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Positive airway pressure

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https://www.readbyqxmd.com/read/28333157/consensus-approach-to-nasal-high-flow-therapy-in-neonates
#1
B A Yoder, B Manley, C Collins, K Ives, A Kugelman, A Lavizzari, M McQueen
OBJECTIVE: Nasal high-flow therapy (nHFT) is commonly used for noninvasive respiratory support in the neonatal intensive care unit. Our objective was to determine which aspects of neonatal nHFT have achieved adequate evidence base to support consensus among experienced clinical investigators, and to document areas lacking consensus to promote future investigations. STUDY DESIGN: Prospective, modified Delphi collation of tabular queries related to specific aspects of neonatal nHFT...
March 23, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28331381/retrospective-nonrandomized-controlled-study-on-autoadjusting-dual-pressure-positive-airway-pressure-therapy-for-a-consecutive-series-of-complex-insomnia-disorder-patients
#2
Barry Krakow, Natalia D McIver, Victor A Ulibarri, Michael R Nadorff
PURPOSE: Emerging evidence shows that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) and upper airway resistance syndrome (UARS) in chronic insomnia patients (proposed "complex insomnia" disorder) leads to substantial decreases in insomnia severity. Although continuous PAP (CPAP) is the pressure mode most widely researched, intolerance to fixed pressurized air is rarely investigated or described in comorbidity patients. This retrospective study examined dual pressure, autoadjusting PAP modes in chronic, complex insomnia disorder patients...
2017: Nature and Science of Sleep
https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#3
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28330459/a-prospective-observational-study-to-evaluate-the-effect-of-social-and-personality-factors-on-continuous-positive-airway-pressure-cpap-compliance-in-obstructive-sleep-apnoea-syndrome
#4
Atul Gulati, Masood Ali, Mike Davies, Tim Quinnell, Ian Smith
BACKGROUND: Compliance with CPAP treatment for OSAS is not reliably predicted by the severity of symptoms or physiological variables. We examined a range of factors which could be measured before CPAP initiation to look for predictors of compliance. METHODS: This was a prospective cohort-study of CPAP treatment for OSAS, recording; socio-economic status, education, type D personality and clinician's prediction of compliance. RESULTS: We recruited 265 subjects, of whom 221 were still using CPAP at 6 months; median age 53 years, M: F, 3...
March 22, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28329099/effect-of-sleeping-position-on-upper-airway-patency-in-obstructive-sleep-apnea-is-determined-by-the-pharyngeal-structure-causing-collapse
#5
Melania Marques, Pedro R Genta, Scott A Sands, Ali Azarbazin, Camila de Melo, Luigi Taranto-Montemurro, David P White, Andrew Wellman
Objectives: In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested the hypothesis that the improvement in pharyngeal patency depends on the anatomical structure causing collapse, with patients with tongue-related obstruction and epiglottic collapse exhibiting preferential improvements. Methods: Twenty-four OSA patients underwent upper airway endoscopy during natural sleep to determine the pharyngeal structure associated with obstruction, with simultaneous recordings of airflow and pharyngeal pressure...
January 31, 2017: Sleep
https://www.readbyqxmd.com/read/28329084/obstructive-sleep-apnea-is-associated-with-early-but-possibly-modifiable-alzheimer-s-disease-changes
#6
Claudio Liguori, Nicola Biagio Mercuri, Francesca Izzi, Andrea Romigi, Alberto Cordella, Giuseppe Sancesario, Fabio Placidi
Study Objectives: Obstructive sleep apnea (OSA) is a common sleep disorder. Actually, literature lacks studies examining sleep, cognition, and Alzheimer's Disease (AD) cerebrospinal-fluid biomarkers in OSA patients. Therefore, we firstly studied cognitive performances, polysomnographic sleep, and CSF β-amyloid, tau proteins and lactate levels in patients affected by subjective cognitive impairment (SCI) divided in three groups: OSA patients (showing an Apnea-Hypopnea Index - AHI ≥15/h), controls (showing an AHI<15/h), and patients treating OSA by continuous positive airway pressure (CPAP)...
