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Peak expiratory pressure

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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/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#2
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28503465/correlation-of-serum-creatine-kinase-level-with-pulmonary-function-in-duchenne-muscular-dystrophy
#3
Eun Young Kim, Jang Woo Lee, Mi Ri Suh, Won Ah Choi, Seong Woong Kang, Hyeon Jun Oh
OBJECTIVE: To investigate the relationship between serum creatine kinase (CK) level and pulmonary function in Duchenne muscular dystrophy (DMD). METHODS: A total of 202 patients with DMD admitted to the Department of Rehabilitation Medicine, Gangnam Severance Hospital were enrolled from January 1, 1999 to March 31, 2015. Seventeen patients were excluded. Data collected from the 185 patients included age, height, weight, body mass index, pulmonary function tests including forced vital capacity (FVC), peak cough flow, maximal expiratory pressure (MEP), and maximal inspiratory pressure (MIP), and laboratory measurements (serum level of CK, CK-MB, troponin-T, and B-type natriuretic peptide)...
April 2017: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28500413/impaired-pulmonary-function-is-an-additional-potential-mechanism-for-the-reduction-of-functional-capacity-in-clinically-stable-fontan-patients
#4
Aída L R Turquetto, Luiz F Canêo, Daniela R Agostinho, Patrícia A Oliveira, Maria Isabel C S Lopes, Patrícia F Trevizan, Frederico L A Fernandes, Maria A Binotto, Gabriela Liberato, Glaucia M P Tavares, Rodolfo A Neirotti, Marcelo B Jatene
Central factors negatively affect the functional capacity of Fontan patients (FP), but "non-cardiac" factors, such as pulmonary function, may contribute to their exercise intolerance. We studied the pulmonary function in asymptomatic FP and its correlations with their functional capacity. Pulmonary function and cardiopulmonary exercise tests were performed in a prospective study of 27 FP and 27 healthy controls (HC). Cardiovascular magnetic resonance was used to evaluate the Fontan circulation. The mean age at tests, the mean age at surgery, and the median follow-up time of FP were 20(±6), 8(±3), and 11(8-17) years, respectively...
May 12, 2017: Pediatric Cardiology
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
#5
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/28458532/relationship-between-lung-function-and-grip-strength-in-older-hospitalized-patients-a-pilot-study
#6
Sarah J Holmes, Stephen C Allen, Helen C Roberts
OBJECTIVE: Older people with reduced respiratory muscle strength may be misclassified as having COPD on the basis of spirometric results. We aimed to evaluate the relationship between lung function and grip strength in older hospitalized patients without known airways disease. METHODS: Patients in acute medical wards were recruited who were aged ≥70 years; no history, symptoms, or signs of respiratory disease; Mini Mental State Examination ≥24; willing and able to consent to participate; and able to perform hand grip and forced spirometry...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28457827/ventilation-distribution-assessed-with-electrical-impedance-tomography-and-the-influence-of-tidal-volume-recruitment-and-positive-end-expiratory-pressure-in-isoflurane-anesthetized-dogs
#7
Aline M Ambrosio, Tatiana P A Carvalho-Kamakura, Keila K Ida, Barbara Varela, Felipe S R M Andrade, Lara L Facó, Denise T Fantoni
OBJECTIVE: To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy. METHODS: Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg(-1); n = 7) or a high (12 mL kg(-1); n = 7) VT...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28442070/comparing-airways-clearance-techniques-in-chronic-obstructive-pulmonary-disease-and-bronchiectasis-positive-expiratory-pressure-or-temporary-positive-expiratory-pressure-a-retrospective-study
#8
Francesco D'Abrosca, Barbara Garabelli, Gloria Savio, Agnese Barison, Lorenzo Appendini, Luis V F Oliveira, Paola Baiardi, Bruno Balbi
BACKGROUND: Airway clearance techniques include positive expiratory pressure, commonly used in our clinical practice, and a recently introduced temporary positive expiratory pressure device called UNIKO(®). It is unclear which one provides the best benefit to patients. OBJECTIVES: The aim of this observational 4-year study was to retrospectively compare the efficacy of and specific indications for temporary positive expiratory pressure compared to positive expiratory pressure in a standard rehabilitation program...
