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Peak inspiratory pressure

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https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#1
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29117951/long-term-benefit-of-enzyme-replacement-therapy-in-pompe-disease-a-5-year-prospective-study
#2
Esther Kuperus, Michelle E Kruijshaar, Stephan C A Wens, Juna M de Vries, Marein M Favejee, Jan C van der Meijden, Dimitris Rizopoulos, Esther Brusse, Pieter A van Doorn, Ans T van der Ploeg, Nadine A M E van der Beek
OBJECTIVE: To determine the effect of enzyme replacement therapy (ERT) after 5 years and to identify predictors for a favorable response because few data are available on the long-term efficacy of ERT in Pompe disease. METHODS: We included 102 adult patients with Pompe disease in a nationwide, prospective cohort study. We assessed muscle strength (manual muscle testing with Medical Research Council [MRC] grading, handheld dynamometry [HHD]), muscle function (6-minute walk test, Quick Motor Function Test), daily life activities (Rasch-Built Pompe-Specific Activity [R-PAct] Scale), and pulmonary function (forced vital capacity [FVC] in upright and supine positions, maximum inspiratory and expiratory pressures) at 3- to 6-month intervals before and after the start of ERT...
November 8, 2017: Neurology
https://www.readbyqxmd.com/read/29109556/management-of-mechanical-ventilation-in-patients-with-hospital-acquired-pneumonia-a-retrospective-observational-study
#3
Radovan Uvizl, Tomas Herkel, Katerina Langova, Petr Jakubec
BACKGROUND: Hospital-acquired pneumonia (HAP) in intensive care patients is a frequent reason for mechanical ventilation (MV). The management of MV and ventilator weaning vary, depending on the type of lung inflammation. This retrospective, observational study screened the data from all patients admitted to the intensive care unit (ICU) of the Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and Dentistry, Palacky University Olomouc between 2011 and 2016...
November 2, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29096634/prediction-of-high-airway-pressure-using-a-non-linear-autoregressive-model-of-pulmonary-mechanics
#4
Ruby Langdon, Paul D Docherty, Christoph Schranz, J Geoffrey Chase
BACKGROUND: For mechanically ventilated patients with acute respiratory distress syndrome (ARDS), suboptimal PEEP levels can cause ventilator induced lung injury (VILI). In particular, high PEEP and high peak inspiratory pressures (PIP) can cause over distension of alveoli that is associated with VILI. However, PEEP must also be sufficient to maintain recruitment in ARDS lungs. A lung model that accurately and precisely predicts the outcome of an increase in PEEP may allow dangerous high PIP to be avoided, and reduce the incidence of VILI...
November 2, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29078756/effects-of-lung-protective-mechanical-ventilation-associated-with-permissive-respiratory-acidosis-on-regional-extra-pulmonary-blood-flow-in-experimental-ards
#5
Rudolf Hering, Stefan Kreyer, Christian Putensen
BACKGROUND: Lung protective mechanical ventilation with limited peak inspiratory pressure has been shown to affect cardiac output in patients with ARDS. However, little is known about the impact of lung protective mechanical ventilation on regional perfusion, especially when associated with moderate permissive respiratory acidosis. We hypothesized that lung protective mechanical ventilation with limited peak inspiratory pressure and moderate respiratory acidosis results in an increased cardiac output but unequal distribution of blood flow to the different organs of pigs with oleic-acid induced ARDS...
October 27, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29077984/neurally-adjusted-ventilatory-assist-compared-to-other-forms-of-triggered-ventilation-for-neonatal-respiratory-support
#6
REVIEW
Thomas E Rossor, Katie A Hunt, Sandeep Shetty, Anne Greenough
BACKGROUND: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi)...
October 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29073266/effect-of-a-short-training-on-neonatal-face-mask-ventilation-performance-in-a-low-resource-setting
#7
Alessandro Mazza, Francesco Cavallin, Anita Cappellari, Antuan Divisic, Ivana Grbin, Jean Akakpo, Abdou Razak Moukaila, Daniele Trevisanuto
BACKGROUND: We assessed whether a short training, effective in a high resource country, was able to improve the quality of face-mask ventilation (FMV) in a low resource setting. METHODS: Local healthcare providers at the Centre Médico-Social, Kouvè, Togo were asked to ventilate a neonatal leak-free manikin before (time-t1) and after (t2) a two-minute training session. Immediately after this section, a further two-minute training with participants aware of the data monitor was offered...
