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Proportional assist ventilation

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https://www.readbyqxmd.com/read/27888836/limited-predictability-of-maximal-muscular-pressure-using-the-difference-between-peak-airway-pressure-and-positive-end-expiratory-pressure-during-proportional-assist-ventilation-pav
#1
Po-Lan Su, Pei-Shan Kao, Wei-Chieh Lin, Pei-Fang Su, Chang-Wen Chen
BACKGROUND: If the proportional assist ventilation (PAV) level is known, muscular effort can be estimated from the difference between peak airway pressure and positive end-expiratory pressure (PEEP) (ΔP) during PAV. We conjectured that deducing muscle pressure from ΔP may be an interesting method to set PAV, and tested this hypothesis using the oesophageal pressure time product calculation. METHODS: Eleven mechanically ventilated patients with oesophageal pressure monitoring under PAV were enrolled...
November 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27854117/treatment-of-neonates-with-respiratory-distress-syndrome-by-proportional-assist-ventilation-plus-synchronized-intermittent-mandatory-ventilation-a-comparison-study
#2
Rong Wu, Zhao F Tian, Xiang Y Kong, Shao D Hua, Jin H Hu, Guo F Zhen
BACKGROUND: The proportion assisted ventilation (PAV) can improve patient-ventilator interaction, reduce the incidence of end-expiratory asynchrony and increase the time of synchrony. PAV could compensate for the leaks by Elastic and resistive unloading and thus is ideal for neonates with uncuffed airways. The aim of this study was to compare the relevant clinical parameters of neonates with respiratory distress syndrome(RDS) who are surported by PAV plus synchronized intermittent mandatory ventilation (SIMV) and SIMV...
November 17, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27828807/predictors-and-outcomes-of-sternotomy-conversion-and-cardiopulmonary-bypass-assistance-in-minimally-invasive-coronary-artery-bypass-grafting
#3
Maria L Rodriguez, Harry R Lapierre, Benjamin Sohmer, Jean-Philippe Ruel, Marc A Ruel
OBJECTIVE: This work's objective was to identify the determinants of conversion of minimally invasive coronary artery bypass grafting to sternotomy, with and without cardiopulmonary bypass assistance, and to compare clinical outcomes in patients who needed conversion. METHODS: This is a prospectively collected data on patients who underwent minimally invasive coronary bypass done by a single surgeon from February 2005 to September 2014. Statistical analyses were expressed as mean values ± standard deviation or proportions...
September 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27821162/physiological-effects-of-invasive-ventilation-with-neurally-adjusted-ventilatory-assist-nava-in-a-crossover-study
#4
Jean-Michel Liet, François Barrière, Bénédicte Gaillard-Le Roux, Pierre Bourgoin, Arnaud Legrand, Nicolas Joram
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a mode of assisted mechanical ventilation that delivers inspiratory pressure proportionally to the electrical activity of the diaphragm. To date, no pediatric study has focused on the effects of NAVA on hemodynamic parameters. This physiologic study with a randomized cross-over design compared hemodynamic parameters when NAVA or conventional ventilation (CV) was applied. METHODS: After a baseline period, infants received NAVA and CV in a randomized order during two consecutive 30-min periods...
November 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27778044/clusters-of-ineffective-efforts-during-mechanical-ventilation-impact-on-outcome
#5
Katerina Vaporidi, Dimitris Babalis, Achilleas Chytas, Emmanuel Lilitsis, Eumorfia Kondili, Vasilis Amargianitakis, Ioanna Chouvarda, Nicos Maglaveras, Dimitris Georgopoulos
PURPOSE: The aim of this study was to investigate the role of ineffective efforts (IEs), specifically clusters of IEs, during mechanical ventilation on the outcome of critically ill patients. METHODS: In a prospective observational study, 24-h recordings were obtained in 110 patients on the 1st day of assisted ventilation (pressure support or proportional assist), using a prototype monitor validated to identify IEs. Patients remaining on assisted ventilation were studied again on the 3rd day (n = 37) and on the 6th day (n = 13)...
October 24, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27686347/neurally-adjusted-ventilatory-assist-as-an-alternative-to-pressure-support-ventilation-in-adults-a-french-multicentre-randomized-trial
#6
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/27637970/supraglottic-jet-oxygenation-and-ventilation-assisted-fibre-optic-bronchoscope-intubation-in-patients-with-difficult-airways
#7
Caineng Wu, Jianqi Wei, Qingyun Cen, Xuefan Sha, Qingxiang Cai, Wuhua Ma, Ying Cao
A difficult airway may lead to hypoxia and brain damage. The WEI Nasal Jet Tube (WNJ) is a new nasal pharyngeal tube that applies supraglottic jet oxygenation and ventilation (SJOV) for patients during tracheal intubation without the need for mask ventilation. We evaluated the effectiveness and safety of SJOV-assisted fibre-optic bronchoscopy (FOB) using the WNJ in the management of difficult tracheal intubations. A total of 50 adult patients with Cormack-Lehane grade ≥3 and general anesthesia with tracheal intubation were randomly assigned to either the laryngeal mask airway (LMA) or WNJ groups...
