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Single lung ventilation

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https://www.readbyqxmd.com/read/28544108/elevated-intrathoracic-co2-pressure-during-thoracoscopic-surgery-decreases-regional-cerebral-oxygen-saturation-in-neonates-and-infants-a-pilot-study
#1
Felix Neunhoeffer, Steven W Warmann, Michael Hofbeck, Alisa Müller, Frank Fideler, Guido Seitz, Martin U Schuhmann, Hans-Joachim Kirschner, Matthias Kumpf, Jörg Fuchs
BACKGROUND: Intraoperative hypercapnia and acidosis are risk factors during thoracoscopy in neonates and infants. METHODS: In a prospective pilot study, we evaluated the effects of thoracoscopy in neonates and infants on cerebral microcirculation, oxygen saturation, and oxygen consumption. Regional cerebral oxygen saturation and blood flow were measured noninvasively using a new device combining laser Doppler flowmetry and white light spectrometry. Additionally, cerebral fractional tissue oxygen extraction and approximated oxygen consumption were calculated...
May 24, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28535820/predicted-body-weight-relationships-for-protective-ventilation-unisex-proposals-from-pre-term-through-to-adult
#2
Dion C Martin, Glenn N Richards
BACKGROUND: The lung-protective ventilation bundle has been shown to reduce mortality in adult acute respiratory distress syndrome (ARDS). This concept has expanded to other areas of acute adult ventilation and is recommended for pediatric ventilation. A component of lung-protective ventilation relies on a prediction of lean body weight from height. The predicted body weight (PBW) relationship employed in the ARDS Network trial is considered valid only for adults, with a dedicated formula required for each sex...
May 23, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28526500/pulmonary-function-tests-do-not-predict-mortality-in-patients-undergoing-continuous-flow-left-ventricular-assist-device-implantation
#3
Edo K S Bedzra, Todd F Dardas, Richard K Cheng, Jay D Pal, Claudius Mahr, Jason W Smith, Kent Shively, S Carolina Masri, Wayne C Levy, Nahush A Mokadam
OBJECTIVES: To investigate the effect of pulmonary function testing on outcomes after continuous flow left ventricular assist device implantation. METHODS: A total of 263 and 239 patients, respectively, had tests of forced expiratory volume in 1 second and diffusing capacity of the lungs for carbon monoxide preoperatively for left ventricular assist device implantations between July 2005 and September 2015. Kaplan-Meier analysis and multivariable Cox regressions were performed to evaluate mortality...
April 11, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28522438/anti-inflammatory-effects-of-oxpapc-involve-endothelial-cell-mediated-generation-of-lxa4
#4
Yunbo Ke, Noureddine Zebda, Olga Oskokova, Taras Afonyushkin, Evgeny Berdyshev, Yufeng Tian, Fanyong Meng, Nicolene Sarich, Valery N Bochkov, Ji Ming Wang, Anna A Birukova, Konstantin G Birukov
Rationale: Oxidation of 1-palmitoyl-2-arachidonoyl-sn-glycero-3-phosphorylcholine generates a group of bioactive oxidized phospholipid products (OxPAPC) with a broad range of biological activities. Barrier-enhancing and anti-inflammatory effects of OxPAPC on pulmonary endothelial cells (EC) are critical for prevention of acute lung injury caused by bacterial pathogens or excessive mechanical ventilation. Anti-inflammatory properties of OxPAPC are associated with its antagonistic effects on toll-like receptors and suppression of RhoA GTPase signaling...
