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https://www.readbyqxmd.com/read/28913327/in-vivo-evaluation-of-the-acute-pulmonary-response-to-poractant-alfa-and-bovactant-treatments-in-lung-lavaged-adult-rabbits-and-in-preterm-lambs-with-respiratory-distress-syndrome
#1
Francesca Ricci, Fabrizio Salomone, Elke Kuypers, Daan Ophelders, Maria Nikiforou, Monique Willems, Tobias Krieger, Xabier Murgia, Matthias Hütten, Boris W Kramer, Federico Bianco
BACKGROUND: Poractant alfa (Curosurf(®)) and Bovactant (Alveofact(®)) are two animal-derived pulmonary surfactants preparations approved for the treatment of neonatal respiratory distress syndrome (nRDS). They differ in their source, composition, pharmaceutical form, and clinical dose. How much these differences affect the acute pulmonary response to treatment is unknown. OBJECTIVES: Comparing these two surfactant preparations in two different animal models of respiratory distress focusing on the short-term response to treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28910340/successful-1-1-proportion-ventilation-with-a-unique-device-for-independent-lung-ventilation-using-a-double-lumen-tube-without-complications-in-the-supine-and-lateral-decubitus-positions-a-pilot-study
#2
Michał Kowalczyk, Sławomir Sawulski, Wojciech Dąbrowski, Luiza Grzycka-Kowalczyk, Edyta Kotlińska-Hasiec, Agnieszka Wrońska-Sewruk, Artur Florek, Rafał Rutyna
INTRODUCTION: Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics...
2017: PloS One
https://www.readbyqxmd.com/read/28898345/-endoscopic-lung-volume-reduction-in-advanced-pulmonary-emphysema-initial-experience-in-chile
#3
Sebastián Fernández-Bussy, Gonzalo Labarca, Iván Caviedes, Hiren J Mehta, Michael Jantz, Adnan Majid
Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28893201/determination-of-the-optimal-inspiratory-pressure-providing-adequate-ventilation-while-minimizing-gastric-insufflation-using-real-time-ultrasonography-in-chinese-children-a-prospective-randomized-double-blind-study
#4
Xiaowei Qian, Qiong Hu, Hang Zhao, Bo Meng, Yang Nan, Hong Cao, Qingquan Lian, Jun Li
BACKGROUND: During facemask ventilation, gastric insufflation is defined as appearance of a comet-tail or an acoustic shadow on ultrasonography. Ultrasonographic measurement of antral cross-section area (CSA) may reflect an insufflated antrum and provide interesting semi-quantitative data in regard to the gastric insufflation. This study aimed to determine the appropriate level of inspiratory pressure sufficient to provide adequate pulmonary ventilation with a lower occurrence of gastric insufflation during facemask pressure-controlled ventilation using real-time ultrasonography in paralyzed children...
September 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28889192/the-economic-impact-of-prematurity-and-bronchopulmonary-dysplasia
#5
María Álvarez-Fuente, Luis Arruza, Marta Muro, Carlos Zozaya, Alejandro Avila, Paloma López-Ortego, Carmen González-Armengod, Alba Torrent, Jose Luis Gavilán, María Jesús Del Cerro
Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed...
September 9, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28882385/lung-deposition-and-systemic-bioavailability-of-different-aerosol-devices-with-and-without-humidification-in-mechanically-ventilated-patients
#6
Islam O F Moustafa, Mohammed R A-A Ali, Moataz Al Hallag, Hoda Rabea, James B Fink, Patricia Dailey, Mohamed E A Abdelrahim
BACKGROUND: During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. METHODS: In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups...
September 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28877216/an-in-vitro-lung-model-to-assess-true-shunt-fraction-by-multiple-inert-gas-elimination
#7
Balamurugan Varadarajan, Andreas Vogt, Volker Hartwich, Rakesh Vasireddy, Jolanda Consiglio, Beate Hugi-Mayr, Balthasar Eberle
The Multiple Inert Gas Elimination Technique, based on Micropore Membrane Inlet Mass Spectrometry, (MMIMS-MIGET) has been designed as a rapid and direct method to assess the full range of ventilation-to-perfusion (V/Q) ratios. MMIMS-MIGET distributions have not been assessed in an experimental setup with predefined V/Q-distributions. We aimed (I) to construct a novel in vitro lung model (IVLM) for the simulation of predefined V/Q distributions with five gas exchange compartments and (II) to correlate shunt fractions derived from MMIMS-MIGET with preset reference shunt values of the IVLM...
