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hypoxemia mechanism

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https://www.readbyqxmd.com/read/29229259/effects-of-positive-airway-pressure-and-mechanical-ventilation-of-the-lungs-during-cardiopulmonary-bypass-on-pulmonary-adverse-events-after-cardiac-surgery-a-systematic-review-and-meta-analysis
#1
Yi-Chia Wang, Chi-Hsiang Huang, Yu-Kang Tu
OBJECTIVE: To investigate whether different ventilation strategies during cardiopulmonary bypass (CPB) can improve outcomes in adult cardiac surgery patients. DESIGN: Systematic review of randomized controlled trials with meta-analyses. SETTING: Clinical trials for human studies up to July 2016 were obtained from electronic databases (Medline, Embase, PubMed, and the Cochrane Central Register of Controlled Trials) and reference lists of relevant randomized trials and review articles...
September 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29221484/the-impacts-of-baseline-ventilator-parameters-on-hospital-mortality-in-acute-respiratory-distress-syndrome-treated-with-venovenous-extracorporeal-membrane-oxygenation-a-retrospective-cohort-study
#2
Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a valuable life support in acute respiratory distress syndrome (ARDS) in adult patients. However, the success of VV-ECMO is known to be influenced by the baseline settings of mechanical ventilation (MV) before its institution. This study was aimed at identifying the baseline ventilator parameters which were independently associated with hospital mortality in non-trauma patients receiving VV-ECMO for severe ARDS. METHODS: This retrospective study included 106 non-trauma patients (mean age: 53 years) who received VV-ECMO for ARDS in a single medical center from 2007 to 2016...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29214337/sleep-disordered-breathing-in-patients-with-sickle-cell-disease
#3
REVIEW
Vikram M Raghunathan, Peter L Whitesell, Seah H Lim
Sickle cell disease is one of the most common hereditary hemoglobinopathies worldwide, and its vaso-occlusive and hemolytic crises cause considerable patient morbidity. A growing body of evidence has shown that sleep-disordered breathing, and in particular, obstructive sleep apnea, occurs at high frequency in the sickle cell population, and that there is significant overlap in the underlying pathophysiology of these two conditions. Through a variety of mechanisms including nocturnal hypoxemia and increased oxidative stress, production of pro-inflammatory cytokines, and endothelial dysfunction, sickle cell anemia and sleep-disordered breathing potentiate each other's clinical effects and end-organ complications...
December 6, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29194281/rbc-transfusions-are-associated-with-prolonged-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#4
Michael E Zubrow, Neal J Thomas, David F Friedman, Nadir Yehya
OBJECTIVES: Blood products are often transfused in critically ill children, although recent studies have recognized their potential for harm. Translatability to pediatric acute respiratory distress syndrome is unknown given that hypoxemia has excluded pediatric acute respiratory distress syndrome patients from clinical trials. We aimed to determine whether an association exists between blood product transfusion and survival or duration of ventilation in pediatric acute respiratory distress syndrome...
November 30, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29188024/managing-persistent-hypoxemia-what-is-new
#5
REVIEW
Jesús Villar, Carlos Ferrando, Robert M Kacmarek
Mechanical ventilation is the standard life-support technique for patients with severe acute respiratory failure. However, some patients develop persistent and refractory hypoxemia because their lungs are so severely damaged that they are unable to respond to the application of high inspired oxygen concentration and high levels of positive end-expiratory pressure. In this article, we review current knowledge on managing persistent hypoxemia in patients with injured lungs.
2017: F1000Research
https://www.readbyqxmd.com/read/29186549/intradialytic-hypertension-is-associated-with-low-intradialytic-arterial-oxygen-saturation
#6
Anna Meyring-Wösten, Ya Luo, Hanjie Zhang, Priscila Preciado, Stephan Thijssen, Yuedong Wang, Peter Kotanko
Background: The pathophysiology of a paradoxical systolic blood pressure (SBP) rise during hemodialysis (HD) is not yet fully understood. Recent research indicated that 10% of chronic HD patients suffer from prolonged intradialytic hypoxemia. Since hypoxemia induces a sympathetic response we entertained the hypothesis that peridialytic SBP change is associated with arterial oxygen saturation (SaO 2 ). Methods: We retrospectively analyzed intradialytic SaO 2 and peridialytic SBP change in chronic HD patients with arteriovenous vascular access...
November 24, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29184617/acute-atrial-fibrillation-complicating-organophosphorus-poisoning
#7
Monika Maheshwari, Shreekant Chaudhary
Organophosphorus (OP) pesticide poisoning is a major clinical and public health problem in a developing country like India. Cardiac injury is a strong predictor of death in these patients. Cardiac complications usually described include cardiac arrest, pulmonary edema, and arrhythmia. Rarely, myocardial infarction has also been reported. The possible mechanisms for myocardial injury include sympathetic/parasympathetic overactivity, hypoxemia, acidosis, dyselectrolytemia, and direct cardiotoxicity. We describe herein one case of OP poisoning, recently admitted in our emergency department and which was complicated by acute onset atrial fibrillation which reverted to sinus rhythm following detoxification of OP compound...
