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JOURNAL ARTICLE
Sasagu Kimura, Katsuaki Toyoshima, Tomoyuki Shimokaze, Kaoru Katsumata, Tomoko Saito, Rikuo Hoshino
INTRODUCTION: For patients with a congenital diaphragmatic hernia, conventional mechanical ventilation (CMV) and high-frequency oscillatory ventilation (HFOV) are used in initial ventilatory management. HFOV has recently been recommended as a rescue therapy; however, we use HFOV for initial ventilation management, with a preoperative challenge test for CMV conversion and respiratory function testing at the time of CMV conversion. We aimed to compare patient characteristics between CMV conversion- and HFOV-preferred treatment groups...
March 2024: Pediatric Pulmonology
#22
REVIEW
Mohammed Bhader, Mohammed Al-Hindi, Abdullah Ghaddaf, Anas Alamoudi, Amal Abualola, Renad Kalantan, Norah AlKhulifi, Ibrahim Halawani, Mansour Al-Qurashi
The noninvasive neurally adjusted ventilatory assist (NIV-NAVA) is a newly developed noninvasive ventilation technique with promising clinical and ventilatory outcomes for preterm infants. This systematic review and meta-analysis aimed to investigate whether NIV-NAVA has better clinical and ventilatory outcomes than nasal continuous airway pressure (NCPAP) or noninvasive positive pressure ventilation (NIPP) on premature infants. MEDLINE, Embase, and CENTRAL were searched, and randomized controlled trials (RCTs) that compared NIV-NAVA with NCPAP or NIPP for preterm infants (gestational age: <37 weeks) were included...
December 18, 2023: Children
#23
JOURNAL ARTICLE
Mattia Docci, Emanuele Rezoagli, Maddalena Teggia-Droghi, Andrea Coppadoro, Matteo Pozzi, Alice Grassi, Isabella Bianchi, Giuseppe Foti, Giacomo Bellani
BACKGROUND: During Pressure Support Ventilation (PSV) an inspiratory hold allows to measure plateau pressure (Pplat), driving pressure (∆P), respiratory system compliance (Crs) and pressure-muscle-index (PMI), an index of inspiratory effort. This study aims [1] to assess systematically how patient's effort (estimated with PMI), ∆P and tidal volume (Vt) change in response to variations in PSV and [2] to confirm the robustness of Crs measurement during PSV. METHODS: 18 patients recovering from acute respiratory failure and ventilated by PSV were cross-randomized to four steps of assistance above (+ 3 and + 6 cmH2 O) and below (-3 and -6 cmH2 O) clinically set PS...
December 20, 2023: Annals of Intensive Care
#24
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
#25
JOURNAL ARTICLE
Özlem Acicbe, Canan Yazıcı Özgür, Payam Rahimi, Emral Canan, Sinan Aşar, Zafer Çukurova
BACKGROUND: Mechanical power may serve as a valuable parameter for predicting ventilation-induced injury in mechanically ventilated patients. Over time, several equations have been developed to calculate power in both volume control ventilation (VCV) and pressure control ventilation (PCV). Among these equations, the linear model mechanical power equation (MPLM ) closely approximates the reference method when applied in PCV. The dynamic mechanical power equation (MPdyn ) computes power by utilizing the ventilatory work of breathing parameter (WOBv ), which is automatically measured by the mechanical ventilator...
December 20, 2023: Intensive Care Medicine Experimental
#26
JOURNAL ARTICLE
Zao M Yang, Tuan-Hsing Loh, Justin Ross, Kajal Dalal, Steffen E Meiler, Gregory N Postma
OBJECTIVES: Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) describes apneic oxygenation using humidified high flow nasal-cannula oxygen. Although it has been described as a sole mode of oxygenation in endoscopic laryngotracheal surgery, its use in endoscopic esophageal surgery under general anesthesia with neuromuscular paralysis has not previously been described. The objective of this study is to assess the safety and efficacy of THRIVE in esophagology. METHODS: We conducted a retrospective review of adult patients undergoing esophageal procedures under general anesthesia who were oxygenated using THRIVE at two academic institutions...
December 5, 2023: Annals of Otology, Rhinology, and Laryngology
#27
JOURNAL ARTICLE
Su-Kiat Chua, Wen-Ling Chen, Lung-Ching Chen, Kou-Gi Shyu, Huei-Fong Hung, Shih-Huang Lee, Tzu-Lin Wang, Wei-Ting Lai, Kuan-Jen Chen, Zhen-Yu Liao, Cheng-Yen Chuang, Ching-Yao Chou
BACKGROUND: This study aimed to investigate the effectiveness of closed-loop stimulation (CLS) pacing compared to the traditional DDD mode in patients with chronotropic incompetence (CI) using bicycle-based cardiopulmonary exercise testing (CPET). METHODS: This single-center, randomized crossover trial involved 40 patients with CI. Patients were randomized to receive either DDD-CLS or DDD mode pacing for 2 months, followed by a crossover to the alternative mode for an additional 2 months...
