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mechanical ventilation physiology

Nikki Kells, Ngaio Beausoleil, Craig Johnson, Mhairi Sutherland
The aim of this research was to evaluate the welfare of pre-weaned piglets euthanised using three different gas treatments: 100% carbon dioxide (CO₂), 100% argon (Ar) or a mixture of 60% Ar/40% carbon dioxide (Ar/CO₂). Two studies (n = 5 piglets/treatment/study) were conducted: (1) behavioural and physiological data were collected from conscious piglets during exposure to test gases via immersion in a pre-filled chamber and (2) electrophysiological data were collected from lightly anaesthetised, intubated and mechanically ventilated piglets exposed to the same test gases...
March 16, 2018: Animals: An Open Access Journal From MDPI
Selcuk Kayir, Hulya Ulusoy, Guvenc Dogan
Background/aims Sedation is one of the most important components of intensive care unit (ICU) in patients who are mechanically ventilated at intensive care conditions. As a result of sedation and analgesia in the intensive care unit, the patient is to be awakened a comfortable and easy process. The aim of the study is to demonstrate the effects of day-time sedation interruptions in intensive care patients. Material and methods We made a retrospective review of 100 patients who were monitored, mechanically ventilated and treated at our intensive care unit between January 2008 and January 2013...
January 13, 2018: Curēus
Daniel Langer, Casey E Ciavaglia, Azmy Faisal, Katherine A Webb, J Alberto Neder, Rik Gosselink, Sauwaluk Dacha, Marko Topalovic, Anna Ivanova, Denis E O'Donnell
Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max)...
March 15, 2018: Journal of Applied Physiology
Penny S Reynolds, Bernard J Fisher, Jacquelyn McCarter, Christopher Sweeney, Erika J Martin, Paul Middleton, Matthew Ellenberg, Evan Fowler, Donald F Brophy, Alpha A Fowler, Bruce D Spiess, Ramesh Natarajan
BACKGROUND: Coagulopathy and inflammation induced by hemorrhagic shock and traumatic injury are associated with increased mortality and morbidity. Vitamin C (VitC) is an antioxidant with potential protective effects on the pro-inflammatory and pro-coagulant pathways. We hypothesized that high-dose VitC administered as a supplement to fluid resuscitation would attenuate inflammation, coagulation dysfunction, and end-organ tissue damage in a swine model of polytrauma and hemorrhage. METHODS: Male Sinclair swine (n = 24; mean body weight 27 kg) were anesthetized, intubated, mechanically ventilated, and instrumented for physiological monitoring...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Guibo Feng, Xin Tian, Liang Wang, Libo Zhao, Xuefeng Wang
BACKGROUND: To investigate the prognostic value of acute thyroid function in patients with severe encephalitis. METHODS: We retrospectively analyzed information from patients with severe encephalitis from June 2012 to June 2017. Using multivariate logistic regression analysis, we examined predictors of poor outcomes in these patients after 6 months. RESULTS: A total of 94 patients with severe encephalitis were included in the study. Univariate analysis showed that patients with good or poor outcomes had significantly different total thyroxine (TT4) (P = 0...
March 13, 2018: Expert Review of Neurotherapeutics
Valliappan Muthu, Sahajal Dhooria, Ritesh Agarwal, Kuruswamy Thurai Prasad, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal
Background: There is a paucity of literature regarding outcome of critically ill patients with tuberculosis (TB) from India. Herein, we describe our experience of patients with active TB admitted to a Respiratory Intensive Care Unit (RICU) of a tertiary care hospital. Methods: This was a retrospective analysis of all the patients admitted with active TB. The baseline clinical, demographic, ICU parameters and mortality were recorded. A multivariate logistic regression analysis was performed to identify factors predicting mortality...
February 2018: Indian Journal of Critical Care Medicine
Talita M Silva, Laiali J Chaar, Reinaldo C Silva, Ana C Takakura, Niels O Câmara, Vagner R Antunes, Thiago S Moreira
NEW FINDINGS: What is the central question of this study? Microglia are presumably the source of inflammatory mediators, which contribute to hypoxia-induced neuroinflammation. However, the relationship between microglia activity during hypoxia and inflammatory responses in specific autonomic brain regions is not well understood. Therefore, we hypothesize that acute hypoxia (AH) initiates an immune response in the central nervous system elicited by an increased expression of inflammatory mediators in specific brain areas related to autonomic control...
