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Protective ventilation

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https://www.readbyqxmd.com/read/28714270/resistive-breathing-and-respiratory-muscle-fatigue-a-load-of-concern-just-expired
#1
Ken D O'Halloran
Pulmonary ventilation is a cyclical process of inhalation and exhalation of air providing dynamic tidal exchange between alveolar gas-exchanging units of the lungs and the external environment. This article is protected by copyright. All rights reserved.
July 17, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28709662/neonatal-aortic-arch-reconstruction-with-direct-splanchnic-perfusion-avoids-deep-hypothermia
#2
Muhammad Aanish Raees, Clinton D Morgan, Venessa L Pinto, Ashly C Westrick, Chevis N Shannon, Karla G Christian, Bret A Mettler, David P Bichell
BACKGROUND: Neonatal aortic arch reconstruction, typically performed with deep hypothermia and selective cerebral perfusion, leaves splanchnic organ protection dependent on hypothermia alone. A simplified method of direct in-field descending aortic perfusion during neonatal arch reconstruction permits the avoidance of deep hypothermia. We hypothesize that direct splanchnic perfusion at mild hypothermia provides improved or equivalent safety compared with deep hypothermia and may contribute to postoperative extracardiac organ recovery...
July 11, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28707030/-update-acute-hypercapnic-respiratory-failure
#3
REVIEW
F Seiler, F C Trudzinski, M Kredel, C Lotz, P M Lepper, R M Muellenbach
BACKGROUND: Hypercapnic respiratory failure is a frequent problem in critical care and mainly affects patients with acute exacerbation of COPD (AECOPD) and acute respiratory distress syndrome (ARDS). In recent years, the usage of extracorporeal CO2 removal (ECCO2R) has been increasing. OBJECTIVE: Summarizing the state of the art in the management of hypercapnic respiratory failure with special regard to the role of ECCO2R. METHODS: Review based on a selective literature search and the clinical and scientific experience of the authors...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28705229/brugada-syndrome-in-a-patient-with-amyotrophic-lateral-sclerosis-a-case-report
#4
Anusha Battineni, Rohit Gummi, Naresh Mullaguri, Raghav Govindarajan
BACKGROUND: Amyotrophic lateral sclerosis is a fatal neuromuscular disorder characterized by progressive death of the upper and lower motor neurons in the central nervous system. Patients with this disease die mostly as a result of respiratory failure; however, owing to prolonged survival through assisted ventilation, cardiovascular causes are increasingly responsible for mortality. We report what is to the best of our knowledge the first case of type 2 Brugada syndrome causing ventricular tachyarrhythmia and cardiac arrest in a patient with upper limb onset amyotrophic lateral sclerosis...
July 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28701843/incidence-proportion-of-acute-cor-pulmonale-in-patients-with-acute-respiratory-distress-syndrome-subjected-to-lung-protective-ventilation-a-systematic-review-and-meta-analysis
#5
Saurabh Kumar Das, Nang Sujali Choupoo, Priyam Saikia, Amitabh Lahkar
INTRODUCTION: Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28698267/clinical-criteria-for-tracheostomy-decannulation-in-subjects-with-acquired-brain-injury
#6
Claudia Enrichi, Irene Battel, Cristiano Zanetti, Isabella Koch, Laura Ventura, Katie Palmer, Francesca Meneghello, Francesco Piccione, Simonetta Rossi, Marta Lazzeri, Maurizio Sommariva, Andrea Turolla
BACKGROUND: Patients with acquired brain injury (ABI) often require long periods of having a tracheostomy tube for airway protection and prolonged mechanical ventilation. It has been recognized that fast and safe decannulation improves outcomes and facilitates the recovery process. Nevertheless, few studies have provided evidence for decannulation criteria, despite the high prevalence of ABI subjects with tracheostomies. The aim of our study was to assess which clinical parameters are the best predictors for decannulation in subjects with ABI...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28697635/the-perpetuation-of-the-misconception-that-rats-receive-a-3-5-times-lower-lung-tissue-dose-than-humans-at-the-same-ozone-concentration
#7
Darrell McCant, Sabine Lange, Joseph Haney, Michael Honeycutt
This paper highlights the pervasive misconception concerning 1994 findings from Hatch et al. about ozone (O3) tissue dose in humans versus rats. That study exposed humans to 0.4 ppm and rats to 2 ppm (18)O-labeled O3 and found comparable incorporation of (18)O into bronchoalveolar lavage constituents. However, during O3 exposure humans were exercising, which increased their ventilation rate five-fold, while rats were at rest. This resulted in similar O3 tissue doses between the two species, and predominantly explained the comparable (18)O incorporation at five-fold different concentrations...
