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Nasal ventilation

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https://www.readbyqxmd.com/read/29149868/can-high-flow-nasal-cannula-reduce-the-rate-of-reintubation-in-adult-patients-after-extubation-a-meta-analysis
#1
Yue-Nan Ni, Jian Luo, He Yu, Dan Liu, Bin-Miao Liang, Rong Yao, Zong-An Liang
BACKGROUND: The effects of high flow nasal cannula (HFNC) on adult patients after extubation remain controversial. We aimed to further determine the effectiveness of HFNC in comparison to noninvasive positive pressure ventilation (NIPPV) and conventional oxygen therapy (COT). METHODS: The Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trails (CENTRAL) as well as the Information Sciences Institute (ISI) Web of Science were searched for all the controlled study comparing HFNC with NIPPV and COT in adult patients after extubation...
November 17, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29149690/a-modified-montpellier-protocol-for-intubating-intensive-care-unit-patients-is-associated-with-an-increase-in-first-pass-intubation-success-and-fewer-complications
#2
Keith A Corl, Christopher Dado, Ankita Agarwal, Nader Azab, Tim Amass, Sarah J Marks, Mitchell M Levy, Roland C Merchant, Jason Aliotta
BACKGROUND: The Montpellier protocol for intubating patients in the intensive care unit (ICU) is associated with a decrease in intubation-related complications. We sought to determine if implementation of a simplified version of the Montpellier protocol that removed selected components and allowed for a variety of pre-oxygenation modalities increased first-pass intubation success and reduced intubation-related complications. METHODS: A prospective pre/post-comparison of a modified Montpellier protocol in two medical and one medical/surgical/cardiac ICU within a hospital system...
November 10, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29149468/pneumoparotitis-as-a-complication-of-long-term-oronasal-positive-airway-pressure-for-sleep-apnea
#3
Andrew J Goates, Daniel J Lee, Joan E Maley, Phillip C Lee, Henry T Hoffman
BACKGROUND: Parotid swelling is rarely caused by pneumoparotitis from retrograde insufflation of air into Stensen's duct. Previous reports have identified occupational exposures, self-induced habits, exercise, spirometry, and short-term positive pressure airway ventilation as causes of salivary duct insufflation. METHODS: We present 2 cases of pneumoparotitis in patients on long-term oronasal continuous positive airway pressure (CPAP) for obstructive sleep apnea...
November 17, 2017: Head & Neck
https://www.readbyqxmd.com/read/29144160/high-flow-nasal-cannula-oxygen-in-adults-an-evidence-based-assessment
#4
Matthew G Drake
High flow nasal cannula oxygenation has distinct advantages over other oxygen devices due to its unique effects on respiratory physiology. In particular, adjustable oxygen delivery and flow-dependent carbon dioxide clearance from the upper airway reduce work of breathing and can better match inspiratory demand during respiratory distress. Historically, few studies had evaluated whether the physiologic effects of these devices translated into clinical benefit. However, recent publications have begun to address this knowledge gap...
November 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29116051/multiple-image-x-radiography-for-functional-lung-imaging
#5
Gurpreet Kaur Aulakh, Anish Mann, George Belev, Sheldon Wiebe, Wolfgang M Kuebler, Baljit Singh, Dean Chapman
Detection and visualization of lung tissue structures is impaired by predominance of air. However, by using synchrotron x-rays, refraction of x-rays at the interface of tissue and air can be utilized to generate contrast which may in turn enable quantification of lung optical properties. We utilized multiple image radiography, a variant of diffraction enhanced imaging, at the Canadian Light Source to quantify changes in unique x-ray optical properties of lungs, namely attenuation, refraction and Ultra Small-Angle Scatter (USAXS or width) contrast ratios as a function of lung orientation in free-breathing or respiratory-gated mice before and after intra-nasal bacterial endotoxin (lipopolysaccharide) instillation...
