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Single lung ventilation

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https://www.readbyqxmd.com/read/29452598/7-versus-14-days-of-antibiotic-treatment-for-critically-ill-patients-with-bloodstream-infection-a-pilot-randomized-clinical-trial
#1
Nick Daneman, Asgar H Rishu, Ruxandra Pinto, Pierre Aslanian, Sean M Bagshaw, Alex Carignan, Emmanuel Charbonney, Bryan Coburn, Deborah J Cook, Michael E Detsky, Peter Dodek, Richard Hall, Anand Kumar, Francois Lamontagne, Francois Lauzier, John C Marshall, Claudio M Martin, Lauralyn McIntyre, John Muscedere, Steven Reynolds, Wendy Sligl, Henry T Stelfox, M Elizabeth Wilcox, Robert A Fowler
BACKGROUND: Shorter-duration antibiotic treatment is sufficient for a range of bacterial infections, but has not been adequately studied for bloodstream infections. Our systematic review, survey, and observational study indicated equipoise for a trial of 7 versus 14 days of antibiotic treatment for bloodstream infections; a pilot randomized clinical trial (RCT) was a necessary next step to assess feasibility of a larger trial. METHODS: We conducted an open, pilot RCT of antibiotic treatment duration among critically ill patients with bloodstream infection across 11 intensive care units (ICUs)...
February 17, 2018: Trials
https://www.readbyqxmd.com/read/29450740/perfluorocarbon-induces-alveolar-epithelial-cell-response-through-structural-and-mechanical-remodeling
#2
Sofia André Dias, Emmanuelle Planus, Christelle Angely, Luc Lotteau, Renaud Tissier, Marcel Filoche, Bruno Louis, Gabriel Pelle, Daniel Isabey
During total liquid ventilation, lung cells are exposed to perfluorocarbon (PFC) whose chemophysical properties highly differ from standard aqueous cell feeding medium (DMEM). We herein perform a systematic study of structural and mechanical properties of A549 alveolar epithelial cells in order to characterize their response to PFC exposure, using DMEM as control condition. Changes in F-actin structure, focal adhesion density and glycocalyx distribution are evaluated by confocal fluorescent microscopy. Changes in cell mechanics and adhesion are measured by multiscale magnetic twisting cytometry (MTC)...
February 15, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29435739/multiparametric-magnetic-resonance-imaging-in-the-assessment-of-pulmonary-hypertension-initial-experience-of-a-one-stop-study
#3
Gisela M B Meyer, Fernanda B Spilimbergo, Stephan Atmayer, Gabriel S Pacini, Matheus Zanon, Guilherme Watte, Edson Marchiori, Bruno Hochhegger
INTRODUCTION: Our goal was to assess the diagnostic performance of magnetic resonance imaging (MRI) as a single method to diagnose pulmonary hypertension (PH) compared to right heart catheterization (RHC), computed tomography (CT), and ventilation/perfusion (V/Q) scintigraphy. METHODS: We identified 35 patients diagnosed with PH by RHC in our institution who have also undergone a CT, a scintigraphy, and an MRI within a month. All cases were discussed in multidisciplinary meetings...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29435738/alveolar-tidal-recruitment-derecruitment-and-overdistension-during-four-levels-of-end-expiratory-pressure-with-protective-tidal-volume-during-anesthesia-in-a-murine-lung-healthy-model
#4
Joao Henrique Neves Soares, Alysson Roncally Carvalho, Bruno Curty Bergamini, Maria Alice Kuster Gress, Frederico Caetano Jandre, Walter Araujo Zin, Antonio Giannella-Neto
PURPOSE: We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. METHODS: Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs × V(t) + R rs × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1 + E 2 × V(t)) × V(t) + (K 1 + K 2 × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2 × F are flow-independent and flow-dependent R rs , respectively...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29430803/an-initial-experience-with-an-extraluminal-ez-blocker-%C3%A2-a-new-alternative-for-1-lung-ventilation-in-pediatric-patients
#5
Thomas Wesley Templeton, Leah B Templeton, Ann E Lawrence, Leah M Sieren, Martina G Downard, Douglas G Ririe
BACKGROUND: The need for 1-lung ventilation in school age, pediatric patients is uncommon and as a result there are relatively few devices available to facilitate lung isolation in this population. Furthermore, little is known about the efficacy and techniques of placement of the currently available devices. One of the newest devices available that may be appropriate in this age group is the EZ-Blocker. AIMS: We aimed to examine our initial experience with the EZ-Blocker to evaluate the performance of this device with respect to potential improvements in technique and patient selection going forward...
