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https://www.readbyqxmd.com/read/28813621/improvement-of-an-in-vitro-model-to-assess-delivered-dose-and-particle-size-for-a-vibrating-mesh-nebulizer-during-mechanical-ventilation
#1
Nani Kadrichu, Derek Daniher
BACKGROUND: In an in vitro model of mechanical ventilation with gravity-dependent filter position we observed artificially high delivered doses resulting from liquid droplet collection and precipitation of aerosolized drug. We sequentially modified the model to obtain accurate reproducible measurements of delivered dose and particle size at endotracheal tube exit. METHODS: Stepwise changes in the model included (1) altering the endotracheal tube position to a gravity-independent position, (2) adding fluid traps, (3) humidifying air near the test lung, and (4) simplifying test lung and filters...
August 16, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28794144/nasal-high-flow-therapy-a-novel-treatment-rather-than-a-more-expensive-oxygen-device
#2
REVIEW
Eleni Ischaki, Ioannis Pantazopoulos, Spyros Zakynthinos
Nasal high flow is a promising novel oxygen delivery device, whose mechanisms of action offer some beneficial effects over conventional oxygen systems. The administration of a high flow of heated and humidified gas mixture promotes higher and more stable inspiratory oxygen fraction values, decreases anatomical dead space and generates a positive airway pressure that can reduce the work of breathing and enhance patient comfort and tolerance. Nasal high flow has been used as a prophylactic tool or as a treatment device mostly in patients with acute hypoxaemic respiratory failure, with the majority of studies showing positive results...
September 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28768499/simultaneous-primary-invasive-cutaneous-aspergillosis-in-two-preterm-twins-case-report-and-review-of-the-literature
#3
Floriane Gallais, Julie Denis, Olfa Koobar, Laurence Dillenseger, Dominique Astruc, Raoul Herbrecht, Ermanno Candolfi, Valérie Letscher-Bru, Marcela Sabou
BACKGROUND: Primary invasive cutaneous aspergillosis is a rare fungal infection that occurs mostly in immunocompromised patients. Newborns of very low birth weight present a high risk for this type of infection due to an immaturity of the cutaneous barrier and of the immune system. CASE PRESENTATION: We describe here a case of simultaneous invasive cutaneous aspergillosis in two preterm twins. Two male preterm bichorionic biamniotic twins (A & B) were born at a general hospital by spontaneous normal delivery at 24 weeks and 6 days of gestation...
August 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#4
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28742340/structure-and-electrical-transport-relations-in-ba-zr-pr-o3-%C3%AE-perovskites
#5
Isabel Antunes, Ulises Amador, Adriana Alves, Maria Rosário Correia, Clemens Ritter, Jorge Ribeiro Frade, Domingo Pérez-Coll, Glenn C Mather, Duncan Paul Fagg
Members of the perovskite solid solution BaZr1-xPrxO3-δ (0.2 ≤ x ≤ 0.8) with potential high-temperature electrochemical applications were synthesized via mechanical activation and high-temperature annealing at 1250 °C. Structural properties were examined by Rietveld analysis of neutron powder diffraction and Raman spectroscopy at room temperature, indicating rhombohedral symmetry (space group R3̅c) for members x = 0.2 and 0.4 and orthorhombic symmetry (Imma) for x = 0.6 and 0.8. The sequence of phase transitions for the complete solid solution from BaZrO3 to BaPrO3 is Pm3̅m → R3̅c → Imma → Pnma...
August 7, 2017: Inorganic Chemistry
https://www.readbyqxmd.com/read/28728621/high-flow-heated-humidified-air-via-nasal-cannula-treats-cpap-intolerant-children-with-obstructive-sleep-apnea
#6
Stephen Hawkins, Stephanie Huston, Kristen Campbell, Ann Halbower
STUDY OBJECTIVES: Continuous positive airway pressure (CPAP) is effective but challenging for children with obstructive sleep apnea (OSA). High-flow air via open nasal cannula (HFNC) as treatment in children remains controversial. We report the efficacy of HFNC in children with OSA and CPAP intolerance, a titration protocol, and a discussion of potential mechanisms. METHODS: Patients aged 1 to 18 years with OSA (defined by obstructive apnea-hypopnea index [OAHI] greater than 1 event/h) and CPAP intolerance were enrolled...
