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Katrina L Weaver, Joanne E Baerg, Manabu Okawada, Go Miyano, Katherine A Barsness, Martin Lacher, Dani O Gonzalez, Peter C Minneci, Lena Perger, Shawn D St Peter
INTRODUCTION: Thoracoscopic repair of a congenital diaphragmatic hernia (CDH) in the neonate is controversial due to reports of increased hernia recurrence. A multicenter review on thoracoscopic CDH repair was conducted to evaluate outcomes and to identify factors that are associated with recurrence. METHODS: A multicenter retrospective review was conducted from 2009 to 2015 in neonates who were treated for CDH with thoracoscopic repair. Demographics, preoperative, intraoperative, including repair techniques, and postoperative variables were analyzed by using descriptive statistics...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Manuel Sánchez-Luna, Noelia González-Pacheco, Martín Santos, Ángel Blanco, Cristina Orden, Jaques Belik, Francisco J Tendillo
UNLABELLED: The objective of this study was to analyze the effect of I/E ratio on carbon dioxide (CO2) elimination during high-frequency oscillatory ventilation (HFOV) combined with volume guarantee (VG). Five 2-day-old piglets were studied before and after a bronchoalveolar lavage (BAL). The effect of an I/E ratio of 1:1 and 1:2 with (VG-ON) and without VG (VG-OFF) on PaCO2, as well as delta and mean airway pressures at the airway opening (∆Phf-ao, mPaw-ao) and at the tracheal level (∆Phf-t, mPaw-t) were evaluated at frequencies of 5, 8, 11, and 14 Hz...
October 2016: European Journal of Pediatrics
Christophe Guervilly, Jean-Marie Forel, Sami Hraiech, Antoine Roch, Daniel Talmor, Laurent Papazian
BACKGROUND: High-frequency oscillatory ventilation (HFOV) has not been shown to be beneficial in the management of moderate-to-severe acute respiratory distress syndrome (ARDS). There is uncertainty about the actual pressure applied into the lung during HFOV. We therefore performed a study to compare the transpulmonary pressure (P L) during conventional mechanical ventilation (CMV) and different levels of mean airway pressure (mPaw) during HFOV. METHODS: This is a prospective randomized crossover study in a university teaching hospital...
December 2016: Annals of Intensive Care
Giovanni Vento, Roberta Pastorino, Luca Boni, Francesco Cota, Virgilio Carnielli, Filip Cools, Carlo Dani, Fabio Mosca, Jane Pillow, Graeme Polglase, Paolo Tagliabue, Anton H van Kaam, Maria Luisa Ventura, Milena Tana, Chiara Tirone, Claudia Aurilia, Alessandra Lio, Cinzia Ricci, Alessandro Gambacorta, Chiara Consigli, Danila D'Onofrio, Camilla Gizzi, Luca Massenzi, Viviana Cardilli, Alessandra Casati, Roberto Bottino, Federica Pontiggia, Elena Ciarmoli, Stefano Martinelli, Laura Ilardi, Mariarosa Colnaghi, Piero Giuseppe Matassa, Valentina Vendettuoli, Paolo Villani, Francesca Fusco, Diego Gazzolo, Alberto Ricotti, Federica Ferrero, Ilaria Stasi, Rosario Magaldi, Gianfranco Maffei, Giuseppe Presta, Roberto Perniola, Francesco Messina, Giovanna Montesano, Chiara Poggi, Lucio Giordano, Enza Roma, Carolina Grassia, Gaetano Ausanio, Fabrizio Sandri, Giovanna Mescoli, Francesco Giura, Giampaolo Garani, Agostina Solinas, Maria Lucente, Gabriella Nigro, Antonello Del Vecchio, Flavia Petrillo, Luigi Orfeo, Lidia Grappone, Lorenzo Quartulli, Antonio Scorrano, Hubert Messner, Alex Staffler, Giancarlo Gargano, Eleonora Balestri, Stefano Nobile, Caterina Cacace, Valerio Meli, Sara Dallaglio, Betta Pasqua, Loretta Mattia, Eloisa Gitto, Marcello Vitaliti, Maria Paola Re, Stefania Vedovato, Alessandra Grison, Alberto Berardi, Francesco Torcetta, Isotta Guidotti, Sandra di Fabio, Eugenia Maranella, Isabella Mondello, Stefano Visentin, Francesca Tormena
BACKGROUND: Although beneficial in clinical practice, the INtubate-SURfactant-Extubate (IN-SUR-E) method is not successful in all preterm neonates with respiratory distress syndrome, with a reported failure rate ranging from 19 to 69 %. One of the possible mechanisms responsible for the unsuccessful IN-SUR-E method, requiring subsequent re-intubation and mechanical ventilation, is the inability of the preterm lung to achieve and maintain an "optimal" functional residual capacity. The importance of lung recruitment before surfactant administration has been demonstrated in animal studies showing that recruitment leads to a more homogeneous surfactant distribution within the lungs...
