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Proportional assist ventilation

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https://www.readbyqxmd.com/read/29125270/alternative-incision-sutureless-aortic-valve-replacement-propensity-matched-comparison-between-partial-sternotomy-and-right-anterior-minithoracotomy
#1
Daniyar Gilmanov, Marco Solinas, Giuseppe Santarpino, Pier A Farneti, Michele Murzi, Theodor Fischlein, Steffen Pfeiffer
BACKGROUND: Sutureless aortic valve prostheses have the potential to augment the adoption of alternative incision approaches for aortic valve replacement (AVR). Still, we lack the evidence on which surgical approach is best associated with sutureless AVR. METHODS: Data on 483 patients undergoing sutureless small incision AVR between 2010-2014 in two European institutions (207 with partial sternotomy (MS) and 276 via right anterior minithoracotomy (RAMT)) have been retrospectively analyzed...
November 10, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29115949/neurally-adjusted-ventilatory-assist-nava-or-pressure-support-ventilation-psv-during-spontaneous-breathing-trials-in-critically-ill-patients-a-crossover-trial
#2
Juliana C Ferreira, Fabia Diniz-Silva, Henrique T Moriya, Adriano M Alencar, Marcelo B P Amato, Carlos R R Carvalho
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a proportional ventilatory mode that uses the electrical activity of the diaphragm (EAdi) to offer ventilatory assistance in proportion to patient effort. NAVA has been increasingly used for critically ill patients, but it has not been evaluated during spontaneous breathing trials (SBT). We designed a pilot trial to assess the feasibility of using NAVA during SBTs, and to compare the breathing pattern and patient-ventilator asynchrony of NAVA with Pressure Support (PSV) during SBTs...
November 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29077984/neurally-adjusted-ventilatory-assist-compared-to-other-forms-of-triggered-ventilation-for-neonatal-respiratory-support
#3
REVIEW
Thomas E Rossor, Katie A Hunt, Sandeep Shetty, Anne Greenough
BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi)...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28841267/effects-of-respiratory-muscle-work-on-respiratory-and-locomotor-blood-flow-during-exercise
#4
Paolo B Dominelli, Bruno Archiza, Andrew H Ramsook, Reid A Mitchell, Carli M Peters, Yannick Molgat-Seon, William R Henderson, Michael S Koehle, Robert Boushel, A William Sheel
What is the central question of this study? Does manipulation of the work of breathing during high-intensity exercise alter respiratory and locomotor muscle blood flow? What is the main finding and its importance? We found that when the work of breathing was reduced during exercise, respiratory muscle blood flow decreased, while locomotor muscle blood flow increased. Conversely, when the work of breathing was increased, respiratory muscle blood flow increased, while locomotor muscle blood flow decreased. Our findings support the theory of a competitive relationship between locomotor and respiratory muscles during intense exercise...
August 25, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28660206/attitudes-and-preferences-of-home-mechanical-ventilation-users-from-four-european-countries-an-ers-elf-survey
#5
Sarah Masefield, Michele Vitacca, Michael Dreher, Michael Kampelmacher, Joan Escarrabill, Mara Paneroni, Pippa Powell, Nicolino Ambrosino
Home mechanical ventilation is increasingly used by people with chronic respiratory failure. However, there are few reports on attitudes towards treatment. A web-based survey in eight languages was disseminated across 11 European countries to evaluate the perception of home mechanical ventilation provision in ventilator-assisted individuals and caregivers. Out of 787 responders from 11 European countries, 687 were patients and 100 were caregivers. 95% of patients and 94% of caregivers were from only 4 countries (Germany, the Netherlands, Italy, Spain)...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28608135/can-proportional-ventilation-modes-facilitate-exercise-in-critically-ill-patients-a-physiological-cross-over-study-pressure-support-versus-proportional-ventilation-during-lower-limb-exercise-in-ventilated-critically-ill-patients
#6
Evangelia Akoumianaki, Nicolas Dousse, Aissam Lyazidi, Jean-Claude Lefebvre, Severine Graf, Ricardo Luiz Cordioli, Nathalie Rey, Jean-Christophe Marie Richard, Laurent Brochard
BACKGROUND: Early exercise of critically ill patients may have beneficial effects on muscle strength, mass and systemic inflammation. During pressure support ventilation (PSV), a mismatch between demand and assist could increase work of breathing and limit exercise. A better exercise tolerance is possible with a proportional mode of ventilation (Proportional Assist Ventilation, PAV+ and Neurally Adjusted Ventilatory Assist, NAVA). We examined whether, in critically ill patients, PSV and proportional ventilation have different effects on respiratory muscles unloading and work efficiency during exercise...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28592029/-effects-of-noninvasive-proportional-assist-vs-pressure-support-ventilation-on-respiratory-work-in-chronic-obstructive-pulmonary-disease-patients-with-hypercapnia
#7
RANDOMIZED CONTROLLED TRIAL
J H Zhang, Q Luo, H J Zhang, R C Chen
Objective: To investigate the effect of noninvasive proportional assist ventilation (PAV) on respiratory work in chronic obstructive pulmonary disease(COPD) patients, in comparison to noninvasive pressure support ventilation(PSV). Methods: Ten severe COPD patients with hypercapnia during acute exacerbation were examined. The baseline inspiratory pressure of PSV (PS) and the assistance level of PAV(PA) were titrated by patients' tolerance. In addition to the baseline PS and PA, an additional decrease by 25% (PS-=75% PS, PA-=75% PA) or increase by 25% (PS+ =125% PS, PA+ =125% PA) of the assist level were applied to the patients...
