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JOURNAL ARTICLE
Jante S Sinnige, Marry R Smit, Aniruddha Ghose, Harm-Jan de Grooth, Theis Skovsgaard Itenov, Eleni Ischaki, John Laffey, Frederique Paulus, Pedro Póvoa, Charalampos Pierrakos, Luigi Pisani, Oriol Roca, Marcus J Schultz, Konstanty Szuldrzynski, Pieter R Tuinman, Claudio Zimatore, Lieuwe D J Bos
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a frequent cause of hypoxemic respiratory failure with a mortality rate of approximately 30%. Identifying ARDS subphenotypes based on "focal" or "non-focal" lung morphology has the potential to better target mechanical ventilation strategies of individual patients. However, classifying morphology through chest radiography or computed tomography is either inaccurate or impractical. Lung ultrasound (LUS) is a non-invasive bedside tool that can accurately distinguish "focal" from "non-focal" lung morphology...
May 7, 2024: Trials
#2
JOURNAL ARTICLE
G Laguna, F Suárez-Sipmann, G Tusman, J Ripollés, O Díaz-Cambronero, R Pujol, E Rivas, I Garutti, R Mellado, J Vallverdú, A Jacas, A Fervienza, R Marrero, J Librero, J Villar, C Ferrando
BACKGROUND: Postoperative pulmonary complications (PPC) are the most frequent postoperative complications, with an estimated prevalence in elective surgery ranging from 20% in observational cohort studies to 40% in randomized clinical trials. However, the prevalence of PPCs in patients undergoing emergency abdominal surgery is not well defined. Lung-protective ventilation aims to minimize ventilator-induced lung injury and reduce PPCs. The open lung approach (OLA), which combines recruitment manoeuvres (RM) and positive end-expiratory pressure (PEEP) titration, aims to minimize areas of atelectasis and the development of PPCs; however, there is no conclusive evidence in the literature that OLA can prevent PPCs...
April 16, 2024: Revista española de anestesiología y reanimación
#3
JOURNAL ARTICLE
Pneumothorax, pneumomediastinum and subcutaneous emphysema as respiratory complications of COVID-19.
Prabhat Rawal, Surendra Man Shrestha, Anju Gurung, Dipesh Poudel
BACKGROUND: Pneumothorax, pneumomediastinum and subcutaneous emphysema are respiratory complications of Coronavirus disease 2019 occurring with noteworthy frequency in patients especially with severe disease. They can be life-threatening and often complicate patient managment. METHODS: This was a retrospective, observational study of patients admitted in Nepal Armed Police Force hospital from 13/05/2020 to 28/12/2021 diagnosed with pneumothorax, pneumomediastinum or subcutaneous emphysema singly or in combination...
March 22, 2024: Journal of Nepal Health Research Council
#4
Amaal F Alshihabi, Saleh A Alnass, Fatimah S Alsammak, Muhammad S Al Abdrabalnabi
We describe a critical case of a respiratory syncytial virus (RSV) infection in a preterm infant resulting in respiratory failure with advanced respiratory interventions and discharge from our hospital without the requirement for home oxygen therapy or tube feeding. The infant, delivered at 35 weeks gestation due to a premature rupture of the membranes with a birth weight of 2 kg, initially demonstrated a stable postnatal course. The baby required no resuscitation, with Apgar scores of 8 and 9 at one and five minutes, respectively...
January 2024: Curēus
#5
Ana Cicvarić, Josipa Glavaš Tahtler, Tajana Turk, Sanda Škrinjarić-Cincar, Despoina Koulenti, Nenad Nešković, Mia Edl, Slavica Kvolik
Chest trauma is one of the most serious and difficult injuries, with various complications that can lead to ventilation-perfusion (V/Q) mismatch and systemic hypoxia. We are presenting a case of a 53-year-old male with no chronic therapy who was admitted to the Intensive Care Unit due to severe respiratory failure after chest trauma. He developed a right-sided pneumothorax, and then a thoracic drain was placed. On admission, the patient was hemodynamically unstable and tachypneic. He was intubated and mechanically ventilated, febrile (38...