March 12, 2018: Experimental Physiology
I Cundrle, P Suk, V Sramek, Z Lacinova, M Haluzik
Physiologically, leptin concentration is controlled by circadian rhythm. However, in critically ill patients, circadian rhythm is disrupted. Thus we hypothesized that circadian leptin concentration changes are not preserved in critically ill patients. Ten consecutive critically ill heart failure patients with the clinical indication for mechanical ventilation and sedation were included into our study. Plasma leptin concentration was measured every 4 h during the first day (0-24 h) and during the third day (48-72 h) after admission...
March 12, 2018: Physiological Research
Arnaud W Thille, Faustine Reynaud, Damien Marie, Stéphanie Barrau, Ludivine Rousseau, Christophe Rault, Véronique Diaz, Jean-Claude Meurice, Rémi Coudroy, Jean-Pierre Frat, René Robert, Xavier Drouot
Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration. We conducted a prospective physiological study performed in a French teaching hospital. ICU-patients intubated at least 24 h and difficult-to-wean were included. Complete polysomnography was performed after the first spontaneous breathing trial failure. Presence of atypical sleep, duration of sleep stages particularly rapid eye movement (REM) sleep, and electroencephalogram (EEG) reactivity at eye opening were assessed by a neurologist...
March 8, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Xiujuan Xu, Geng Zhang, Mahong Hu, Chunlian Ji, Jianbiao Meng, Zhizhen Lai, Muhua Dai, Lisha Pang, Wei Zhang
OBJECTIVE: To study the influence of clinical nutritional support on the effects of mechanical ventilation (MV), and to find the factors affecting the outcome of patients undergoing MV. METHODS: A case-control study was conducted. The clinical data of 235 patients undergoing MV admitted to intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2017 were retrospectively analyzed. The patients were divided into two groups according to whether weaning successfully within 7 days...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Qi Chen, Weidong Tang, Xuebo Shao, Lijun Zhu
OBJECTIVE: To analyze the difference between indirect calorimetry (IC) and predicted energy estimation in patients with chronic obstructive pulmonary disease (COPD), and its possible factors affecting the difference, to provide reasonable energy supply basis for COPD patients. METHODS: A prospective cohort study was conducted. Twenty-six patients with COPD undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Hangzhou City Fuyang District First People's Hospital in Zhejiang Province from January to December in 2016 were enrolled...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Christopher J Miller, Bruce A Doepker, Andrew N Springer, Matthew C Exline, Gary Phillips, Claire V Murphy
BACKGROUND: Hypo- and hyperphosphatemia are common in severe sepsis and septic shock. Published outcome data in patients with phosphate derangements primarily focus on hypophosphatemia and the general critically ill population. This study aimed to determine the impact of serum phosphate on clinical outcomes in patients with severe sepsis and septic shock. METHODS: A retrospective cohort analysis of adult mechanically ventilated patients with severe sepsis or septic shock was performed...
