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Peak inspiratory pressure

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https://www.readbyqxmd.com/read/28435650/postnatal-transitional-weight-loss-and-adverse-outcomes-in-extremely-premature-neonates
#1
Rita P Verma, Syed Shibli, Eugene Komaroff
The early postnatal weight loss (EPWL) is highly variable in the extremely low birth weight infants (birth weight <1000 g, ELBW). It is reported to be unassociated with adverse outcomes within a range of 3-21% of birth weight. Its wide range might have contributed to this lack of association. The aim of our paper is to study the effects of maximum EPWL, graded as low, medium and large on clinical outcomes in ELBW infants. In a retrospective cohort observational study EPWL was measured as maximum weight loss from birth weight (MWL) in ELBW infants and grouped as low (5-12%) moderate (18...
March 22, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/28430689/perioperative-outcomes-of-robotic-assisted-hysterectomy-compared-with-open-hysterectomy
#2
Bhargavi Gali, Jamie N Bakkum-Gamez, David J Plevak, Darrell Schroeder, Timothy O Wilson, Christopher J Jankowski
BACKGROUND: Increasing numbers of robotic hysterectomies (RH) are being performed. To provide ventilation (with pneumoperitoneum and steep Trendelenburg position) for these procedures, utilization of lung protective strategies with limiting airway pressures and tidal volumes is difficult. Little is known about the effects of intraoperative mechanical ventilation and high peak airway pressures on perioperative complications. We performed a retrospective review to determine whether patients undergoing RH had increased pulmonary complications compared to total abdominal hysterectomy (TAH)...
April 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28427883/born-not-breathing-a-randomised-trial-comparing-two-self-inflating-bag-masks-during-newborn-resuscitation-in-tanzania
#3
Monica Thallinger, Hege Langli Ersdal, Fortunata Francis, Anita Yeconia, Estomih Mduma, Hussein Kidanto, Jørgen Erland Linde, Joar Eilevstjønn, Nina Gunnes, Ketil Størdal
AIMS: Effective ventilation is crucial to save non-breathing newborns. We compared standard equipment for newborn resuscitation to a new Upright bag, in an area with high neonatal mortality. METHODS: Newborns requiring resuscitation at Haydom Lutheran Hospital, Tanzania, were ventilated with 230ml standard or 320ml Upright bag-mask by weekly non-blinded block randomization. A Laerdal Newborn Resuscitation Monitor collected ventilation data through a flow sensor between mask and bag and heart rate with electrocardiography electrodes...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28424510/the-effect-of-slow-loaded-breathing-training-on-the-blood-pressure-response-to-handgrip-exercise-in-patients-with-isolated-systolic-hypertension
#4
Chulee Ubolsakka-Jones, Benjarat Sangthong, Wilaiwan Khrisanapant, David A Jones
Isolated systolic hypertension (ISH) is the most common form of hypertension in older people. It is characterized by increased resting systolic blood pressure (sBP) and increased sBP in response to exercise. It has previously been shown that slow breathing training reduces resting sBP, and the objective of the present study was to determine whether it also reduced the blood pressure response to static handgrip exercise. ISH patients aged between 60 and 74 years were randomly divided into a control group (10 subjects, 4 of which were male) that breathed normally and a trained group (10 subjects, 4 of which were male) that trained daily for 8 weeks by slow breathing against an inspiratory resistance of 18 cmH2O...
April 20, 2017: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/28403594/the-effect-of-surgical-technique-on-hemodynamics-arterial-oxygenation-and-pulmonary-mechanics-in-radical-prostatectomy-operations
#5
Yucel Yuce, Kutlu Hakan Erkal, Cemal Goktas, Bilal Eryildirim, Kemal Sarica
OBJECTIVE: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. METHODS: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2) values were evaluated at 10 minutes after induction...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28403406/comparison-of-effectiveness-of-two-commonly-used-two-handed-mask-ventilation-techniques-on-unconscious-apnoeic-obese-adults
#6
M Fei, J L Blair, M J Rice, D A Edwards, Y Liang, M A Pilla, M S Shotwell, Y Jiang
Background.: Mask ventilation and tracheal intubation are basic techniques for airway management and mutually inclusive rescue measures to restore ventilation. The aim of this study was to compare the effectiveness of mask ventilation between two commonly used techniques of two-handed mask ventilation in obese unconscious apnoeic adults. Methods.: Eighty-one obese adults received mask ventilation after induction using C-E clamp and modified V-E clamp techniques in a randomized crossover manner...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-non-invasive-neurally-adjusted-ventilatory-assist-niv-nava-in-preterm-infants
#7
Christopher Gibu, Phillip Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BACKGROUND: Non-invasive Neurally Adjusted Ventilator Assist (NIV-NAVA) was introduced to our clinical practice via a pilot and a randomized observational study to assess its safety, feasibility, and short term physiological effects. METHODS: The pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula (HFNC), or nasal IMV (NIMV), in multiple 2-4 h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational cross-over study in 8 additional infants to compare the physiological effects of NIV-NAVA to NIMV during 2-hour steady state conditions...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28388225/effects-of-pressure-support-ventilation-may-be-lost-at-high-exercise-intensities-in-people-with-copd
