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Single lung ventilation

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https://www.readbyqxmd.com/read/29926549/predicting-mortality-in-patients-with-tuberculous-destroyed-lung-receiving-mechanical-ventilation
#1
Won Young Kim, Mi Hyun Kim, Eun Jung Jo, Jung Seop Eom, Jeongha Mok, Ki Uk Kim, Hye Kyung Park, Min Ki Lee, Kwangha Lee
BACKGROUND: Patients with acute respiratory failure secondary to tuberculous destroyed lung (TDL) have a poor prognosis. The aim of the present retrospective study was to develop a mortality prediction model for TDL patients who require mechanical ventilation. METHODS: Data from consecutive TDL patients who had received mechanical ventilation at a single university-affiliated tertiary care hospital in Korea were reviewed. Binary logistic regression was used to identify factors predicting intensive care unit (ICU) mortality...
June 19, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29920152/selective-management-of-multiple-bronchopleural-fistulae-in-a-pediatric-patient-on-extracorporeal-membrane-oxygenation-a-multidisciplinary-approach
#2
Cory N Criss, Ryan Barbaro, Kristy Ann Bauman, Odetola Folafoluwa, Ranjith Vellody, Marcus D Jarboe
INTRODUCTION: This case highlights the successful utilization of a multidisciplinary approach to numerous bilateral bronchopleural fistulae (BPF) using minimally invasive techniques. In this study, we present a previously healthy 14-year-old male hospitalized with 2009 H1N1 influenza and methicillin-resistant Staphylococcus aureus coinfection complicated by severe acute respiratory distress syndrome and multifocal necrotizing pneumonia, with significant lung tissue damage requiring prolonged extracorporeal membrane oxygenation (ECMO) support...
June 19, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29916009/lack-of-durable-protection-against-cotton-smoke-induced-acute-lung-injury-in-sheep-by-nebulized-single-chain-urokinase-plasminogen-activator-or-tissue-plasminogen-activator
#3
Satoshi Fukuda, Perenlei Enkhbaatar, Christina Nelson, Robert A Cox, Marla R Wolfson, Thomas H Shaffer, Robert O Williams, Soraya Hengsawas Surasarang, Sahakijpijarn Sawittree, Galina Florova, Andrey A Komissarov, Kathleen Koenig, Krishna Sarva, Harrison T Ndetan, Karan P Singh, Steven Idell
BACKGROUND: Airway fibrin casts are clinically important complications of severe inhalational smoke-induced acute lung injury (ISIALI) for which reliable evidence-based therapy is lacking. Nebulized anticoagulants or a tissue plasminogen activator; tPA, has been advocated, but airway bleeding is a known and lethal potential complication. We posited that nebulized delivery of single chain urokinase plasminogen activator, scuPA, is well-tolerated and improves physiologic outcomes in ISIALI...
June 18, 2018: Clinical and Translational Medicine
https://www.readbyqxmd.com/read/29910625/epidemiology-practice-patterns-and-prognostic-factors-for-candidemia-and-characteristics-of-fourteen-patients-with-breakthrough-candida-bloodstream-infections-a-single-tertiary-hospital-experience-in-japan
#4
Ryuichi Hirano, Yuichi Sakamoto, Junichi Kitazawa, Shoji Yamamoto, Hiroyuki Kayaba
Background: Candidemia is associated with high mortality, and its prognostic factors need to be examined in more detail in order to improve its management. A case of breakthrough (BT) candidemia is defined as the development of candidemia during antifungal therapy. The microbiological characteristics of and appropriate clinical practices for BT candidemia remain unclear. Objectives: The primary objective of the present study was to identify the prognostic factors of candidemia, while the secondary objective was to elucidate the microbiological characteristics of patients with BT candidemia...
2018: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29907900/-anesthesia-ventilation-and-pain-treatment-in-thoracic-trauma
#5
REVIEW
M Weigeldt, M Paul, S Schulz-Drost, M D Schmittner
The management of anesthesia plays a central role in the treatment of thoracic trauma, both in the initial phase when safeguarding the difficult airway and in the intensive care unit. A rapid transfer to a trauma center should be considered in order to recognize and treat organ dysfunction in time. Development of atelectasis, pneumonia and acute lung failure are common pulmonary complications. Non-invasive ventilation combined with physiotherapy and respiratory training can help to minimize these pulmonary complications...
June 15, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29898436/endotracheal-intubation-and-in-hospital-mortality-after-intracerebral-hemorrhage
#6
Vasileios-Arsenios Lioutas, Sarah Marchina, Louis R Caplan, Magdy Selim, Joseph Tarsia, Luciana Catanese, Jonathan Edlow, Sandeep Kumar
BACKGROUND: Many patients with acute intracerebral hemorrhages (ICHs) undergo endotracheal intubation with subsequent mechanical ventilation (MV) for "airway protection" with the intent to prevent aspiration, pneumonias, and its related mortality. Conversely, these procedures may independently promote pneumonia, laryngeal trauma, dysphagia, and adversely affect patient outcomes. The net benefit of intubation and MV in this patient cohort has not been systematically investigated...
