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Plateau pressure

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https://www.readbyqxmd.com/read/27894328/effect-of-driving-pressure-on-mortality-in-ards-patients-during-lung-protective-mechanical-ventilation%C3%A2-in-two-randomized-controlled-trials
#1
Claude Guérin, Laurent Papazian, Jean Reignier, Louis Ayzac, Anderson Loundou, Jean-Marie Forel
BACKGROUND: Driving pressure (ΔPrs) across the respiratory system is suggested as the strongest predictor of hospital mortality in patients with acute respiratory distress syndrome (ARDS). We wonder whether this result is related to the range of tidal volume (VT). Therefore, we investigated ΔPrs in two trials in which strict lung-protective mechanical ventilation was applied in ARDS. Our working hypothesis was that ΔPrs is a risk factor for mortality just like compliance (Crs) or plateau pressure (Pplat,rs) of the respiratory system...
November 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27875409/extracorporeal-membrane-oxygenation-beyond-rescue-therapy-for-acute-respiratory-distress-syndrome
#2
Alain Combes, Nicolas Bréchot, Charles-Edouard Luyt, Matthieu Schmidt
PURPOSE OF REVIEW: This article summarizes the results of past and more recent series on venovenous extracorporeal membrane oxygenation (VV-ECMO) and discusses its potential indications beyond the rescue of patients with lung failure refractory to conventional mechanical ventilation. RECENT FINDINGS: Successful VV-ECMO treatment in patients with extremely severe influenza A(H1N1)-associated acute respiratory distress syndrome (ARDS) and positive results of the CESAR trial have led to an exponential use of the technology in recent years...
November 19, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27864919/using-a-novel-assessment-of-procedural-proficiency-provides-medical-educators-insight-into-blood-pressure-measurement
#3
Michael Holmstrup, Brock Jensen, Rebecca Burkart, Malorie Levis
Objective: This investigation was performed to determine how students in a health sciences program utilize and explain techniques within blood pressure measurement using a novel assessment, and changes associated with greater curricular exposure. Methods: An exploratory, qualitative and quantitative study was conducted using a 'Think Aloud' design with protocol analysis. Following familiarization, participants performed the task of measuring blood pressure on a reference subject while stating their thought processes...
November 19, 2016: International Journal of Medical Education
https://www.readbyqxmd.com/read/27859721/analysis-of-the-learning-curve-of-peroral-endoscopic-myotomy-for-esophageal-achalasia-single-center-two-operator-experience
#4
Lv Houning, Ningning Zhao, Zhongqing Zheng, Tao Wang, Fang Yang, Xihui Jiang, Lin Lin, Chao Sun, Bangmao Wang
OBJECTIVES: Peroral endoscopic myotomy (POEM) has emerged as an advanced technique for the treatment of achalasia, and defining the learning curve is mandatory. METHODS: From August 2011 to June 2014, two operators in our institution (A&B) have performed POEM on 35 and 33 consecutive patients, respectively. The moving average and cumulative sum (CUSUM) methods were employed to analyze the POEM learning curve for corrected operative time (cOT), referring to duration of per centimeter myotomy...
November 17, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/27855477/recruitment-manoeuvres-for-adults-with-acute-respiratory-distress-syndrome-receiving-mechanical-ventilation
#5
REVIEW
Carol Hodgson, Ewan C Goligher, Meredith E Young, Jennifer L Keating, Anne E Holland, Lorena Romero, Scott J Bradley, David Tuxen
BACKGROUND: Recruitment manoeuvres involve transient elevations in airway pressure applied during mechanical ventilation to open ('recruit') collapsed lung units and increase the number of alveoli participating in tidal ventilation. Recruitment manoeuvres are often used to treat patients in intensive care who have acute respiratory distress syndrome (ARDS), but the effect of this treatment on clinical outcomes has not been well established. This systematic review is an update of a Cochrane review originally published in 2009...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27837370/intraocular-pressure-and-cerebral-oxygenation-during-prolonged-headward-acceleration
#6
Ola Eiken, Michail E Keramidas, Nigel A S Taylor, Mikael Grönkvist
PURPOSE: Supra-tolerance head-to-foot directed gravitoinertial load (+Gz) typically induces a sequence of symptoms/signs, including loss of: peripheral vision-central vision-consciousness. The risk of unconsciousness is greater when anti-G-garment failure occurs after prolonged rather than brief exposures, presumably because, in the former condition, mental signs are not consistently preceded by impaired vision. The aims were to investigate if prolonged exposure to moderately elevated +Gz reduces intraocular pressure (IOP; i...
