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One lung ventilation

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https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#1
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#2
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28818610/surfactant-and-continuous-positive-airway-pressure-for-the-prevention-of-chronic-lung-disease-history-reality-and-new-challenges
#3
REVIEW
Hany Aly, Mohamed A Mohamed, Jen-Tien Wung
The discovery of surfactant was one of the most significant research events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered non-viable. However, the prevention of chronic lung disease did not progress and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. A dilemma exists over the priorities in premature management to intubate and administer surfactant or not to intubate and support these infants non-invasively with the use of continuous positive airway pressure...
August 14, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#4
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28808186/oxygenation-inflammatory-response-and-lung-injury-during-one-lung-ventilation-in-rabbits-using-inspired-oxygen-fraction-of-0-6-vs-1-0
#5
Zeping Xu, Lianbing Gu, Qingming Bian, Pengyi Li, Lijun Wang, Jingyuan Zhang, Yanning Qian
Maintaining adequate oxygenation during one-lung ventilation (OLV) requires high inspired oxygen fraction (FiO2). However, high FiO2 also causes inflammatory response and lung injury. Therefore, it remains a great interest to clinicians and scientists to optimize the care of patients undergoing OLV. The aim of this study was to determine and compare oxygenation, inflammatory response and lung injury during OLV in rabbits using FiO2 of 0.6 vs. 1.0. After 30 minutes of two-lung ventilation (TLV) as baseline, 30 rabbits were randomly assigned to three groups receiving mechanical ventilation for 3 hours: the sham group, receiving TLV with 0...
October 17, 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28807576/evaluation-of-three-tidal-volumes-10-12-and-15%C3%A2-ml%C3%A2-kg-1-in-dogs-for-controlled-mechanical-ventilation-assessed-by-volumetric-capnography-a-randomized-clinical-trial
#6
Seline Bumbacher, Johannes P Schramel, Martina Mosing
OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg(-1)) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg(-1). After induction CMV was started...
May 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28804889/a-randomised-trial-comparing-real-time-double-lumen-endobronchial-tube-placement-with-the-disposcope-%C3%A2-with-conventional-blind-placement
#7
P T Chen, C K Ting, M Y Lee, H W Cheng, K H Chan, W K Chang
Double-lumen endobronchial tube placement is challenging. This study compared double-lumen tube placement with the Disposcope(®) , a wireless videostylet allowing real-time visualisation, with conventional blind placement. Patients undergoing elective thoracic surgery with normal airways requiring one-lung ventilation were randomly allocated into two groups (27 patients in each group). The Disposcope was used to assist left-sided double-lumen tube placement in one group, and conventional blind placement was performed in the control group...
September 2017: Anaesthesia
https://www.readbyqxmd.com/read/28803774/do-low-tidal-volumes-decrease-lung-injury-during-one-lung-ventilation
#8
EDITORIAL
Peter D Slinger
No abstract text is available yet for this article.
July 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800989/a-prospective-comparison-of-intraluminal-and-extraluminal-placement-of-the-9-french-arndt-bronchial-blocker-in-adult-thoracic-surgery-patients
#9
T Wesley Templeton, Benjamin N Morris, Eduardo J Goenaga-Diaz, Daniel J Forest, Rhett Hadley, Blake A Moore, Yvon F Bryan, Roger L Royster
OBJECTIVE: To compare the standard intraluminal approach with the placement of the 9-French Arndt endobronchial blocker with an extraluminal approach by measuring the time to positioning and other relevant intraoperative and postoperative parameters. DESIGN: A prospective, randomized, controlled trial. SETTING: University hospital. PARTICIPANTS: The study comprised 41 patients (20 intraluminal, 21 extraluminal) undergoing thoracic surgery...
