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Proportional assist ventilation

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https://www.readbyqxmd.com/read/29750687/evaluation-of-clinical-outcomes-with-phosphodiesterase-5-inhibitor-therapy-for-right-ventricular-dysfunction-after-left-ventricular-assist-device-implantation
#1
Katherine L Roberts, Jerrica E Shuster, Nicholas S Britt, Keki R Balsara, Thomas J Graetz, Mohammad Helwani, Akinobu Itoh, Bethany R Tellor
Few studies have evaluated the use of phosphodiesterase-5 inhibitors (PDE5-i) for right ventricular (RV) dysfunction after left ventricular assist device (LVAD) implantation. The study purpose was to examine the impact of postoperative inpatient PDE5-i therapy on clinical outcomes in patients with LVADs. This single-center, retrospective cohort study screened 428 LVAD recipients between January 2011 and May 2015 for eligibility. Subjects receiving post-LVAD PDE5-i were compared with those who did not. The primary outcome was the proportion of all-cause hospital readmission at 30 days...
May 7, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#2
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29652758/is-inspiratory-muscle-weakness-a-determinant-of-endurance-exercise-tolerance-during-niv-supported-exercise-in-patients-with-copd
#3
Rodrigo Koch, Gabriel Victor Guimarães Rapello, Paulo de Tarso Müller
PURPOSE: Previous research has reported that inspiratory muscle weakness is critical to decreased exercise tolerance and exercise tolerance improves with 10 cmH2O pressure support ventilation in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the effects of proportional assist ventilation (PAV) and continuous positive airway pressure (CPAP) compared with sham on exercise tolerance in patients with and without inspiratory muscle weakness...
April 11, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29558879/geographic-distance-from-transplant-center-does-not-impact-pediatric-heart-transplant-outcomes
#4
Meghann McKane, Debra A Dodd, Bret A Mettler, Kari A Wujcik, Justin Godown
BACKGROUND: Many pediatric heart transplant recipients live a significant distance from their transplant center. This results in families either traveling long distances or relying on outside physicians to assume aspects of their care. Distance has been implicated to play a role in congenital heart disease outcomes, but its impact on heart transplantation has not been reported. The aim of this study was to assess the impact of distance on pediatric heart transplant outcomes. METHODS: The Scientific Registry of Transplant Recipients database was queried for all pediatric heart transplant recipients from large US children's hospitals (1987-2014)...
January 1, 2018: Progress in Transplantation
https://www.readbyqxmd.com/read/29553157/different-durations-of-corticosteroid-therapy-for-exacerbations-of-chronic-obstructive-pulmonary-disease
#5
REVIEW
Julia Ae Walters, Daniel J Tan, Clinton J White, Richard Wood-Baker
BACKGROUND: Current guidelines recommend that patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) should be treated with systemic corticosteroid for seven to 14 days. Intermittent systemic corticosteroid use is cumulatively associated with adverse effects such as osteoporosis, hyperglycaemia and muscle weakness. Shorter treatment could reduce adverse effects. OBJECTIVES: To compare the efficacy of short-duration (seven or fewer days) and conventional longer-duration (longer than seven days) systemic corticosteroid treatment of adults with acute exacerbations of COPD...
March 19, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29530114/-risk-factors-for-elevated-serum-total-bile-acid-in-preterm-infants
#6
Yan-Ting Song, Yong-Qin Wang, Yue-Hua Zhao, Hai-Ling Zhu, Qian Liu, Xiao Zhang, Yi-Wen Gao, Wei-Ye Zhang, Yu-Tong Sang
OBJECTIVE: To study the risk factors for elevated serum total bile acid (TBA) in preterm infants. METHODS: A retrospective analysis was performed for the clinical data of 216 preterm infants who were admitted to the neonatal intensive care unit. According to the presence or absence of elevated TBA (TBA >24.8 μmol/L), the preterm infants were divided into elevated TBA group with 53 infants and non-elevated TBA group with 163 infants. A univariate analysis and an unconditional multivariate logistic regression analysis were used to investigate the risk factors for elevated TBA...