January 1, 2018: Journal of Intensive Care Medicine
Justin C Sowder, Mar Janna Dahl, Kaitlin R Zuspan, Kurt H Albertine, Donald M Null, Mitchell D Barneck, J Fredrik Grimmer
Objective To (1) compare physiologic changes during rigid bronchoscopy during spontaneous and mechanical ventilation and (2) evaluate the efficacy of a helium-oxygen (heliox) gas mixture as compared with room air during rigid bronchoscopy. Study Design Crossover animal study evaluating physiologic parameters during rigid bronchoscopy. Outcomes were compared with predicted computational fluid analysis. Setting Simulated ventilation via computational fluid dynamics analysis and term lambs undergoing rigid bronchoscopy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Ashley C Newell, Kelly Davis, Li Wang, David Bichell, Mark A Clay
BACKGROUND: Underweight infants with single-ventricle cardiac physiology have been shown to have increased morbidity, mortality, and resource utilization. The purpose of this study was to determine whether patients who were overweight, as defined by weight-for-length z score >90th percentile, were similarly at risk for increased resource utilization, as defined by mechanical ventilation hours (VHs) and intensive care unit length of stay (ICU LOS). METHODS: We evaluated resource utilization for 109 patients from our institution who underwent bidirectional Glenn surgery from January 2010 to June 2015 and met prespecified inclusion criteria...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Yahya Shehabi, Rinaldo Bellomo, Suhaini Kadiman, Lian Kah Ti, Belinda Howe, Michael C Reade, Tien Meng Khoo, Anita Alias, Yu-Lin Wong, Amartya Mukhopadhyay, Colin McArthur, Ian Seppelt, Steven A Webb, Maja Green, Michael J Bailey
OBJECTIVES: In the absence of a universal definition of light or deep sedation, the level of sedation that conveys favorable outcomes is unknown. We quantified the relationship between escalating intensity of sedation in the first 48 hours of mechanical ventilation and 180-day survival, time to extubation, and delirium. DESIGN: Harmonized data from prospective multicenter international longitudinal cohort studies SETTING:: Diverse mix of ICUs. PATIENTS: Critically ill patients expected to be ventilated for longer than 24 hours...
March 1, 2018: Critical Care Medicine
Margaret Disselkamp, David Adkins, Subodh Pandey, Angel O Coz Yataco
No abstract text is available yet for this article.
March 2018: Annals of the American Thoracic Society
Gail Otulakowski, Doreen Engelberts, Martin Post, Claire Masterson, Brian P Kavanagh
BACKGROUND: Lower tidal volumes are increasingly used in acute respiratory distress syndrome, but mortality has changed little in the last 20 yr. Therefore, in addition to ventilator settings, it is important to target molecular mediators of injury. Sepsis and other inflammatory states increase circulating concentrations of Gas6, a ligand for the antiinflammatory receptor Axl, and of a soluble decoy form of Axl. We investigated the effects of lung stretch on Axl signaling. METHODS: We used a mouse model of early injury from high tidal volume and assessed the effects of inhibiting Axl on in vivo lung injury (using an antagonist R428, n = 4/group)...
February 23, 2018: Anesthesiology
Vera A de Vries, Marcella C A Müller, M Sesmu Arbous, Bart J Biemond, Nicole M A Blijlevens, Nuray Kusadasi, Goda C W Choi, Alexander P J Vlaar, David J van Westerloo, Hanneke C Kluin-Nelemans, Walter M van den Bergh
A few decades ago, the chances of survival for patients with a haematological malignancy needing Intensive Care Unit (ICU) support were minimal. As a consequence, ICU admission policy was cautious. We hypothesized that the long-term outcome of patients with a haematological malignancy admitted to the ICU has improved in recent years. Furthermore, our objective was to evaluate the predictive value of the Acute Physiology and Chronic Health Evaluation (APACHE) II score. A total of 1095 patients from 5 Dutch university hospitals were included from 2003 until 2015...
February 22, 2018: British Journal of Haematology
Wan-Ling Chen, Chin-Ming Chen, Shu-Chen Kung, Ching-Min Wang, Chih-Cheng Lai, Chien-Ming Chao
This retrospective cohort study investigated the outcomes and prognostic factors in nonagenarians (patients 90 years old or older) with acute respiratory failure. Between 2006 and 2016, all nonagenarians with acute respiratory failure requiring invasive mechanical ventilation (MV) were enrolled. Outcomes including in-hospital mortality and ventilator dependency were measured. A total of 173 nonagenarians with acute respiratory failure were admitted to the intensive care unit (ICU). A total of 56 patients died during the hospital stay and the rate of in-hospital mortality was 32...
January 23, 2018: Oncotarget
Kristyna Buzkova, Martin Muller, Ales Rara, Karel Roubik, Tomas Tyll
BACKGROUND AND AIMS: During laparoscopic surgery, a capnoperitoneum is created to optimize the operating space for surgeons. One effect of this is abdominal pressure which alters the physiological thoraco-abdominal configuration and pushes the diaphragm and lungs cranially. Since the lung image acquired by electrical impedance tomography (EIT) depends on the conditions within the thorax and abdomen, it is crucial to know the diaphragm position to determine the effect of diaphragm shift on EIT thorax image...
February 21, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
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