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Peak inspiratory pressure

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https://www.readbyqxmd.com/read/29771711/respiratory-muscle-effort-during-expiration-in-successful-and-failed-weaning-from-mechanical-ventilation
#1
Jonne Doorduin, Lisanne H Roesthuis, Diana Jansen, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29757584/effects-of-nerve-growth-factor-shrna-inhibition-on-asthma-phenotypes-in-a-mouse-model-of-asthma
#2
Jinhong Wu, Bing Chen, Wenxian Li, Yanan Xiao
Nerve growth factor (NGF) plays an important role in airway hyper-responsiveness (AHR). In this study, we aimed at investigating the effect of NGF inhibition on AHR and other asthma phenotypes in a mouse model of asthma. 12 mice in each group were injected with lentiviral vectors expressing non-targeting shRNA (sham shRNA), targeting NGF (shRNA-1 and shRNA-2), or normal saline for control before the asthma models were established. Peak inspiratory pressure (PIP), NGF levels in bronchoalveolar lavage fluid (BALF), and bronchoconstriction in response to acetylcholine (ACh) were measured...
April 2018: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/29756459/the-effects-of-respiratory-muscle-training-on-peak-cough-flow-in-patients-with-parkinson-s-disease-a-randomized-controlled-study
#3
Alvaro Reyes, Adrián Castillo, Javiera Castillo, Isabel Cornejo
OBJECTIVE: To compare the effects of an inspiratory versus and expiratory muscle-training program on voluntary and reflex peak cough flow in patients with Parkinson disease. DESIGN: A randomized controlled study. SETTING: Home-based training program. PARTICIPANTS: In all, 40 participants with diagnosis of Parkinson's disease were initially recruited in the study and randomly allocated to three study groups. Of them, 31 participants completed the study protocol (control group, n = 10; inspiratory training group, n = 11; and expiratory training group, n = 10) Intervention: The inspiratory and expiratory group performed a home-based inspiratory and expiratory muscle-training program, respectively (five sets of five repetitions)...
May 1, 2018: Clinical Rehabilitation
https://www.readbyqxmd.com/read/29744774/performance-and-applications-of-bedside-visual-inspection-of-airway-pressure-time-curve-profiles-for-estimating-stress-index-in-patients-with-acute-respiratory-distress-syndrome
#4
Phunsup Wongsurakiat, Nadwipa Yuangtrakul
To determine the performance of bedside visual inspection of airway pressure-time (Paw-t) curve profiles (VI) for estimating stress index (SI) in patients with acute respiratory distress syndrome (ARDS). A prospective study in 30 subjects with ARDS receiving mechanical ventilation at two peak inspiratory flow (PIF) settings: 60 or 40 L/min. For each study session, two physicians inspected real-time Paw-t waveforms from mechanical ventilator's monitoring screens at bedside for 30 s and interpreted which of the three patterns (tidal recruitment, noninjurious ventilation or tidal overdistension) the Paw-t curve profile was compatible with...
May 9, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29734983/the-effects-of-experimental-sleep-fragmentation-and-sleep-deprivation-on-the-response-of-the-genioglossus-muscle-to-inspiratory-resistive-loads
#5
Jennifer M Cori, Christian L Nicholas, Joanne Avraam, V Vien Lee, Rachel Schembri, Melinda L Jackson, Amy S Jordan
STUDY OBJECTIVES: Poor upper airway dilator muscle function may contribute to obstructive sleep apnea (OSA). Sleep deprivation reduces dilator muscle responsiveness, but sleep fragmentation, which is most characteristic of OSA, has not been assessed. This study compared the effects of sleep deprivation and fragmentation on dilator muscle responsiveness during wakefulness. METHOD: Twenty-four healthy individuals (10 female) participated in two consecutive overnight polysomnography (PSG) sessions...