March 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29479941/current-views-of-complications-associated-with-neonatal-ventilation-a-review
#7
Gang Liu, Hongwei Wu, Zhenguang Li
Infants born prematurely require external respiratory support device like ventilation for the purpose of life saving. However, these ventilation machines have complications that sometimes unfortunately result in morbidity. New ventilation techniques have been developed to prevent morbidity, but have yet to be fully evaluated. The present review article would discuss current aspects of this life saving gear especially for pediatric patients in clinical setting. Besides basic ventilation apparatus, advancements in the filed like Proportional assist ventilation , Volume Targeted Ventilation would be discussed...
February 23, 2018: Minerva Pediatrica
https://www.readbyqxmd.com/read/29475456/detection-of-inspiratory-recruitment-of-atelectasis-by-automated-lung-sound-analysis-as-compared-to-four-dimensional-computed-tomography-in-a-porcine-lung-injury-model
#8
Stefan Boehme, Frédéric P R Toemboel, Erik K Hartmann, Alexander H Bentley, Oliver Weinheimer, Yang Yang, Tobias Achenbach, Michael Hagmann, Eugenijus Kaniusas, James E Baumgardner, Klaus Markstaller
BACKGROUND: Cyclic recruitment and de-recruitment of atelectasis (c-R/D) is a contributor to ventilator-induced lung injury (VILI). Bedside detection of this dynamic process could improve ventilator management. This study investigated the potential of automated lung sound analysis to detect c-R/D as compared to four-dimensional computed tomography (4DCT). METHODS: In ten piglets (25 ± 2 kg), acoustic measurements from 34 thoracic piezoelectric sensors (Meditron ASA, Norway) were performed, time synchronized to 4DCT scans, at positive end-expiratory pressures of 0, 5, 10, and 15 cmH2 O during mechanical ventilation, before and after induction of c-R/D by surfactant washout...
February 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29458319/proportional-assist-ventilation-versus-pressure-support-ventilation-in-weaning-ventilation-a-pilot-randomised-controlled-trial
#9
John Botha, Cameron Green, Ian Carney, Kavi Haji, Sachin Gupta, Ravindranath Tiruvoipati
OBJECTIVE: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a mode of ventilation that provides assistance in proportion to patient effort. This may have physiological and clinical advantages when compared with pressure support ventilation (PSV). Our objective was to compare these two modes in patients being weaned from mechanical ventilation. DESIGN: Prospective randomised controlled trial comparing PSV with PAV+. SETTING: University-affiliated, tertiary referral intensive care unit (ICU)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29404723/physiological-predictors-of-respiratory-and-cough-assistance-needs-after-extubation
#10
Nicolas Terzi, Frédéric Lofaso, Romain Masson, Pascal Beuret, Hervé Normand, Edith Dumanowski, Line Falaize, Bertrand Sauneuf, Cédric Daubin, Jennifer Brunet, Djillali Annane, Jean-Jacques Parienti, David Orlikowski
BACKGROUND: Identifying patients at high risk of post-extubation acute respiratory failure requiring respiratory or mechanical cough assistance remains challenging. Here, our primary aim was to evaluate the accuracy of easily collected parameters obtained before or just after extubation in predicting the risk of post-extubation acute respiratory failure requiring, at best, noninvasive mechanical ventilation (NIV) and/or mechanical cough assistance and, at worst, reintubation after extubation...
February 5, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29315458/implementation-and-effectiveness-of-a-video-based-debriefing-programme-for-neonatal-resuscitation
#11
C Skåre, T E Calisch, E Saeter, T Rajka, A M Boldingh, B Nakstad, D E Niles, J Kramer-Johansen, T M Olasveengen
BACKGROUND: Approximately 5%-10% of newly born babies need intervention to assist transition from intra- to extrauterine life. All providers in the delivery ward are trained in neonatal resuscitation, but without clinical experience or exposure, training competency is transient with a decline in skills within a few months. The aim of this study was to evaluate whether neonatal resuscitations skills and team performance would improve after implementation of video-assisted, performance-focused debriefings...
March 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29125270/alternative-incision-sutureless-aortic-valve-replacement-propensity-matched-comparison-between-partial-sternotomy-and-right-anterior-minithoracotomy
#12
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 ministernotomy [MS] and 276 via right anterior minithoracotomy [RAMT]) have been retrospectively analyzed...
April 2018: 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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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