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https://www.readbyqxmd.com/read/28743318/benefits-of-manometer-in-non-invasive-ventilatory-support
#1
Rodrigo Silva Lacerda, Fernando Cesar Anastácio de Lima, Leonardo Pereira Bastos, Anderson Fardin Vinco, Felipe Britto Azevedo Schneider, Yves Luduvico Coelho, Heitor Gomes Costa Fernandes, João Marcus Ramos Bacalhau, Igor Matheus Simonelli Bermudes, Claudinei Ferreira da Silva, Luiza Paterlini da Silva, Rogério Pezato
Introduction Effective ventilation during cardiopulmonary resuscitation (CPR) is essential to reduce morbidity and mortality rates in cardiac arrest. Hyperventilation during CPR reduces the efficiency of compressions and coronary perfusion. Problem How could ventilation in CPR be optimized? The objective of this study was to evaluate non-invasive ventilator support using different devices. METHODS: The study compares the regularity and intensity of non-invasive ventilation during simulated, conventional CPR and ventilatory support using three distinct ventilation devices: a standard manual resuscitator, with and without airway pressure manometer, and an automatic transport ventilator...
July 26, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28737194/-face-protective-patches-do-not-reduce-facial-pressure-ulcers-in-a-simulated-model-of-non-invasive-ventilation
#2
Hugo Riquelme M, David Wood V, Santiago Martínez F, Fernando Carmona M, Axel Peña V, Adriana Wegner A
Noninvasive ventilation (NIV) frequently involves the development of facial pressure ulcers (FPU). Its prevention considers the empirical use of protective patches between skin and mask, in order to reduce the pressure exerted by it. OBJECTIVES: To evaluate the effect of protective patches on the pressure exerted by the facial mask, and its impact on the programmed ventilatory parameters. METHOD: Bilevel NIV simulated model using full face mask in phantom with a physiological airway (ALS PRO +) in supine position...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28736665/airway-compliance-measured-by-anatomic-optical-coherence-tomography
#3
Ruofei Bu, Santosh Balakrishnan, Nicusor Iftimia, Hillel Price, Carlton Zdanski, Amy L Oldenburg
Quantification of airway compliance can aid in the diagnosis and treatment of obstructive airway disorders by detecting regions vulnerable to collapse. Here we evaluate the ability of a swept-source anatomic optical coherence tomography (SSaOCT) system to quantify airway cross-sectional compliance (CC) by measuring changes in the luminal cross-sectional area (CSA) under physiologically relevant pressures of 10-40 cmH2O. The accuracy and precision of CC measurements are determined using simulations of non-uniform rotation distortion (NURD) endemic to endoscopic scanning, and experiments performed in a simplified tube phantom and ex vivo porcine tracheas...
April 1, 2017: Biomedical Optics Express
https://www.readbyqxmd.com/read/28733314/effects-of-an-airway-clearance-device-on-inflammation-bacteriology-and-mucus-transport-in-bronchiectasis
#4
Joana Tambascio, Hugo Celso Dutra de Souza, Roberto Martinez, José Antônio Baddini-Martinez, Peter John Barnes, Ada Clarice Gastaldi
BACKGROUND: Bronchiectasis is characterized by abnormal and permanent dilation of the bronchi, caused by the perpetuation of inflammation and impairment of mucociliary clearance. Physiotherapy techniques can help to decrease the retention of respiratory secretions. The flutter valve combines high-frequency oscillation and positive expiratory pressure to facilitate the removal of secretions. We evaluated the effects of the flutter valve on sputum inflammation, microbiology, and transport of respiratory secretions in patients with bronchiectasis...
August 2017: Respiratory Care
https://www.readbyqxmd.com/read/28718208/quantification-of-nasal-airflow-resistance-in-english-bulldogs-using-computed-tomography-and-computational-fluid-dynamics
#5
Eric T Hostnik, Brian A Scansen, Rachel Zielinski, Samir N Ghadiali
Stenotic nares, edematous intranasal turbinates, mucosal swelling, and an elongated, thickened soft palate are common sources of airflow resistance for dogs with brachycephalic airway syndrome. Surgery has focused on enlarging the nasal apertures and reducing tissue of the soft palate. However, objective measures of surgical efficacy are lacking. Twenty-one English bulldogs without previous surgery were recruited for this prospective, pilot study. Computed tomography was performed using conscious sedation and without endotracheal intubation using a 128 multidetector computed tomography scanner...
July 17, 2017: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/28715132/return-of-neonatal-cpap-resistance-the-medijet-device-family-examined-using-in-vitro-flow-simulations
#6
M Falk, S Donaldsson, B Jonsson, T Drevhammar
AIM: Medijet nasal continuous positive airway pressure (CPAP) generators are a family of devices developed from the Benveniste valve. Previous studies have shown that the in-vitro performance of the Medijet disposable generator was similar to the Neopuff resistor system. We hypothesised that resistance would be the main mechanism of CPAP generation in the Medijet disposable generator. METHODS: The in-vitro performance of the Medijet reusable and disposable systems, the Neopuff resistor system and the Benveniste and Infant Flow non-resistor systems were investigated using static and dynamic bench tests...
