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Mechanical ventillation

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https://www.readbyqxmd.com/read/29046009/-experiences-of-patients-with-invasive-and-non-invasive-home-mechanical-ventilation-a-systematic-review-of-qualitative-research
#1
V Nelißen, S Metzing, W Schnepp
Aim of the study Human beings can be ventilated outside of a hospital after a lung failure or due to a neurodegenerative disease. This can be done in different living conditions. This article examines the question of what experiences such patients have made with invasive home mechanical ventilation, and how they have adapted their new lives. Methodology On the basis of a systematic literature research, qualitative studies were analyzed that depict the social reality of patients with invasive and non-invasive home mechanical ventilation...
October 18, 2017: Pneumologie
https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#2
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29044830/optimal-management-of-apparatus-dead-space-in-the-anesthetized-infant
#3
REVIEW
Michael R King, Jeffrey M Feldman
Mechanical ventilation of the anesthetized infant requires careful attention to equipment and ventilator settings to assure optimal gas exchange and minimize the potential for lung injury. Apparatus dead space, defined as dead space resulting from devices placed between the endotracheal tube and the Y-piece of the breathing circuit, is the primary source of dead space controlled by the clinician. Due to the small tidal volumes required by infants and neonates, it is easy to create excessive apparatus dead space resulting in unintended hypercarbia or increased minute ventilation in an effort to achieve a desirable PCO2 ...
October 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29044304/delirium-in-a-latin-american-intensive-care-unit-a-prospective-cohort-study-of-mechanically-ventilated-patients
#4
Patricia Mesa, Ignacio José Previgliano, Sonia Altez, Silvina Favretto, María Orellano, Cinthya Lecor, Ana Soca, Ely Wesley
OBJECTIVE: To establish the prevalence of delirium in a general intensive care unit and to identify associated factors, clinical expression and the influence on outcomes. METHODS: This was a prospective cohort study in a medical surgical intensive care unit. The Richmond Agitation-Sedation Scale and Confusion Assessment Method for the Intensive Care Unit were used daily to identify delirium in mechanically ventilated patients. RESULTS: In this series, delirium prevalence was 80% (N = 184 delirious patients out of 230 patients)...
July 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29043837/lung-recruitment-maneuvers-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#5
Ewan Goligher, Carol Hodgson, Neill Kj Adhikari, Maureen O Meade, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: In patients with acute respiratory distress syndrome (ARDS), lung recruitment maneuvers (LRMs) may prevent ventilator-induced lung injury and improve survival. OBJECTIVES: To summarize the current evidence in support of the use of LRMs in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mechanical ventilation strategies with and without LRMs. Eligible trials were identified from previously published systematic reviews and an updated literature search...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29043834/higher-peep-versus-lower-peep-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#6
Allan J Walkey, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. OBJECTIVE: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. METHODS: We performed a systematic review and meta-analysis of clinical trials investigating mechanical ventilation strategies using higher versus lower PEEP levels...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29043832/high-frequency-oscillation-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#7
Ewan Goligher, Laveena Munshi, Neill Kj Adhikari, Maureen O Meade, Carol Hodgson, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: By minimizing tidal lung strain and maintaining alveolar recruitment, high frequency oscillatory ventilation (HFOV) may protect against ventilator-induced lung injury. OBJECTIVES: To summarize the current evidence in support of the use of HFOV in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mortality rates with the use of HFOV vs. conventional mechanical ventilation for adult patients with acute respiratory distress syndrome...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29043491/the-multifactorial-origin-of-posterior-reversible-encephalopathy-syndrome-in-cyclophosphamide-treated-lupus-patients
#8
REVIEW
Tatjana Zekić, Mirjana Stanić Benić, Ronald Antulov, Igor Antončić, Srđan Novak
The cyclophosphamide as a predisposing factor for Posterior Reversible Encephalopathy Syndrome (PRES) and therapeutic option for systemic lupus erythematosus (SLE) is still confusing. The first and only case of PRES, probably induced by cyclophosphamide, in Croatia followed by the findings of 36 SLE patients diagnosed with PRES after treatment with cyclophosphamide worldwide are described. An 18-year-old Caucasian female patient with a 1-year history of SLE was admitted to the hospital due to lupus nephritis and acute arthritis...
