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Positive expiratory pressure

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https://www.readbyqxmd.com/read/28634173/a-comparison-of-2-respiratory-devices-for-sputum-clearance-in-adults-with-non-cystic-fibrosis-bronchiectasis
#1
Yasmin R Silva, Tracy A Greer, Lucy C Morgan, Frank Li, Claude S Farah
BACKGROUND: Airway clearance techniques are a vital part of routine care for patients with bronchiectasis. There is no clear superior modality. The Flutter combines oscillations (6-20Hz) and positive expiratory pressure; the Lung Flute combines positive expiratory pressure and low frequency acoustic waves (18-22Hz), to augment clearance. This project aimed to compare these devices. METHODS: This was a randomized crossover study of adult subjects with stable non-cystic fibrosis bronchiectasis (expectorating >25 mL/d)...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28633157/epidemiology-practice-of-ventilation-and-outcome-for-patients-at-increased-risk-of-postoperative-pulmonary-complications-an-observational-study-in-29-countries
#2
(no author information available yet)
BACKGROUND: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification...
June 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28632529/respiratory-system-mechanics-during-low-versus-high-positive-end-expiratory-pressure-in-open-abdominal-surgery-a-substudy-of-provhilo-randomized-controlled-trial
#3
Davide D'Antini, Robert Huhle, Jacob Herrmann, Demet S Sulemanji, Jun Oto, Pasquale Raimondo, Lucia Mirabella, Sabrine N T Hemmes, Marcus J Schultz, Paolo Pelosi, David W Kaczka, Marcos Francisco Vidal Melo, Marcelo Gama de Abreu, Gilda Cinnella
BACKGROUND: In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D)...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631764/-hemodynamic-effects-of-positive-end-expiratory-pressure
#4
Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Andrea Mortara, Renata De Maria, Piera Capasso, Serafina Valente, Michele Massimo Gulizia
The application of a positive end-expiratory pressure (PEEP), the cornerstone of noninvasive ventilation (NIV), causes hemodynamic changes in the cardiovascular system. To understand the benefits of NIV it is necessary to resume concepts of cardiovascular physiology and pathophysiology about cardiac function determinants, venous return, ventricular interdependence and heart-lung interaction, and to understand how PEEP interacts with them. The hemodynamic effects of PEEP are mediated by the increase in transpulmonary pressure, which results in increased pulmonary vascular resistance and in an attending small reduction of venous return in conditions of euvolemia, in a substantial reduction of left ventricular afterload and a potential positive effect on left ventricular stroke volume...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28625243/-experimental-study-on-effect-of-airway-pressure-on-cardiopulmonary-resuscitation
#5
Dingyu Tan, Feng Sun, Yangyang Fu, Shihuan Shao, Yazhi Zhang, Yingying Hu, Jun Xu, Huadong Zhu, Xuezhong Yu
OBJECTIVE: To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. METHODS: Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622568/per-protocol-investigation-of-a-best-practice-exercise-referral-scheme
#6
L Stewart, E Dolan, P Carver, P A Swinton
OBJECTIVES: To investigate the effects of an exercise referral scheme (ERS) aligned to the UK best practice guidelines on a range of outcomes including those associated with key health concerns of the Scottish population. STUDY DESIGN: A longitudinal design with data collection at three time points (baseline, midway and post) during a 12-week ERS intervention was employed. METHODS: Health-related physical fitness was assessed through measurement of resting heart rate, blood pressure, FEV1:FEV6 (ratio of forced expiratory volume over one [FEV1] and six [FEV6] seconds), body mass and peak oxygen uptake (VO2 peak), whilst functional capacity was assessed through the five times sit to stand test...
