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Airway pressure release ventilation

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https://www.readbyqxmd.com/read/27913141/acute-lung-injury-and-persistent-small-airway-disease-in-a-rabbit-model-of-chlorine-inhalation
#1
Sadiatu Musah, Connie F Schlueter, David M Humphrey, Karen S Powell, Andrew M Roberts, Gary W Hoyle
Chlorine is a pulmonary toxicant to which humans can be exposed through accidents or intentional releases. Acute effects of chlorine inhalation in humans and animal models have been well characterized, but less is known about persistent effects of acute, high-level chlorine exposures. In particular, animal models that reproduce the long-term effects suggested to occur in humans are lacking. Here, we report the development of a rabbit model in which both acute and persistent effects of chlorine inhalation can be assessed...
November 29, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27850698/1060-multidisciplinary-attitudes-about-airway-pressure-release-ventilation-in-an-academic-picu
#2
Mohammad Quraishi, Ryan Breuer, Amanda Hassinger
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850620/982-airway-pressure-release-ventilation-accelerates-mucus-clearance-via-increased-expiratory-flow-rate
#3
Melissa Mahajan, David DiStefano, Josh Satalin, Penny Andrews, Sumeet Jain, Quinn Searles, Louis Gatto, Nader Habashi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#4
REVIEW
Gregory A Schmidt
The foundation of mechanical ventilation for acute respiratory distress syndrome involves limiting lung overdistention by using small tidal volumes or transpulmonary pressures. Potential for additional lung recruitment with higher positive end-expiratory pressure (PEEP) should be assessed. When stress index indicates tidal recruitment-derecruitment, PEEP is increased to higher values. Alternatively, a high PEEP table is used in all patients. When these conventional approaches are insufficient to sustain acceptable gas exchange, rescue is attempted using extracorporeal therapies, airway pressure-release ventilation, inhaled vasodilators, or high-frequency oscillatory ventilation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27842540/the-impact-of-low-frequency-low-force-cyclic-stretching-of-human-bronchi-on-airway-responsiveness
#5
Morgan Le Guen, Stanislas Grassin-Delyle, Emmanuel Naline, Amparo Buenestado, Marion Brollo, Elisabeth Longchampt, Philippe Kleinmann, Philippe Devillier, Christophe Faisy
BACKGROUND: In vivo, the airways are constantly subjected to oscillatory strain (due to tidal breathing during spontaneous respiration) and (in the event of mechanical ventilation) positive pressure. This exposure is especially problematic for the cartilage-free bronchial tree. The effects of cyclic stretching (other than high-force stretching) have not been extensively characterized. Hence, the objective of the present study was to investigate the functional and transcriptional response of human bronchi to repetitive mechanical stress caused by low-frequency, low-force cyclic stretching...
November 14, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27742245/airway-pressure-release-ventilation-during-ex%C3%A2-vivo-lung-perfusion-attenuates-injury
#6
J Hunter Mehaffey, Eric J Charles, Ashish K Sharma, Dustin T Money, Yunge Zhao, Mark H Stoler, Christine L Lau, Curtis G Tribble, Victor E Laubach, Mark E Roeser, Irving L Kron
OBJECTIVE: Critical organ shortages have resulted in ex vivo lung perfusion gaining clinical acceptance for lung evaluation and rehabilitation to expand the use of donation after circulatory death organs for lung transplantation. We hypothesized that an innovative use of airway pressure release ventilation during ex vivo lung perfusion improves lung function after transplantation. METHODS: Two groups (n = 4 animals/group) of porcine donation after circulatory death donor lungs were procured after hypoxic cardiac arrest and a 2-hour period of warm ischemia, followed by a 4-hour period of ex vivo lung perfusion rehabilitation with standard conventional volume-based ventilation or pressure-based airway pressure release ventilation...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27651443/changes-in-therapeutic-intensity-level-following-airway-pressure-release-ventilation-in-severe-traumatic-brain-injury
#7
Jeffrey J Fletcher, Thomas J Wilson, Venkatakrishna Rajajee, Scott B Davidson, Jon C Walsh
PURPOSE: Airway pressure release ventilation (APRV) utilizes high levels of airway pressure coupled with brief expiratory release to facilitate open lung ventilation. The aim of our study was to evaluate the effects of APRV-induced elevated airway pressure mean in patients with severe traumatic brain injury. MATERIALS AND METHODS: This was a retrospective cohort study at a 424-bed Level I trauma center. Linear mixed effects models were developed to assess the difference in therapeutic intensity level (TIL), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) over time following the application of APRV...
