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Positive end expiratory pressure

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https://www.readbyqxmd.com/read/28634173/a-comparison-of-2-respiratory-devices-for-sputum-clearance-in-adults-with-non-cystic-fibrosis-bronchiectasis
#1
Yasmin R Silva, Tracy A Greer, Lucy C Morgan, Frank Li, Claude S Farah
BACKGROUND: Airway clearance techniques are a vital part of routine care for patients with bronchiectasis. There is no clear superior modality. The Flutter combines oscillations (6-20Hz) and positive expiratory pressure; the Lung Flute combines positive expiratory pressure and low frequency acoustic waves (18-22Hz), to augment clearance. This project aimed to compare these devices. METHODS: This was a randomized crossover study of adult subjects with stable non-cystic fibrosis bronchiectasis (expectorating >25 mL/d)...
June 20, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28633157/epidemiology-practice-of-ventilation-and-outcome-for-patients-at-increased-risk-of-postoperative-pulmonary-complications-an-observational-study-in-29-countries
#2
(no author information available yet)
BACKGROUND: Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES: To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN: This was a prospective international 1-week observational study using the 'Assess Respiratory Risk in Surgical Patients in Catalonia risk score' (ARISCAT score) for PPC for risk stratification...
June 20, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28632529/respiratory-system-mechanics-during-low-versus-high-positive-end-expiratory-pressure-in-open-abdominal-surgery-a-substudy-of-provhilo-randomized-controlled-trial
#3
Davide D'Antini, Robert Huhle, Jacob Herrmann, Demet S Sulemanji, Jun Oto, Pasquale Raimondo, Lucia Mirabella, Sabrine N T Hemmes, Marcus J Schultz, Paolo Pelosi, David W Kaczka, Marcos Francisco Vidal Melo, Marcelo Gama de Abreu, Gilda Cinnella
BACKGROUND: In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D)...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631764/-hemodynamic-effects-of-positive-end-expiratory-pressure
#4
Marco Marini, Giorgio Caretta, Fabio Vagnarelli, Fabiana Lucà, Emilia Biscottini, Alberto Lavorgna, Vincenza Procaccini, Letizia Riva, Gabriele Vianello, Nadia Aspromonte, Andrea Mortara, Renata De Maria, Piera Capasso, Serafina Valente, Michele Massimo Gulizia
The application of a positive end-expiratory pressure (PEEP), the cornerstone of noninvasive ventilation (NIV), causes hemodynamic changes in the cardiovascular system. To understand the benefits of NIV it is necessary to resume concepts of cardiovascular physiology and pathophysiology about cardiac function determinants, venous return, ventricular interdependence and heart-lung interaction, and to understand how PEEP interacts with them. The hemodynamic effects of PEEP are mediated by the increase in transpulmonary pressure, which results in increased pulmonary vascular resistance and in an attending small reduction of venous return in conditions of euvolemia, in a substantial reduction of left ventricular afterload and a potential positive effect on left ventricular stroke volume...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28625243/-experimental-study-on-effect-of-airway-pressure-on-cardiopulmonary-resuscitation
#5
Dingyu Tan, Feng Sun, Yangyang Fu, Shihuan Shao, Yazhi Zhang, Yingying Hu, Jun Xu, Huadong Zhu, Xuezhong Yu
OBJECTIVE: To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. METHODS: Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28616282/pressure-controlled-versus-volume-controlled-ventilation-during-one-lung-ventilation-for-video-assisted-thoracoscopic-lobectomy
#6
Yi-Qi Zhu, Fang Fang, Xiao-Min Ling, Jian Huang, Jing Cang
BACKGROUND: It is controversial as to which ventilation mode is better during one-lung ventilation (OLV). This study was designed to figure out whether there was any difference between volume controlled ventilation (VCV) and pressure controlled ventilation (PCV) on oxygenation and postoperative complications under the condition of protective ventilation (PV). METHODS: Sixty-five patients undergoing video-assisted thoracoscopic lobectomy were randomized into two groups...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28612267/auto-trilevel-versus-bilevel-positive-airway-pressure-ventilation-for-hypercapnic-overlap-syndrome-patients
#7
Mei Su, De Huai, Juan Cao, Ding Ning, Rong Xue, Meijie Xu, Mao Huang, Xilong Zhang
PURPOSE: Although bilevel positive airway pressure (Bilevel PAP) therapy is usually used for overlap syndrome (OS), there is still a portion of OS patients in whom Bilevel PAP therapy could not simultaneously eliminate residual apnea events and hypercapnia. The current study was expected to explore whether auto-trilevel positive airway pressure (auto-trilevel PAP) therapy with auto-adjusting end expiratory positive airway pressure (EEPAP) can serve as a better alternative for these patients...