June 12, 2017: Public Health
https://www.readbyqxmd.com/read/28616282/pressure-controlled-versus-volume-controlled-ventilation-during-one-lung-ventilation-for-video-assisted-thoracoscopic-lobectomy
#7
Yi-Qi Zhu, Fang Fang, Xiao-Min Ling, Jian Huang, Jing Cang
BACKGROUND: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV). METHODS: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612267/auto-trilevel-versus-bilevel-positive-airway-pressure-ventilation-for-hypercapnic-overlap-syndrome-patients
#8
Mei Su, De Huai, Juan Cao, Ding Ning, Rong Xue, Meijie Xu, Mao Huang, Xilong Zhang
PURPOSE: Although bilevel positive airway pressure (Bilevel PAP) therapy is usually used for overlap syndrome (OS), there is still a portion of OS patients in whom Bilevel PAP therapy could not simultaneously eliminate residual apnea events and hypercapnia. The current study was expected to explore whether auto-trilevel positive airway pressure (auto-trilevel PAP) therapy with auto-adjusting end expiratory positive airway pressure (EEPAP) can serve as a better alternative for these patients...
June 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28607760/effects-of-expiratory-muscle-strength-training-on-maximal-respiratory-pressure-and-swallow-related-quality-of-life-in-individuals-with-multiple-sclerosis
#9
Erin Pearson Silverman, Sarah Miller, Yi Zhang, Bari Hoffman-Ruddy, James Yeager, Janis J Daly
BACKGROUND: Weakening and dyscoordination of expiratory muscles in multiple sclerosis (MS) can impair respiratory and swallow function. OBJECTIVE: The objective of this paper is to test a novel expiratory muscle strength training (EMST) device on expiratory pressure, swallow function, and swallow-related quality-of-life (SWAL-QOL) in individuals with MS. METHODS: Participants with MS were randomized to a five-week breathing practice of either positive pressure load (EMST) or near-zero pressure (sham)...
April 2017: Multiple Sclerosis Journal—Experimental, Translational and Clinical
https://www.readbyqxmd.com/read/28606716/the-relation-between-given-volume-and-heart-rate-during-newborn-resuscitation
#10
J E Linde, J Schulz, J M Perlman, K Øymar, L Blacy, H Kidanto, H L Ersdal
BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR...
June 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28593896/synergistic-effect-of-hyperoxia-and-biotrauma-on-ventilator-induced-lung-injury
#11
Mirjana Shosholcheva, Nikola Јankulovski, Andrijan Kartalov, Biljana Kuzmanovska, Daniela Miladinova
Patients undergoing mechanical ventilation in intensive care units (ICUs) may develop ventilator-induced lung injury (VILI). Beside the high tidal volume (Vt) and plateau pressure (Pplat), hyperoxia is supposed to precipitate lung injury. Oxygen toxicity is presumed to occur at levels of fraction of inspired oxygen (FiO2) exceeding 0.40. The exposure time to hyperoxia is certainly very important and patients who spend extended time on mechanical ventilation (MV) are probably more exposed to severe hyperoxic acute lung injury (HALI)...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28592276/different-strategies-for-mechanical-ventilation-during-cardiopulmonary-bypass-cpbvent-2014-study-protocol-for-a-randomized-controlled-trial
#12
Elena Bignami, Marcello Guarnieri, Francesco Saglietti, Enivarco Massimo Maglioni, Sabino Scolletta, Stefano Romagnoli, Stefano De Paulis, Gianluca Paternoster, Cinzia Trumello, Roberta Meroni, Antonio Scognamiglio, Alessandro Maria Budillon, Vincenzo Pota, Alberto Zangrillo, Ottavio Alfieri
BACKGROUND: There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28584436/titration-of-ideal-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-comparison-between-lower-inflection-point-and-esophageal-pressure-method-using-volumetric-capnography
#13
Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28571581/erratum-to-protective-intraoperative-ventilation-with-higher-versus-lower-levels-of-positive-end-expiratory-pressure-in-obese-patients-probese-study-protocol-for-a-randomized-controlled-trial
#14
T Bluth, R Teichmann, T Kiss, I Bobek, J Canet, G Cinnella, L De Baerdemaeker, C Gregoretti, G Hedenstierna, S N Hemmes, M Hiesmayr, M W Hollmann, S Jaber, J G Laffey, M J Licker, K Markstaller, I Matot, G Müller, G H Mills, J P Mulier, C Putensen, R Rossaint, J Schmitt, M Senturk, A Serpa Neto, P Severgnini, J Sprung, M F Vidal Melo, H Wrigge, M J Schultz, P Pelosi, Marcelo Gama de Abreu
No abstract text is available yet for this article.