November 8, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29109835/anterior-submandibular-approach-for-transmylohyoid-endotracheal-intubation-a-reappraisal-with-prospective-study-in-206-cases-of-craniomaxillofacial-fractures
#6
Nitin Bhola, Anendd Jadhav, Atul Kala, Rahul Deshmukh, Umesh Bhutekar, G S V Prasad
Despite a paradigm shift in anesthesia and trauma airway management, the craniomaxillofacial fracture (CMF) patients continue to pose a challenge. A prospective study was planned between April 2007 and March 2015 to investigate the safety, efficacy, utility, and complications of anterior submandibular approach for transmylohyoid intubation (TMI) in CMFs using an armored endotracheal tube (ETT). Out of 1,207 maxillofacial trauma cases reported, this study recruited 206 patients (152 males and 54 females) aged between 21 and 60 years...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29099420/predictors-of-intubation-in-patients-with-acute-hypoxemic-respiratory-failure-treated-with-a-noninvasive-oxygenation-strategy
#7
Jean-Pierre Frat, Stéphanie Ragot, Rémi Coudroy, Jean-Michel Constantin, Christophe Girault, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Keyvan Razazi, Jean-Baptiste Lascarrou, Jérôme Devaquet, Jean-Paul Mira, Laurent Argaud, Jean-Charles Chakarian, Muriel Fartoukh, Saad Nseir, Alain Mercat, Laurent Brochard, René Robert, Arnaud W Thille
OBJECTIVES: In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians to decide early. We aimed to identify factors associated with intubation in patients with acute hypoxemic respiratory failure treated with different noninvasive oxygenation techniques...
November 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29089459/choosing-the-proper-interface-for-positive-airway-pressure-therapy-in-subjects-with-acute-respiratory-failure
#8
REVIEW
Ahmed S BaHammam, Tripat Deep Singh, Ravi Gupta, Seithikurippu R Pandi-Perumal
Noninvasive ventilation is an effective treatment for a significant proportion of patients with acute respiratory failure. The success of noninvasive ventilation, however, depends on several factors, a major one being the selection of the proper interface. The choice and application of the interface in patients with acute respiratory failure is a considerable challenge for any treatment team. This review discusses the different types of interfaces that can be used in patients with acute respiratory failure, the differences between nasal, oro-nasal, and total face masks and the helmet, as well as the effect of interface type on treatment success and upper airway patency, mask fitting, problems related to the interface, and the relationship between ventilator type and interface choice...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066588/effect-of-high-flow-nasal-cannula-on-expiratory-pressure-and-ventilation-in-infant-pediatric-and-adult-models
#9
Katie R Nielsen, Laura E Ellington, Alan J Gray, Larissa I Stanberry, Lincoln S Smith, Robert M DiBlasi
BACKGROUND: Heated and humidified high-flow nasal cannula (HFNC) is a widely used form of respiratory support; however, data regarding optimal flows for a given patient size or disease state are lacking. A comprehensive study of the physiologic effects of HFNC is needed to better understand the mechanisms of action. The objective of the current study was to quantify the effect of HFNC settings in age-specific, anatomically correct nasal airways and spontaneously breathing lung models...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066587/heart-rate-variability-in-extremely-preterm-infants-receiving-nasal-cpap-and-non-synchronized-noninvasive-ventilation-immediately-after-extubation
#10
Samantha Latremouille, Ali Al-Jabri, Philippe Lamer, Lara Kanbar, Wissam Shalish, Robert E Kearney, Guilherme M Sant' Anna
INTRODUCTION: There is a paucity of studies comparing the physiological effects of nasal CPAP or non-synchronized noninvasive ventilation (ns-NIV) during the postextubation phase in preterm infants. Heart rate variability (HRV) can identify system instability before clinical or laboratory signs of deterioration. Thus, we sought to investigate any differences in HRV between those modes. METHODS: 15 preterm infants with birthweight ≤1,250 g and undergoing their first extubation attempt were studied immediately after disconnection from mechanical ventilation...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29056267/airway-ciliary-dysfunction-association-with-adverse-postoperative-outcomes-in-nonheterotaxy-congenital-heart-disease-patients
#11
Eileen Stewart, Phillip S Adams, Xin Tian, Omar Khalifa, Peter Wearden, Maliha Zahid, Cecilia W Lo
OBJECTIVE: Heterotaxy (HTX) congenital heart disease (CHD) patients with ciliary dysfunction (CD) have been shown to have increased postoperative respiratory morbidity. We hypothesized that non-HTX CHD infants with CD also will have increased postoperative morbidity, particularly respiratory complications. METHODS: Sixty-three infants with non-HTX CHD undergoing cardiac surgery were enrolled. Tests commonly used to assess for CD, nasal nitric oxide (nNO) measurements and nasal epithelial ciliary motion (CM) assessment, were obtained...