June 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28606716/the-relation-between-given-volume-and-heart-rate-during-newborn-resuscitation
#8
J E Linde, J Schulz, J M Perlman, K Øymar, L Blacy, H Kidanto, H L Ersdal
BACKGROUND: During delivery room resuscitation of depressed newborns, provision of appropriate tidal volume (TV) with establishment of functional residual capacity (FRC) is essential for circulatory recovery. Effective positive pressure ventilation (PPV) is associated with a rapid increase in heart rate (HR). The relationship between delivery of TV and HR responses remains unclear. OBJECTIVES: The study objectives were to determine (1) the relationship between a given TV during initial PPV and HR responses of depressed newborns, and (2) the optimal delivered TV associated with a rapid increase in HR...
June 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28593896/synergistic-effect-of-hyperoxia-and-biotrauma-on-ventilator-induced-lung-injury
#9
Mirjana Shosholcheva, Nikola Јankulovski, Andrijan Kartalov, Biljana Kuzmanovska, Daniela Miladinova
Patients undergoing mechanical ventilation in intensive care units (ICUs) may develop ventilator-induced lung injury (VILI). Beside the high tidal volume (Vt) and plateau pressure (Pplat), hyperoxia is supposed to precipitate lung injury. Oxygen toxicity is presumed to occur at levels of fraction of inspired oxygen (FiO2) exceeding 0.40. The exposure time to hyperoxia is certainly very important and patients who spend extended time on mechanical ventilation (MV) are probably more exposed to severe hyperoxic acute lung injury (HALI)...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28592276/different-strategies-for-mechanical-ventilation-during-cardiopulmonary-bypass-cpbvent-2014-study-protocol-for-a-randomized-controlled-trial
#10
Elena Bignami, Marcello Guarnieri, Francesco Saglietti, Enivarco Massimo Maglioni, Sabino Scolletta, Stefano Romagnoli, Stefano De Paulis, Gianluca Paternoster, Cinzia Trumello, Roberta Meroni, Antonio Scognamiglio, Alessandro Maria Budillon, Vincenzo Pota, Alberto Zangrillo, Ottavio Alfieri
BACKGROUND: There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28584436/titration-of-ideal-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-comparison-between-lower-inflection-point-and-esophageal-pressure-method-using-volumetric-capnography
#11
Nandakishore Baikunje, Inderpaul Singh Sehgal, Sahajal Dhooria, Kuruswamy Thurai Prasad, Ritesh Agarwal
The tenets of mechanical ventilation in acute respiratory distress syndrome (ARDS) include the utilization of low tidal volume and optimal application of positive end-expiratory pressure (PEEP). Optimal PEEP in ARDS is characterized by reduction in alveolar dead space along with improvement in the lung compliance and resultant betterment in oxygenation. There are various methods of setting PEEP in ARDS. Herein, we report a patient of ARDS, wherein we employed measurement of dead space using volumetric capnography to compare two different PEEP strategies, namely, the lower inflection point and transpulmonary pressure monitoring...
May 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28571581/erratum-to-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, Marcelo Gama de Abreu
No abstract text is available yet for this article.
June 1, 2017: Trials
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#13
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28554331/outcome-of-acute-respiratory-distress-syndrome-in-university-and-non-university-hospitals-in-germany
#14
Konstantinos Raymondos, Tamme Dirks, Michael Quintel, Ulrich Molitoris, Jörg Ahrens, Thorben Dieck, Kai Johanning, Dietrich Henzler, Rolf Rossaint, Christian Putensen, Hermann Wrigge, Ralph Wittich, Maximilian Ragaller, Thomas Bein, Martin Beiderlinden, Maxi Sanmann, Christian Rabe, Jörn Schlechtweg, Monika Holler, Fernando Frutos-Vivar, Andres Esteban, Hartmut Hecker, Simone Rosseau, Vera von Dossow, Claudia Spies, Tobias Welte, Siegfried Piepenbrock, Steffen Weber-Carstens
BACKGROUND: This study investigates differences in treatment and outcome of ventilated patients with acute respiratory distress syndrome (ARDS) between university and non-university hospitals in Germany. METHODS: This subanalysis of a prospective, observational cohort study was performed to identify independent risk factors for mortality by examining: baseline factors, ventilator settings (e.g., driving pressure), complications, and care settings-for example, case volume of ventilated patients, size/type of intensive care unit (ICU), and type of hospital (university/non-university hospital)...