August 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28794867/rapid-onset-of-amiodarone-induced-pulmonary-toxicity-after-lung-lobe-resection-a-case-report-and-review-of-recent-literature
#10
Heiko Baumann, Phillip Fichtenkamm, Thomas Schneider, Jürgen Biscoping, Michael Henrich
Amiodarone-induced pulmonary toxicity (APT) is a severe side effect that can lead to lung fibrosis or fatal respiratory failure. Usually APT occurs during long term therapy after administration of prolonged loading doses or high cumulative doses. We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection. She developed atrial fibrillation with hemodynamic-instability on the first post-operative day. We initiated amiodarone therapy and four days later she developed respiratory failure...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28794843/whole-lung-lavage-complicated-with-pneumothorax-a-case-report
#11
Hyun-Joo Ahn, Mikyung Yang, Jie Ae Kim, Burnyoung Heo, Jin-Kyoung Kim, So Yoon Park
A patient with pulmonary alveolar proteinosis underwent whole lung lavage of the right lung. Lavage of the left lung was not immediately possible because of severe hypoxemia. Three days later, after correction of hypoxemia, we re-attempted the left lung lavage. However, the patient had severe hypoxemia (SpO2 < 80%) within a few minutes of performing right one lung ventilation (OLV). On bronchoscopic examination, proper tube location was confirmed. Bronchodilator nebulization and steroid injection were attempted with no effect...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28790813/asynchrony-in-respiratory-movements-between-the-pulmonary-lobes-in-patients-with-copd-continuous-measurement-of-lung-density-by-4-dimensional-dynamic-ventilation-ct
#12
Tsuneo Yamashiro, Hiroshi Moriya, Shin Matsuoka, Yukihiro Nagatani, Maho Tsubakimoto, Nanae Tsuchiya, Sadayuki Murayama
PURPOSE: Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT. MATERIALS AND METHODS: Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28775071/the-acute-effects-of-long-acting-bronchodilators-on-small-airways-detected-in-copd-patients-by-single-breath-n2-test-and-lung-p-v-curve
#13
Matteo M Pecchiari, Pierachille Santus, Dejan Radovanovic, Edgardo Giacomo D'Angelo
Small airways represent the key factor of chronic obstructive pulmonary disease (COPD) pathophysiology. The effect of different classes of bronchodilators on small airways is still poorly understood and difficult to assess. Hence, the acute effects of tiotropium (18 µg) and indacaterol (150 µg) on closing volume (CV) and ventilation inhomogeneity were investigated and compared in 51 stable patients (mean age (SD): 70±7 years; 82% males) with moderate to very severe COPD. Patients underwent body-plethysmography, arterial blood gas-analysis, tidal expiratory flow limitation (EFL), dyspnea assessment, and simultaneous recording of single breath nitrogen test (SBN) and transpulmonary pressure-volume curve (PL-V), before and one hour after drug administration...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28774356/prevention-of-bronchopulmonary-dysplasia-current-strategies
#14
Deepak Jain, Eduardo Bancalari
Bronchopulmonary dysplasia (BPD) is one of the few diseases affecting premature infants that have continued to evolve since its first description about half a century ago. The current form of BPD, a more benign and protracted respiratory failure in extremely preterm infants, is in contrast to the original presentation of severe respiratory failure with high mortality in larger premature infants. This new BPD is end result of complex interplay of various antenatal and postnatal factors causing lung injury and subsequent abnormal repair leading to altered alveolar and vascular development...
August 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28768120/investigation-of-lung-pharmacokinetic-of-the-novel-pde4-inhibitor-chf6001-in-preclinical-models-evaluation-of-the-preciseinhale-technology
#15
Alessandro Fioni, Ewa Selg, Valentina Cenacchi, Fernando Acevedo, Giandomenico Brogin, Per Gerde, Paola Puccini
BACKGROUND: Preclinical evaluation of new chemical entities (NCEs) designed to be administered by inhalation route requires lung administration to rodents, especially in the discovery phase. Different administration methods have been used until now, but more efforts are required to obtain controlled and reproducible lung deposition when only small amounts of neat powder material are available. METHODS: The PreciseInhale platform used in the present study enables well-controlled powder aerosol exposures with only small amounts of micronized neat material, providing data on inhalation pharmacokinetic (PK) of NCEs at a very early stage...
