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Protective ventilation

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https://www.readbyqxmd.com/read/28081532/cardiovascular-events-in-moderately-to-severely-obese-obstructive-sleep-apnea-patients-on-positive-airway-pressure-therapy
#1
Anna Maria Marotta, Jean-Christian Borel, Louis M Galerneau, Renaud Tamisier, Maria R Bonsignore, Jean Louis Pépin
BACKGROUND: In moderately to severely obese patients with obstructive sleep apnea (OSA), the effects of long-term positive airway pressure (PAP) treatment on cardiovascular risk are poorly defined. PURPOSE: To assess the effect of continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV) on the occurrence of cardiovascular events in obese OSA patients. METHODS: We performed a noninterventional observational study in obese OSA patients recruited between 2007 and 2010 at the Sleep Center, University of Grenoble, treated with CPAP or NIV, and followed for 5...
January 13, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28079607/mapping-regional-differences-of-local-pressure-volume-curves-with-electrical-impedance-tomography
#2
Alessandro Beda, Alysson R Carvalho, Nadja C Carvalho, Sören Hammermüller, Marcelo B P Amato, Thomas Muders, Claudia Gittel, Katharina Noreikat, Hermann Wrigge, Andreas W Reske
OBJECTIVES: Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#3
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28063223/neurally-adjusted-ventilatory-assist-for-infants-under-prolonged-ventilation
#4
Juyoung Lee, Han-Suk Kim, Young Hwa Jung, Chang Won Choi, Yong Hoon Jun
BACKGROUND: Severe bronchopulmonary dysplasia (BPD) often leads to prolonged mechanical ventilation lasting several months. Cyanotic episodes frequently occur in these patients, which necessitate long-term sedation and/or intermittent muscle paralysis. Neurally adjusted ventilatory assist (NAVA) might provide precisely the amount of support that these patients need without sedation. METHODS: We reviewed the medical records of preterm infants who underwent a tracheostomy and required mechanical ventilation for more than 6 months during a period of 6 years...
January 7, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28054365/mapping-for-acute-transvenous-phrenic-nerve-stimulation-study-maps-study
#5
Lukas R C Dekker, Bart Gerritse, Avram Scheiner, Lilian Kornet
AIMS: Central Sleep Apnea Syndrome, correlated with the occurrence of heart failure, is characterized by periods of insufficient ventilation during sleep. This acute study in 15 patients aims to map the venous system and determine, if diaphragmatic movement can be achieved by phrenic nerve stimulation at various locations within the venous system. METHODS: Subjects underwent a scheduled catheter ablation procedure. During the procedural waiting time, one multi-electrode EP catheter was subsequently placed at the the superior and inferior vena cava and the junctions of the left jugular and left brachiocephalic vein and right jugular and right brachiocephalic vein, for phrenic nerve stimulation (1-2 seconds ON / 2-3 seconds OFF, 40 Hz, pulse width 210 μs)...
January 5, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28048879/su-f-t-656-monte-carlo-study-on-air-activation-around-a-medical-electron-linac
#6
F Horst, G Fehrenbacher, K Zink
PURPOSE: In high energy photon therapy, several radiation protection issues result from photonuclear reactions. The activation of air - directly by photonuclear reactions as well as indirectly by capture of photoneutrons generated inside the linac head - is a major point of concern for the medical staff. The purpose of this study was to estimate the annual effective dose to medical workers due to activated air around a medical high energy electron linac by means of Monte Carlo simulations...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28036088/current-concepts-of-ards-a-narrative-review
#7
REVIEW
Michele Umbrello, Paolo Formenti, Luca Bolgiaghi, Davide Chiumello
Acute respiratory distress syndrome (ARDS) is characterized by the acute onset of pulmonary edema of non-cardiogenic origin, along with bilateral pulmonary infiltrates and reduction in respiratory system compliance. The hallmark of the syndrome is refractory hypoxemia. Despite its first description dates back in the late 1970s, a new definition has recently been proposed. However, the definition remains based on clinical characteristic. In the present review, the diagnostic workup and the pathophysiology of the syndrome will be presented...
December 29, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28034711/ventilatory-and-chemoreceptor-responses-to-hypercapnia-in-neonatal-rats-chronically-exposed-to-moderate-hyperoxia
#8
Ryan W Bavis, Ke-Yong Li, Kathryn J DeAngelis, Ryan J March, Josefine A Wallace, Sarah Logan, Robert W Putnam
Rats reared in hyperoxia hypoventilate in normoxia and exhibit progressive blunting of the hypoxic ventilatory response, changes which are at least partially attributed to abnormal carotid body development. Since the carotid body also responds to changes in arterial CO2/pH, we tested the hypothesis that developmental hyperoxia would attenuate the hypercapnic ventilatory response (HCVR) of neonatal rats by blunting peripheral and/or central chemoreceptor responses to hypercapnic challenges. Rats were reared in 21% O2 (Control) or 60% O2 (Hyperoxia) until studied at 4, 6-7, or 13-14days of age...
