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Protective ventilation

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https://www.readbyqxmd.com/read/29452815/variable-versus-conventional-lung-protective-mechanical-ventilation-during-open-abdominal-surgery-provar-a-randomised-controlled-trial
#1
P M Spieth, A Güldner, C Uhlig, T Bluth, T Kiss, C Conrad, K Bischlager, A Braune, R Huhle, A Insorsi, F Tarantino, L Ball, M J Schultz, N Abolmaali, T Koch, P Pelosi, M Gama de Abreu
BACKGROUND: Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. METHODS: Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29451075/short-term-outcomes-of-preoperative-intra-aortic-balloon-pump-use-in-patients-undergoing-adjunctive-coronary-endarterectomy-a-retrospective-observational-study
#2
Liangshan Wang, Xing Hao, Xiaomeng Wang, Chengxiong Gu, Hong Wang, Xiaotong Hou
BACKGROUND: Coronary artery bypass grafting (CABG) combined with coronary endarterectomy (CE) can be associated with high operative mortality and morbidity. An intra-aortic balloon pump (IABP) has been the most widely used mechanical circulatory support device during perfusion treatment. However, the benefits of preoperative IABP in CABG combined with CE remain unknown. We conducted a retrospective observational study to evaluate the efficacy of preoperative IABP therapy in patients undergoing adjunctive right coronary artery (RCA) endarterectomy...
February 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29446472/hantavirus-induced-cardiopulmonary-syndrome-a-public-health-concern
#3
REVIEW
Sibghat Tul Llah, Sheema Mir, Sumaiya Sharif, Salman Khan, Mohammed A Mir
Hantavirus cardiopulmonary syndrome is characterized by pulmonary capillary leakage and alveolar flooding, resulting in 50% mortality due to fulminant hypoxic respiratory failure. In addition, depression of cardiac function ensues, which complicates the picture with cardiogenic shock. Early diagnosis and appropriate use of extracorporeal membrane oxygenation (ECMO) are amongst the lifesaving interventions in this fatal illness. However, a recent case report demonstrates that implementation of high volume continuous hemofilteration along with protective ventilation reverses the cardiogenic shock within few hours in hantavirus infected patients...
February 15, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29445595/anesthesia-and-analgesia-how-does-the-role-of-anesthetists-changes-in-the-eras-program-for-vats-lobectomy
#4
Federico Piccioni, Riccardo Ragazzi
Enhanced recovery after surgery (ERAS) programs are developed to prevent factors that delay postoperative recovery as well as issues that cause complications. The development of video-assist thoracoscopic surgery (VATS) techniques favors the fast recovery after thoracic procedures. ERAS strategies are based on multidisciplinary approach in which the anesthetist plays an important role from the preoperative to the postoperative phase with several goals. After preoperative evaluation and medical optimization, the anesthetist must ensure a tailored anesthetic plan aiming to a fast recovery and adequate pain relief to reduce the response to the surgical stress...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29444361/environmental-exposure-to-polycyclic-aromatic-hydrocarbons-kitchen-ventilation-fractional-exhaled-nitric-oxide-and-risk-of-diabetes-among-chinese-females
#5
Jian Hou, Huizhen Sun, Yun Zhou, Youjian Zhang, Wenjun Yin, Tian Xu, Juan Cheng, Weihong Chen, Jing Yuan
Diabetes is related to exposure to polycyclic aromatic hydrocarbons (PAHs), inflammation in the body and housing characters. However, associations of urinary monohydroxy-PAHs (OH-PAHs) or fractional exhaled nitric oxide (FeNO) with diabetes risk in relation to housing characters are unclear. In this study, 2645 individuals were drawn from the baseline survey of the Wuhan-Zhuhai Cohort Study. Associations of diabetes with urinary OH-PAHs or FeNO among cooking participants were estimated using logistics regression models...
