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Spontaneous breathing trials

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https://www.readbyqxmd.com/read/29771711/respiratory-muscle-effort-during-expiration-in-successful-and-failed-weaning-from-mechanical-ventilation
#1
Jonne Doorduin, Lisanne H Roesthuis, Diana Jansen, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29742222/to-behavior-of-lung-ultrasound-findings-during-spontaneous-breathing-trial
#2
Jacobo Bacariza Blanco, Antonio M Esquinas
No abstract text is available yet for this article.
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29742210/reply-to-behavior-of-lung-ultrasound-findings-during-spontaneous-breathing-trial
#3
Ana Carolina Peçanha Antonio, Cassiano Teixeira
No abstract text is available yet for this article.
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29740716/increase-in-intra-abdominal-pressure-during-airway-suctioning-induced-cough-after-a-successful-spontaneous-breathing-trial-is-associated-with-extubation-outcome
#4
Yasuhiro Norisue, Jun Kataoka, Yosuke Homma, Takaki Naito, Junpei Tsukuda, Kentaro Okamoto, Takeshi Kawaguchi, Lonny Ashworth, Shimada Yumiko, Yuiko Hoshina, Eiji Hiraoka, Shigeki Fujitani
BACKGROUND: A patient's ability to clear secretions and protect the airway with an effective cough is an important part of the pre-extubation evaluation. An increase in intra-abdominal pressure (IAP) is important in generating the flow rate necessary for a cough. This study investigated whether an increase from baseline in IAP during a coughing episode induced by routine pre-extubation airway suctioning is associated with extubation outcome after a successful spontaneous breathing trial (SBT)...
May 8, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29727028/effects-of-depth-of-neuromuscular-block-on-surgical-conditions-during-laparoscopic-colorectal-surgery-a-randomised-controlled-trial
#5
B W Koo, A Y Oh, H S Na, H J Lee, S B Kang, D W Kim, K S Seo
There have been few objective evaluations of the effects of deep neuromuscular blockade on intra-operative conditions. In this prospective randomised controlled study, we evaluated the effects of deep neuromuscular block on surgical conditions during laparoscopic colorectal surgery. Patients were randomly allocated using a computer-generated randomisation code to either moderate (train-of-four count 1-2 maintained and antagonised with neostigmine) or deep (post-tetanic count 1-2 maintained and reversed with sugammadex) levels of neuromuscular blockade...
May 4, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29713575/an-evaluation-of-complications-in-femoral-arterial-sheaths-maintained-post-neuroangiographic-procedures
#6
Zalan Khan, Premkumar Nattanamai, Premkumar Keerthivaas, Christopher R Newey
BACKGROUND: Digital subtraction angiography (DSA) is a frequently used technique in the neuro-diagnosis and treatment of cerebrovascular diseases. The routine use of femoral arterial sheaths (FAS) peri-procedurally has become standard. The maintenance of a FAS post-procedure may be warranted while awaiting the normalization of coagulopathy or to reaccess emergently. We retrospectively reviewed our stroke dataset to evaluate for complications associated with the prolonged use of FAS post-procedure...
February 26, 2018: Curēus
https://www.readbyqxmd.com/read/29702003/elevated-levels-of-peep-during-spontaneous-breathing-trial-decreases-work-of-breathing-in-an-obese-patient-allowing-extubation-at-high-peep
#7
Maddalena Teggia Droghi, Roberta R De Santis Santiago, Riccardo Pinciroli, Francesco Marrazzo, Edward A Bittner, Marcelo B P Amato, Robert M Kacmarek, Lorenzo Berra
No abstract text is available yet for this article.
April 27, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29687276/diaphragm-function-and-weaning-from-mechanical-ventilation-an-ultrasound-and-phrenic-nerve-stimulation-clinical-study
#8
Martin Dres, Ewan C Goligher, Bruno-Pierre Dubé, Elise Morawiec, Laurence Dangers, Danielle Reuter, Julien Mayaux, Thomas Similowski, Alexandre Demoule
BACKGROUND: Diaphragm dysfunction is defined by a value of twitch tracheal pressure in response to magnetic phrenic stimulation (twitch pressure) amounting to less than 11 cmH2 O. This study assessed whether this threshold or a lower one would predict accurately weaning failure from mechanical ventilation. Twitch pressure was compared to ultrasound measurement of diaphragm function. METHODS: In patients undergoing a first spontaneous breathing trial, diaphragm function was evaluated by twitch pressure and by diaphragm ultrasound (thickening fraction)...
