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Positive expiratory pressure

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https://www.readbyqxmd.com/read/29340488/impact-of-continuous-positive-airway-pressure-on-the-pulmonary-changes-promoted-by-immersion-in-water
#1
Danize Aparecida Rizzetti, Janayna Rodembuch Borba Quadros, Bruna Esmerio Ribeiro, Letícia Callegaro, Aline Arebalo Veppo, Giulia Alessandra Wiggers, Franck Maciel Peçanha
OBJECTIVE: To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. METHODS: This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR), and FEF25-75%) at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol...
November 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29325856/is-insufficient-pulmonary-air-support-the-cause-of-dysphonia-in-chronic-obstructive-pulmonary-disease
#2
Megahed M Hassan, Mona T Hussein, Ahmed Mamdouh Emam, Usama M Rashad, Ibrahim Rezk, Al Hussein Awad
OBJECTIVE: Optimal pulmonary air support is essential pre-requisite for efficient phonation. The objective is to correlate pulmonary and vocal functions in chronic obstructive pulmonary disease (COPD) to find out whether the reduced pulmonary function per se could induce dysphonia. METHODS: In this prospective case-control study, sixty subjects with stable COPD underwent evaluation of pulmonary and vocal functions. The pulmonary functions measured include {Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), maximum mid-expiratory flow (MMEF)}...
January 8, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29324568/effects-of-pressure-support-ventilation-on-ventilator-induced-lung-injury-in-mild-acute-respiratory-distress-syndrome-depend-on-level-of-positive-end-expiratory-pressure
#3
Paulo A F Magalhães, Gisele de A Padilha, Lillian Moraes, Cíntia L Santos, Ligia de A Maia, Cassia L Braga, Maria do Carmo M B Duarte, Lívia B Andrade, Alberto Schanaider, Vera L Capellozzi, Robert Huhle, Marcelo Gama de Abreu, Paolo Pelosi, Patricia R M Rocco, Pedro L Silva
BACKGROUND: Harmful effects of spontaneous breathing have been shown in experimental severe acute respiratory distress syndrome (ARDS). However, in the clinical setting, spontaneous respiration has been indicated only in mild ARDS. To date, no study has compared the effects of spontaneous assisted breathing with those of fully controlled mechanical ventilation at different levels of positive end-expiratory pressure (PEEP) on lung injury in ARDS. OBJECTIVE: To compare the effects of assisted pressure support ventilation (PSV) with pressure-controlled ventilation (PCV) on lung function, histology and biological markers at two different PEEP levels in mild ARDS in rats...
January 10, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29323536/high-positive-end-expiratory-pressure-renders-spontaneous-effort-non-injurious
#4
Caio C A Morais, Yukiko Koyama, Takeshi Yoshida, Glauco M Plens, Susimeire Gomes, Cristhiano L A S Lima, Ozyres P Ramos, Sérgio M Pereira, Naomasa Kawaguchi, Hirofumi Yamamoto, Akinori Uchiyama, João B Borges, Marcos F Vidal Melo, Mauro R Tucci, Marcelo B P Amato, Brian P Kavanagh, Eduardo L V Costa, Yuji Fujino
RATIONALE: In ARDS, atelectatic 'solid-like' lung tissue impairs transmission of negative 'swings' in pleural pressure (Ppl) resulting from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions, e.g., non-dependent lung (Pendelluft) or from the ventilator. Lowering of the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort non-injurious...
January 11, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29321341/exercise-tolerance-and-balance-of-inspiratory-to-expiratory-muscle-strength-in-relation-to-breathing-timing-in-patients-with-chronic-obstructive-pulmonary-disease
#5
Keisuke Miki, Kazuyuki Tsujino, Tatsuya Edahiro, Seigo Kitada, Mari Miki, Kenji Yoshimura, Hiroyuki Kagawa, Yohei Oshitani, Yuko Ohara, Yuki Hosono, Hiroyuki Kurebe, Ryoji Maekura
Little is known about the applicability of respiratory muscle training based on exertional pathophysiological conditions in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to investigate the relationship between breathing timing and exertional responses, as well as whether exertional changes in the inspiratory duty cycle (inspiratory time [Ti]/total time [Ttot]) affect pathophysiological conditions, including respiratory muscles. Methods: Forty-five stable COPD patients (mean age: 71...