2017: PloS One
https://www.readbyqxmd.com/read/29072677/the-impact-of-neurally-adjusted-ventilatory-assist-mode-on-respiratory-severity-score-and-energy-expenditure-in-infants-a-randomized-crossover-trial
#8
J L Rosterman, E K Pallotto, W E Truog, H Escobar, K A Meinert, A Holmes, H Dai, W M Manimtim
OBJECTIVE: Examine respiratory severity scores (RSS) (mean airway pressure × fraction of inspired oxygen) and resting energy expenditure (REE) on neurally adjusted ventilatory assist (NAVA) compared with synchronized intermittent mandatory ventilation with pressure controlled and supported breath (SIMV (PC)PS). STUDY DESIGN: A randomized, crossover trial in a level IV neonatal intensive care unit. Twenty-four patients were ventilated with NAVA or SIMV (PC) PS for 12 h and then crossed over to the alternative mode for 12 h...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29066585/use-of-cardiac-cycle-locating-to-minimize-the-influence-of-cardiac-artifacts-on-esophageal-pressure-measurement-during-dynamic-occlusion-test
#9
Xuan He, Xiu-Mei Sun, Guang-Qiang Chen, Yan-Lin Yang, Zhong-Hua Shi, Ming Xu, Jian-Xin Zhou
BACKGROUND: The dynamic occlusion test is used to guide balloon catheter placement during esophageal pressure (Pes) monitoring. We introduced a cardiac cycle locating method to attenuate the influence of cardiac artifacts on Pes measurement. The aim was to provide a reliable analytic algorithm for the occlusion test. METHODS: Esophageal balloon catheters were placed in subjects receiving pressure support ventilation. During balloon position adjustment, end-expiratory occlusion was performed to induce 3 consecutive inspiratory efforts...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29060706/development-of-respiratory-function-monitor-for-neonates
#10
Fumihiko Takatori, Shinichiro Inoue, Satoru Togo, Shinji Yamamori
Approximately, 10 million babies do not breathe immediately at birth and some of them require positive pressure ventilation. However, inappropriate and excessive tidal volume delivery could lead to lung injury in neonatal patients. We developed a respiratory function monitor which can monitor mask leak, expiratory tidal volume, respiratory rate, peak inspiratory pressure, and end-tidal CO2 on a real-time basis. A neonatal flow sensor was specially designed and was integrated with a small mainstream capnometer, cap-ONE...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29056811/multi-modal-anatomical-optical-coherence-tomography-and-ct-for-in-vivo-dynamic-upper-airway-imaging
#11
Santosh Balakrishnan, Ruofei Bu, Hillel Price, Carlton Zdanski, Amy L Oldenburg
We describe a novel, multi-modal imaging protocol for validating quantitative dynamic airway imaging performed using anatomical Optical Coherence Tomography (aOCT). The aOCT system consists of a catheter-based aOCT probe that is deployed via a bronchoscope, while a programmable ventilator is used to control airway pressure. This setup is employed on the bed of a Siemens Biograph CT system capable of performing respiratory-gated acquisitions. In this arrangement the position of the aOCT catheter may be visualized with CT to aid in co-registration...
February 2017: Proceedings of SPIE
https://www.readbyqxmd.com/read/29037658/simple-artificial-training-device-for-respiratory-muscle-strength-and-lung-volumes-in-healthy-young-male-and-female-subjects-a-pilot-study
#12
Jirakrit Leelarungrayub, Decha Pinkaew, Araya Yankai, Busaba Chautrakoon, Rungtiwa Kuntain
OBJECTIVE: The aim of this study was to evaluate the efficiency of a simple artificial device for respiratory muscle strength training and lung volumes using either combined or non-combined exercise with elastic bands in healthy young participants. METHODS: Forty healthy young participants (20 male and 20 female) aged 19-24 years old were randomized into two main experiments with four sub-groups; (1) artificial device (n = 10) & standard device (n = 10) training, and (2) artificial device training combined with elastic band (EB) exercise (n = 10) & standard device training combined with EB (n = 10) exercise...
October 2017: Journal of Bodywork and Movement Therapies
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
#13
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/28985727/respiratory-mechanics-in-infants-with-severe-bronchiolitis-on-controlled-mechanical-ventilation
#14
Pablo Cruces, Sebastián González-Dambrauskas, Julio Quilodrán, Jorge Valenzuela, Javier Martínez, Natalia Rivero, Pablo Arias, Franco Díaz
BACKGROUND: Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. METHODS: Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV...
