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https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#1
Venkateswaran Ramkumar, Ekambaram Dinesh, Sumalatha Radhakrishna Shetty, Amit Shah, Pankaj Kundra, Sabyasachi Das, Sheila Nainan Myatra, Syed Moied Ahmed, Jigeeshu Vasishtha Divatia, Apeksh Patwa, Rakesh Garg, Ubaradka S Raveendra, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh
The various physiological changes in pregnancy make the parturient vulnerable for early and rapid desaturation. Severe hypoxaemia during intubation can potentially compromise two lives (mother and foetus). Thus tracheal intubation in the pregnant patient poses unique challenges, and necessitates meticulous planning, ready availability of equipment and expertise to ensure maternal and foetal safety. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for the safe management of the airway in obstetric patients...
December 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27994384/severe-acute-respiratory-distress-syndrome-caused-by-unintentional-sewing-machine-lubricant-ingestion-a-case-report
#2
Sunil Kishore, Sudha Chandelia, Neha Patharia, Swarnim
Sewing machine oil ingestion is rare but is possible due to its availability at home. Chemically, it belongs to hydrocarbon family which is toxic if aspirated, owing to their physical properties such as high volatility and low viscosity. On the contrary, sewing machine lubricant has high viscosity and low volatility which makes it aspiration less likely. The main danger of hydrocarbon ingestion is chemical pneumonitis which may be as severe as acute respiratory distress syndrome (ARDS). We report a case of a 5-year-old girl with accidental ingestion of sewing machine lubricant oil, who subsequently developed ARDS refractory to mechanical ventilation...
November 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27913141/acute-lung-injury-and-persistent-small-airway-disease-in-a-rabbit-model-of-chlorine-inhalation
#3
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...
January 15, 2017: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27871083/work-of-breathing-in-fixed-and-pressure-relief-continuous-positive-airway-pressure-c-flex%C3%A2-a-post-hoc-analysis
#4
Lukas Jerrentrup, Sebastian Canisius, Susanne Wilhelm, Karl Kesper, Thomas Ploch, Claus Vogelmeier, Timm Greulich, Heinrich F Becker
BACKGROUND: Expiratory pressure relief continuous positive airway pressure (pressure relief CPAP; C-Flex™) causes increases in inspiratory duty cycle and shortening of expiratory time. It has been suggested that these changes are caused by an increase in work of breathing. OBJECTIVES: We studied the effects of C-Flex on work of breathing and intrinsic positive end-expiratory pressure as compared to fixed CPAP. METHODS: Work of breathing was analyzed in 24 patients with obstructive sleep apnea during treatment with fixed CPAP and C-Flex with 3 different pressure relief settings in a randomized order during rapid-eye-movement (REM) and non-REM sleep...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27850698/1060-multidisciplinary-attitudes-about-airway-pressure-release-ventilation-in-an-academic-picu
#5
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
#6
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/27848886/liposomes-for-pulmonary-drug-delivery-the-role-of-formulation-and-inhalation-device-design
#7
Abdelbary Elhissi
Liposomes are established drug carriers for inhalation owing to their safety and ability to provide controlled drug release in the lung. These carriers can entrap a wide range of therapeutic molecules for delivery in large volumes to the peripheral airways using medical nebulizers. Pressurized metered inhalers (pMDIs), soft mist inhalers (SMIs) and dry powder inhalers (DPIs) can deliver relatively small quantities of medication to the lung when compared to medical nebulizers which can deliver large volumes using simple liposome preparation techniques...
November 16, 2016: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#8
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
#9
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/27825728/csa-is-not-beneficial-long-term-in-heart-failure-patients-with-reduced-ejection-fraction
#10
EDITORIAL
Olaf Oldenburg, Andrew Coats
Central sleep apnea (CSA) affects many patients, with heart failure and results in hypoxia and nor-epinephrine release and is associated with high morbidity and mortality. Recent trials in the treatment of CSA using positive airway pressure therapies have failed to demonstrate improvement in mortality and as a result, the compensatory nature of CSA has been questioned. The detrimental effects from CSA are clear. While there may be a short term compensatory effect, the long term effects cause chronic insult to the cardiovascular system indicating that CSA should be treated, but alternative treatment options need to be considered...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27749289/dose-response-and-cardiopulmonary-side-effects-of-the-novel-neuromuscular-blocking-drug-cw002-in-man
#11
Paul M Heerdt, Hiroshi Sunaga, Joel S Owen, Matthew T Murrell, Jaideep K Malhotra, Deena Godfrey, Michelle Steinkamp, Peter Savard, John J Savarese, Cynthia A Lien
BACKGROUND: CW002 is a benzylisoquinolinium nondepolarizing neuromuscular-blocking drug found to be inactivated by cysteine in preclinical studies. The current study represents a dose escalation clinical trial designed to describe CW002 potency, duration, cardiopulmonary side effects, and histamine release. METHODS: Healthy subjects anesthetized with sevoflurane/nitrous oxide were divided into five groups (n = 6), each receiving a fixed CW002 dose (0.02, 0.04, 0...
December 2016: Anesthesiology
https://www.readbyqxmd.com/read/27742245/airway-pressure-release-ventilation-during-ex%C3%A2-vivo-lung-perfusion-attenuates-injury
#12
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...
January 2017: 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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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...
July 5, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27235312/should-airway-pressure-release-ventilation-be-the-primary-mode-in-ards
#20
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
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