2016: Trials
Mohd Basri Mat Nor, Azrina Md Ralib, Noor Airini Ibrahim, Mohd Rasydan Abdul-Ghani
Hypoxemia in severe leptospirosis-associated pulmonary hemorrhage syndrome (LPHS) is a challenging clinical scenario not usually responsive to maximal support on mechanical ventilation. We described the efficacy and safety of high frequency oscillatory ventilation (HFOV) as rescue therapy in acute respiratory failure secondary to LPHS. This is a retrospective case study of five patients with diagnosis of severe LPHS, who were admitted to Intensive Care Unit from October 2014 to January 2015. They developed refractory hypoxemia on conventional mechanical ventilation and rescue therapy was indicated...
June 2016: Indian Journal of Critical Care Medicine
Albert P Nguyen, Ulrich H Schmidt, Neil R MacIntyre
High-frequency oscillatory ventilation (HFOV) can improve ventilation-perfusion matching without excessive alveolar tidal stretching or collapse-reopening phenomenon. This is an attractive feature in the ventilation of patients with ARDS. However, two recent large multi-center trials of HFOV failed to show benefits in this patient population. The following review addresses whether, in view of these trails, HFOV should be abandoned in the adult population?
June 2016: Respiratory Care
Masahiro Enomoto, Martin Keszler, Mio Sakuma, Shin Kikuchi, Yoshinori Katayama, Atsuko Takei, Hitoshi Ikegami, Hirotaka Minami
Objectives Although adding volume guarantee (VG) to conventional ventilation has been a well-established respiratory management for preterm infants, the evidence of VG combined with high-frequency oscillatory ventilation (HFOV) has not been studied well. The aim of this study was to investigate the effect of VG added to HFOV on respiratory and other physiological parameters. Methods We conducted a pilot study in extremely low-birth-weight infants ventilated with HFOV + VG with stable pulmonary status after 28 days of age...
May 16, 2016: American Journal of Perinatology
Robert M DiBlasi, Dave N Crotwell, Shuijie Shen, Jiang Zheng, James B Fink, Delphine Yung
Iloprost is a selective pulmonary vasodilator approved for inhalation by the Food and Drug Administration. Iloprost has been increasingly used in the management of critically ill neonates with hypoxic lung disease. This in vitro study was designed to test the hypothesis that aerosol drug delivery could be effectively administered to infants with both conventional ventilation and high-frequency oscillatory ventilation (HFOV). A neonatal test lung model configured with newborn lung mechanics was ventilated with a conventional ventilator and an HFOV with standard settings...
March 2016: Pulmonary Circulation
Yahya H Ethawi, Ayman Abou Mehrem, John Minski, Chelsea A Ruth, Peter G Davis
BACKGROUND: Respiratory distress syndrome (RDS) is considered one of the major contributors to severe pulmonary dysfunction and consequent death in preterm infants. Despite widespread improvements in care, including increased utilization of antenatal steroids, use of surfactant replacement therapy, and advances in conventional mechanical ventilation (CMV), chronic lung disease (CLD) occurs in 42% of surviving preterm infants born at less than 28 weeks gestational age (GA). High frequency ventilation (HFV) aims to optimize lung expansion while minimizing tidal volume (Vt) to decrease lung injury...