February 14, 2018: Indoor Air
https://www.readbyqxmd.com/read/29444340/antipsychotics-delirium-and-acute-respiratory-distress-syndrome-what-is-the-link
#6
Heather Torbic, Abhijit Duggal
Acute respiratory distress syndrome (ARDS) is an acute inflammatory process that impairs the ability of the lungs to oxygenate and ultimately leads to respiratory failure. Patients who develop ARDS often have prolonged and complicated hospital courses putting them at risk for intensive care unit (ICU) delirium. Patients with ICU delirium often need chemical sedation, mechanical ventilation, prolonged duration of ICU and hospital stays, long-term cognitive impairment, and increased mortality. In a patient with ARDS, ICU delirium further complicates the hospital course and increases the risk of morbidly and mortality...
February 14, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29436647/mir%C3%A2-21%C3%A2-5p-regulates-type-ii-alveolar-epithelial-cell-apoptosis-in-hyperoxic-acute-lung-injury
#7
Song Qin, Miao Chen, Hui Ji, Guo-Yue Liu, Hong Mei, Kang Li, Tao Chen
Hyperoxia‑induced acute lung injury (HALI) as one of the most common complications in patents on mechanical ventilation, and there are no efficient methods to overcome this at present. It was hypothesized that microRNA 21‑5p(miR‑21‑5p) can promote the survival of type II alveolar epithelial cells (AECII), alleviating HALI. The present study aimed to combine gene chip analysis with the overexpression miR‑21‑5p to develop a novel therapeutic option for HALI. It was found that AECII apoptosis was an important pathogenic event in the development of HALI, and the overexpression of miR‑21‑5p prevented HALI, associated with reducing AECII apoptosis...
February 6, 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29435738/alveolar-tidal-recruitment-derecruitment-and-overdistension-during-four-levels-of-end-expiratory-pressure-with-protective-tidal-volume-during-anesthesia-in-a-murine-lung-healthy-model
#8
Joao Henrique Neves Soares, Alysson Roncally Carvalho, Bruno Curty Bergamini, Maria Alice Kuster Gress, Frederico Caetano Jandre, Walter Araujo Zin, Antonio Giannella-Neto
PURPOSE: We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. METHODS: Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs × V(t) + R rs × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1 + E 2 × V(t)) × V(t) + (K 1 + K 2 × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2 × F are flow-independent and flow-dependent R rs , respectively...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29434789/effects-of-pumpless-extracorporeal-lung-assist-on-hemodynamics-gas-exchange-and-inflammatory-cascade-response-during-experimental-lung-injury
#9
Zhihai Ju, Jinhui Ma, Chen Wang, Jie Yu, Yeru Qiao, Feilong Hei
Pumpless extracorporeal lung assist (pECLA) has been reported to efficiently remove the systemic CO 2 production and provide mild to moderate oxygenation, thereby allowing for ventilator settings and modes prioritizing oxygenation and lung protection. However, an adequate bypass flow, the capacity to provide respiratory support and the effect on the inflammatory cascade response and tissue perfusion require further study to be determined. After induction of acute lung injury (ALI) by oleic acid injection, pECLA was implemented in 12 anaesthetized and mechanically ventilated dogs for 48 h...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29434764/pediatric-acute-respiratory-distress-syndrome-current-views
#10
Jinfeng Liu, Wei Wang, Fengli Liu, Zhenguang Li
Acute respiratory distress syndrome (ARDS) mainly involves acute respiratory failure. In addition to this affected patients feel progressive arterial hypoxemia, dyspnea, and a marked increase in the work of breathing. The only clinical solution for the above pathological state is ventilation. Mechanical ventilation is necessary to support life in ARDs but it itself worsen lung injury and the term is known clinically as 'ventilation induced lung injury' (VILI). At the cellular level, respiratory epithelial cells are subjected to cyclic stretch, i...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29433595/management-practices-associated-with-reproductive-performance-in-holstein-cows-on-large-commercial-dairy-farms
#11
I Fodor, Zs Abonyi-Tóth, L Ózsvári
As a result of the increase in herd size and the intensification of production, the complexity of reproductive management has been growing in dairy herds. The aim of our study was to examine the associations of management practices and reproductive performance in Holstein cows on large commercial dairy farms. Management practices applied to cows were surveyed between 22 May and 6 November 2015 in 34 large Holstein-Friesian dairy herds in Hungary. Individual data of 23 784 cows that calved between 1 January 2014 and 31 December 2014 in the surveyed herds were gathered...