January 11, 2018: Journal of Breath Research
https://www.readbyqxmd.com/read/29317351/a-new-physiological-model-for-studying-the-effect-of-chest-compression-and-ventilation-during-cardiopulmonary-resuscitation-the-thiel-cadaver
#6
Emmanuel Charbonney, Stéphane Delisle, Dominique Savary, Gilles Bronchti, Marceau Rigollot, Adrien Drouet, Bilal Badat, Paul Ouellet, Patrice Gosselin, Alain Mercat, Laurent Brochard, Jean-Christophe M Richard
BACKGROUND: Studying ventilation and intrathoracic pressure (ITP) induced by chest compressions (CC) during Cardio Pulmonary Resuscitation is challenging and important aspects such as airway closure have been mostly ignored. We hypothesized that Thiel Embalmed Cadavers could constitute an appropriate model. METHODS: We assessed respiratory mechanics and ITP during CC in 11 cadavers, and we compared it to measurements obtained in 9 out-of-hospital cardiac arrest patients and to predicted values from a bench model...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29313906/respiratory-complications-of-anaesthesia
#7
REVIEW
G H Mills
Postoperative pulmonary complications are a major determinant of outcome for patients and consume huge resources within hospital, particularly in critical care. Prediction and anticipation of postoperative pulmonary complications are vital for patient selection and, in some cases, for informed patient consent. Being able to assess the likelihood of postoperative pulmonary complications also allows research into methods to reduce them by allowing allocation of patients to the appropriate arms of research trials...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29312748/acute-respiratory-distress-syndrome-in-traumatic-brain-injury-how-do-we-manage-it
#8
REVIEW
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310868/high-velocity-nasal-insufflation-in-the-treatment-of-respiratory-failure-a-randomized-clinical-trial
#9
Pratik Doshi, Jessica S Whittle, Michael Bublewicz, Joseph Kearney, Terrell Ashe, Russell Graham, Suesann Salazar, Terry W Ellis, Dianna Maynard, Rose Dennis, April Tillotson, Mandy Hill, Misha Granado, Nancy Gordon, Charles Dunlap, Sheldon Spivey, Thomas L Miller
STUDY OBJECTIVE: We compare high-velocity nasal insufflation, a form of high-flow nasal cannula, with noninvasive positive-pressure ventilation in the treatment of undifferentiated respiratory failure with respect to therapy failure, as indicated by requirement for endotracheal intubation or cross over to the alternative therapy. METHODS: This was a multicenter, randomized trial of adults presenting to the emergency department (ED) with respiratory failure requiring noninvasive positive-pressure ventilation...
January 5, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29308751/-role-and-mechanism-of-mitochondrial-dna-mediated-toll-like-receptor-9-myeloid-differentiation-factor-88-signaling-pathway-activation-in-rats-with-ventilator-induced-lung-injury
#10
Jinyuan Lin, Ren Jing, Linghui Pan
OBJECTIVE: To investigate the role and mechanism of mitochondrial DNA (mtDNA) in rats with ventilator-induced lung injury (VILI) via Toll-like receptor 9 (TLR9)-myeloid differentiation factor 88 (MyD88) signaling pathway. METHODS: Thirty adult male Sprague-Dawley (SD) rats were randomly divided into three groups (each n = 10): spontaneous breathing group, normal tidal volume (VT) group (NVT group, VT = 8 mL/kg), and high VT group (HVT group, VT = 40 mL/kg). Rats in the NVT group and HVT group were ventilated mechanically with a positive end-expiratory pressure (PEEP) of 0 and the fraction of inspired oxygen (FiO2) at 0...