February 11, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29425463/genome-wide-association-study-in-african-americans-with-acute-respiratory-distress-syndrome-identifies-the-selectin-p-ligand-gene-as-a-risk-factor
#6
Christian Bime, Nima Pouladi, Saad Sammani, Ken Batai, Nancy Casanova, Tong Zhou, Carrie L Kempf, Xiaoguang Sun, Sara M Camp, Ting Wang, Rick A Kittles, Yves A Lussier, Tiffanie K Jones, John P Reilly, Nuala J Meyer, Jason D Christie, Jason Karnes, Manuel Gonzalez-Garay, David C Christiani, Charles R Yates, Mark M Wurfel, Gianfranco U Meduri, Joe G N Garcia
RATIONALE: Genetic factors are involved in acute respiratory distress syndrome (ARDS) susceptibility. Identification of novel candidate genes associated with increased risk and severity will improve our understanding of ARDS pathophysiology and enhance efforts to develop novel preventive and therapeutic approaches. METHODS: A genome-wide association study was performed on 232 African-American patients with ARDS and 162 at-risk controls. The Identify Candidate Causal single nucleotide polymorphisms (SNPs) and Pathways platform was used to infer the association of known gene sets with the top prioritized intragenic SNPs...
February 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29409314/data-driven-respiratory-gating-for-ventilation-perfusion-lung-scan
#7
David Morland, Sofiane Guendouzen, Edmond Rust, Dimitri Papathanassiou, Nicolas Passat, Fabrice Hubelé
BACKGROUND: Ventilation/perfusion lung scan is subject to blur due to respiratory motion whether with planar acquisition or single photon emission computed tomography (SPECT). We propose a data- driven gating method for extracting different respiratory phases from lung scan list-mode or dynamic data. METHODS: The algorithm derives a surrogate respiratory signal from an automatically detected diaphragmatic region of interest. The time activity curve generated is then filtered using a Savitzky- Golay filter...
February 5, 2018: Quarterly Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29394907/the-effect-of-an-intraoperative-lung-protective-ventilation-strategy-in-neurosurgical-patients-undergoing-craniotomy-study-protocol-for-a-randomized-controlled-trial
#8
Liyong Zhang, Wei Xiong, Yuming Peng, Wei Zhang, Ruquan Han
BACKGROUND: Ventilator-induced lung injury is a major cause of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgery after general anesthesia. However, there is no study on the effect of a lung-protective ventilation strategy in patients undergoing neurosurgery. METHODS: This is a single-center, randomized, parallel-group controlled trial which will be carried out at Beijing Tiantan Hospital, Capital Medical University. Three hundred and thirty-four patients undergoing intracranial tumor surgery will be randomly allocated to the control group and the protective-ventilation strategy group...
February 2, 2018: Trials
https://www.readbyqxmd.com/read/29391372/normal-saline-instillation-versus-no-normal-saline-instillation-and-lung-recruitment-versus-no-lung-recruitment-with-paediatric-endotracheal-suction-the-nares-trial-a-study-protocol-for-a-pilot-factorial-randomised-controlled-trial
#9
Jessica A Schults, Marie Cooke, Debbie A Long, Andreas Schibler, Robert S Ware, Marion L Mitchell
INTRODUCTION: Endotracheal suction (ETS) is a frequent and necessary airway intervention for the intubated child. The aim of ETS is to clear the endotracheal tube and airways of respiratory secretions; however, the methods of performing ETS are varied. Internationally a number of ETS treatments are in use. Many have not been rigorously evaluated in a randomised controlled trial setting, and it is uncertain whether any are associated with better outcomes for the critically ill child. With approximately 50% of paediatric intensive care admissions requiring intubation, ETS interventions that maximise the efficacy and minimise the complications of ETS could translate to improved health for substantial numbers of critically ill children, and significant cost savings...