June 1, 2017: Trials
https://www.readbyqxmd.com/read/28558927/in-vitro-and-in-vivo-evaluation-of-the-combination-of-oscillating-positive-expiratory-pressure-and-nebulization-a-randomized-cross-over-study
#15
Gregory Reychler, Teresinha Leal, Anne-Sophie Aubriot, Giuseppe Liistro
No abstract text is available yet for this article.
May 27, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#16
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28554331/outcome-of-acute-respiratory-distress-syndrome-in-university-and-non-university-hospitals-in-germany
#17
Konstantinos Raymondos, Tamme Dirks, Michael Quintel, Ulrich Molitoris, Jörg Ahrens, Thorben Dieck, Kai Johanning, Dietrich Henzler, Rolf Rossaint, Christian Putensen, Hermann Wrigge, Ralph Wittich, Maximilian Ragaller, Thomas Bein, Martin Beiderlinden, Maxi Sanmann, Christian Rabe, Jörn Schlechtweg, Monika Holler, Fernando Frutos-Vivar, Andres Esteban, Hartmut Hecker, Simone Rosseau, Vera von Dossow, Claudia Spies, Tobias Welte, Siegfried Piepenbrock, Steffen Weber-Carstens
BACKGROUND: This study investigates differences in treatment and outcome of ventilated patients with acute respiratory distress syndrome (ARDS) between university and non-university hospitals in Germany. METHODS: This subanalysis of a prospective, observational cohort study was performed to identify independent risk factors for mortality by examining: baseline factors, ventilator settings (e.g., driving pressure), complications, and care settings-for example, case volume of ventilated patients, size/type of intensive care unit (ICU), and type of hospital (university/non-university hospital)...
May 30, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28552071/vitamin-d-levels-in-middle-aged-patients-with-obstructive-sleep-apnoea-syndrome
#18
K Archontogeorgis, E Nena, N Papanas, A Zissimopoulos, A Voulgaris, M Xanthoudaki, V Manolopoulos, M Froudarakis, P Steiropoulos
BACKGROUND: Vitamin D (Vit D) insufficiency has been implicated in the pathophysiology of numerous diseases. Obstructive sleep apnoea syndrome (OSAS), a disorder associated with increased cardiovascular and cerebrovascular morbidity, has been associated with lowered Vit D levels, but reports are inconclusive. AIM: To evaluate the association between serum 25-hydroxyvitamin D [25(OH)D], a marker of Vit D status, and anthropometric and sleep characteristics of OSAS patients and to compare those levels between OSAS patients and non-apnoeic controls...
May 28, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28545875/regional-volume-characteristics-of-the-preterm-infant-receiving-first-intention-continuous-positive-airway-pressure
#19
Risha Bhatia, Peter G Davis, David G Tingay
OBJECTIVE: To determine whether applying nasal continuous positive airway pressure (CPAP) using systematic changes in continuous distending pressure (CDP) results in a quasi-static pressure-volume relationship in very preterm infants receiving first intention CPAP in the first 12-18 hours of life. STUDY DESIGN: Twenty infants at <32 weeks' gestation with mild respiratory distress syndrome (RDS) managed exclusively with nasal CPAP had CDP increased from 5 to 8 to 10 cmH2O, and then decreased to 8 cmH2O and returned to baseline CDP...
May 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28543857/vena-cava-responsiveness-to-controlled-isovolumetric-respiratory-efforts
#20
Anna Folino, Marco Benzo, Paolo Pasquero, Andrea Laguzzi, Luca Mesin, Alessandro Messere, Massimo Porta, Silvestro Roatta
OBJECTIVES: Respirophasic variation of inferior vena cava (IVC) size is affected by large variability with spontaneous breathing. This study aims at characterizing the dependence of IVC size on controlled changes in intrathoracic pressure. METHODS: Ten healthy subjects, in supine position, performed controlled isovolumetric respiratory efforts at functional residual capacity, attaining positive (5, 10, and 15 mmHg) and negative (-5, -10, and -15 mmHg) alveolar pressure levels...
May 22, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
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