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https://www.readbyqxmd.com/read/28736291/clinical-and-hemodynamic-correlates-and-prognostic-value-of-ve-vco2-slope-in-patients-with-heart-failure-with-preserved-ejection-fraction-and-pulmonary-hypertension
#1
Sebastiaan H C Klaassen, Licette C Y Liu, Yoran M Hummel, Kevin Damman, P van der Meer, Adriaan A Voors, Elke S Hoendermis, Dirk J van Veldhuisen
BACKGROUND: Impaired exercise capacity is one of the hallmarks of heart failure with preserved ejection fraction (HFpEF), but the clinical and hemodynamic correlates and prognostic value of exercise testing in patients with HFpEF is unknown. METHODS: Patients with HFpEF (Left ventricular ejection fraction [LVEF] ≥ 45%) and pulmonary hypertension, underwent cardiopulmonary exercise test (CPX) to measure maximal (peak VO2) and sub maximal (ventilatory equivalent for carbon dioxide [VE/VCO2] slope) exercise capacity...
July 20, 2017: Journal of Cardiac Failure
https://www.readbyqxmd.com/read/28698268/effects-of-volume-guaranteed-ventilation-combined-with-two-different-modes-in-preterm-infants
#2
Sezin Unal, Ebru Ergenekon, Selma Aktas, Nilgun Altuntas, Serdar Beken, Ebru Kazanci, Ferit Kulali, Ozlem Gulbahar, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Volume-controlled ventilation modes have been shown to reduce duration of mechanical ventilation, incidence of chronic lung disease, failure of primary mode of ventilation, hypocarbia, severe intraventricular hemorrhage, pneumothorax, and periventricular leukomalacia in preterm infants when compared with pressure limited ventilation modes. Volume-guarantee (VG) ventilation is the most commonly used mode for volume-controlled ventilation. Assist control, pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV) can be combined with VG; however, there is a lack of knowledge on the superiority of each regarding clinical outcomes...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#3
Federico Longhini, Chun Pan, Jianfeng Xie, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Yi Yang, Paolo Navalesi, Haibo Qiu
BACKGROUND: Noninvasive ventilation (NIV) is generally delivered using pneumatically-triggered and cycled-off pressure support (PSP) through a mask. Neurally adjusted ventilatory assist (NAVA) is the only ventilatory mode that uses a non-pneumatic signal, i.e., diaphragm electrical activity (EAdi), to trigger and drive ventilator assistance. A specific setting to generate neurally controlled pressure support (PSN) was recently proposed for delivering NIV by helmet. We compared PSN with PSP and NAVA during NIV using a facial mask, with respect to patient comfort, gas exchange, and patient-ventilator interaction and synchrony...
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28671175/a-rare-cause-of-ventilatory-failure-in-a-patient-with-post-traumatic-intracranial-hemorrhage
#4
Balamugesh Thangakunam, Shakti Kumar Bal, Ajay V Venkatapathy, Aparna Irodi, Devasahayam Jesudas Christopher
High minute ventilation is required to lower intracranial pressures in patients with intracranial bleed. Respiratory acidemia consequent to ventilatory difficulty is dangerous in such patients as it further raises intracranial tension. We describe such a case. A 24-year-old man had to be intubated and mechanically ventilated after he met with a road traffic accident and sustained extensive maxillofacial injuries and intracranial bleed. A tooth was accidentally aspirated in this injury and progressively resulted in left lower lobe collapse, pneumomediastinum, and consequent difficult ventilation...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28665692/excess-ventilation-in-copd-heart-failure-overlap-implications-for-dyspnea-and-exercise-intolerance
#5
Alcides Rocha, Flavio F Arbex, Priscilla A Sperandio, Aline Souza, Ligia Biazzim, Frederico Mancuso, Danilo C Berton, Bruno Hochhegger, Maria Clara N Alencar, Luiz E Nery, Denis E O'Donnell, J Alberto Neder
BACKGROUND: An increased ventilatory response to exertional metabolic demand (high ventilation (⩒E)-carbon dioxide output (⩒CO2) relationship) is a common finding in patients with coexistent COPD-heart failure. We aimed to determine the mechanisms underlying high ⩒E-⩒CO2 and its impact on operating lung volumes, dyspnea and exercise tolerance in these patients. METHODS: Twenty-two ex-smokers with combined COPD and heart failure with reduced left ventricular ejection fraction (LVEF) undertook, after careful treatment optimization, a progressive cycle exercise test with capillary (c) blood gas collection...