2016: Cochrane Database of Systematic Reviews
Rujipat Samransamruajkit, Chavisa Rassameehirun, Khemmachart Pongsanon, Sumalee Huntrakul, Jitladda Deerojanawong, Suchada Sritippayawan, Nuanchan Prapphal
PURPOSE: To determine the efficacy of lung volume recruitment maneuver (LVRM) with high frequency oscillatory ventilation (HFOV) on oxygenation, hemodynamic alteration, and clinical outcomes when compared to conventional mechanical ventilation (CV) in children with severe acute respiratory distress syndrome (ARDS). MATERIALS: We performed a randomized controlled trial and enrolled pediatric patients who were diagnosed to have severe ARDS upon pediatric intensive care unit (PICU) admission...
February 2016: Indian Journal of Critical Care Medicine
Marianna Laviola, Jakub Rafl, Martin Rozanek, Petr Kudrna, Karel Roubik
UNLABELLED: Purpose/Aim : High-frequency oscillatory ventilation (HFOV) is a method of ventilation that theoretically achieves the goals of lung protective ventilation in acute respiratory distress syndrome (ARDS) patients. It is characterized by a rapid delivery of small tidal volumes at high frequencies oscillating around a continuous distending pressure (CDP). Optimization of CDP is not an easy task and it is titrated empirically in the clinical practice. The aim of this study is to investigate whether the level of CDP consistently affects the shape of the partial pressure of oxygen (PaO2) response to stepwise changes in CDP during HFOV of healthy and ARDS-induced pigs...
2016: Experimental Lung Research
Tien-Pei Fang, Hui-Ling Lin, Shu-Hua Chiu, Szu-Hui Wang, Robert M DiBlasi, Ying-Huang Tsai, James B Fink
BACKGROUND: High frequency oscillatory ventilation (HFOV) is used in critically ill patients with severe hypoxemic respiratory failure. The purpose of this in vitro study was to determine the efficiency of aerosol delivery with different lung parameters during simulated neonatal, pediatric, and adult HFOV. METHODS: Sensormedics 3100A/B ventilators were used to deliver infant, pediatric, and adult HFOV. Two types of aerosol generators were chosen for testing: 1) a continuous jet nebulizer (JN) with a unit-dose of 5...
March 14, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Tariq Altokhais, Mohammad Aqil Soomro, Abdulmonem Gado, Abdulrahman Albassam
Objectives This study aims to evaluate the feasibility, safety, limitations, and outcomes of performing different surgical approaches and techniques for the bedside repair of congenital diaphragmatic hernia (CDH) in critically ill patients who cannot be transferred to the operating room. Study Design Between December 1997 and July 2013, medical charts of all neonates operated on at the bedside for CDH while on high-frequency oscillatory ventilation (HFOV) and nitric oxide were reviewed. Demographic data; contributing antenatal, perinatal, and postnatal factors; clinical presentation; associated anomalies; respiratory and hemodynamic status; operative details; complications, and outcome were analyzed...
July 2016: American Journal of Perinatology
Ewa Basiewicz-Slaczka, Bogumiła Wołoszczuk-Gebicka, Sadeq Yaqoub, Andrzej Kamiński
UNLABELLED: The predicitive values of fetal ultrasonography and magnetic resonance imaging are well established as antenatal outcome predictors in neonates with congenital diaphragmatic hernia (CHD). Postnatal outcome predictors remain elusive. THE AIM: To evaluate the value of the oxygenation index (OI) as a predictor of postnatal survival. MATERIAL AND METHODS: 58 newborns with congenital diaphragmatic hernia, treated in the same centre (a university hospital) between February 2006 and March 2014 were involved in the retrospective study...
July 2015: Developmental Period Medicine
YueYang Yuan, JianGuo Sun, Baicun Wang, Pei Feng, ChongChang Yang
After the High Frequency Oscillatory Ventilation (HFOV) has been applied in the invasive ventilator, the new technique of noninvasive High Frequency Oscillatory Ventilation (nHFOV) which does not require opening the patient's airway has attracted much attention from the field. This paper proposes the design of an experimental positive pressure-controlled nHFOV ventilator which utilizes a blower and a special valve and has three ventilation modes: spontaneous controlled ventilation combining HFOV, time-cycled ventilation combining HFOV (T-HFOV), and continuous positive airway pressure ventilation combining HFOV...
