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https://www.readbyqxmd.com/read/29138242/role-of-ecmo-in-congenital-diaphragmatic-hernia
#1
REVIEW
Merrill McHoney, Philip Hammond
Congenital diaphragmatic hernia (CDH) is typified morphologically by failure of diaphragmatic development with accompanying lung hypoplasia and persistent pulmonary hypertension of the newborn (PPHN). Patients who have labile physiology and low preductal saturations despite optimal ventilatory and inotropic support may be considered for extracorporeal membrane oxygenation (ECMO). Systematic reviews into the benefits of ECMO in CDH concluded that any benefit is unclear. Few randomised trials exist to demonstrate clear benefit and guide management...
November 14, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29135515/association-between-allergic-and-nonallergic-rhinitis-and-obstructive-sleep-apnea
#2
Ming Zheng, Xiangdong Wang, Luo Zhang
PURPOSE OF REVIEW: Allergic rhinitis and nonallergic rhinitis (NAR) are common disorders, which have been considered as potential risk factors for obstructive sleep apnea (OSA). This review summarizes the proposed underlying pathophysiological mechanisms to provide a better understanding of the relationship between these conditions. RECENT FINDINGS: In adults, allergic rhinitis and NAR may be considered as symptoms potentiating, rather than risk potentiating factors in the pathophysiology of OSA, whereas in children, these are considered to be independent predictors for sleep-disordered breathing (SDB) and failure of adeno-tonsillectomy, the recommended first-line therapy for children with OSA...
November 14, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#3
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29115949/neurally-adjusted-ventilatory-assist-nava-or-pressure-support-ventilation-psv-during-spontaneous-breathing-trials-in-critically-ill-patients-a-crossover-trial
#4
Juliana C Ferreira, Fabia Diniz-Silva, Henrique T Moriya, Adriano M Alencar, Marcelo B P Amato, Carlos R R Carvalho
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a proportional ventilatory mode that uses the electrical activity of the diaphragm (EAdi) to offer ventilatory assistance in proportion to patient effort. NAVA has been increasingly used for critically ill patients, but it has not been evaluated during spontaneous breathing trials (SBT). We designed a pilot trial to assess the feasibility of using NAVA during SBTs, and to compare the breathing pattern and patient-ventilator asynchrony of NAVA with Pressure Support (PSV) during SBTs...
November 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29114876/translating-carotid-body-function-into-clinical-medicine
#5
Rodrigo Iturriaga
The carotid body (CB) is considered the main O2 chemoreceptor, which contributes to the cardiorespiratory homeostasis and ventilatory acclimatization. In clinical medicine, the most common pathology associated with the CB are tumours. However, a growing body of evidences supports the novel idea that an enhanced CB chemosensory discharge contributes to the autonomic dysfunction and pathological consequences in obstructive sleep apnoea (OSA), hypertension, systolic heart failure (HF) and cardiometabolic diseases...
November 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29109879/legionnaires-disease-complicated-with-rhabdomyolysis-and-acute-kidney-injury-in-an-aids-patient
#6
Karan Seegobin, Satish Maharaj, Cherisse Baldeo, Julio Perez Downes, Pramod Reddy
Objective: To present a case of an uncommon triad of Legionella pneumonia, rhabdomyolysis, and renal failure, with review of the relevant literature. Case: A 51-year-old with a history of human immunodeficiency virus (HIV), chronic obstructive pulmonary disease (COPD), and hypertension presented with fever, cough, and shortness of breath over four days. Chest X-ray showed consolidation in left lower lung field; urine was positive for Legionella antigen and myoglobin; creatine kinase was 51092U/L; creatine was 6...
2017: Case Reports in Infectious Diseases
https://www.readbyqxmd.com/read/29108614/noninvasive-mechanical-ventilation-in-acute-ventilatory-failure-rationale-and-current-applications
#7
REVIEW
Antonio M Esquinas, Maly Oron Benhamou, Alastair J Glossop, Bushra Mina
Noninvasive ventilation plays a pivotal role in acute ventilator failure and has been shown, in certain disease processes such as acute exacerbation of chronic obstructive pulmonary disease, to prevent and shorten the duration of invasive mechanical ventilation, reducing the risks and complications associated with it. The application of noninvasive ventilation is relatively simple and well tolerated by patients and in the right setting can change the course of their illness.
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29091557/single-dose-gene-replacement-therapy-for-spinal-muscular-atrophy
#8
Jerry R Mendell, Samiah Al-Zaidy, Richard Shell, W Dave Arnold, Louise R Rodino-Klapac, Thomas W Prior, Linda Lowes, Lindsay Alfano, Katherine Berry, Kathleen Church, John T Kissel, Sukumar Nagendran, James L'Italien, Douglas M Sproule, Courtney Wells, Jessica A Cardenas, Marjet D Heitzer, Allan Kaspar, Sarah Corcoran, Lyndsey Braun, Shibi Likhite, Carlos Miranda, Kathrin Meyer, K D Foust, Arthur H M Burghes, Brian K Kaspar
BACKGROUND: Spinal muscular atrophy type 1 (SMA1) is a progressive, monogenic motor neuron disease with an onset during infancy that results in failure to achieve motor milestones and in death or the need for mechanical ventilation by 2 years of age. We studied functional replacement of the mutated gene encoding survival motor neuron 1 (SMN1) in this disease. METHODS: Fifteen patients with SMA1 received a single dose of intravenous adeno-associated virus serotype 9 carrying SMN complementary DNA encoding the missing SMN protein...
