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Respiratory Mechanical Ventilation

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https://www.readbyqxmd.com/read/28221999/coupling-effect-of-double-lungs-on-a-vcv-ventilator-with-automatic-secretion-clearance-function
#1
Yan Shi, Bolun Zhang, Maolin Cai, Weiqing Xu
For patients with mechanical ventilation, secretions in airway are harmful and sometimes even mortal, it's of great significance to clear secretion timely and efficiently. In this paper, a new secretion clearance method for VCV (volume-controlled ventilation) ventilator is put forward, and a secretion clearance system with a VCV ventilator and double lungs is designed. Furthermore, the mathematical model of the secretion clearance system is built and verified via experimental study. Finally, to illustrate the influence of key parameters of respiratory system and secretion clearance system on the secretion clearance characteristics, coupling effects of two lungs on VCV secretion clearance system are studied by an orthogonal experiment, it can be obtained that rise of tidal volume adds to efficiency of secretion clearance while effect of area, compliance and suction pressure on efficiency of secretion clearance needs further study...
February 16, 2017: IEEE/ACM Transactions on Computational Biology and Bioinformatics
https://www.readbyqxmd.com/read/28221200/pathogenic-link-between-postextubation-pneumonia-and-ventilator-associated-pneumonia-an-experimental-study
#2
Emanuele Rezoagli, Alberto Zanella, Massimo Cressoni, Lorenzo De Marchi, Theodor Kolobow, Lorenzo Berra
BACKGROUND: The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours...
February 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#3
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28219811/stress-echocardiography-in-patients-who-experienced-mechanical-ventilation-weaning-failure
#4
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana Castillo-Rivera, María Dolores Pola-Gallego-de-Guzmán, Antonio Cárdenas-Cruz, Antonio Martínez-Amat, María Sevilla-Martínez, Clara Hernández-Caballero
INTRODUCTION: Critically ill patients may suffer varying degrees of temporary myocardial dysfunction during respiratory weaning that could play an important role in weaning failure. OBJECTIVES: In this study, we tried to assess the existence of temporary diastolic dysfunction during respiratory weaning. METHODS: Inclusion period is from 2006 to 2015. In this study, we included 181 ventilated patients with cardiogenic shock that were being weaned from mechanical ventilation...
January 18, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28219612/hyperoxia-and-hypertonic-saline-in-patients-with-septic-shock-hypers2s-a-two-by-two-factorial-multicentre-randomised-clinical-trial
#5
Pierre Asfar, Frédérique Schortgen, Julie Boisramé-Helms, Julien Charpentier, Emmanuel Guérot, Bruno Megarbane, David Grimaldi, Fabien Grelon, Nadia Anguel, Sigismond Lasocki, Matthieu Henry-Lagarrigue, Frédéric Gonzalez, François Legay, Christophe Guitton, Maleka Schenck, Jean Marc Doise, Jérôme Devaquet, Thierry Van Der Linden, Delphine Chatellier, Jean Philippe Rigaud, Jean Dellamonica, Fabienne Tamion, Ferhat Meziani, Alain Mercat, Didier Dreyfuss, Valérie Seegers, Peter Radermacher
BACKGROUND: There is insufficient research into the use of mechanical ventilation with increased inspiratory oxygen concentration (FiO2) and fluid resuscitation with hypertonic saline solution in patients with septic shock. We tested whether these interventions are associated with reduced mortality. METHODS: This two-by-two factorial, multicentre, randomised, clinical trial (HYPERS2S) recruited patients aged 18 years and older with septic shock who were on mechanical ventilation from 22 centres in France...
February 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28218802/non-invasive-ventilation-for-cystic-fibrosis
#6
REVIEW
Fidelma Moran, Judy M Bradley, Amanda J Piper
BACKGROUND: Non-invasive ventilation may be a means to temporarily reverse or slow the progression of respiratory failure in cystic fibrosis by providing ventilatory support and avoiding tracheal intubation. Using non-invasive ventilation, in the appropriate situation or individuals, can improve lung mechanics through increasing airflow and gas exchange and decreasing the work of breathing. Non-invasive ventilation thus acts as an external respiratory muscle. This is an update of a previously published review...
