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mechanical ventilation physiology

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https://www.readbyqxmd.com/read/28806218/hypoxemic-patients-with-bilateral-infiltrates-treated-with-high-flow-nasal-cannula-present-a-similar-pattern-of-biomarkers-of-inflammation-and-injury-to-acute-respiratory-distress-syndrome-patients
#1
Marina García-de-Acilu, Judith Marin-Corral, Antonia Vázquez, Laura Ruano, Mònica Magret, Ricard Ferrer, Joan R Masclans, Oriol Roca
OBJECTIVE: To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. DESIGN: Prospective, multicenter study. SETTING: ICUs at three university tertiary hospitals. PATIENTS: Intubated and nonintubated patients admitted to the ICU with acute hypoxemia (PaO2/FIO2 ≤ 300) and bilateral opacities...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28802877/declining-mortality-in-critically-ill-patients-with-cirrhosis-in-australia-and-new-zealand-between-2000-and-2015
#2
Avik Majumdar, Michael Bailey, William M Kemp, Rinaldo Bellomo, Stuart K Roberts, David Pilcher
BACKGROUND AND AIMS: Few studies have described the outcomes of patients with cirrhosis receiving intensive care unit (ICU) admission at a population level. We aimed to describe trends in the mortality of such patients in Australia and New Zealand (ANZ), and to investigate the relationship with associated organ failures. METHODS: We studied patients admitted to 172 ICUs on a non-elective basis, with and without cirrhosis between January 1(st) 2000 and December 31(st) 2015 as recorded by the ANZ Intensive Care Society Centre for Outcome and Resource Evaluation Adult Patient Database...
August 9, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28794524/an-analysis-of-the-predictors-of-mortality-and-morbidity-in-patients-admitted-after-suicidal-hanging-to-an-indian-multidisciplinary-intensive-care-unit
#3
M K Renuka, M S Kalaiselvan, A S Arunkumar
BACKGROUND AND AIMS: Hanging is a frequently used method to attempt suicide in India. There is a lack of data in the Indian population regarding clinical features and outcomes of suicidal hanging. The purpose of this study was to evaluate the factors affecting mortality and morbidity in patients admitted with suicidal hanging to the Intensive Care Unit (ICU). METHODS: A 6-year retrospective study of adult patients admitted to the ICU with suicidal hanging was analysed for demographics, mode of hanging, lead time to emergency room (ER) admission, clinical presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, admission Glasgow coma scale (GCS) and neurological outcomes...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28777198/nosocomial-infections-during-extracorporeal-membrane-oxygenation-incidence-etiology-and-impacton-patients-outcome
#4
Giacomo Grasselli, Vittorio Scaravilli, Stefano Di Bella, Stefano Biffi, Michela Bombino, Nicolò Patroniti, Luca Bisi, Anna Maria Peri, Antonio Pesenti, Andrea Gori, Laura Alagna
OBJECTIVE: To study incidence, type, etiology, risk factors, and impact on outcome of nosocomial infections during extracorporeal membrane oxygenation. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Italian tertiary referral center medical-surgical ICU. PATIENTS: One hundred five consecutive patients who were treated with extracorporeal membrane oxygenation from January 2010 to November 2015...
August 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28777178/sleep-disordered-breathing
#5
Nancy R Foldvary-Schaefer, Tina E Waters
PURPOSE OF REVIEW: Sleep-disordered breathing encompasses a broad spectrum of sleep-related breathing disorders, including obstructive sleep apnea (OSA), central sleep apnea, as well as sleep-related hypoventilation and hypoxemia. Diagnostic criteria have been updated in the International Classification of Sleep Disorders, Third Edition and the American Academy of Sleep Medicine Manual for Scoring Sleep and Associated Events. Neurologic providers should have basic knowledge and skills to identify at-risk patients, as these disorders are associated with substantial morbidity, the treatment of which is largely reversible...
