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Peak expiratory pressure

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https://www.readbyqxmd.com/read/28185634/usefulness-of-a-noninvasive-device-to-identify-elevated-left-ventricular-filling-pressure-using-finger-photoplethysmography-during-a-valsalva-maneuver
#1
Panagis Galiatsatos, Theingi Tiffany Win, Jennifer Monti, Peter V Johnston, William Herzog, Jeffrey C Trost, Chao-Wei Hwang, Gene Y Fridman, Nae-Yuh Wang, Harry A Silber
The high rate of re-hospitalization for heart failure might be reduced by improving noninvasive techniques for identifying elevated left ventricular (LV) filling pressure. We previously showed that changes in a finger photoplethysmography (PPG) waveform during the Valsalva maneuver (VM) reflect invasively measured LV end-diastolic pressure (LVEDP). We have since developed a hand-held device that analyzes PPG while guiding the expiratory effort of a VM. Here we assessed the sensitivity and specificity of this device for identifying elevated LVEDP in patients...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28144134/evaluation-of-carbon-dioxide-rebreathing-during-exercise-assisted-by-noninvasive-ventilation-with-plateau-exhalation-valve
#2
Yong-Er Ou, Zhi-Min Lin, Dong-Ming Hua, Ying Jiang, Ya-Ting Huo, Qun Luo, Rong-Chang Chen
Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28124234/dynamic-driving-pressure-associated-mortality-in-acute-respiratory-distress-syndrome-with-extracorporeal-membrane-oxygenation
#3
Li-Chung Chiu, Han-Chung Hu, Chen-Yiu Hung, Chih-Hao Chang, Feng-Chun Tsai, Cheng-Ta Yang, Chung-Chi Huang, Huang-Pin Wu, Kuo-Chin Kao
BACKGROUND: The survival predictors and optimal mechanical ventilator settings in patients with severe acute respiratory distress syndrome (ARDS) undergoing extracorporeal membrane oxygenation (ECMO) are uncertain. This study was designed to investigate the influences of clinical variables and mechanical ventilation settings on the outcomes for severe ARDS patients receiving ECMO. METHODS: We reviewed severe ARDS patients who received ECMO due to refractory hypoxemia from May 2006 to October 2015...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#4
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28107276/the-effect-of-deep-versus-moderate-neuromuscular-block-on-surgical-conditions-and-postoperative-respiratory-function-in-bariatric-laparoscopic-surgery-a-randomized-double-blind-clinical-trial
#5
Sam Baete, Gerd Vercruysse, Margot Vander Laenen, Pieter De Vooght, Jeroen Van Melkebeek, Dimitri Dylst, Maud Beran, Jan Van Zundert, René Heylen, Willem Boer, Sam Van Boxstael, Tom Fret, Hans Verhelst, Cathy De Deyne, Frank Jans, Pascal Vanelderen
BACKGROUND: In recent literature, it has been suggested that deep neuromuscular block (NMB) improves surgical conditions during laparoscopy; however, the evidence supporting this statement is limited, and this was not investigated in laparoscopic bariatric surgery. Moreover, residual NMB could impair postoperative respiratory function. We tested the hypotheses that deep NMB could improve the quality of surgical conditions for laparoscopic bariatric surgery compared with moderate NMB and investigated whether deep NMB puts patients at risk for postoperative respiratory impairment compared with moderate NMB...
January 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28099641/sepsis-related-acute-respiratory-distress-syndrome-in-children-with-cancer-the-respiratory-dynamics-of-a-devastating-condition
#6
Rodrigo Genaro Arduini, Orlei Ribeiro de Araujo, Dafne Cardoso Bourguignon da Silva, Andreza Almeida Senerchia, Antonio Sergio Petrilli
Objective: To evaluate the clinical course and respiratory parameters of mechanically ventilated children with cancer suffering from sepsis-related acute respiratory distress syndrome. Methods: This 2-year prospective, longitudinal, observational cohort study enrolled 29 children and adolescents. Clinical data, measurements of blood gases and ventilation parameters were collected at four different time points. Fluctuations between measurements as well as differences in estimated means were analyzed by linear mixed models in which death within 28 days from the onset of acute respiratory distress syndrome was the primary endpoint...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28094413/electrical-impedance-tomography-for-lung-ventilation-monitoring-of-the-dog
#7
Simon Gloning, Korbinian Pieper, Martin Zoellner, Andrea Meyer-Lindenberg
BACKGROUND: Electrical impedance tomography (EIT) is a radiation free technique which takes advantage of the different electrical conductivities of different tissues. Its main field of application is lung ventilation monitoring. The aim of this prospective study was to evaluate the feasibility of collecting EIT information on a sample of dogs with different thoracic shapes under clinical conditions by connecting an electrode belt without fur clipping. MATERIAL AND METHODS: Fifteen pulmonary healthy dogs were anaesthetized, positioned in sternal recumbency and ventilated in a pressure-controlled mode at three different positive end-expiratory pressure levels (PEEP) of 0, 5 and 10 cmH2O for five breaths each, with a peak inspiratory pressure of 15 cmH2O...