July 17, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28712105/evaluation-of-a-low-cost-3d-printed-model-for-bronchoscopy-training
#7
Matteo Parotto, Joshua Qua Jiansen, Ahmed AboTaiban, Svetlana Ioukhova, Alisher Agzamov, Richard Cooper, Gerald O'Leary, Massimiliano Meineri
BACKGROUND: Flexible bronchoscopy is a fundamental procedure in anesthesia and critical care medicine. Learning this procedure is a complex task, but the use of simulation-based training provides significant advantages like enhanced patient safety. Access to bronchoscopy simulators may be limited in low resources settings. We developed a low-cost 3D printed bronchoscopy training model. METHODS: A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28709415/assessing-anesthesiology-residents-out-of-the-operating-room-ooor-emergent-airway-management
#8
Lauryn R Rochlen, Michelle Housey, Ian Gannon, Shannon Mitchell, Deborah M Rooney, Alan R Tait, Milo Engoren
BACKGROUND: At many academic institutions, anesthesiology residents are responsible for managing emergent intubations outside of the operating room (OOOR), with complications estimated to be as high as 39%. In order to create an OOOR training curriculum, we evaluated residents' familiarity with the content and correct adherence to the American Society of Anesthesiologists' Difficult Airway Algorithm (ASA DAA). METHODS: Residents completed a pre-simulation multiple-choice survey measuring their understanding and use of the DAA...
July 15, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28701167/a-combined-experimental-and-numerical-study-on-upper-airway-dosimetry-of-inhaled-nanoparticles-from-an-electrical-discharge-machine-shop
#9
Lin Tian, Yidan Shang, Rui Chen, Ru Bai, Chunying Chen, Kiao Inthavong, Jiyuan Tu
BACKGROUNDS: Exposure to nanoparticles in the workplace is a health concern to occupational workers with increased risk of developing respiratory, cardiovascular, and neurological disorders. Based on animal inhalation study and human lung tumor risk extrapolation, current authoritative recommendations on exposure limits are either on total mass or number concentrations. Effects of particle size distribution and the implication to regional airway dosages are not elaborated. METHODS: Real time production of particle concentration and size distribution in the range from 5...
July 12, 2017: Particle and Fibre Toxicology
https://www.readbyqxmd.com/read/28688537/calculated-ventilation-and-effort-distribution-as-a-measure-of-respiratory-disease-and-heliox-effectiveness
#10
N Pozin, S Montesantos, I Katz, M Pichelin, C Grandmont, I Vignon-Clementel
In spite of numerous clinical studies, there is no consensus on the benefit Heliox mixtures can bring to asthmatic patients in terms of work of breathing and ventilation distribution. In this article we use a 3D finite element mathematical model of the lung to study the impact of asthma on effort and ventilation distribution along with the effect of Heliox compared to air. Lung surface displacement fields extracted from computed tomography medical images are used to prescribe realistic boundary conditions to the model...
June 23, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28687819/association-of-lateral-crural-overlay-technique-with-strength-of-the-lower-lateral-cartilages
#11
Louis Insalaco, Emma R Rashes, Samuel J Rubin, Jeffrey H Spiegel
Importance: The lateral crural overlay technique is a powerful technique for altering nasal tip projection and rotation. By overlapping and thus shortening the lateral crura, the nasal tip is shortened and rotated upward, thus decreasing projection and increasing rotation. There is no data to show the association of this technique with the strength of the lower lateral cartilage. Strengthening of the lower lateral cartilages would presumably lead to resistance to external nasal valve collapse and improved airway...
July 6, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28683222/application-of-a-one-dimensional-computational-model-for-the-prediction-of-deposition-from-a-dry-powder-inhaler
#12
Konstantinos Gourgoulianis, Zoi Daniil, Katerina Athanasiou, Stavroula Rozou, Vasileios Bontozoglou
BACKGROUND: Accurate prediction of the regional deposition of inhaled dry powders as a function of powder properties and breathing pattern is a long-term research goal for pulmonary drug delivery. In the present work, deposition along the respiratory tract of dry powders of Fluticasone propionate and Salmeterol is predicted. METHODS: A one-dimensional particle transport and deposition model is used, whose novelty is in the treatment of the alveolar space of each airway generation as an efficient mixing chamber...
July 6, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28678068/anesthesia-adverse-events-voluntarily-reported-in-the-veterans-health-administration-and-lessons-learned
#13
Julia Neily, Elda S Silla, Sam John T Sum-Ping, Roberta Reedy, Douglas E Paull, Lisa Mazzia, Peter D Mills, Robin R Hemphill
BACKGROUND: Anesthesia providers have long been pioneers in patient safety. Despite remarkable efforts, anesthesia errors still occur, resulting in complications, injuries, and even death. The Veterans Health Administration (VHA) National Center of Patient Safety uses root cause analysis (RCA) to examine why system-related adverse events occur and how to prevent future similar events. This study describes the types of anesthesia adverse events reported in VHA hospitals and their root causes and preventative actions...