May 18, 2017: Circulation Research
https://www.readbyqxmd.com/read/28504995/remote-ischemic-preconditioning-decreases-oxidative-lung-damage-after-pulmonary-lobectomy-a-single-center-randomized-double-blind-controlled-trial
#5
José García-de-la-Asunción, Laura Bruno, Jaume Perez-Griera, Genaro Galan, Alfonso Morcillo, Richard Wins, Eva García-Del-Olmo, Ricardo Guijarro, Benjamín Sarriá, Francisco Martí, Marina Soro, Francisco Javier Belda
BACKGROUND: During lobectomy in patients with lung cancer, the operated lung is often -collapsed and hypoperfused. Ischemia/reperfusion injury may then occur when the lung is -re-expanded. We hypothesized that remote ischemic preconditioning (RIPC) would decrease oxidative lung damage and improve gas exchange in the postoperative period. METHODS: We conducted a single-center, randomized, double-blind trial in patients with nonsmall cell lung cancer undergoing elective lung lobectomy...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28502060/comparison-of-univent-tube-and-ez-blocker-in-one-lung-ventilation-airway-pressures-and-gas-exchange
#6
Tülay Hoşten, Can Aksu, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Mine Solak
Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, ventilation and haemodynamics during OLV. Patients undergoing elective thoracotomy for the first time were included in this prospective randomized study. Patients were divided into two groups as UT and EZ...
May 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28495235/prenatal-detection-of-megacystis-not-always-an-adverse-prognostic-factor-experience-in-25-consecutive-cases-in-a-tertiary-referral-center-with-complete-neonatal-outcome-and-follow-up
#7
Marcella Pellegrino, Daniela Visconti, Vincenzo Davide Catania, Luisa D'Oria, Carlo Manzoni, Maria Giovanna Grella, Alessandro Caruso, Lucia Masini, Giuseppe Noia
INTRODUCTION: Megacystis is a condition of abnormal enlarged fetal bladder for gestational age, which is usually associated with urological malformations that may constitute a life-threatening condition for the baby. OBJECTIVE: The purpose of this study was to assess the prognostic and etiological criteria of fetal megacystis and to describe the neonatal outcome in a large series collected in a single tertiary center. STUDY DESIGN: A retrospective observational study was conducted between 2008 and 2012...
April 14, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28477378/evaluating-the-accuracy-of-4d-ct-ventilation-imaging-first-comparison-with-technegas-spect-ventilation
#8
Fiona Hegi-Johnson, Paul Keall, Jeff Barber, Chuong Bui, John Kipritidis
INTRODUCTION: Computed tomography ventilation imaging (CTVI) is a highly accessible functional lung imaging modality that can unlock the potential for functional avoidance in lung cancer radiation therapy. Previous attempts to validate CTVI against clinical ventilation single-photon emission computed tomography (V-SPECT) have been hindered by radioaerosol clumping artifacts. This work builds on those studies by performing the first comparison of CTVI with (99m) Tc-carbon ('Technegas'), a clinical V-SPECT modality featuring smaller radioaerosol particles with less clumping...
May 5, 2017: Medical Physics
https://www.readbyqxmd.com/read/28476919/v%C3%AC-o2-kinetics-associated-with-moderate-intensity-exercise-in-heart-failure-impact-of-intrathecal-fentanyl-inhibition-of-group-iii-iv-locomotor-muscle-afferents
#9
Erik H Van Iterson, Bruce D Johnson, Michael J Joyner, Timothy B Curry, Thomas P Olson
Heart failure (HF) patients demonstrate impaired pulmonary, circulatory, and nervous system responses to exercise. While HF demonstrate prolonged (time-constant, τ) pulmonary oxygen uptake (V̇O2) on-kinetics contributing to exercise intolerance, it is unknown if abnormal V̇O2 kinetics couple with ventilatory and circulatory dysfunction secondary to impaired group III/IV afferents in HF. Because lower-lumbar intrathecal fentanyl inhibits locomotor muscle afferents resulting in improved exercise ventilation and hemodynamics, we tested the hypotheses, HF will demonstrate: 1) rapid V̇O2 on-kinetics, and 2) attenuated steady-state V̇O2 amplitude and oxygen deficit (O2def) during exercise with fentanyl versus placebo...