June 30, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28630772/severe-rhabdomyolysis-due-to-presumed-drug-interactions-between-atorvastatin-with-amlodipine-and-ticagrelor
#6
Iouri Banakh, Kavi Haji, Ross Kung, Sachin Gupta, Ravindranath Tiruvoipati
Atorvastatin and ticagrelor combination is a widely accepted therapy for secondary prevention of ischaemic heart disease. However, rhabdomyolysis is a well-known rare side effect of statins which should be considered when treatments are combined with cytochrome P450 3A4 enzyme inhibitors. We report a case of atorvastatin and ticagrelor associated severe rhabdomyolysis that progressed to multiorgan failure requiring renal replacement therapy, inotropes, intubation, and mechanical ventilation. Despite withdrawal of the precipitating cause and the supportive measures including renal replacement therapy, creatinine kinase increased due to ongoing rhabdomyolysis rapidly progressing to upper and lower limbs weakness...
2017: Case Reports in Critical Care
https://www.readbyqxmd.com/read/28623885/monitoring-the-electric-activity-of-the-diaphragm-during-noninvasive-positive-pressure-ventilation-a-case-report
#7
Fabia Diniz-Silva, Anna Miethke-Morais, Adriano M Alencar, Henrique T Moriya, Pedro Caruso, Eduardo L V Costa, Juliana C Ferreira
BACKGROUND: In patients with post-extubation respiratory distress, delayed reintubation may worsen clinical outcomes. Objective measures of extubation failure at the bedside are lacking, therefore clinical parameters are currently used to guide the need of reintubation. Electrical activity of the diaphragm (EAdi) provides clinicians with valuable, objective information about respiratory drive and could be used to monitor respiratory effort. CASE PRESENTATION: We describe the case of a patient with Chronic Obstructive Pulmonary Disease (COPD), from whom we recorded EAdi during four different ventilatory conditions: 1) invasive mechanical ventilation, 2) spontaneous breathing trial (SBT), 3) unassisted spontaneous breathing, and 4) Noninvasive Positive Pressure Ventilation (NPPV)...
June 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28612902/comparison-of-prognostic-values-of-cardiopulmonary-and-heart-rate-parameters-in-exercise-testing-in-men-with-heart-failure
#8
Łukasz Czubaszewski, Anna Straburzyńska-Lupa, Jacek Migaj, Ewa Straburzyńska-Migaj
BACKGROUND: Cardiopulmonary exercise testing (CPET) is the gold standard in the evaluation of patients with chronic heart failure (CHF). However, this test is relatively expensive, assessment of its results requires experience, and in Poland it is available only in tertiary health care centers. Many heart rate (HR) parameters taken during a standard electrocardiographic (ECG) exercise test also shows prognostic values. Thus, the aim of this study is to compare prognostic values of ventilatory and HR parameters in exercise testing in CHF patients, and to find out if HR parameters can be used instead of ventilatory in the evaluation of a prognosis...
June 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28604467/transnasal-humidified-rapid-insufflation-ventilatory-exchange-for-preoxygenation-before-cesarean-delivery-under-general-anesthesia-a-case-report
#9
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/28600154/markers-of-successful-extubation-in-extremely-preterm-infants-and-morbidity-after-failed-extubation
#10
Sanjay Chawla, Girija Natarajan, Seetha Shankaran, Benjamin Carper, Luc P Brion, Martin Keszler, Waldemar A Carlo, Namasivayam Ambalavanan, Marie G Gantz, Abhik Das, Neil Finer, Ronald N Goldberg, C Michael Cotten, Rosemary D Higgins
OBJECTIVES: To identify variables associated with successful elective extubation, and to determine neonatal morbidities associated with extubation failure in extremely preterm neonates. STUDY DESIGN: This study was a secondary analysis of the National Institute of Child Health and Human Development Neonatal Research Network's Surfactant, Positive Pressure, and Oxygenation Randomized Trial that included extremely preterm infants born at 24(0/7) to 27(6/7) weeks' gestation...
