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https://www.readbyqxmd.com/read/28442135/-anesthetic-management-of-late-pressure-angioedema
#1
Inês Furtado, Filipe Linda, Sílvia Pica, Marco Monteiro
BACKGROUND AND OBJECTIVES: Late pressure angioedema is a rare form of angioedema in which light pressure stimulus can lead to edema after 1-12h. This uncommon and unreported entity is especially important in patients who undergo general anesthesia, for whom the usual harmless supine position, intravenous catheter insertion, standard monitoring, airway management and ventilation can lead to life threatening consequences as the trigger is a physical stimulus. CASE REPORT: In this report, we describe a successful perioperative anesthetic management of a 30 year old patient, proposed for intra-ocular lens insertion, with a severe form of the disease with peri-oral, tongue and limb edema presentation...
April 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28425576/bone-marrow-adipose-and-lung-tissue-derived-murine-mesenchymal-stromal-cells-release-different-mediators-and-differentially-affect-airway-and-lung-parenchyma-in-experimental-asthma
#2
Soraia C Abreu, Mariana A Antunes, Debora G Xisto, Fernanda F Cruz, Vivian C Branco, Elga Bandeira, Jamil Zola Kitoko, Almair F de Araújo, Ludmilla Dellatorre-Texeira, Priscilla C Olsen, Daniel J Weiss, Bruno L Diaz, Marcelo M Morales, Patricia R M Rocco
Mesenchymal stromal cells (MSCs) from different sources have differential effects on lung injury. To compare the effects of murine MSCs from bone marrow (BM), adipose tissue (AD), and lung tissue (LUNG) on inflammatory and remodeling processes in experimental allergic asthma, female C57BL/6 mice were sensitized and challenged with ovalbumin (OVA) or saline (C). Twenty-four hours after the last challenge, mice received either saline (50 µl, SAL), BM-MSCs, AD-MSCs, or LUNG-MSCs (10(5) cells per mouse in 50 µl total volume) intratracheally...
April 20, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28417254/whom-are-we-treating-with-adaptive-servo-ventilation-a-clinical-post-hoc-analysis
#3
Maximilian V Malfertheiner, C Lerzer, L Kolb, K Heider, F Zeman, F Gfüllner, L S Maier, M Pfeifer, M Arzt
BACKGROUND: Recent evidence has shown that adaptive servo-ventilation (ASV) is contraindicated in patients with predominant central sleep apnea (CSA) and reduced left ventricular ejection fraction (LVEF ≤45%). The objective of this study was to assess the clinical usage of ASV in patients at the time-point of the release of a safety warning by type of SDB, breathing pattern and LVEF. METHODS: Patients of a cardiac and a respirology sleep center, both in Germany, who received ASV therapy were contacted between May and October 2015...
April 17, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28323904/pyrrolidine-dithiocarbamate-administered-during-ex-vivo-lung-perfusion-promotes-rehabilitation-of-injured-donor-rat-lungs-obtained-after-prolonged-warm-ischemia
#4
Cyril Francioli, Xingyu Wang, Roumen Parapanov, Etienne Abdelnour, Jérôme Lugrin, Fabrizio Gronchi, Jean Perentes, Philippe Eckert, Hans-Beat Ris, Lise Piquilloud, Thorsten Krueger, Lucas Liaudet
Damaged lung grafts obtained after circulatory death (DCD lungs) and warm ischemia may be at high risk of reperfusion injury after transplantation. Such lungs could be pharmacologically reconditioned using ex-vivo lung perfusion (EVLP). Since acute inflammation related to the activation of nuclear factor kappaB (NF-κB) is instrumental in lung reperfusion injury, we hypothesized that DCD lungs might be treated during EVLP by pyrrolidine dithiocarbamate (PDTC), an inhibitor of NF-κB. Rat lungs exposed to 1h warm ischemia and 2 h cold ischemia were subjected to EVLP during 4h, in absence (CTRL group, N = 6) or in presence of PDTC (2...
2017: PloS One
https://www.readbyqxmd.com/read/28284294/optimal-strategies-for-severe-acute-respiratory-distress-syndrome
#5
REVIEW
Jeremy W Cannon, Jacob T Gutsche, Daniel Brodie
Acute respiratory distress syndrome (ARDS) occurs in more than 10% of intensive care unit admissions and in nearly 25% of ventilated patients. Mortality remains high at 40%, and, for patients who survive, recovery continues for months or even years. Early recognition and minimizing further lung injury remain essential to successful management of severe ARDS. Advanced treatment strategies, which complement lung protective ventilation, include short-term neuromuscular blockade, prone positioning, and extracorporeal membrane oxygenation...
April 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/28150228/personalizing-mechanical-ventilation-according-to-physiologic-parameters-to-stabilize-alveoli-and-minimize-ventilator-induced-lung-injury-vili
#6
REVIEW
Gary F Nieman, Joshua Satalin, Penny Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28117793/topical-airway-anesthesia-for-awake-endoscopic-intubation-using-the-spray-as-you-go-technique-with-high-oxygen-flow
#7
Nina Pirlich, Jana A Lohse, Rüdiger R Noppens
A patient's willingness to cooperate is an absolute precondition for successful awake intubation of the trachea. Whilst drug-sedation of patients can jeopardize their spontaneous breathing, topical anesthesia of the airway is a popular technique. The spray-as-you-go technique represents one of the simplest opportunities to anesthetize the airway mucosa. The application of local anesthetic through the working channel of the flexible endoscope is a widespread practice for anesthetists as well as pulmonologists...
January 13, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28003691/all-india-difficult-airway-association-2016-guidelines-for-the-management-of-unanticipated-difficult-tracheal-intubation-in-obstetrics
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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