June 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28542233/is-survival-improved-by-the-use-of-niv-and-peg-in-amyotrophic-lateral-sclerosis-als-a-post-mortem-study-of-80-als-patients
#8
Christian Burkhardt, Christoph Neuwirth, Andreas Sommacal, Peter M Andersen, Markus Weber
BACKGROUND: Non-invasive ventilation (NIV) and percutaneous gastrostomy (PEG) are guideline-recommended interventions for symptom management in amyotrophic lateral sclerosis (ALS). Their effect on survival is controversial and the impact on causes of death is unknown. OBJECTIVE: To investigate the effect of NIV and PEG on survival and causes of death in ALS patients. METHODS: Eighty deceased ALS patients underwent a complete post mortem analysis for causes of death between 2003 and 2015...
2017: PloS One
https://www.readbyqxmd.com/read/28524229/exercise-induced-quadriceps-muscle-fatigue-in-men-and-women-effects-of-arterial-oxygen-content-and-respiratory-muscle-work
#9
Paolo B Dominelli, Yannick Molgat-Seon, Donald E G Griesdale, Carli M Peters, Jean-Sébastien Blouin, Mypinder Sekhon, Giulio S Dominelli, William R Henderson, Glen E Foster, Lee M Romer, Michael S Koehle, A William Sheel
KEY POINTS: High work of breathing and exercise-induced arterial hypoxaemia (EIAH) can decrease O2 delivery and exacerbate exercise-induced quadriceps fatigue in healthy men. Women have a higher work of breathing during exercise, dedicate a greater fraction of whole-body V̇O2 towards their respiratory muscles and develop EIAH. Despite a greater reduction in men's work of breathing, the attenuation of quadriceps fatigue was similar between the sexes. The degree of EIAH was similar between sexes, and regardless of sex, those who developed the greatest hypoxaemia during exercise demonstrated the most attenuation of quadriceps fatigue...
August 1, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28510574/dose-of-antivenom-for-the-treatment-of-snakebite-with-neurotoxic-envenoming-evidence-from-a-randomised-controlled-trial-in-nepal
#10
RANDOMIZED CONTROLLED TRIAL
Emilie Alirol, Sanjib Kumar Sharma, Anup Ghimire, Antoine Poncet, Christophe Combescure, Chabilal Thapa, Vijaya Prasad Paudel, Kalidas Adhikary, Walter Robert Taylor, David Warrell, Ulrich Kuch, François Chappuis
BACKGROUND: Currently, there is inadequate evidence on which to base clinical management of neurotoxic snakebite envenoming, especially in the choice of initial antivenom dosage. This randomised controlled trial compared the effectiveness and safety of high versus low initial antivenom dosage in victims of neurotoxic envenoming. METHODOLOGY/ PRINCIPAL FINDINGS: This was a balanced, randomised, double-blind trial that was conducted in three health care centers located in the Terai plains of Nepal...
May 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#11
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28433644/supraspinal-respiratory-plasticity-following-acute-cervical-spinal-cord-injury
#12
Tatiana Bezdudnaya, Vitaliy Marchenko, Lyandysha V Zholudeva, Victoria M Spruance, Michael A Lane
Impaired breathing is a devastating result of high cervical spinal cord injuries (SCI) due to partial or full denervation of phrenic motoneurons, which innervate the diaphragm - a primary muscle of respiration. Consequently, people with cervical level injuries often become dependent on assisted ventilation and are susceptible to secondary complications. However, there is mounting evidence for limited spontaneous recovery of respiratory function following injury, demonstrating the neuroplastic potential of respiratory networks...