June 6, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28583555/veno-arterial-venous-hybrid-mode-of-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome-combined-with-septic-shock-in-a-liver-transplant-patient-a-case-report
#11
J-I Park, B-H Jung, S-G Lee
BACKGROUND: Post-operative respiratory failure is common in liver transplant patients, with a direct effect on graft and recipient outcomes. We present a case of successful treatment for a patient who had acute respiratory distress syndrome combined with septic shock after living-donor liver transplantation with veno-arterial-venous hybrid mode of extracorporeal membrane oxygenation (ECMO) support. METHODS: A 49-year-old male patient underwent successful emergency living-donor liver transplantation for acute-on-chronic liver failure associated with alcoholic liver cirrhosis...
June 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28562381/respiratory-involvement-in-neuromuscular-disorders
#12
Matthias Boentert, Stephan Wenninger, Valeria A Sansone
PURPOSE OF REVIEW: In numerous neuromuscular disorders (NMDs), respiratory muscle weakness is present, and acute or chronic respiratory failure may evolve. Very often, respiratory involvement substantially adds to the burden of disease, impairs quality of life, or reduces life expectancy. This article summarizes new aspects of both diagnosis and management of respiratory muscle weakness in patients with NMDs. RECENT FINDINGS: Drugs like deflazacort, ataluren, eteplirsen, and nusinersen are now approved treatments for Duchenne Muscular Dystrophy and Spinal Muscular Atrophy, and others are on their way in NMDs...
May 29, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28560821/ecto-5-nucleotidase-cd73-regulates-peripheral-chemoreceptor-activity-and-cardiorespiratory-responses-to-hypoxia
#13
Andrew P Holmes, Clare J Ray, Selina A Pearson, Andrew M Coney, Prem Kumar
Augmented sensory neuronal activity from the carotid body (CB) has emerged as a principal cause of hypertension in a number of cardiovascular related pathologies including obstructive sleep apnoea, heart failure and diabetes. Development of new targets and pharmacological treatment strategies aiming to reduce CB sensory activity may thus improve outcomes in these key patient cohorts. The current study tested whether ecto-5'-nucleotidase (CD73), an enzyme that generates adenosine, is functionally important in modifying CB sensory activity and cardiovascular respiratory responses to hypoxia...
May 31, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28560615/effect-of-continuous-dialysis-on-blood-ph-in-acidemic-hypercapnic-animals-with-severe-acute-kidney-injury-a-randomized-experimental-study-comparing-high-vs-low-bicarbonate-affluent
#14
Thiago Gomes Romano, Luciano Cesar Pontes Azevedo, Pedro Vitale Mendes, Eduardo Leite Vieira Costa, Marcelo Park
BACKGROUND: Controlling blood pH during acute ventilatory failure and hypercapnia in individuals suffering from severe acute kidney injury (AKI) and undergoing continuous renal replacement therapy (CRRT) is of paramount importance in critical care settings. In this situation, the optimal concentration of sodium bicarbonate in the dialysate is still an unsolved question in critical care since high concentrations may worsen carbon dioxide levels and low concentrations may not be as effective in controlling pH...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28555950/lowland-copperhead-austrelaps-superbus-envenomation-causing-severe-neuromuscular-paralysis-in-a-dog
#15
L V Wright, Y H Indrawirawan
CASE REPORT: A case of lowland copperhead snake (Austrelaps superbus) envenomation in a dog is described. The dog developed severe and prolonged neuromuscular paralysis, including ventilatory failure. The dog was treated successfully with antivenom, intravenous fluids and mechanical ventilation. CLINICAL SIGNIFICANCE: The toxic components of lowland copperhead snake venom are reviewed.