February 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28218729/exhaled-breath-metabolomics-for-the-diagnosis-of-pneumonia-in-intubated-and-mechanically-ventilated-intensive-care-unit-icu-patients
#7
Pouline M P van Oort, Sanne de Bruin, Hans Weda, Hugo H Knobel, Marcus J Schultz, Lieuwe D Bos, On Behalf Of The Mars Consortium
The diagnosis of hospital-acquired pneumonia remains challenging. We hypothesized that analysis of volatile organic compounds (VOCs) in exhaled breath could be used to diagnose pneumonia or the presence of pathogens in the respiratory tract in intubated and mechanically-ventilated intensive care unit patients. In this prospective, single-centre, cross-sectional cohort study breath from mechanically ventilated patients was analysed using gas chromatography-mass spectrometry. Potentially relevant VOCs were selected with a p-value < 0...
February 19, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28217183/affection-of-the-respiratory-muscles-in-combined-complex-i-and-iv-deficiency
#8
Josef Finsterer, Helmut Rauschka, Liane Segal, Gabor G Kovacs, Boris Rolinski
OBJECTIVES: Combined complex I+IV deficiency has rarely been reported to manifest with the involvement of the respiratory muscles. CASE REPORT: A 45y male was admitted for hypercapnia due to muscular respiratory insufficiency. He required intubation and mechanical ventilation. He had a previous history of ophthalmoparesis since age 6y, ptosis since age 23y, and anterocollis since at least age 40y. Muscle biopsy from the right deltoid muscle at age 41y was indicative of mitochondrial myopathy...
2017: Open Neurology Journal
https://www.readbyqxmd.com/read/28217046/effect-of-nebulized-budesonide-on-respiratory-mechanics-and-oxygenation-in-acute-lung-injury-acute-respiratory-distress-syndrome-randomized-controlled-study
#9
Hatem Saber Mohamed, Mona Mohamed Abdel Meguid
BACKGROUND: We tested the hypothesis that nebulized budesonide would improve lung mechanics and oxygenation in patients with early acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS) during protective mechanical ventilation strategy without adversely affecting systemic hemodynamics. METHODS: Patients with ALI/ARDS were included and assigned into two groups; budesonide group (30 cases) in whom 1 mg-2 ml budesonide suspension was nebulized through the endotracheal tube and control group (30 cases) in whom 2 ml saline (placebo) were nebulized instead of budesonide...
January 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28216699/comparison-of-volume-controlled-ventilation-and-pressure-controlled-ventilation-in-patients-undergoing-robot-assisted-pelvic-surgeries-an-open-label-trial
#10
Rishabh Jaju, Pooja Bihani Jaju, Mamta Dubey, Sadik Mohammad, A K Bhargava
BACKGROUND AND AIMS: Although volume controlled ventilation (VCV) has been the traditional mode of ventilation in robotic surgery, recently pressure controlled ventilation (PCV) has been used more frequently. However, evidence on whether PCV is superior to VCV is still lacking. We intended to compare the effects of VCV and PCV on respiratory mechanics and haemodynamic in patients undergoing robotic surgeries in steep Trendelenburg position. METHODS: This prospective, randomized trial was conducted on sixty patients between 20 and 70 years belonging to the American Society of Anesthesiologist Physical Status I-II...
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215425/outcomes-of-lung-transplantation-for-infants-and-children-with-genetic-disorders-of-surfactant-metabolism
#11
Whitney B Eldridge, Qunyuan Zhang, Albert Faro, Stuart C Sweet, Pirooz Eghtesady, Aaron Hamvas, F Sessions Cole, Jennifer A Wambach
OBJECTIVE: To compare outcomes of infants and children who underwent lung transplantation for genetic disorders of surfactant metabolism (SFTPB, SFTPC, ABCA3, and NKX2-1) over 2 epochs (1993-2003 and 2004-2015) at St Louis Children's Hospital. STUDY DESIGN: We retrospectively reviewed clinical characteristics, mortality, and short- and long-term morbidities of infants (transplanted at <1 year; n = 28) and children (transplanted >1 year; n = 16) and compared outcomes by age at transplantation (infants vs children) and by epoch of transplantation...
February 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28215134/drainage-of-pleural-effusion-improves-diaphragmatic-function-in-mechanically-ventilated-patients
#12
Michele Umbrello, Giovanni Mistraletti, Andrea Galimberti, Ilaria R Piva, Ottavia Cozzi, Paolo Formenti
BACKGROUND: Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. OBJECTIVE: To investigate the effect of drainage of unilateral pleural effusion on diaphragmatic function...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28214832/the-burden-of-respiratory-disease-in-very-low-birth-weight-infants-changes-in-perinatal-care-and-outcomes-in-a-decade-in-spain
#13
Fermín García-Muñoz Rodrigo, Antonio Losada Martínez, María Dolores Elorza Fernández, Julio Moreno Hernando, Josep Figueras Aloy, Máximo Vento Torres
BACKGROUND: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease. OBJECTIVES: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). METHODS: This is a retrospective analysis of data prospectively collected of all VLBW infants included in the Spanish SEN1500 network...