April 23, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29666295/lung-ultrasound-prior-to-spontaneous-breathing-trial-is-not-helpful-in-weaning-the-decision-making-process
#9
Ana Carolina P Antonio, Marli M Knorst, Cassiano Teixeira
BACKGROUND: Lung ultrasound is increasingly becoming a diagnostic tool in the critical care setting. B-pattern on a lung ultrasound is an artifact composed of multiple B-lines and correlates with interstitial edema. A randomized controlled trial concluded that bedside thoracic ultrasound could predict postextubation distress through changes in lung aeration during a weaning procedure; however, it could not screen patients before performance of a spontaneous breathing trial (SBT). METHODS: We conducted a 2-year, prospective, multicenter, observational study in 2 adult medical-surgical ICUs in southern Brazil...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#10
Chuong Ngo, Stephan Dahlmanns, Thomas Vollmer, Berno Misgeld, Steffen Leonhardt
BACKGROUND AND OBJECTIVE: This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS: Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29643948/central-venous-oxygen-saturation-as-a-predictor-of-a-successful-spontaneous-breathing-trial-from-mechanical-ventilation-a-prospective-nested-case-control-study
#11
Ioannis Georgakas, Afroditi K Boutou, Georgia Pitsiou, Ioannis Kioumis, Milly Bitzani, Kristina Matei, Paraskevi Argyropoulou, Ioannis Stanopoulos
Background: Weaning from mechanical ventilation is a key element in the care of critically ill patients, and Spontaneous Breathing Trial (SBT) is a crucial step in this procedure. This nested case-control study aimed to evaluate whether central oxygen saturation (ScvO2 ) values and their changes could independently predict the SBT outcome among mechanically ventilated patients. Methods: A prospective cohort of patients who were mechanically ventilated for at least 48hours and fulfilled the criteria of readiness to wean constituted the study population...
2018: Open Respiratory Medicine Journal
https://www.readbyqxmd.com/read/29578749/positive-end-expiratory-pressure-ventilation-induces-longitudinal-atrophy-in-diaphragm-fibers
#12
Johan Lindqvist, Marloes van den Berg, Robbert van der Pijl, Pleuni E Hooijman, Albertus Beishuizen, Judith Elshof, Monique de Waard, Armand Girbes, Angelique Spoelstra-de Man, Zhong-Hua Shi, Charissa van den Brom, Sylvia Bogaards, Shengyi Shen, Joshua Strom, Henk Granzier, Jeroen Kole, René J P Musters, Marinus A Paul, Leo M A Heunks, Coen A C Ottenheijm
RATIONALE: Diaphragm weakness in critically ill patients prolongs ventilator dependency and duration of hospital stay, and increases mortality and health care costs. The mechanisms underlying diaphragm weakness include cross-sectional fiber atrophy and contractile protein dysfunction, but whether additional mechanisms are at play is unknown. OBJECTIVES: To test the hypothesis that mechanical ventilation with positive end-expiratory pressure (PEEP) induces longitudinal atrophy by displacing the diaphragm in caudal direction and reducing the length of fibers...
March 26, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29559375/contemporary-outcomes-of-ecmo-used-as-bridge-to-lung-transplantation
#13
Ali H Hakim, Usman Ahmad, Kenneth R McCurry, Douglas R Johnston, Gosta B Pettersson, Marie Budev, Sudish Murthy, Eugene H Blackstone, Michael Z Tong
BACKGROUND: Extracorporeal membrane oxygenation (ECMO), when used as bridge to lung transplantation (BTT) identifies high-risk candidates. Recent advances in cannula design and patient selection fosters "awake ambulatory ECMO" as a viable option for critically ill candidates in an attempt to retard deconditioning while awaiting allografts. METHODS: From 2012 to 2015, 30 patients underwent ECMO as BTT. Candidacy for ECMO was determined prior to listing for transplant...
March 17, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29557378/neuroprotective-effect-of-bispectral-index-guided-fast-track-anesthesia-using-sevoflurane-combined-with-dexmedetomidine-for-intracranial-aneurysm-embolization
#14
Chao-Liang Tang, Juan Li, Zhe-Tao Zhang, Bo Zhao, Shu-Dong Wang, Hua-Ming Zhang, Si Shi, Yang Zhang, Zhong-Yuan Xia
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1...