April 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#6
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29717157/effective-in-vivo-treatment-of-acute-lung-injury-with-helical-amphipathic-peptoid-mimics-of-pulmonary-surfactant-proteins
#7
Ann M Czyzewski, Lynda M McCaig, Michelle T Dohm, Lauren A Broering, Li-Juan Yao, Nathan J Brown, Maruti K Didwania, Jennifer S Lin, Jim F Lewis, Ruud Veldhuizen, Annelise E Barron
Acute lung injury (ALI) leads to progressive loss of breathing capacity and hypoxemia, as well as pulmonary surfactant dysfunction. ALI's pathogenesis and management are complex, and it is a significant cause of morbidity and mortality worldwide. Exogenous surfactant therapy, even for research purposes, is impractical for adults because of the high cost of current surfactant preparations. Prior in vitro work has shown that poly-N-substituted glycines (peptoids), in a biomimetic lipid mixture, emulate key biophysical activities of lung surfactant proteins B and C at the air-water interface...
May 1, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29705115/suction-mask-vs-conventional-mask-ventilation-in-term-and-near-term-infants-in-the-delivery-room-a-randomized-controlled-trial
#8
Laila Lorenz, Christoph M Rüegger, Eoin O'Currain, Jennifer A Dawson, Marta Thio, Louise S Owen, Susan M Donath, Peter G Davis, C Omar F Kamlin
OBJECTIVE: To compare the suction mask, a new facemask that uses suction to create a seal between the mask and the infant's face, with a conventional soft, round silicone mask during positive pressure ventilation (PPV) in the delivery room in newborn infants >34 weeks of gestation. STUDY DESIGN: Single-center randomized controlled trial in the delivery room. The primary outcome was mask leak. RESULTS: Forty-five infants were studied at a median gestational age of 38...
April 25, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29687968/spinal-bracing-and-lung-function-in-type-2-spinal-muscular-atrophy
#9
Chiara Di Pede, Eleonora Salamon, Matteo Motta, Caterina Agosto, Franca Benini, Adriano Ferrari
BACKGROUND: Respiratory muscle weakness associated with scoliosis in type-2 spinal muscular atrophy (SMA) leads to respiratory impairment. Spinal brace, generally utilized to slow scoliosis progression and support sitting, could worsen lung function and hamper cough maneuvers. CASE SERIES: Six home-treated type-2 SMA children (aged 6 -15 years, subtype 2.1-2.5) were assessed to evaluate time-dependent influence of "static-balanced brace" on pulmonary function...
April 24, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29682532/effect-of-upright-and-slouched-sitting-postures-on-the-respiratory-muscle-strength-in-healthy-young-males
#10
Ali Albarrati, Hamayun Zafar, Ahmad H Alghadir, Shahnwaz Anwer
Objective: The present study compared the effects of upright and slouched sitting postures on the respiratory muscle strength in healthy young males. Methods: A total of 35 adult male subjects aged 18-35 years participated in this study. Respiratory muscle strength was determined by measurement of sniff nasal inspiratory pressure (SNIP) using a MicroRPM device in the upright and slouched sitting positions. The subjects were asked to perform the pulmonary function test including peak expiratory flow (PEF), forced expiratory volume in one second (FEV1 ), forced vital capacity (FVC), and FEV1 /FVC ratio at baseline...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29673610/low-exertional-inspiratory-capacity-is-not-related-to-dynamic-inspiratory-muscle-weakness-in-heart-failure
#11
Franciele Plachi, Fernanda Machado Balzan, Ricardo Gass, Rui Gustavo Dorneles, Reisi Zambiazi, Danton Pereira da Silva, Paulo R Sanches, Nadine Oliveira Clausell, Danilo C Berton
Reduction in inspiratory capacity (IC) during exercise has been reported in chronic heart failure (CHF). Since inspiratory muscle dysfunction may be present to a variable degree, the assumption that IC reduction during exercise represents an increase in end-expiratory lung volume must be made with caution. This interpretation is flawed if patients develop dynamic inspiratory muscle strength reduction, i.e., progressively lower esophageal (Pes) pressures as the IC maneuvers are repeated. Sixteen CHF patients and 9 age-matched controls performed an incremental exercise test with serial IC and respiratory pressure measurements...
