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Mechanical and non-invasive ventilation

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https://www.readbyqxmd.com/read/29467461/the-association-of-aspirin-use-with-severity-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-a-retrospective-cohort-study
#1
Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
Little is known about the effect of long-term aspirin use on acute severity of COPD. We hypothesized that, in patients hospitalized for acute exacerbation of COPD (AECOPD), long-term aspirin use is associated with lower risks of disease severity (in-hospital death, mechanical ventilation use, and hospital length-of-stay). We conducted a retrospective cohort study using large population-based data from 2012 through 2013. Among 206,686 patients (aged ≥40 years) hospitalized for AECOPD, aspirin users had lower in-hospital mortality (1...
February 21, 2018: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29460470/the-inspired-sinewave-technique-a-novel-method-to-measure-lung-volume-and-ventilatory-heterogeneity
#2
Richard M Bruce, Phi Anh Phan, Edmund Pacpaco, Najib M Rahman, Andrew Farmery
The Inspired Sinewave Technique (IST) is a novel method which can provide simple, non-invasive cardiopulmonary measurements. Over successive tidal-breaths the concentration of a tracer gas (i.e. nitrous oxide, N2 O) is sinusoidally modulated in inspired air. Using a single-compartment tidal-ventilation lung model, the resulting amplitude/phase of the expired sinewave allows estimation of end-expired lung volume (ELV), pulmonary blood flow and three indices for ventilatory heterogeneity (VH; ELV180 /FRCpleth , ELV180 /FRCpred and ELV60 /ELV180 )...
February 19, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29426051/-respiratory-failure-innovations-in-diagnostics-and-therapy
#3
Gunther Hempel, Philipp Simon, Peter Salz, Hermann Wrigge
Acute and chronic respiratory failures require immediate diagnosis and preferably individualized ventilation therapy. If possible, non-invasive ventilation should be considered to avoid complications of invasive mechanical ventilation. Especially in patients with ARDS and moderate to severe cases, non-invasive ventilation may not be suitable and should not be used uncritically.Invasive mechanical ventilation parameters should be adjusted individually. In the future, additional parameters such as transpulmonary pressure, monitoring of regional ventilation using electrical impedance tomography could help to individualize ventilator settings...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29426048/-respiratory-insufficiency-state-of-the-art-diagnosis-and-therapy
#4
Sebastian Fritsch, Johannes Bickenbach
The term "respiratory insufficiency" (RI) describes the inability of an organism to maintain the gas exchange between the ambient air and its peripheral organs. This causes a hypoxia and hypercapnia. The mechanisms that lead to RI are either an impaired gas exchange in the lung tissue or an alveolar hypoventilation caused by an insufficient ventilatory pump. Thus the RI is divided into a hypoxic or a hypercapnic RI. The diagnostic procedure for RI contains several examinations. One key aspect of the exploration is the identification of potential reversible and thus correctable reasons of the RI...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29424194/evaluation-of-endothelial-function-and-cardiovascular-risk-in-non-obese-patients-with-slight-degree-of-obstructive-sleep-apnea-syndrome
#5
Fiorella Devito, Annapaola Zito, Silvano Dragonieri, Pierluigi Carratù, Vitaliano N Quaranta, Francesco Vitale, Nicola Quaranta, Francesco Panza, Giancarlo Logroscino, Matteo Cameli, Onofrio Resta, Marco Matteo Ciccone
Recently, it has been clearly described an independent relationship between obstructive sleep apnea syndrome (OSAS) and cardiovascular risk, with underlying mechanisms also including endothelial dysfunction. We enrolled 32 consecutive non-obese patients (mean age of 39.5±11.5 years), of which 16 with mild OSAS and 16 snoring without OSAS. Mild OSAS is defined by an AHI index between 5 and 15. We have investigated if whether there was a relationship between mild OSAS, endothelial function and carotid intima-media thickness (C-IMT)...