November 2, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29054325/use-of-ideal-alveolar-air-equations-and-corrected-end-tidal-pco2-to-estimate-arterial-pco2-and-physiological-dead-space-during-exercise-in-patients-with-heart-failure
#9
Erik H Van Iterson, Thomas P Olson
BACKGROUND: Arterial CO2 tension (PaCO2) and physiological dead space (VD) are not routinely measured during clinical cardiopulmonary exercise testing (CPET). Abnormal changes in PaCO2 accompanied by increased VD directly contribute to impaired exercise ventilatory function in heart failure (HF). Because arterial catheterization is not standard practice during CPET, this study tested the construct validity of PaCO2 and VD prediction models using 'ideal' alveolar air equations and basic ventilation and gas-exchangegas exchange measurements during CPET in HF...
October 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29049534/high-frequency-percussive-ventilation-in-cardiac-surgery-patients-failing-mechanical-conventional-ventilation
#10
Ivan Wong, Berhane Worku, Jeremy A Weingarten, Alexander Ivanov, Felix Khusid, Ashwad Afzal, Robert F Tranbaugh, Iosif Gulkarov
OBJECTIVES: Failure of mechanical conventional ventilation (MCV) after cardiac surgery portends a dismal prognosis, with extracorporeal membrane oxygenation frequently utilized as a salvage therapy. We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue therapy for hypoxaemia refractory to MCV after cardiac surgery. METHODS: In a 6-year retrospective analysis from 2009 to 2015, we identified 16 subjects who required HFPV after cardiac surgery...
July 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29031455/does-permanent-atrial-fibrillation-modify-response-to-cardiac-resynchronization-therapy-in-heart-failure-patients
#11
Ana Abreu, Mário Oliveira, Pedro Silva Cunha, Helena Santa Clara, Guilherme Portugal, Inês Gonçalves Rodrigues, Vanessa Santos, Luís Morais, Mafalda Selas, Rui Soares, Luísa Branco, Rui Ferreira, Miguel Mota Carmo
INTRODUCTION: The benefits of cardiac resynchronization therapy (CRT) documented in heart failure (HF) may be influenced by atrial fibrillation (AF). We aimed to compare CRT response in patients in AF and in sinus rhythm (SR). METHODS: We prospectively studied 101 HF patients treated by CRT. Rates of clinical, echocardiographic and functional response, baseline NYHA class and variation, left ventricular ejection fraction, volumes and mass, atrial volumes, cardiopulmonary exercise test (CPET) duration (CPET dur), peak oxygen consumption (VO2max) and ventilatory efficiency (VE/VCO2 slope) were compared between AF and SR patients, before and at three and six months after implantation of a CRT device...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29027210/oedema-fibrosis-in-duchenne-muscular-dystrophy-role-of-cardiovascular-magnetic-resonance-imaging
#12
REVIEW
Sophie Mavrogeni, Antigoni Papavasiliou, Katerina Giannakopoulou, George Markousis-Mavrogenis, Maria Roser Pons, Evangelos Karanasios, Ioannis Nikas, George Papadopoulos, Genovefa Kolovou, George P Chrousos
Duchenne muscular dystrophy (DMD) is an X-linked muscle disorder characterized by progressive, irreversible loss of cardiac and skeletal muscular function. Muscular enlargement in DMD is attributed to oedema, due to the increased cytoplasmic Na+ concentration. The aim in this review is to present the current experience and emphasize the role of cardiovascular magnetic resonance (CMR) in the diagnosis of this condition. DMD patients' survival depends on ventilatory assistance, as respiratory muscle dysfunction was the most common cause of death in the past...
October 13, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28990307/physiological-dead-space-and-arterial-carbon-dioxide-contributions-to-exercise-ventilatory-inefficiency-in-patients-with-reduced-or-preserved-ejection-fraction-heart-failure
#13
Erik H Van Iterson, Bruce D Johnson, Barry A Borlaug, Thomas P Olson
AIMS: Patients with heart failure (HF) with reduced (HFrEF) or preserved (HFpEF) ejection fraction demonstrate an increased ventilatory equivalent for carbon dioxide (V̇E /V̇CO2 ) slope. The physiological correlates of the V̇E /V̇CO2 slope remain unclear in the two HF phenotypes. We hypothesized that changes in the physiological dead space to tidal volume ratio (VD /VT ) and arterial CO2 tension (PaCO2 ) differentially contribute to the V̇E /V̇CO2 slope in HFrEF vs. HFpEF. METHODS AND RESULTS: Adults with HFrEF (n = 32) and HFpEF (n = 27) [mean ± standard deviation (SD) left ventricular ejection fraction: 22 ± 7% and 61 ± 9%, respectively; mean ± SD body mass index: 28 ± 4 kg/m(2) and 33 ± 6 kg/m(2) , respectively; P < 0...