August 2017: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/28776171/the-role-of-heterogeneity-in-asthma-a-structure-to-function-perspective
#6
REVIEW
Justin K Lui, Kenneth R Lutchen
A number of methods have evolved through the years in probing the dysfunction that impacts mechanics and ventilation in asthma. What has been consistently found is the notion of heterogeneity that is not only captured in the frequency dependence of lung mechanics measurements but also rendered on imaging as patchy diffuse areas of ventilation defects. The degree of heterogeneity has been linked to airway hyperresponsiveness, a hallmark feature of asthma. How these heterogeneous constriction patterns lead to functional impairment in asthma have only been recently explored using computational airway tree models...
December 2017: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/28775065/effect-of-hypoxia-and-hyperoxia-on-exercise-performance-in-healthy-individuals-and-in-patients-with-pulmonary-hypertension-a-systematic-review
#7
Silvia Ulrich, Simon Raphael Schneider, Konrad E Bloch
Exercise performance is determined by oxygen supply to working muscles and vital organs. In healthy individuals, exercise performance is limited in the hypoxic environment at altitude, when oxygen delivery is diminished due to the reduced alveolar and arterial oxygen partial pressures. In patients with pulmonary hypertension, exercise performance is already reduced near sea level due to impairments of the pulmonary circulation and gas exchange and, presumably, these limitations are more pronounced at altitude...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28774204/apache-ii-score-cannot-predict-successful-weaning-from-prolonged-mechanical-ventilation
#8
Anna Rojek-Jarmuła, Rainer Hombach, Łukasz J Krzych
At least 5% of all intensive care unit patients require prolonged respiratory support. Multiple factors have been suggested as possible predictors of successful respiratory weaning so far. We sought to verify whether the Acute Physiology and Chronic Health Evaluation II (APACHE II) can predict freedom from prolonged mechanical ventilation (PMV) in patients treated in a regional weaning centre. The study group comprised 130 consecutive patients (age; median (interquartile range): 71 (62-77) years), hospitalized between 1 January 2012, and 31 December 2013...
August 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28770543/feasibility-and-safety-of-virtual-reality-based-early-neurocognitive-stimulation-in-critically-ill-patients
#9
Marc Turon, Sol Fernandez-Gonzalo, Mercè Jodar, Gemma Gomà, Jaume Montanya, David Hernando, Raquel Bailón, Candelaria de Haro, Victor Gomez-Simon, Josefina Lopez-Aguilar, Rudys Magrans, Melcior Martinez-Perez, Joan Carles Oliva, Lluís Blanch
BACKGROUND: Growing evidence suggests that critical illness often results in significant long-term neurocognitive impairments in one-third of survivors. Although these neurocognitive impairments are long-lasting and devastating for survivors, rehabilitation rarely occurs during or after critical illness. Our aim is to describe an early neurocognitive stimulation intervention based on virtual reality for patients who are critically ill and to present the results of a proof-of-concept study testing the feasibility, safety, and suitability of this intervention...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28763506/the-delta-neutrophil-index-is-a-prognostic-factor-for-postoperative-mortality-in-patients-with-sepsis-caused-by-peritonitis
#10
Jong Wan Kim, Jun Ho Park, Doo Jin Kim, Won Hyuk Choi, Jin Cheol Cheong, Jeong Yeon Kim
INTRODUCTION: The delta neutrophil index (DNI) represents the fraction of circulating immature granulocytes and is a marker of infection and sepsis. Our objective was to evaluate the usefulness of DNI for predicting in-hospital mortality within 30 days after surgery in patients with sepsis caused by peritonitis by means of comparing DNI, white blood cell (WBC) count, neutrophil percentage, and C-reactive protein (CRP) before and after surgery. MATERIALS AND METHODS: We performed a retrospective analysis of demographic, clinical, and laboratory data...
2017: PloS One
https://www.readbyqxmd.com/read/28751375/automated-full-range-pressure-volume-curves-in-mice-and-rats
#11
Annette Robichaud, Liah Fereydoonzad, Nathachit Limjunyawong, Richard Rabold, Benoit Allard, Andrea Benedetti, James G Martin, Wayne Mitzner
Pressure-volume (PV) curves constructed over the entire lung volume range can reliably detect functional changes in mouse models of lung diseases. In the present study, we constructed full-range PV curves in healthy and elastase-treated mice using either a classic manually-operated technique or an automated approach using a computer-controlled piston ventilator (flexiVent FX; SCIREQ Inc, Montreal, Qc, Canada). On the day of the experiment, subjects were anaesthetized, tracheotomized and mechanically ventilated...