December 5, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29419414/motor-neuron-degeneration-correlates-with-respiratory-dysfunction-in-sca1
#6
James P Orengo, Meike E van der Heijden, Shuang Hao, Jianrong Tang, Harry T Orr, Huda Y Zoghbi
Spinocerebellar ataxia type 1 (SCA1) is characterized by adult-onset cerebellar degeneration with attendant loss of motor coordination. Bulbar function is eventually impaired, and patients tend to die from inability to clear the airway. We asked whether motor neuron degeneration is at the root of bulbar dysfunction by studying SCA1 knock-in mice. We analyzed spinal cord and brainstem motor neurons in SCA1 knock-in (Atxn1154Q) mice at 1, 3, and 6 months of age. Specifically, we assessed breathing physiology, diaphragm histology and electromyography, and motor neuron histology and immunohistochemistry...
January 29, 2018: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29404183/effects-of-modes-obesity-and-body-position-on-non-invasive-positive-pressure-ventilation-success-in-the-intensive-care-unit-a-randomized-controlled-study
#7
Murat Türk, Müge Aydoğdu, Gül Gürsel
OBJECTIVES: Different outcomes and success rates of non-invasive positive pressure ventilation (NPPV) in patients with acute hypercapnic respiratory failure (AHRF) still pose a significant problem in intensive care units. Previous studies investigating different modes, body positioning, and obesity-associated hypoventilation in patients with chronic respiratory failure showed that these factors may affect ventilator mechanics to achieve a better minute ventilation. This study tried to compare pressure support (BiPAP-S) and average volume targeted pressure support (AVAPS-S) modes in patients with acute or acute-on-chronic hypercapnic respiratory failure...
January 2018: Turkish Thoracic Journal
https://www.readbyqxmd.com/read/29399131/efficacy-of-caspofungin-combined-with-trimethoprim-sulfamethoxazole-as-first-line-therapy-to-treat-non-hiv-patients-with-severe-pneumocystis-pneumonia
#8
Gensheng Zhang, Miaomiao Chen, Shufang Zhang, Hongwei Zhou, Xiaozhen Ji, Jiachang Cai, Tianzheng Lou, Wei Cui, Ning Zhang
Combined treatment with caspofungin and trimethoprim/sulfamethoxazole (TMP/SMZ) as salvage therapy in non-HIV positive patients with severe pneumocystis pneumonia (PCP) yields poor outcomes. It remains unknown whether the use of this combination strategy as a first-line therapy would improve patient outcomes. The present study aimed to assess the efficacy of caspofungin combined with TMP/SMZ as a first-line therapy in non-HIV positive patients with severe PCP. A retrospective cohort study was conducted between March 2016 and February 2017...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29398169/efficacy-of-respiratory-muscle-training-in-weaning-of-mechanical-ventilation-in-patients-with-mechanical-ventilation-for-48hours-or-more-a-randomized-controlled-clinical-trial
#9
L M Sandoval Moreno, I C Casas Quiroga, E C Wilches Luna, A F García
OBJECTIVE: To evaluate the efficacy of respiratory muscular training in the weaning of mechanical ventilation and respiratory muscle strength in patients on mechanical ventilation of 48hours or more. DESIGN: Randomized controlled trial of parallel groups, double-blind. Ambit: Intensive Care Unit of a IV level clinic in the city of Cali. PATIENTS: 126 patients in mechanical ventilation for 48hours or more. INTERVENTIONS: The experimental group received daily a respiratory muscle training program with treshold, adjusted to 50% of maximal inspiratory pressure, additional to standard care, conventional received standard care of respiratory physiotherapy...
February 2, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29380189/respiratory-changes-in-subclavian-vein-diameters-predicts-fluid-responsiveness-in-intensive-care-patients-a-pilot-study
#10
Raphaël Giraud, Paul S Abraham, Pauline Brindel, Nils Siegenthaler, Karim Bendjelid
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. Cardiac output (CO) and dynamic parameters [stroke volume variation (SVV) and pulse pressure variation (PPV)] measured by transpulmonary thermodilution and pulse contour analysis (PiCCO™) as well as classical hemodynamic parameters were recorded at baseline and after FC...