February 2, 2024: Journal of Clinical Medicine
#6
JOURNAL ARTICLE
Quentin Delhez, Laurent Bairy, John Mitchell, Adrien Maseri
BACKGROUND: To perform step-by-step analysis of the different factors (material, anesthesia technique, human, and location) that led to major pneumothorax during an infrequent pediatric cardiac MRI and to prevent its occurrence in the future. Anesthesia equipment used in a remote location is often different than those in operating rooms. For magnetic resonance imaging (MRI), ventilation devices and monitors must be compatible with the magnetic fields. During cardiac MRI numerous apneas are required and, visual contact with the patient is limited for clinical evaluation...
January 2, 2024: BMC Anesthesiology
#7
RANDOMIZED CONTROLLED TRIAL
Carlos Ferrando, Albert Carramiñana, Patricia Piñeiro, Lucia Mirabella, Savino Spadaro, Julián Librero, Fernando Ramasco, Gaetano Scaramuzzo, Oriol Cervantes, Ignacio Garutti, Ana Parera, Marta Argilaga, Gracia Herranz, Carmen Unzueta, Marc Vives, Kevin Regi, Marta Costa-Reverte, María Sonsoles Leal, Jesús Nieves-Alonso, Esther García, Aurelio Rodríguez-Pérez, Roberto Fariña, Sergio Cabrera, Elisabeth Guerra, Lucia Gallego-Ligorit, Alba Herrero-Izquierdo, J Vallés-Torres, Silvia Ramos, Daniel López-Herrera, Manuel De La Matta, Sertcakacilar Gokhan, Evrim Kucur, Ana Mugarra, Marina Soro, Laura García, José Alfonso Sastre, Pilar Aguirre, Claudia Jimena Salazar, María Carolina Ramos, Diego Rolando Morocho, Ramón Trespalacios, Félix Ezequiel-Fernández, Angella Lamanna, Leonarda Pia Cantatore, Donato Laforgia, Soledad Bellas, Carlos López, Ricard Navarro-Ripoll, Samira Martínez, Jordi Vallverdú, Adriana Jacas, María José Yepes-Temiño, Francisco Javier Belda, Gerardo Tusman, Fernando Suárez-Sipmann, Jesús Villar
BACKGROUND: It is uncertain whether individualisation of the perioperative open-lung approach (OLA) to ventilation reduces postoperative pulmonary complications in patients undergoing lung resection. We compared a perioperative individualised OLA (iOLA) ventilation strategy with standard lung-protective ventilation in patients undergoing thoracic surgery with one-lung ventilation. METHODS: This multicentre, randomised controlled trial enrolled patients scheduled for open or video-assisted thoracic surgery using one-lung ventilation in 25 participating hospitals in Spain, Italy, Turkey, Egypt, and Ecuador...
March 2024: Lancet Respiratory Medicine
#8
Masayuki Akatsuka, Naoya Yama
Bronchiolitis obliterans syndrome (BOS) is a non-infectious pulmonary complication that can occur in patients who have undergone allogeneic bone marrow transplantation (BMT). BOS is characterized by the irreversible narrowing and obstruction of bronchi, resulting in severe respiratory distress and poor outcomes. This case report focuses on the complex management of a patient with a multifaceted medical history. A 20-year-old man was initially diagnosed with precursor B lymphoblastic lymphoma and subsequently underwent allogeneic BMT...
October 2023: Curēus
#9
Qianling Wang, Longxiang Su, Jing Jiang, Na Wang, Huaiwu He, Yun Long
Pneumothorax is a potentially fatal complication in patients with acute respiratory distress syndrome (ARDS), presenting challenges in determining the optimal positive end-expiratory pressure (PEEP) level to prevent atelectasis without exacerbating the pneumothorax. This case report describes the successful application of transpulmonary pressure and electrical impedance tomography (EIT) at the bedside to guide PEEP selection in a patient with ARDS complicated by pneumothorax due to methicillin-resistant Staphylococcus aureus infection...
