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https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#1
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148626/effects-of-detraining-on-breathing-pattern-and-ventilatory-efficiency-in-young-soccer-players
#2
José R Alvero Cruz, Mauro Ronconi, Jerónimo Garcia Romero, José Naranjo Orellana
BACKGROUND: This study investigated the effects of detraining on breathing pattern. The aim of this study was to evaluate the effect of a sixweek detraining period on breathing patterns and ventilatory efficiency. METHODS: Fourteen young soccer players were evaluated at the end of a competitive season and after a sixweek detraining period. Assessment of respiratory efficiency was based on VE/VCO2 slope changes below 70% of exercise intensity. All participants underwent twice an incremental graded exercise test up to exhaustion...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29145478/electrical-impedance-tomography-amplitudes-of-cardiac-related-impedance-changes-in-the-lung-are-highly-position-dependent
#3
Michael Graf, Thomas Riedel
BACKGROUND: Electrical impedance tomography (EIT) is used on the thorax to measure impedance changes due to the presence of air and blood in the lung. This experimental study was performed to investigate the effect of posture on cardiac and respiratory related impedance changes. METHODS: EIT measurements were performed on 14 healthy subjects in left-, right lateral, prone, supine and upright positions. Simultaneously, tidal volume was recorded with an ultrasonic flowmeter...
2017: PloS One
https://www.readbyqxmd.com/read/29142549/comparison-of-pressure-vs-volume-controlled-ventilation-on-oxygenation-parameters-of-obese-patients-undergoing-laparoscopic-cholecystectomy
#4
Reza Movassagi, Majid Montazer, Ata Mahmoodpoor, Vahid Fattahi, Afshin Iranpour, Sarvin Sanaie
Background & Objective: There is no special guideline for the best ventilation mode during laparoscopic anesthesia in obese patients and there are too many studies with different controversial points. The aim of this study was to compare the effect of pressure controlled ventilation (PCV) vs. volume controlled ventilation (VCV) on respiratory and oxygenation parameters in patients undergoing laparoscopic cholecystectomy. Methods: Seventy patients with 30 <BMI<40 and ASA physical status I-II were studied in this randomized prospective trial...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29140452/mechanical-ventilation-induces-il-4-secretion-in-lungs-and-reduces-the-phagocytic-capacity-of-lung-macrophages
#5
Kenny Bielen, Bart 's Jongers, Jan Boddaert, Christine Lammens, Philippe G Jorens, Surbhi Malhotra-Kumar, Herman Goossens, Samir Kumar-Singh
Patients receiving mechanical ventilation are at risk of developing ventilator-associated pneumonia. Here, we show that clinically utilized ventilation protocols in rat with 5 or 8 mL/kg tidal volumes cause increased IL-4 expression, lowered ratio of TH1:TH2 transcriptional factors (Tbet:Gata3) and increased arginase1-positive (Arg1+) macrophages and eosinophils in lungs. Macrophages from ventilated lungs had reduced ex vivo capacity towards phagocytosing bacteria. Ventilated animals, when further challenged with bacterial pneumonia, continued to show persistence of Arg1+ M2 macrophages as well as an increased bacterial burden compared to spontaneously breathing animals receiving the same bacterial dose...
November 13, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29134425/quick-reference-tidal-volume-cards-reduce-the-incidence-of-large-tidal-volumes-during-surgery
#6
Chirag K Shah, Angela Moss, William Henderson, Breandan Sullivan, Ana Fernandez-Bustamante
Ventilation with large tidal volumes (V T), greater than 10 ml/kg of predicted body weight (PBW), is associated with worse outcomes in critically ill and surgical patients. We hypothesized that the availability of quick reference cards with proposed V T ranges specific to gender and different heights would reduce the intraoperative use of large V T during prolonged abdominal surgery. We compared retrospectively the incidence of median V T used during prolonged (≥4-h-long) abdominal surgery before ("before") and after ("after") the quick reference V T cards were made available in all anesthesia machines in operating rooms of a single academic US medical center...