September 20, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27649372/the-improvement-of-respiratory-performance-after-phototherapy-induced-epc-mobilization-in-preterm-infants-with-rds
#8
Vahid Siavashi, Simin Asadian, Masoud Taheri-Asl, Homa Babaei, Samaneh Keshavarz, Mohammad Bazaei, Seyed Mahdi Nassiri
Many infants who develop bronchopulmonary dysplasia (BPD) are born with serious respiratory distress syndrome (RDS), which is associated with impaired vascular and alveolar growth. RDS is a breathing disorder that mostly affects preterm infants and occurs in infants whose lungs have not yet been fully developed. The use of surfactant in RDS treatment does not necessarily prevent BPD. Endothelial progenitor cells (EPCs) may contribute to lung angiogenesis for the prevention and treatment of BPD. The aim of this study was to evaluate the therapeutic efficacy of phototherapy for EPC release in preterm infants born with RDS...
September 20, 2016: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/27591380/successful-management-using-airway-pressure-release-ventilation-for-severe-postoperative-pulmonary-edema
#9
Yoshihisa Morimoto, Takaki Sugimoto, Hiroki Arase, Fumiya Haba
INTRODUCTION: Postoperative pulmonary edema is a fatal adverse event after a cardiac surgery. We here report successful management using airway pressure release ventilation (APRV) for severe hypoxia with pulmonary edema after a cardiac surgery. PRESENTATION OF CASE: A 58-year-old man underwent an uneventful mitral valve repair. Immediately afterwards, the patient became agitated and made vigorous inspiratory efforts. His oxygen saturation dropped to 90%. Coarse inspiratory rhonchi were heard on auscultation, and copious, pink, frothy sputum was obtained with suctioning...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27588065/effect-of-setting-high-aprv-guided-by-expiratory-inflection-point-of-pressure-volume-curve-on-oxygen-delivery-in-canine-models-of-severe-acute-respiratory-distress-syndrome
#10
Jia-Qiong Li, Hong-Yang Xu, Mao-Qin Li, Jing-Yu Chen
In the present study, the effect of setting high airway pressure release ventilation (APRV) pressure guided by an expiratory inflection point of pressure-volume (PV) curve following lung recruitment maneuver (RM) on oxygen delivery (DO2) in canine models of severe acute respiratory distress syndrome (ARDS) was examined. Canine models of severe ARDS were established by intravenous injection of oleic acid. After injection of sedative muscle relaxants, a PV curve plotted using the super-syringe technique, and the pressure at lower inflection point (LIP) at the inhale branch and the pressure at the point of maximum curvature (PMC) at the exhale branch were measured...
September 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27470480/-application-of-research-advance-in-airway-pressure-release-ventilation-in-children
#11
Zheng Li, Quan Wang, Suyun Qian
No abstract text is available yet for this article.
January 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27383316/clinical-research-about-airway-pressure-release-ventilation-for-moderate-to-severe-acute-respiratory-distress-syndrome
#12
J-Q Li, N Li, G-J Han, C-G Pan, Y-H Zhang, X-Z Shi, J-Y Xu, B Lu, M-Q Li
OBJECTIVE: To evaluate clinical effects of airway pressure release ventilation (APRV) in patients suffering from moderate to severe acute respiratory distress syndrome (ARDS).e of a patient presented with significant high aminotransferase levels due to the first human R. aeschlimannii infection ever detected in Italy. The hypothesis of rickettsiosis was made on the basis of a comprehensive medical history and was confirmed by serological tests. Molecular analyses made on a sample of hepatic tissue revealed the presence of a rickettsial species never found before in human liver...
June 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27377010/worsening-hypoxemia-in-the-face-of-increasing-peep-a-case-of-large-pulmonary-embolism-in-the-setting-of-intracardiac-shunt
#13
Glen T Granati, Getu Teressa
BACKGROUND Patent foramen ovale (PFO) are common, normally resulting in a left-to-right shunt or no net shunting. Pulmonary embolism (PE) can cause sustained increased pulmonary vascular resistance (PVR) and right atrial pressure. Increasing positive end-expiratory pressure (PEEP) improves oxygenation at the expense of increasing intrathoracic pressures (ITP). Airway pressure release ventilation (APRV) decreases shunt fraction, improves ventilation/perfusion (V/Q) matching, increases cardiac output, and decreases right atrial pressure by facilitating low airway pressure...
