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https://www.readbyqxmd.com/read/28542443/effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-damage-in-a-model-of-mild-extrapulmonary-acute-lung-injury-with-intra-abdominal-hypertension
#1
Cintia L Santos, Raquel S Santos, Lillian Moraes, Cynthia S Samary, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Robert Huhle, Marcelo G Abreu, Alberto Schanaider, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH...
2017: PloS One
https://www.readbyqxmd.com/read/28536796/development-and-evaluation-of-a-family-of-human-face-and-upper-airway-models-for-the-laboratory-testing-of-orally-inhaled-products
#2
Mark W Nagel, Jason A Suggett, Dominic P Coppolo, Jolyon P Mitchell
Many orally inhaled products are supplied with a facemask instead of a mouthpiece, enabling aerosolized medication to be transferred from the inhaler to the lungs when the user lacks the capability to use a mouthpiece. Until recently, laboratory evaluation of an orally inhaled product-facemask was frequently undertaken by removing the facemask, treating the facemask adapter as being equivalent to a mouthpiece. Measurements of delivered drug mass were therefore subject to bias arising from the absence of dead volume, had the facemask been present...
May 23, 2017: AAPS PharmSciTech
https://www.readbyqxmd.com/read/28535788/endexpiratory-lung-volume-measurement-correlates-with-the-ventilation-perfusion-mismatch-in-lung-injured-pigs
#3
Jens Kamuf, Andreas Garcia-Bardon, Bastian Duenges, Tanghua Liu, Antje Jahn-Eimermacher, Florian Heid, Matthias David, Erik K Hartmann
BACKGROUND: In acute respiratory respiratory distress syndrome (ARDS) a sustained mismatch of alveolar ventilation and perfusion (VA/Q) impairs the pulmonary gas exchange. Measurement of endexpiratory lung volume (EELV) by multiple breath-nitrogen washout/washin is a non-invasive, bedside technology to assess pulmonary function in mechanically ventilated patients. The present study examines the association between EELV changes and VA/Q distribution and the possibility to predict VA/Q normalization by means of EELV in a porcine model...
May 23, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28535074/synchrotron-imaging-shows-effect-of-ventilator-settings-on-intra-breath-cyclic-changes-in-pulmonary-blood-volume
#4
Liisa Porra, Ludovic Broche, Loïc Dégrugilliers, Gergely Albu, Iliona Malaspinas, Camille Doras, Mats Wallin, Magnus Hallbäck, Walid Habre, Sam Bayat
RATIONALE: Despite the importance of dynamic changes in the regional distributions of gas and blood during the breathing cycle for lung function in the mechanically ventilated patient, no quantitative data on such cyclic changes is currently available. METHODS: We used a novel gated synchrotron CT-imaging to quantitatively image regional lung gas (Vg), tissue density and blood volume (Vb) in 6 anaesthetized, paralyzed and mechanically ventilated rabbits with normal lungs...
May 23, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28528760/experimental-evaluation-of-four-airway-devices-in-anaesthetized-new-zealand-white-rabbits
#5
Sandra Wenger, Désirée Müllhaupt, Stefanie Ohlerth, Sarah Prasse, Karina Klein, Bianca da Silva Valente, Martina Mosing
OBJECTIVE: To compare airway management during induction of anaesthesia, spontaneous ventilation (SV) and controlled mechanical ventilation (CMV), using an endotracheal tube (ETT), laryngeal mask (LM), rabbit-specific supraglottic airway device (v-gel) or facemask (FM). STUDY DESIGN: Prospective randomized crossover experiment. ANIMALS: Ten New Zealand White rabbits. METHODS: After premedication, rabbits were randomly allocated to four groups: 1) ETT; 2) LM; 3) v-gel or 4) FM...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#6
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28526483/effects-of-air-stacking-maneuver-on-cough-peak-flow-and-chest-wall-compartmental-volumes-of-amyotrophic-lateral-sclerosis-subjects
#7
Antonio Sarmento, Vanessa Regiane Resqueti, Mario Emílio Teixeira Dourado-Júnior, Lailane Saturnino, Andrea Aliverti, Guilherme Augusto de Freitas Fregonezi, Armele de Fátima Dornelas de Andrade
OBJECTIVES: To assess the acute effects of air stacking on cough peak flow (CPF) and chest wall compartmental volumes of persons with amyotrophic lateral sclerosis (ALS) versus healthy controls positioned at 45° body inclination. DESIGN: Cross-sectional study with a matched-pair design. SETTING: University hospital. PARTICIPANTS: Twelve persons with ALS and twelve age-matched healthy. MAIN OUTCOMES: CPF, chest wall compartmental inspiratory capacity (ICCW), vital capacity (VCCW), tidal volume (VTCW) and operational volumes, breathing pattern and percentage of contribution of the compartments to the inspired volume were measured by optoelectronic plethysmography...