2023: Frontiers in Medicine
#10
JOURNAL ARTICLE
Jakob Wittenstein, Martin Scharffenberg, Xiuli Yang, Thomas Bluth, Thomas Kiss, Marcus J Schultz, Patricia R M Rocco, Paolo Pelosi, Marcelo Gama de Abreu, Robert Huhle
Background . Global and regional transpulmonary pressure (PL ) during one-lung ventilation (OLV) is poorly characterized. We hypothesized that global and regional PL and driving PL (ΔPL ) increase during protective low tidal volume OLV compared to two-lung ventilation (TLV), and vary with body position. Methods . In sixteen anesthetized juvenile pigs, intra-pleural pressure sensors were placed in ventral, dorsal, and caudal zones of the left hemithorax by video-assisted thoracoscopy. A right thoracotomy was performed and lipopolysaccharide administered intravenously to mimic the inflammatory response due to thoracic surgery...
2023: Frontiers in Physiology
#11
REVIEW
Brigitte Lemyre, Marc-Olivier Deguise, Paige Benson, Haresh Kirpalani, Osayame A Ekhaguere, Peter G Davis
BACKGROUND: Nasal continuous positive airway pressure (NCPAP) is a strategy to maintain positive airway pressure throughout the respiratory cycle through the application of a bias flow of respiratory gas to an apparatus attached to the nose. Early treatment with NCPAP is associated with decreased risk of mechanical ventilation exposure and might reduce chronic lung disease. Nasal intermittent positive pressure ventilation (NIPPV) is a form of noninvasive ventilation delivered through the same nasal interface during which patients are exposed to short inflations, along with background end-expiratory pressure...
July 19, 2023: Cochrane Database of Systematic Reviews
#12
JOURNAL ARTICLE
Giorgio Bosso, Gennaro Sansone, Martina Papillo, Alessandro Giaquinto, Silvia Orefice, Enrico Allegorico, Claudia Serra, Valentina Minerva, Valentina Mercurio, Francesca Cannavacciuolo, Ferdinando Dello Vicario, Giovanni Porta, Antonio Pagano, Fabio Giuliano Numis
OBJECTIVES: An increasing number of COVID-19 patients were treated with continuous positive airways pressure (CPAP). To evaluate the clinical effects of personalized positive end-expiratory pressure (PEEP) compared to standard fixed PEEP in COVID-19 patients requiring CPAP. METHODS: This is a single center, prospective, randomized clinical study. Sixty-three COVID-19 patients with hypoxemic respiratory failure and bilateral pneumonia were randomized in two Groups: Group A received CPAP with fixed PEEP of 10 cm H2 O, Group B performed the "PEEP trial", that consists in the evaluation of best PEEP defined as the PEEP value that precedes the echographic appearance of "lung pulse" determining a PaO2 /FiO2 increase...
July 20, 2023: Journal of Basic and Clinical Physiology and Pharmacology
#13
JOURNAL ARTICLE
Nodoka Miyake, Yutaka Igarashi, Ryuta Nakae, Taiki Mizobuchi, Tomohiko Masuno, Shoji Yokobori
BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia is reportedly associated with air leak syndrome (ALS), including mediastinal emphysema and pneumothorax, and has a high mortality rate. In this study, we compared values obtained every minute from ventilators to clarify the relationship between ventilator management and risk of developing ALS. METHODS: This single-center, retrospective, observational study was conducted at a tertiary care hospital in Tokyo, Japan, over a 21-month period...
July 10, 2023: BMC Pulmonary Medicine
#14
REVIEW
Luis Zapata, Rafael Blancas, Isabel Conejo-Márquez, Marina García-de-Acilu
Comprehensive ultrasound assessment has become an essential tool to facilitate the diagnosis and therapeutic management of critically ill patients with acute respiratory failure (ARF). There is evidence supporting the use of ultrasound for the diagnosis of pneumothorax, acute respiratory distress syndrome, cardiogenic pulmonary edema, pneumonia and acute pulmonary thromboembolism, and in patients with COVID-19. In addition, in recent years, the use of ultrasound to evaluate responses to treatment in critically ill patients with ARF has been developed, providing a noninvasive tool for titrating positive end-expiratory pressure, monitoring recruitment maneuvers and response to prone position, as well as for facilitating weaning from mechanical ventilation...