February 18, 2017: Neonatology
https://www.readbyqxmd.com/read/28214457/operative-fixation-of-rib-fractures-indications-techniques-and-outcomes
#14
David Galos, Benjamin Taylor, Toni McLaurin
Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28213470/higher-mini-bal-total-protein-concentration-in-early-ards-predicts-faster-resolution-of-lung-injury-measured-by-more-ventilator-free-days
#15
Carolyn M Hendrickson, Jason Abbott, Hanjing Zhuo, Kathleen D Liu, Carolyn S Calfee, Michael A Matthay
The protein concentration of alveolar edema fluid in acute respiratory distress syndrome (ARDS) is dynamic. It reflects alveolar flooding during acute injury as well as fluid and protein clearance over time. We hypothesized that among ARDS patients treated with low tidal volume ventilation, higher concentrations of protein in mini-bronchoalveolar lavage (mBAL) samples would predict slower resolution of lung injury and worse clinical outcomes. Total protein and IgM concentrations in Day 0 mBAL samples from 79 subjects enrolled in the aerosolized albuterol (ALTA) ARDS Network Albuterol trial were measured by colorimetric assay and ELISA respectively...
February 17, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28213294/a-low-cost-simplified-and-scaleable-pneumotachograph-and-face-mask-for-neonatal-mouse-respiratory-measurements
#16
Jenny J Sun, Roshan Nanu, Russell S Ray
INTRODUCTION: Neonatal respiratory disorders are a leading cause of perinatal mortality due to complications resulting from premature births and prenatal exposure to drugs of abuse, but optimal treatments for these symptoms are still unclear due to a variety of confounds and risk factors. Mouse models present an opportunity to study the underlying mechanisms and efficacy of potential treatments of these conditions with controlled variables. However, measuring respiration in newborn mice is difficult and commercial components are expensive and often require modification, creating a barrier and limiting our understanding of the short and long-term effects of birth complications on respiratory function...
February 15, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28213266/noninvasivepositive-pressure-ventilation-vsinvasive-mechanical-ventilation-as-first-line-therapy-for-acute-hypoxemic-respiratory-failure-in-cancer-patients
#17
Nisha K Rathi, Sajid A Haque, Ron Nates, Alyssa Kosturakis, Hao Wang, Wenli Dong, Lei Feng, Rose J Erfe, Christina Guajardo, Laura Withers, Clarence Finch, Kristen J Price, Joseph L Nates
PURPOSE: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure. MATERIAL AND METHODS: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28212451/relationship-between-pre-anesthetic-and-intra-anesthetic-airway-resistance-in-patients-undergoing-general-anesthesia-a-prospective-observational-study
#18
Takamitsu Ikeda, Kanji Uchida, Yasuhiro Yamauchi, Takahide Nagase, Koji Oba, Yoshitsugu Yamada
Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. So far, there have been no attempts to calculate airway resistance using flow-volume curves. Therefore, we performed a prospective, observational study to investigate the relationship between pre-anesthetic and intra-anesthetic airway resistance in patients scheduled for surgery under general anesthesia...
2017: PloS One
https://www.readbyqxmd.com/read/28212163/multiple-organ-dysfunction-in-children-mechanically-ventilated-for-acute-respiratory-failure
#19
Scott L Weiss, Lisa A Asaro, Heidi R Flori, Geoffrey L Allen, David Wypij, Martha A Q Curley
OBJECTIVES: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. DESIGN: Secondary observational analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure cluster-randomized prospective clinical trial conducted between 2009 and 2013...
February 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28210321/telemedicine-in-chronic-obstructive-pulmonary-disease
#20
Nicolino Ambrosino, Guido Vagheggini, Stefano Mazzoleni, Michele Vitacca
: Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. The legal problems associated with telemedicine are still controversial. Economic advantages for healthcare systems, though potentially high, are still poorly investigated. A European Respiratory Society Task Force has defined indications, follow-up, equipment, facilities, legal and economic issues of tele-monitoring of COPD patients including those undergoing home mechanical ventilation...
December 2016: Breathe
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