January 28, 2017: Sleep
https://www.readbyqxmd.com/read/28328850/measurement-of-exhaled-nitric-oxide-concentration-in-patients-with-obstructive-sleep-apnea-a-meta-analysis
#7
Dongmei Zhang, Jinmei Luo, Yixian Qiao, Yi Xiao, Rong Huang, Xu Zhong
BACKGROUND: Exhaled nitric oxide (eNO) has been proposed as a noninvasive measure of airway inflammation. However, its value in patients with obstructive sleep apnea (OSA) is still controversial. The authors aim to assess the difference in eNO levels between patients with OSA and controls by a meta-analysis. METHODS: A systematic search was performed in the PubMed, EMBASE, the Cochrane Library, and MEDLINE databases to collect relevant studies published from 1996 to 2016...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#8
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#9
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28327130/obstructive-sleep-apnoea-accelerates-fev1-decline-in-asthmatic-patients
#10
Tsai-Yu Wang, Yu-Lun Lo, Shu-Min Lin, Chien-Da Huang, Fu-Tasi Chung, Horng-Chyuan Lin, Chun-Hua Wang, Han-Pin Kuo
BACKGROUND: Although the prevalence of both obstructive sleep apnoea (OSA) and asthma are both increasing, little is known about the impact of OSA on the natural history of lung function in asthmatic patients. METHODS: A total of 466 patients from our sleep laboratory were retrospectively enrolled. Of them, 77 patients (16.5%) had asthma with regular follow-up for more than 5 years. Their clinical characteristics, pulmonary function, emergency room visits, and results of polysomnography results were analysed...
March 21, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28326793/changes-in-habitual-sleep-duration-after-continuous-positive-airway-pressure-for-obstructive-sleep-apnea
#11
Ryo Tachikawa, Takuma Minami, Takeshi Matsumoto, Kimihiko Murase, Kiminobu Tanizawa, Morito Inouchi, Toru Oga, Kazuo Chin
RATIONALE: Obstructive sleep apnea (OSA) can affect not only sleep quality but also sleep duration. Determining the therapeutic effects of continuous positive airway pressure (CPAP) on habitual sleep profiles may shed light on the impact of OSA on sleep duration. OBJECTIVES: To determine whether and how CPAP affects habitual sleep duration in patients with OSA. METHODS: Assessments of sleep duration and sleep quality were performed on 57 newly diagnosed study subjects with OSA (46 men, median 63 years, apnea-hypopnea index >20 h-1) at baseline and 3 months after initiation of CPAP therapy...
March 22, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28324596/blood-pressure-and-metabolic-changes-after-3-month-cpap-therapy-in-a-very-elderly-obese-with-severe-obstructive-sleep-apnea-a-case-report-and-review-of-the-literature
#12
Francesco Spannella, Federico Giulietti, Chiara Di Pentima, Francesca Elena Lombardi, Elisabetta Borioni, Riccardo Sarzani
Age is one of the main risk factor for the presence of obstructive sleep apnea (OSA). This syndrome is associated with hypertension, cardiovascular disease, cognitive impairment and metabolic abnormalities, such as type 2 diabetes. Continuous positive airway pressure (CPAP) represents the gold standard therapy, but its benefit is still to be determined in very elderly. We report the blood pressure and metabolic changes in a very elderly obese with severe OSA after 3-month CPAP therapy. We have evaluated a very elderly obese male affected by severe symptomatic OSA, poor controlled nocturnal hypertension and insulin resistance...
March 21, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#13
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322112/national-database-analysis-of-single-level-versus-multilevel-sleep-surgery
#14
Scott E Brietzke, Stacey L Ishman, Seth Cohen, Derek D Cyr, Jennifer J Shin, Eric J Kezirian
Objective Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database. Study Design Retrospective cohort study. Setting National insurance claims database. Subjects and Methods An adult cohort undergoing single-level UPPP versus UPPP with nasal and/or tongue/hypopharyngeal surgery was identified in the Truven Health Analytics MarketScan Research Databases for the years 2010 through 2012...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28320992/right-ventricular-enlargement-and-renal-function-are-associated-with-smooth-introduction-of-adaptive-servo-ventilation-therapy-in-chronic-heart-failure-patients
#15
Toshihiro Iwasaku, Yoshitaka Okuhara, Akiyo Eguchi, Tomotaka Ando, Yoshiro Naito, Tohru Masuyama, Shinichi Hirotani
Although adaptive servo-ventilation (ASV) therapy has beneficial effects on chronic heart failure (CHF), a relatively large number of CHF patients cannot undergo ASV therapy due to general discomfort from the mask and/or positive airway pressure. The present study aimed to clarify baseline patient characteristics which are associated with the smooth introduction of ASV treatment in stable CHF inpatients.Thirty-two consecutive heart failure (HF) inpatients were enrolled (left ventricular ejection fraction (LVEF) < 45%, estimated glomerular filtration rate (eGFR) > 10 mL/minute/1...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28315041/positive-pressure-ventilation-in-a-patient-with-a-right-upper-lobar-bronchocutaneous-fistula-right-upper-bronchus-occlusion-using-the-cuff-of-a-left-sided-double-lumen-endobronchial-tube
#16
Chieko Omori, Hiroaki Toyama, Yusuke Takei, Yutaka Ejima, Masanori Yamauchi
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage...