December 3, 2023: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
#28
REVIEW
Yuliang Sheng, Wei Shao, Yuhao Wang, Xiuwen Kang, Rong Hu
Mechanical ventilation has, since its introduction into clinical practice, undergone a major evolution from controlled ventilation to diverse modes of assisted ventilation. Conventional mechanical ventilators depend on flow sensors and pneumatic pressure and controllers to complete the respiratory cycle. Neurally adjusted ventilatory assist (NAVA) is a new form of assisted ventilation in recent years, which monitors the electrical activity of the diaphragm (EAdi) to provide an appropriately level of pressure support...
November 2023: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
#29
REVIEW
Saikiran Mandyam, Muhammad Qureshi, Yamini Katamreddy, Devam Parghi, Priyanka Patel, Vidhi Patel, Fnu Anshul
Mechanical ventilation serves as crucial life support for critically ill patients. Although it is life-saving prolonged ventilation carries risks and complications like barotrauma, Ventilator-associated pneumonia, sepsis, and many others. Optimizing patient-ventilator interactions and facilitating early weaning is necessary for improved intensive care unit (ICU) outcomes. Traditionally Pressure support ventilation (PSV) mode is widely used for weaning patients who are intubated and mechanically ventilated. Neurally adjusted ventilatory assist (NAVA) mode of the ventilator is an emerging ventilator mode that delivers pressure depending on the patient's respiratory drive, which in turn prevents over-inflation and improves the patient's ventilator interactions...
November 15, 2023: Journal of Intensive Care Medicine
#30
RANDOMIZED CONTROLLED TRIAL
Ayse Zeynep Turan Civraz, Ayten Saracoglu, Kemal Tolga Saracoglu
Background and Objectives : Laparoscopic surgery, which results in less bleeding, less postoperative pain, and better cosmetic results, may affect the lung dynamics via the pneumoperitoneum. After laparoscopic surgery, atelectasis develops. The primary aim of the present study is to demonstrate the effects of two different ventilation modes on the development of atelectasis using lung ultrasound, and the secondary outcomes include the plateau pressure, peak inspiratory pressure, and compliance differences between the groups...
October 7, 2023: Medicina
#31
Ricardo Sabastian Pinto-Villalba, Jose E Leon-Rojas
BACKGROUND: Emergency medical services (EMS) and critical care transport crews constantly face critically-ill patients who need ventilatory support in scenarios where correct interventions can be the difference between life and death; furthermore, challenges like limited staff working on the patient and restricted spaces are often present. Due to these, mechanical ventilation (MV) can be a support by liberating staff from managing the airway and allowing them to focus on other areas; however, these patients face many complications that personnel must be aware of...
2023: Frontiers in Medicine
#32
JOURNAL ARTICLE
Alison Protain, Kimberly Firestone, Saima Hussain, Daniel Lubarsky, Howard Stein
BACKGROUND: Neonates with apnea of prematurity (AOP) clinically deteriorate because continuous positive airway pressure (CPAP) provides inadequate support during apnea. Neurally adjusted ventilatory assist (NAVA) provides proportional ventilator support from the electrical activity of the diaphragm. When the NAVA level is 0 cmH2 O/mcV (NAVA-PAP), patients receive CPAP when breathing and backup ventilation when apneic. This study evaluates NAVA-PAP and time spent in backup ventilation...
2023: Frontiers in Pediatrics
#33
JOURNAL ARTICLE
Kanellos C Spiliopoulos, Dimosthenis Lykouras, Dimitra Veltsista, Vasileios Skaramagkas, Kiriakos Karkoulias, Argyrios Tzouvelekis, Elisabeth Chroni
INTRODUCTION/AIMS: Amyotrophic lateral sclerosis (ALS) leads to diaphragmatic weakness at some point during its course, which is a major cause of respiratory insufficiency. The aim of this study was to evaluate ultrasound-based measures for assessing the diaphragmatic competency and the need for ventilatory support. METHODS: Twenty-six subjects with ALS and 12 healthy controls were enrolled. All participants underwent B-mode diaphragm ultrasound (DUS). Diaphragm thickness and thickening indices were recorded...
October 10, 2023: Muscle & Nerve
#34
JOURNAL ARTICLE
C Zhang, H Liao, H Li, Y Xu, G Zhang, X Wang, H Bao
OBJECTIVE: To explore the effect of THRIVE combined with i-gel laryngeal mask on the safety of oxygen therapy in apnea and surgical precision of retrograde intrarenal surgery. METHODS: A total of 120 patients undergoing retrograde intrarenal surgery under general anesthesia with laryngeal mask were randomized into 3 groups ( n =40), and after the flexible ureteroscope entered the renal pelvis and located the stones, the patients received assisted ventilation in APPV mode (control group), ventilation with small tidal volume and high respiratory rate (group H), or THRIVE combined with laryngeal mask for oxygen supply without using the ventilator (THRIVE group)...