April 16, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29672227/mimicking-a-flow-limited-human-upper-airway-using-a-collapsible-tube-relationships-between-flow-patterns-and-pressures-in-a-respiratory-model
#12
Kaixian Zhu, Ramon Farre, Ira Katz, Sébastien Hardy, Pierre Escourrou
The upper airway (UA) in humans is commonly modeled as a Starling resistor. However, negative effort dependence (NED) observed in some patients with obstructive sleep apnea (OSA) contradicts predictions based on the Starling resistor model in which inspiratory flow is independent of inspiratory driving pressure when flow is limited. In a respiratory bench model consisting of a collapsible tube and an active lung model (ASL5000), inspiratory flow characteristics were investigated in relation to upstream, downstream and extra-luminal pressures (denoted as Pus, Pds and Pout, respectively) by varying inspiratory effort (muscle pressure) from -1 to -20 cmH2 O in the active lung...
April 19, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29663179/the-impact-of-obesity-on-pulmonary-deterioration-in-patients-undergoing-robotic-assisted-laparoscopic-prostatectomy
#13
Sebastian Blecha, Marion Harth, Florian Zeman, Timo Seyfried, Matthias Lubnow, Maximilian Burger, Stefan Denzinger, Michael T Pawlik
Obesity affects respiratory and hemodynamic function in anesthetized patients. The aim of this study was to evaluate the influence of the body mass index (BMI) on pulmonary changes in a permanent 45° steep Trendelenburg position (STP) during robotic-assisted laparoscopic prostatectomy (RALP). 51 patients undergoing RALP under standardized anesthesia were included. Perioperative pulmonary function and oxygenation were measured in awake patients (T0 ), 20 min after the induction of anesthesia (T1 ), after insufflation of the abdomen in supine position (T2 ), after 30 min in STP (T3 ), when controlling Santorini's plexus in STP (T4 ), before awakening while supine (T5 ), and after 45 min in the recovery room (T6 )...
April 16, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29659626/influence-of-respiratory-mechanics-and-drive-on-genioglossus-movement-under-ultrasound-imaging
#14
Benjamin C H Kwan, Rachel A McBain, Billy L Luu, Jane E Butler, Lynne E Bilston, Simon C Gandevia
METHODS: Twenty healthy subjects (10 males, age 28±5 years [mean ± SD]) lay supine, awake, with the head in a neutral position. Ventilation was monitored with inductance bands. Real-time B-mode ultrasound movies were analysed. We measured genioglossus motion (i) during spontaneous breathing, voluntary targeted breathing (normal tidal volume Vt), and voluntary hyperpnoea (at 1.5Vt and 2 Vt); (ii) during inspiratory flow resistive loading; (iii) with changes in end-expiratory lung volume (EELV)...
2018: PloS One
https://www.readbyqxmd.com/read/29628583/pressure-controlled-volume-guaranteed-mode-improves-respiratory-dynamics-during-laparoscopic-cholecystectomy-a-comparison-with-conventional-modes
#15
Apoorwa Kothari, Deepa Baskaran
Background: Pneumoperitoneum and altered positioning 1in laparoscopic cholecystectomy predispose to alterations in cardiorespiratory physiology. We compared the effects of volume controlled, pressure controlled, and the newly introduced pressure controlled-volume guaranteed ventilation (PCV-VG) modes of ventilation on respiratory mechanics and oxygenation during laparoscopic cholecystectomy. Materials and Methods: Seventy-five physical status American Society of Anesthesiologists Classes I and II patients with normal lungs undergoing laparoscopic cholecystectomy were randomly allocated to receive volume controlled ventilation (VCV), pressure-controlled ventilation (PCV), or PCV-VG modes of ventilation during general anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628557/intraocular-pressure-changes-during-laparoscopic-surgery-in-trendelenburg-position-in-patients-anesthetized-with-propofol-based-total-intravenous-anesthesia-compared-to-sevoflurane-anesthesia-a-comparative-study
#16
Gagandeep Kaur, Mamta Sharma, Poonam Kalra, Shobha Purohit, Kanchan Chauhan
