keyword
https://read.qxmd.com/read/38509583/the-diaphragmatic-initiated-ventilatory-assist-diva-trial-study-protocol-for-a-randomized-controlled-trial-comparing-rates-of-extubation-failure-in-extremely-premature-infants-undergoing-extubation-to-non-invasive-neurally-adjusted-ventilatory-assist-versus
#1
JOURNAL ARTICLE
David N Matlock, Sarah J Ratcliffe, Sherry E Courtney, Haresh Kirpalani, Kimberly Firestone, Howard Stein, Kevin Dysart, Karen Warren, Mitchell R Goldstein, Kelli C Lund, Aruna Natarajan, Ejigayehu Demissie, Elizabeth E Foglia
BACKGROUND: Invasive mechanical ventilation contributes to bronchopulmonary dysplasia (BPD), the most common complication of prematurity and the leading respiratory cause of childhood morbidity. Non-invasive ventilation (NIV) may limit invasive ventilation exposure and can be either synchronized or non-synchronized (NS). Pooled data suggest synchronized forms may be superior. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA) delivers NIV synchronized to the neural signal for breathing, which is detected with a specialized catheter...
March 20, 2024: Trials
https://read.qxmd.com/read/38301744/-how-i-do-it-home-non-invasive-ventilation-in-copd
#2
REVIEW
Marta Kaminska, Veronique Adam, Jeremy Orr
There is increasing evidence that long-term NIV (LT-NIV) can improve outcomes in individuals with severe, hypercapnic COPD. Though the evidence remains uncluear in some aspects, LT-NIV appears to be able to improve patient-related and physiological outcomes like dyspnea, FEV1, PCO2 , and also reduce rehospitalizations and mortality. Efficacy is generally associated with reduction in PCO2 . To achieve this, an adequate interface (mask) is essential, as are appropriate ventilation settings that target the specific respiratory physiology of COPD...
January 30, 2024: Chest
https://read.qxmd.com/read/38117367/pendelluft-in-hypoxemic-patients-resuming-spontaneous-breathing-proportional-modes-versus-pressure-support-ventilation
#3
JOURNAL ARTICLE
Daniel H Arellano, Roberto Brito, Caio C A Morais, Pablo Ruiz-Rudolph, Abraham I J Gajardo, Dannette V Guiñez, Marioli T Lazo, Ivan Ramirez, Verónica A Rojas, María A Cerda, Juan N Medel, Victor Illanes, Nivia R Estuardo, Alejandro R Bruhn, Laurent J Brochard, Marcelo B P Amato, Rodrigo A Cornejo
BACKGROUND: Internal redistribution of gas, referred to as pendelluft, is a new potential mechanism of effort-dependent lung injury. Neurally-adjusted ventilatory assist (NAVA) and proportional assist ventilation (PAV +) follow the patient's respiratory effort and improve synchrony compared with pressure support ventilation (PSV). Whether these modes could prevent the development of pendelluft compared with PSV is unknown. We aimed to compare pendelluft magnitude during PAV + and NAVA versus PSV in patients with resolving acute respiratory distress syndrome (ARDS)...
December 20, 2023: Annals of Intensive Care
https://read.qxmd.com/read/38088791/an-initial-investigation-of-diaphragm-neurostimulation-in-patients-with-acute-respiratory-distress-syndrome
#4
JOURNAL ARTICLE
Mélodie Parfait, Elizabeth Rohrs, Vincent Joussellin, Julien Mayaux, Maxens Decavèle, Steven Reynolds, Thomas Similowski, Alexandre Demoule, Martin Dres
BACKGROUND: Lung protective ventilation aims at limiting lung stress and strain. By reducing the amount of pressure transmitted by the ventilator into the lungs, diaphragm neurostimulation offers a promising approach to minimize ventilator-induced lung injury. This study investigates the physiologic effects of diaphragm neurostimulation in acute respiratory distress syndrome (ARDS) patients. The hypothesis was that diaphragm neurostimulation would improve oxygenation, would limit the distending pressures of the lungs, and would improve cardiac output...
March 1, 2024: Anesthesiology
https://read.qxmd.com/read/37902352/lung-and-diaphragm-protection-during-mechanical-ventilation-synchrony-matters
#5
EDITORIAL
L Felipe Damiani, Ewan C Goligher
No abstract text is available yet for this article.
