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mechanical ventilation physiology

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https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#1
Tatiana Cathoud do Amaral Paes, Kátia Cansanção Correa de Oliveira, Patrícia de Carvalho Padilha, Wilza Arantes Ferreira Peres
PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes...
January 10, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#2
Whitney Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina Patel, Daniel Brodie, Matthew Bacchetta, Matthew Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of interstitial lung disease (ILD) patients with acute respiratory failure, and to identify those at lower versus higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an intensive care unit (ICU) for respiratory failure at a tertiary care hospital between 2010 and 2014 who did not undergo lung transplantation during their hospitalization...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29349777/in-bed-cycling-in-the-icu-patient-safety-and-recollections-with-motivational-effects
#3
M Ringdal, M Warren Stomberg, K Egnell, E Wennberg, R Zätterman, C Rylander
BACKGROUND: In-bed cycling (IBC) is gaining interest for implementation in intensive care units. Our main objective was to explore patient recollections and experiences of early mobilization, including IBC. Secondly, we aimed to examine if IBC was safe and feasible. METHODS: Eleven participants were interviewed about their experiences during their critical illnesses and active mobilization in the intensive care unit. The interviews were analyzed thematically. Six participants were also monitored for physiological reactions and adverse events during IBC while mechanically ventilated...
January 18, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#4
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29338772/incidence-risk-factors-and-impact-of-protocolised-care-on-exposure-keratopathy-in-critically-ill-adults-a-two-phase-prospective-cohort-study
#5
Obaid Kousha, Zubaid Kousha, Jonathan Paddle
BACKGROUND: Exposure keratopathy (EK) has a high incidence in critically ill patients. We aimed to determine the rate of EK in patients admitted to our intensive care unit (ICU), identify risk factors for developing EK and ascertain the effectiveness of a protocol to prevent EK. METHODS: We undertook a two-phase prospective cohort single-centre study in a general adult ICU. The first phase of the study was observational. In the second phase of the study an eye care protocol was introduced...
January 16, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29338307/the-impact-of-prehabilitation-on-post-surgical-complications-in-patients-undergoing-non-urgent-cardiovascular-surgical-intervention-systematic-review-and-meta-analysis
#6
Filipe Marmelo, Vânia Rocha, Daniel Gonçalves
Introduction Cardiac surgery is an aggressive procedure, inducing a great level of stress and disturbance to the homeostasis of the organism and underlying several postoperative complications. Surgical prehabilitation comprises pre-operative physical conditioning designed to improve the physiological and functional capacities of the individual, prepare the organism for surgical stress and reduce the risk of postoperative morbidity. Aim This systematic review and meta-analysis is aimed at evaluating the ability of prehabilitation to prevent post-surgical complications in cardiac patients...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#7
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29319194/aging-of-the-carotid-body
#8
Camillo Di Giulio
The aging process is characterized by a decline in several physiological functions resulting in a reduced capability to maintain homeostasis. The lowered homeostatic capacity seems to involve the carotid body (CB), whose role is to modulate ventilation and tissue oxygen supply, thus playing a prime role in all aging processes. Aging causes marked changes in CB morphology. Indeed, it is enlarged and shows a concomitant decrease in the percentage of chemoreceptor tissue, as well as a proliferation of Type II cells...
January 10, 2018: Journal of Physiology
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
#9
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/29304863/gm-csf-overexpression-after-influenza-a-virus-infection-prevents-mortality-and-moderates-m1-like-airway-monocyte-macrophage-polarization
#10
E Scott Halstead, Todd M Umstead, Michael L Davies, Yuka Imamura Kawasawa, Patricia Silveyra, Judie Howyrlak, Linlin Yang, Weichao Guo, Sanmei Hu, Eranda Kurundu Hewage, Zissis C Chroneos
BACKGROUND: Influenza A viruses cause life-threatening pneumonia and lung injury in the lower respiratory tract. Application of high GM-CSF levels prior to infection has been shown to reduce morbidity and mortality from pathogenic influenza infection in mice, but the mechanisms of protection and treatment efficacy have not been established. METHODS: Mice were infected intranasally with influenza A virus (PR8 strain). Supra-physiologic levels of GM-CSF were induced in the airways using the double transgenic GM-CSF (DTGM) or littermate control mice starting on 3 days post-infection (dpi)...
January 5, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29304746/a-multi-center-study-on-the-risk-factors-of-infection-caused-by-multi-drug-resistant-acinetobacter-baumannii
#11
Huiping Huang, Borong Chen, Gang Liu, Jing Ran, Xianyu Lian, Xinhua Huang, Nan Wang, Zhengjie Huang
BACKGROUND: Acinetobacter baumannii (AB) is critical for healthcare-associated infections (HAI) with significant regional differences in the resistance rate, but its risk factors and infection trends has not been well studied. We aimed to explore the risk factors, epidemiological characteristics and resistance of multidrug-resistant Acinetobacter baumannii (MDR-AB) in intensive care unit inpatients. METHODS: Data of patients with MDR-AB (195 cases), and with antibiotic-sensitive AB infection (294 cases, control) during January to December, 2015 in three medical centers in Xiamen, China were conducted and analyzed in the present retrospective study...
