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Modes of ventilation adults

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https://www.readbyqxmd.com/read/27855477/recruitment-manoeuvres-for-adults-with-acute-respiratory-distress-syndrome-receiving-mechanical-ventilation
#1
REVIEW
Carol Hodgson, Ewan C Goligher, Meredith E Young, Jennifer L Keating, Anne E Holland, Lorena Romero, Scott J Bradley, David Tuxen
BACKGROUND: Recruitment manoeuvres involve transient elevations in airway pressure applied during mechanical ventilation to open ('recruit') collapsed lung units and increase the number of alveoli participating in tidal ventilation. Recruitment manoeuvres are often used to treat patients in intensive care who have acute respiratory distress syndrome (ARDS), but the effect of this treatment on clinical outcomes has not been well established. This systematic review is an update of a Cochrane review originally published in 2009...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27783382/short-term-effects-of-neuromuscular-blockade-on-global-and-regional-lung-mechanics-oxygenation-and-ventilation-in-pediatric-acute-hypoxemic-respiratory-failure
#2
Marlon E F Wilsterman, Pauline de Jager, Robert Blokpoel, Inez Frerichs, Sandra K Dijkstra, Marcel J I J Albers, Johannes G M Burgerhof, Dick G Markhorst, Martin C J Kneyber
BACKGROUND: Neuromuscular blockade (NMB) has been shown to improve outcome in acute respiratory distress syndrome (ARDS) in adults, challenging maintaining spontaneous breathing when there is severe lung injury. We tested in a prospective physiological study the hypothesis that continuous administration of NMB agents in mechanically ventilated children with severe acute hypoxemic respiratory failure (AHRF) improves the oxygenation index without a redistribution of tidal volume V T toward non-dependent lung zones...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27687426/noninvasive-ventilation-during-spontaneous-breathing-anesthesia-an-observational-study-using-electrical-impedance-tomography
#3
Julien Bordes, Philippe Goutorbe, Pierre Julien Cungi, Marie Caroline Boghossian, Eric Kaiser
STUDY OBJECTIVE: To assess the effects of noninvasive ventilation (NIV) during spontaneous breathing anesthesia on functional residual capacity and ventilation distribution. DESIGN: Prospective and observational study. SETTING: Operating room, military teaching hospital. PATIENTS: Eighteen adult patients submitted to digestive endoscopic procedures under spontaneous breathing anesthesia. INTERVENTIONS: Anesthetic management was standardized...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27686347/neurally-adjusted-ventilatory-assist-as-an-alternative-to-pressure-support-ventilation-in-adults-a-french-multicentre-randomized-trial
#4
A Demoule, M Clavel, C Rolland-Debord, S Perbet, N Terzi, A Kouatchet, F Wallet, H Roze, F Vargas, C Guerin, J Dellamonica, S Jaber, L Brochard, T Similowski
PURPOSE: Neurally adjusted ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. The objective of this study was to compare NAVA and pressure support ventilation (PSV) in the early phase of weaning from mechanical ventilation. METHODS: A multicentre randomized controlled trial of 128 intubated adults recovering from acute respiratory failure was conducted in 11 intensive care units...
November 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27522580/automatic-detection-of-ventilatory-modes-during-invasive-mechanical-ventilation
#5
Gastón Murias, Jaume Montanyà, Encarna Chacón, Anna Estruga, Carles Subirà, Rafael Fernández, Bernat Sales, Candelaria de Haro, Josefina López-Aguilar, Umberto Lucangelo, Jesús Villar, Robert M Kacmarek, Lluís Blanch
BACKGROUND: Expert systems can help alleviate problems related to the shortage of human resources in critical care, offering expert advice in complex situations. Expert systems use contextual information to provide advice to staff. In mechanical ventilation, it is crucial for an expert system to be able to determine the ventilatory mode in use. Different manufacturers have assigned different names to similar or even identical ventilatory modes so an expert system should be able to detect the ventilatory mode...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27318572/tidal-volume-measurement-error-in-pressure-control-modes-of-mechanical-ventilation-a-model-study
#6
Robert L Chatburn, Eduardo Mireles-Cabodevila, Madhu Sasidhar
UNLABELLED: Tidal volume (VT) measurement during pressure control (PC) ventilation with preset inspiratory time may produce errors due to patient inspiratory effort. We evaluated VT error in 3 common ICU ventilators. METHODS: Simulated patient: 60kg adult with ARDS using IngMar Medical ASL 5000 having moderate inspiratory effort. Ventilators evaluated: Covidien PB 840, Maquet Servo-i, and Dräger Evita XL, PC breaths at preset inspiratory time (TI) 0.6-1.4s. VT error was defined as ventilator displayed VT minus the simulator displayed VT (mL/kg or % of true)...