October 8, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28990273/exercise-ventilatory-inefficiency-in-heart-failure-some-fresh-news-into-the-roadmap-of-heart-failure-with-preserved-ejection-fraction-phenotyping
#14
EDITORIAL
Piergiuseppe Agostoni, Marco Guazzi
No abstract text is available yet for this article.
October 9, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28985727/respiratory-mechanics-in-infants-with-severe-bronchiolitis-on-controlled-mechanical-ventilation
#15
Pablo Cruces, Sebastián González-Dambrauskas, Julio Quilodrán, Jorge Valenzuela, Javier Martínez, Natalia Rivero, Pablo Arias, Franco Díaz
BACKGROUND: Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. METHODS: Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV...
October 6, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28977266/potential-clinical-application-of-surface-electromyography-as-indicator-of-neuromuscular-recovery-during-weaning-tests-after-organophosphate-poisoning
#16
Maria Bernarda Salazar Sánchez, Alher Mauricio Hernández Valdivieso, Miguel Ángel Mañanas Villanueva, Andrés Felipe Zuluaga Salazar
This study aimed to explore the usefulness of measuring respiratory muscle activity in mechanically ventilated patients suffering from acute organophosphate poisoning, with a view towards providing complementary information to determine the best time to suspend ventilatory support. Surface electromyography in respiratory muscles (diaphragm, external intercostal and sternocleidomastoid muscles) was recorded in a young man affected by self-poisoning with an unknown amount of parathion to determine the muscle activity level during several weaning attempts from mechanical ventilation...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28977261/assessment-of-weaning-indexes-based-on-diaphragm-activity-in-mechanically-ventilated-subjects-after-cardiovascular-surgery-a-pilot-study
#17
Isabel Cristina Muñoz Ortega, Alher Mauricio Hernández Valdivieso, Joan Francesc Alonso Lopez, Miguel Ángel Mañanas Villanueva, Luis Horacio Atehortúa Lopez
OBJECTIVE: The aim of this pilot study was to evaluate the feasibility of surface electromyographic signal derived indexes for the prediction of weaning outcomes among mechanically ventilated subjects after cardiac surgery. METHODS: A sample of 10 postsurgical adult subjects who received cardiovascular surgery that did not meet the criteria for early extubation were included. Surface electromyographic signals from diaphragm and ventilatory variables were recorded during the weaning process, with the moment determined by the medical staff according to their expertise...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28977060/minute-ventilation-variability-during-cardiopulmonary-exercise-test-is-higher-in-sedentary-men-than-in-athletes
#18
Renata Rodrigues Teixeira de Castro, Sabrina Pedrosa Lima, Allan Robson Kluser Sales, Antonio Claudio Lucas da Nóbrega
BACKGROUND: The occurrence of minute-ventilation oscillations during exercise, named periodic breathing, exhibits important prognostic information in heart failure. Considering that exercise training could influence the fluctuation of ventilatory components during exercise, we hypothesized that ventilatory variability during exercise would be greater in sedentary men than athletes. OBJECTIVE: To compare time-domain variability of ventilatory components of sedentary healthy men and athletes during a progressive maximal exercise test, evaluating their relationship to other variables usually obtained during a cardiopulmonary exercise test...
September 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28974075/elevated-preoperative-heart-rate-is-associated-with-cardiopulmonary-and-autonomic-impairment-in-high-risk-surgical-patients
#19
T E F Abbott, G Minto, A M Lee, R M Pearse, G L Ackland
Background: Elevated preoperative heart rate (HR) is associated with perioperative myocardial injury and death. In apparently healthy individuals, high resting HR is associated with development of cardiac failure. Given that patients with overt cardiac failure have poor perioperative outcomes, we hypothesized that subclinical cardiac failure, identified by cardiopulmonary exercise testing, was associated with elevated preoperative HR > 87 beats min -1 (HR > 87). Methods: This was a secondary analysis of an observational cohort study of surgical patients aged ≥45 yr...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28968259/intraoperative-venovenous-extracorporeal-membrane-oxygenation-during-thoracic-surgery-that-requires-1-lung-ventilation-a-case-report
#20
Yuri Miyamoto, Yusuke Nagamine, Takahisa Goto, Kiyoyasu Kurahashi
We report 3 cases of thoracic surgery that required 1-lung ventilation where venovenous extracorporeal membrane oxygenation was prophylactically used because severe hypoxemia and ventilatory failure were anticipated intraoperatively. The surgery was successfully completed in all 3 cases. However, we had to withdraw the extracorporeal membrane oxygenation support in 1 case because of uncontrollable hemorrhage. Venovenous extracorporeal membrane oxygenation is a feasible option when severe hypoxemia and/or ventilatory failure is anticipated during 1-lung ventilation...
September 29, 2017: A & A Case Reports
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