January 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28440860/doppler-ultrasonographic-measurement-of-short-term-effects-of-valsalva-maneuver-on-retrobulbar-blood-flow
#9
Sabit Kimyon, Ahmet Mete, Alper Mete, Duçem Mete
BACKGROUND: To investigate the effects of Valsalva maneuver (VM) on retrobulbar blood flow parameters in healthy subjects. METHODS: Participants without any ophthalmologic or systemic pathology were examined in supine position with color and pulsed Doppler imaging for blood flow measurement, via a paraocular approach, in the ophthalmic artery (OA), central retinal artery (CRA), central retinal vein (CRV), nasal posterior ciliary artery (NPCA), and temporal posterior ciliary artery (TPCA), 10 seconds after a 35- to 40-mm Hg expiratory pressure was reached...
April 25, 2017: Journal of Clinical Ultrasound: JCU
https://www.readbyqxmd.com/read/28427883/born-not-breathing-a-randomised-trial-comparing-two-self-inflating-bag-masks-during-newborn-resuscitation-in-tanzania
#10
Monica Thallinger, Hege Langli Ersdal, Fortunata Francis, Anita Yeconia, Estomih Mduma, Hussein Kidanto, Jørgen Erland Linde, Joar Eilevstjønn, Nina Gunnes, Ketil Størdal
AIMS: Effective ventilation is crucial to save non-breathing newborns. We compared standard equipment for newborn resuscitation to a new Upright bag, in an area with high neonatal mortality. METHODS: Newborns requiring resuscitation at Haydom Lutheran Hospital, Tanzania, were ventilated with 230ml standard or 320ml Upright bag-mask by weekly non-blinded block randomisation. A Laerdal Newborn Resuscitation Monitor collected ventilation data through a flow sensor between mask and bag and heart rate with electrocardiography electrodes...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28413273/intraoperative-low-tidal-volume-ventilation-strategy-has-no-benefits-during-laparoscopic-cholecystectomy
#11
Vandna Arora, Asha Tyagi, Surendra Kumar, Aanchal Kakkar, Shukla Das
BACKGROUND AND AIMS: Benefits of intraoperative low tidal volume ventilation during laparoscopic surgery are not conclusively proven, even though its advantages were seen in other situations with intraoperative respiratory compromise such as one-lung ventilation. The present study compared the efficacy of intraoperative low tidal volume ventilatory strategy (6 ml/kg along with positive end-expiratory pressure [PEEP] of 10 cmH2O) versus one with higher tidal volume (10 ml/kg with no PEEP) on various clinical parameters and plasma levels of interleukin (IL)-6 in patients undergoing laparoscopic cholecystectomy...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28410638/utility-of-objective-chest-tube-management-after-pulmonary-resection-using-a-digital-drainage-system
#12
Kazuya Takamochi, Kota Imashimizu, Mariko Fukui, Tatsuo Maeyashiki, Mikiko Suzuki, Takuya Ueda, Hironori Matsuzawa, Shunki Hirayama, Takeshi Matsunaga, Shiaki Oh, Kenji Suzuki
BACKGROUND: We sought to evaluate the clinical utility of chest tube management after pulmonary resection based on objective digital monitoring of pleural pressure and digital surveillance for air leaks. METHODS: We prospectively recorded the perioperative data of 308 patients who underwent pulmonary resection between December 2013 and January 2016. We used information from a digital monitoring thoracic drainage system to measure peak air leakage during the first 24 hours after the operation, patterns of air leakage over the first 72 hours, and patterns of pleural pressure changes until the chest tubes were removed...
April 12, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28403406/comparison-of-effectiveness-of-two-commonly-used-two-handed-mask-ventilation-techniques-on-unconscious-apnoeic-obese-adults
#13
M Fei, J L Blair, M J Rice, D A Edwards, Y Liang, M A Pilla, M S Shotwell, Y Jiang
Background.: Mask ventilation and tracheal intubation are basic techniques for airway management and mutually inclusive rescue measures to restore ventilation. The aim of this study was to compare the effectiveness of mask ventilation between two commonly used techniques of two-handed mask ventilation in obese unconscious apnoeic adults. Methods.: Eighty-one obese adults received mask ventilation after induction using C-E clamp and modified V-E clamp techniques in a randomized crossover manner...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28397558/measurement-of-cough-aerodynamics-in-healthy-adults
#14
Aaron J Feinstein, Zhaoyan Zhang, Dinesh K Chhetri, Jennifer Long
IMPORTANCE: Cough is a critical human reflex and also among the most frequent symptoms in medicine. Despite the prevalence of disordered cough in laryngeal pathologies, comprehensive and quantitative evaluation of cough in these patients is lacking. OBJECTIVE: Herein we seek to establish normative values for cough aerodynamics to provide a population standard for reference in future studies. DESIGN, SETTING, AND PARTICIPANTS: Healthy subjects were recruited from an outpatient clinic to perform voluntary cough...