June 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28555443/-extracorporeal-lung-support
#16
REVIEW
S Braune, A Sieweke, D Jarczak, S Kluge
Systems for extracorporeal lung support have recently undergone significant technological improvements leading to more effective and safe treatment. Despite limited scientific evidence these systems are increasingly used in the intensive care unit for treatment of different types of acute respiratory failure. In general two types of systems can be differentiated: devices for extracorporeal carbon dioxide removal (ECCO2R) for ventilatory insufficiency and devices for extracorporeal membrane oxygenation (ECMO) for severe hypoxemic failure...
June 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28546380/respiratory-implications-of-pediatric-neuromuscular-disease
#17
Howard B Panitch
Children with progressive neuromuscular weakness undergo a stereotypical progression of respiratory involvement, beginning with impaired airway clearance and progressing to nocturnal and then diurnal ventilatory failure. This review examines issues related to airway clearance and mucus mobilization, sleep problems, and use of assisted ventilation in children with neuromuscular diseases. Interventions for each of these problems have been created or adapted for the pediatric population. The use of airway clearance therapies and assisted ventilation have improved survival of children with neuromuscular weakness...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28541747/evidence-based-utilization-of-non-invasive-ventilation-and-patient-outcomes
#18
Anuj B Mehta, Ivor S Douglas, Allan J Walkey
RATIONALE: Strong evidence supports use of non-invasive ventilation (NIV) for patients with respiratory distress from chronic obstructive pulmonary disease and heart failure (strong evidence conditions). Despite unclear benefits of NIV for other causes of acute respiratory failure, utilization for conditions with weaker evidence is increasing despite evidence demonstrating higher mortality for patients who suffer NIV failure (progression from NIV to invasive mechanical ventilation (IMV)) compared to being treated initially with IMV...
May 25, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28531336/loop-gain-predicts-the-response-to-upper-airway-surgery-in-patients-with-obstructive-sleep-apnoea-ventilatory-control-abnormalities-predict-surgical-responsiveness
#19
Simon A Joosten, Paul Leong, Shane A Landry, Scott A Sands, Philip I Terrill, Dwayne Mann, Anthony Turton, Jhanavi Rangaswamy, Christopher Andara, Glen Burgess, Darren Mansfield, Garun S Hamilton, Bradley A Edwards
Study Objectives: Upper airway surgery is often recommended to treat OSA patients who cannot tolerate continuous positive airways pressure (CPAP). However, the response to surgery is variable, potentially because it does not improve the non-anatomical factors (i.e. loop gain and arousal threshold) causing OSA. Measuring these traits clinically might predict responses to surgery. Our primary objective was to test the value of loop gain and arousal threshold to predict surgical success defined as 50% reduction in apnea-hypopnea index (AHI) and AHI <10 events/hr post-surgery...
May 22, 2017: Sleep
https://www.readbyqxmd.com/read/28515334/central-acting-therapeutics-alleviate-respiratory-weakness-caused-by-heart-failure-induced-ventilatory-overdrive
#20
Andrew J Foster, Mathew J Platt, Jason S Huber, Ashley L Eadie, Alicia M Arkell, Nadya Romanova, David C Wright, Todd E Gillis, Coral L Murrant, Keith R Brunt, Jeremy A Simpson
Diaphragmatic weakness is a feature of heart failure (HF) associated with dyspnea and exertional fatigue. Most studies have focused on advanced stages of HF, leaving the cause unresolved. The long-standing theory is that pulmonary edema imposes a mechanical stress, resulting in diaphragmatic remodeling, but stable HF patients rarely exhibit pulmonary edema. We investigated how diaphragmatic weakness develops in two mouse models of pressure overload-induced HF. As in HF patients, both models had increased eupneic respiratory pressures and ventilatory drive...
May 17, 2017: Science Translational Medicine
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