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mechanical ventilation physiology

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https://www.readbyqxmd.com/read/28530118/readmission-to-intensive-care-unit-incidence-risk-factors-resource-use-and-outcomes-a-retrospective-cohort-study
#1
Carolina R Ponzoni, Thiago D Corrêa, Roberto R Filho, Ary Serpa Neto, Murillo Sc Assunção, Andreia Pardini, Guilherme Pp Schettino
RATIONALE: Readmission to intensive care unit (ICU) is associated with poor clinical outcomes, increased length of ICU and hospital stay and higher costs. Nevertheless, knowledge on epidemiology of ICU readmissions, risk factors and attributable outcomes are restricted to developed countries. OBJECTIVES: Determine the effect of ICU readmissions on in-hospital mortality, incidence of ICU readmissions, identify predictors of ICU readmissions and hospital mortality and compare resource use and outcomes between readmitted and nonreadmitted patients in a developing country...
May 21, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28524027/-effect-of-chest-physiotherapy-in-patients-undergoing-mechanical-ventilation-a-prospective-randomized-controlled-trial
#2
Hui Zeng, Zhen Zhang, Yuan Gong, Miao Chen
OBJECTIVE: To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28522760/on-the-existence-of-a-central-respiratory-oxygen-sensor
#3
Alexander V Gourine, Gregory D Funk
A commonly held view that dominates both the scientific and educational literature is that in terrestrial mammals the central nervous system lacks a physiological hypoxia sensor capable of triggering increases in lung ventilation in response to decreases in PO2 of the brain parenchyma. Indeed, a normocapnic hypoxic ventilatory response has never been observed in humans following bilateral resection of the carotid bodies. In contrast, almost complete or partial recovery of the hypoxic ventilatory response after denervation/removal of the peripheral respiratory oxygen chemoreceptors has been demonstrated in many experimental animals when assessed in an awake state...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28510483/improvement-in-ventilation-perfusion-mismatch-after-bronchoscopic-lung-volume-reduction-quantitative-image-analysis
#4
Sei Won Lee, Sang Min Lee, So Youn Shin, Tai Sun Park, Sang Young Oh, Namkug Kim, Yoonki Hong, Jae Seung Lee, Yeon-Mok Oh, Sang-Do Lee, Joon Beom Seo
Purpose To evaluate whether bronchoscopic lung volume reduction (BLVR) increases ventilation and therefore improves ventilation-perfusion (V/Q) mismatch. Materials and Methods All patients provided written informed consent to be included in this study, which was approved by the Institutional Review Board (2013-0368) of Asan Medical Center. The physiologic changes that occurred after BLVR were measured by using xenon-enhanced ventilation and iodine-enhanced perfusion dual-energy computed tomography (CT). Patients with severe emphysema plus hyperinflation who did not respond to usual treatments were eligible...
May 16, 2017: Radiology
https://www.readbyqxmd.com/read/28507751/validation-of-the-efficacy-of-the-prognostic-factor-score-in-the-japanese-severity-criteria-for-severe-acute-pancreatitis-a-large-multicenter-study
#5
Tsukasa Ikeura, Masayasu Horibe, Masamitsu Sanui, Mitsuhito Sasaki, Yasuyuki Kuwagata, Kenichiro Nishi, Shuji Kariya, Hirotaka Sawano, Takashi Goto, Tsuyoshi Hamada, Takuya Oda, Hideto Yasuda, Yuki Ogura, Dai Miyazaki, Kaoru Hirose, Katsuya Kitamura, Nobutaka Chiba, Tetsu Ozaki, Takahiro Yamashita, Toshitaka Koinuma, Taku Oshima, Tomonori Yamamoto, Morihisa Hirota, Satoshi Yamamoto, Kyoji Oe, Tetsuya Ito, Eisuke Iwasaki, Takanori Kanai, Kazuichi Okazaki, Toshihiko Mayumi
BACKGROUND: The Japanese severity criteria for acute pancreatitis (AP), which consist of a prognostic factor score and contrast-enhanced computed tomography grade, have been widely used in Japan. OBJECTIVE: This large multicenter retrospective study was conducted to validate the predictive value of the prognostic factor score for mortality and complications in severe AP patients in comparison to the Acute Physiology and Chronic Health Evaluation II (APACHE II) score...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28495240/risk-factors-for-pulmonary-complication-following-operative-fixation-of-spine-fractures
#6
Douglas S Weinberg, Brian Z Hedges, Jonathan E Belding, Timothy A Moore, Heather A Vallier
BACKGROUND CONTEXT: Previous studies have suggested pulmonary complications are common among patients undergoing fixation for traumatic spine fractures. This leads to prolonged hospital stay, worse functional outcomes, and increased economic burden. However, only limited prognostic information exists regarding which patients are at greatest risk for pulmonary complications. PURPOSE: To identify factors predictive of perioperative pulmonary complications in patients undergoing fixation of spine fractures...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28493819/the-choice-of-freely-preferred-cadence-by-trained-nonprofessional-cyclists-may-not-be-characterized-by-mechanical-efficiency
#7
Yitzhak Weinstein, Ron Mor-Unikowski, Shachar Nice, Shraga Hocherman, Omri Inbar
BACKGROUND: Most cycling studies involve professional cyclists. Because training may affect riding style, it is of interest to determine the physiological basis for the personal choice of cycling cadence in nonprofessional cyclists. METHODS: Eleven nonprofessional (5.2±1.7-year-riding experience) male road cyclists, aged 35.0±11.0 years, underwent four separate laboratory test sessions. The first two sessions included habituation, anthropometry, V˙O2max,$\dot V{{\text{O}}_{\text{2}}}{\text{max}},$ and lactate threshold (LaTH) measurements...