#8
David Anekwe, Michel de Marchie, Jadranka Spahija
Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H2O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H2O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28377402/assessing-initial-response-to-high-frequency-jet-ventilation-in-premature-infants-with-hypercapnic-respiratory-failure
#9
Craig R Wheeler, Craig D Smallwood, Iris O'Donnell, Daniel Gagner, Martha C Sola-Visner
BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for infants with respiratory failure. We sought to identify parameters that were associated with successful application of HFJV in patients with hypercapnic respiratory failure. METHODS: A single-center, retrospective review of infants who received HFJV was conducted. Subjects were enrolled if birthweight was ≤2,000 g and capillary PCO2 was ≥55 mm Hg...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28364460/estimation-of-pharyngeal-collapsibility-during-sleep-by-peak-inspiratory-airflow
#10
Ali Azarbarzin, Scott A Sands, Luigi Taranto-Montemurro, Melania D Oliveira Marques, Pedro R Genta, Bradley A Edwards, James Butler, David P White, Andrew Wellman
Objectives: Pharyngeal critical closing pressure (Pcrit) or collapsibility is a major determinant of obstructive sleep apnea (OSA) and may be used to predict the success/failure of non-continuous positive airway pressure (CPAP) therapies. Since its assessment involves overnight manipulation of CPAP, we sought to validate the peak inspiratory flow during natural sleep (without CPAP) as a simple surrogate measurement of collapsibility. Methods: Fourteen patients with OSA attended overnight polysomnography with pneumotachograph airflow...
January 1, 2017: Sleep
https://www.readbyqxmd.com/read/28359172/efficacy-of-a-new-device-to-optimize-positive-pressure-ventilation-via-face-mask-in-edentulous-patients-a-randomized-trial
#11
Maria C Niño, Andres Pauwels, Fernando Raffan, Enrique Arango, David J Romero, Daniel Benitez
BACKGROUND: Mask ventilation is routinely performed during anesthesia. Under some circumstances, it might be difficult to perform, such as in edentulous patients, due to inadequate mask seal. We developed a new device called NIPARA and studied its use For ventilation optimization in edentulous patients. METHODS: This randomized controlled trial included edentulous adults who had no other predictors of difficult airway, scheduled to undergo general anesthesia. Patients were assigned either to the NIPARA device group or to the control group (oral airway only)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28350644/disassociating-lung-mechanics-and-oxygenation-in-pediatric-acute-respiratory-distress-syndrome
#12
Nadir Yehya, Neal J Thomas
OBJECTIVES: Both oxygenation and peak inspiratory pressure are associated with mortality in pediatric acute respiratory distress syndrome. Since oxygenation and respiratory mechanics are linked, it is difficult to identify which variables, pressure or oxygenation, are independently associated with outcome. We aimed to determine whether respiratory mechanics (peak inspiratory pressure, positive end-expiratory pressure, ΔP [PIP minus PEEP], tidal volume, dynamic compliance [Cdyn]) or oxygenation (PaO2/FIO2) was associated with mortality...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28347790/key-conceptional-considerations-on-nebulization-of-antimicrobial-agents-to-mechanically-ventilated-patients
#13
Jordi Rello, Jean Jacques Rouby, Candela Sole-Lleonart, Jean Chastre, Stijn Blot, Charles Edouard Luyt, Jordi Riera, Margreet C Vos, Antoine Monsel, Jayesh Dhanani, Jason A Roberts
Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this Consensus Paper of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: A. Vibrating mesh nebulizers should be preferred to jet or ultrasonic nebulizers; B...
March 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28347629/the-effect-of-experience-simulator-training-and-biometric-feedback-on-manual-ventilation-technique
#14
Rebecca Lewis, Cerrie A Sherfield, Christopher R Fellows, Rachel Burrow, Iain Young, Alex Dugdale
OBJECTIVE: To determine the frequency of provision and main providers (veterinary surgeons, nurses or trainees) of manual ventilation in UK veterinary practices. Furthermore, to determine the variation in peak inspiratory (inflation) pressure (PIP), applied to a lung model during manual ventilation, by three different groups of operators (inexperienced, experienced and specialist), before and after training. STUDY DESIGN: Questionnaire survey, lung model simulator development and prospective testing...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28343335/a-new-infant-hybrid-respiratory-simulator-preliminary-evaluation-based-on-clinical-data
#15
Barbara Stankiewicz, Krzysztof J Pałko, Marek Darowski, Krzysztof Zieliński, Maciej Kozarski
A new hybrid (numerical-physical) simulator of the respiratory system, designed to simulate spontaneous and artificial/assisted ventilation of preterm and full-term infants underwent preliminary evaluation. A numerical, seven-compartmental model of the respiratory system mechanics allows the operator to simulate global and peripheral obstruction and restriction of the lungs. The physical part of the simulator is a piston-based construction of impedance transformer. LabVIEW real-time software coordinates the work of both parts of the simulator and its interaction with a ventilator...
