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Spontaneous breathing trials

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https://www.readbyqxmd.com/read/29146451/effect-of-rate-of-administration-of-propofol-or-alfaxalone-on-induction-dose-requirements-and-occurrence-of-apnea-in-dogs
#1
Sarah E Bigby, Thierry Beths, Sébastien Bauquier, Jennifer E Carter
OBJECTIVE: To evaluate the effect of rate of administration of propofol or alfaxalone on induction dose requirements and incidence of postinduction apnea (PIA) in dogs following premedication with methadone and dexmedetomidine. STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: Thirty-two healthy American Society of Anesthesiologists class I client-owned dogs (seven females, 25 males), aged between 5 and 54 months, weighing between 2...
May 2, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29123562/the-role-of-occupational-and-physiotherapy-in-multi-modal-approach-to-tackling-delirium-in-the-intensive-care
#2
REVIEW
Jenny Rains, Nigel Chee
The presence of delirium within critical care remains a long-standing challenge for patients and clinicians alike. A myriad of pre-disposing and precipitating factors lead to this patient cohort being high risk for developing delirium during their critical care stay. Until now, non-pharmacological management of these patients usually encompasses a 'bundle' of principles to reduce delirium days. These bundles have limited focus on the entire multi-disciplinary team (including occupational therapists and physiotherapists) who could assist with the reduction of delirium...
November 2017: J Intensive Care Soc
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
#3
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/29099420/predictors-of-intubation-in-patients-with-acute-hypoxemic-respiratory-failure-treated-with-a-noninvasive-oxygenation-strategy
#4
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
https://www.readbyqxmd.com/read/29078680/nonintubated-uniportal-vats-pulmonary-anatomical-resections
#5
REVIEW
Carlos Galvez, Jose Navarro-Martinez, Sergio Bolufer, Francisco Lirio, Julio Sesma, Juan Manuel Corcoles
Nonintubated procedures have widely developed during the last years, thus nowadays major anatomical resections are performed in spontaneously breathing patients in some centers. In an attempt for combining less invasive surgical approaches with less aggressive anesthesia, nonintubated uniportal video-assisted thoracic surgery (VATS) lobectomies and segmentectomies have been proved feasible and safe, but there are no comparative trials and the evidence is still poor. A program in nonintubated uniportal major surgery should be started in highly experienced units, overcoming first a learning period performing minor procedures and a training program for the management of potential crisis situations when operating on these patients...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29072676/comparison-of-sprinting-vs-non-sprinting-to-wean-nasal-continuous-positive-airway-pressure-off-in-very-preterm-infants
#6
N Eze, D Murphy, V Dhar, V K Rehan
OBJECTIVE: Though nasal continuous positive airway pressure (NCPAP) is commonly used for non-invasive neonatal respiratory support, the optimal method of weaning NCPAP is not established. In this prospective, two-center randomized control trial we hypothesize that gradually increasing spontaneous breathing time off NCPAP increases successful weaning from NCPAP in infants born <31 weeks gestational age. STUDY DESIGN: Infants were randomized to one of the two NCPAP weaning protocols, a sprinting, that is, gradually increasing spontaneous breathing time off CPAP, protocol vs a non-sprinting (weaning pressure down) protocol...
October 26, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29042870/update-of-minimally-invasive-surfactant-therapy
#7
REVIEW
Gyu-Hong Shim
To date, preterm infants with respiratory distress syndrome (RDS) after birth have been managed with a combination of endotracheal intubation, surfactant instillation, and mechanical ventilation. It is now recognized that noninvasive ventilation (NIV) such as nasal continuous positive airway pressure (CPAP) in preterm infants is a reasonable alternative to elective intubation after birth. Recently, a meta-analysis of large controlled trials comparing conventional methods and nasal CPAP suggested that CPAP decreased the risk of the combined outcome of bronchopulmonary dysplasia or death...
September 2017: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/29037544/effects-of-pushing-techniques-during-the-second-stage-of-labor-a%C3%A2-randomized-controlled-trial
#8
Refika Genç Koyucu, Nurdan Demirci
OBJECTIVE: Spontaneous pushing is a method that is used in the management of the second stage of labor and suggested to be more physiological for the mother and infant. The present study aims to evaluate the effects of pushing techniques on the mother and newborn. MATERIALS AND METHODS: This randomized prospective study was performed between June 2013-March 2014 in a tertiary maternity clinic in Istanbul. 80 low risk, nulliparous cases were randomized to pushing groups...