February 13, 2018: Animal: An International Journal of Animal Bioscience
https://www.readbyqxmd.com/read/29432350/an-exploratory-reanalysis-of-the-randomized-trial-on-efficacy-of-corticosteroids-as-rescue-therapy-for-the-late-phase-of-acute-respiratory-distress-syndrome
#12
G Umberto Meduri, Lisa Bridges, Reed A C Siemieniuk, Mehmet Kocak
OBJECTIVES: In the Acute Respiratory Distress Syndrome Network randomized controlled trial, methylprednisolone treatment was associated with increased return to mechanical ventilation with partial loss of early improvements. We hypothesize a causal relationship between protocol-driven rapid discontinuation of methylprednisolone post extubation and return to mechanical ventilation. To explore this possibility, we investigated the timing that events occurred in each treatment arm during active treatment intervention (efficacy) and after stopping therapy...
February 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29432348/trends-of-incidence-and-risk-factors-of-ventilator-associated-pneumonia-in-elderly-patients-admitted-to-french-icus-between-2007-and-2014
#13
Cédric Dananché, Philippe Vanhems, Anaïs Machut, Martine Aupée, Caroline Bervas, François L'Hériteau, Alain Lepape, Jean-Christophe Lucet, Vincent Stoeckel, Jean-François Timsit, Anne Berger-Carbonne, Anne Savey, Thomas Bénet
OBJECTIVES: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. DESIGN: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). SETTINGS: Two-hundred fifty six ICUs in 246 settings in France. PATIENTS: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network...
February 9, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29430447/mechanisms-involved-in-brain-dysfunction-in-mechanically-ventilated-critically-ill-patients-implications-and-therapeutics
#14
REVIEW
Marc Turon, Sol Fernández-Gonzalo, Candelaria de Haro, Rudys Magrans, Josefina López-Aguilar, Lluís Blanch
Critical illness may lead to significant long-term neurological morbidity and patients frequently develop neuropsychological disturbances including acute delirium or memory impairment after intensive care unit (ICU) discharge. Mechanical ventilation (MV) is a risk factor to the development of adverse neurocognitive outcomes. Patients undergoing MV for long periods present neurologic impairment with memory and cognitive alteration. Delirium is considered an acute form of brain dysfunction and its prevalence rises in mechanically ventilated patients...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430444/heart-lung-interactions-in-acute-respiratory-distress-syndrome-pathophysiology-detection-and-management-strategies
#15
REVIEW
Fernando Suarez Sipmann, Arnoldo Santos, Gerardo Tusman
Acute respiratory distress syndrome (ARDS) is the most severe form of acute respiratory failure characterized by diffuse alveolar and endothelial damage. The severe pathophysiological changes in lung parenchyma and pulmonary circulation together with the effects of positive pressure ventilation profoundly affect heart lung interactions in ARDS. The term pulmonary vascular dysfunction (PVD) refers to the specific involvement of the vascular compartment in ARDS and is expressed clinically by an increase in pulmonary arterial (PA) pressure and pulmonary vascular resistance both affecting right ventricular (RV) afterload...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29429931/protecting-the-right-ventricle-in-ards-the-role-of-prone-ventilation
#16
EDITORIAL
Vasileios Zochios, Ken Parhar, Antoinne Vieillard-Baron
No abstract text is available yet for this article.