June 13, 2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29895029/bronchoscopic-thermal-vapor-ablation-best-practice-recommendations-from-an-expert-panel-on-endoscopic-lung-volume-reduction
#7
Daniela Gompelmann, Pallav L Shah, Arschang Valipour, Felix J F Herth
Bronchoscopic thermal vapor ablation (BTVA) represents one of the endoscopic lung volume reduction (ELVR) techniques that aims at hyperinflation reduction in patients with advanced emphysema to improve respiratory mechanics. By targeted segmental vapor ablation, an inflammatory response leads to tissue and volume reduction of the most diseased emphysematous segments. So far, BTVA has been demonstrated in several single-arm trials and 1 multinational randomized controlled trial to improve lung function, exercise capacity, and quality of life in patients with upper lobe-predominant emphysema irrespective of the collateral ventilation...
June 12, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29846802/dual-energy-ct-dect-lung-perfusion-in-pulmonary-hypertension-concordance-rate-with-v-q-scintigraphy-in-diagnosing-chronic-thromboembolic-pulmonary-hypertension-cteph
#8
Matthieu Masy, Jessica Giordano, Grégory Petyt, Claude Hossein-Foucher, Alain Duhamel, Maeva Kyheng, Pascal De Groote, Marie Fertin, Nicolas Lamblin, Jean-François Bervar, Jacques Remy, Martine Remy-Jardin
OBJECTIVES: To evaluate the concordance between DECT perfusion and ventilation/perfusion (V/Q) scintigraphy in diagnosing chronic thromboembolic pulmonary hypertension (CTEPH). METHODS: Eighty patients underwent V/Q scintigraphy and DECT perfusion on a 2nd- and 3rd-generation dual-source CT system. The imaging criteria for diagnosing CTEPH relied on at least one segmental triangular perfusion defect on DECT perfusion studies and V/Q mismatch on scintigraphy examinations...
May 30, 2018: European Radiology
https://www.readbyqxmd.com/read/29845759/pressure-decay-testing-of-pleural-air-leaks-in-intact-murine-lungs-evidence-for-peripheral-airway-regulation
#9
Andrew B Servais, Cristian D Valenzuela, Alexandra B Ysasi, Willi L Wagner, Arne Kienzle, Stephen H Loring, Akira Tsuda, Maximilian Ackermann, Steven J Mentzer
The critical care management of pleural air leaks can be challenging in all patients, but particularly in patients on mechanical ventilation. To investigate the effect of central airway pressure and pleural pressure on pulmonary air leaks, we studied orotracheally intubated mice with pleural injuries. We used clinically relevant variables - namely, airway pressure and pleural pressure - to investigate flow through peripheral air leaks. The model studied the pleural injuries using a pressure-decay maneuver. The pressure-decay maneuver involved a 3 sec ramp to 30 cmH2 0 followed by a 3 sec breath hold...
May 2018: Physiological Reports
https://www.readbyqxmd.com/read/29800126/the-feasibility-of-extubation-in-the-operating-room-after-bilateral-lung-transplantation-in-adult-emphysema-patients-an-observational-retrospective-study
#10
Valentina Assenzo, Cristina Assenzo, Rosalinda Filippo, Morgan Le Guen, Edouard Sage, Antoine Roux, Marc Fischler, Ngai Liu
OBJECTIVES: We introduced an extubation strategy for emphysema patients after bilateral lung transplantation. Patients who met the extubation criteria were extubated in the operating room (OR) followed by non-invasive ventilation, and the other patients were extubated in the intensive care unit (ICU). The primary objective was to determine the extubation rate. The secondary outcomes were to determine the factors allowing for extubation in the OR and the postoperative course. METHODS: This study is a single-centre retrospective database analysis of 96 patients...
May 23, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29794336/regional-lung-ventilation-and-perfusion-by-electrical-impedance-tomography-compared-to-single-photon-emission-computed-tomography
#11
Benjamin Hentze, Thomas Muders, Henning Luepschen, Enn Maripuu, Göran Hedenstierna, Christian Putensen, Marian Walter, Steffen Leonhardt
Electrical impedance tomography (EIT) is a noninvasive imaging modality that allows real-time monitoring of regional lung ventilation (V) in intensive care patients at bedside. However, for improved guidance of ventilation therapy it would be beneficial to obtain regional ventilation-to-perfusion ratio (V/Q) by EIT. In order to further explore the feasibility, we first evaluate a model-based approach, based on semi-negative matrix factorization and a gamma-variate model, to extract regional lung perfusion (Q) from EIT measurements...