November 1, 2023: Critical Care Medicine
https://read.qxmd.com/read/37464381/management-of-severe-acute-respiratory-distress-syndrome-a-primer
#6
REVIEW
John C Grotberg, Daniel Reynolds, Bryan D Kraft
This narrative review explores the physiology and evidence-based management of patients with severe acute respiratory distress syndrome (ARDS) and refractory hypoxemia, with a focus on mechanical ventilation, adjunctive therapies, and veno-venous extracorporeal membrane oxygenation (V-V ECMO). Severe ARDS cases increased dramatically worldwide during the Covid-19 pandemic and carry a high mortality. The mainstay of treatment to improve survival and ventilator-free days is proning, conservative fluid management, and lung protective ventilation...
July 18, 2023: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/37373973/hiccup-like-contractions-in-mechanically-ventilated-patients-individualized-treatment-guided-by-transpulmonary-pressure
#7
JOURNAL ARTICLE
Evangelia Akoumianaki, Maria Bolaki, Georgios Prinianakis, Ioannis Konstantinou, Meropi Panagiotarakou, Katerina Vaporidi, Dimitrios Georgopoulos, Eumorfia Kondili
Hiccups-like contractions, including hiccups, respiratory myoclonus, and diaphragmatic tremor, refer to involuntary, spasmodic, and inspiratory muscle contractions. They have been repeatedly described in mechanically ventilated patients, especially those with central nervous damage. Nevertheless, their effects on patient-ventilator interaction are largely unknown, and even more overlooked is their contribution to lung and diaphragm injury. We describe, for the first time, how the management of hiccup-like contractions was individualized based on esophageal and transpulmonary pressure measurements in three mechanically ventilated patients...
June 12, 2023: Journal of Personalized Medicine
https://read.qxmd.com/read/37368792/successful-management-of-suspected-propofol-dependence-with-phenobarbital-in-an-adult-patient-with-covid-19
#8
JOURNAL ARTICLE
Megan E Feeney, Katrina Steiling
DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: In critically ill patients, high sedation requirements for prolonged durations are often needed to achieve ventilator synchrony, a practice that was particularly common during the early stages of the coronavirus disease 2019 (COVID-19) pandemic...
June 27, 2023: American Journal of Health-system Pharmacy: AJHP
https://read.qxmd.com/read/37259052/comparative-evaluation-of-three-total-full-face-masks-for-delivering-non-invasive-positive-pressure-ventilation-nppv-a-bench-study
#9
JOURNAL ARTICLE
Giorgia Spinazzola, Giuliano Ferrone, Roberta Costa, Marco Piastra, Gianmarco Maresca, Marco Rossi, Massimo Antonelli, Giorgio Conti
Historically, the oro-nasal mask has been the preferred interface to deliver Non-Invasive Positive Pressure Ventilation (NPPV) in critically ill patients. To overcome the problems related to air leaks and discomfort, Total Full-face masks have been designed. No study has comparatively evaluated the performance of the total Full-face masks available.The aim of this bench study was to evaluate the influence of three largely diffuse models of total Full -face masks on patient-ventilator synchrony and performance during pressure support ventilation...
May 31, 2023: BMC Pulmonary Medicine
https://read.qxmd.com/read/37057237/the-effect-of-switching-from-volume-controlled-to-pressure-controlled-ventilation-on-respiratory-distress-and-asynchrony-index-improvement-among-mechanically-ventilated-adults
#10
JOURNAL ARTICLE
Mahmoud Saghaei, Saeed Abbasi, Babak Alikiaii, Sayed Hamid Pakzad Moghadam
BACKGROUND: It is important to synchrony the time, intensity, and respiratory signal of the phrenic nerve between the patient and the ventilator. This study aimed to evaluate the effect of switching from volume-controlled to pressure-controlled ventilation on respiratory distress and asynchrony index improvement. MATERIALS AND METHODS: In this randomized controlled clinical trial, 70 patients admitted to the intensive care unit under mechanical ventilation were included...