November 13, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29134246/does-high-peep-prevent-alveolar-cycling
#7
REVIEW
M Cressoni, C Chiurazzi, D Chiumello, L Gattinoni
Acute respiratory distress syndrome (ARDS) patients need mechanical ventilation to sustain gas exchange. Animal experiments showed that mechanical ventilation with high volume/plateau pressure and no positive end-expiratory pressure (PEEP) damages healthy lungs, while low tidal volumes and the application of higher PEEP levels are protective. PEEP makes the lung homogeneous, reducing the pressure multiplication at the interface between lung units with different inflation statuses and keeps the lung open through the whole respiratory cycle, avoiding intratidal opening and closing...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29132458/-efficacy-of-analgesic-and-sedative-treatments-in-children-with-mechanical-ventilation-in-the-pediatric-intensive-care-unit
#8
Xiao-Fang Cai, Fu-Rong Zhang, Long Zhang, Ji-Min Sun, Wen-Bin Li
OBJECTIVE: To compare the efficacy and safety of different analgesic and sedative treatments in children with mechanical ventilation in the pediatric intensive care unit (PICU). METHODS: Eighty children with mechanical ventilation in the PICU who needed analgesic and sedative treatments were equally and randomly divided into midazolam group and remifentanil+midazolam group. The sedative and analgesic effects were assessed using the Ramsay Scale and the Face, Legs, Activity, Cry and Consolability (FLACC) Scale...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29131002/low-tidal-volume-positive-end-expiratory-pressure-versus-high-tidal-volume-zero-positive-end-expiratory-pressure-and-postoperative-pulmonary-functions-in-robot-assisted-laparoscopic-radical-prostatectomy
#9
Murat Haliloglu, Beliz Bilgili, Mehtap Ozdemir, Tumay Umuroglu, Nurten Bakan
OBJECTIVE: The aim was to compare the effects of low tidal volume (VT) and moderate positive end-expiratory pressure(PEEP) with high tidal volume (VT) and zero end-expiratory pressure(ZEEP), on postoperative pulmonary functions and oxygenation in patients undergoing robot-assisted laparoscopic radical prostatectomy. SUBJECTS AND METHODS: Forty-four (44) patients were randomized into low VT-PEEP and high VT-ZEEP groups. The patients were ventilated with VT of 6 ml/kg and 8 cmH2O PEEP in low VT-PEEP group and VT of 10 ml/kg and 0 cmH2O PEEP in high VT-ZEEP group...
October 31, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29124561/technology-iii-in-line-vaporizer-with-reflector
#10
A Mashari, J A Fisher, L Fedorko, M Wąsowicz, M Meineri
As the clinical advantages of vapor anesthesia (VA) for sedation of patients in ICU become more apparent, the ergonomics, economy and safety issues need to be better addressed. Here we describe the use of a new commercial digital in-line anesthetic vaporizer that can be attached to the inspiratory limb of a ventilator. If used with a simple, and easily assembled secondary circuit and anesthetic reflector, the circuit remains remote from the patient, the VA consumption approaches a physical minimum, VA level is controlled and monitored, and the tidal volume size is not limited...
November 9, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29121081/intraoperative-ventilatory-leak-predicts-prolonged-air-leak-after-lung-resection-a-retrospective-observational-study
#11
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Hyun-Kyu Yoon, Chul-Woo Jung
Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volume data were retrieved from the electronic anesthesia records. Ventilatory leak (%) was calculated as [(inspiratory tidal volume-expiratory tidal volume)/ inspiratory tidal volume × 100] and was measured after restart of two-lung ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/29118843/the-balance-of-accuracy-and-reliability-in-estimating-tidal-volume-from-height
#12
M Lyons, E Gill, B Hogan, E Hayes, K Feather, J Bain, R Paterson
No abstract text is available yet for this article.
August 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/29117205/hypoxia-preconditioned-mesenchymal-stem-cells-ameliorate-ischemia-reperfusion-induced-lung-injury
#13
Yung-Yang Liu, Chi-Huei Chiang, Shih-Chieh Hung, Chih-Feng Chian, Chen-Liang Tsai, Wei-Chih Chen, Haibo Zhang
BACKGROUND: Hypoxia preconditioning has been proven to be an effective method to enhance the therapeutic action of mesenchymal stem cells (MSCs). However, the beneficial effects of hypoxic MSCs in ischemia/reperfusion (I/R) lung injury have yet to be investigated. In this study, we hypothesized that the administration of hypoxic MSCs would have a positive therapeutic impact on I/R lung injury at molecular, cellular, and functional levels. METHODS: I/R lung injury was induced in isolated and perfused rat lungs...
2017: PloS One
https://www.readbyqxmd.com/read/29116360/role-of-the-extracellular-matrix-in-the-genesis-of-ventilator-induced-lung-injury
#14
REVIEW
F F Cruz, P R M Rocco, P Pelosi
The extracellular matrix represents the three-dimensional scaffold of the alveolar wall, which is composed of a layer of epithelial and endothelial cells, their basal membrane, and a thin interstitial layer containing fibrous proteins, glycoproteins, glycosaminoglycans, and proteoglycans. Mechanical ventilation with low and high tidal volumes can induce proteoglycan fragmentation, which may cause activation of the inflammatory cascade, leading to the main features of ventilator-induced lung injury (VILI): alveolar edema and collagen deposition...