January 29, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29374088/healthcare-utilisation-and-costs-of-home-mechanical-ventilation
#11
Mika L Nonoyama, Douglas A McKim, Jeremy Road, Denise Guerriere, Peter C Coyte, Marina Wasilewski, Monica Avendano, Sherri L Katz, Reshma Amin, Roger Goldstein, Brandon Zagorski, Louise Rose
BACKGROUND: Individuals using home mechanical ventilation (HMV) frequently choose to live at home for quality of life, despite financial burden. Previous studies of healthcare utilisation and costs do not consider public and private expenditures, including caregiver time. OBJECTIVES: To determine public and private healthcare utilisation and costs for HMV users living at home in two Canadian provinces, and examine factors associated with higher costs. METHODS: Longitudinal, prospective observational cost analysis study (April 2012 to August 2015) collecting data on public and private (out-of-pocket, third-party insurance, caregiving) costs every 2 weeks for 6 months using the Ambulatory and Home Care Record...
January 26, 2018: Thorax
https://www.readbyqxmd.com/read/29372630/what-can-we-apply-to-manage-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-acute-respiratory-failure
#12
REVIEW
Deog Kyeom Kim, Jungsil Lee, Ju Hee Park, Kwang Ha Yoo
Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29370285/severe-community-acquired-pneumonia-characteristics-and-prognostic-factors-in-ventilated-and-non-ventilated-patients
#13
Miquel Ferrer, Chiara Travierso, Catia Cilloniz, Albert Gabarrus, Otavio T Ranzani, Eva Polverino, Adamantia Liapikou, Francesco Blasi, Antoni Torres
BACKGROUND: Patients with severe community-acquired pneumonia (SCAP) and life-threatening acute respiratory failure may require invasive mechanical ventilation (IMV). Since use of IMV is often associated with significant morbidity and mortality, we assessed whether patients invasively ventilated would represent a target population for interventions aimed at reducing mortality of SCAP. METHODS: We prospectively recruited consecutive patients with SCAP for 12 years...
2018: PloS One
https://www.readbyqxmd.com/read/29364487/prophylactic-use-of-non-invasive-mechanical-ventilation-in-lung-resection
#14
E Guerra Hernández, A Rodríguez Pérez, J Freixinet Gilard, M N Martín Álamo, M Escudero Socorro, P Rodríguez Suárez, A M Esquinas
OBJECTIVE: To evaluate if the prophylactic application of BiPAP previous to lung resection and 17 hours postoperatively improves respiratory function. In order to do this, we studied the results of arterial blood gases and portable spirometry in the immediate postoperative period and at the first and third postoperative day. Secondary objectives included evaluating whether this same pattern decreases the incidence of postoperative pulmonary complications (PPC) and hospital stay. PATIENTS AND METHODS: This was a prospective, randomized clinical study...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29363502/prevention-of-bronchopulmonary-dysplasia-in-extremely-low-gestational-age-neonates-current-evidence
#15
REVIEW
Christian F Poets, Laila Lorenz
Bronchopulmonary dysplasia (BPD) is one of the most frequent complications in extremely low gestational age neonates, but has remained largely unchanged in rate. We reviewed data on BPD prevention focusing on recent meta-analyses. Interventions with proven effectiveness in reducing BPD include the primary use of non-invasive respiratory support, the application of surfactant without endotracheal ventilation and the use of volume-targeted ventilation in infants requiring endotracheal intubation. Following extubation, synchronised nasal ventilation is more effective than continuous positive airway pressure in reducing BPD...