2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27235312/should-airway-pressure-release-ventilation-be-the-primary-mode-in-ards
#14
Eduardo Mireles-Cabodevila, Robert M Kacmarek
Airway pressure release ventilation (APRV) was originally described as a mode to treat lung-injured patients with the goal to maintain a level of airway pressure that would not depress the cardiac function, deliver mechanical breaths without excessive airway pressure, and to allow unrestricted spontaneous ventilation. Indeed, based on its design, APRV has technological features that serve the goals of safety and comfort. Animal studies suggest that APRV leads to alveolar stability and recruitment which result in less lung injury...
June 2016: Respiratory Care
https://www.readbyqxmd.com/read/27207149/the-30-year-evolution-of-airway-pressure-release-ventilation-aprv
#15
REVIEW
Sumeet V Jain, Michaela Kollisch-Singule, Benjamin Sadowitz, Luke Dombert, Josh Satalin, Penny Andrews, Louis A Gatto, Gary F Nieman, Nader M Habashi
Airway pressure release ventilation (APRV) was first described in 1987 and defined as continuous positive airway pressure (CPAP) with a brief release while allowing the patient to spontaneously breathe throughout the respiratory cycle. The current understanding of the optimal strategy to minimize ventilator-induced lung injury is to "open the lung and keep it open". APRV should be ideal for this strategy with the prolonged CPAP duration recruiting the lung and the minimal release duration preventing lung collapse...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27128143/refractory-hypoxemia-and-use-of-rescue-strategies-a-u-s-national-survey-of-adult-intensivists
#16
Rabe E Alhurani, Richard A Oeckler, Pablo Moreno Franco, Sarah M Jenkins, Ognjen Gajic, Sonal R Pannu
RATIONALE: The management of severe and refractory hypoxemia in critically ill adult patients is practice based. Variability across individual practitioners and institutions is not well documented. OBJECTIVES: To conduct a nationwide survey of critical care physicians in the United States regarding accepted definitions and management strategies for severe and refractory hypoxemia. METHODS: A web-based survey was distributed to a stratified random sample of adult intensivists listed in the American Medical Association Physician Masterfile...
July 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27020770/characteristics-and-outcomes-of-patients-treated-with-airway-pressure-release-ventilation-for-acute-respiratory-distress-syndrome-a-retrospective-observational-study
#17
Jolene Lim, Edward Litton, Hayley Robinson, Mike Das Gupta
BACKGROUND: The optimal mode of ventilation in acute respiratory distress syndrome (ARDS) remains uncertain. Airway pressure release ventilation (APRV) is a recognized treatment for mechanically-ventilated patients with severe hypoxaemia. However, contemporary data on its role as a rescue modality in ARDS is lacking. The goal of this study was to describe the clinical and physiological effects of APRV in patients with established ARDS. METHODS: This retrospective observational study was performed in a 23-bed adult intensive care unit in a tertiary extracorporeal membrane oxygenation (ECMO) referral centre...
August 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/26914779/airway-pressure-release-ventilation-in-a-patient-with-refractory-intracranial-hypertension
#18
Christopher J Montanaro
Patients with refractory intracranial hypertension often require short-term mechanical ventilation because they cannot protect their airway. Airway pressure release ventilation (APRV) is less commonly used than other modes because it is thought to increase intracranial pressure. However, this case study describes how APRV improved alveolar recruitment and functional residual capacity in a patient with refractory intracranial hypertension secondary to severe traumatic brain injury.
March 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/26855896/preemptive-mechanical-ventilation-can-block-progressive-acute-lung-injury
#19
REVIEW
Benjamin Sadowitz, Sumeet Jain, Michaela Kollisch-Singule, Joshua Satalin, Penny Andrews, Nader Habashi, Louis A Gatto, Gary Nieman
Mortality from acute respiratory distress syndrome (ARDS) remains unacceptable, approaching 45% in certain high-risk patient populations. Treating fulminant ARDS is currently relegated to supportive care measures only. Thus, the best treatment for ARDS may lie with preventing this syndrome from ever occurring. Clinical studies were examined to determine why ARDS has remained resistant to treatment over the past several decades. In addition, both basic science and clinical studies were examined to determine the impact that early, protective mechanical ventilation may have on preventing the development of ARDS in at-risk patients...
February 4, 2016: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/26844863/airway-management-and-training-in-obstetric-anaesthesia
#20
Mary C Mushambi, Sahana Jaladi
PURPOSE OF REVIEW: Airway management and failed intubation in the pregnant woman requires unique considerations, which differ from the nonpregnant patient. Factors that influence airway management in this setting include anatomical and physiological changes in pregnancy, environmental factors as well as training matters. In addition, surgery is often being performed with extreme urgency, which requires rapid decision-making process that takes into account safe outcome of mother and baby...
June 2016: Current Opinion in Anaesthesiology
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