December 26, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28029185/case-control-study-demonstrates-that-surfactant-without-intubation-delayed-mechanical-ventilation-in-preterm-infants
#9
Sigrid Dannheim Vik, Torstein Vik, Stian Lydersen, Ragnhild Støen
AIM: This Norwegian study explored whether administering surfactant without intubation (SWI) delayed the need for early mechanical ventilation and reduced respiratory and non-respiratory complications in infants born before 32 weeks of gestational age. METHODS: We compared 262 infants admitted to a level three neonatal intensive care unit: 134 born before the introduction of SWI on 1 December 2011 were in the control group and 128 infants born after this date were in the study group...
December 28, 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/28027602/is-size-the-only-determinant-of-delayed-abdominal-closure-in-pediatric-liver-transplant
#10
Shirin Elizabeth Khorsandi, Arthur William Raven Day, Miriam Cortes, Akash Deep, Anil Dhawan, Hector Vilca-Melendez, Nigel Heaton
The aim was to determine the factors associated with the use of delayed abdominal closure in pediatric liver transplant and whether this affected outcome. From a prospectively maintained database, transplants performed in children (≤ 18 years) were identified (October 2010 - March 2015). Primary abdominal closure was defined as mass closure performed at time of transplant. Delayed abdominal closure was defined as mass closure not initially performed at the same time as transplant. 230 children underwent liver transplantation...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28027592/outcomes-of-liver-retransplantation-in-patients-with-primary-sclerosing-cholangitis
#11
Jacqueline B Henson, Yuval A Patel, Lindsay Y King, Jiayin Zheng, Shein-Chung Chow, Andrew J Muir
: Liver retransplantation in patients with primary sclerosing cholangitis (PSC) has not been well studied. The aims of this study were to characterize patients with PSC listed for and undergoing retransplantation and to describe the outcomes in these patients. The United Network for Organ Sharing/Organ Procurement and Transplantation Network database was used to identify all primary liver transplantations and subsequent relistings and first retransplantations in adults with PSC between 1987 and 2015...
December 27, 2016: Liver Transplantation
https://www.readbyqxmd.com/read/28026119/bench-evaluation-of-commercially-available-and-newly-developed-interfaces-for-mouthpiece-ventilation
#12
Adam Ogna, Helene Prigent, Line Falaize, Karl Leroux, Dante Santos, Isabelle Vaugier, David Orlikowski, Frederic Lofaso
INTRODUCTION: Mouthpiece ventilation represents a valuable treatment for patients needing daytime non-invasive ventilation. This modality is however underused, in part because of limitations in the available equipment. OBJECTIVE: To develop a new flexible and moldable mouthpiece, aiming to address some of the issues of the currently available interfaces. METHODS: We compared two commercially available and the newly developed mouthpieces in a bench test using four life-support home ventilators and three settings per ventilator...
December 27, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28026113/prognostic-evaluation-by-oxygenation-with-positive-end-expiratory-pressure-in-acute-exacerbation-of-idiopathic-pulmonary-fibrosis-a-retrospective-cohort-study
#13
Atsushi Suzuki, Hiroyuki Taniguchi, Masahiko Ando, Yasuhiro Kondoh, Tomoki Kimura, Kensuke Kataoka, Toshiaki Matsuda, Toshiki Yokoyama, Koji Sakamoto, Yoshinori Hasegawa
INTRODUCTION: Acute exacerbation (AE) is a severe complication of idiopathic pulmonary fibrosis (IPF), which shares some common pathological features with acute respiratory distress syndrome (ARDS). The new definition of ARDS requires positive end-expiratory pressure (PEEP) to assess gas exchange and has better predictive validity for short-term mortality compared with the previous definition. OBJECTIVES: The aim of this study was to evaluate the prognostic utility of oxygenation with PEEP in AE-IPF...