July 1, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28673875/numerical-investigation-of-transient-transport-and-deposition-of-microparticles-under-unsteady-inspiratory-flow-in-human-upper-airways
#14
Arash Naseri, Sana Shaghaghian, Omid Abouali, Goodarz Ahmadi
In the present study, unsteady airflow patterns and particle deposition in healthy human upper airways were simulated. A realistic 3-D computational model of the upper airways including the vestibule to the end of the trachea was developed using a series of CT scan images of a healthy human. Unsteady simulations of the inhaled and exhaled airflow fields in the upper airway passages were performed by solving the Navier-Stokes and continuity equations for low breathing rates corresponding to low and moderate activities...
July 1, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28669462/advanced-pediatric-airway-simulation
#15
REVIEW
Charles M Myer, Noel Jabbour
Simulation is an emerging and viable means to increase pediatric airway surgical training. A variety of simulators currently exist that may be used or modified for laryngoscopy, bronchoscopy, and endoscopic intervention, although anatomic realism and utility for complex procedures are limited. There is a need for further development of improved endoscopic and anatomic models. Innovative techniques are enabling small-scale manufacturing of generalizable and patient-specific simulators. The high acuity of the pediatric airway patient makes the use of simulation an attractive modality for training, competency maintenance, and patient safety quality-improvement studies...
June 29, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28669461/simulators-for-laryngeal-and-airway-surgery
#16
REVIEW
James A Burns, Lacey K Adkins, Seth Dailey, Adam M Klein
There is growing support from the Accreditation Council for Graduate Medical Education and the Joint Commission of Accreditation of Health Care Organizations for a competency-based evaluation of medical and surgical performance. This is part of the quality movement in health care whereby the Centers for Medicare and Medicaid Services and third-party insurance companies have begun to link reimbursement incentives to positive surgical outcomes. Laryngeal and airway surgery require precise technique and significant mastered skill that can be difficult to obtain during otolaryngology residency training...
June 29, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28658109/exchange-of-supraglottic-airways-for-endotracheal-tube-using-the-eschmann-introducer-during-simulated-child-resuscitation-a-randomized-study-comparing-4-devices
#17
RANDOMIZED CONTROLLED TRIAL
Lukasz Szarpak, Zenon Truszewski, Joseph Vitale, Logan Glosser, Kurt Ruetzler, Antonio Rodríguez-Núñez
BACKGROUND: The aim of this study was to examine the application of the Eschmann tracheal tube introducer (ETTI) with 4 types of supraglottic airway devices (SADs) using a child-manikin. METHODS: A total of 79 paramedics were asked to exchange the 4 SADs for an endotracheal tube with the ETTI in 3 different scenarios using a randomized crossover study format: normal airway without chest compression; normal airway with uninterrupted chest compression; and difficult airway with uninterrupted chest compression...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28657696/evaluation-of-high-fidelity-simulation-as-a-training-tool-in-transoral-robotic-surgery
#18
Andrés M Bur, Ernest D Gomez, Jason G Newman, Gregory S Weinstein, Bert W O'Malley, Christopher H Rassekh, Katherine J Kuchenbecker
OBJECTIVES/HYPOTHESIS: To develop and evaluate a high-fidelity training simulator for transoral robotic posterior hemiglossectomy. STUDY DESIGN: Prospective observational study. METHODS: We constructed a transoral robotic surgery (TORS) simulator using porcine tongue in a modified airway mannequin. Twenty-nine surgeons performed transoral robotic posterior hemiglossectomy on the simulator. The 20 resident subjects completed six trials each, and the five fellows and four attending surgeons completed two trials each...
June 28, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28647226/inhalation-of-nanoplatelets-theoretical-deposition-simulations
#19
Robert Sturm
Primary objective of the contribution was the theoretical prediction of nanoplatelet deposition in the human respiratory tract. Modeling was founded on the hypothetical inhalation of graphene nanoplatelets (GNP) measuring 0.01 and 0.1μm in thickness and adopting a projected area diameter of 1-30μm. Particle uptake was assumed to take place with inhalation flow rates of 250, 500, 750, and 1000cm(3)s(-1), respectively. For an appropriate description of pulmonary particle behavior, transport of GNP in a stochastic lung structure and deposition formulae based on analytical and numerical studies were presupposed...
June 21, 2017: Zeitschrift Für Medizinische Physik
https://www.readbyqxmd.com/read/28625309/maternal-mortality-and-the-role-of-the-obstetric-anesthesiologist
#20
REVIEW
Gillian Abir, Jill Mhyre
Maternal mortality is increasing in the United States and remains unacceptably high in many parts of the world. Pre-existing conditions and social determinants of health frequently contribute to maternal death. General solutions to enhance maternal safety focus on systems to identify women at high risk and to tailor the management before, during, and after pregnancy. This review highlights condition-specific solutions for the leading etiologies of maternal death, including cardiac disease, sepsis, hemorrhage, venous thromboembolism, hypertensive disorders of pregnancy, and amniotic fluid embolism...
March 2017: Best Practice & Research. Clinical Anaesthesiology
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