2017: PloS One
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#8
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871631/characteristics-and-outcomes-among-patients-with-need-of-early-dialysis-after-lung-transplantation-surgery
#9
Amit Banga, Manish Mohanka, Jessica Mullins, Srinivas Bollineni, Vaidehi Kaza, Bekir Tanriover, Fernando Torres
BACKGROUND: With the introduction of lung allocation (LAS), increasingly sicker patients are undergoing lung transplantation (LT). The current study was conducted to determine the time trends in need of dialysis after LT, identify variables independently associated with need of dialysis and evaluate its association with one and five-year mortality. METHODS: We queried the UNOS database for adult patients undergoing LT between 1994 and 2014. We excluded patients with simultaneous dual organ transplantation and where data regarding the need of dialysis was not available...
September 4, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28865973/recovery-of-pulmonary-function-after-allogeneic-hematopoietic-cell-transplantation-in-children-is-associated-with-improved-survival
#10
Ashok Srinivasan, Anusha Sunkara, William Mitchell, Sudeep Sunthankar, Guolian Kang, Dennis C Stokes, Saumini Srinivasan
Abnormal pulmonary function is prevalent in survivors of allogeneic hematopoietic cell transplantation. Post-transplant recovery of pulmonary function, and its effect on survival in children is not known. This is a retrospective cohort study of 308 children followed for 10 years after transplantation at a single institution. There were 2 groups of patients. Group 1 included 188 patients with 3 or more pulmonary function test (PFT) results, of which at least 1 was abnormal, group 2 included 120 patients with 3 or more PFTs, all of which were normal...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864030/a-fatal-outbreak-of-st11-carbapenem-resistant-hypervirulent-klebsiella-pneumoniae-in-a-chinese-hospital-a-molecular-epidemiological-study
#11
Danxia Gu, Ning Dong, Zhiwei Zheng, Di Lin, Man Huang, Lihua Wang, Edward Wai-Chi Chan, Lingbin Shu, Jiang Yu, Rong Zhang, Sheng Chen
BACKGROUND: Hypervirulent Klebsiella pneumoniae strains often cause life-threatening community-acquired infections in young and healthy hosts, but are usually sensitive to antibiotics. In this study, we investigated a fatal outbreak of ventilator-associated pneumonia caused by a new emerging hypervirulent K pneumoniae strain. METHODS: The outbreak occurred in the integrated intensive care unit of a new branch of the Second Affiliated Hospital of Zhejiang University (Hangzhou, China)...
August 29, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28856715/feasibility-of-quantitative-regional-ventilation-and-perfusion-mapping-with-phase-resolved-functional-lung-preful-mri-in-healthy-volunteers-and-copd-cteph-and-cf-patients
#12
Andreas Voskrebenzev, Marcel Gutberlet, Filip Klimeš, Till F Kaireit, Christian Schönfeld, Alexander Rotärmel, Frank Wacker, Jens Vogel-Claussen
PURPOSE: In this feasibility study, a phase-resolved functional lung imaging postprocessing method for extraction of dynamic perfusion and ventilation parameters using a conventional 1H lung MRI Fourier decomposition acquisition is introduced. METHODS: Time series of coronal gradient-echo MR images with a temporal resolution of 288 to 324 ms of two healthy volunteers, one patient with chronic thromboembolic hypertension, one patient with cystic fibrosis, and one patient with chronic obstructive pulmonary disease were acquired at 1...
August 30, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28843606/impact-of-low-tidal-volumes-during-one-lung-ventilation-a-meta-analysis-of-randomized-controlled-trials
#13
Mohamed R El Tahan, Laura Pasin, Nandor Marczin, Giovanni Landoni
OBJECTIVES: The link between ventilation strategies and perioperative outcomes remains one of the fundamental paradigms of thoracic anaesthesia. During one-lung ventilation (OLV), one lung is excluded from gas exchange and ventilation is directed at the dependent lung. The authors hypothesised that the use of low tidal volumes (VT) during OLV provides adequate gas exchange and improves postoperative outcome. DESIGN: Meta-analysis of randomized clinical trials. SETTING: Thoracic surgery...
June 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28842155/the-history-of-one-lung-anesthesia-and-the-double-lumen-tube
#14
REVIEW
Brendan McGrath, Christopher Tennuci, George Lee
One-lung anesthesia presents many practical, anatomical, and physiological challenges to the anesthetist in modern day practice. The techniques and equipment that we use today have developed slowly over the course of the last century. The idea of isolated lung ventilation came from bronchospirometry studies by pioneering physiologists as early as 1871, and some of their original equipment was adapted for clinical use in the 1930s. Anesthetic techniques have generally been developed to facilitate surgical advances, and the development of double-lumen tubes is no exception...