September 20, 2023: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
#35
REVIEW
Mitali Sahni, Vineet Bhandari
In the age of surfactant and antenatal steroids, neonatal care has improved outcomes of preterm infants dramatically. Since the early 2000's neonatologists have strived to decrease bronchopulmonary dysplasia (BPD) by decreasing ventilator-associated lung injury and utilizing many novel modes of non-invasive respiratory support. After the initial success with nasal continuous positive airway pressure, it was established that discontinuing invasive ventilation early in favor of non-invasive respiratory support is the most effective way to reduce the incidence of BPD...
October 2023: Seminars in Perinatology
#36
JOURNAL ARTICLE
Jeremy E Orr, Kenneth Chen, Florin Vaida, Christopher N Schmickl, Chamindra G Laverty, John Ravits, Daniel Lesser, Rakesh Bhattacharjee, Atul Malhotra, Robert L Owens
BACKGROUND AND OBJECTIVE: Patients with neuromuscular disease are often treated with home noninvasive ventilation (NIV) with devices capable of remote patient monitoring. We sought to determine whether long-term NIV data could provide insight into the effectiveness of ventilation over time. METHODS: We abstracted available longitudinal data for adults with neuromuscular disease in monthly increments from first available to most recent. Generalised linear mixed-effects modelling with subject-level random effects was used to evaluate trajectories over time...
September 2023: ERJ Open Research
#37
JOURNAL ARTICLE
Tayyba N Aslam, Thomas L Klitgaard, Christian A O Ahlstedt, Finn H Andersen, Michelle S Chew, Marie O Collet, Maria Cronhjort, Stine Estrup, Ole K Fossum, Shirin K Frisvold, Hans-Joerg Gillmann, Anders Granholm, Trine M Gundem, Kristin Hauss, Jacob Hollenberg, Maria E Huanca Condori, Johanna Hästbacka, Bror A Johnstad, Eric Keus, Maj-Brit N Kjaer, Pål Klepstad, Mette Krag, Reidar Kvåle, Manu L N G Malbrain, Christian S Meyhoff, Matt Morgan, Anders Møller, Carmen A Pfortmueller, Lone M Poulsen, Andrew C Robertson, Joerg C Schefold, Olav L Schjørring, Martin Siegemund, Martin I Sigurdsson, Fredrik Sjövall, Kristian Strand, Thomas Stueber, Wojciech Szczeklik, Rebecka R Wahlin, Helge L Wangberg, Karl-Andre Wian, Sine Wichmann, Kristin Hofsø, Morten H Møller, Anders Perner, Bodil S Rasmussen, Jon H Laake
BACKGROUND: When caring for mechanically ventilated adults with acute hypoxaemic respiratory failure (AHRF), clinicians are faced with an uncertain choice between ventilator modes allowing for spontaneous breaths or ventilation fully controlled by the ventilator. The preferences of clinicians managing such patients, and what motivates their choice of ventilator mode, are largely unknown. To better understand how clinicians' preferences may impact the choice of ventilatory support for patients with AHRF, we issued a survey to an international network of intensive care unit (ICU) researchers...
September 22, 2023: Acta Anaesthesiologica Scandinavica
#38
JOURNAL ARTICLE
José Manuel Serrano Simón, Carolina Joya Montosa, Juan Francisco Martínez Carmona, Manuel Jesús Delgado Amaya, Javier Luna Castro, Ashlen Rodríguez Carmona, José Castaño Pérez, Marina Rodríguez Delgado, Guillermo Besso Centeno, José Antonio Benítez Lozano
BACKGROUND: High drive and high effort during spontaneous breathing can generate patient self-inflicted lung injury (P-SILI) due to uncontrolled high transpulmonary and transvascular pressures, with deterioration of respiratory failure. P-SILI has been demonstrated in experimental studies and supported in recent computational models. Different treatment strategies have been proposed according to the phenotype of elastance of the respiratory system (Ers) for patients with COVID-19. This study aimed to investigate the effect of three spontaneous ventilation modes on respiratory drive and muscle effort in clinical practice and their relationship with different phenotypes...
September 8, 2023: BMC Pulmonary Medicine
#39
JOURNAL ARTICLE
Mengyu Wu, Xiaohong Zhang, Yu Jiang, Yun Guo, Wenjing Zhang, Hong He, Yanhua Yin
PURPOSE: To evaluate the effects of different mechanical ventilation modes on critical patients. METHODS: PubMed, Embase, Web of science, and Cochrane Library databases were searched from their inception to November 15, 2022 for randomized controlled trials on the application of different mechanical ventilation modes in critical patients. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies...
2023: Frontiers in Medicine
#40
REVIEW
Denise Battaglini, Ida Giorgia Iavarone, Chiara Robba, Lorenzo Ball, Pedro Leme Silva, Patricia R M Rocco
INTRODUCTION: Although there has been extensive research on mechanical ventilation for acute respiratory distress syndrome (ARDS), treatment remains mainly supportive. Recent studies and new ventilatory modes have been proposed to manage patients with ARDS; however, the clinical impact of these strategies remains uncertain and not clearly supported by guidelines. The aim of this narrative review is to provide an overview and update on ventilatory management for patients with ARDS. AREAS COVERED: This article reviews the literature regarding mechanical ventilation in ARDS...
2023: Expert Review of Medical Devices
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