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https://www.readbyqxmd.com/read/28444079/use-of-noninvasive-ventilation-in-severe-acute-respiratory-distress-syndrome-due-to-accidental-chlorine-inhalation-a-case-report
#1
Adriano Medina Matos, Rodrigo Ribeiro de Oliveira, Mauro Martins Lippi, Rodrigo Ryoji Takatani, Wilson de Oliveira
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). Among the direct causes of acute respiratory distress syndrome, chlorine inhalation is an uncommon cause, generating mucosal and airway irritation in most cases. We present a case of severe acute respiratory distress syndrome after accidental inhalation of chlorine in a swimming pool, with noninvasive ventilation used as a treatment with good response in this case...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443564/transpulmonary-hypothermia-with-cooled-oxygen-inhalation-shows-promising-results-as-a-novel-hypothermia-technique
#2
Yahya Ayhan Acar, Banu Karakuş Yılmaz, Duygu Sultan Çelik, Erdem Çevik, Hatice Topçu, Şule Özsoy, Aylin Haklıgör, Orhan Çınar
BACKGROUND: Therapeutic hypothermia was showed to improve neurologic outcome but current therapeutic hypothermia techniques have limitations. Novel techniques such as transpulmonary hypothermia with cooled oxygen inhalation may be beneficial. AIMS: To evaluate the performance of transthoracic hypothermia with cooled medical oxygen inhalation as a therapeutic hypothermia method. STUDY DESIGN: Animal experimentation. METHODS: A total of 36 adult male Wistar-Hannover rats were used in this research...
April 6, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28441053/evaluation-of-oxygen-administration-with-a-high-flow-nasal-cannula-to-clinically-normal-dogs
#3
Jennifer L Daly, Christine L Guenther, Jamie M Haggerty, Iain Keir
OBJECTIVE To evaluate the safety and efficacy of oxygen administration by use of a high-flow nasal cannula (HFNC) in sedated clinically normal dogs. ANIMALS 6 healthy adult dogs undergoing routine dental prophylaxis. PROCEDURES Dogs were sedated with butorphanol tartrate and dexmedetomidine. An esophageal balloon catheter was inserted into the esophagus, a double-pronged nasal cannula was inserted into the nares, and a catheter was inserted into the dorsal pedal artery. Dogs were positioned in right lateral recumbency...
May 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28440110/in-parallel-connected-intermittent-hemodialysis-through-ecmo-does-not-affect-hemodynamic-parameters-derived-from-transpulmonary-thermodilution
#4
Tobias Lahmer, Ulrich Mayr, Sebastian Rasch, Gonzalo Batres Baires, Roland M Schmid, Wolfgang Huber
INTRODUCTION: We report a case of renal replacement therapy (RRT) during extracorporeal membrane oxygenation (ECMO) via a single venous access and analyze the feasibility of transpulmonary thermodilution (TPTD) for hemodynamic monitoring. CASE REPORT: ECMO and RRT connected into the ECMO-extracorporeal circuit were performed via a single venous access because of multiple venous thromboses. An indicator for TPTD and pulse contour analysis (PCA) was applied into the central venous catheter (CVC) placed in the right vena jugularis...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#5
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28401152/hemodynamic-analysis-of-pediatric-septic-shock-and-cardiogenic-shock-using-transpulmonary-thermodilution
#6
En-Pei Lee, Shao-Hsuan Hsia, Jainn-Jim Lin, Oi-Wa Chan, Jung Lee, Chia-Ying Lin, Han-Ping Wu
Septic shock and cardiogenic shock are the two most common types of shock in children admitted to pediatric intensive care units (PICUs). The aim of the study was to investigate which hemodynamic variables were associated with mortality in children with shock. We retrospectively analyzed 50 children with shock (37 septic shock cases and 13 cardiogenic shock cases) in the PICU and monitored their hemodynamics using transpulmonary thermodilution from 2003 to 2016. Clinical factors were analyzed between the patients with septic and cardiogenic shock...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28353026/effect-of-milrinone-infusion-on-pulmonary-vasculature-and-stroke-work-indices-a-single-center-retrospective-analysis-in-69-patients-awaiting-cardiac-transplantation
#7
Dmitry Abramov, Nicholas A Haglund, Thomas G Di Salvo
BACKGROUND: Although milrinone infusion is reported to benefit left ventricular function in chronic left heart failure, few insights exist regarding its effects on pulmonary circulation and right ventricular function. METHODS: We retrospectively reviewed right heart catheterization data at baseline and during continuous infusion of milrinone in 69 patients with advanced heart failure and analyzed the effects on ventricular stroke work indices, pulmonary vascular resistance and pulmonary arterial compliance...