October 17, 2017: Rheumatology International
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#9
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/29042707/the-effect-of-subglottic-secretion-drainage-on-the-incidence-of-ventilator-associated-pneumonia
#10
Marta Walaszek, Agnieszka Gniadek, Malgorzata Kolpa, Zdzislaw Wolaka, Alicja Kosiarska
BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs). AIM: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU. METHODS: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014)...
October 17, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29042486/parameters-for-simulation-of-adult-patients-during-mechanical-ventilation
#11
Jean-Michel Arnal, Aude Garnero, Mathieu Saoli, Robert L Chatburn
BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulation studies of intubated, passive, adult subjects with normal lungs, COPD, or ARDS. METHODS: Consecutive adult patients admitted to the ICU were included if they were deeply sedated and mechanically ventilated for <48 h without any spontaneous breathing activity...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29042090/the-natural-history-of-flail-chest-injuries
#12
Kamil Naidoo, Layth Hanbali, Peter Bates
PURPOSE: Flail chest (FC) injuries represent a significant burden on trauma services because of its high morbidity and mortality. Current gold standard conservative management strategies for FC, are now being challenged by renewed interest in surgical rib fixation. This retrospective epidemiological study sets out to evaluate FC patients, and quantify the natural history of this injury by studying the injury patterns, epidemiology and mortality of patients sustaining FC injuries admitted to a major trauma centre (MTC)...
September 19, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29042051/extracorporeal-membrane-oxygenation-as-a-bridge-to-lung-transplantation-a-single-center-experience-in-the-present-era
#13
Emily M Todd, Sreeja Biswas Roy, A Samad Hashimi, Rosemarie Serrone, Roshan Panchanathan, Paul Kang, Katherine E Varsch, Barry E Steinbock, Jasmine Huang, Ashraf Omar, Vipul Patel, Rajat Walia, Michael A Smith, Ross M Bremner
OBJECTIVE: Extracorporeal membrane oxygenation has been used as a bridge to lung transplantation in patients with rapid pulmonary function deterioration. The reported success of this modality and perioperative and functional outcomes are varied. METHODS: We retrospectively reviewed all patients who underwent lung transplantation at our institution over 1 year (January 1, 2015, to December 31, 2015). Patients were divided into 2 groups depending on whether they required extracorporeal membrane oxygenation support as a bridge to transplant; preoperative characteristics, lung transplantation outcomes, and survival were compared between groups...
November 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29041985/simplified-prognostic-model-for-critically-ill-patients-in-resource-limited-settings-in-south-asia
#14
Rashan Haniffa, Mavuto Mukaka, Sithum Bandara Munasinghe, Ambepitiyawaduge Pubudu De Silva, Kosala Saroj Amarasiri Jayasinghe, Abi Beane, Nicolette de Keizer, Arjen M Dondorp
BACKGROUND: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29041861/in-vitro-evaluation-of-aerosol-delivery-of-aztreonam-lysine-azli-an-adult-mechanical-ventilation-model
#15
A Rodríguez, M Cabrera, L F Reyes, M Bodí, S Trefler, L Canadell, D Barahona, S Ehrmann, I Martin-Loeches, M I Restrepo, L Vecellio
BACKGROUND: The delivery profile of Aztreonam lysine (AZLI) during mechanical ventilation (MV) is unknown. We evaluated the amount of AZLI drug delivered using an in vitro model of adult MV. METHODS: An adult lung model designed to mimic current clinical practice was used. Both nebulizers were placed before a Y-piece and 4 settings were tested: A) Aeroneb solo® [AS] with a t-piece; B) AS with the spacer; C) M-Neb® [MN] with a t-piece and D) MN with the spacer...
