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mechanical ventilation physiology

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https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#1
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28931718/solar-powered-ventilation-of-african-termite-mounds
#2
Samuel A Ocko, Hunter King, David Andreen, Paul Bardunias, J Scott Turner, Rupert Soar, L Mahadevan
How termite mounds function to facilitate climate control is still only partially understood. Recent experimental evidence in the mounds of a single species, the south Asian termite Odontotermes obesus, suggests that the daily oscillations of radiant heating associated with diurnal insolation patterns drive convective flow within them. How general this mechanism is remains unknown. To probe this, we consider the mounds of the African termite Macrotermes michaelseni, which thrives in a very different environment...
September 15, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28918201/clinical-management-of-pressure-control-ventilation-an-algorithmic-method-of-patient-ventilatory-management-to-address-forgotten-but-important-variables
#3
Lonny Ashworth, Yasuhiro Norisue, Megan Koster, Jeff Anderson, Junko Takada, Hatsuyo Ebisu
Pressure controlled ventilation is a common mode of ventilation used to manage both adult and pediatric populations. However, there is very little evidence that distinguishes the efficacy of pressure controlled ventilation over that of volume controlled ventilation in the adult population. This gap in the literature may be due to the absence of a consistent and systematic algorithm for managing pressure controlled ventilation. This article provides a brief overview of the applications of both pressure controlled ventilation and volume controlled ventilation and proposes an algorithmic approach to the management of patients receiving pressure controlled ventilation...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#4
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904477/studying-the-power-of-the-integrative-weaning-index-in-predicting-the-success-rate-of-the-spontaneous-breathing-trial-in-patients-under-mechanical-ventilation
#5
Sahar Ebrahimabadi, Ahmad Bagheri Moghadam, Mohammadali Vakili, Mahnaz Modanloo, Homeira Khoddam
BACKGROUND AND AIMS: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation. MATERIALS AND METHODS: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28898557/improved-survival-for-rural-trauma-patients-transported-by-helicopter-to-a-verified-trauma-center-a-propensity-score-analysis
#6
Thein Hlaing Zhu, Lisa Hollister, Dazar Opoku, Samuel M Galvagno
OBJECTIVES: Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) vs. ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting. METHODS: The ascertainment of trauma patients age ≥15 years (n=469 cases) by HT and (n=580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center...
September 12, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28895696/b-type-natriuretic-peptide-usefulness-in-the-management-of-critically-ill-neonates
#7
Gisela L Salas, Mariela Jozefkowicz, Gustavo S Goldsmit, Gabriela Disa, Alejandra Rodiño, Susana Rodríguez, Diana Fariña
INTRODUCTION: B-type natriuretic peptide (BNP) is responsible for changes in the heart organogenesis and is associated with transition to extrauterine life. In the first week of life, BNP levels are high and return to normal with the physiological loss in weight. High BNP levels are associated with different conditions. OBJETIVE: To establish the relationship between BNP levels and criticality and the short-term clinical course among patients hospitalized in the neonatal intensive care unit...
October 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28887766/short-term-effects-of-passive-mobilization-on-the-sublingual-microcirculation-and-on-the-systemic-circulation-in-patients-with-septic-shock
#8
Tuanny Teixeira Pinheiro, Flávio Geraldo Rezende de Freitas, Karla Tuanny Fiorese Coimbra, Vanessa Marques Ferreira Mendez, Heloísa Baccaro Rossetti, Paulo Vinicius Talma, Antônio Tonete Bafi, Flávia Ribeiro Machado
BACKGROUND: Active mobilization is not possible in patients under deep sedation and unable to follow commands. In this scenario, passive therapy is an interesting alternative. However, in patients with septic shock, passive mobilization may have risks related to increased oxygen consumption. Our objective was to evaluate the impact of passive mobilization on sublingual microcirculation and systemic hemodynamics in patients with septic shock. METHODS: We included patients who were older than 18 years, who presented with septic shock, and who were under sedation and mechanical ventilation...
September 8, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28879449/prognostic-factors-of-mortality-in-iranian-patients-with-systemic-lupus-erythematosus-admitted-to-intensive-care-unit
#9
Alimohammad Fatemi, Somayeh Shamsaee, Ahmad Raeisi, Zahra Sayedbonakdar, Abbas Smiley
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. Predictors of mortality were compared between alive and dead patients by Cox regression analysis...