July 12, 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28697424/peak-exposures-to-main-components-of-ash-and-gaseous-diesel-exhausts-in-closed-and-open-ash-loading-stations-at-biomass-fuelled-power-plants
#8
Juha Laitinen, Hanna Koponen, Olli Sippula, Kirsi Korpijärvi, Mika Jumpponen, Sirpa Laitinen, Marjaleena Aatamila, Jarkko Tissari, Tommi Karhunen, Kari Ojanen, Jorma Jokiniemi, Leena Korpinen
Fly and bottom ashes are collected at power plants to reduce the environmental effects of energy production. However, handling the ashes causes health problems for operators, maintenance workers and truck drivers at the power plants. Hence, we evaluated ash loaders' peak inhalation exposures to the chemical components of ash and diesel exhausts in open and closed ash loading stations at biomass-fuelled combined heat and power plants. We also carried out chemical and morphological analyses of the ashes to evaluate their health hazard potential in order to find practical technical measures to reduce workers' exposure...
July 4, 2017: Chemosphere
https://www.readbyqxmd.com/read/28696966/defining-a-ventilation-strategy-for-flexible-bronchoscopy-on-mechanically-ventilated-patients-in-the-medical-intensive-care-unit
#9
Yonatan Y Greenstein, Eric Shakespeare, Peter Doelken, Paul H Mayo
BACKGROUND: Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. METHODS: We studied 16 subjects who were intubated on mechanical ventilation and required FB...
July 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#10
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28695576/mechanical-ventilation-and-extracorporeal-membrane-oxygenation-as-a-bridging-strategy-to-lung-transplantation-significant-gains-in-survival
#11
Awori J Hayanga, Angela L Du, Kyla Joubert, Tuft Marie, Rachel Baird, Joseph Pilewski, Mathew Morrell, Jonathan D'Cunha, Norihisa Shigemura
Mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) are increasingly used to bridge patients to lung transplantation. We investigated the impact of using MV, with or without ECMO, prior to lung transplantation on survival after transplantation by performing a retrospective analysis of 826 patients who underwent transplantation at our high-volume center. Recipient characteristics and posttransplant outcomes were analyzed. Most lung transplant recipients (729 patients) did not require bridging; 194 of these patients were propensity matched with patients who were bridged using MV alone (48 patients) or MV and ECMO (49 patients)...
July 11, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28692612/occupational-safety-and-health-and-healthy-housing-a-review-of-opportunities-and-challenges
#12
David E Jacobs, Linda Forst
PURPOSE: Occupational safety and health (OSH) risks in construction of healthy housing (HH) have not been examined and collaboration between HH and OSH professionals is inadequate. The World Health Organization is developing international HH guidelines and the International Labour Organization is working to improve OSH in construction globally. METHODS: We searched for exemplary reports (including gray literature) on construction hazards; preventive measures for occupants and workers; OSH frameworks, laws, and regulations; definitions; and HH...
July 7, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28685722/can-dexmedetomidine-improve-arterial-oxygenation-and-intrapulmonary-shunt-during-one-lung-ventilation-in-adults-undergoing-thoracic-surgery-a-meta-analysis-of-randomized-placebo-controlled-trials
#13
Su-Qin Huang, Jian Zhang, Xiong-Xin Zhang, Lu Liu, Yang Yu, Xian-Hui Kang, Xiao-Min Wu, Sheng-Mei Zhu
BACKGROUND: One-lung ventilation (OLV) is a common ventilation technology during thoracic surgery that can cause serious clinical problems. We aimed to conduct a meta-analysis to compare oxygenation and intrapulmonary shunt during OLV in adults undergoing thoracic surgery with dexmedetomidine (Dex) versus placebo to assess the influence and safety of using Dex. METHODS: Randomized controlled trials comparing lung protection in patients who underwent thoracic surgery with Dex or a placebo were retrieved from PubMed, EMBASE, MEDLINE, Cochrane Library, and China CNKI database...
July 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28684287/high-frequency-oscillatory-ventilation-in-adults-with-ards-past-present-and-future
#14
REVIEW
Michael C Sklar, Eddy Fan, Ewan C Goligher
High-frequency oscillatory ventilation (HFOV) is a unique mode of mechanical ventilation that utilizes non-conventional gas exchange mechanisms to deliver ventilation at very low tidal volumes and high frequencies. The properties of HFOV make it a potentially ideal mode to prevent ventilator-induced lung injury in patients with acute respiratory distress syndrome. Despite a compelling physiological basis and promising experimental data, large randomized controlled trials have not detected an improvement in survival with the use of HFOV; the use of HFOV as an early lung-protective strategy in patients with ARDS may be harmful...