May 30, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28545875/regional-volume-characteristics-of-the-preterm-infant-receiving-first-intention-continuous-positive-airway-pressure
#15
Risha Bhatia, Peter G Davis, David G Tingay
OBJECTIVE: To determine whether applying nasal continuous positive airway pressure (CPAP) using systematic changes in continuous distending pressure (CDP) results in a quasi-static pressure-volume relationship in very preterm infants receiving first intention CPAP in the first 12-18 hours of life. STUDY DESIGN: Twenty infants at <32 weeks' gestation with mild respiratory distress syndrome (RDS) managed exclusively with nasal CPAP had CDP increased from 5 to 8 to 10 cmH2O, and then decreased to 8 cmH2O and returned to baseline CDP...
May 22, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28542443/effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-damage-in-a-model-of-mild-extrapulmonary-acute-lung-injury-with-intra-abdominal-hypertension
#16
Cintia L Santos, Raquel S Santos, Lillian Moraes, Cynthia S Samary, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Robert Huhle, Marcelo G Abreu, Alberto Schanaider, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH...
2017: PloS One
https://www.readbyqxmd.com/read/28512431/variable-ventilation-improved-respiratory-system-mechanics-and-ameliorated-pulmonary-damage-in-a-rat-model-of-lung-ischemia-reperfusion
#17
André Soluri-Martins, Lillian Moraes, Raquel S Santos, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Paolo Pelosi, Pedro L Silva, Marcelo Gama de Abreu, Patricia R M Rocco
Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28504997/lung-rest-during-extracorporeal-membrane-oxygenation-for-neonatal-respiratory-failure-practice-variations-and-outcomes
#18
Deepthi Alapati, Zubair H Aghai, Md Jobayer Hossain, Daniel R Dirnberger, Mark T Ogino, Thomas H Shaffer
OBJECTIVE: Describe practice variations in ventilator strategies used for lung rest during extracorporeal membrane oxygenation for respiratory failure in neonates, and assess the potential impact of various lung rest strategies on the duration of extracorporeal membrane oxygenation and the duration of mechanical ventilation after decannulation. DATA SOURCES: Retrospective cohort analysis from the Extracorporeal Life Support Organization registry database during the years 2008-2013...
May 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28489667/increasing-levels-of-positive-end-expiratory-pressure-improve-the-left-ventricular-strain
#19
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana M Castillo-Rivera, María C Iniesta-Carricondo, María D Pola Gallego de Guzmán, Antonio Cárdenas-Cruz
PURPOSE: The goal of this study was to evaluate possible changes in the left myocardial performance of patients with cardiogenic shock (CS) during ascending levels of positive end-expiratory pressure (PEEP) using speckle-tracking echocardiography. MATERIALS AND METHODS: This was an interventional clinical study performed on CS patients under mechanical ventilation. These patients underwent echocardiography after 15 to 30 minutes of progressive increases in PEEP (ZEEP, PEEP 5, PEEP 10, PEEP 15 cm H2O)...
May 9, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28461167/singing-lessons-for-respiratory-health-a-literature-review
#20
REVIEW
Rachel B Goldenberg
OBJECTIVE: Several studies have explored the role of music and singing as a treatment for respiratory symptoms. The objective of this paper was to review the current body of literature in regard to the use of singing as both a physiological and a psychological therapy for respiratory disease and assess the role the singing teacher might play in this treatment. STUDY DESIGN: This is a literature review, discussion of results and directions for further research. METHOD: Multiple databases were searched using keywords such as "respiratory," "physiotherapy," and "pulmonary" in conjunction with "singing...
April 28, 2017: Journal of Voice: Official Journal of the Voice Foundation
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