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https://www.readbyqxmd.com/read/28737194/-face-protective-patches-do-not-reduce-facial-pressure-ulcers-in-a-simulated-model-of-non-invasive-ventilation
#1
Hugo Riquelme M, David Wood V, Santiago Martínez F, Fernando Carmona M, Axel Peña V, Adriana Wegner A
Noninvasive ventilation (NIV) frequently involves the development of facial pressure ulcers (FPU). Its prevention considers the empirical use of protective patches between skin and mask, in order to reduce the pressure exerted by it. OBJECTIVES: To evaluate the effect of protective patches on the pressure exerted by the facial mask, and its impact on the programmed ventilatory parameters. METHOD: Bilevel NIV simulated model using full face mask in phantom with a physiological airway (ALS PRO +) in supine position...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28736528/linking-ventilator-injury-induced-leak-across-the-blood-gas-barrier-to-derangements-in-murine-lung-function
#2
Bradford J Smith, Elizabeth Bartolak-Suki, Bela Suki, Gregory S Roy, Katharine L Hamlington, Chantel M Charlebois, Jason H T Bates
Mechanical ventilation is vital to the management of acute respiratory distress syndrome, but it frequently leads to ventilator-induced lung injury (VILI). Understanding the pathophysiological processes involved in the development of VILI is an essential prerequisite for improving lung-protective ventilation strategies. The goal of this study was to relate the amount and nature of material accumulated in the airspaces to biomarkers of injury and the derecruitment behavior of the lung in VILI. Forty-nine BALB/c mice were mechanically ventilated with combinations of tidal volume and end-expiratory pressures to produce varying degrees of overdistension and atelectasis while lung function was periodically assessed...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28736210/effects-of-positive-expiratory-pressure-on-chest-wall-volumes-in-subjects-with-stroke-compared-to-healthy-controls-a-case-control-study
#3
Elis E A Cabral, Vanessa R Resqueti, Illia N D F Lima, Lucien P Gualdi, Andrea Aliverti, Guilherme A F Fregonezi
BACKGROUND: Alterations in respiratory system kinematics in stroke lead to restrictive pattern associated with decreased lung volumes. Chest physical therapy, such as positive expiratory pressure, may be useful in the treatment of these patients; however, the optimum intensity to promote volume and motion changes of the chest wall remains unclear. OBJECTIVE: To assess the effect of different intensities of positive expiratory pressure on chest wall kinematics in subjects with stroke compared to healthy controls...
July 8, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28734854/pulse-pressure-variation-as-a-guide-for-volume-expansion-in-dogs-undergoing-orthopedic-surgery
#4
Denise T Fantoni, Keila K Ida, André M Gimenes, Matheus M Mantovani, Jacqueline R Castro, Geni C F Patrício, Aline M Ambrósio, Denise A Otsuki
OBJECTIVE: To investigate whether pulse pressure variation (PPV) can predict fluid responsiveness in healthy dogs during clinical surgery. STUDY DESIGN: Prospective clinical study. ANIMALS: Thirty-three isoflurane-anesthetized dogs with arterial hypotension during orthopedic surgery. METHODS: Fluid challenge with lactated Ringer's solution (15 mL kg(-1) in 15 minutes) was administered in mechanically ventilated dogs (tidal volume 10 mL kg(-1)) with hypotension [mean arterial pressure (MAP) < 65 mmHg]...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28734021/effect-of-fixed-value-positive-end-expiratory-pressure-valves-on-canine-thoracic-volume-and-atelectasis
#5
A Allison, X Huizing, C Jolliffe, I Schaafsma
OBJECTIVES: The objective of this study was to investigate whether a fixed 10 cm H2 O positive end-expiratory pressure valve would increase the aeration of, and reduce atelectasis formation in, the lungs after induction of anaesthesia in dogs undergoing thoracic CT. MATERIALS AND METHODS: 28 dogs were paired based on breed, bodyweight and body condition score and then randomly allocated to either Group Z (0 cm H2 O) or Group P (10 cm H2 O positive end-expiratory pressure valve) immediately after the induction of anaesthesia...
July 22, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28730574/mechanical-ventilation-guided-by-electrical-impedance-tomography-in-pediatric-acute-respiratory-distress-syndrome
#6
Jeffrey Dmytrowich, Tanya Holt, Karen Schmid, Gregory Hansen
Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to assess regional tidal volumes in real time at the bedside. Here we report the utilization of thoracic electrical impedance tomography to guide daily PEEP settings and recruitment maneuvers in a child with pARDS...