March 25, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28337149/influence-of-inspiratory-muscle-training-on-ventilatory-efficiency-and-cycling-performance-in-normoxia-and-hypoxia
#16
Eduardo Salazar-Martínez, Hannes Gatterer, Martin Burtscher, José Naranjo Orellana, Alfredo Santalla
The aim of this study was to analyse the influence of inspiratory muscle training (IMT) on ventilatory efficiency, in normoxia and hypoxia, and to investigate the relationship between ventilatory efficiency and cycling performance. Sixteen sport students (23.05 ± 4.7 years; 175.11 ± 7.1 cm; 67.0 ± 19.4 kg; 46.4 ± 8.7 ml·kg(-1)·min(-1)) were randomly assigned to an inspiratory muscle training group (IMTG) and a control group (CG). The IMTG performed two training sessions/day [30 inspiratory breaths, 50% peak inspiratory pressure (Pimax), 5 days/week, 6-weeks]...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28333703/higher-fresh-gas-flow-rates-decrease-tidal-volume-during-pressure-control-ventilation
#17
Shazia Mohammad, Nikolaus Gravenstein, Drew Gonsalves, Terrie Vasilopoulos, Samsun Lampotang
BACKGROUND: We observed that increasing fresh gas flow (FGF) decreased exhaled tidal volume (VT) during pressure control ventilation (PCV). A literature search produced no such description whereby unintended VT changes occur with FGF changes during PCV. METHODS: To model an infant's lungs, 1 lung of a mechanical lung model (Dual Adult TTL 1600; Michigan Instruments, Inc, Grand Rapids, MI) was set at a compliance of 0.0068 L/cm H2O. An Rp50 resistor (27.2 cm H2O/L/s at 15 L/min) simulated normal bronchial resistance...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28331306/is-cardiac-autonomic-modulation-during-upper-limb-isometric-contraction-and-valsalva-maneuver-impaired-in-copd-patients
#18
Cássia da Luz Goulart, Ramona Cabiddu, Paloma de Borba Schneiders, Elisabete Antunes San Martin, Renata Trimer, Audrey Borghi-Silva, Andréa Lúcia Gonçalves da Silva
PURPOSE: To evaluate the heart rate variability (HRV) indices and heart rate (HR) responses during isometric contraction (IC) and Valsalva maneuver (VM) in COPD patients. METHODS: Twenty-two stable moderate to severe COPD patients were evaluated. R-R intervals were recorded (monitor Polar(®) S810i) during dominant upper limb IC (2 minutes). Stable signals were analyzed by Kubios HRV(®) software. Indices of HRV were computed in the time domain (mean HR; square root of the mean squared differences of successive RR intervals [RMSSD] and HRV triangular index [RR tri index]) and in the frequency domain (high frequency [HF]; low frequency [LF] and LF/HF ratio)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28329099/effect-of-sleeping-position-on-upper-airway-patency-in-obstructive-sleep-apnea-is-determined-by-the-pharyngeal-structure-causing-collapse
#19
Melania Marques, Pedro R Genta, Scott A Sands, Ali Azarbazin, Camila de Melo, Luigi Taranto-Montemurro, David P White, Andrew Wellman
Objectives: In some patients, obstructive sleep apnea (OSA) can be resolved with improvement in pharyngeal patency by sleeping lateral rather than supine, possibly as gravitational effects on the tongue are relieved. Here we tested the hypothesis that the improvement in pharyngeal patency depends on the anatomical structure causing collapse, with patients with tongue-related obstruction and epiglottic collapse exhibiting preferential improvements. Methods: Twenty-four OSA patients underwent upper airway endoscopy during natural sleep to determine the pharyngeal structure associated with obstruction, with simultaneous recordings of airflow and pharyngeal pressure...
March 1, 2017: Sleep
https://www.readbyqxmd.com/read/28298784/ventilation-of-nonparalyzed-patients-under-anesthesia-with-laryngeal-mask-airway-comparison-of-three-modes-of-ventilation-volume-controlled-ventilation-pressure-controlled-ventilation-and-pressure-controlled-ventilation-volume-guarantee
#20
Maroun Badwi Ghabach, Elie M El Hajj, Rouba D El Dib, Jeanette M Rkaiby, May S Matta, May R Helou
BACKGROUND: Pressure controlled ventilation (PCV) is the preferable mode of ventilation of nonparalyzed patients undergoing anesthesia with laryngeal mask airway (LMA) as compared to volume controlled ventilation (VCV) and spontaneously breathing patient. In this study, we compared the PC-volume guarantee (PC-VG) mode of ventilation with VCV and PCV modes. MATERIALS AND METHODS: A total of 30 patients, American Society of Anesthesiologists (ASA) physical status Classes I and II, scheduled for elective surgery under general anesthesia with a classic LMA were ventilated, subsequently, with the three modes of ventilation: VCV, PCV, and PC-VG for 10 min each mode...
January 2017: Anesthesia, Essays and Researches
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