July 14, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28720675/the-effect-of-nebulizer-position-on-aerosolized-epoprostenol-delivery-in-an-adult-lung-model
#7
Allison C Anderson, Meagan N Dubosky, Kelly A Fiorino, Vanessa Quintana, Carl A Kaplan, David L Vines
BACKGROUND: Aerosolized epoprostenol is an alternative for inhaled nitric oxide in the management of pulmonary arterial hypertension and possibly acute hypoxemia. Our objective was to determine differences in drug deposition based on different nebulizer positions in the ventilator circuit, using a vibrating mesh nebulizer. METHODS: An 8.0-mm inner diameter endotracheal tube (ETT) was connected to a training test lung, compliance of 30 mL/cm H2O, with a collecting filter placed at the ETT-test lung junction...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28661028/increased-use-of-heated-humidified-high-flow-nasal-cannula-is-associated-with-longer-oxygen-requirements
#8
Rachael C Heath Jeffery, Margaret Broom, Bruce Shadbolt, David A Todd
AIM: There has been an increased use of heated humidified high flow nasal canula (HFNC) in premature babies (PBs) admitted to our neonatal unit. The aim of this study is to identify clinical characteristics in PBs < 29 weeks gestational age (GA) that distinguish between those who did not or did receive HFNC. METHODS: This study compared prospectively collected data from 2010 to 2012. Comparisons were undertaken between PBs<29 weeks GA who received continuous positive airway pressure (CPAP: 44/72 (61...
June 29, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28654138/a-prospective-cohort-study-of-awake-fibreoptic-intubation-practice-at-a-tertiary-centre
#9
K El-Boghdadly, D N Onwochei, J Cuddihy, I Ahmad
Contemporary data are lacking for procedural practice, training provision and outcomes for awake fibreoptic intubation in the UK. We performed a prospective cohort study of awake fibreoptic intubations at a tertiary centre to assess current practice. Data from 600 elective or emergency awake fibreoptic intubations were collected to include information on patient and operator demographics, technical performance and complications. This comprised 1.71% of patients presenting for surgery requiring a general anaesthetic, with the majority occurring in patients presenting for head and neck surgery...
June 2017: Anaesthesia
https://www.readbyqxmd.com/read/28653583/warm-and-humidified-versus-cold-and-dry-co2-pneumoperitoneum-in-minimally-invasive-colon-resection-a-randomized-controlled-trial
#10
Elie Sutton, Geoffrey Bellini, Michael J Grieco, H M C Shantha Kumara, Xiaohong Yan, Vesna Cekic, Linda Njoh, Richard L Whelan
INTRODUCTION: Peritoneal insufflation with warm-humidified (WH) CO2 gas during minimally invasive surgical procedures is purported to prevent hypothermia and peritoneal desiccation and is associated with decreased postoperative IL-6 levels. This randomized study's purpose was to determine the clinical impact of WH versus cold-dry (CD) CO2 in minimally invasive colon resection (MICR), and to assess perioperative plasma levels of IL-6, TIMP-1, sVEGF-R1, and HSP-70 after MICR. METHODS: Operative and short-term clinical data plus perioperative blood samples were collected on MICR patients randomized to receive either WH (36...
June 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28651960/humid-versus-dry-incubator-a%C3%A2-prospective-randomized-controlled-trial
#11
Mohamed Fawzy, Mohamed Y AbdelRahman, Mohamed H Zidan, Faten F Abdel Hafez, Hazem Abdelghafar, Hesham Al-Inany, Mohamed A Bedaiwy
OBJECTIVE: To evaluate the efficacy of a dry versus humidified incubator on human embryo development ex vivo. DESIGN: Prospective, double-blind, randomized, controlled trial. SETTING: Private fertility centers. PATIENT(S): A total of 297 women undergoing in vitro fertilization randomized into two groups. INTERVENTION(S): From days 0 to day 5 or 6 of culture, intervention group embryos exposed to dry culture and control group embryos exposed to humidified culture...
June 23, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28636155/the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-17-cases-of-subglottic-stenosis
#12
Kim To, Fleur Harding, McNeill Scott, Pamela Milligan, Iain J Nixon, Richard Adamson, Alistair F McNarry
Shared airway management in patients with subglottic stenosis (SGS) is challenging for both the anaesthetist and surgeon. Various methods of airway management have been described but currently no gold standard exists. Jet ventilation has been described as the preferred technique despite a UK National Survey highlighting potential complications including pneumothorax, pneumomediastinum, surgical emphysema, hypoxia and death. This article is protected by copyright. All rights reserved.
June 21, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28627376/inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-invasive-mechanical-ventilation
#13
Muhammad H E ElHansy, Marina E Boules, Assem Fouad Mohamed El Essawy, Mohamed Bakry Al-Kholy, Maha M Abdelrahman, Amira S A Said, Raghda R S Hussein, Mohamed E Abdelrahim
BACKGROUND: Patient receiving invasive mechanical ventilation (IMV) may benefit from medical aerosol, but guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to compare aerosol delivery with five different types of aerosol generators during IMV. METHOD: In randomized design, 60 (30 female) mechanically ventilated chronic obstructive pulmonary disease (COPD) patients were assigned to one of 5 groups. Groups 1-4 received 5000 μg salbutamol using Aerogen Pro (PRO), Aerogen Solo (SOLO), NIVO vibrating mesh and jet nebulizers (JN), respectively, while group 5 received 800 μg (8 puffs) of salbutamol via metered dose inhaler with AeroChamber-MV (MDI-AC)...