May 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28524027/-effect-of-chest-physiotherapy-in-patients-undergoing-mechanical-ventilation-a-prospective-randomized-controlled-trial
#8
Hui Zeng, Zhen Zhang, Yuan Gong, Miao Chen
OBJECTIVE: To investigate the effect of chest physiotherapy (CPT) on patients undergoing mechanical ventilation (MV). METHODS: A prospective randomized controlled trial (RCT) was conducted. Sixty-eight adult patients undergoing invasive MV over 48 hours admitted to intensive care unit (ICU) of Affiliated Hospital of Zunyi Medical College from December 2014 to October 2016 were enrolled, and they were divided into CPT group (n = 37) and control group (n = 31) by random number table...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28522756/influence-of-sex-menstrual-cycle-and-oral-contraceptives-on-cerebrovascular-resistance-and-cardiorespiratory-function-during-valsalva-or-standing
#9
Syed Abidi, Misha Nili, Stephania Serna, Simon Kim, Christopher Hazlett, Heather Edgell
Women experience orthostatic intolerance more than men, and experience faintness more in the early follicular (i.e. low hormone (LH)) compared to the luteal (i.e. high hormone (HH)) phase of the menstrual cycle. Men (n=13, age: 25.8±1.8) and women in the LH (day 2-5; placebo) and HH) (day 18-24; high dose) phases of the menstrual cycle with (OC; n=14, age: 22.0±0.8) or without oral contraceptives (NOC; n=12, age: 21.8±0.5) underwent the Valsalva maneuver and a supine-sit-stand protocol. Blood pressure, normalized stroke volume (SVi), cardiac output index (Qi), heart rate (HR), end-tidal carbon dioxide (ET-CO2), and middle cerebral artery blood velocity (MCA) were measured...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28515830/how-different-respiratory-rate-patterns-affect-cardiorespiratory-variables-and-performance
#10
Minas Nalbandian, Zsolt Radak, Jun Taniguchi, Takeda Masaki
This study aims to elucidate how respiratory rate (RR) patterns may affect respiratory gas exchange variables and performance during incremental intensity- exercise. 10 healthy young men (mean ± SD, age: 20.7 ± 0.5 years, height: 174.3 ± 5.7 cm, and body mass: 72.6 ± 10.4 kg) performed three incremental tests on a cycle ergometer at three different RR (60, 45 and 30 breaths per min) in each trial. During the tests, tidal volume (TV), minute ventilation (VE), fractional content of oxygen (FeO2), fractional content of carbon dioxide (FeCO2), oxygen uptake (VO2), expiratory carbon dioxide (VCO2), equivalent of oxygen (EqO2), VE/VCO2, and respiratory exchange ratio (RER) were determinate breath-by-breath...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/28513002/one-oxygen-breath-shortened-the-time-to-return-of-spontaneous-circulation-in-severely-asphyxiated-piglets
#11
Rikard Linner, Doris Cunha-Goncalves, Valeria Perez-de-Sa
AIM: Asphyxiated neonates should be resuscitated with air, but it remains unclear if oxygen supplementation is needed in ineffectively ventilated newborn infants. We studied the return of spontaneous circulation (ROSC) with oxygen or air in an experimental model of inadequate ventilation. METHODS: Asphyxia was induced in 16 newborn piglets until their heart rate was <60 bpm or mean arterial pressure (MAP) <30 mmHg. During the first 10 minutes of resuscitation, they received one breath per minute of oxygen (n=8) or air (n=8)...