October 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29035950/nurse-initiated-protocols-for-spontaneous-breathing-trials-in-adult-intensive-care-unit-patients-a-scoping-review-protocol
#9
Elizabeth Starnes, Michelle Palokas
The objectives of this scoping review are to explore the existing literature regarding protocols initated by nurses for a spontaneous breathing trial (SBT) in adult intensive care unit (ICU) patients, to examine and conceptually map the evidence, and to identify any gaps in the literature.The questions of this review are.
October 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29020995/sedation-with-propofol-during-ercp-is-the-combination-with-esketamine-more-effective-and-safer-than-with-alfentanil-study-protocol-for-a-randomized-controlled-trial
#10
Susanne Eberl, Lena Koers, Jeanin E van Hooft, Edwin de Jong, Thomas Schneider, Markus W Hollmann, Benedikt Preckel
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur. Esketamine has hypnotic, analgesic, and sympathomimetic effects. Our assumption is that a combination of propofol with esketamine reduces the dosage of individual drugs, thereby minimizing sedation side effects while keeping the same satisfaction level of patients and endoscopists...
October 11, 2017: Trials
https://www.readbyqxmd.com/read/29018041/spontaneous-breathing-trials-and-conservative-sedation-practices-reduce-mechanical-ventilation-duration-in-subjects-with-ards
#11
Richard H Kallet, Hanjing Zhuo, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: Spontaneous breathing trials (SBTs) and daily sedation interruptions (DSIs) reduce both the duration of mechanical ventilation and ICU length of stay (LOS). The impact of these practices in patients with ARDS has not previously been reported. We examined whether implementation of SBT/DSI protocols reduce duration of mechanical ventilation and ICU LOS in a retrospective group of subjects with ARDS at a large, urban, level-1 trauma center. METHODS: All ARDS survivors from 2002 to 2016 (N = 1,053) were partitioned into 2 groups: 397 in the pre-SBT/DSI group (June 2002-December 2007) and 656 in the post-SBT/DSI group (January 2009-April 2016)...
October 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28986852/effect-of-inspiratory-synchronization-during-pressure-controlled-ventilation-on-lung-distension-and-inspiratory-effort
#12
Nuttapol Rittayamai, François Beloncle, Ewan C Goligher, Lu Chen, Jordi Mancebo, Jean-Christophe M Richard, Laurent Brochard
BACKGROUND: In pressure-controlled (PC) ventilation, tidal volume (V T) and transpulmonary pressure (P L ) result from the addition of ventilator pressure and the patient's inspiratory effort. PC modes can be classified into fully, partially, and non-synchronized modes, and the degree of synchronization may result in different V T and P L despite identical ventilator settings. This study assessed the effects of three PC modes on V T, P L , inspiratory effort (esophageal pressure-time product, PTPes), and airway occlusion pressure, P 0...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28978488/icu-team-composition-and-its-association-with-abcde-implementation-in-a-quality-collaborative
#13
Deena Kelly Costa, Thomas S Valley, Melissa A Miller, Milisa Manojlovich, Sam R Watson, Phyllis McLellan, Corine Pope, Robert C Hyzy, Theodore J Iwashyna
PURPOSE: Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. MATERIALS & METHODS: We administered a survey at MHA Keystone Center ICU 2015 workshop. We measured team composition by the frequency of nurse, respiratory therapist, physician, physical therapist, nurse practitioner/physician assistant or nursing assistant involvement in 1) spontaneous awakening trials (SATs), 2) spontaneous breathing trials, 3) delirium and 4) early mobility...