September 20, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#12
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29037221/high-flow-oxygen-via-nasal-cannulae-in-patients-with-acute-hypoxemic-respiratory-failure-a-systematic-review-and-meta-analysis
#13
Murdoch Leeies, Eric Flynn, Alexis F Turgeon, Bojan Paunovic, Hal Loewen, Rasheda Rabbani, Ahmed M Abou-Setta, Niall D Ferguson, Ryan Zarychanski
BACKGROUND: We performed a systematic review and meta-analysis to evaluate the efficacy and safety of high-flow oxygen via nasal cannulae (HFNC) compared to non-invasive ventilation (NIV) and/or standard oxygen in patients with acute, hypoxemic respiratory failure. METHODS: We reviewed randomized controlled trials from CENTRAL, EMBASE, MEDLINE, Scopus and the International Clinical Trials Registry Platform (inception to February 2016), conference proceedings, and relevant article reference lists...
October 16, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29029284/the-influence-of-co2-on-genioglossus-muscle-after-discharge-following-arousal-from-sleep-hypocapnia-and-genioglossus-muscle-after-discharge
#14
Jennifer M Cori, Peter D Rochford, Fergal J O'Donoghue, John Trinder, Amy S Jordan
Objectives: Ventilatory after-discharge (sustained elevation of ventilation following stimulus removal), occurs during sleep but not when hypocapnia is present. Genioglossus after-discharge also occurs during sleep, but CO2 effects have not been assessed. The relevance is that post-arousal after-discharge may protect against upper airway collapse. This study aimed to determine whether arousal elicits genioglossus after-discharge that persists into sleep, and whether it is influenced by CO2...
October 6, 2017: Sleep
https://www.readbyqxmd.com/read/29025898/aging-is-associated-with-increased-propensity-for-central-apnea-during-nrem-sleep
#15
Susmita Chowdhuri, Sukanya Pranathiageswaran, Hillary Loomis-King, Anan Salloum, M Safwan Badr
The reason for increased sleep disordered breathing with predominance of central apneas in the elderly is unknown. We hypothesized that the propensity to central apneas is increased in older adults, manifested by a reduced carbon-dioxide (CO2) reserve in older compared to young adults during non-REM (NREM) sleep. METHODS: 10 elderly and 15 young healthy adults underwent multiple brief trials of nasal noninvasive positive pressure ventilation during stable NREM sleep. Cessation of mechanical ventilation (MV) resulted in hypocapnic central apnea or hypopnea...