May 11, 2017: Journal of Basic and Clinical Physiology and Pharmacology
https://www.readbyqxmd.com/read/28493197/risk-factors-for-ventilator-associated-pneumonia-among-patients-undergoing-major-oncological-surgery-for-head-and-neck-cancer
#8
Yutao Liu, Yaxia Di, Shuai Fu
Patients undergoing major oncological surgery for head and neck cancer (SHNC) have a particularly high risk of nosocomial infections. We aimed to identify risk factors for ventilator-associated pneumonia (VAP) in patients undergoing SHNC. The study included 465 patients who underwent SHNC between June 2011 and June 2014. The rate of VAP, risk factors for VAP, and biological aspects of VAP were retrospectively evaluated. The incidence of VAP was 19.6% (n = 95) in patients who required more than 48 h of mechanical ventilation...
May 11, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#9
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28485315/assessment-of-1-year-outcomes-in-survivors-of-severe-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation-or-mechanical-ventilation-a-prospective-observational-study
#10
Zhi-Yong Wang, Tong Li, Chun-Ting Wang, Lei Xu, Xin-Jing Gao
BACKGROUND: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population. METHODS: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28485314/effects-of-propofol-on-respiratory-drive-and-patient-ventilator-synchrony-during-pressure-support-ventilation-in-postoperative-patients-a-prospective-study
#11
Ling Liu, Ai-Ping Wu, Yi Yang, Song-Qiao Liu, Ying-Zi Huang, Jian-Feng Xie, Chun Pan, Cong-Shan Yang, Hai-Bo Qiu
BACKGROUND: Propofol is increasingly used during partial support mechanical ventilation such as pressure support ventilation (PSV) in postoperative patients. However, breathing pattern, respiratory drive, and patient-ventilator synchrony are affected by the sedative used and the sedation depth. The present study aimed to evaluate the physiologic effects of varying depths of propofol sedation on respiratory drive and patient-ventilator synchrony during PSV in postoperative patients. METHODS: Eight postoperative patients receiving PSV for <24 h were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28465843/hypercapnea-and-acidemia-despite-hyperventilation-following-endotracheal-intubation-in-a-case-of-unknown-severe-salicylate-poisoning
#12
Shannon M Fernando, Valérie Charbonneau, Hans Rosenberg
Salicylates are common substances for deliberate self-harm. Acute salicylate toxicity is classically associated with an initial respiratory alkalosis, followed by an anion gap metabolic acidosis. The respiratory alkalosis is achieved through hyperventilation, driven by direct stimulation on the respiratory centers in the medulla and considered as a compensatory mechanism to avoid acidemia. However, in later stages of severe salicylate toxicity, patients become increasingly obtunded, with subsequent loss of airway reflexes, and therefore intubation may be necessary...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28462121/effects-of-environmental-temperature-on-physiological-responses-during-submaximal-and-maximal-exercises-in-soccer-players
#13
MiHyun No, Hyo-Bum Kwak
BACKGROUND: Although thermoregulation is effective in regulating body temperature under normal conditions, exercise or physical activity in extreme cold or heat exerts heavy stress on the mechanisms that regulate body temperature. The purpose of this study was to investigate the effects of environmental temperature on physiological responses and endurance exercise capacity during submaximal and maximal exercises in healthy adults. METHODS: Nine male soccer players participated in this study...