September 6, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28877748/a-pilot-clinical-trial-of-recombinant-human-angiotensin-converting-enzyme-2-in-acute-respiratory-distress-syndrome
#10
Akram Khan, Cody Benthin, Brian Zeno, Timothy E Albertson, John Boyd, Jason D Christie, Richard Hall, Germain Poirier, Juan J Ronco, Mark Tidswell, Kelly Hardes, William M Powley, Tracey J Wright, Sarah K Siederer, David A Fairman, David A Lipson, Andrew I Bayliffe, Aili L Lazaar
BACKGROUND: Renin-angiotensin system (RAS) signaling and angiotensin-converting enzyme 2 (ACE2) have been implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). We postulated that repleting ACE2 using GSK2586881, a recombinant form of human angiotensin-converting enzyme 2 (rhACE2), could attenuate acute lung injury. METHODS: We conducted a two-part phase II trial comprising an open-label intrapatient dose escalation and a randomized, double-blind, placebo-controlled phase in ten intensive care units in North America...
September 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28872972/expression-and-significance-of-th17-and-treg-cells-in-pulmonary-infections-with-gram-negative-bacteria
#11
Ying Liu, Jia-Kui Sun, Xiang Qi, Yong-Ming Chen, Jing Li, Shang-Yu Chen, Han Liu
The aim of this study was to investigate the expression and significance of T helper type 17 (Th17) and regulatory T (Treg) cells in severe pulmonary infection with gram-negative bacteria (GNB). The peripheral venous blood (PVB) and bronchoalveolar lavage fluid (BALF) were collected from patients receiving mechanical ventilation in the intensive care unit (ICU) owing to: (1) pulmonary GNB infection (group I) and (2) nonpulmonary infection (group NI). Patients from the two groups were matched based on their Acute Physiology and Chronic Health Evaluation II (APACHE II) scores and were recruited in the same period...
October 2017: Immunological Investigations
https://www.readbyqxmd.com/read/28872376/caffeine-and-physiological-responses-to-submaximal-exercise-a-meta-analysis
#12
Mark Glaister, Conor Gissane
The aim of this study was to carry out a systematic review and meta-analysis of the effects of caffeine supplementation on physiological responses to submaximal exercise. 26 studies met the inclusion criteria of adopting double-blind, randomised, crossover designs that included a sustained (5 - 30 minutes) fixed-intensity bout of submaximal exercise (constrained to 60 - 85% V̇O2max) using a standard caffeine dose of 3 - 6 mg∙kg(-1) administered 30 - 90 minutes prior to exercise. Meta-analyses were completed using a random-effects model, and data are presented as raw mean difference (D) with associated 95% confidence limits (CL95)...
September 5, 2017: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/28870355/mechanical-ventilation-state-of-the-art
#13
REVIEW
Tài Pham, Laurent J Brochard, Arthur S Slutsky
Mechanical ventilation is the most used short-term life support technique worldwide and is applied daily for a diverse spectrum of indications, from scheduled surgical procedures to acute organ failure. This state-of-the-art review provides an update on the basic physiology of respiratory mechanics, the working principles, and the main ventilatory settings, as well as the potential complications of mechanical ventilation. Specific ventilatory approaches in particular situations such as acute respiratory distress syndrome and chronic obstructive pulmonary disease are detailed along with protective ventilation in patients with normal lungs...
September 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#14
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. We review recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active asthma management during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28864081/hypoxic-acclimation-leads-to-metabolic-compensation-after-reoxygenation-in-atlantic-salmon-yolk-sac-alevins
#15
Elias T Polymeropoulos, Nicholas G Elliott, Peter B Frappell
Hypoxia is common in aquatic environments and has substantial effects on development, metabolism and survival of aquatic organisms. To understand the physiological effects of hypoxia and its dependence on temperature, metabolic rate (Ṁo2) and cardiorespiratory function were studied in response to acute hypoxia (21 ➔ 5kPa) at different measurement temperatures (Ta; 4, 8 and 12°C) in Salmo salar alevins that were incubated under normoxic conditions (PO2=21kPa) or following hypoxic acclimation (PO2=10kPa) as well as two different temperatures (4°C or 8°C)...