December 27, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28026018/a-preliminary-investigation-into-the-morphology-of-oral-papillae-and-denticles-of-blue-sharks-prionace-glauca-with-inferences-about-its-functional-significance-across-life-stages
#14
Bianca de S Rangel, Natascha Wosnick, Neil Hammerschlag, Adriano P Ciena, José Roberto Kfoury Junior, Rose E G Rici
Sensory organs in elasmobranchs (sharks, skates, rays) detect and respond to a different set of biotic and/or abiotic stimuli, through sight, smell, taste, hearing, mechanoreception and electroreception. Although gustation is crucial for survival and essential for growth, mobility, and maintenance of neural activity and the proper functioning of the immune system, comparatively little is known about this sensory system in elasmobranchs. Here we present a preliminary investigation into the structural and dimensional characteristics of the oral papillae and denticles found in the oropharyngeal cavity of the blue shark (Prionace glauca) during embryonic development through adulthood...
December 27, 2016: Journal of Anatomy
https://www.readbyqxmd.com/read/28019649/the-relative-accuracy-of-4d-dose-accumulation-for-lung-radiotherapy-using-rigid-dose-projection-versus-dose-recalculation-on-every-breathing-phase
#15
Gilmer Valdes, Chul Lee, Stephen Tenn, Percy Lee, Clifford Robinson, Keisuke Iwamoto, Daniel Low, James M Lamb
PURPOSE: To investigate the accuracy of 4D dose accumulation using projection of dose calculated on the end-exhalation, mid-ventilation, or average intensity breathing phase CT scan, versus dose accumulation performed using full Monte Carlo dose recalculation on every breathing phase. METHODS: Radiotherapy plans for 10 patients with stage I-II lung cancer were analyzed. All patients had respiratory-correlated computed tomography (4D-CT) performed as part of an IRB-approved research protocol...
December 26, 2016: Medical Physics
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#16
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
December 21, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28012314/do-air-quality-targets-really-represent-safe-limits-for-lung-cancer-risk
#17
G Buonanno, L Stabile, L Morawska, G Giovinco, X Querol
In order to estimate the lung cancer risk associated to airborne particles, exposure and risk-assessment studies ordinarily use particle mass concentration as dosimetry parameter. Consequently, the corresponding air quality targets are based on this metrics, neglecting the potential impact of ultrafine particles (UFPs) due to their negligible mass. The main purpose of this study was to evaluate the reliability of air quality targets in protecting Italian non-smoking people from lung cancer risk due to exposure to polycyclic aromatic hydrocarbons and some heavy metals associated with particle inhalation...
December 21, 2016: Science of the Total Environment
https://www.readbyqxmd.com/read/28008651/determinants-of-pre-transplantation-pectoralis-muscle-area-and-post-transplantation-change-in-pectoralis-muscle-area-in-lung-transplant-recipients
#18
Van Hoang, Gloria W Li, Christina C Kao, Goutham Dronavalli, Amit D Parulekar
BACKGROUND: This study aimed to determine predictors of pectoralis muscle area (PMA) and assess change in PMA following lung transplantation and its relationship to outcomes. METHODS: A retrospective review of 88 lung transplant recipients at a single center was performed. PMA was determined on a single axial slice from chest computerized tomography. Pectoralis muscle index (PMI) was calculated from the PMA divided by the height squared. RESULTS: PMI decreased post transplantation (8...
December 23, 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/28005297/predicted-percentage-dissatisfied-with-ankle-draft
#19
Shichao Liu, Stefano Schiavon, Alan Kabanshi, William W Nazaroff
Draft is unwanted local convective cooling. The draft risk model of Fanger et al. (Energy and Buildings 12, 21-39, 1988) estimates the percentage of people dissatisfied with air movement due to overcooling at the neck. There is no model for predicting draft at ankles, which is more relevant to stratified air distribution systems such as underfloor air distribution (UFAD) and displacement ventilation (DV). We developed a model for predicted percentage dissatisfied with ankle draft (PPDAD ) based on laboratory experiments with 110 college students...
December 22, 2016: Indoor Air
https://www.readbyqxmd.com/read/28005296/current-wheeze-asthma-respiratory-infections-and-rhinitis-among-adults-in-relation-to-inspection-data-and-indoor-measurements-in-single-family-houses-in-sweden-the-betsi-study
#20
Juan Wang, Karin Engvall, Greta Smedje, Håkan Nilsson, Dan Norbäck
In the Swedish BETSI study, a total of 1160 adults from 605 single-family houses answered a questionnaire on respiratory health. Building inspectors investigated the homes and measured temperature, air humidity, air exchange rate and wood moisture content (in attic and crawl space). Moisture load was calculated as the difference between indoor and outdoor absolute humidity. Totally 7.3% were smokers; 8.7% had doctor' diagnosed asthma; 11.2% current wheeze and 9.5% current asthma symptoms. Totally 50.3% had respiratory infections and 26...
December 22, 2016: Indoor Air
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