August 1, 2016: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/27310926/in-vitro-comparison-of-a-vibrating-mesh-nebulizer-operating-in-inspiratory-synchronized-and-continuous-nebulization-modes-during-noninvasive-ventilation
#7
Jean-Bernard Michotte, Enrico Staderini, Deborah Le Pennec, Jonathan Dugernier, Rares Rusu, Jean Roeseler, Laurent Vecellio, Giuseppe Liistro, Grégory Reychler
UNLABELLED: Backround: Coupling nebulization with noninvasive ventilation (NIV) has been shown to be effective in patients with respiratory diseases. However, a breath-synchronized nebulization option that could potentially improve drug delivery by limiting drug loss during exhalation is currently not available on bilevel ventilators. The aim of this in vitro study was to compare aerosol delivery of amikacin with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes...
August 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27270585/a-retrospective-comparison-of-helicopter-transport-versus-ground-transport-in-patients-with-severe-sepsis-and-septic-shock
#8
Rahul Kashyap, Peter W Anderson, Abhay Vakil, Christopher S Russi, Rodrigo Cartin-Ceba
BACKGROUND: Helicopter emergency medical services (HEMS) extend the reach of a tertiary care center significantly. However, its role in septic patients is unclear. Our study was performed to clarify the role of HEMS in severe sepsis and septic shock. METHODS: This is a single-center retrospective cohort study. This study was performed at Mayo Clinic, Rochester, MN, in years 2007-2009. This study included a total of 181 consecutive adult patients admitted to the medical intensive care unit meeting criteria for severe sepsis or septic shock within 24 h of admission and transported from an acute care facility by a helicopter or ground ambulance...
December 2016: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27118355/non-invasive-ventilation-in-paediatric-critical-care
#9
Sarah L Morley
Non-invasive ventilation (NIV) is a well recognised and increasingly prevalent intervention in the paediatric critical care setting. In the acute setting NIV is used to provide respiratory support in a flexible manner that avoids a requirement for endotracheal intubation or tracheostomy, with the aim of avoiding the complications of invasive ventilation. This article will explore the physiological benefits, complications and epidemiology of the different modes of NIV including continuous positive airway pressure (CPAP), non-invasive positive pressure ventilation (NIPPV) and high-flow nasal cannula oxygen (HFNC)...
March 14, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27056642/pressure-attenuation-during-high-frequency-airway-clearance-therapy-across-different-size-endotracheal-tubes-an-in-vitro-study
#10
Craig D Smallwood, Kevin J Bullock, Andrew Gouldstone
PURPOSE: High-frequency airway clearance therapy is a positive pressure secretion clearance modality used in pediatric and adult applications. However, pressure attenuation across different size endotracheal tubes (ETT) has not been adequately described. This study quantifies attenuation in an in vitro model. MATERIALS AND METHODS: The MetaNeb® System was used to deliver high-frequency pressure pulses to 3.0, 4.0, 6.0 and 8.0mm ID ETTs connected to a test lung during mechanical ventilation...
August 2016: Journal of Critical Care
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
#11
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/26807682/a-pilot-randomized-trial-comparing-weaning-from-mechanical-ventilation-on-pressure-support-versus-proportional-assist-ventilation
#12
Karen J Bosma, Brooke A Read, Mohammad J Bahrgard Nikoo, Philip M Jones, Fran A Priestap, James F Lewis
OBJECTIVES: Despite protocols incorporating spontaneous breathing trials, 31% of ICU patients experience difficult or prolonged weaning from mechanical ventilation. Nonfatiguing modes such as pressure support ventilation are recommended. Proportional assist ventilation provides assistance in proportion to patient effort, which may optimize weaning. However, it is not known how proportional assist ventilation performs relative to pressure support ventilation over a prolonged period in the complex ICU setting...
June 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26764895/ventilator-assisted-preoxygenation-protocol-for-combining-non-invasive-ventilation-and-apnoeic-oxygenation-using-a-portable-ventilator
#13
Steven Grant, Faisal Khan, Gerben Keijzers, Mark Shirran, Leo Marneros
OBJECTIVE: To describe a simple protocol for ventilator-assisted preoxygenation (VAPOX) prior to rapid sequence intubation in the ED using a Hamilton T1 ventilator in an effort to further reduce the incidence of transient and critical hypoxaemia. METHODS: Ventilator-assisted preoxygenation includes the following steps; preparation for rapid sequence intubation as per institutional protocols, including departmental checklists. Hamilton T1 ventilator is setup in non-invasive spontaneous/timed mode with settings as described...
February 2016: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/26672979/extracorporeal-membrane-oxygenation-ecmo-for-critically-ill-adults-in-the-emergency-department-history-current-applications-and-future-directions
#14
Jarrod M Mosier, Melissa Kelsey, Yuval Raz, Kyle J Gunnerson, Robyn Meyer, Cameron D Hypes, Josh Malo, Sage P Whitmore, Daniel W Spaite
Extracorporeal membrane oxygenation (ECMO) is a mode of extracorporeal life support that augments oxygenation, ventilation and/or cardiac output via cannulae connected to a circuit that pumps blood through an oxygenator and back into the patient. ECMO has been used for decades to support cardiopulmonary disease refractory to conventional therapy. While not robust, there are promising data for the use of ECMO in acute hypoxemic respiratory failure, cardiac arrest, and cardiogenic shock and the potential indications for ECMO continue to increase...