January 23, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29362986/transcutaneous-electromyographic-respiratory-muscle-recordings-to-quantify-patient-ventilator-interaction-in-mechanically-ventilated-children
#16
Alette A Koopman, Robert G T Blokpoel, Leo A van Eykern, Frans H C de Jongh, Johannes G M Burgerhof, Martin C J Kneyber
BACKGROUND: To explore the feasibility of transcutaneous electromyographic respiratory muscle recordings to automatically quantify the synchronicity of patient-ventilator interaction in the pediatric intensive care unit. METHODS: Prospective observational study in a tertiary paediatric intensive care unit in an university hospital. Spontaneous breathing mechanically ventilated children < 18 years of age were eligible for inclusion. Patients underwent a 5-min continuous recording of ventilator pressure waveforms and transcutaneous electromyographic signal of the diaphragm...
January 24, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29362918/clinical-characteristics-and-outcomes-of-cancer-patients-requiring-intensive-care-unit-admission-a-prospective-study
#17
Frank Daniel Martos-Benítez, Andrés Soto-García, Anarelys Gutiérrez-Noyola
PURPOSE: The study was aimed to describe the characteristics of cancer patients admitted to the oncological ICU and to identify clinical features associated with outcomes. METHODS: This is a prospective study (January 2014 to December 2015) of 522 cancer patients consecutively admitted to the oncological ICU. Patients with a length of oncological ICU stay ≤ 1 day were excluded. Demographic and clinical variables were obtained at oncological ICU admission...
January 23, 2018: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/29357862/the-mortality-risk-factor-of-community-acquired-pneumonia-patients-with-chronic-obstructive-pulmonary-disease-a-retrospective-cohort-study
#18
Ruo-Xuan Dai, Qing-Hua Kong, Bei Mao, Wen Xu, Ru-Jia Tao, Xiao-Ru Wang, Qing-Yao Kong, Jin-Fu Xu
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is one of the most common comorbidities in community acquired pneumonia (CAP) patients. We aimed to investigate the characteristics and mortality risk factors of COPD patients hospitalized with CAP. METHODS: A retrospective cohort study was conducted at Shanghai Pulmonary Hospital and Shanghai Dahua Hospital. Clinical and demographic data in patients diagnosed with CAP were collected between January 2015 and June 2016...
January 22, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29355694/mechanical-ventilation-modulates-the-pro-inflammatory-cytokine-expression-in-spinal-cord-tissue-after-injury-in-rats
#19
K Truflandier, E Beaumont, E Charbonney, K Maghni, Michel De Marchie, J Spahija
RATIONALE: Spinal cord injury (SCI) may induce significant respiratory muscle weakness and paralysis, which in turn may cause a patient to require ventilator support. Central nervous system alterations can also exacerbate local inflammatory responses with immune cell infiltration leading to additional risk of inflammation at the injury site. Although mechanical ventilation is the traditional treatment for respiratory insufficiency, evidence has shown that it may directly affect distant organs through systemic inflammation...
January 17, 2018: Neuroscience Letters
https://www.readbyqxmd.com/read/29353023/diaphragm-excursion-time-index-a-new-parameter-using-ultrasonography-to-predict-extubation-outcome
#20
Atul Palkar, Mangala Narasimhan, Harly Greenberg, Karan Singh, Seth Koenig, Paul Mayo, Eric Gottesman
INTRODUCTION: The diaphragmatic response to increased mechanical load following withdrawal of mechanical ventilation (MV) is critical in determining the outcome of extubation. Using ultrasonography, we aimed to evaluate the performance of excursion-time (E-T) index- a product of diaphragm excursion and inspiratory time, to predict the outcome of extubation. METHODS: Right hemidiaphragm excursion, inspiratory time (Ti) and E-T index were measured using ultrasonography during MV: (1) On assist control mode (A/C) during consistent patient triggered ventilation (2) Following 30 minutes during a spontaneous breathing trial (SBT) (3) Between 4-24 hours following extubation...
January 15, 2018: Chest
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