February 9, 2017: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
https://www.readbyqxmd.com/read/28057838/temporal-evolution-of-thoracocentesis-induced-changes-in-spirometry-and-respiratory-muscle-pressures
#8
Stylianos A Michaelides, George D Bablekos, Antonis Analitis, George Ionas, Petros Bakakos, Konstantinos A Charalabopoulos
BACKGROUND: Several studies investigated the effects of thoracocentesis on aspects of respiratory function without generally ensuring absence of coexistent lung pathology or homogeneity in initial size of the effusion. METHODS: We studied 90 patients aged 61.6±15.9 years (mean±SD) separated into a group A with small-sized or medium-sized effusion (A=56 patients) and a group B with large and massive one (B=34 patients). There was no significant lung lesion or cardiovascular pathology...
January 5, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28056816/optimization-of-pressure-settings-during-adaptive-servo-ventilation-support-using-real-time-heart-rate-variability-assessment-initial-case-report
#9
Teruhiko Imamura, Daisuke Nitta, Koichiro Kinugawa
BACKGROUND: Adaptive servo-ventilation (ASV) therapy is a recent non-invasive positive pressure ventilation therapy that was developed for patients with heart failure (HF) refractory to optimal medical therapy. However, it is likely that ASV therapy at relatively higher pressure setting worsens some of the patients' prognosis compared with optimal medical therapy. Therefore, identification of optimal pressure settings of ASV therapy is warranted. CASE PRESENTATION: We present the case of a 42-year-old male with HF, which was caused by dilated cardiomyopathy, who was admitted to our institution for evaluating his eligibility for heart transplantation...
January 5, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28052465/respiratory-impairment-in-multiple-sclerosis-a-study-of-respiratory-function-in-wheelchair-bound-patients
#10
J Levy, D Bensmail, A Brotier-Chomienne, S Butel, C Joussain, C Hugeron, H Prigent
BACKGROUND AND PURPOSE: Respiratory disorders are a major cause of morbidity and mortality in multiple sclerosis (MS). Mainly reported in walking patients, they are poorly explored when walking is severely impaired. To characterize respiratory impairment in patients with advanced MS. METHODS: From 2012 to 2015, patients with MS with an Expanded Disability Status Scale (EDSS) score of ≥7 who were referred for functional and rehabilitation evaluation underwent pulmonary function tests to study lung volumes, cough efficacy and respiratory muscle pressures...
January 3, 2017: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#11
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
March 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28011794/can-ambu-self-inflating-bag-and-neopuff-infant-resuscitator-provide-adequate-and-safe-manual-inflations-for-infants-up-to-10%C3%A2-kg-weight
#12
Mark Tracy, Rajesh Maheshwari, Dharmesh Shah, Murray Hinder
BACKGROUND: Manual resuscitation devices for infants and newborns must be able to provide adequate ventilation in a safe and consistent manner across a wide range of patient sizes (0.5-10 kg) and differing clinical states. There are little comparative data assessing biomechanical performance of common infant manual resuscitation devices across the manufacturers' recommended operating weight ranges. We aimed to compare performance of the Ambu self-inflating bag (SIB) with the Neopuff T-piece resuscitator in three resuscitation models...
December 23, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28009638/the-effect-of-head-rotation-on-efficiency-of-face-mask-ventilation-in-anaesthetised-apnoeic-adults-a-prospective-randomised-crossover-study
#13
Taiga Itagaki, Jun Oto, Sara M Burns, Yandong Jiang, Robert M Kacmarek, Jeremi R Mountjoy
BACKGROUND: Upper airway obstruction occurs commonly after induction of general anaesthesia. It is the major cause of difficult mask ventilation. OBJECTIVES: The aim of this study was to determine whether head rotation improves the efficiency of mask ventilation of anaesthetised apnoeic adults. DESIGN: A prospective crossover study. SETTING: Single university teaching hospital. PATIENTS: Forty patients, aged 18 to 75 years with a BMI 18...
December 22, 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28005993/decreased-peak-expiratory-flow-associated-with-muscle-fiber-type-switching-in-spinal-and-bulbar-muscular-atrophy
#14
Shinichiro Yamada, Atsushi Hashizume, Yasuhiro Hijikata, Tomonori Inagaki, Keisuke Suzuki, Naohide Kondo, Kaori Kawai, Seiya Noda, Hirotaka Nakanishi, Haruhiko Banno, Akihiro Hirakawa, Haruki Koike, Katherine Halievski, Cynthia L Jordan, Masahisa Katsuno, Gen Sobue
The aim of this study was to characterize the respiratory function profile of subjects with spinal and bulbar muscular atrophy (SBMA), and to explore the underlying pathological mechanism by comparing the clinical and biochemical indices of this disease with those of amyotrophic lateral sclerosis (ALS). We enrolled male subjects with SBMA (n = 40) and ALS (n = 25) along with 15 healthy control subjects, and assessed their respiratory function, motor function, and muscle strength. Predicted values of peak expiratory flow (%PEF) and forced vital capacity were decreased in subjects with SBMA compared with controls...