October 12, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28974061/supraglottic-jet-oxygenation-and-ventilation-enhances-oxygenation-during-upper-gastrointestinal-endoscopy-in-patients-sedated-with-propofol-a-randomized-multicentre-clinical-trial
#16
Y Qin, L Z Li, X Q Zhang, Y Wei, Y L Wang, H F Wei, X R Wang, W F Yu, D S Su
Background: Hypoventilation is the main reason for hypoxia during upper gastrointestinal endoscopy procedures with sedation. The key to preventing hypoxia is to maintain normal ventilation during the procedure. We introduced supraglottic jet oxygenation and ventilation (SJOV) through a new Wei nasal jet tube (WNJ) to reduce the incidence of hypoxia in patients sedated with propofol during upper gastrointestinal endoscopy procedures. Methods: In a multicentre, prospective randomized single-blinded study, 1781 outpatients undergoing routine upper gastrointestinal endoscopy who were sedated with propofol by an anaesthetist were randomized into the following three groups: the supplementary oxygen via nasal cannula group [nasal cannula oxygen: O 2 (2 litres min -1 ) was administered via a nasal cannula]; the supplementary oxygen via WNJ group [WNJ oxygen: O 2 (2 litres min -1 ) was administered through a WNJ]; and the SJOV via WNJ group (WNJ SJOV: SJOV was administered via WNJ) at three centres from March 2015 to July 2016...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28970662/dual-oxygen-therapy-in-patient-on-bilevel-positive-airway-pressure-prevented-invasive-mechanical-ventilation
#17
Amarjeet Kumar, Lalit Kumar, Chandni Sinha, Neeraj Kumar, Umesh Kumar Bhadani
During noninvasive bilevel positive airway pressure (BiPAP) ventilation it is found that several times patients are unable to maintain oxygen saturation and develop breathing difficulty despite its high setting and high oxygen flow, further management requires invasive positive pressure mechanical ventilation. Increasing oxygen concentration inside the BiPAP mask using nasal cannula with addition of another flow meter not only increase oxygen saturation but also make the patient more comfortable and prevent intubation and its complications...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28947043/does-high-flow-nasal-cannula-oxygen-improve-outcome-in-acute-hypoxemic-respiratory-failure-a-systematic-review-and-meta-analysis
#18
REVIEW
Si-Ming Lin, Kai-Xiong Liu, Zhi-Hong Lin, Pei-Hong Lin
INTRODUCTION: To evaluate the efficacy of high-flow nasal cannula (HFNC) in the rate of intubation and mortality for patients with acute hypoxemic respiratory failure. METHODS: We searched Pubmed, EMBASE, and the Cochrane Library for relevant studies. Two reviewers extracted data and reviewed the quality of the studies independently. The primary outcome was the rate of intubation; secondary outcome was mortality in the hospital. Study-level data were pooled using a random-effects model when I2 was >50% or a fixed-effects model when I2 was <50%...
October 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28936951/-preliminary-evaluation-of-sequential-therapy-by-high-flow-nasal-cannula-oxygen-therapy-following-endotracheal-tube-extubation-in-mechanically-ventilated-patients
#19
Zhengfang Zhu, Yuhao Liu, Qixing Wang, Sheng Wang
OBJECTIVE: To evaluate the feasibility and effect of sequential treatment by the heated humidified high flow nasal cannula oxygen therapy (HFNC) in mechanically ventilated patients following endotracheal tube extubation. METHODS: A prospective randomized controlled trial was conducted. Forty-nine patients with the sequential treatment after tracheal intubation extraction admitted to Department of Critical Care Medicine of Shanghai Tenth People's Hospital from January 1st to December 31st 2016 were enrolled...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28935428/predictive-factors-for-the-outcome-of-high-flow-nasal-cannula-therapy-in-a-pediatric-intensive-care-unit-is-the-spo2-fio2-ratio-useful
#20
Fulya Kamit Can, Ayşe Berna Anil, Murat Anil, Neslihan Zengin, Fatih Durak, Caner Alparslan, Zeynep Goc
OBJECTIVES: To determine the predictive factors for the outcome of high-flow nasal cannula (HFNC) therapy in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: We prospectively included all patients with acute respiratory distress/failure aged 1month to 18years who were admitted to the PICU between January 2015 and May 2016 and treated with HFNC as a primary support and for postextubation according to our pre-established protocol. HFNC failure was defined as the need for escalation to non-invasive ventilation (NIV) or invasive mechanical ventilation (MV)...
September 6, 2017: Journal of Critical Care
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