January 31, 2018: BMJ Open
https://www.readbyqxmd.com/read/29369741/reflex-bronchoconstriction-evoked-by-inhaled-nicotine-aerosol-in-guinea-pigs-role-of-the-nicotinic-acetylcholine-receptor
#10
Lu-Yuan Lee, Ruei-Lung Lin, Mehdi Khosravi, Fadi Xu
Inhaled cigarette smoke stimulated vagal bronchopulmonary C-fibers via an action of nicotine on neuronal nicotinic acetylcholine receptor (nAChR). Recent studies have reported that nicotine at high concentrations can also activate the transient receptor potential ankyrin 1 receptor (TRPA1) expressed in these sensory nerves. This study was carried out to characterize the airway response to inhaled nicotine aerosol and to investigate the relative roles of nAChR and TRPA1 in this response. Guinea pigs were anesthetized and mechanically ventilated; one tidal volume of nicotine aerosol (2% solution) was diluted by equal volume of air and delivered directly into the lung via a tracheal cannula in a single breath...
January 25, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29368419/utility-of-single-versus-multiple-breath-washout-in-adult-asthma
#11
S Kjellberg, E Viklund, P D Robinson, O Zetterström, A-C Olin, P Gustafsson
Nitrogen multiple breath washout (N2 MBW) is a sensitive method to identify peripheral airway involvement in asthma, but is a time-consuming test. The N2 vital capacity single breath (VC SBW) test offers greater time efficiency, but concordance with N2 MBW is poorly understood. The prevalence of peripheral airway abnormality was determined by N2 MBW and N2 SBW tests in 194 asthmatic subjects aged 18-1 years. N2 MBW data were related to findings in 400 healthy controls, aged 17-71 years, while N2 SBW data were compared to findings in 224 healthy controls, aged 15-65 years, to derive equipment-specific reference values...
January 24, 2018: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#12
Whitney Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina Patel, Daniel Brodie, Matthew Bacchetta, Matthew Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of interstitial lung disease (ILD) patients with acute respiratory failure, and to identify those at lower versus higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an intensive care unit (ICU) for respiratory failure at a tertiary care hospital between 2010 and 2014 who did not undergo lung transplantation during their hospitalization...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29350658/experience-of-oesophageal-atresia-management-in-a-tertiary-bangladeshi-hospital
#13
Md Kabirul Islam
OBJECTIVES: Background and aim: This study has been conducted to determine the clinical presentations and surgical outcome of patients with OA admitted in a tertiary level hospital in Bangladesh. METHODS: A prospective analysis was conducted for 32 patients with confirmed OA between July 2007 and June 2015. Of them surgical correction was done in 25 cases. The other 7, in whom surgery could not be done, were excluded from the study. RESULTS: Of the 25 cases, that had been operated, 15 were full term and 52% were more than 48 hours old...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29290405/ct-ventilation-imaging-derived-from-breath-hold-ct-exhibits-good-regional-accuracy-with-galligas-pet
#14
Enid M Eslick, John Kipritidis, Denis Gradinscak, Mark J Stevens, Dale L Bailey, Benjamin Harris, Jeremy T Booth, Paul J Keall
BACKGROUND AND PURPOSE: CT ventilation imaging (CTVI) derived from four dimensional CT (4DCT) has shown only moderate spatial accuracy in humans due to 4DCT image artefacts. Here we assess the accuracy of an improved CTVI using high quality exhale/inhale breath-hold CT (BHCT). MATERIALS AND METHODS: Eighteen lung cancer patients underwent exhale/inhale BHCT, 4DCT and Galligas PET ventilation scans in a single imaging session. For each BHCT and 4DCT scan, we performed deformable image registration (DIR) between the inhale and exhale phase images to quantify ventilation using three published metrics: (i) breathing induced lung density change, CTVIDIR-HU (ii) breathing induced volume change CTVIDIR-Jac and (iii) the regional air-tissue product, CTVIHU Spatial accuracy was reported as the voxel-wise Spearman correlation r between CTVI and Galligas PET...