July 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/29149363/indications-for-extracorporeal-support-why-do-we-need-the-results-of-the-eolia-trial
#8
REVIEW
A Combes, N Bréchot, C-E Luyt, M Schmidt
Acute respiratory distress syndrome (ARDS) is a severe lung disease, with an associated mortality rate exceeding 60% for the most severe forms of the disease. In these situations, establishing an extracorporeal circuit, combining a centrifugal pump and a membrane oxygenator (extra-corporeal membrane oxygenation, ECMO), can ensure total pulmonary assistance and allow the lungs to rest under ultraprotective mechanical ventilation. Unfortunately, former trials of ECMO in ARDS were negative or highly criticized due to many technical and methodological shortcomings...
November 17, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29118026/carbon-monoxide-in-lung-cell-physiology-and-disease
#9
Stefan W Ryter, Kevin C Ma, Augustine M K Choi
Carbon monoxide (CO) is an endogenously produced gas that has gained recognition as a biological signal transduction effector with properties similar, but not identical, to that of nitric oxide (NO). CO, which binds primarily to heme iron, may activate the hemoprotein guanylate cyclase (sGC), although with lower potency than NO. Furthermore, CO can modulate the activities of several cellular signaling molecules such as p38 MAPK, ERK1/2, JNK, AKT, NF-κB, and others. Emerging studies suggest that mitochondria, the energy-generating organelle of cells, represent a key target of CO action in eukaryotes...
November 8, 2017: American Journal of Physiology. Cell Physiology
https://www.readbyqxmd.com/read/29115600/messenger-rna-sequencing-reveals-similar-mechanisms-between-neonatal-and-acute-respiratory-distress-syndrome
#10
Hua Mei, Yuheng Zhang, Chunzhi Liu, Yayu Zhang, Chunli Liu, Dan Song, Chun Xin, Jing Wang, Jonathan Josephs-Spaulding, Yan Zhu, Feng Tang
Hypoxemia and hypercarbia resulting from a lack of surfactant is considered to be the primary mechanism underlying neonatal respiratory distress syndrome (NRDS). Surfactant replacement therapy may mitigate the symptoms of the disease by decreasing the surface tension of alveoli and facilitating inflation. However, surfactant serves an additional role in immunological processes. Therefore, it may be hypothesized that mechanisms of NRDS involving surfactant exert additional functions to promoting alveolar inflation...
October 26, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29105540/mechanically-ventilating-the-severe-asthmatic
#11
Abdullah E Laher, Sean K Buchanan
The management of the critically ill patients with asthma can be rather challenging. Potentially devastating complications relating to this presentation include hypoxemia, worsening bronchospasm, pulmonary aspiration, tension pneumothorax, dynamic hyperinflation, hypotension, dysrhythmias, and seizures. In contrast to various other pathologies requiring mechanical ventilation, acute asthma is generally associated with better outcomes. This review serves as a practical guide to the physician managing patients with severe acute asthma requiring mechanical ventilation...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29084407/hypoxemia-episodes-during-day-and-night-and-their-impact-on-oxygen-saturation-targeting-in-mechanically-ventilated-preterm-infants
#12
Deepak Jain, Carmen D'Ugard, Jose Bello, Eduardo Bancalari, Nelson Claure
BACKGROUND: Hypoxemia episodes (HE) occur frequently in ventilated preterm infants and hinder the achievement of arterial oxygen saturation (SpO2) targets. These episodes may increase the risk for retinopathy of prematurity and neurodevelopmental disability. There are no data on the variation in HE and SpO2 targeting between day and night. OBJECTIVE: The aim of this study was to evaluate the difference between day and night on the frequency and severity of HE and achievement of SpO2 targets...
October 31, 2017: Neonatology
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#13
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29054769/positive-end-expiratory-pressure-adjusted-for-intra-abdominal-pressure-a-pilot-study
#14
Adrian Regli, Bart Leon De Keulenaer, Annamaria Palermo, Peter Vernon van Heerden
PURPOSE: Intra-abdominal hypertension (IAH) is associated with impaired respiratory function. Animal data suggest that positive end-expiratory pressure (PEEP) levels adjusted to intra-abdominal pressure (IAP) levels may counteract IAH-induced respiratory dysfunction. In this pilot study, our aim was to assess whether PEEP adjusted for IAP can be applied safely in patients with IAH. MATERIALS AND METHODS: We included patients on mechanical ventilation and with IAH...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29033350/phenotypical-characterization-of-human-rhinovirus-infections-in-severely-premature-children
#15
Geovanny F Perez, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos E Rodriguez-Martinez, Dinesh Pillai, Gustavo Nino
BACKGROUND: Human Rhinovirus (HRV) has been identified as the most common cause of acute respiratory infections and hospitalizations in premature children. It is unclear if premature children are more susceptible to HRV due to their decreased pulmonary reserve or because they have enhanced lower airway reactivity to HRV. METHODS: We conducted a retrospective analysis of the clinical respiratory presentation of all PCR-confirmed HRV infections in full-term and premature children aged ≤3 years in our institution...