July 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28730554/bedside-selection-of-positive-end-expiratory-pressure-by-electrical-impedance-tomography-in-hypoxemic-patients-a-feasibility-study
#7
Nilde Eronia, Tommaso Mauri, Elisabetta Maffezzini, Stefano Gatti, Alfio Bronco, Laura Alban, Filippo Binda, Tommaso Sasso, Cristina Marenghi, Giacomo Grasselli, Giuseppe Foti, Antonio Pesenti, Giacomo Bellani
BACKGROUND: Positive end-expiratory pressure (PEEP) is a key element of mechanical ventilation. It should optimize recruitment, without causing excessive overdistension, but controversy exists on the best method to set it. The purpose of the study was to test the feasibility of setting PEEP with electrical impedance tomography in order to prevent lung de-recruitment following a recruitment maneuver. We enrolled 16 patients undergoing mechanical ventilation with PaO2/FiO2 <300 mmHg...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28720675/the-effect-of-nebulizer-position-on-aerosolized-epoprostenol-delivery-in-an-adult-lung-model
#8
Allison C Anderson, Meagan N Dubosky, Kelly A Fiorino, Vanessa Quintana, Carl A Kaplan, David L Vines
BACKGROUND: Aerosolized epoprostenol is an alternative for inhaled nitric oxide in the management of pulmonary arterial hypertension and possibly acute hypoxemia. Our objective was to determine differences in drug deposition based on different nebulizer positions in the ventilator circuit, using a vibrating mesh nebulizer. METHODS: An 8.0-mm inner diameter endotracheal tube (ETT) was connected to a training test lung, compliance of 30 mL/cm H2O, with a collecting filter placed at the ETT-test lung junction...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28718683/the-measurement-of-cough-response-to-bronchoconstriction-induced-by-methacholine-inhalation-in-healthy-subjects-an-examination-using-the-astograph-method
#9
Johsuke Hara, Masaki Fujimura, Noriyuki Ohkura, Tamami Sakai, Kenta Yamamura, Miki Abo, Hayato Koba, Satoshi Watanabe, Taro Yoneda, Shingo Nishikawa, Takashi Sone, Hideharu Kimura, Yoshihisa Ishiura, Kazuo Kasahara
BACKGROUND: We demonstrated that heightened cough response to bronchoconstriction is a fundamental feature of cough variant asthma (CVA). To evaluate this physiological feature of CVA in daily clinical practice, it is necessary to clarify the cough response to bronchoconstriction in healthy subjects. We evaluated cough response to methacholine (MCh)-induced bronchoconstriction in healthy subjects. A forced oscillometry technique was used to measure airway resistance changes with Mch. METHODS: Healthy never-smokers (21 men, 20 women; mean 22...
July 18, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#10
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as PaO2/FIO2 < 150 mm Hg (i.e., severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4-8 mL/kg predicted body weight (PBW) with plateau pressure ≤30 cm H2O, and initial PEEP of 10 - 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 - 3 cm, provided plateau pressure remains ≤30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28715240/the-effect-of-inspiratory-muscle-training-on-respiratory-variables-in-a-patient-with-ankylosing-spondylitis-a-case-report
#11
Marlon L Wong, Rachael G Anderson, Kelsey Garcia, Elissa M Housmann, Erin McHale, Gregory S Goldberger, Lawrence P Cahalin
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION: A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES: At baseline, the patient presented with a resting respiratory rate (RR) of 14...
July 17, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28707030/-update-acute-hypercapnic-respiratory-failure
#12
REVIEW
F Seiler, F C Trudzinski, M Kredel, C Lotz, P M Lepper, R M Muellenbach
BACKGROUND: Hypercapnic respiratory failure is a frequent problem in critical care and mainly affects patients with acute exacerbation of COPD (AECOPD) and acute respiratory distress syndrome (ARDS). In recent years, the usage of extracorporeal CO2 removal (ECCO2R) has been increasing. OBJECTIVE: Summarizing the state of the art in the management of hypercapnic respiratory failure with special regard to the role of ECCO2R. METHODS: Review based on a selective literature search and the clinical and scientific experience of the authors...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28701178/the-future-of-mechanical-ventilation-lessons-from-the-present-and-the-past
#13
REVIEW
Luciano Gattinoni, John J Marini, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural pressure during positive or negative pressure ventilation. The transpulmonary pressure-related side effects primarily account for ventilator-induced lung injury (VILI) while the pleural pressure-related side effects primarily account for hemodynamic alterations. The changes of transpulmonary pressure and pleural pressure resulting from a given applied driving pressure depend on the relative elastances of the lung and chest wall...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28700514/low-volume-high-intensity-interval-versus-continuous-endurance-training-effects-on-hematological-and-cardiorespiratory-system-adaptations-in-professional-canoe-polo-athletes
#14
Mohsen Sheykhlouvand, Mohammadali Gharaat, Erfan Khalili, Hamid Agha-Alinejad, Farhad Rahmaninia, Hamid Arazi
The aim of this study was to compare the effect of two paddling-based high-intensity interval training (HIIT) and continuous endurance training (CET) on hematological, immunological, and cardiorespiratory adaptations in professional canoe polo athletes. Twenty one male canoe polo athletes were randomly divided into one of three groups (N=7): 1) HIIT with variable intensity (VIHIIT) (6×60-second at 100,110,120,130,130, 130,120,110,100% vV[Combining Dot Above]O2peak from 1 to 9 session respectively, 1:3 work to recovery ratio); 2) HIIT with variable volume (VVHIIT) (6,7,8,9,9,9,8,7,6 repetitions/session from 1 to 9 session respectively)×60-second at lowest velocity that elicited V[Combining Dot Above]O2peak (vV[Combining Dot Above]O2peak), 1:3 work to recovery ratio); and 3) the CET group performed 3 times × 60 min paddling sessions (75% vV[Combining Dot Above]O2peak) per week for 3 weeks...