October 18, 2017: Expert Opinion on Drug Delivery
https://www.readbyqxmd.com/read/29041034/inhaled-versus-systemic-corticosteroids-for-preventing-bronchopulmonary-dysplasia-in-ventilated-very-low-birth-weight-preterm-neonates
#16
REVIEW
Sachin S Shah, Arne Ohlsson, Henry L Halliday, Vibhuti S Shah
BACKGROUND: Bronchopulmonary dysplasia (BPD) remains an important cause of mortality and morbidity in preterm infants and inflammation plays a significant role in its pathogenesis. The use of inhaled corticosteroids may modulate the inflammatory process without concomitant high systemic steroid concentrations and less risk of adverse effects. This is an update of a review published in 2012 (Shah 2012). We recently updated the related review on "Inhaled versus systemic corticosteroids for treating bronchopulmonary dysplasia in ventilated very low birth weight preterm neonates"...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#17
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29039883/volume-targeted-versus-pressure-limited-ventilation-in-neonates
#18
REVIEW
Claus Klingenberg, Kevin I Wheeler, Naomi McCallion, Colin J Morley, Peter G Davis
BACKGROUND: Damage caused by lung overdistension (volutrauma) has been implicated in the development of bronchopulmonary dysplasia (BPD). Modern neonatal ventilation modes can target a set tidal volume as an alternative to traditional pressure-limited ventilation (PLV) using a fixed inflation pressure. Volume-targeted ventilation (VTV) aims to produce a more stable tidal volume in order to reduce lung damage and stabilise the partial pressure of carbon dioxide (pCO2). OBJECTIVES: To determine whether VTV compared with PLV leads to reduced rates of death and death or BPD in newborn infants and to determine whether use of VTV affected outcomes including air leak, cranial ultrasound findings and neurodevelopment...
October 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29038746/influence-of-exercise-duration-on-cardiorespiratory-responses-energy-cost-and-tissue-oxygenation-within-a-6-hour-treadmill-run
#19
Hugo A Kerhervé, Scott McLean, Karen Birkenhead, David Parr, Colin Solomon
PURPOSE: The physiological mechanisms for alterations in oxygen utilization ([Formula: see text]) and the energy cost of running (Cr ) during prolonged running are not completely understood, and could be linked with alterations in muscle and cerebral tissue oxygenation. METHODS: Eight trained ultramarathon runners (three women; mean ± SD; age 37 ± 7 yr; maximum [Formula: see text] 60 ± 15 mL min(-1) kg(-1)) completed a 6 hr treadmill run (6TR), which consisted of four modules, including periods of moderate (3 min at 10 km h(-1), 10-CR) and heavy exercise intensities (6 min at 70% of maximum [Formula: see text], HILL), separated by three, 100 min periods of self-paced running (SP)...
2017: PeerJ
https://www.readbyqxmd.com/read/29038671/inspiratory-muscle-training-in-the-intensive-care-unit-a-new-perspective
#20
Rodrigo Marques Tonella, Ligia Dos Santos Roceto Ratti, Lilian Elisabete Bernardes Delazari, Carlos Fontes Junior, Paula Lima Da Silva, Aline Ribeiro Da Silva Herran, Daniela Cristina Dos Santos Faez, Ivete Alonso Bredda Saad, Luciana Castilho De Figueiredo, Rui Moreno, Desanka Dragosvac, Antonio Luis Eiras Falcao
BACKGROUND: Prolonged use of mechanical ventilation (MV) leads to weakening of the respiratory muscles, especially in patients subjected to sedation, but this effect seems to be preventable or more quickly reversible using respiratory muscle training. The aims of the study were to assess variations in respiratory and hemodinamic parameters with electronic inspiratory muscle training (EIMT) in tracheostomized patients requiring MV and to compare these variations with those in a group of patients subjected to an intermittent nebulization program (INP)...
November 2017: Journal of Clinical Medicine Research
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