January 12, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29429217/-phrenic-nerve-stimulation-protects-against-mechanical-ventilation-induced-diaphragmatic-dysfunction-through-myogenic-regulatory-factors
#17
G H An, M Chen, W F Zhan, B Hu, H X Zhang
Objective: To explore the protective effect of electrical stimulation of phrenic nerve on diaphragmatic function during mechanical ventilation. Methods: Forty healthy adult SD rats were randomly divided into 5 groups: blank control group (BC), spontaneous breathing group (SB), electrical stimulation group (ES), mechanical ventilation group (MV), and electrical stimulation and mechanical ventilation group (MS). The rats in each group were treated for 18 h except for the BC group. After treatment, the diaphragm muscle tissue was obtained and the diaphragm contractility including peak-to-peak value(Vpp) and maximum rate of contraction(+ dT/dt max) were measured...
February 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29426051/-respiratory-failure-innovations-in-diagnostics-and-therapy
#18
Gunther Hempel, Philipp Simon, Peter Salz, Hermann Wrigge
Acute and chronic respiratory failures require immediate diagnosis and preferably individualized ventilation therapy. If possible, non-invasive ventilation should be considered to avoid complications of invasive mechanical ventilation. Especially in patients with ARDS and moderate to severe cases, non-invasive ventilation may not be suitable and should not be used uncritically.Invasive mechanical ventilation parameters should be adjusted individually. In the future, additional parameters such as transpulmonary pressure, monitoring of regional ventilation using electrical impedance tomography could help to individualize ventilator settings...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29424792/in-depth-characterization-of-the-effects-of-cigarette-smoke-exposure-on-the-acute-trauma-response-and-hemorrhage-in-mice
#19
Clair Hartmann, Michael Gröger, Jan-Philipp Noirhomme, Angelika Scheuerle, Peter Möller, Ulrich Wachter, Markus Huber-Lang, Benedikt Nussbaum, Birgit Jung, Tamara Merz, Oscar McCook, Sandra Kress, Bettina Stahl, Enrico Calzia, Michael Georgieff, Peter Radermacher, Martin Wepler
INTRODUCTION: Hemorrhagic shock accounts for a large amount of trauma-related mortality. The severity of trauma can be further aggravated by an additional blunt chest trauma (TxT), which independently contributes to mortality upon the development of an acute lung injury (ALI). Besides, cigarette smoke (CS) exposure before TxT enhanced posttraumatic inflammation, thereby aggravating ALI. We therefore aimed to characterize the impact of an acute and/or chronic lung injury on organ dysfunction in a murine model of traumatic hemorrhagic shock (HS)...
February 8, 2018: Shock
https://www.readbyqxmd.com/read/29420341/is-overall-mortality-the-right-composite-endpoint-in-clinical-trials-of-acute-respiratory-distress-syndrome
#20
Jesús Villar, Domingo Martínez, Fernando Mosteiro, Alfonso Ambrós, José M Añón, Carlos Ferrando, Juan A Soler, Raquel Montiel, Anxela Vidal, Luís A Conesa-Cayuela, Jesús Blanco, Regina Arrojo, Rosario Solano, Lucía Capilla, Rafael Del Campo, Belén Civantos, María Mar Fernández, César Aldecoa, Laura Parra, Andrea Gutiérrez, Chanel Martínez-Jiménez, Jesús M González-Martín, Rosa L Fernández, Robert M Kacmarek
OBJECTIVES: Overall mortality in patients with acute respiratory distress syndrome is a composite endpoint because it includes death from multiple causes. In most acute respiratory distress syndrome trials, it is unknown whether reported deaths are due to acute respiratory distress syndrome or the underlying disease, unrelated to the specific intervention tested. We investigated the causes of death after contracting acute respiratory distress syndrome in a large cohort. DESIGN: A secondary analysis from three prospective, multicenter, observational studies...
February 7, 2018: Critical Care Medicine
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