January 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29301259/sphingolipids-in-ventilator-induced-lung-injury-role-of-sphingosine-1-phosphate-lyase
#11
Vidyani Suryadevara, Panfeng Fu, David Lenin Ebenezer, Evgeny Berdyshev, Irina A Bronova, Long Shuang Huang, Anantha Harijith, Viswanathan Natarajan
Mechanical ventilation (MV) performed in respiratory failure patients to maintain lung function leads to ventilator-induced lung injury (VILI). This study investigates the role of sphingolipids and sphingolipid metabolizing enzymes in VILI using a rodent model of VILI and alveolar epithelial cells subjected to cyclic stretch (CS). MV (0 PEEP (Positive End Expiratory Pressure), 30 mL/kg, 4 h) in mice enhanced sphingosine-1-phosphate lyase (S1PL) expression, and ceramide levels, and decreased S1P levels in lung tissue, thereby leading to lung inflammation, injury and apoptosis...
January 1, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29297365/regional-physiology-of-ards
#12
REVIEW
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
The acute respiratory distress (ARDS) lung is usually characterized by a high degree of inhomogeneity. Indeed, the same lung may show a wide spectrum of aeration alterations, ranging from completely gasless regions, up to hyperinflated areas. This inhomogeneity is normally caused by the presence of lung edema and/or anatomical variations, and is deeply influenced by the gravitational forces.For any given airway pressure generated by the ventilator, the pressure acting directly on the lung (i.e., the transpulmonary pressure or lung stress) is determined by two main factors: 1) the ratio between lung elastance and the total elastance of the respiratory system (which has been shown to vary widely in ARDS patients, between 0...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29289490/positive-end-expiratory-pressure-during-resuscitation-at-birth-in-very-low-birth-weight-infants-a-randomized-controlled-pilot-trial
#13
Ratchada Kitsommart, Kittaya Nakornchai, Buranee Yangthara, Ratchada Jiraprasertwong, Bosco Paes
BACKGROUND: There is limited evidence of the effect of positive end-expiratory pressure (PEEP) during resuscitation soon after birth. Premature neonates may experience respiratory distress from surfactant insufficiency and providing PEEP after the very first breath, may improve outcomes following appropriate resuscitation. The objective of this study was to evaluate the short term respiratory outcomes after positive pressure ventilation (PPV) with PEEP in preterm infants at birth. METHODS: A prospective randomized-controlled, pilot trial was conducted...
December 9, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29284866/does-pulmonary-artery-systolic-pressure-as-estimated-by-transthoracic-echocardiography-alter-the-effect-of-positive-end-expiratory-pressure-on-arterial-blood-gases-and-hemodynamics-in-morbidly-obese-patients
#14
Dipti Saxena, Priyank Singh, Atul Dixit, Bipin Arya, Mohit Bhandari, Sadhana Sanwatsarkar
Background: Positive end-expiratory pressure (PEEP) at the time of induction increases oxygenation by preventing lung atelectasis. However, PEEP may not prove beneficial in all cases. Factors affecting the action of PEEP have not been elucidated well and remain controversial. Pulmonary vasculature has direct bearing on the action of PEEP as has been proven in the previous studies. Thus, this prospective study was planned to evaluate the action of PEEP on the basis of pulmonary artery systolic pressure (PASP) which is noninvasive and easily measured by transthoracic echocardiography...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29282101/association-of-physical-activity-with-lung-function-in-lung-healthy-german-adults-results-from-the-kora-ff4-study
#15
Agnes Luzak, Stefan Karrasch, Barbara Thorand, Dennis Nowak, Rolf Holle, Annette Peters, Holger Schulz
BACKGROUND: In lung disease, physical activity (PA) yields beneficial health effects, but its association with the function of healthy lungs has rarely been studied. We investigated the association of accelerometer-based PA with spirometric indices, maximal inspiratory mouth pressure (PImax) and lung diffusion capacity in lung-healthy adults. METHODS: In total, 341 apparently lung-healthy participants from the population-based KORA (Cooperative Health Research in the Region of Augsburg) FF4 cohort study (45% male, aged 48-68 years, 47% never smokers) completed lung function testing and wore ActiGraph accelerometers over a one week period at the hip...