December 28, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29286940/sustained-lung-inflation-at-birth-for-preterm-infants-at-risk-of-respiratory-distress-syndrome-the-proper-pressure-and-duration
#15
N Abd El-Fattah, N Nasef, M F Al-Harrass, Mohammed Khashaba
BACKGROUND: Variations exist among the administered pressure and duration of sustained lung inflation (SLI) in the delivery room (DR). We aimed to evaluate the appropriate pressure and duration needed for SLI in preterm infants with respiratory distress syndrome. METHODS: We prospectively randomized 100 preterm (<32 weeks) infants to receive either conventional therapy of continuous positive airway pressure (CPAP) at 5 cm H2O, or four groups of CPAP plus a single maneuver of SLI at four regimens based on administered pressures and durations; P20D20 (Pressure of 20 cm H2O for a duration of 20 seconds), P20D10 (20 cm H2O for 10 seconds), P15D20 (15 cm H2O for 20 seconds), and P15D10 (15 cm H2O for 10 seconds) using a T-piece ventilator...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29278555/lung-recruitment-prevents-collapse-during-laparoscopy-in-children-a-randomised-controlled-trial
#16
Cecilia M Acosta, Tomás Sara, Martín Carpinella, Giovanni Volpicelli, Lila Ricci, Sergio Poliotto, Diego Abrego, Sergio Gonorazky, Stephan H Böhm, Gerardo Tusman
BACKGROUND: Capnoperitoneum and anaesthesia impair lung aeration during laparoscopy in children. These changes can be detected and monitored at the bedside by lung ultrasound (LUS). OBJECTIVE: The aim of our study was to assess the impact of general anaesthesia and capnoperitoneum on lung collapse and the potential preventive effect of lung recruitment manoeuvres, using LUS in children undergoing laparoscopy. DESIGN: Randomised controlled study...
December 22, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29277952/a-tale-of-two-cases-of-pulmonary-arteriovenous-malformation-how-they-fared-after-cardiac-transplantation
#17
Bethany L Wisotzkey, Dari L Magyar, Thomas K Jones, Robert J Boucek, Lester C Permut, Mariska S Kemna, Yuk M Law
BACKGROUND: In single ventricle patients, aorticopulmonary collaterals (APCs) and pulmonary arteriovenous malformations (PAVMs) following superior cavopulmonary shunt (CPS) can complicate orthotopic heart transplant (OHT) by cyanosis and hemoptysis. Though PAVMs can regress with restoration of hepatic venous flow to the pulmonary circulation, the effects of hypoxemia on the "unconditioned" allograft are not known. CASES: Two patients with significant PAVMs after CPS were cyanotic following OHT...
December 26, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29275133/inert-gas-washout-in-bronchiolitis-obliterans-following-hematopoietic-cell-transplantation
#18
Sylvia Nyilas, Luzia Baumeler, Michael Tamm, Jörg P Halter, Spasenija Savic, Insa Korten, Anja Meyer, Florian Singer, Jakob R Passweg, Philipp Latzin, Daiana Stolz
BACKGROUND: Bronchiolitis obliterans (BO) syndrome is a leading cause of chronic graft-versus-host disease (cGvHD) and is associated with mortality after allogeneic hematopoietic stem cell transplantation (alloHCT). Nitrogen multiple breath washout test (N2-MBW) measures ventilation inhomogeneity, a biomarker of central and peripheral airways obstruction. The aim of the study was to examine ventilation inhomogeneity according to cGvHD score and histologically defined BO. METHODS: This single center prospective cross-sectional study included 225 adults (mean age 52...
December 21, 2017: Chest
https://www.readbyqxmd.com/read/29261454/development-of-an-inline-dry-power-inhaler-that-requires-low-air-volume
#19
Dale Farkas, Michael Hindle, P Worth Longest
BACKGROUND: Inline dry powder inhalers (DPIs) are actuated by an external air source and have distinct advantages for delivering aerosols to infants and children, and to individuals with compromised lung function or who require ventilator support. However, current inline DPIs either perform poorly, are difficult to operate, and/or require large volumes (∼1 L) of air. The objective of this study was to develop and characterize a new inline DPI for aerosolizing spray-dried formulations with powder masses of 10 mg and higher using a dispersion air volume of 10 mL per actuation that is easy to load (capsule-based) and operate...
December 20, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/29248322/-can-a-simple-lung-ultrasound-score-predict-length-of-ventilation-for-infants-with-severe-acute-viral-bronchiolitis
#20
M Taveira, N Yousef, J Miatello, C Roy, C Claude, B Boutillier, C Dubois, A-F Pierre, P Tissières, P Durand
BACKGROUND: Lung ultrasound (LU) is a bedside point-of-care technique in critical care and emergency medicine. LU is quick and non-irradiating, and provides accurate diagnostic information when compared with chest radiographs. Specific LU signs have been described for bronchiolitis. This study aimed to evaluate the correlation between severity of LU-diagnosed lung lesions, using a quantitative LU score, and the length of non-invasive ventilation (LOV) for infants diagnosed with severe viral bronchiolitis...
December 13, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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