May 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28388225/effects-of-pressure-support-ventilation-may-be-lost-at-high-exercise-intensities-in-people-with-copd
#15
David Anekwe, Michel de Marchie, Jadranka Spahija
Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H2O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H2O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28368939/application-of-the-novel-ventilation-mode-flow-controlled-expiration-flex-a-crossover-proof-of-principle-study-in-lung-healthy-patients
#16
Steffen Wirth, Sebastian Springer, Johannes Spaeth, Silke Borgmann, Ulrich Goebel, Stefan Schumann
BACKGROUND: Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. METHODS: In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O...
March 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28350644/disassociating-lung-mechanics-and-oxygenation-in-pediatric-acute-respiratory-distress-syndrome
#17
Nadir Yehya, Neal J Thomas
OBJECTIVES: Both oxygenation and peak inspiratory pressure are associated with mortality in pediatric acute respiratory distress syndrome. Since oxygenation and respiratory mechanics are linked, it is difficult to identify which variables, pressure or oxygenation, are independently associated with outcome. We aimed to determine whether respiratory mechanics (peak inspiratory pressure, positive end-expiratory pressure, ΔP [PIP minus PEEP], tidal volume, dynamic compliance [Cdyn]) or oxygenation (PaO2/FIO2) was associated with mortality...
March 27, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28347790/key-conceptional-considerations-on-nebulization-of-antimicrobial-agents-to-mechanically-ventilated-patients
#18
Jordi Rello, Jean Jacques Rouby, Candela Sole-Lleonart, Jean Chastre, Stijn Blot, Charles Edouard Luyt, Jordi Riera, Margreet C Vos, Antoine Monsel, Jayesh Dhanani, Jason A Roberts
Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this Consensus Paper of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: A. Vibrating mesh nebulizers should be preferred to jet or ultrasonic nebulizers; B...
March 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28340306/the-effects-of-positive-end-expiratory-pressure-at-different-levels-on-postoperative-respiration-parameters-in-patients-undergoing-laparoscopic-cholecystectomy
#19
Bahadır Ciftci, Mehmet Aksoy, Ilker Ince, Ali Ahıskalıoglu, Elif Yılmazel Ucar
Purpose/Aim of the study: We investigated the effects of different positive end-expiratory pressure (PEEP) levels on postoperative respiration parameters in patients undergoing laparoscopic cholecystectomy. MATERIALS AND METHODS: One hundred and five consecutive patients were randomly divided to three groups (n = 35, for each group). Group I did not receive PEEP whereas group II received PEEP as 5 cmH2O and group III received PEEP as 8 cm H2O. Measurements with spirometer were taken 1 hour before the operation (T1) and, 1 (T2), 6 (T3), and 24 hours (T4) after extubation by an anesthetist...
March 24, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28333703/higher-fresh-gas-flow-rates-decrease-tidal-volume-during-pressure-control-ventilation
#20
Shazia Mohammad, Nikolaus Gravenstein, Drew Gonsalves, Terrie Vasilopoulos, Samsun Lampotang
BACKGROUND: We observed that increasing fresh gas flow (FGF) decreased exhaled tidal volume (VT) during pressure control ventilation (PCV). A literature search produced no such description whereby unintended VT changes occur with FGF changes during PCV. METHODS: To model an infant's lungs, 1 lung of a mechanical lung model (Dual Adult TTL 1600; Michigan Instruments, Inc, Grand Rapids, MI) was set at a compliance of 0.0068 L/cm H2O. An Rp50 resistor (27.2 cm H2O/L/s at 15 L/min) simulated normal bronchial resistance...
May 2017: Anesthesia and Analgesia
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