December 17, 2015: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26645553/mechanical-ventilation-for-children
#15
REVIEW
Giorgio Conti, Marco Piastra
PURPOSE OF REVIEW: The aim of this review is to analyze innovative data pertaining to the clinical use of mechanical ventilation for children. RECENT FINDINGS: The optimal definition and treatment of pediatric acute respiratory distress syndrome, the application of innovative ventilation modes in children to optimize child/ventilator interaction, and pediatric noninvasive ventilation, including specific interfaces, have been recently evaluated in the literature...
February 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/26479512/efficacy-of-coaxial-ventilation-with-a-novel-endotracheal-catheter-equipped-with-a-functional-cuff-a-swine-model-study
#16
Jun Oto, Zhenbo Su, Michael Duggan, Jingwen Wang, David R King, Robert M Kacmarek, Yandong Jiang
BACKGROUND: We have developed an endotracheal catheter with a functional cuff (ECFC) that inflates during inspiration and deflates during expiration. This catheter, together with a regular ICU ventilator, can provide coaxial ventilation. OBJECTIVE: The aim of this study was to determine the efficacy of ventilation in adult human-sized swine using an ECFC and a regular ICU ventilator. DESIGN: A prospective animal study. SETTING: Experimental, Trauma Transplant Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA...
April 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26439374/non-pharmacological-interventions-for-sleep-promotion-in-the-intensive-care-unit
#17
REVIEW
Rong-Fang Hu, Xiao-Ying Jiang, Junmin Chen, Zhiyong Zeng, Xiao Y Chen, Yueping Li, Xin Huining, David J W Evans
BACKGROUND: Adults in intensive care units (ICUs) often suffer from a lack of sleep or frequent sleep disruptions. Non-pharmacological interventions can improve the duration and quality of sleep and decrease the risk of sleep disturbance, delirium, post-traumatic stress disorder (PTSD), and the length of stay in the ICU. However, there is no clear evidence of the effectiveness and harms of different non-pharmacological interventions for sleep promotion in adults admitted to the ICU. OBJECTIVES: To assess the efficacy of non-pharmacological interventions for sleep promotion in critically ill adults in the ICU...
2015: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/26369672/feasibility-of-neurally-adjusted-positive-end-expiratory-pressure-in-rabbits-with-early-experimental-lung-injury
#18
Ling Liu, Daijiro Takahashi, Haibo Qui, Arthur S Slutsky, Christer Sinderby, Jennifer Beck
BACKGROUND: During conventional Neurally Adjusted Ventilatory Assist (NAVA), the electrical activity of the diaphragm (EAdi) is used for triggering and cycling-off inspiratory assist, with a fixed PEEP (so called "Triggered Neurally Adjusted Ventilatory Assist" or "tNAVA"). However, significant post-inspiratory activity of the diaphragm can occur, believed to play a role in maintaining end-expiratory lung volume. Adjusting pressure continuously, in proportion to both inspiratory and expiratory EAdi (Continuous NAVA, or cNAVA), would not only offer inspiratory assist for tidal breathing, but also may aid in delivering a "neurally adjusted PEEP", and more specific breath-by-breath unloading...
2015: BMC Anesthesiology
https://www.readbyqxmd.com/read/26290121/is-there-still-a-role-for-high-frequency-oscillatory-ventilation-in-neonates-children-and-adults
#19
REVIEW
Susan R Hupp, David A Turner, Kyle J Rehder
Critically ill patients with respiratory pathology often require mechanical ventilation and while low tidal volume ventilation has become the mainstay of treatment, achieving adequate gas exchange may not be attainable with conventional ventilator modalities. In attempt to achieve gas exchange goals and also mitigate lung injury, high frequency ventilation is often implemented which couples low tidal volumes with sustained mean airway pressure. This manuscript presents the physiology of high-frequency oscillatory ventilation, reviews the currently available data on its use and provides strategies and approaches for this mode of ventilation...
October 2015: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/26265088/is-there-still-a-role-for-high-frequency-oscillatory-ventilation-in-neonates-children-and-adults
#20
Susan R Hupp, David A Turner, Kyle J Rehder
Critically ill patients with respiratory pathology often require mechanical ventilation and while low tidal volume ventilation has become the mainstay of treatment, achieving adequate gas exchange may not be attainable with conventional ventilator modalities. In attempt to achieve gas exchange goals and also mitigate lung injury, high frequency ventilation is often implemented which couples low tidal volumes with sustained mean airway pressure. This manuscript presents the physiology of high-frequency oscillatory ventilation, reviews the currently available data on its use and provides strategies and approaches for this mode of ventilation...
August 11, 2015: Expert Review of Respiratory Medicine
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