October 6, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28948400/effects-of-non-fatiguing-respiratory-muscle-loading-induced-by-expiratory-flow-limitation-during-strenuous-incremental-cycle-exercise-on-metabolic-stress-and-circulating-natural-killer-cells
#15
Camille Rolland-Debord, Capucine Morelot-Panzini, Thomas Similowski, Roberto Duranti, Pierantonio Laveneziana
Exercise induces release of cytokines and increase of circulating natural killers (NK) lymphocyte during strong activation of respiratory muscles. We hypothesised that non-fatiguing respiratory muscle loading during exercise causes an increase in NK cells and in metabolic stress indices. Heart rate (HR), ventilation (VE), oesophageal pressure (Pes), oxygen consumption (VO2), dyspnoea and leg effort were measured in eight healthy humans (five men and three women, average age of 31 ± 4 years and body weight of 68 ± 10 kg), performing an incremental exercise testing on a cycle ergometer under control condition and expiratory flow limitation (FL) achieved by putting a Starling resistor...
September 26, 2017: Pflügers Archiv: European Journal of Physiology
https://www.readbyqxmd.com/read/28927375/effects-of-lubrication-on-air-sealing-performance-of-a-pediatric-cuffed-tracheal-tube
#16
Hiroko Nishioka, Yutaka Usuda, Go Hirabayashi, Koichi Maruyama, Tomio Andoh
BACKGROUND: Lubrication of cuffed tracheal tubes (CTTs) reduces liquid leakage. However, it is not clear how cuff lubrication influences air leakage. We aimed to test the hypothesis that pretreatment with K-Y jelly, a water-soluble lubricant, would improve the air-sealing performance of pediatric CTTs in a model study. METHODS: We placed Parker Flex-Tip™ CTT with 4.0- and 5.0-mm internal diameter (ID) into a tracheal model with 9- and 12-mm ID. The tracheal model was connected to a test lung ventilated in pressure control mode...
September 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28926488/potential-acceptability-of-a-pediatric-ventilator-management-computer-protocol
#17
Katherine A Sward, Christopher J L Newth, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Allan Doctor, J Michael Dean, Richard Holobkov, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome. DESIGN: Survey/questionnaire. SETTING: The eight PICUs in the Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: One hundred twenty-two physicians (attendings and fellows). INTERVENTIONS: None...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28904850/effects-of-exercise-on-cervical-angle-and-respiratory-function-in-smartphone-users
#18
Na Kyung Lee, Sang In Jung, Do Youn Lee, Kyung Woo Kang
OBJECTIVES: The aim of this study was to determine whether exercises can change the cervical angle and respiratory function in smartphone users. METHODS: Thirty healthy volunteers were recruited. The subjects were randomly divided into an exercise group and a control group. All participants used a smartphone for 1 hour while maintaining a sitting posture. Then, each group performed their assigned activity. The exercise group performed two types of exercises and the control group maintained routine activities for 20 minutes...
August 2017: Osong Public Health and Research Perspectives
https://www.readbyqxmd.com/read/28879341/airway-obstruction-by-dissection-of-the-inner-layer-of-a-reinforced-endotracheal-tube-in-a-patient-with-ludwig-s-angina-a-case-report
#19
Sung-Min Shim, Jae-Ho Park, Dong-Min Hyun, Hwa-Mi Lee
Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl (100 µg), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to 38 cmH2O and plateau pressure increased from 20 to 28 cmH2O...
June 2017: J Dent Anesth Pain Med
https://www.readbyqxmd.com/read/28857785/comparison-of-the-laryngeal-mask-airway-supreme-and-the-i-gel-in-paralysed-elderly-patients-a-randomised-controlled-trial
#20
Myoung H Kim, Jae H Lee, Yong S Choi, Sujung Park, Seokyung Shin
BACKGROUND: The laryngeal mask airway supreme (LMA-S) and i-gel are both popular second-generation supraglottic airway devices that have been widely studied in surgical patients, but their differences in clinical performance in the elderly are not clear. OBJECTIVE: We compared the efficacy and safety of the LMA-S and i-gel in anaesthetised and paralysed elderly patients. DESIGN: A prospective, randomised and parallel study. SETTING: Single-centre trial, study period January 2014 from to October 2016...
August 28, 2017: European Journal of Anaesthesiology
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