September 14, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27629375/comparing-changing-neurally-adjusted-ventilatory-assist-nava-levels-in-intubated-and-recently-extubated-neonates
#8
B LoVerde, K S Firestone, H M Stein
OBJECTIVE: Neurally adjusted ventilatory assist (NAVA) is a mode of mechanical ventilation that delivers ventilatory support in synchrony to the patient's respiratory needs using NAVA level, a proportionality constant that converts the electrical activity of the diaphragm (Edi) into a peak pressure (PIP). Recent published studies suggest that neonates can control the delivered ventilatory support through neural feedback. Systematically increasing the NAVA level initially increases the PIP while maintaining a constant Edi until an inflection point or breakpoint (BrP) is reached, at which time the PIP plateaus and the Edi signal decreases...
December 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27553482/characteristics-of-and-predictors-for-apnea-and-clinical-interventions-during-procedural-sedation
#9
Baruch S Krauss, Gary Andolfatto, Benjamin A Krauss, Rebecca J Mieloszyk, Michael C Monuteaux
STUDY OBJECTIVE: We describe the characteristics of and predictors for apnea and clinical interventions during emergency department (ED) procedural sedation. METHODS: High-resolution data were collected prospectively, using a convenience sample of ED patients undergoing propofol or ketofol sedation. End tidal CO2 (etco2), respiratory rate, pulse rate, and SpO2 were electronically recorded in 1-second intervals. Procedure times, drug delivery, and interventions were electronically annotated...
August 20, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27390463/neurally-adjusted-ventilation-assist-in-weaning-difficulty-first-case-report-from-india
#10
Milind Baldi, Inderpaul Singh Sehgal, Sahajal Dhooria, Digambar Behera, Ritesh Agarwal
Invasive mechanical ventilation is an integral component in the management of critically ill patients. In certain situations, liberation from mechanical ventilation becomes difficult resulting in prolonged ventilation. Patient-ventilator dyssynchrony is a frequently encountered reason for difficult weaning. Neurally adjusted ventilatory assist (NAVA) is a novel mode of ventilation that utilizes the electrical activity of diaphragm to pick up respiratory signals and delivers assistance in proportion to the ventilatory requirement of a patient...
June 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27381707/comparison-of-proportional-assist-ventilation-plus-t-tube-ventilation-and-pressure-support-ventilation-as-spontaneous-breathing-trials-for-extubation-a-randomized-study-reply
#11
Erica F Osaku, Cláudia Rlm Costa, Sandy N Teixeira, Péricles Ad Duarte
No abstract text is available yet for this article.
July 2016: Respiratory Care
https://www.readbyqxmd.com/read/27358909/data-on-respiratory-variables-in-critically-ill-patients-with-acute-respiratory-failure-placed-on-proportional-assist-ventilation-with-load-adjustable-gain-factors-pav
#12
Dimitris Georgopoulos, Nectaria Xirouchaki, Nikolaos Tzanakis, Magdy Younes
The data show respiratory variables in 108 critically ill patients with acute respiratory failure placed on proportional assist ventilation with load adjustable gain factors (PAV+) after at least 36 h on passive mechanical ventilation. PAV+ was continued for 48 h until the patients met pre-defined criteria either for switching to controlled modes or for breathing without ventilator assistance. Data during passive mechanical ventilation and during PAV+ are reported. Data are acquired from the whole population, as well as from patients with and without acute respiratory distress syndrome...
September 2016: Data in Brief
https://www.readbyqxmd.com/read/27295155/care-practices-and-health-related-quality-of-life-for-individuals-receiving-assisted-ventilation-a-cross-national-study
#13
Liam M Hannan, Hamna Sahi, Jeremy D Road, Christine F McDonald, David J Berlowitz, Mark E Howard
RATIONALE: Comparisons of home mechanical ventilation services have demonstrated considerable regional variation in patient populations managed with this therapy. The respiratory care practices used to support individuals receiving assisted ventilation also appear to vary, but they are not well described. It is uncertain whether differences in the approach to care could influence health outcomes for individuals receiving assisted ventilation. OBJECTIVES: We sought to identify and describe the respiratory care practices of home ventilation providers in two different regions and determine whether care practice differences influence health-related quality of life...