Background: Intraocular pressure (IOP) is increased during laparoscopic surgery with Trendelenburg position and may contribute to deleterious effects on optic nerve in susceptible patients. Aims: The primary objective of this study is to compare the effects of propofol-based total intravenous anesthesia (TIVA) with those of sevoflurane anesthesia on IOP in patients undergoing lower abdominal laparoscopic surgery in Trendelenburg position. Secondary objectives are to compare hemodynamic changes, mean arterial pressure (MAP), end-tidal CO2 , and peak inspiratory pressure changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29595879/capturing-the-multifactorial-nature-of-ards-two-hit-approach-to-model-murine-acute-lung-injury
#17
Sandra Hoegl, Nana Burns, Martín Angulo, Daniel Francis, Christopher M Osborne, Tingting W Mills, Michael R Blackburn, Holger K Eltzschig, Christine U Vohwinkel
Severe acute respiratory distress syndrome (ARDS) presents typically with an initializing event, followed by the need for mechanical ventilation. Most animal models of ALI are limited by the fact that they focus on a singular cause of acute lung injury (ALI) and therefore fail to mimic the complex, multifactorial pathobiology of ARDS. To better capture this scenario, we provide a comprehensive characterization of models of ALI combining two injuries: intra tracheal (i.t.) instillation of LPS or hypochloric acid (HCl) followed by ventilator-induced lung injury (VILI)...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29589419/influence-of-head-and-neck-position-on-performance-of-the-ambu%C3%A2-auragaintm-laryngeal-mask-a-randomised-crossover-study
#18
Seokha Yoo, Sun-Kyung Park, Won Ho Kim, Min Hur, Jae-Hyon Bahk, Young-Jin Lim, Jin-Tae Kim
BACKGROUND: The purpose of this study was to investigate the influence of different head and neck positions on the performance of the Ambu® AuraGainTM, a novel laryngeal mask with anatomical curvature. METHODS: Oropharyngeal leak pressure, expiratory tidal volume, peak inspiratory pressure, ventilation score, and fibreoptic view score through the AuraGainTM were measured in the neutral, flexed, and extended neck positions as well as the right rotated head and neck position in each patient in a random order...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29575957/ventilator-induced-lung-injury-during-controlled-ventilation-in-patients-with-acute-respiratory-distress-syndrome-less-is-probably-better
#19
Fernanda Ferreira Cruz, Lorenzo Ball, Patricia Rieken Macedo Rocco, Paolo Pelosi
Mechanical ventilation is required to support respiratory function in the acute respiratory distress syndrome (ARDS), but it may promote lung damage, a phenomenon known as ventilator-induced lung injury (VILI). Areas covered: Several mechanisms of VILI have been described, such as: inspiratory and/or expiratory stress inducing overdistension (volutrauma); interfaces between collapsed or edema-filled alveoli with surrounding open alveoli, acting as stress raisers; alveoli that repetitively open and close during tidal breathing (atelectrauma); and peripheral airway dynamics...
May 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29557595/complications-during-esophageal-endoscopy-with-or-without-baloon-dilation-under-general-anesthesia-in-pediatric-patients-a-prospective-and-observational-study
#20
Pinar Kendigelen, Ayse C Tutuncu, Senol Emre, Fatis Altindas, Guner Kaya
BACKGROUND: Complications can occur during esophagoscopy as a result of applied procedure in children, especially during dilation techic. Our aim was to identify cardio-respiratory alterations during esophagoscopy with or without baloon dilation under anesthesia in children, and to investigate the postoperative complications. METHODS: Prospective, observational study of endoscopic procedures in patients 0-16 years. The patients were divided into two groups: the endoscopy-dilation group (Group ED: endoscopy and balloon dilation due to esophageal stricture) and endoscopy without dilation (Group E: endoscopy for diagnostic reasons, control esophagoscopy or sclerotherapy)...
April 1, 2018: Archivos Argentinos de Pediatría
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