2023: Advanced Biomedical Research
https://read.qxmd.com/read/36983171/monitoring-systems-in-home-ventilation
#11
REVIEW
Jean-Michel Arnal, Mathilde Oranger, Jésus Gonzalez-Bermejo
Non-invasive ventilation (NIV) is commonly used at home for patient with nocturnal hypoventilation caused by a chronic respiratory failure. Monitoring NIV is required to optimize the ventilator settings when the lung condition changes over time, and to detect common problems such as unintentional leaks, upper airway obstructions, and patient-ventilator asynchronies. This review describes the accuracy and limitations of the data recorded by the ventilator. To efficiently interpret this huge amount of data, clinician assess the daily use and regularity of NIV utilization, the unintentional leaks and their repartition along the NIV session, the apnea-hypopnea index and the flow waveform, and the patient-ventilator synchrony...
March 10, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/36973743/study-protocol-for-a-randomized-controlled-trial-of-proportional-assist-ventilation-for-minimizing-the-duration-of-mechanical-ventilation-the-promizing-study
#12
JOURNAL ARTICLE
Karen J Bosma, Claudio M Martin, Karen E A Burns, Jordi Mancebo Cortes, Juan Carlos Suárez Montero, Yoanna Skrobik, Kevin E Thorpe, Andre Carlos Kajdacsy-Balla Amaral, Yaseen Arabi, John Basmaji, Gaëtan Beduneau, Francois Beloncle, Guillaume Carteaux, Emmanuel Charbonney, Alexandre Demoule, Martin Dres, Vito Fanelli, Anna Geagea, Ewan Goligher, François Lellouche, Tommaso Maraffi, Alain Mercat, Pablo O Rodriguez, Jason Shahin, Stephanie Sibley, Savino Spadaro, Katerina Vaporidi, M Elizabeth Wilcox, Laurent Brochard
BACKGROUND: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a mechanical ventilation mode that delivers assistance to breathe in proportion to the patient's effort. The proportional assistance, called the gain, can be adjusted by the clinician to maintain the patient's respiratory effort or workload within a normal range. Short-term and physiological benefits of this mode compared to pressure support ventilation (PSV) include better patient-ventilator synchrony and a more physiological response to changes in ventilatory demand...
March 27, 2023: Trials
https://read.qxmd.com/read/36935544/successful-treatment-of-propofol-related-infusion-syndrome-in-critically-ill-patient-receiving-low-dose-propofol-infusion-a-case-report
#13
Nahyeon Park, Tae Sun Ha
Propofol is widely used to sedate agitated patients in intensive care units. However, it can cause a rare but fatal complication, propofol-related infusion syndrome (PRIS). The pathophysiology of PRIS is not clear, and there is no definitive diagnosis and treatment. We report a successfully treated case of PRIS in a critically ill patient receiving low-dose propofol infusion. A 59-year-old male patient complaining of sudden chest pain repeatedly collapsed in an ambulance and the emergency room, and veno-arterial extracorporeal membrane oxygenation was delivered...
February 2023: Acute and critical care
https://read.qxmd.com/read/36274552/influence-of-total-face-masks-design-and-circuit-on-synchrony-and-performance-during-pressure-support-ventilation-a-bench-study
#14
JOURNAL ARTICLE
Giuliano Ferrone, Giorgia Spinazzola, Roberta Costa, Marco Piastra, Gianmarco Maresca, Massimo Antonelli, Giorgio Conti
BACKGROUND: Few studies investigated the influence of the circuit applied during non-invasive ventilation (NIV) with a total face mask. The aim of this bench study was to evaluate the effects of separated inflow and outflow ports in a total face mask on patient ventilator interaction and performance during NIV through a total face mask. METHODS: A mannequin was connected to an active lung simulator. NIV was applied both via a standard total face mask (STFM) with a Y-piece connector for inflow/outflow gases and a modified total face mask (MTFM) with 2 different connectors for inflow and outflow gases...
October 20, 2022: Respiratory medicine and research
https://read.qxmd.com/read/36272922/neurally-adjusted-ventilatory-assist-in-infants-a-review-article
#15
REVIEW
Shih-Jou Fang, Chih-Cheng Chen, Da-Ling Liao, Mei-Yung Chung
Neurally adjusted ventilatory assist (NAVA) and non-invasive (NIV)-NAVA are innovative modes of synchronized and proportional respiratory support. They can synchronize with the patients' breathing and promote patient comfort. Both techniques are increasingly being used these years, however experience with their use in newborns and premature infants in Taiwan is relatively few. Because increasing evidence supports the use of NAVA and NIV-NAVA in newborns and premature infants requiring respiratory assist to achieve better synchrony, the aim of this article is to discuss whether NAVA can provide better synchronization and comfort for ventilated newborns and premature babies...