August 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28622152/use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-emergent-surgical-tracheostomy-a-case-report
#14
Neel Desai, Anna Fowler
Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is a novel airway technique that utilizes high-flow humidified nasal oxygen. It can extend apnea time and maintain oxygen saturation. Here we report the use of THRIVE in a 35-year-old man who required emergent surgical tracheostomy for a clinically relevant compromised airway secondary to acute supraglottic and glottic pathology. Intravenous sedation resulted in hypoventilation close to apnea. THRIVE maintained oxygen saturation for 40 minutes until transient desaturation developed after complete airway obstruction...
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#15
Maryse Hengen, Rosalie Willemain, Alain Meyer, Bruno Langer, Girish P Joshi, Pierre Diemunsch
Transnasal humidified rapid-insufflation ventilatory exchange has been shown to improve oxygenation and increase apnea time in difficult airway cases. It may also be beneficial in patients vulnerable to rapid desaturation due to limited pulmonary reserve. We report the use of transnasal humidified rapid-insufflation ventilatory exchange for preoxygenation before a cesarean delivery under general anesthesia in a patient with respiratory distress because of pneumonia and heart failure from severe mitral stenosis...
June 8, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28588119/high-flow-nasal-cannula-utilization-in-pediatric-critical-care
#16
Kristen D Coletti, Dayanand N Bagdure, Linda K Walker, Kenneth E Remy, Jason W Custer
BACKGROUND: High-flow nasal cannula (HFNC) is increasingly utilized in pediatrics, delivering humidified air and oxygen for respiratory conditions causing hypoxia and distress. In the neonatal ICU, it has been associated with better tolerance, lower complications, and lower cost. Few data exist regarding indications for use and the epidemiology of disease/pathology that warrants HFNC in the pediatric ICU. METHODS: This study is a retrospective cohort study of patients admitted to a tertiary children's hospital pediatric ICU and placed on HFNC from October 1, 2011 to October 31, 2013...
August 2017: Respiratory Care
https://www.readbyqxmd.com/read/28588117/aerosol-delivery-through-adult-high-flow-nasal-cannula-with-heliox-and-oxygen
#17
Patricia A Dailey, Robert Harwood, Kyle Walsh, James B Fink, Tina Thayer, Greg Gagnon, Arzu Ari
BACKGROUND: Heliox (helium-oxygen mixture) has been shown to reduce turbulence and improve aerosol delivery in a range of clinical settings. We questioned whether heliox as compared with oxygen via high-flow nasal cannula (HFNC) would affect aerosol delivery. We hypothesized that heliox would have a significant effect on aerosol delivery as compared with oxygen with both quiet and distressed breathing patterns. METHODS: A vibrating mesh nebulizer was placed at the inlet of a humidifier via HFNC with small adult cannula distal to the heated-wire circuit with prongs placed into simulated nares with a T-shaped trap and absolute filter connected to a breath simulator set to adult quiet and distressed breathing parameters...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28584285/oxygen-atoms-are-critical-in-rendering-thp-1-leukaemia-cells-susceptible-to-cold-physical-plasma-induced-apoptosis
#18
Sander Bekeschus, Kristian Wende, Mohamed Mokhtar Hefny, Katrin Rödder, Helena Jablonowski, Anke Schmidt, Thomas von Woedtke, Klaus-Dieter Weltmann, Jan Benedikt
Cold physical plasma has been suggested as a powerful new tool in oncology. However, some cancer cells such as THP-1 leukaemia cells have been shown to be resistant towards plasma-induced cell death, thereby serving as a good model for optimizing plasmas in order to foster pro-apoptotic anticancer effects. A helium/oxygen radio frequency driven atmospheric plasma profoundly induced apoptosis in THP-1 cells whereas helium, humidified helium, and humidified helium/oxygen plasmas were inefficient. Hydrogen peroxide - previously shown as central plasma-derived agent - did not participate in the killing reaction but our results suggest hypochlorous acid to be responsible for the effect observed...
June 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#19
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/28552074/heat-and-moisture-exchangers-hmes-and-heated-humidifiers-hhs-in-adult-critically-ill-patients-a-systematic-review-meta-analysis-and-meta-regression-of-randomized-controlled-trials
#20
Maria Vargas, Davide Chiumello, Yuda Sutherasan, Lorenzo Ball, Antonio M Esquinas, Paolo Pelosi, Giuseppe Servillo
BACKGROUND: The aims of this systematic review and meta-analysis of randomized controlled trials are to evaluate the effects of active heated humidifiers (HHs) and moisture exchangers (HMEs) in preventing artificial airway occlusion and pneumonia, and on mortality in adult critically ill patients. In addition, we planned to perform a meta-regression analysis to evaluate the relationship between the incidence of artificial airway occlusion, pneumonia and mortality and clinical features of adult critically ill patients...
May 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
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