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Ventilatory modes

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https://www.readbyqxmd.com/read/29792537/recognizing-quantifying-and-managing-patient-ventilator-asynchrony-in-invasive-and-noninvasive-ventilation
#1
Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Luisa Liparota, Nicola Lombardo, Federico Longhini, Paolo Navalesi
Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and non-invasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, considering the techniques used to properly detect asynchronies, by either ventilator waveform observation, or through systems based on more complexes mathematical algorithms, by means of adjunctive signals, such as the electrical activity of the diaphragm or esophageal pressure...
May 24, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#2
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29556805/serial-diaphragm-ultrasonography-to-predict-successful-discontinuation-of-mechanical-ventilation
#3
Atul Palkar, Paul Mayo, Karan Singh, Seth Koenig, Mangala Narasimhan, Anup Singh, Rivkah Darabaner, Harly Greenberg, Eric Gottesman
INTRODUCTION: Diaphragm excursion and contraction velocity measured using ultrasonography have been used to assess diaphragm function. We aimed to evaluate the performance of diaphragm ultrasonography during weaning from mechanical ventilation (MV). METHODS: Diaphragm ultrasonography was performed on 73 mechanically ventilated patients who were being considered for extubation on three separate occasions: (1) on assist control mode (A/C) during consistent patient triggered ventilation, (2) following 30 min during a spontaneous breathing trial (SBT), (3) 4-24 h following extubation...
June 2018: Lung
https://www.readbyqxmd.com/read/29512020/noninvasive-auto-titrating-ventilation-avaps-ae-versus-average-volume-assured-pressure-support-avaps-ventilation-in-hypercapnic-respiratory-failure-patients
#4
Gul Gursel, Avsar Zerman, Burcu Basarik, Kamil Gonderen, Muge Aydogdu, Serriyye Memmedova
Auto-titrating noninvasive ventilation (NIV) has been developed as a new mode applying variable expiratory-positive airway pressure (EPAP) in addition to variable inspiratory pressures (IPAP), both to deliver targeted tidal volume (VT) and to eliminate upper airway resistance. The purpose of this study is to evaluate whether NIV with auto-titrating mode will decrease more PaCO2 within a shorter time compared to volume-assured mode in hypercapnic intensive care unit (ICU) patients. The hypercapnic respiratory failure patients treated with average volume assured pressure support- automated EPAP mode (group1) were compared with those treated with average volume-assured pressure support mode (group2)...
April 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29435333/combining-perceptual-regulation-and-exergaming-for-exercise-prescription-in-low-active-adults-with-and-without-cognitive-impairment
#5
Liam McAuliffe, Gaynor C Parfitt, Roger G Eston, Caitlin Gray, Hannah A D Keage, Ashleigh E Smith
 Background: Exercise adherence in already low-active older adults with and without mild cognitive impairment (MCI) remains low. Perceptual regulation and exergaming may facilitate future exercise behaviour by improving the affective experience, however evidence that this population can perceptually regulate is lacking. To explore this, we investigated 1) perceptual regulation of exercise intensity during either exergaming or regular ergometer cycling and 2) explored affective responses...
2018: BMC Sports Science, Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29431543/high-flow-nasal-oxygen-therapy-utilization-7-year-experience-at-a-community-teaching-hospital
#6
Mihaela S Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K Lindenauer, Jay S Steingrub
OBJECTIVE: To examine the use of high flow nasal cannula oxygen therapy (HFNC) between 2008 and 2014 in patients 18 years or older at a community teaching hospital. METHODS: Yearly utilization rates of HFNC, noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were calculated among admissions with a set of cardiopulmonary diagnoses (heart failure, COPD, asthma or pneumonia). RESULTS: Among the 41,711 admissions with at least one of the above cardiopulmonary condition, HFNC was utilized in 1,128 or 27...
April 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29420394/second-stage-duration-and-outcomes-among-women-who-labored-after-a-prior-cesarean-delivery
#7
Mark P Hehir, Dwight J Rouse, Russell S Miller, Cande V Ananth, Jason D Wright, Zainab Siddiq, Mary E DʼAlton, Alexander M Friedman
OBJECTIVE: To characterize probabilities of vaginal delivery based on second-stage duration along with maternal and neonatal risks for women undergoing labor after cesarean delivery. METHODS: This unplanned secondary analysis of the Maternal-Fetal Medicine Units Cesarean Registry, a prospective observational cohort, assessed outcomes in women with a prior uterine scar and included women with a previous cesarean delivery without prior vaginal delivery who reached the second stage of labor...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29319038/noninvasive-ventilation-neurally-adjusted-ventilator-assist-for-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#8
Vijay Hadda, Tajamul Hussain Shah, Karan Madan, Anant Mohan, Gopi C Khilnani, Randeep Guleria
Patient-ventilator asynchrony is common with noninvasive ventilation (NIV) used for management of acute exacerbation of chronic obstructive pulmonary disease (COPD). Neurally adjusted ventilator assist (NAVA) is a mode of ventilatory support which can minimize the patient-ventilator asynchrony. Delivering NIV with NAVA (NIV-NAVA) during acute exacerbation of COPD seems a logical approach and may be useful in reducing patient-ventilator asynchrony. However, there are no published reports which describe the use of NIV-NAVA for management of acute exacerbation of COPD...
January 2018: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29247545/neurally-adjusted-ventilatory-assist-can-be-used-to-wean-infants-with-congenital-diaphragmatic-hernias-off-respiratory-support
#9
Arata Oda, Liisa Lehtonen, Hanna Soukka
No abstract text is available yet for this article.