May 5, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28476473/decrease-in-delivery-room-intubation-rates-after-use-of-nasal-intermittent-positive-pressure-ventilation-in-the-delivery-room-for-resuscitation-of-very-low-birth-weight-infants
#10
Manoj Biniwale, Fiona Wertheimer
BACKGROUND: The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. OBJECTIVE: To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28467885/diving-and-pulmonary-physiology-surfactant-binding-protein-lung-fluid-and-cardiopulmonary-test-changes-in-professional-divers
#11
Zora Susilovic-Grabovac, Cristina Banfi, Denise Brusoni, Massimo Mapelli, Stefania Ghilardi, Ante Obad, Darija Bakovic-Kramaric, Zeljko Dujic, Piergiuseppe Agostoni
Alteration of breathing pattern ranging from an increase of respiratory rate to overt hyperventilation during and after SCUBA diving is frequently reported and is associated with intrathoracic fluid overload. This study was undertaken to assess breathing efficiency after diving and the association with damage of alveolar cells. Ventilation efficiency (VE/VCO2) during maximal cardiopulmonary exercise test (CPET) before and 2h after a standard protocol dive has been analyzed in twelve professional males divers (39...
April 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28454590/protective-intraoperative-ventilation-with-higher-versus-lower-levels-of-positive-end-expiratory-pressure-in-obese-patients-probese-study-protocol-for-a-randomized-controlled-trial
#12
T Bluth, R Teichmann, T Kiss, I Bobek, J Canet, G Cinnella, L De Baerdemaeker, C Gregoretti, G Hedenstierna, S N Hemmes, M Hiesmayr, M W Hollmann, S Jaber, J G Laffey, M J Licker, K Markstaller, I Matot, G Müller, G H Mills, J P Mulier, C Putensen, R Rossaint, J Schmitt, M Senturk, A Serpa Neto, P Severgnini, J Sprung, M F Vidal Melo, H Wrigge, M J Schultz, P Pelosi, M Gama de Abreu
BACKGROUND: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients...
April 28, 2017: Trials
https://www.readbyqxmd.com/read/28448324/intraoperative-use-of-the-ventrain-for-single-lung-ventilation-after-iatrogenic-trauma-to-the-left-main-bronchus-during-thoracoscopy-a-case-report
#13
Veronika M Evers, Rogier V Immink, Willem J P van Boven, Mark I van Berge Henegouwen, Markus W Hollmann, Denise P Veelo
In a patient undergoing thoracoscopic esophagectomy and concomitant wedge resection, an iatrogenic lesion in the left main bronchus was observed following deflation of the right lung. Because the bronchial cuff of the double-lumen tube was visible through the lesion, repair was only possible after deflation of the bulging cuff. Positive pressure ventilation would result in air leakage jeopardizing ventilation and oxygenation. This challenging situation was resolved using the Ventrain device to oxygenate the patient through a small-bore catheter placed through the lumen beyond the bronchial defect...
April 26, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28442965/unusual-airways-management-during-one-lung-ventilation-in-thoracic-surgery
#14
Paolo Primieri, Paolo Ancona, Elisabetta Gualtieri
Airways management in thoracic surgery is usually more difficult than in other surgery. We reported a case of a patient who underwent surgery of evacuation of empyema where after a correct insertion of a left double-lumen tube 37 Fr (DLT), one-lung ventilation was not permitted by the high airways pressure. In fact, the hole of bronchial tip was just against the left bronchial wall retracted probably from inflammatory process. We introduced blindly an Arndt blocker 9 Fr inside the tracheal lumen of DLT until the orifice of the right upper lobe bronchus, the distance was checked before...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#15
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28390643/a-46-year-old-man-with-dyspnea-hypoxemia-and-radiographic-asymmetry-after-redo-bilateral-lung-transplantation
#16
Sofya Tokman, Michael A Smith, A Samad Hashimi, Ashraf Omar
A 46-year-old man underwent redo bilateral sequential lung transplantation for rapidly progressive bronchiolitis obliterans syndrome that developed 3.5 years after initial transplantation. In the operating room, he was sedated and intubated with a dual lumen endotracheal tube with subsequent single right-lung ventilation and left allograft implantation. His pulmonary arterial pressure became elevated with reperfusion of the newly implanted left lung, which required initiation of cardiopulmonary bypass to facilitate implantation of the right lung...