January 2023: Pediatrics and Neonatology
https://read.qxmd.com/read/36258708/novel-treatment-of-ventilator-dyssynchrony-from-central-alveolar-hypoventilation-syndrome-utilizing-scheduled-5-hydroxytryptamine-3-receptor-antagonist
#16
Aldin Malkoc, Ashley Stading, Stephanie Wong, Tara Weaver, Leslie Ghisletta
Traumatic brain injury (TBI) occurs in a large percentage of surgical trauma patients and is one of the leading causes of death amongst young teens and adults. Furthermore, individuals with TBIs often require mechanical ventilation and admission to the intensive care unit. As a result of their TBIs, these patients can develop central alveolar hypoventilation (CAH) secondary to disruptions in neuromodulatory respiratory brainstem control and neural signal initiation and integration. Prior studies have primarily focused their attention on treatment of congenital disorders of CAH, and limited research is available on intubated trauma patients who have signs of ventilator dyssynchrony...
September 2022: Journal of Medical Cases
https://read.qxmd.com/read/36116818/patient-ventilator-synchrony
#17
REVIEW
Kevin C Doerschug
Patient-ventilator asynchrony develops when the ventilator output does not match the efforts of the patient and contributes to excess work of breathing, lung injury, and mortality. Asynchronies are categorized as trigger (breath initiation), flow (delivery of the breath), and cycle (transition from inspiration to expiration). Clinicians should be skilled at ventilator waveform analysis to detect patient-ventilator asynchronies and make informed ventilator adjustments. Ventilator overdrive suppresses respiratory drive and reduces asynchrony, while other adjustments specific to the asynchrony are also useful...
September 2022: Clinics in Chest Medicine
https://read.qxmd.com/read/35941145/synchronized-and-proportional-sub-diaphragmatic-unloading-in-an-animal-model-of-respiratory-distress
#18
JOURNAL ARTICLE
Jennifer Beck, Hong-Liang Li, Cong Lu, Douglas M Campbell, Christer Sinderby
BACKGROUND: A sealed abdominal interface was positioned below the diaphragm (the "NeoVest") to apply synchronized and proportional negative pressure ventilation (NPV) and was compared to positive pressure ventilation (PPV) using neurally adjusted ventilatory assist (NAVA). Both modes were controlled by the diaphragm electrical activity (Edi). METHODS: Eleven rabbits (mean weight 2.9 kg) were instrumented, tracheotomized, and ventilated with either NPV or PPV (sequentially) with different loads (resistive, dead space, acute lung injury)...
August 8, 2022: Pediatric Research
https://read.qxmd.com/read/35795983/the-use-of-neurally-adjusted-ventilatory-assist-nava-for-infants-with-congenital-diaphragmatic-hernia-cdh
#19
REVIEW
Grace Poole, Sandeep Shetty, Anne Greenough
OBJECTIVES: Newborns with congenital diaphragmatic hernia (CDH) can have complex respiratory problems which are worsened by ventilatory induced lung injury. Neurally adjusted ventilator assist (NAVA) is a potentially promising ventilation mode for this population, as it can result in improved patient-ventilator interactions and provision of adequate gas exchange at lower airway pressures. CONTENT: A literature review was undertaken to provide an overview of NAVA and examine its role in the management of infants with CDH...
November 25, 2022: Journal of Perinatal Medicine
https://read.qxmd.com/read/35593878/analgosedation-in-critically-ill-adults-receiving-extracorporeal-membrane-oxygenation-support
#20
REVIEW
Jessica Crow, John Lindsley, Sung-Min Cho, Jing Wang, James H Lantry, Bo S Kim, Pouya Tahsili-Fahadan
Extracorporeal membrane oxygenation (ECMO) is an increasingly utilized intervention for cardiopulmonary failure. Analgosedation during ECMO support is essential to ensure adequate pain and agitation control and ventilator synchrony, optimize ECMO support, facilitate patient assessment, and minimize adverse events. Although the principles of analgosedation are likely similar for all critically ill patients, ECMO circuitry alters medication pharmacodynamics and pharmacokinetics. The lack of clinical guidelines for analgosedation during ECMO, especially at times of medication shortage, can affect patient management...
December 1, 2022: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
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