September 2016: Integr Med Res
https://www.readbyqxmd.com/read/28461543/predictive-associations-of-music-anxiety-and-sedative-exposure-on-mechanical-ventilation-weaning-trials
#14
Breanna Hetland, Ruth Lindquist, Craig R Weinert, Cynthia Peden-McAlpine, Kay Savik, Linda Chlan
BACKGROUND: Weaning from mechanical ventilation requires increased respiratory effort, which can heighten anxiety and later prolong the need for mechanical ventilation. OBJECTIVES: To examine the predictive associations of music intervention, anxiety, sedative exposure, and patients' characteristics on time to initiation and duration of weaning trials of patients receiving mechanical ventilation. METHODS: A descriptive, correlational design was used for a secondary analysis of data from a randomized trial...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28459412/-high-flow-nasal-cannula-in-patients-after-trachea-extubation
#15
Jiawei Shen, Youzhong An
Acute respiratory failure (ARF) is one primary cause of intensive care unit (ICU) admittance, which is usually treated with intubation and mechanical ventilation in order to maintain a necessary ventilation and oxygenation function. After the remove of trachea tube, available oxygenation supports include nasal cannula, venturi mask, non-invasive ventilator and high flow nasal cannula (HFNC). In this article we reviewed the physiological mechanism related to HFNC therapy and trails about the application of HFNC in extubated patients...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459409/-correlation-factor-analysis-on-constipation-in-long-term-ventilated-patients-in-intensive-care-unit-a-prospective-observational-cohort-study
#16
Mingying Dai, Huimin Wang, Kun Li, Bangxu Yu, Xinting Pan
OBJECTIVE: To explore the factors associated with delayed defecation in long-term ventilated patients in intensive care unit (ICU) and their potential effect on prognosis. METHODS: A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days)...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459402/-effect-of-different-transpulmonary-pressures-guided-mechanical-ventilation-on-respiratory-and-hemodynamics-of-patients-with-ards-a-prospective-randomized-controlled-trial
#17
Jianqiu Li, Zhihui Luo, Xiaolei Li, Zhongyi Huang, Jie Han, Zifeng Li, Zhaoxiong Zhou, Houwang Chen
OBJECTIVE: To assess the effect of different transpulmonary pressures (Ptp) guided mechanical ventilation (MV) on respiratory function and hemodynamics parameters of patients with acute respiratory distress syndrome (ARDS), and to find out a more optimized Ptp. METHODS: A prospective randomized controlled trial (RCT) was conducted. The ventilated patients with ARDS admitted to Department of Critical Care Medicine (ICU) of Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University and Department of Emergency and Critical Care Medicine (EICU) of Shenzhen Hospital of South Medical University from February 2013 to August 2016 were enrolled...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459401/-value-of-procalcitonin-on-predicting-the-severity-and-prognosis-in-patients-with-early-ards-a-prospective-observation-study
#18
Zhixin Yu, Musen Ji, Xiulan Hu, Jun Yan, Zhaochen Jin
OBJECTIVE: To investigate the value of procalcitonin (PCT) on predicting the severity and prognosis in patients with early acute respiratory distress syndrome (ARDS). METHODS: A prospective observation study was conducted. A total of 113 patients with ARDS undergoing mechanical ventilation admitted to intensive care unit (ICU) of Affiliated People's Hospital of Jiangsu University from October 2012 to April 2016 were enrolled. Based on oxygenation index (PaO2/FiO2), the patients were classified into mild, moderate, and severe groups according to Berlin Definition...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28452761/respiratory-gated-kes-imaging-of-a-rat-model-of-acute-lung-injury-at-the-canadian-light-source
#19
P Deman, S Tan, G Belev, N Samadi, M Martinson, D Chapman, N L Ford
In this study, contrast-enhanced X-ray tomographic imaging for monitoring and quantifying respiratory disease in preclinical rodent models is proposed. A K-edge imaging method has been developed at the Canadian Light Source to very accurately obtain measurements of the concentration of iodinated contrast agent in the pulmonary vasculature and inhaled xenon in the airspaces of rats. To compare the iodine and xenon concentration maps, a scout projection image was acquired to define the region of interest within the thorax for imaging and to ensure the same locations were imaged in each K-edge subtraction (KES) acquisition...
May 1, 2017: Journal of Synchrotron Radiation
https://www.readbyqxmd.com/read/28448528/minimally-invasive-estimation-of-ventricular-dead-space-volume-through-use-of-frank-starling-curves
#20
Shaun Davidson, Chris Pretty, Antoine Pironet, Thomas Desaive, Nathalie Janssen, Bernard Lambermont, Philippe Morimont, J Geoffrey Chase
This paper develops a means of more easily and less invasively estimating ventricular dead space volume (Vd), an important, but difficult to measure physiological parameter. Vd represents a subject and condition dependent portion of measured ventricular volume that is not actively participating in ventricular function. It is employed in models based on the time varying elastance concept, which see widespread use in haemodynamic studies, and may have direct diagnostic use. The proposed method involves linear extrapolation of a Frank-Starling curve (stroke volume vs end-diastolic volume) and its end-systolic equivalent (stroke volume vs end-systolic volume), developed across normal clinical procedures such as recruitment manoeuvres, to their point of intersection with the y-axis (where stroke volume is 0) to determine Vd...
2017: PloS One
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