July 3, 2017: Chest
https://www.readbyqxmd.com/read/28683161/the-ventilation-problem-in-schools-literature-review
#15
REVIEW
William J Fisk
Based on a review of literature published in refereed archival journals, ventilation rates in classrooms often fall far short of the minimum ventilation rates specified in standards. There is compelling evidence, from both cross sectional and intervention studies, of an association of increased student performance with increased ventilation rates. There is evidence that reduced respiratory health effects and reduced student absence are associated with increased ventilation rates. Increasing ventilation rates in schools imposes energy costs and can increase HVAC system capital costs...
July 6, 2017: Indoor Air
https://www.readbyqxmd.com/read/28678385/release-of-atp-by-preb%C3%A3-tzinger-complex-astrocytes-contributes-to-the-hypoxic-ventilatory-response-via-a-ca-2-dependent-p2y1-receptor-mechanism
#16
V Rajani, Y Zhang, V Jalubula, V Rancic, S SheikhBahaei, J D Zwicker, S Pagliardini, C T Dickson, K Ballanyi, S Kasparov, A V Gourine, G D Funk
The hypoxic ventilatory response (HVR) is biphasic, consisting of a phase I increase in ventilation followed by a secondary depression (to a steady-state phase II) that can be life-threatening in premature infants who suffer from frequent apneas and respiratory depression. ATP released in the ventrolateral medulla oblongata during hypoxia attenuates the secondary depression. We explored a working hypothesis that vesicular release of ATP by astrocytes in the preBötzinger Complex (preBötC) inspiratory rhythm generating network acts via P2Y1 receptors to mediate this effect...
July 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28677303/glial-eaat2-regulation-of-extracellular-nts-glutamate-critically-controls-neuronal-activity-and-cardiorespiratory-reflexes
#17
Michael P Matott, David D Kline, Eileen M Hasser
Glutamatergic signalling is critical in the nucleus tractus solitarii (nTS) for cardiorespiratory homeostasis and initiation of sensory reflexes, including the chemoreflex activated during hypoxia. Maintenance of nTS glutamate concentration occurs in part through astrocytic excitatory amino acid transporters (EAATs). We previously established the importance of EAATs in the nTS by demonstrating their inhibition produced neuronal excitation to alter basal cardiorespiratory function. Since EAAT2 is the most expressed EAAT in the nTS, this study specifically determined EAAT2's role in nTS astrocytes, their influence on neuronal and synaptic properties, and ultimately on basal and reflex cardiorespiratory function...
July 5, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28677276/research-on-the-cause-of-death-for-severe-stroke-patients
#18
Mei-Zhen Yuan, Feng Li, Qin Fang, Wei Wang, Jing-Jing Peng, De-Yu Qin, Xue-Feng Wang, Guang-Wei Liu
AIMS AND OBJECTIVES: This study aimed to explore the characteristics of mortality among severe stroke patients, analyze their causes of death, and provide evidence for improving the survival rate of stroke patients. BACKGROUND: Stroke is an important fatal and disabling disease that poses a large burden on its patients, and its high death rates have caused substantial concern to the World Health Organization. DESIGN: A retrospective case-control study...
July 5, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28677019/-acute-respiratory-distress-syndrome-basic-principles-and-treatment
#19
P M Spieth, A Güldner, M Gama de Abreu
Even after many years of intensive research acute respiratory distress syndrome (ARDS) is still associated with a high mortality. Epidemiologically, ARDS represents a central challenge for modern intensive care treatment. The multifactorial etiology of ARDS complicates the clear identification and evaluation of new therapeutic interventions. Lung protective mechanical ventilation and adjuvant therapies, such as the prone position and targeted extracorporeal lung support are of particular importance in the treatment of ARDS, depending on the severity of the disease...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28673010/rhubarb-vs-glycerin-enema-for-treatment-of-critically-ill-patients-with-intra-abdominal-hypertension
#20
Bing Wan, Hao Zhang, Jiangtao Yin, Haiyan Fu, Yikun Chen, Liping Yang, Dadong Liu, Tangfeng Lv, Yong Song
Rhubarb has been used as an evacuant for thousands of years. However, recent research has indicated that rhubarb inhibits inflammation and protects organ function. In the current study, the use of rhubarb was investigated in patients with intra-abdominal hypertension (IAH). Specifically, its dual role in attenuating lung and bowel injury by catharsis and inhibiting inflammation was evaluated. Patients in the glycerin group (n=56) received 110 ml of glycerin enema by coloclysis once daily for 7 to 9 days. Patients in the rhubarb group (n=56) were treated with a mixture of 0...
July 2017: Experimental and Therapeutic Medicine
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