April 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29211196/analysis-of-ineffective-breathing-pattern-and-impaired-spontaneous-ventilation-of-adults-with-oxygen-therapy
#10
Deborah Hein Seganfredo, Beatriz Amorim Beltrão, Viviane Martins da Silva, Marcos Venícios de Oliveira Lopes, Stela Maris de Jezus Castro, Miriam de Abreu Almeida
OBJECTIVE: to analyze the manifestation of the defining characteristics of the nursing diagnoses of ineffective breathing pattern and impaired spontaneous ventilation, of the NANDA International and the defining characteristics identified in the literature for the concept of "ventilation" in adult patients hospitalized in an intensive care unit with use of oxygen therapy. METHOD: clinical diagnostic validation study, conducted with 626 patients in intensive care using oxygen therapy, in three different modalities...
December 4, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/29206781/perceptual-responses-to-high-and-moderate-intensity-interval-exercise-in-adolescents
#11
Adam A Malik, Craig A Williams, Kathryn L Weston, Alan R Barker
PURPOSE: Continuous high-intensity exercise is proposed to evoke unpleasant sensations as predicted by the dual-mode theory and may negatively impact on future exercise adherence. Previous studies support unpleasant sensations in affective responses during continuous high-intensity exercise, but the affect experience during high-intensity interval exercise (HIIE) involving brief bursts of high-intensity exercise separated by low-intensity activity is poorly understood in adolescents. We examined the acute affective, enjoyment, and perceived exertion responses to HIIE compared with moderate-intensity interval exercise (MIIE) in adolescents...
May 2018: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/29138242/role-of-ecmo-in-congenital-diaphragmatic-hernia
#12
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...
March 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29133427/phasic-inhibition-as-a-mechanism-for-generation-of-rapid-respiratory-rhythms
#13
Jared M Cregg, Kevin A Chu, Thomas E Dick, Lynn T Landmesser, Jerry Silver
Central neural networks operate continuously throughout life to control respiration, yet mechanisms regulating ventilatory frequency are poorly understood. Inspiration is generated by the pre-Bötzinger complex of the ventrolateral medulla, where it is thought that excitation increases inspiratory frequency and inhibition causes apnea. To test this model, we used an in vitro optogenetic approach to stimulate select populations of hindbrain neurons and characterize how they modulate frequency. Unexpectedly, we found that inhibition was required for increases in frequency caused by stimulation of Phox2b-lineage, putative CO2 -chemosensitive neurons...
November 28, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29129133/association-between-hypocapnia-and-ventilation-during-the-first-days-of-life-and-brain-injury-in-asphyxiated-newborns-treated-with-hypothermia
#14
Maria Agustina Lopez Laporte, Hui Wang, Priscille-Nice Sanon, Stephanie Barbosa Vargas, Julie Maluorni, Emmanouil Rampakakis, Pia Wintermark
PURPOSE: Therapeutic hypothermia is the standard treatment for asphyxiated newborns. Since hypocapnia is common in these newborns, the aim of this study was to assess the association among hypocapnia, ventilation, and brain injury. METHODS: We conducted a retrospective cohort study of all asphyxiated newborns treated with hypothermia from 2008 to 2014. Partial pressure of carbon dioxide (pCO2 ), ventilatory status, and modes of ventilation were recorded during the first 4 days of life...
November 27, 2017: Journal of Maternal-fetal & Neonatal Medicine
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
#15
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/29077984/neurally-adjusted-ventilatory-assist-compared-to-other-forms-of-triggered-ventilation-for-neonatal-respiratory-support
#16
REVIEW
Thomas E Rossor, Katie A Hunt, Sandeep Shetty, Anne Greenough
BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi)...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29072677/the-impact-of-neurally-adjusted-ventilatory-assist-mode-on-respiratory-severity-score-and-energy-expenditure-in-infants-a-randomized-crossover-trial
#17
J L Rosterman, E K Pallotto, W E Truog, H Escobar, K A Meinert, A Holmes, H Dai, W M Manimtim
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS). STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h...
January 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29060280/an-ic-based-controllable-stimulator-for-respiratory-muscle-stimulation-investigations
#18
Jonathan Castelli, Florian Kolbl, Ricardo Siu, Gilles N'Kaoua, Yannick Bornat, Ashwin Mangalore, Brian Hillen, James J Abbas, Sylvie Renaud, Ranu Jung, Noelle Lewis
Functional Electrical Stimulation can be used to restore motor functions loss consecutive to spinal cord injury, such as respiratory deficiency due to paralysis of ventilatory muscles. This paper presents a fully configurable IC-centered stimulator designed to investigate muscle stimulation paradigms. It provides 8 current stimulation channels with high-voltage compliance and real-time operation capabilities, to enable a wide range of FES applications. The stimulator can be used in a standalone mode, or within a closed-loop setup...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059880/evaluation-of-indirect-measures-of-neural-inspiratory-time-from-invasive-and-noninvasive-recordings-of-respiratory-activity
#19
Daniel Garcia-Castellote, Abel Torres, Luis Estrada, Leonardo Sarlabous, Raimon Jane
Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29059227/exergaming-feels-good-despite-working-harder
#20
Kate Glen, Roger Eston, Tobias Loetscher, Gaynor Parfitt
Strategies to encourage exercise have led to research on cycle ergometer 'exergaming', as a means of enhancing exercise enjoyment. This research has typically prescribed the exercise intensity and used one exercise mode. The aim of this study was to compare self-selected exercise intensity on a cycle ergometer with and without exergaming modes activated. A total of 20 participants aged between 18-40 years (M = 24.2 ± 5.9) completed a sub-maximal exercise test. Participants returned two days later to complete one 45 minute session of self-selected exercise with 15 minutes in each of 'control' (standard ergometer), 'track', and 'game' modes, with order randomized...
2017: PloS One
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