April 2017: Chest
https://www.readbyqxmd.com/read/28382694/quantitative-analysis-of-hyperpolarized-129-xe-gas-transfer-mri
#17
Ziyi Wang, Scott Haile Robertson, Jennifer Wang, Mu He, Rohan S Virgincar, Geoffry M Schrank, Elianna A Bier, Sudarshan Rajagopal, Yuh Chin Huang, Thomas G O'Riordan, Craig R Rackley, H Page McAdams, Bastiaan Driehuys
PURPOSE: Hyperpolarized (129) Xe magnetic resonance imaging (MRI) using Dixon-based decomposition enables single-breath imaging of (129) Xe in the airspaces, interstitial barrier tissues, and red blood cells (RBCs). However, methods to quantitatively visualize information from these images of pulmonary gas transfer are lacking. Here, we introduce a novel method to transform these data into quantitative maps of pulmonary ventilation, and (129) Xe gas transfer to barrier and RBC compartments...
April 6, 2017: Medical Physics
https://www.readbyqxmd.com/read/28376242/lung-perfusion-mri-vs-spect-for-screening-in-suspected-chronic-thromboembolic-pulmonary-hypertension
#18
Christopher S Johns, Andrew J Swift, Smitha Rajaram, Paul J C Hughes, David J Capener, David G Kiely, James M Wild
PURPOSE: To assess the diagnostic accuracy of magnetic resonance imaging (MRI) perfusion against perfusion single photon emission tomography (SPECT) screening for chronic thromboembolic pulmonary hypertension (CTEPH). Ventilation/perfusion (V/Q) scintigraphy is recommended to screen for suspected CTEPH. It has previously been shown that 3D dynamic contrast-enhanced (DCE) lung perfusion MRI has a similar sensitivity for diagnosing CTEPH in comparison to planar perfusion scintigraphy; however, planar scintigraphy has now been largely replaced by SPECT, due to higher spatial resolution and sensitivity...
April 4, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28368706/resting-physiological-correlates-of-reduced-exercise-capacity-in-smokers-with-mild-airway-obstruction
#19
Amany F Elbehairy, Azmy Faisal, Jordan A Guenette, Dennis Jensen, Katherine A Webb, Rashid Ahmed, J Alberto Neder, Denis E O'Donnell
Smokers with minor spirometric abnormalities can experience persistent activity-related dyspnea and exercise intolerance. Additional resting tests can expose heterogeneous physiological abnormalities, but their relevance and association with clinical outcomes remain uncertain. Subjects included sixty-two smokers (≥20 pack-years), with cough and/or dyspnea and minor airway obstruction [forced expiratory volume in one-second (FEV1) ≥80% predicted and >5th percentile lower limit of normal (LLN) (i.e., z-score >-1...
April 3, 2017: COPD
https://www.readbyqxmd.com/read/28366711/predicting-the-necessity-for-extracorporeal-circulation-during-lung-transplantation-a-feasibility-study
#20
Ludwig Christian Hinske, Dominik Johannes Hoechter, Eva Schröeer, Nikolaus Kneidinger, René Schramm, Gerhard Preissler, Roland Tomasi, Alma Sisic, Lorenz Frey, Vera von Dossow, Patrick Scheiermann
OBJECTIVE: The factors leading to the implementation of unplanned extracorporeal circulation during lung transplantation are poorly defined. Consequently, the authors aimed to identify patients at risk for unplanned extracorporeal circulation during lung transplantation. DESIGN: Retrospective data analysis. SETTING: Single-center university hospital. PARTICIPANTS: A development data set of 170 consecutive patients and an independent validation cohort of 52 patients undergoing lung transplantation...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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