
Air conditioning for the human respiratory system is the most important function of the nose. When obstruction occurs in the nasal airway, turbinectomy is used to correct such pathology. However, mucosal atrophy may occur sometime after this surgery when it is overdone. There is not enough information about long-term recovery of nasal air conditioning performance after partial or total surgery. The purpose of this research was to assess if, based on the flow and temperature/humidity characteristics of the air intake to the choana, partial resection of turbinates is better than total resection...
April 16, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#17
Chuong Ngo, Stephan Dahlmanns, Thomas Vollmer, Berno Misgeld, Steffen Leonhardt
BACKGROUND AND OBJECTIVE: This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS: Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29644401/-skill-retention-using-extraglottic-airways-in-out-of-hospital-emergencies-efficacy-and-long-term-results-of-simulator-based-medical-education-a-prospective-follow-up-study
#18
V Mann, F Limberg, S T W Mann, S Little, M Müller, M Sander, R Röhrig
OBJECTIVE: For emergency medicine personnel (EMP), there is little evidence concerning the adequate timing for refresher courses to maintain routine in the application of extraglottic airways. The aim of this study was to evaluate the efficacy and long-term results of a simulator-based education concept teaching the basic airway management skills with extraglottic airways for EMP and also to draw conclusions concerning the adequate time interval for refresher courses. METHODS: By use of an explorative, prospective simulator-study with nonphysician EMP, airway management skills using the Larynxmaske Supreme® (LMA‑S) after an introduction lecture were examined...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29628666/cardiopulmonary-resuscitation-unusual-techniques-for-unusual-situations
#19
Vidhu Bhatnagar, Kavitha Jinjil, Deepak Dwivedi, Rohit Verma, Urvashi Tandon
Background: The cardiopulmonary resuscitation (CPR) in prone position has been dealt with in 2010 American Heart Association (AHA) guidelines but have not been reviewed in 2015 guidelines. The guidelines for patients presenting with cardiac arrest under general anesthesia in lateral decubitus position and regarding resuscitation in confined spaces like airplanes are also not available in AHA guidelines. This article is an attempt to highlight the techniques adopted for resuscitation in these unusual situations...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29628333/multidisciplinary-difficult-airway-course-an-essential-educational-component-of-a-hospital-wide-difficult-airway-response-program
#20
W Robert Leeper, Elliott R Haut, Vinciya Pandian, Sajan Nakka, Jeffrey Dodd-O, Nasir Bhatti, Elizabeth A Hunt, Mustapha Saheed, Nicholas Dalesio, Adam Schiavi, Christina Miller, Thomas D Kirsch, Lauren Berkow
OBJECTIVE: A hospital-wide difficult airway response team was developed in 2008 at The Johns Hopkins Hospital with three central pillars: operations, safety monitoring, and education. The objective of this study was to assess the outcomes of the educational pillar of the difficult airway response team program, known as the multidisciplinary difficult airway course (MDAC). DESIGN: The comprehensive, full-day MDAC involves trainees and staff from all provider groups who participate in airway management...
April 5, 2018: Journal of Surgical Education
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