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https://www.readbyqxmd.com/read/28331446/lung-transplantation-and-the-routine-use-of-cardiopulmonary-bypass-and-median-sternotomy-experience-at-the-ochsner-multi-organ-transplant-institute
#1
Michael Bates, Matthew Factor, P Eugene Parrino, Aditya Bansal, Reinaldo Rampolla, Leonardo Seoane, Jose Mena, Matthew Gaudet, William Smith, P Michael McFadden
BACKGROUND: From 1990-2005 at Ochsner Medical Center in New Orleans, LA, cardiopulmonary bypass (CPB) was used only when necessary during lung transplantation surgeries. Ochsner's lung transplant program was closed for more than 4 years after Hurricane Katrina, and since the program's reestablishment in 2010, the majority of lung transplantation surgeries have been performed with the patient on CPB and with a median sternotomy incision. The purpose of this study was to compare the outcomes of the CPB and non-CPB groups...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28328587/bedside-breath-wise-visualization-of-bronchospasm-by-electrical-impedance-tomography-could-improve-perioperative-patient-safety-a-case-report
#2
Pedro de la Oliva, Andreas D Waldmann, Stephan H Böhm, Cristina Verdú-Sánchez, Antonio Pérez-Ferrer, Elena Alvarez-Rojas
Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Electrical impedance tomography (EIT), a new noninvasive technique, can potentially identify bronchospasms by determining regional expiratory time constants (τ) for each one of the pixels of a functional EIT image...
March 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28323236/rationale-study-design-and-analysis-plan-of-the-lung-imaging-morphology-for-ventilator-settings-in-acute-respiratory-distress-syndrome-study-live-study-study-protocol-for-a-randomised-controlled-trial
#3
Matthieu Jabaudon, Thomas Godet, Emmanuel Futier, Jean-Etienne Bazin, Vincent Sapin, Laurence Roszyk, Bruno Pereira, Jean-Michel Constantin
Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study)...
March 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28315041/positive-pressure-ventilation-in-a-patient-with-a-right-upper-lobar-bronchocutaneous-fistula-right-upper-bronchus-occlusion-using-the-cuff-of-a-left-sided-double-lumen-endobronchial-tube
#4
Chieko Omori, Hiroaki Toyama, Yusuke Takei, Yutaka Ejima, Masanori Yamauchi
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage...
March 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28314081/delirium-after-lung-transplantation-association-with-recipient-characteristics-hospital-resource-utilization-and-mortality
#5
Yelizaveta Sher, Joshua Mooney, Gundeep Dhillon, Roy Lee, José R Maldonado
BACKGROUND: Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. METHODS: The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS and one-year mortality...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#6
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28286833/ventilator-associated-pneumonia-and-its-responsible-germs-an-epidemiological-study
#7
Rama Bozorgmehr, Vanousheh Bahrani, Alireza Fatemi
INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. METHODS: In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283007/-mortality-related-factors-in-patients-requiring-hospitalization-for-influenza-like-illness
#8
Lale Özışık, Mine Durusu Tanrıöver, Meral Çıblak Akçay, Kübra Yuntçu, Serhat Ünal, Selim Badur, Banu Çakır
The knowledge about the viral etiologies causing respiratory disease in adults is limited. Viral respiratory diseases may lead deterioration in certain patient populations. The aim of this study was to determine the viral etiologies of influenza-like illness among patients requiring hospitalization and to document the risk factors for mortality. This prospective study was performed in one of the 7 centers in Turkey in the context of influenza surveillance by the Global Influenza Hospital Surveillance Network...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28277372/one-hit-models-of-ventilator-induced-lung-injury-benign-inflammation-versus-inflammation-as-a-by-product
#9
Dennis Lex, Stefan Uhlig
BACKGROUND: One important explanation for the detrimental effects of conventional mechanical ventilation is the biotrauma hypothesis that ventilation may trigger proinflammatory responses that subsequently cause lung injury. This hypothesis has frequently been studied in so-called one-hit models (overventilation of healthy lungs) that so far have failed to establish an unequivocal link between inflammation and hypoxemic lung failure. This study was designed to develop a one-hit biotrauma model...