November 7, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29115949/neurally-adjusted-ventilatory-assist-nava-or-pressure-support-ventilation-psv-during-spontaneous-breathing-trials-in-critically-ill-patients-a-crossover-trial
#15
Juliana C Ferreira, Fabia Diniz-Silva, Henrique T Moriya, Adriano M Alencar, Marcelo B P Amato, Carlos R R Carvalho
BACKGROUND: Neurally Adjusted Ventilatory Assist (NAVA) is a proportional ventilatory mode that uses the electrical activity of the diaphragm (EAdi) to offer ventilatory assistance in proportion to patient effort. NAVA has been increasingly used for critically ill patients, but it has not been evaluated during spontaneous breathing trials (SBT). We designed a pilot trial to assess the feasibility of using NAVA during SBTs, and to compare the breathing pattern and patient-ventilator asynchrony of NAVA with Pressure Support (PSV) during SBTs...
November 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29112971/effects-of-positive-end-expiratory-pressure-and-recruitment-maneuvers-in-a-ventilator-induced-injury-mouse-model
#16
Laura A Cagle, Lisa M Franzi, Angela L Linderholm, Jerold A Last, Jason Y Adams, Richart W Harper, Nicholas J Kenyon
BACKGROUND: Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury...
2017: PloS One
https://www.readbyqxmd.com/read/29106562/incomplete-fissures-are-associated-with-increased-alveolar-ventilation-via-spiracles-in-severe-emphysema
#17
Samih Khauli, Eric Abston, Hassan Sajjad, Servet Bolukbas, Julio Mott Ancona Lopez, Roberto Saad, Surya P Bhatt, Michael Eberlein
OBJECTIVES: In emphysema, air can flow preferentially via collateral pathways, which can connect an entire lung when incomplete fissures are present. Spiracles are openings through the chest wall into the lung parenchyma. We previously observed increased alveolar ventilation (VA) in subjects with severe emphysema, when spiracles occurred during lung transplant operations. In this study, we set out to identify a computed tomography (CT) imaging phenotype associated with improved VA via spiracles in severe emphysema...
July 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29101346/development-and-validation-of-a-multi-algorithm-analytic-platform-to-detect-off-target-mechanical-ventilation
#18
Jason Y Adams, Monica K Lieng, Brooks T Kuhn, Greg B Rehm, Edward C Guo, Sandra L Taylor, Jean-Pierre Delplanque, Nicholas R Anderson
Healthcare-specific analytic software is needed to process the large volumes of streaming physiologic waveform data increasingly available from life support devices such as mechanical ventilators. Detection of clinically relevant events from these data streams will advance understanding of critical illness, enable real-time clinical decision support, and improve both clinical outcomes and patient experience. We used mechanical ventilation waveform data (VWD) as a use case to address broader issues of data access and analysis including discrimination between true events and waveform artifacts...
November 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29100692/ground-air-a-first-approximation-of-the-earth-s-second-largest-reservoir-of-carbon-dioxide-gas
#19
James U L Baldini, Rachel A Bertram, Harriet E Ridley
It is becoming increasingly clear that a substantial reservoir of carbon exists in the unsaturated zone of aquifers, though the total size of this reservoir on a global scale remains unquantified. Here we provide the first broad estimate of the amount of carbon dioxide gas found in this terrestrial reservoir. We calculate that between 2 and 53 PgC exists as gaseous CO2 in aquifers worldwide, generated by the slow microbial oxidation of organic particles transported into aquifers by percolating groundwater. Importantly, this carbon reservoir is in the form of CO2 gas, and is therefore transferable to the Earth's atmosphere without any phase change...
October 31, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29099420/predictors-of-intubation-in-patients-with-acute-hypoxemic-respiratory-failure-treated-with-a-noninvasive-oxygenation-strategy
#20
Jean-Pierre Frat, Stéphanie Ragot, Rémi Coudroy, Jean-Michel Constantin, Christophe Girault, Gwénael Prat, Thierry Boulain, Alexandre Demoule, Jean-Damien Ricard, Keyvan Razazi, Jean-Baptiste Lascarrou, Jérôme Devaquet, Jean-Paul Mira, Laurent Argaud, Jean-Charles Chakarian, Muriel Fartoukh, Saad Nseir, Alain Mercat, Laurent Brochard, René Robert, Arnaud W Thille
OBJECTIVES: In patients with acute hypoxemic respiratory failure, noninvasive ventilation and high-flow nasal cannula oxygen are alternative strategies to conventional oxygen therapy. Endotracheal intubation is frequently needed in these patients with a risk of delay, and early predictors of failure may help clinicians to decide early. We aimed to identify factors associated with intubation in patients with acute hypoxemic respiratory failure treated with different noninvasive oxygenation techniques...
November 2, 2017: Critical Care Medicine
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