August 2, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28765496/impact-of-a-post-discharge-integrated-disease-management-program-on-copd-hospital-readmissions
#16
Ashlee N Russo, Gayathri Sathiyamoorthy, Chris Lau, Didem Saygin, Xiaozhen Han, Xiao-Feng Wang, Richard Rice, Loutfi S Aboussouan, James K Stoller, Umur Hatipoğlu
BACKGROUND: Readmission following a hospitalization for COPD is associated with significant health-care expenditure. METHODS: A multicomponent COPD post-discharge integrated disease management program was implemented at the Cleveland Clinic to improve the care of patients with COPD and reduce readmissions. This retrospective study reports our experience with the program. Groups of subjects who were exposed to different components of the program were compared regarding their readmission rates...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28763898/-effect-of-single-lumen-endobronchial-tube-and-double-lumen-endobronchial-tube-on-ventilation-and-lung-injury-in-patients-with-esophageal-cancer-undergoing-combined-thoracoscopic-and-laparoscopic-esophagectomy
#17
Y L Sun, Y Bai, T K Li, S G Lü, L Wang, X H Lu
Objective: To investigate the effect of the single lumen endobronchial tube and the double lumen endobronchial tube on ventilation and lung injury in patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy. Methods: Sixty patients with esophageal cancer undergoing combined thoracoscopic and laparoscopic esophagectomy were divided into single lumen endobronchial tube group (D group, n=30) and double lumen endobronchial tube group (S, n=30) according to the random number table...
July 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28763474/effects-of-individualized-electrical-impedance-tomography-and-image-reconstruction-settings-upon-the-assessment-of-regional-ventilation-distribution-comparison-to-4-dimensional-computed-tomography-in-a-porcine-model
#18
Florian Thürk, Stefan Boehme, Daniel Mudrak, Stefan Kampusch, Alice Wielandner, Helmut Prosch, Christina Braun, Frédéric P R Toemboel, Johannes Hofmanninger, Eugenijus Kaniusas
Electrical impedance tomography (EIT) is a promising imaging technique for bedside monitoring of lung function. It is easily applicable, cheap and requires no ionizing radiation, but clinical interpretation of EIT-images is still not standardized. One of the reasons for this is the ill-posed nature of EIT, allowing a range of possible images to be produced-rather than a single explicit solution. Thus, to further advance the EIT technology for clinical application, thorough examinations of EIT-image reconstruction settings-i...
2017: PloS One
https://www.readbyqxmd.com/read/28760476/continuous-procedural-full-lung-ventilation-during-minimally-invasive-coronary-bypass-grafting
#19
Stephan Sixt, Hug Aubin, Robert Kalb, Philipp Rellecke, Artur Lichtenberg, Alexander Albert
BACKGROUND: In the past, minimally invasive cardiac surgery (MICS)- coronary artery bypass graft surgery (CABG) alternatives have been introduced that dramatically reduce the invasiveness of standard operative procedures while still showing excellent clinical outcomes. However, in patients with high morbidity, reduced lung function impeding single-lung ventilation is one of the major concerns for MICS-CABG procedures, although those patients might reap the largest benefit from a procedure of reduced invasiveness...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28760317/evaluating-the-use-of-a-stability-guideline-for-long-term-ventilator-dependent-children-discharging-to-home-a%C3%A2-quality-improvement-project
#20
Jacquie Hanks, Catherine A Carrico
INTRODUCTION: Defining stability before discharge for children with severe chronic lung disease requiring home ventilation has historically been dependent on an individual provider's opinion. METHODS: An institutional guideline based on expert opinion was used for patients who were first discharged home on mechanical ventilation. A retrospective review determined if the guideline was used. Electronic medical record changes were initiated to improve compliance with the guideline...
July 28, 2017: Journal of Pediatric Health Care
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