February 2018: Neural Regeneration Research
https://www.readbyqxmd.com/read/29556805/serial-diaphragm-ultrasonography-to-predict-successful-discontinuation-of-mechanical-ventilation
#15
Atul Palkar, Paul Mayo, Karan Singh, Seth Koenig, Mangala Narasimhan, Anup Singh, Rivkah Darabaner, Harly Greenberg, Eric Gottesman
INTRODUCTION: Diaphragm excursion and contraction velocity measured using ultrasonography have been used to assess diaphragm function. We aimed to evaluate the performance of diaphragm ultrasonography during weaning from mechanical ventilation (MV). METHODS: Diaphragm ultrasonography was performed on 73 mechanically ventilated patients who were being considered for extubation on three separate occasions: (1) on assist control mode (A/C) during consistent patient triggered ventilation, (2) following 30 min during a spontaneous breathing trial (SBT), (3) 4-24 h following extubation...
June 2018: Lung
https://www.readbyqxmd.com/read/29539643/benchmarking-of-four-near-infrared-spectroscopy-devices-for-long-time-use-in-neonates
#16
Anna Schneider, Edda Hofstätter, Johannes Brandner, Angelika Moder, Silke Häusler, Martin Wald
BACKGROUND: Using near-infrared spectroscopy (NIRS) mixed tissue saturation can be calculated by measuring the oxygen saturation of oxygenated and deoxygenated erythrocytes in the tissue. Quality of the calculated value is not only dependent on the exposure of the measured values in the calculation, but also on external factors such as artifacts. Main object of this study was to determine whether and how the measurement quality of different devices varies in their long-term use in premature infants...
March 14, 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29521716/interprofessional-care-and-teamwork-in-the-icu
#17
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz, Kathleen Turner, Jayne McCullough, Jennifer Schwarz, Kathleen D Liu, Wendy Anderson, Raman Khanna, Priyanka Agarwal, Heidi Engel, Brian Daniel, Kelly Timothy, Amie Lencioni, Robert Newton, Trese Biagini, Megan Rathfon, Charlotte Garwood, Jenica Cimino, Min Zhu, Michael Blum, Alvin Rajkomar, Chetna Pathak
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29521283/effectiveness-and-safety-of-a-novel-approach-for-management-of-patients-with-potential-difficult-mask-ventilation-and-tracheal-intubation-a-multi-center-randomized-trial
#18
Ji-Ming Wang, Er-Li Ma, Qing-Ping Wu, Ming Tian, Yan-Yan Sun, Jing Lin, Liang Peng, Qiang Xu, Wei Wei, Hong Tan, Cen Yang, Xiao-Qiang Li, Yun-Xia Zuo, Jin Liu
Background: Patients with potential difficult mask ventilation (DV) and difficult intubation (DI) are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation (FDAE). We hypothesized that the FDAE approach would reduce the need for awake intubation. Methods: After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group (Group E) and the control group (Group C)...
March 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29519925/impact-of-sleep-alterations-on-weaning-duration-in-mechanically-ventilated-patients-a-prospective-study
#19
Arnaud W Thille, Faustine Reynaud, Damien Marie, Stéphanie Barrau, Ludivine Rousseau, Christophe Rault, Véronique Diaz, Jean-Claude Meurice, Rémi Coudroy, Jean-Pierre Frat, René Robert, Xavier Drouot
Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration.We conducted a prospective physiological study at a French teaching hospital. ICU patients intubated for at least 24 h and difficult to wean were included. Complete polysomnography (PSG) was performed after the first spontaneous breathing trial failure. Presence of atypical sleep, duration of sleep stages, particularly rapid eye movement (REM) sleep, and electroencephalogram (EEG) reactivity at eyes opening were assessed by a neurologist...
April 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29519808/predictors-of-extubation-readiness-in-preterm-infants-a-systematic-review-and-meta-analysis
#20
Wissam Shalish, Samantha Latremouille, Jesse Papenburg, Guilherme Mendes Sant'Anna
CONTEXT: A variety of extubation readiness tests have already been incorporated into clinical practice in preterm infants. OBJECTIVE: To identify predictor tests of successful extubation and determine their accuracy compared with clinical judgement alone. METHODS: MEDLINE, Embase, PubMed, Cochrane Library and Web of Science were searched between 1984 and June 2016. Studies evaluating predictors of extubation success during a period free of mechanical inflations in infants less than 37 weeks' gestation were included...
March 8, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
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