July 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28751366/recent-advances-in-oxygen-sensing-and-signal-transduction-in-hypoxic-pulmonary-vasoconstriction
#12
Ievgen Strielkov, Oleg Pak, Natascha Sommer, Norbert Weissmann
Hypoxic pulmonary vasoconstriction (HPV) is a physiological reaction, which adapts lung perfusion to regional ventilation and optimizes gas exchange. Impaired HPV may cause systemic hypoxemia, while generalized HPV contributes to the development of pulmonary hypertension. The triggering mechanisms underlying HPV are still not fully elucidated. Several hypotheses are currently under debate, including a possible decrease as well as an increase in reactive oxygen species as a triggering event. Recent findings suggest an increase in the production of reactive oxygen species in pulmonary artery smooth muscle cells by complex III of the mitochondrial electron transport chain and occurrence of oxygen sensing at complex IV...
July 27, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28746528/simple-motor-tasks-independently-predict-extubation-failure-in-critically-ill-neurological-patients
#13
Fernanda Machado Kutchak, Marcelo de Mello Rieder, Josué Almeida Victorino, Carla Meneguzzi, Karla Poersch, Luiz Alberto Forgiarini, Marino Muxfeldt Bianchin
Objective: To evaluate the usefulness of simple motor tasks such as hand grasping and tongue protrusion as predictors of extubation failure in critically ill neurological patients. Methods: This was a prospective cohort study conducted in the neurological ICU of a tertiary care hospital in the city of Porto Alegre, Brazil. Adult patients who had been intubated for neurological reasons and were eligible for weaning were included in the study. The ability of patients to perform simple motor tasks such as hand grasping and tongue protrusion was evaluated as a predictor of extubation failure...
May 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28743938/lactate-provides-a-strong-ph-independent-ventilatory-signal-in-the-facultative-air-breathing-teleost-pangasianodon-hypophthalmus
#14
Mikkel T Thomsen, Tobias Wang, William K Milsom, Mark Bayley
Fish regulate ventilation primarily by sensing O2-levels in the water and arterial blood. It is well established that this sensory process involves several steps, but the underlying mechanisms remain frustratingly elusive. Here we examine the effect of increasing lactate ions at constant pH on ventilation in a teleost; specifically the facultative air-breathing catfish Pangasianodon hypophthalmus. At lactate levels within the physiological range obtained by Na-Lactate injections (3.5 ± 0.8 to 10.9 ± 0...
July 25, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28743336/-analysis-of-factors-affecting-the-prognosis-of-icu-patients-by-multiple-logistic-regression-model-a-retrospective-cohort-study-of-1-299-patients-in-12-consecutive-years
#15
Jianfeng Liang, Zhiyong Li, Yan Zhang, Wei Zhang, Haishan Dong, Yun Zhang, Chang Xu, Maolong Gao
OBJECTIVE: To explore the prognostic factors of intensive care unit (ICU) patients. METHODS: A retrospective cohort study was conducted. The clinical data of patients admitted to ICU of Beijing Geriatric Hospital from January 2005 to December 2016 were collected. According to the prognosis, the patients were divided into death group and survival group, and the mortality trend with time and age was observed. Survival and death were treated as dependent variables, while the gender, age, reason of ICU admission, acute physiology and chronic health evaluation II (APACHE II) score, whether undergoing invasive mechanical ventilation (MV), invasive MV reason, duration of invasive MV, whether successful weaning, whether ICU nosocomial infection, hospital acquired pneumonia (HAP), central line-associated bloodstream infection (CLABSI), acute kidney injury (AKI) occurred, whether undergoing continuous blood purification (CBP), whether septic shock occurred, whether undergoing invasive hemodynamic monitoring or blood transfusion and length of ICU stay were used as the independent variables...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28743332/-clinical-significance-of-early-immunological-paralysis-in-patients-with-severe-h1n1-influenza-a
#16
Yongbing Qian, Hui Xie, Rui Tian, Jian Lu, Wei Jin, Ruilan Wang