January 5, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29301259/sphingolipids-in-ventilator-induced-lung-injury-role-of-sphingosine-1-phosphate-lyase
#12
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/29297798/evaluation-of-blood-gas-values-in-anesthetized-southern-white-rhinoceros-ceratotherium-simum-ventilated-with-a-novel-demand-ventilator-in-a-zoological-park-setting
#13
Mark Jeon, Khursheed R Mama, Jeffrey R Zuba, Nadine Lamberski, James E Oosterhuis, Meredith M Clancy, Katie W Delk, Matthew E Kinney, Patrick J Morris, Francisco Olea-Popelka
Rhinoceros conservation efforts are essential to the survival of the species. One such effort is focused on using advanced reproductive technologies to produce viable northern white rhinoceros ( Ceratotherium simum cottoni) embryos for implantation into southern white rhinoceros ( Ceratotherium simum simum) surrogates. Anesthesia may be required to facilitate necessary procedures in these surrogate rhinoceros, but commonly reported side effects including hypercapnia and hypoxemia limit anesthetic recumbency time due to animal safety concerns...
December 2017: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/29297365/regional-physiology-of-ards
#14
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/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#15
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29277163/criterion-validity-and-inter-rater-reliability-of-a-palliative-care-screening-tool-for-patients-admitted-to-an-emergency-department-intensive-care-unit
#16
Sabrina Corrêa da Costa Ribeiro, Ricardo Tavares de Carvalho, Juraci Aparecida Rocha, Roger Daglius Dias
OBJECTIVE: The use of palliative care (PC) screening criteria to trigger PC consultations may optimize the utilization of PC services, improve patient comfort, and reduce invasive and futile end-of-life care. The aim of the present study was to assess the criterion validity and inter-rater reliability of a PC screening tool for patients admitted to an emergency department intensive care unit (ED-ICU). METHOD: Observational retrospective study evaluating PC screening criteria based on the presence of advanced diagnosis and the use of two "surprise questions" (traditional and modified)...
December 26, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29274318/the-burden-of-viruses-in-pneumonia-associated-with-acute-respiratory-failure-an-underappreciated-issue
#17
Andrew F Shorr, Kristen Fisher, Scott T Micek, Marin H Kollef
BACKGROUND: Pneumonia associated with mechanical ventilation (MV) results in substantial mortality and represents a leading reason for antibiotic utilization. The role of viruses in this setting is unclear. Identifying a viral etiology such instances could facilitate antibiotic stewardship. METHODS: We performed a secondary analysis of a prospective cohort with pneumonia requiring MV. We included both community and hospital-onset cases and classified patients as to the pneumonia's etiology...
December 20, 2017: Chest
https://www.readbyqxmd.com/read/29261564/long-term-return-to-functional-baseline-after-mechanical-ventilation-in-the-icu
#18
Michael E Wilson, Amelia Barwise, Katherine J Heise, Theodore O Loftsgard, Mikhail Dziadzko, Andrea Cheville, Abdul Majzoub, Paul J Novotny, Ognjen Gajic, Michelle Biehl
OBJECTIVE: Predictors of long-term functional impairment in acute respiratory failure of all causes are poorly understood. Our objective was to assess the frequency and predictors of long-term functional impairment or death after invasive mechanical ventilation for acute respiratory failure of all causes. DESIGN: Population-based, observational cohort study. SETTING: Eight adult ICUs of a single center. PATIENTS: All adult patients from Olmsted County, Minnesota, without baseline functional impairment who received mechanical ventilation in ICUs for acute respiratory failure of all causes from 2005 through 2009...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29258377/clinical-features-of-kidney-transplant-recipients-admitted-to-the-intensive-care-unit
#19
Flávio Geraldo Rezende Freitas, Fábio Lombardi, Eduardo Souza Pacheco, Tainá Veras de Sandes-Freitas, Laila Almeida Viana, Hélio Tedesco-Silva Junior, José Osmar Medina-Pestana, Antônio Tonete Bafi, Flavia Ribeiro Machado
INTRODUCTION: There is a paucity of data regarding the complications in kidney transplant patients who may require intensive care unit (ICU) management, despite being the most common solid organ transplant worldwide. OBJECTIVE: To identify the main reasons for ICU admission and to determine the factors associated with hospital mortality in kidney transplant recipients. DESIGN: This single-center retrospective cohort study was conducted between September 2013 and June 2014, including all consecutive kidney transplant patients requiring ICU admission...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29246713/determination-of-physiological-dead-space-in-anaesthetized-horses-a-method-comparison-study
#20
Zuzana Drábková, Johannes P Schramel, Radovan Kabeš
OBJECTIVE: To compare two methods of Bohr-Enghoff physiological dead space to tidal volume ratio (VD/VTBohr-Enghoff) determination using a mixing chamber and an E-CAiOVX metabolic monitor. STUDY DESIGN: Prospective, clinical, method-comparison study. ANIMALS: Twenty horses anaesthetized for elective orthopaedic procedures. METHODS: Horses were anaesthetized with isoflurane in oxygen and the lungs were mechanically ventilated (VT 15±2 mL kg-1)...
April 18, 2017: Veterinary Anaesthesia and Analgesia
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