February 2016: Review of Scientific Instruments
Daniele De Luca, Roberta Costa, Federico Visconti, Marco Piastra, Giorgio Conti
OBJECTIVE: Noninvasive high frequency oscillatory ventilation (NHFOV) has not been studied beyond neonatal age and with interfaces other than nasal prongs. We set up a preliminary study to investigate feasibility, oscillation transmission, and volume delivery of face mask-delivered NHFOV in a bench model mimicking a normal 1-year infant without any lung disease and then in vivo in a series of infants with same characteristics. DESIGN: A mannequin with upper airways was connected to an electronic active lung simulator ventilated through NHFOV with varying parameters...
July 2016: Pediatric Pulmonology
N González-Pacheco, M Sánchez-Luna, C Ramos-Navarro, N Navarro-Patiño, A R-S de la Blanca
OBJECTIVE: High-frequency oscillatory ventilation (HFOV) has been described as a rescue therapy in severe respiratory distress syndrome (RDS) with a potential protective effect in immature lungs. In recent times, HFOV combined with the use of volume guarantee (VG) strategy has demonstrated an independent effect of the frequency on tidal volume to increase carbon-dioxide (CO2) elimination. The aim of this study was to demonstrate the feasibility of using the lowest tidal volume on HFOV+VG to prevent lung damage, maintaining a constant CO2 elimination by increasing the frequency...
April 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Jie Luo, Guanghua Guo, Feng Zhu, Zhonghua Fu, Xincheng Liao, Mingzhuo Liu
OBJECTIVE: To compare the effects of high frequency oscillatory ventilation (HFOV) combined with incremental positive end-expiratory pressure (IP) and those of pure HFOV on myocardial ischemia and hypoxia and apoptosis of cardiomyocytes in dogs with smoke inhalation injury. METHODS: Twelve healthy male dogs were divided into group HFOV and group HFOV+IP according to the random number table, with 6 dogs in each group. After being treated with conventional mechanical ventilation, dogs in both groups were inflicted with severe smoke inhalation injury, and then they received corresponding ventilation for 8 hours respectively...
August 2015: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Selma Aktas, Sezin Unal, Meltem Aksu, Ebru Ozcan, Ebru Ergenekon, Canan Turkyilmaz, Ibrahim Hirfanoglu, Yildiz Atalay
Non-invasive ventilation has been used increasingly in recent years to reduce the duration of endotracheal ventilation and its complications, especially bronchopulmonary dysplasia. Nasal continuous positive airway pressure and nasal intermittent positive pressure ventilation are the most common non-invasive modalities, and nasal high-frequency oscillatory ventilation (n-HFOV) is relatively new but it seems effective and feasible. We present three premature cases who were ventilated with n-HFOV with Neotech RAM Cannula as interphase...
April 2016: Journal of Tropical Pediatrics
Toshiharu Matsuura, Koichiro Yoshimaru, Yusuke Yanagi, Genshiro Esumi, Makoto Hayashida, Tomoaki Taguchi
A massive pulmonary hemorrhage in patients with liver cirrhosis is a life-threatening complication that may result in a contraindication of a liver transplantation because of its high mortality rate. Herein, we present two infant biliary atresia cases that successfully underwent an LDLT that was followed by intensive respiratory care for the pretransplant massive pulmonary hemorrhage. Both cases exhibited severe respiratory failure (minimum PaO2/FiO2; 46 mmHg and 39 mmHg, respectively). To arrest the bleeding, we applied a very high positive pressure ventilation treatment (maximum PIP/PEEP; 38/14 cmH2O and 55/15 cmH2O, respectively), plasma exchange, several FFP transfusions, and recombinant factor VIIa via intrapulmonary administration...
February 2016: Pediatric Transplantation
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