July 2017: Journal of Anesthesia History
https://www.readbyqxmd.com/read/28840003/expedite-recovery-from-esophagectomy-and-reconstruction-for-esophageal-squamous-cell-carcinoma-after-perioperative-management-protocol-reinvention
#15
Yu-Wei Liu, Fan-Wei Yan, Dong-Lin Tsai, Hsien-Pin Li, Yen-Lung Lee, Hung-Hsing Chiang, Hung-Te Hsu, Hung-Yi Chuang, Shah-Hwa Chou
BACKGROUND: Surgery for esophageal cancer is invasive and challenging, and always to be followed with arduous post-operative care and recovery. This study, maybe one of the first in Asian populations, is to determine whether a reinvented protocol for perioperative management for esophageal cancer surgery which is being implemented in our department, will lead to a faster convalescence and also significantly decrease financial burdens garnered by patients during hospitalization. METHODS: Operated on by the same surgeon and team in the same hospital, consecutive patients who had received esophagectomy and reconstruction for esophageal squamous cell carcinoma were retrospectively reviewed...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28839496/use-of-nasal-non-invasive-ventilation-with-a-ram-cannula-in-the-outpatient-home-setting
#16
Wilfredo De Jesus Rojas, Cheryl L Samuels, Traci R Gonzales, Katrina E McBeth, Aravind Yadav, James M Stark, Cindy Jon, Ricardo A Mosquera
BACKGROUND: Nasal non-invasive-ventilation (Nasal NIV) is a mode of ventilatory support providing positive pressure to patients via a nasal interface. The RAM Cannula is an oxygen delivery device that can be used as an alternative approach to deliver positive pressure. Together they have been successfully used to provide respiratory support in neonatal in-patient settings. OBJECTIVE: To describe the outpatient use of Nasal NIV/RAM Cannula as a feasible alternative for home respiratory support in children with chronic respiratory failure...
2017: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/28828363/positive-end-expiratory-pressure-how-to-set-it-at-the-individual-level
#17
REVIEW
Luciano Gattinoni, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Federica Romitti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The positive end-expiratory pressure (PEEP), since its introduction in the treatment of acute respiratory failure, up to the 1980s was uniquely aimed to provide a viable oxygenation. Since the first application, a large debate about the criteria for selecting the PEEP levels arose within the scientific community. Lung mechanics, oxygen transport, venous admixture thresholds were all proposed, leading to PEEP recommendations from 5 up to 25 cmH2O. Throughout this period, the main concern was the hemodynamics...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828361/driving-pressure-and-mechanical-power-new-targets-for-vili-prevention
#18
REVIEW
Tommaso Tonetti, Francesco Vasques, Francesca Rapetti, Giorgia Maiolo, Francesca Collino, Federica Romitti, Luigi Camporota, Massimo Cressoni, Paolo Cadringher, Michael Quintel, Luciano Gattinoni
Several factors have been recognized as possible triggers of ventilator-induced lung injury (VILI). The first is pressure (thus the 'barotrauma'), then the volume (hence the 'volutrauma'), finally the cyclic opening-closing of the lung units ('atelectrauma'). Less attention has been paid to the respiratory rate and the flow, although both theoretical considerations and experimental evidence attribute them a significant role in the generation of VILI. The initial injury to the lung parenchyma is necessarily mechanical and it could manifest as an unphysiological distortion of the extracellular matrix and/or as micro-fractures in the hyaluronan, likely the most fragile polymer embedded in the matrix...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828360/transpulmonary-pressure-importance-and-limits
#19
REVIEW
Domenico Luca Grieco, Lu Chen, Laurent Brochard
Transpulmonary pressure (PL) is computed as the difference between airway pressure and pleural pressure and separates the pressure delivered to the lung from the one acting on chest wall and abdomen. Pleural pressure is measured as esophageal pressure (PES) through dedicated catheters provided with esophageal balloons. We discuss the role of PL in assessing the effects of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). In the supine position, directly measured PL represents the pressure acting on the alveoli and airways...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828357/definition-and-epidemiology-of-acute-respiratory-distress-syndrome
#20
REVIEW
Emanuele Rezoagli, Roberto Fumagalli, Giacomo Bellani
Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians...
July 2017: Annals of Translational Medicine
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