September 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29028081/serum-ykl-40-level-is-correlated-with-apnea-hypopnea-index-in-patients-with-obstructive-sleep-apnea-sindrome
#16
L C Mutlu, F Tülübaş, R Alp, G Kaplan, Z D Yildiz, A Gürel
OBJECTIVE: Obstructive sleep apnea syndrome (OSAS) has been associated with elevated biochemical markers of inflammation. Although the exact mechanism is unknown, both sleep deprivation and hypoxemia are believed to be important causative factors. YKL-40, also known as chitinase-like protein, has been shown to be related to various inflammatory conditions including atherosclerosis, diabetes, cancer, and asthma. The present study aimed to evaluate the relationship between YKL-40 levels and the Apnea Hypopnea Index (AHI) in patients with obstructive sleep apnea syndrome...
September 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29027655/determinants-of-immediate-failure-of-noninvasive-mechanical-ventilation-outside-the-intensive-care-unit
#17
Killen H Briones Claudett, Monica H Briones Claudett, Antonio M Esquinas, Michelle Grunauer Andrade
BACKGROUND: This study aimed to characterize which are the early determinants of immediate failure of the use of noninvasive mechanical ventilation (NIMV) outside the ICU. METHODS: This prospective study included patients who were admitted to the Military Hospital in Guayaquil, Ecuador. Each variable was analyzed independently by using a multiple logistic regression model toward establishing an association with the event. A P-value of < 0.05 was considered statistically significant...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29025100/an-examination-of-pain-s-relationship-to-sleep-fragmentation-and-disordered-breathing-across-common-sleep-disorders
#18
Jennifer M Mundt, Stephan Eisenschenk, Michael E Robinson
Objective: Short sleep duration and insomnia have been linked to higher pain and an increased risk of developing chronic pain, but relatively little research has examined the contribution of sleep disordered breathing (SDB) to pain. This study examined the unique contributions of SDB and insomnia to chronic pain. Subjects: Adult patients referred to an academic sleep center for overnight polysomnography were invited to participate. Methods: Participants (N = 105) completed questionnaires about their sleep and pain, including the Insomnia Severity Index, Medical College of Virginia Pain Questionnaire, and two weeks of sleep/pain diaries...
August 28, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29023811/placental-growth-factor-inhibition-targets-pulmonary-angiogenesis-and-represents-a-novel-therapy-for-hepatopulmonary-syndrome-in-mice
#19
Sarah Raevens, Anja Geerts, Annelies Paridaens, Sander Lefere, Xavier Verhelst, Anne Hoorens, Jo Van Dorpe, Tania Maes, Ken R Bracke, Christophe Casteleyn, Bart Jonckx, Thomas Horvatits, Valentin Fuhrmann, Hans Van Vlierberghe, Christophe Van Steenkiste, Lindsey Devisscher, Isabelle Colle
Hepatopulmonary syndrome (HPS) is a severe complication of cirrhosis with increased risk of mortality. Pulmonary microvascular alterations are key features of HPS, but underlying mechanisms are incompletely understood, and studies on HPS are limited to rats. Placental growth factor (PlGF), a pro-angiogenic molecule that is selectively involved in pathological angiogenesis, may play an important role in HPS development, however, its role has never been investigated. In this study, we validated an HPS model by common bile duct ligation (CBDL) in mice, investigated the kinetic changes in pulmonary angiogenesis and inflammation during HPS development, and provide evidence for a novel therapeutic strategy by targeting pathological angiogenesis...
October 10, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29016366/acute-life-threatening-hypoxemia-during-mechanical-ventilation
#20
Thomas Piraino, Eddy Fan
PURPOSE OF REVIEW: To describe current evidence-based practice in the management of acute life-threatening hypoxemia in mechanically ventilated patients and some of the methods used to individualize the care of the patient. RECENT FINDINGS: Patients with acute life-threatening hypoxemia will often meet criteria for severe ARDS, for which there are only a few treatment strategies that have been shown to improve survival outcomes. Recent findings have increased our knowledge of the physiological effects of spontaneous breathing and the application of PEEP...
December 2017: Current Opinion in Critical Care
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