September 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28969859/effects-of-acute-use-of-pursed-lips-breathing-during-exercise-in-patients-with-copd-a-systematic-review-and-meta-analysis
#14
REVIEW
Anamaria Fleig Mayer, Manuela Karloh, Karoliny Dos Santos, Cintia Laura Pereira de Araujo, Aline Almeida Gulart
BACKGROUND: Pursed-lips breathing (PLB) is a ventilatory strategy frequently adopted spontaneously by patients with chronic obstructive pulmonary disease (COPD) to relieve dyspnoea, and its practice is widely taught as a respiratory strategy to increase exercise tolerance. OBJECTIVE: To investigate the effects of acute use of PLB in exercise performance, dyspnoea, ventilatory parameters and oxygen saturation during exercise in patients with COPD. DATA SOURCES: PEDro, EMBASE, MEDLINE via OVID, and EBSCO up to May 2016...
August 31, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28948503/extubating-the-neurocritical-care-patient-a-spontaneous-breathing-trial-algorithmic-approach
#15
Naresh Mullaguri, Zalan Khan, Premkumar Nattanmai, Christopher R Newey
BACKGROUND: Delaying extubation in neurologically impaired patients otherwise ready for extubation is a source for significant morbidity, mortality, and costs. There is no consensus to suggest one spontaneous breathing trial (SBT) over another in predicting extubation success. We studied an algorithm using zero pressure support and zero positive end-expiratory pressure (ZEEP) SBT followed by 5-cm H2O pressure support and 5-cm H2O positive end-expiratory pressure (i.e., 5/5) SBT in those who failed ZEEP SBT...
May 25, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28936952/-application-of-injection-test-in-confirming-the-ideal-position-of-esophageal-balloon-catheter
#16
Han Chen, Ming Xu, Yanlin Yang, Xuan He, Jianxin Zhou
OBJECTIVE: To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter. METHODS: A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936675/reconnection-to-mechanical-ventilation-for-1%C3%A2-h-after-a-successful-spontaneous-breathing-trial-reduces-reintubation-in-critically-ill-patients-a-multicenter-randomized-controlled-trial
#17
M Mar Fernandez, Alejandro González-Castro, Monica Magret, M Teresa Bouza, Marcos Ibañez, Carolina García, Begoña Balerdi, Arantxa Mas, Vanesa Arauzo, José M Añón, Francisco Ruiz, José Ferreres, Roser Tomás, Marta Alabert, Ana Isabel Tizón, Susana Altaba, Noemi Llamas, Rafael Fernandez
BACKGROUND: Spontaneous breathing trials (SBT) can be exhausting, but the preventive role of rest has never been studied. This study aimed to evaluate whether reconnection to mechanical ventilation (MV) for 1 h after the effort of a successful SBT could reduce the need for reintubation in critically ill patients. METHODS: Randomized multicenter trial conducted in 17 Spanish medical-surgical intensive care units (Oct 2013-Jan 2015). Patients under MV for longer than 12 h who fulfilled criteria for planned extubation were randomly allocated after a successful SBT to direct extubation (control group) or reconnection to the ventilator for a 1-h rest before extubation (rest group)...
November 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28927811/postinduction-apnoea-in-dogs-premedicated-with-acepromazine-or-dexmedetomidine-and-anaesthetized-with-alfaxalone-or-propofol
#18
Sarah E Bigby, Thierry Beths, Sébastien Bauquier, Jennifer E Carter
OBJECTIVE: To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg...
March 2, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28924023/implementing-spontaneous-breathing-trials-but-a-piece-of-the-puzzle
#19
EDITORIAL
Silvia M Hartmann, Robert M DiBlasi
No abstract text is available yet for this article.
October 2017: Respiratory Care
https://www.readbyqxmd.com/read/28912163/neonatal-resuscitation-using-a-laryngeal-mask-airway-a-randomised-trial-in-uganda
#20
Nicolas J Pejovic, Daniele Trevisanuto, Clare Lubulwa, Susanna Myrnerts Höök, Francesco Cavallin, Josaphat Byamugisha, Jolly Nankunda, Thorkild Tylleskär
OBJECTIVE: Mortality rates from birth asphyxia in low-income countries remain high. Face mask ventilation (FMV) performed by midwives is the usual method of resuscitating neonates in such settings but may not always be effective. The i-gel is a cuffless laryngeal mask airway (LMA) that could enhance neonatal resuscitation performance. We aimed to compare LMA and face mask (FM) during neonatal resuscitation in a low-resource setting. SETTING: Mulago National Referral Hospital, Kampala, Uganda...
September 14, 2017: Archives of Disease in Childhood
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