May 16, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28512431/variable-ventilation-improved-respiratory-system-mechanics-and-ameliorated-pulmonary-damage-in-a-rat-model-of-lung-ischemia-reperfusion
#12
André Soluri-Martins, Lillian Moraes, Raquel S Santos, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Paolo Pelosi, Pedro L Silva, Marcelo Gama de Abreu, Patricia R M Rocco
Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28510504/cardiopulmonary-exercise-testing-basics-of-methodology-and-measurements
#13
Alessandro Mezzani
Cardiopulmonary exercise testing adds measurement of ventilation and volume of oxygen uptake and exhaled carbon dioxide to routine physiological and performance parameters obtainable from conventional exercise testing, furnishing an all-round vision of the systems involved in both oxygen transport from air to mitochondria and its utilization during exercise. Peculiarities of cardiopulmonary exercise testing methodology are the use of ramp protocols and calibration procedures for flow meters and gas analyzers...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28504341/breathing-circuit-compliance-and-accuracy-of-displayed-tidal-volume-during-pressure-controlled-ventilation-of-infants-a-quality-improvement-project
#14
Todd A Glenski, Carrie Diehl, Rachel G Clopton, Robert H Friesen
INTRODUCTION: Anesthesia machines have evolved to deliver desired tidal volumes more accurately by measuring breathing circuit compliance during a preuse self-test and then incorporating the compliance value when calculating expired tidal volume. The initial compliance value is utilized in tidal volume calculation regardless of whether the actual compliance of the breathing circuit changes during a case, as happens when corrugated circuit tubing is manually expanded after the preuse self-test but before patient use...
May 15, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28502060/comparison-of-univent-tube-and-ez-blocker-in-one-lung-ventilation-airway-pressures-and-gas-exchange
#15
Tülay Hoşten, Can Aksu, Alparslan Kuş, Sevim Cesur, Neşe Türkyılmaz, Mine Solak
Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, ventilation and haemodynamics during OLV. Patients undergoing elective thoracotomy for the first time were included in this prospective randomized study. Patients were divided into two groups as UT and EZ...
May 13, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28499130/extracorporeal-membrane-oxygenation-ecmo-as-a-treatment-strategy-for-severe-acute-respiratory-distress-syndrome-ards-in-the-low-tidal-volume-era-a-systematic-review
#16
REVIEW
Bourke W Tillmann, Michelle L Klingel, Alla E Iansavichene, Ian M Ball, A Dave Nagpal
OBJECTIVE: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included...
April 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28497420/the-role-of-high-airway-pressure-and-dynamic-strain-on-ventilator-induced-lung-injury-in-a-heterogeneous-acute-lung-injury-model
#17
Sumeet V Jain, Michaela Kollisch-Singule, Joshua Satalin, Quinn Searles, Luke Dombert, Osama Abdel-Razek, Natesh Yepuri, Antony Leonard, Angelika Gruessner, Penny Andrews, Fabeha Fazal, Qinghe Meng, Guirong Wang, Louis A Gatto, Nader M Habashi, Gary F Nieman
BACKGROUND: Acute respiratory distress syndrome causes a heterogeneous lung injury with normal and acutely injured lung tissue in the same lung. Improperly adjusted mechanical ventilation can exacerbate ARDS causing a secondary ventilator-induced lung injury (VILI). We hypothesized that a peak airway pressure of 40 cmH2O (static strain) alone would not cause additional injury in either the normal or acutely injured lung tissue unless combined with high tidal volume (dynamic strain). METHODS: Pigs were anesthetized, and heterogeneous acute lung injury (ALI) was created by Tween instillation via a bronchoscope to both diaphragmatic lung lobes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28497325/the-effect-of-pressure-controlled-inverse-ratio-ventilation-on-lung-protection-in-obese-patients-undergoing-gynecological-laparoscopic-surgery
#18
Lili Xu, Jianjun Shen, Min Yan
SPECIFIC AIM: To examine the effects of pressure-controlled inverse ratio ventilation (PCIRV) and volume-control ventilation (VCV) on arterial oxygenation, pulmonary function, hemodynamics, levels of surfactant protein A (SP-A), and tumor necrosis factor-α (TNF-α) in obese patients undergoing gynecological laparoscopic surgery. METHODS: Sixty patients, body mass index (BMI) ≥30 kg/m(2), scheduled for elective gynecological laparoscopic surgery were enrolled in the study...
May 11, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#19
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28493943/open-lung-approach-versus-standard-protective-strategies-effects-on-driving-pressure-and-ventilatory-efficiency-during-anesthesia-a-pilot-randomized-controlled-trial
#20
Carlos Ferrando, Fernando Suarez-Sipmann, Gerardo Tusman, Irene León, Esther Romero, Estefania Gracia, Ana Mugarra, Blanca Arocas, Natividad Pozo, Marina Soro, Francisco J Belda
BACKGROUND: Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia...
2017: PloS One
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