March 28, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28337672/fentanyl-formulations-in-the-management-of-pain-an-update
#8
REVIEW
Stephan A Schug, Sonya Ting
Fentanyl is a synthetic, highly selective opioid with many desirable physicochemical properties, including a high lipophilicity and predictable pharmacokinetics. These properties have an established record in the management of pain in a variety of settings, particularly acute pain and breakthrough cancer pain. Fentanyl was initially developed for parenteral use; however, this is invasive and impractical in the outpatient setting. Unfortunately, the high first-pass metabolism of fentanyl makes oral formulations unfeasible...
May 2017: Drugs
https://www.readbyqxmd.com/read/28330726/provision-of-physiological-data-and-reference-values-in-awake-and-anaesthetized-female-sheep-aged-6-12-months
#9
Tim Kampmeier, Philip Arnemann, Michael Heßler, Sebastian Rehberg, Andrea Morelli, Martin Westphal, Matthias Lange, Hugo Van Aken, Christian Ertmer
OBJECTIVE: To provide physiological data and reference values in awake and anaesthetized sheep aged 6-12 months. STUDY DESIGN: Descriptive study. ANIMALS: Data from 260 female sheep of the species Ovis orientalis aries aged 6-12 months were extracted from 10 experimental trials. METHODS: Data from pulmonary arterial thermodilution in awake (cohort 1; n = 109) and anaesthetized animals (cohort 2; n = 81), and transpulmonary thermodilution in anaesthetized animals (cohort 3; n = 70) were analysed...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28306327/fifty-years-of-research-in-ards-respiratory-mechanics-in-acute-respiratory-distress-syndrome
#10
William R Henderson, Lu Chen, Marcelo B P Amato, Laurent J Brochard
Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, while lifesaving, is associated with new iatrogenic injury. Current best practice involves the use of small tidal volumes, low plateau and driving pressures, and high levels of positive end expiratory pressure. Collectively, these interventions are termed "lung protective ventilation". Recent investigations suggest that individualized measurements of pulmonary mechanical variables rather than population based ventilation prescriptions may be used to set the ventilator with the potential to improve outcomes beyond those achieved with standard lung protective ventilation...
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28295526/pharmacological-treatments-in-asthma-affected-horses-a-pair-wise-and-network-meta-analysis
#11
L Calzetta, P Roncada, D di Cave, L Bonizzi, A Urbani, E Pistocchini, P Rogliani, M G Matera
BACKGROUND: Equine asthma is a disease characterised by reversible airflow obstruction, bronchial hyperresponsiveness and airway inflammation following exposure of susceptible horses to specific airborne agents. Although clinical remission can be achieved in a low-airborne dust environment, repeated exacerbations may lead to irreversible airway remodelling. The available data on the pharmacotherapy of equine asthma results from several small studies, and no head-to-head clinical trials have been conducted among the available medications...
March 10, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28288587/the-value-of-arterial-pressure-waveform-cardiac-output-measurements-in-the-radial-and-femoral-artery-in-major-cardiac-surgery-patients
#12
A van Drumpt, J van Bommel, S Hoeks, F Grüne, T Wolvetang, J Bekkers, M Ter Horst
BACKGROUND: A relatively new uncalibrated arterial pressure waveform cardiac output (CO) measurement technique is the Pulsioflex-ProAQT® system. Aim of this study was to validate this system in cardiac surgery patients with a specific focus on the evaluation of a difference in the radial versus the femoral arterial access, the value of the auto-calibration modus and the ability to show fluid-induced changes. METHODS: In twenty-five patients scheduled for ascending aorta, aortic arch replacement, or both we measured CO simultaneously by transpulmonary thermodilution (COtd) and by using the ProAQT® system connected to the radial (COpR), as well as the femoral artery catheter (COpF)...
March 14, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28212050/volume-controlled-ventilation-does-not-prevent-injurious-inflation-during-spontaneous-effort
#13
Takeshi Yoshida, Susumu Nakahashi, Maria Aparecida Miyuki Nakamura, Yukiko Koyama, Rollin Roldan, Vinicius Torsani, Roberta R De Santis, Susimeire Gomes, Akinori Uchiyama, Marcelo B P Amato, Brian P Kavanagh, Yuji Fujino
RATIONALE: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort. OBJECTIVES: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation...
February 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28146639/fifty-years-of-research-in-ards-setting-positive-end-expiratory-pressure-in-the-acute-respiratory-distress-syndrome
#14
Sarina K Sahetya, Ewan C Goligher, Roy G Brower
Positive end-expiratory pressure (PEEP) has been utilized during mechanical ventilation since the first description of the acute respiratory distress syndrome (ARDS). In the subsequent decades, many different strategies for optimally titrating PEEP have been proposed. Higher PEEP can improve arterial oxygenation, reduce tidal lung stress and strain, and promote more homogenous ventilation by preventing alveolar collapse at end expiration. However, PEEP may also cause circulatory depression and contribute to ventilator-induced lung injury through alveolar overdistention...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28145907/evaluation-of-reperfusion-pulmonary-edema-by-extravascular-lung-water-measurements-after-pulmonary-endarterectomy
#15
François Stéphan, Aurélien Mazeraud, Florent Laverdure, Julien Camous, Elie Fadel
OBJECTIVES: Reperfusion pulmonary edema is a specific complication of pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. Extravascular lung water measurement may be valuable for diagnosing reperfusion pulmonary edema. The primary objective of this study was to describe and assess the clinical significance of extravascular lung water variations after pulmonary endarterectomy. DESIGN: Prospective observational study. SETTING: Nineteen-bed cardiothoracic ICU...