July 8, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/28698268/effects-of-volume-guaranteed-ventilation-combined-with-two-different-modes-in-preterm-infants
#15
Sezin Unal, Ebru Ergenekon, Selma Aktas, Nilgun Altuntas, Serdar Beken, Ebru Kazanci, Ferit Kulali, Ozlem Gulbahar, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Volume-controlled ventilation modes have been shown to reduce duration of mechanical ventilation, incidence of chronic lung disease, failure of primary mode of ventilation, hypocarbia, severe intraventricular hemorrhage, pneumothorax, and periventricular leukomalacia in preterm infants when compared with pressure limited ventilation modes. Volume-guarantee (VG) ventilation is the most commonly used mode for volume-controlled ventilation. Assist control, pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV) can be combined with VG; however, there is a lack of knowledge on the superiority of each regarding clinical outcomes...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28697778/electrical-impedance-tomography-for-predicting-failure-of-spontaneous-breathing-trials-in-patients-with-prolonged-weaning
#16
Johannes Bickenbach, Michael Czaplik, Mareike Polier, Gernot Marx, Nikolaus Marx, Michael Dreher
BACKGROUND: Spontaneous breathing trials (SBTs) on a T-piece can be difficult in patients with prolonged weaning because of remaining de-recruitment phenomena and/or insufficient ventilation. There is no clinically established method existent other than experience for estimating whether an SBT is most probably beneficial. Electrical impedance tomography (EIT) is a clinical useful online monitoring technique during mechanical ventilation, particularly because it enables analysis of effects of regional ventilation distribution...
July 12, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28696966/defining-a-ventilation-strategy-for-flexible-bronchoscopy-on-mechanically-ventilated-patients-in-the-medical-intensive-care-unit
#17
Yonatan Y Greenstein, Eric Shakespeare, Peter Doelken, Paul H Mayo
BACKGROUND: Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. METHODS: We studied 16 subjects who were intubated on mechanical ventilation and required FB...
July 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28695586/intra-operative-protective-mechanical-ventilation-in-lung-transplantation-a-randomised-controlled-trial
#18
G L Verbeek, P S Myles, G P Westall, E Lin, S L Hastings, S F Marasco, J Jaffar, A C Meehan
Primary graft dysfunction occurs in up to 25% of patients after lung transplantation. Contributing factors include ventilator-induced lung injury, cardiopulmonary bypass, ischaemia-reperfusion injury and excessive fluid administration. We evaluated the feasibility, safety and efficacy of an open-lung protective ventilation strategy aimed at reducing ventilator-induced lung injury. We enrolled adult patients scheduled to undergo bilateral sequential lung transplantation, and randomly assigned them to either a control group (volume-controlled ventilation with 5 cmH2 O, positive end-expiratory pressure, low tidal volumes (two-lung ventilation 6 ml...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28693425/cyclic-pao2-oscillations-assessed-in-the-renal-microcirculation-correlation-with-tidal-volume-in-a-porcine-model-of-lung-lavage
#19
Rainer Thomas, Christian Möllmann, Alexander Ziebart, Tanghua Liu, Matthias David, Erik K Hartmann
BACKGROUND: Oscillations of the arterial partial pressure of oxygen induced by varying shunt fractions occur during cyclic alveolar recruitment within the injured lung. Recently, these were proposed as a pathomechanism that may be relevant for remote organ injury following acute respiratory distress syndrome. This study examines the transmission of oxygen oscillations to the renal tissue and their tidal volume dependency. METHODS: Lung injury was induced by repetitive bronchoalveolar lavage in eight anaesthetized pigs...
July 11, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28690548/optimization-of-variable-ventilation-for-physiology-immune-response-and-surfactant-enhancement-in-preterm-lambs
#20
Erzsébet Bartolák-Suki, Peter B Noble, Samer Bou Jawde, Jane J Pillow, Béla Suki
Preterm infants often require mechanical ventilation due to lung immaturity including reduced or abnormal surfactant. Since cyclic stretch with cycle-by-cycle variability is known to augment surfactant release by epithelial cells, we hypothesized that such in vivo mechanotransduction improves surfactant maturation and hence lung physiology in preterm subjects. We thus tested whether breath-by-breath variability in tidal volume (VT) in variable ventilation (VV) can be tuned for optimal performance in a preterm lamb model...
2017: Frontiers in Physiology
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