July 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28341473/pneumonia-after-cardiac-surgery-experience-of-the-national-institutes-of-health-canadian-institutes-of-health-research-cardiothoracic-surgical-trials-network
#13
Gorav Ailawadi, Helena L Chang, Patrick T O'Gara, Karen O'Sullivan, Y Joseph Woo, Joseph J DeRose, Michael K Parides, Vinod H Thourani, Sophie Robichaud, A Marc Gillinov, Wendy C Taddei-Peters, Marissa A Miller, Louis P Perrault, Robert L Smith, Lyn Goldsmith, Keith A Horvath, Kristen Doud, Kim Baio, Annetine C Gelijns, Alan J Moskowitz, Emilia Bagiella, John H Alexander, Alexander Iribarne
RATIONALE: Pneumonia remains the most common major infection after cardiac surgery despite numerous preventive measures. OBJECTIVES: To prospectively examine the timing, pathogens, and risk factors, including modifiable management practices, for postoperative pneumonia and estimate its impact on clinical outcomes. METHODS: A total of 5158 adult cardiac surgery patients were enrolled prospectively in a cohort study across 10 centers. All infections were adjudicated by an independent committee...
June 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28273701/-analysis-of-clinical-characteristics-and-factors-associated-with-short-term-outcomes-in-early-term-neonates
#14
S S Long, Q X Tang, B X Huang, B Y Lin, L S Wang
Objective: To investigate the clinical characteristics of early term and full term neonates, and analyze the risk factors associated with short term outcomes in early term neonates. Method: Neonates with birth weight (BW) ≥2 500 g from year 2013 were analyzed retrospectively based on American Congress of Obstericians & Gynecologists (ACOG) latest definition of term infants. According to inclusion and exclusion criteria, early term (gestational age 37-38 weeks) and full term(gestational age 39-40 weeks) neonates were included, whose morbidity constituent proportion was analyzed by χ(2) test or Fisher accuracy test or t test or Wilcoxon test...
March 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28241090/plasma-exchange-for-guillain-barr%C3%A3-syndrome
#15
REVIEW
Sylvie Chevret, Richard Ac Hughes, Djillali Annane
BACKGROUND: Guillain-Barré syndrome (GBS) is an acute paralysing disease caused by peripheral nerve inflammation. This is an update of a review first published in 2001 and last updated in 2012. OBJECTIVES: To assess the effects of plasma exchange for treating GBS. SEARCH METHODS: On 18 January 2016 we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, and Embase. We also searched clinical trials registries. SELECTION CRITERIA: Randomised and quasi-randomised trials of plasma exchange versus sham exchange or supportive treatment, or comparing different regimens or techniques of plasma exchange...
February 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28196936/influences-of-duration-of-inspiratory-effort-respiratory-mechanics-and-ventilator-type-on-asynchrony-with-pressure-support-and-proportional-assist-ventilation
#16
Renata S Vasconcelos, Raquel P Sales, Luíz H de P Melo, Liégina S Marinho, Vasco Pd Bastos, Andréa da Nc Nogueira, Juliana C Ferreira, Marcelo A Holanda
BACKGROUND: Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). METHODS: We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0...
May 2017: Respiratory Care
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#17
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#18
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
June 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28149025/comparison-of-patient-ventilator-asynchrony-during-pressure-support-ventilation-and-proportional-assist-ventilation-modes-in-surgical-intensive-care-unit-a-randomized-crossover-study
#19
Parshotam Lal Gautam, Gaganjot Kaur, Sunil Katyal, Ruchi Gupta, Preetveen Sandhu, Nikhil Gautam
BACKGROUND: The patient-ventilator asynchrony is almost observed in all modes of ventilation, and this asynchrony affects lung mechanics adversely resulting in deleterious outcome. Innovations and advances in ventilator technology have been trying to overcome this problem by designing newer modes of ventilation. Pressure support ventilation (PSV) is a commonly used flow-cycled mode where a constant pressure is delivered by ventilator. Proportional assist ventilation (PAV) is a new dynamic inspiratory pressure assistance and is supposed to be better than PSV for synchrony and tolerance, but reports are still controversial...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28089646/a-risk-score-to-predict-the-incidence-of-prolonged-air-leak-after-video-assisted-thoracoscopic-lobectomy-an-analysis-from-the-european-society-of-thoracic-surgeons-database
#20
Cecilia Pompili, Pierre Emmanuel Falcoz, Michele Salati, Zalan Szanto, Alessandro Brunelli
OBJECTIVE: The study objective was to develop an aggregate risk score for predicting the occurrence of prolonged air leak after video-assisted thoracoscopic lobectomy from patients registered in the European Society of Thoracic Surgeons database. METHODS: A total of 5069 patients who underwent video-assisted thoracoscopic lobectomy (July 2007 to August 2015) were analyzed. Exclusion criteria included sublobar resections or pneumonectomies, lung resection associated with chest wall or diaphragm resections, sleeve resections, and need for postoperative assisted mechanical ventilation...
December 22, 2016: Journal of Thoracic and Cardiovascular Surgery
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