August 29, 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/28855775/studying-morbidity-and-predicting-mortality-in-patients-with-blunt-chest-trauma-using-a-novel-clinical-score
#16
Priyadarshini Manay, Rajeev R Satoskar, V Karthik, Ram P Prajapati
BACKGROUND: A departmental audit in March 2015 revealed significant mortality rate of 40% in blunt chest trauma patients (much greater than the global 25%). A study was thus planned to study morbidity and predictors of mortality in blunt chest trauma patients admitted to our hospital. METHODS: This study was a prospective observational study of 139 patients with a history of blunt chest trauma between June 2015 and November 2015 after the Institutional Ethics Committee approval in April 2015...
July 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28845902/persistence-of-delirium-after-cessation-of-sedatives-and-analgesics-and-impact-on-clinical-outcomes-in-critically-ill-patients
#17
Michael T Kenes, Joanna L Stollings, Li Wang, Timothy D Girard, E Wesley Ely, Pratik P Pandharipande
STUDY OBJECTIVE: As delirium is a common manifestation in critically ill patients and is associated with worse clinical outcomes, we sought to characterize the reversibility of delirium after discontinuation of sedation and to determine whether sedation-associated delirium that rapidly reverses impacts clinical outcomes. DESIGN: Post hoc subgroup analysis of prospectively collected data from a previously published study. PATIENTS: Seventy adults admitted to a medical intensive care unit (ICU) between March and July 2012 who required mechanical ventilation with continuous analgesia and/or sedation and underwent a spontaneous awakening trial (SAT)...
August 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28839004/ventilation-and-neurochemical-changes-during-%C3%A2%C2%B5-opioid-receptor-activation-or-blockade-of-excitatory-receptors-in-the-hypoglossal-motor-nucleus-of-goats
#18
Thomas M Langer, Suzanne E Neumueller, Emma Crumley, Nicholas J Burgraff, Sawan Talwar, Matthew Robert Hodges, Lawrence G Pan, Hubert V Forster
Neuromodulator interdependence posits that changes in one or more neuromodulators are compensated by changes in other modulators to maintain stability in the respiratory control network. Herein, we studied compensatory neuromodulation in the hypoglossal motor nucleus (HMN) after chronic implantation of microtubules unilaterally (n=5) or bilaterally (n=5) into the HMN. After recovery, receptor agonists or antagonists in mock cerebrospinal fluid (mCSF) were dialyzed during the awake and NREM sleep state. During day studies, dialysis of the µ-opioid inhibitory receptor agonist DAMGO (100 µM) decreased pulmonary ventilation (V̇I), breathing frequency (f), and genioglossus (GG) muscle activity, but did not alter neuromodulators measured in the effluent mCSF...
August 24, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28828367/spontaneous-breathing-a-double-edged-sword-to-handle-with-care
#19
REVIEW
Tommaso Mauri, Barbara Cambiaghi, Elena Spinelli, Thomas Langer, Giacomo Grasselli
In acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS) patients, spontaneous breathing is associated with multiple physiologic benefits: it prevents muscles atrophy, avoids paralysis, decreases sedation needs and is associated with improved hemodynamics. On the other hand, in the presence of uncontrolled inspiratory effort, severe lung injury and asynchronies, spontaneous ventilation might also worsen lung edema, induce diaphragm dysfunction and lead to muscles exhaustion and prolonged weaning...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828362/tidal-volume-in-acute-respiratory-distress-syndrome-how-best-to-select-it
#20
REVIEW
Michele Umbrello, Antonella Marino, Davide Chiumello
Mechanical ventilation is the type of organ support most widely provided in the intensive care unit. However, this form of support does not constitute a cure for acute respiratory distress syndrome (ARDS), as it mainly works by buying time for the lungs to heal while contributing to the maintenance of vital gas exchange. Moreover, it can further damage the lung, leading to the development of a particular form of lung injury named ventilator-induced lung injury (VILI). Experimental evidence accumulated over the last 30 years highlighted the factors associated with an injurious form of mechanical ventilation...
July 2017: Annals of Translational Medicine
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