November 11, 2016: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/27815135/klebsiella-pneumoniae-blakpc-3-nosocomial-epidemic-bayesian-and-evolutionary-analysis
#7
Silvia Angeletti, Alessandra Lo Presti, Eleonora Cella, Marta Fogolari, Lucia De Florio, Etleva Dedej, Aletheia Blasi, Teresa Milano, Stefano Pascarella, Raffaele Antonelli Incalzi, Roberto Coppola, Giordano Dicuonzo, Massimo Ciccozzi
K. pneumoniae isolates carrying blaKPC-3 gene were collected to perform Bayesian phylogenetic and selective pressure analysis and to apply homology modeling to the KPC-3 protein. A dataset of 44 blakpc-3 gene sequences from clinical isolates of K. pneumoniae was used for Bayesian phylogenetic, selective pressure analysis and homology modeling. The mean evolutionary rate for blakpc-3 gene was 2.67×10(-3) substitution/site/year (95% HPD: 3.4×10(-4-)5.59×10(-)(3)). The root of the Bayesian tree dated back to the year 2011 (95% HPD: 2007-2012)...
December 2016: Infection, Genetics and Evolution
https://www.readbyqxmd.com/read/27806751/research-on-rapid-initial-adaption-to-the-environment-of-a-plateau
#8
Bin Hua Wang, Zheng Tao Cao, Feng Wu, Jun Yang, Yuan Yuan Liu, Meng Sun Yu
We designed two types of pre-adaption plans for this study. One was a pre-adaption training with progressive intermittent hypoxia, with a constant lower pressure oxygen tank used in the plain before arriving at the plateau (PG). The other was by progressively increasing the time of exposure to hypoxia with oxygen supplied in stages after radical plateau (RG). By testing the blood oxygen saturation (SpO2), heart rate (HR), and quality of sleep after arriving at the 3800 m high plateau, results showed that the pre-acclimatization and radical groups performed better than the control group (CG)...
September 2016: Biomedical and Environmental Sciences: BES
https://www.readbyqxmd.com/read/27805309/positive-end-expiratory-pressure-titration-guided-by-plateau-pressure-in-chronic-obstructive-pulmonary-disease-patients
#9
Guopeng Liang, Zhongwei Zhang
BACKGROUND: PEEP decreases intrinsic PEEP (PEEPi) in COPD patients. However, the best PEEP for someone with COPD is unclear. METHODS: Ten COPD patients who received invasive mechanical ventilation were enrolled. Before PEEP titration, subjects were sedated and received mandatory ventilation. PEEP increased from 0 to 15 cmH2 O. At each PEEP, peak pressure (Ppeak), plateau pressure (Pplat), PEEPi, and other variables were recorded. Increment of Pplat (ΔPplat) and PEEPi were plotted against PEEP applied...
November 2, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27798690/environmental-humidity-regulates-effects-of-experimental-warming-on-vegetation-index-and-biomass-production-in-an-alpine-meadow-of-the-northern-tibet
#10
Gang Fu, Zhen Xi Shen
Uncertainty about responses of vegetation index, aboveground biomass (AGB) and gross primary production (GPP) limits our ability to predict how climatic warming will influence plant growth in alpine regions. A field warming experiment was conducted in an alpine meadow at a low (4313 m), mid- (4513 m) and high elevation (4693 m) in the Northern Tibet since May 2010. Growing season vapor pressure deficit (VPD), soil temperature (Ts) and air temperature (Ta) decreased with increasing elevation, while growing season precipitation, soil moisture (SM), normalized difference vegetation index (NDVI), soil adjusted vegetation index (SAVI), AGB and GPP increased with increasing elevation...
2016: PloS One
https://www.readbyqxmd.com/read/27795903/effects-of-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-systemic-stress-response-during-prone-position
#11
Oznur Sen, Mefkur Bakan, Tarik Umutoglu, Nurdan Aydın, Mehmet Toptas, Ibrahim Akkoc
BACKGROUND: Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27786300/molecular-evidence-of-rna-polymerase-ii-gene-reveals-the-origin-of-worldwide-cultivated-barley
#12
Yonggang Wang, Xifeng Ren, Dongfa Sun, Genlou Sun
The origin and domestication of cultivated barley have long been under debate. A population-based resequencing and phylogenetic analysis of the single copy of RPB2 gene was used to address barley domestication, to explore genetic differentiation of barley populations on the worldwide scale, and to understand gene-pool exchanges during the spread and subsequent development of barley cultivation. Our results revealed significant genetic differentiation among three geographically distinct wild barley populations...
October 27, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27783382/short-term-effects-of-neuromuscular-blockade-on-global-and-regional-lung-mechanics-oxygenation-and-ventilation-in-pediatric-acute-hypoxemic-respiratory-failure
#13
Marlon E F Wilsterman, Pauline de Jager, Robert Blokpoel, Inez Frerichs, Sandra K Dijkstra, Marcel J I J Albers, Johannes G M Burgerhof, Dick G Markhorst, Martin C J Kneyber
BACKGROUND: Neuromuscular blockade (NMB) has been shown to improve outcome in acute respiratory distress syndrome (ARDS) in adults, challenging maintaining spontaneous breathing when there is severe lung injury. We tested in a prospective physiological study the hypothesis that continuous administration of NMB agents in mechanically ventilated children with severe acute hypoxemic respiratory failure (AHRF) improves the oxygenation index without a redistribution of tidal volume V T toward non-dependent lung zones...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27761975/grazing-effects-on-surface-energy-fluxes-in-a-desert-steppe-on-the-mongolian-plateau
#14
Changliang Shao, Jiquan Chen, Linghao Li, Gang Dong, Juanjuan Han, Michael Abraha, Ranjeet John
Quantifying the surface energy fluxes of grazed and ungrazed steppes is essential to understand the roles of grasslands in local and global climate and in land use change. We used paired eddy-covariance towers to investigate the effects of grazing on energy balance (EB) components: net radiation (Rn ), latent heat (LE), sensible heat (H), and soil heat (G) fluxes on adjacent grazed and ungrazed areas in a desert steppe of the Mongolian Plateau for a two-year period (2010-2012). Near 95% of Rn was partitioned as LE and H, whereas the contributions of G and other components of the EB were 5% at an annual scale...