March 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28277322/utilizing-forced-vital-capacity-to-predict-low-lung-compliance-and-select-intraoperative-tidal-volume-during-thoracic-surgery
#10
Nir Hoftman, Eric Eikermann, John Shin, Jack Buckley, Kaveh Navab, Fereidoun Abtin, Tristan Grogan, Maxime Cannesson, Aman Mahajan
BACKGROUND: Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. METHODS: One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT)...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28276077/quantifying-the-reproducibility-of-lung-ventilation-images-between-4-dimensional-cone-beam-ct-and-4-dimensional-ct
#11
Henry C Woodruff, Chun-Chien Shieh, Fiona Hegi-Johnson, Paul J Keall, John Kipritidis
PURPOSE: Deformable image registration (DIR) based computed tomography ventilation imaging derived from four-dimensional cone-beam CT (CTVI(4)(DCBCT) ) can complement existing 4DCT-based methods (CTVI(4)(DCT) ) to track lung function changes over a course of lung cancer radiation therapy. However the accuracy of CTVI(4)(DCBCT) needs to be assessed since anatomic 4DCBCT has demonstrably poor image quality and small field of view (FOV) compared to treatment planning 4DCT. We perform a direct comparison between short interval CTVI(4)(DCBCT) and CTVI(4)(DCT) pairs to understand the patient specific image quality factors affecting the intermodality CTVI reproducibility in the clinic...
March 9, 2017: Medical Physics
https://www.readbyqxmd.com/read/28268882/noninvasive-estimation-of-alveolar-pressure
#12
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267940/a-six-month-evaluation-of-the-vivasight%C3%A2-video-double-lumen-endotracheal-tube-after-introduction-into-thoracic-anaesthetic-practice-at-a-single-institution
#13
I L Rapchuk, Sam Kunju, I J Smith, D J Faulke
For a six-month period, all airway options used for non-emergent patients undergoing thoracic surgery requiring one-lung ventilation at a single institution were assessed after introduction of the VivaSight™ double-lumen endotracheal tube (VivaSight-DL), a novel double-lumen tube with an integrated camera. This device displays a continuous view of the position of the tube relative to the carina. A total of 72 patients had lung separation with the VivaSight-DL. Lung separation was achieved on first attempt without additional manipulation in 85% of cases...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28267435/-the-right-ventricle-in-acute-respiratory-distress-syndrome
#14
REVIEW
Vasileios Zochios, Ken Parhar, William Tunnicliffe, Andrew Roscoe, Fang Gao
Acute respiratory distress syndrome is associated with poor clinical outcomes with a pooled mortality rate of approximately 40% despite best standards of care. Current therapeutic strategies are based upon improving oxygenation and pulmonary compliance while minimizing ventilator induced lung injury. It has been demonstrated that relative hypoxemia can be well tolerated and improvements in oxygenation do not necessarily translate into survival benefit. Cardiac failure, in particular right ventricular dysfunction, is commonly encountered in moderate to severe acute respiratory distress syndrome and is reported to be one of the major determinants of mortality...
March 3, 2017: Chest
https://www.readbyqxmd.com/read/28262243/pitfalls-in-the-diagnostic-management-of-pulmonary-embolism-in-pregnancy
#15
Cécile Tromeur, Liselotte M van der Pol, Frederikus A Klok, Francis Couturaud, Menno V Huisman
Women are at increased risk of venous thromboembolism (VTE) during pregnancy and VTE remains one of the main causes of maternal mortality in developed countries (Konstantinides SV, et al. Eur Heart J 2014; 35(43):3033-69, 69a-69k). Although an accurate diagnosis of acute pulmonary embolism (PE) in pregnant patients is thus of crucial importance, the diagnostic management of suspected PE is challenging for this specific patient category. As D-dimer levels increase physiologically throughout pregnancy, the optimal D-dimer threshold to rule out PE during pregnancy remains unknown...