December 28, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29278555/lung-recruitment-prevents-collapse-during-laparoscopy-in-children-a-randomised-controlled-trial
#16
Cecilia M Acosta, Tomás Sara, Martín Carpinella, Giovanni Volpicelli, Lila Ricci, Sergio Poliotto, Diego Abrego, Sergio Gonorazky, Stephan H Böhm, Gerardo Tusman
BACKGROUND: Capnoperitoneum and anaesthesia impair lung aeration during laparoscopy in children. These changes can be detected and monitored at the bedside by lung ultrasound (LUS). OBJECTIVE: The aim of our study was to assess the impact of general anaesthesia and capnoperitoneum on lung collapse and the potential preventive effect of lung recruitment manoeuvres, using LUS in children undergoing laparoscopy. DESIGN: Randomised controlled study...
December 22, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29275926/variation-in-positive-end-expiratory-pressure-levels-for-mechanically-ventilated-extremely-low-birth-weight-infants
#17
Nicolas A Bamat, James P Guevara, Matthew Bryan, Robin S Roberts, Bradley A Yoder, Brigitte Lemyre, Aaron Chiu, David Millar, Haresh Kirpalani
OBJECTIVE: To test the hypothesis that significant positive end-expiratory pressure (PEEP) level variation exists between neonatal centers. STUDY DESIGN: We performed a secondary analysis cohort study of the Nasal Intermittent Positive-Pressure Ventilation trial. Our study population was extremely low birth weight infants requiring mechanical ventilation within 28 days of life. The exposure was neonatal center; 34 international centers participated in the trial...
December 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29250319/patients-with-uninjured-lungs-may-also-benefit-from-lung-protective-ventilator-settings
#18
REVIEW
Roger Alencar, Vittorio D'Angelo, Rachel Carmona, Marcus J Schultz, Ary Serpa Neto
Although mechanical ventilation is a life-saving strategy in critically ill patients and an indispensable tool in patients under general anesthesia for surgery, it also acts as a double-edged sword. Indeed, ventilation is increasingly recognized as a potentially dangerous intrusion that has the potential to harm lungs, in a condition known as 'ventilator-induced lung injury' (VILI). So-called 'lung-protective' ventilator settings aiming at prevention of VILI have been shown to improve outcomes in patients with acute respiratory distress syndrome (ARDS), and, over the last few years, there has been increasing interest in possible benefit of lung-protective ventilation in patients under ventilation for reasons other than ARDS...
2017: F1000Research
https://www.readbyqxmd.com/read/29238252/the-effect-of-respiratory-muscle-training-on-fin-swimmers-performance
#19
Jana Vašíčková, Kateřina Neumannová, Zbyněk Svozil
Although respiratory muscle functions can influence swimming performance, respiratory muscle training (RMT) is not routinely used for improving fin-swimmers´ performance. The aim of our study was to verify the benefit of a one month of RMT in young fin-swimmers. We assessed the effect of this training on respiratory muscles and on maximal underwater swimming distance. 28 fin-swimmers were randomly divided into an experimental group (EG) and a control group (CG). The study finished with 20 fin-swimmers (EG: n = 12; average age 12...
December 2017: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/29237497/hyaluronic-acid-is-associated-with-organ-dysfunction-in-acute-respiratory-distress-syndrome
#20
Anthony J Esposito, Pavan K Bhatraju, Renee D Stapleton, Mark M Wurfel, Carmen Mikacenic
BACKGROUND: Hyaluronic acid (HA), an extracellular matrix component, is degraded in response to local tissue injury or stress. In various animal models of lung injury, HA has been shown to play a mechanistic role in modulating inflammation and injury. While HA is present in the lungs of patients with acute respiratory distress syndrome (ARDS), its relationship to patient outcomes is unknown. METHODS: We studied 86 patients with ARDS previously enrolled in the Phase II Randomized Trial of Fish Oil in Patients with Acute Lung Injury (NCT00351533) at five North American medical centers...
December 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
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