OBJECTIVE: To analysis the immunological characteristics of patients with severe H1N1 influenza A, and to provide theoretical basis for predicting the prognosis of the disease. METHODS: A retrospective analysis was conducted. The clinical data of 15 patients diagnosed with severe H1N1 influenza A and admitted to Shanghai General Hospital of Nanjing Medical University from October 2015 to December 2016 were collected. All the patients were divided into survival and death groups according to 28-day survival...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28732512/prolonged-acute-care-and-post-acute-care-admission-and-recovery-of-physical-function-in-survivors-of-acute-respiratory-failure-a-secondary-analysis-of-a-randomized-controlled-trial
#17
Anna Neumeier, Amy Nordon-Craft, Dan Malone, Margaret Schenkman, Brendan Clark, Marc Moss
BACKGROUND: The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Little is known about their trajectory of functional recovery. We sought to determine whether prolonged admission influenced the trajectory of physical function recovery and whether patient age modified the recuperation rate. METHODS: We performed a secondary analysis of a randomized clinical trial of intensive physical therapy for patients with acute respiratory failure requiring mechanical ventilation for ≥4 days...
July 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28725211/critical-evaluation-of-the-lund-concept-for-treatment-of-severe-traumatic-head-injury-25%C3%A2-years-after-its-introduction
#18
REVIEW
Per-Olof Grände
When introduced in 1992, the Lund concept (LC) was the first complete guideline for treatment of severe traumatic brain injury (s-TBI). It was a theoretical approach, based mainly on general physiological principles-i.e., of brain volume control and optimization of brain perfusion and oxygenation of the penumbra zone. The concept gave relatively strict outlines for cerebral perfusion pressure, fluid therapy, ventilation, sedation, nutrition, the use of vasopressors, and osmotherapy. The LC strives for treatment of the pathophysiological mechanisms behind symptoms rather than just treating the symptoms...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28721821/current-perspectives-for-the-use-of-gonane-progesteronergic-drugs-in-the-treatment-of-central-hypoventilation-syndromes
#19
Camille Loiseau, Florence Cayetanot, Fanny Joubert, Anne-Sophie Perrin-Terrin, Philippe Cardot, Marie-Noëlle Fiamma, Alain Frugiere, Christian Straus, Laurence Bodineau
BACKGROUND: Central alveolar hypoventilation syndromes (CHS) encompass neurorespiratory diseases resulting from congenital or acquired neurological disorders. Hypercapnia, acidosis, and hypoxemia resulting from CHS negatively affect physiological functions and can be life-threatening. To date, the absence of pharmacological treatment implies that the patients must receive assisted ventilation throughout their lives. OBJECTIVE: To highlight the relevance of determining conditions in which using gonane synthetic progestins could be of potential clinical interest for the treatment of CHS...
July 19, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28711381/effectiveness-assessment-of-a-guideline-based-protocol-for-ventilatory-support-management-of-copd-exacerbations-in-an-emergency-department
#20
Franciele Plachi, Fernando Nataniel Vieira, Danilo Cortozi Berton, Marli Knorst, Alexandre Simões Dias, Fernanda Machado Balzan
OBJECTIVES: To investigate clinical outcomes according to ventilatory support indication in subjects with chronic obstructive pulmonary disease exacerbation in a "real-life" Emergency Department and to analyze potential predictors of successful noninvasive positive pressure ventilation. METHODS: Retrospective cohort performed over an 18-month period, comparing the following patient groups with chronic obstructive pulmonary disease exacerbation: Group A composed of patients initially selected to receive noninvasive positive pressure ventilation without the subsequent need for invasive mechanical ventilation (successful-noninvasive positive pressure ventilation); Group B composed of patients transitioning from noninvasive positive pressure ventilation to invasive mechanical ventilation (failed-noninvasive positive pressure ventilation); and Group C composed of patients who presented with immediate need for invasive mechanical ventilation (without prior noninvasive positive pressure ventilation)...
July 5, 2017: Brazilian Journal of Physical Therapy
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