March 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28258938/ventilation-distribution-and-small-airway-function-in-patients-with-systemic-sclerosis
#16
B R A Silva, R Rufino, C H Costa, V S Vilela, R A Levy, A J Lopes
BACKGROUND: Despite the importance of traditional pulmonary function tests (PFTs) in managing systemic sclerosis (SSc), many patients with pulmonary disease diagnosed by computed tomography (CT) present with normal PFTs. OBJECTIVE: To evaluate the efficacy of the nitrogen single-breath washout (N2SBW) test in diagnosing SSc and to correlate N2SBW parameters with the PFT indexes used in the follow-up of these patients, clinical data, and CT findings. METHODS: Cross-sectional study in which 52 consecutive SSc patients were subjected to spirometry, body plethysmography, analysis of the diffusing capacity for carbon monoxide (DLCO), analysis of respiratory muscle strength, N2SBW testing, and CT analysis...
March 1, 2017: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/28258374/polymorphism-4g-5g-of-the-plasminogen-activator-inhibitor-1-gene-as-a-risk-factor-for-the-development-of-allergic-rhinitis-symptoms-in-patients-with-asthma
#17
Marina Lampalo, Irena Jukic, Jasna Bingulac-Popovic, Ivona Marunica, Roberta Petlevski, Gordana Pavlisa, Sanja Popovic-Grle
Plasminogen activator inhibitor-1 (PAI-1) is a glycoprotein which has a role in tissue remodelling after inflammatory processes. The objective is to investigate the frequency of PAI-1 gene polymorphism (4G/5G) in patients with a lung ventilation dysfunction in asthma and allergic rhinitis. Genomic DNA was isolated and genotypes of polymorphism of PAI-1 4G/5G and ABO were determined using the methods of RT-PCR and PCR-SSP. Study group includes 145 adult patients diagnosed with chronic asthma, with all clinically relevant parameters and the laboratory markers of pO2, IgE and eosinophils in sputum and nasal swab...
March 3, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28256331/-deep-versus-moderate-neuromuscular-block-during-one-lung-ventilation-in-lung-resection-surgery
#18
Javier Casanova, Patricia Piñeiro, Francisco De La Gala, Luis Olmedilla, Patricia Cruz, Patricia Duque, Ignacio Garutti
BACKGROUND AND OBJECTIVES: Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious...
February 27, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28241695/-clinical-abservations-of-pulmonary-surfactant-s-autologous-transfusion-in-massive-lung-lavage
#19
X Y Xiao, X P Zhang, G Chen, Y Yuan, G X Ma, J Y Duan, Z Q Sun, J H Huang, X Cao, J Zhang
Objective: Investigate the pulmonary surfactant autotransfusion effect on the recovery of respiratory function in patients with whole lung lavage, to provide theoretical basis for the clinical application. Methods: We taken 30 patients of pneumoconiosis treated by whole lung lavage as the subjects. We extracted the pulmonary surfactant from lavage fluid, after single postoperative lung lavage for the first time; after one weeks when the second times of lung lavage were performed to the other side of the lung of patients, we put PS into the right side...
January 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/28240689/randomized-clinical-trial-of-a-combination-of-an-inhaled-corticosteroid-and-beta-agonist-in-patients-at-risk-of-developing-the-acute-respiratory-distress-syndrome
#20
Emir Festic, Gordon E Carr, Rodrigo Cartin-Ceba, Richard F Hinds, Valerie Banner-Goodspeed, Vikas Bansal, Adijat T Asuni, Daniel Talmor, Govindarajan Rajagopalan, Ryan D Frank, Ognjen Gajic, Michael A Matthay, Joseph E Levitt
OBJECTIVES: Effective pharmacologic treatments directly targeting lung injury in patients with the acute respiratory distress syndrome are lacking. Early treatment with inhaled corticosteroids and beta agonists may reduce progression to acute respiratory distress syndrome by reducing lung inflammation and enhancing alveolar fluid clearance. DESIGN: Double-blind, randomized clinical trial (ClinicalTrials.gov: NCT01783821). The primary outcome was longitudinal change in oxygen saturation divided by the FIO2 (S/F) through day 5...
February 24, 2017: Critical Care Medicine
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