June 2016: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/27290497/impact-of-the-assist-ventilation-mode-on-work-of-breathing-wob-neurally-adjusted-ventilatory-assist-nava-versus-pressure-support-ventilation-psv-versus-proportional-assist-ventilation-plus-pav
#14
R Di Mussi, S Spadaro, C A Volta, T Stripoli, A Armenise, L Pisani, R G Renna, A Civita, G Altamura, F Bruno, S Grasso
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27289851/evaluation-of-the-relation-between-respiratory-muscle-pressure-pmus-and-diaphragmatic-thickness-in-icu-patients-ventillated-with-proportional-assist-ventillation-pav-a-preliminary-study
#15
G Minas, N Koronakis, S Fetta, L Kypri, T Kyprianou
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27138896/bronchial-blocker-versus-left-double-lumen-endotracheal-tube-in-video-assisted-thoracoscopic-surgery-a-randomized-controlled-trial-examining-time-and-quality-of-lung-deflation
#16
Jean S Bussières, Jacques Somma, José Luis Carrasco Del Castillo, Jérôme Lemieux, Massimo Conti, Paula A Ugalde, Nathalie Gagné, Yves Lacasse
INTRODUCTION: Double-lumen endotracheal tubes (DL-ETT) and bronchial blockers (BB) have both been used for lung isolation in video-assisted thoracic surgery (VATS). Though not well studied, it is widely thought that a DL-ETT provides faster and better quality lung collapse. The aim of this study was to compare a BB technique vs a left-sided DL-ETT strategy with regard to the time and quality of lung collapse during one-lung ventilation (OLV) for elective VATS. METHODS: Forty patients requiring OLV for VATS were randomized to receive a BB (n = 20) or a left-sided DL-ETT (n = 20)...
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27093203/case-report-non-invasive-neurally-adjusted-ventilatory-assist-in-a-newborn-with-unilateral-diaphragmatic-paralysis
#17
Sander Roosens, Frank Derriks, Filip Cools
Diaphragmatic paralysis is a rare cause of respiratory distress in the newborn. In this paper, a patient with unilateral phrenic nerve injury after traumatic delivery is presented. The child inadequately responded to standard respiratory supportive measures. Non-invasive neurally adjusted ventilatory assist (NIV-NAVA®), providing an optimally synchronized respiratory support proportional to the effort of the patient, resulted in prompt clinical and biological improvement of the patient's respiratory condition...
November 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27076185/accuracy-of-delivered-airway-pressure-and-work-of-breathing-estimation-during-proportional-assist-ventilation-a-bench-study
#18
Francois Beloncle, Evangelia Akoumianaki, Nuttapol Rittayamai, Aissam Lyazidi, Laurent Brochard
BACKGROUND: Proportional assist ventilation+ (PAV+) delivers airway pressure (P aw) in proportion to patient effort (P mus) by using the equation of motion of the respiratory system. PAV+ calculates automatically respiratory mechanics (elastance and resistance); the work of breathing (WOB) is estimated by the ventilator. The accuracy of P mus estimation and hence accuracy of the delivered P aw and WOB calculation have not been assessed. This study aimed at assessing the accuracy of delivered P aw and calculated WOB by PAV+ and examining the factors influencing this accuracy...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27028110/a-proportional-assist-ventilator-to-unload-respiratory-muscles-experimentally-during-exercise-in-humans
#19
Paolo B Dominelli, William R Henderson, A William Sheel
What is the central question of this study? Can a modern proportional assist ventilator (PAV) function sufficiently well to unload the respiratory muscles during exercise? What is the main finding and its importance? A PAV can be constructed with contemporary hardware and software and be used at all exercise intensities to unload the respiratory muscles by up to 70%. Previously, PAVs have allowed researchers to address many fundamental physiological problems in clinical and healthy populations, but those versions are no longer functional or available...
June 1, 2016: Experimental Physiology
https://www.readbyqxmd.com/read/27019043/real-time-automated-sampling-of-electronic-medical-records-predicts-hospital-mortality
#20
Hargobind S Khurana, Robert H Groves, Michael P Simons, Mary Martin, Brenda Stoffer, Sherri Kou, Richard Gerkin, Eric Reiman, Sairam Parthasarathy
BACKGROUND: Real-time automated continuous sampling of electronic medical record data may expeditiously identify patients at risk for death and enable prompt life-saving interventions. We hypothesized that a real-time electronic medical record-based alert could identify hospitalized patients at risk for mortality. METHODS: An automated alert was developed and implemented to continuously sample electronic medical record data and trigger when at least 2 of 4 systemic inflammatory response syndrome criteria plus at least one of 14 acute organ dysfunction parameters was detected...
July 2016: American Journal of Medicine
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