September 2023: Medicina intensiva
#15
RANDOMIZED CONTROLLED TRIAL
Xue-Fei Li, Rong-Juan Jiang, Wen-Jie Mao, Hong Yu, Juan Xin, Hai Yu
STUDY OBJECTIVE: Postoperative pulmonary complications occur frequently and are associated with worse postoperative outcomes in cardiac surgical patients. The advantage of driving pressure-guided ventilation strategy in decreasing pulmonary complications remains to be definitively established. We aimed to investigate the effect of intraoperative driving pressure-guided ventilation strategy compared with conventional lung-protective ventilation on pulmonary complications following on-pump cardiac surgery...
October 2023: Journal of Clinical Anesthesia
#16
REVIEW
Beri Massa-Buck, Deepa Rastogi, Shantanu Rastogi
Nasal continuous positive airway pressure (nCPAP) is a safe, effective, non-invasive respiratory modality to deliver positive end expiratory pressure in neonates. Many studies have established its associated improved respiratory outcomes without increase in major morbidities associated with preterm neonates. In contrast, there is paucity in literature addressing complications such as nasal injury, abdominal distention, air leak syndromes (especially pneumothorax), hearing loss, heat and chemical burns, swallowing and aspiration of small components of the nasal interface and delay in escalation of respiratory support associated with the use of nCPAP, most frequently due to its incorrect use...
August 2023: Journal of Perinatology: Official Journal of the California Perinatal Association
#17
JOURNAL ARTICLE
Determinants of point-of-care ultrasound lung sliding amplitude in mechanically ventilated patients.
David N Briganti, Christine E Choi, Julien Nguyen, Charles W Lanks
BACKGROUND: Although lung sliding seen by point-of-care ultrasound (POCUS) is known to be affected to varying degrees by different physiologic and pathologic processes, it is typically only reported qualitatively in the critical care setting. Lung sliding amplitude quantitatively expresses the amount of pleural movement seen by POCUS but its determinants in mechanically ventilated patients are largely unknown. METHODS: This was a single-center, prospective, observational pilot study examining 40 hemithoraces in 20 adult patients receiving mechanical ventilation...
May 23, 2023: The ultrasound journal
#18
REVIEW
Jae Y Choi, Miriam A Al-Saedy, Brian Carlson
OBJECTIVE: In patients with obesity, use of positive end-expiratory pressure (PEEP) > 5 cm H2 O (centimeters of water) has been shown to prevent intraoperative atelectasis. This study compares the rate of postoperative pulmonary complications (PPCs) associated with PEEP > 5 cm H2 O and PEEP ≤ 5 cm H2 O in patients with obesity who underwent surgery under general anesthesia with mechanical ventilation. METHODS: This study searched Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) using the terms "PEEP," "anesthesia," and "ventilation...
April 2023: Obesity
#19
JOURNAL ARTICLE
Hugo Goulart de Oliveira, Amarilio Macedo-Neto, Maurício Saueressig, Paulo Sanches, Léa Fialkow, Edino Parolo, Fabiano Nagel, Tiago Garcia, Patricia Rieken Macedo Rocco
BACKGROUND: Several minimally invasive treatments have been offered to patients with severe emphysema over the last two decades. Currently, endobronchial valves (EBVs) are the only approved therapeutic option, but this method has drawbacks: only a few can undergo this therapy and the incidence of pneumothorax remains high. A minimally invasive technique, appropriate for a broader patient population and posing fewer risks, would represent a desirable alternative to improve lung function in these patients...
2023: Respiration; International Review of Thoracic Diseases
#20
JOURNAL ARTICLE
Sanya Chandna, John Paul Colombo, Ankit Agrawal, Kavin Raj, Divyansh Bajaj, Sidharth Bhasin, Umesh Bhagat, Pooja Gogia, Balaji Yegneswaran
Pneumothorax is a rare complication among mechanically ventilated patients since low tidal volumes are used nowadays instead of traditional high tidal volumes, but the incidence is slightly higher in patients with high positive end-expiratory pressure (PEEP). Herein we describe a case series of nine patients who were on mechanical ventilation due to acute respiratory distress syndrome (ARDS) secondary to coronavirus disease 2019 (COVID-19) and developed pneumothorax in due course. A retrospective analysis was done on COVID-19 intubated patients from March 2020 to June 2020 in a community hospital in Central New Jersey, which was one of the early hit states in the United States at the beginning of the pandemic...
November 2022: Curēus
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