April 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28139013/aortopulmonary-window-morphology-diagnosis-and-long-term-results
#16
Sachin Talwar, Palkesh Agarwal, Shiv Kumar Choudhary, Shyam Sunder Kothari, Rajnish Juneja, Anita Saxena, Balram Airan
OBJECTIVE: Aortopulmonary window (APW) is a rare congenital heart defect. We reviewed our experience with this condition over the last two decades. METHODS: Between September 1993 and December 2013, 62 patients underwent surgery for APW. Depending on the associated lesions, they were divided into two groups: Simple (Group 1) or complex (Group 2). In the complex group, six patients had a ventricular septal defect, five patients had interrupted aortic arch, three patients had tetralogy of Fallot, two patients had double outlet right ventricle, and one patient had the right pulmonary artery arising from the ascending aorta...
February 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28106970/surgical-repair-of-a-complete-atrioventricular-septal-defect-with-tetralogy-of-fallot-using-a-classical-one-patch-technique-and-pulmonary-valve-preservation
#17
Carine Pavy, Olivier Ghez
The association of complete atrial ventricular septal defect (cAVSD) with tetralogy of Fallot remains a complex malformation that involves both inlet and outlet components of the ventricles. The surgical treatment used to be, in the 1980s, a staged repair strategy due to the high mortality rate of first primary repairs (PRs). However, nowadays, PRs have better outcomes. Although double-patch procedures are widely performed, this article describes the single-patch approach for cAVSD repair with transatrial-transpulmonary repair of the Fallot component with preservation of the pulmonary valve...
September 28, 2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/28090301/pulmonary-pulse-wave-transit-time-is-associated-with-right-ventricular-pulmonary-artery-coupling-in-pulmonary-arterial-hypertension
#18
Kurt W Prins, E Kenneth Weir, Stephen L Archer, Jeremy Markowitz, Lauren Rose, Marc Pritzker, Richard Madlon-Kay, Thenappan Thenappan
Pulmonary pulse wave transit time (pPTT), defined as the time for the systolic pressure pulse wave to travel from the pulmonary valve to the pulmonary veins, has been reported to be reduced in pulmonary arterial hypertension (PAH); however, the underlying mechanism of reduced pPTT is unknown. Here, we investigate the hypothesis that abbreviated pPTT in PAH results from impaired right ventricular-pulmonary artery (RV-PA) coupling. We quantified pPTT using pulsed-wave Doppler ultrasound from 10 healthy age- and sex-matched controls and 36 patients with PAH...
December 2016: Pulmonary Circulation
https://www.readbyqxmd.com/read/28074800/effectiveness-of-ventilation-of-nondependent-lung-for-a-brief-period-in-improving-arterial-oxygenation-during-one-lung-ventilation-a-prospective-study
#19
Keerthi Chigurupati, Suneel Puthuvassery Raman, Unnikrishnan Koraparambil Pappu, Unnikrishnan Madathipat
BACKGROUND: Hypoxemia is common during one-lung ventilation(OLV), predominantly due to transpulmonary shunt. None of the strategies tried showed consistent results. We evaluated the effectiveness of ventilating the operated, non-dependent lung (NDL) with small tidal volumes in improving the oxygenation during OLV. METHODS: 30 ASA 1 and 2 patients undergoing elective, open thoracotomy were studied. After standard induction of anesthesia, lung seperation was acheived with left sided DLT...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28062514/cardiopulmonary-exercise-testing-for-detecting-pulmonary-arterial-hypertension-in-systemic-sclerosis
#20
Daniel Dumitrescu, Christian Nagel, Gabor Kovacs, Tom Bollmann, Michael Halank, Jörg Winkler, Martin Hellmich, Ekkehard Grünig, Horst Olschewski, Ralf Ewert, Stephan Rosenkranz
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a devastating disease with limited survival and occurs as a frequent complication in patients with systemic sclerosis (SSc). A definite diagnosis of PAH is obtained by right heart catheterisation (RHC); however, the initial suspicion is raised by non-invasive methods. We assessed the diagnostic accuracy of key parameters derived from cardiopulmonary exercise testing (CPET) for detecting and ruling out SSc-associated PAH. METHODS: In a multicentre setting, we prospectively evaluated 173 consecutive patients with SSc without known PAH, but with clinical suspicion of PAH...
January 6, 2017: Heart: Official Journal of the British Cardiac Society
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