October 20, 2016: Ecological Applications: a Publication of the Ecological Society of America
https://www.readbyqxmd.com/read/27757516/potentially-modifiable-factors-contributing-to-outcome-from-acute-respiratory-distress-syndrome-the-lung-safe-study
#15
John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, Ednan K Bajwa, Laurent Brochard, Kevin Clarkson, Andres Esteban, Luciano Gattinoni, Frank van Haren, Leo M Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Anders Larsson, Daniel F McAuley, Lia McNamee, Nicolas Nin, Haibo Qiu, Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents...
October 18, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27738482/comparison-of-combined-tofogliflozin-and-glargine-tofogliflozin-added-to-insulin-and-insulin-dose-increase-therapy-in-uncontrolled-type-2-diabetes
#16
Katsunori Suzuki, Yurie Mitsuma, Takaaki Sato, Takumi Anraku, Mariko Hatta
BACKGROUND: Some patients with type 2 diabetes mellitus (T2DM) on insulin have poor glycemic control and require add-on therapy to reach target glucose values. Increased insulin doses or the addition of an oral antidiabetic drug (OAD) may improve glycemic control, but many patients fail to achieve target values. The aim of this study was to compare the treatment efficacy and safety of three different therapies in such patients. METHODS: T2DM outpatients with poor glycemic control (HbA1c ≥ 7...
November 2016: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27733932/characterisation-of-the-complexity-of-intracranial-pressure-signals-measured-from-idiopathic-and-secondary-normal-pressure-hydrocephalus-patients
#17
Tricia Adjei, Daniel Abásolo, David Santamarta
Hydrocephalus is a condition characterised by enlarged cerebral ventricles, which in turn affects intracranial pressure (ICP); however, the mechanisms regulating ICP are not fully understood. A nonlinear signal processing approach was applied to ICP signals measured during infusion studies from patients with two forms of hydrocephalus, in a bid to compare the differences. This is the first study of its kind. The two forms of hydrocephalus were idiopathic normal pressure hydrocephalus (iNPH) and secondary normal pressure hydrocephalus (SH)...
September 2016: Healthcare Technology Letters
https://www.readbyqxmd.com/read/27730385/does-aqueductal-stenosis-influence-the-lumbar-infusion-test-in-normal-pressure-hydrocephalus
#18
Emilio Luis González-Martínez, David Santamarta
BACKGROUND: Late-onset idiopathic aqueductal stenosis may present with clinical features indistinct from idiopathic normal-pressure hydrocephalus (NPH). Moreover, aqueductal stenosis (AS) is not always detected by conventional magnetic resonance imaging (MRI). The aim of this study was to compare the hydrodynamic pattern among NPH patients according to the patency of the aqueduct. METHODS: Fifty-six consecutive lumbar infusion tests were performed in patients with NPH syndrome...
October 11, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27727070/correlation-between-pao2-fio2-and-airway-and-vascular-parameters-in-the-assessment-of-cellular-ex-vivo-lung-perfusion-system
#19
Toshihiro Okamoto, David Wheeler, Qiang Liu, Cristiano Quintini, J Steven Hata, Kenneth R McCurry
BACKGROUND: Ex vivo lung perfusion (EVLP) may be an essential process for the pre-transplant evaluation of the donor lungs. Currently, the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2, or PF) ratio is the standard in the assessment of lung function in cellular EVLP, whereas other parameters, including airway and vascular parameters, have only been partially utilized. The primary purpose of this study is to assess the potential utility of other parameters as a surrogate of lung function in EVLP...
May 20, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27723351/aggregate-elasticity-crystal-structure-and-tableting-performance-for-p-aminobenzoic-acid-and-a-series-of-its-benzoate-esters
#20
Aditya B Singaraju, Kyle Nguyen, Abhay Jain, Rahul V Haware, Lewis L Stevens
The tableting performance for p-aminobenzoic acid (PABA) and a series of its benzoate esters with increasing alkyl chain length (methyl-, ethyl- and n-butyl) was determined over a broad range of compaction pressures. The crystalline structure of methyl benzoate (Me-PABA) exhibits no slip systems and does not form viable compacts under any compaction pressure. The ethyl (Et-PABA) and n-butyl (Bu-PABA) esters each have a similar, corrugated-layer structure that displays a prominent slip plane and improves material plasticity at low compaction pressure...
October 10, 2016: Molecular Pharmaceutics
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