May 24, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29778333/radiotracer-localization-of-nonpalpable-pulmonary-nodules-a-single-center-experience
#12
Sandra L Starnes, Michael Wolujewicz, Julian Guitron, Valerie Williams, Jennifer Scheler, Ross Ristagno
OBJECTIVE: Multiple localization techniques to facilitate intraoperative identification of small or nonsolid pulmonary nodules have been developed. Radiotracer localization using technetium-labeled macroaggregated albumin has been our preferred localization method since 2009. We report our experience, including technical pitfalls and modifications, of our initial 77 patients who underwent this technique. METHODS: All patients undergoing preoperative radiotracer localization were identified from a prospective database...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#13
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29774726/single-lung-ventilation-associated-to-ecmo-an-alternative-approach-to-manage-ventilator-induced-lung-injuries-in-infants
#14
Matteo Di Nardo, Joseph Nunziata, Francesca Stoppa, Margherita Lonero, Daniela Perrotta, Corrado Cecchetti, Salvatore Grasso
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29758177/the-efficacy-of-antenatal-steroid-therapy-is-dependent-on-the-duration-of-low-concentration-fetal-exposure-evidence-from-a-sheep-model-of-pregnancy
#15
Matthew W Kemp, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Shinichi Sato, Takushi Hanita, Yusaku Kumagai, Timothy J Molloy, Michael Clarke, Peter J Eddershaw, Gabrielle C Musk, Augusto Schmidt, Demelza Ireland, Lucy Furfaro, Matthew S Payne, John P Newnham, Alan H Jobe
OBJECTIVE: Antenatal corticosteroids (ANS) are among the most important and widely used interventions to improve outcomes for preterm infants. ANS dosing regimens remain un-optimized and without maternal weight-adjusted dosing. We, and others, have hypothesised that once a low concentration of materno-fetal steroid exposure is achieved and maintained, the duration of the steroid exposure determines treatment efficacy. Using a sheep model of pregnancy, we tested the relationship between steroid dose, and duration of exposure, and treatment efficacy...
May 9, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29754733/assessing-the-benefits-of-preoperative-thoracic-epidural-placement-for-lung-transplantation
#16
Sean R McLean, Peter von Homeyer, Aaron Cheng, Michael L Hall, Michael S Mulligan, Kevin Cain, Kei Togashi
OBJECTIVE: The authors investigated the effect of preoperative thoracic epidural (PreTE) catheter placement versus not placing a preoperative thoracic epidural catheter (NoPreTE) on the duration of postoperative ventilation time, time to become coherent (measured as time to become Confusion Assessment Method-intensive care unit [ICU] negative), opioid consumption, ICU length of stay (LOS), and hospital LOS. DESIGN: Retrospective cohort design. SETTING: Single institution, university hospital...
April 3, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29754418/comprehensive-outcomes-after-lung-retransplantation-a-single-center-review
#17
Kieran Halloran, Meghan Aversa, Kathryn Tinckam, Tereza Martinu, Matthew Binnie, Cecilia Chaparro, Chung-Wai Chow, Tom Waddell, Karen McRae, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Marcelo Cypel, Shaf Keshavjee, Lianne G Singer
INTRODUCTION: Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. METHODS: We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n=38). We analyzed the post-operative course, graft function, renal function, microbiology, donor specific antibodies (DSA), quality of life and survival compared to a control cohort of primary transplant recipients matched for age and era...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29728414/t-piece-resuscitators-how-do-they-compare
#18
Murray Hinder, Alistair McEwan, Thomas Drevhammer, Snorri Donaldson, Mark Brian Tracy
BACKGROUND: The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study...
May 4, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29726010/lower-versus-higher-oxygen-concentrations-titrated-to-target-oxygen-saturations-during-resuscitation-of-preterm-infants-at-birth
#19
REVIEW
Kei Lui, Lisa J Jones, Jann P Foster, Peter G Davis, See Kwee Ching, Ju Lee Oei, David A Osborn
BACKGROUND: Initial resuscitation with air is well tolerated by most infants born at term. However, the optimal fractional inspired oxygen concentration (FiO2 - proportion of the breathed air that is oxygen) targeted to oxygen saturation (SpO2 - an estimate of the amount of oxygen in the blood) for infants born preterm is unclear. OBJECTIVES: To determine whether lower or higher initial oxygen concentrations, when titrated according to oxygen saturation targets during the resuscitation of preterm infants at birth, lead to improved short- and long-term mortality and morbidity...
May 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29707346/a-comparison-between-two-lung-ventilation-with-co-2-artificial-pneumothorax-and-one-lung-ventilation-during-thoracic-phase-of-minimally-invasive-esophagectomy
#20
Miao Lin, Yaxing Shen, Hao Wang, Yong Fang, Cheng Qian, Songtao Xu, Di Ge, Mingxiang Feng, Lijie Tan, Qun Wang
Background: To investigate the feasibility and safety of two lung ventilation with artificial pneumothorax in minimally invasive esophagectomy (MIE) through a comparison with conventional one lung ventilation. Methods: Eleven hundred and sixty-six patients with esophageal cancer, who underwent McKeown MIE in our center from February 2006 to December 2016, were studied retrospectively. Seven hundred and five patients who underwent one lung ventilation with double lumen endotracheal tube (DLET) were assigned to DLET group...
March 2018: Journal of Thoracic Disease
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