2016: PloS One
https://www.readbyqxmd.com/read/27984249/predicting-fluid-responsiveness-in-acute-liver-failure-a-prospective-study
#15
Vinod Kumar Audimoolam, Mark J W McPhail, Chris Willars, William Bernal, Julia A Wendon, Maurizio Cecconi, Georg Auzinger
BACKGROUND: The profound hemodynamic changes seen in acute liver failure (ALF) resemble the hyperdynamic state found in the later stages of septic shock. Vasopressor support frequently is required after initial volume therapy. Markers of preload dependency have not been studied in this patient group. Dynamic maneuvers such as passive leg raising or end-expiratory hold, which have shown good predictive accuracy in a general intensive care unit population, cannot be considered safe in this cohort because of the concerns of intracranial hypertension...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27965949/a-novel-prototype-neonatal-resuscitator-that-controls-tidal-volume-and-ventilation-rate-a-comparative-study-of-mask-ventilation-in-a-newborn-manikin
#16
Anne Lee Solevåg, Enrico Haemmerle, Sylvia van Os, Katinka P Bach, Po-Yin Cheung, Georg M Schmölzer
The objective of this randomized controlled manikin trial was to examine tidal volume (VT) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next Step™ device for neonatal resuscitation. We hypothesized that VT and rate would be closest to target with the Next Step™. Twenty-five Neonatal Resuscitation Program providers provided mask PPV to a newborn manikin (simulated weight 1 kg) in a randomized order with a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone resuscitation system T-piece, and the Next Step™...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27943294/laryngeal-pacing-for-bilateral-vocal-fold-paralysis-voice-and-respiratory-aspects
#17
Andreas H Mueller, Rudolf Hagen, Claus Pototschnig, Gerhard Foerster, Wilma Grossmann, Katrin Baumbusch, Markus Gugatschka, Tadeus Nawka
OBJECTIVE: To evaluate the effects of neurostimulation with the laryngeal pacemaker (LP) system in patients with bilateral vocal fold paralysis (BVFP) in terms of voice quality and respiratory function. STUDY DESIGN: Feasibility study, first-in-human, single-arm, open-label, prospective, multicenter study with group-sequential design and 6-month follow-up period, as described in details in our previous publication. METHODS: Nine symptomatic BVFP subjects were unilaterally implanted with the LP system at three study sites in Germany and Austria...
December 10, 2016: Laryngoscope
https://www.readbyqxmd.com/read/27920046/resuscitation-of-infants-with-congenital-diaphragmatic-hernia
#18
Anthony O'Rourke-Potocki, Kamal Ali, Vadivelam Murthy, Anthony Milner, Anne Greenough
OBJECTIVE: To determine whether the respiratory response to resuscitation in infants with congenital diaphragmatic hernia (CDH) as measured by a respiratory function monitor differed between those who did and did not survive. DESIGN: Observational study. SETTING: Tertiary perinatal centre. PATIENTS: Thirty-eight infants born at 34 weeks of gestation or greater and diagnosed antenatally with a CDH. INTERVENTIONS: Expiratory tidal volume (VTe), peak inflation pressure (PIP) and end-tidal carbon dioxide level (ETCO2) were simultaneously recorded during resuscitation using a respiratory function monitor...
December 5, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/27894507/do-simple-beside-lung-function-tests-predict-morbidity-after-rib-fractures
#19
Christopher A Butts, John J Brady, Sara Wilhelm, Laura Castor, Alicia Sherwood, Abby McCall, John Patch, Pamela Jones, Vicente Cortes, Adrian W Ong
BACKGROUND: We evaluated if incentive spirometry volume (ISV) and peak expiratory flow rate (PEFR) could predict acute respiratory failure (ARF) in patients with rib fractures. METHODS: Normotensive, co-operative patients were enrolled prospectively. ISV and PEFR were measured on admission, at 24 h and at 48 h by taking the best of three readings each time. The primary outcome, ARF, was defined as requiring invasive or noninvasive positive pressure ventilation...
November 19, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27888836/limited-predictability-of-maximal-muscular-pressure-using-the-difference-between-peak-airway-pressure-and-positive-end-expiratory-pressure-during-proportional-assist-ventilation-pav
#20
Po-Lan Su, Pei-Shan Kao, Wei-Chieh Lin, Pei-Fang Su, Chang-Wen Chen
BACKGROUND: If the proportional assist ventilation (PAV) level is known, muscular effort can be estimated from the difference between peak airway pressure and positive end-expiratory pressure (PEEP) (ΔP) during PAV. We conjectured that deducing muscle pressure from ΔP may be an interesting method to set PAV, and tested this hypothesis using the oesophageal pressure time product calculation. METHODS: Eleven mechanically ventilated patients with oesophageal pressure monitoring under PAV were enrolled...
November 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
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