March 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28298788/effects-of-lignocaine-administered-intravenously-or-intratracheally-on-airway-and-hemodynamic-responses-during-emergence-and-extubation-in-patients-undergoing-elective-craniotomies-in-supine-position
#17
Tabasum Shabnum, Zulfiqar Ali, Imtiaz Ahmad Naqash, Aabid Hussain Mir, Khan Azhar, Syed Amer Zahoor, Abdul Waheed Mir
INTRODUCTION: Sympathoadrenergic responses during emergence and extubation can lead to an increase in heart rate (HR) and blood pressure whereas increased airway responses may lead to coughing and laryngospasm. The aim of our study was to compare the effects of lignocaine administered intravenously (IV) or intratracheally on airway and hemodynamic responses during emergence and extubation in patients undergoing elective craniotomies. METHODOLOGY: Sixty patients with physical status American Society of Anaesthesiologists Classes I and II aged 18-70 years, scheduled to undergo elective craniotomies were included...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294957/regional-ventilation-redistribution-measured-by-electrical-impedance-tomography-during-spontaneous-breathing-trial-with-automatic-tube-compensation
#18
Yeong-Long Hsu, Ai-Jia Tien, Mei-Yun Chang, Hao-Tai Chang, Knut Moeller, Inez Frerichs, Zhanqi Zhao
Automatic tube compensation (ATC) was developed to overcome the flow resistance of endotracheal tube and decrease the imposed work of breathing. Although ATC is used as an evidence-based strategy to predict successful weaning from assisted ventilation, the changes in regional ventilation distribution induced by this technique are not known. We hypothesized that continuous positive airway pressure plus ATC (CPAP+100%ATC) could reactivate the respiratory muscles in patients with prolonged mechanical ventilation (PMV) more effectively than volume assist-control mandatory ventilation (ACMV)...
March 15, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28294380/oral-appliance-therapy-versus-nasal-continuous-positive-airway-pressure-in-obstructive-sleep-apnea-syndrome-a-randomized-placebo-controlled-trial-on-self-reported-symptoms-of-common-sleep-disorders-and-sleep-related-problems
#19
Maria Nikolopoulou, Anna Byraki, Jari Ahlberg, Martijn W Heymans, H L Hamburger, Jan De Lange, Frank Lobbezoo, Ghizlane Aarab
Obstructive sleep apnea syndrome (OSAS) is associated with several sleep disorders and sleep-related problems. Therefore, the aim of this study was to compare the effects of a mandibular advancement device (MAD) with those of nasal continuous positive airway pressure (nCPAP) on self-reported symptoms of common sleep disorders and sleep-related problems in mild and moderate OSAS patients. In this randomized placebo-controlled trial sixty-four OSAS patients (52.0± 9.6 years) were randomly assigned to an MAD, nCPAP or an intra-oral placebo appliance in a parallel design...
March 10, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28292973/evaluation-of-functional-characteristics-of-4-oscillatory-positive-pressure-devices-in-a-simulated-cystic-fibrosis-model
#20
Hillary Van Fleet, Diane K Dunn, Neil L McNinch, Teresa A Volsko
BACKGROUND: Oscillatory positive expiratory pressure (OPEP) is an airway clearance therapy that delivers positive pressure and air-flow oscillations during exhalation. This study described functional characteristic differences of 4 OPEP devices during an active exhalation in a simulated model. We hypothesized peak pressure (Ppeak), positive expiratory pressure (PEP), oscillatory frequency (f), and pressure amplitude will differ, depending upon the device used, device resistance setting, and time (repeated consecutive active exhalations through the device)...
March 14, 2017: Respiratory Care
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