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Respiratory Mechanical Ventilation

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https://www.readbyqxmd.com/read/28820175/noninvasive-mechanical-ventilation-in-early-acute-respiratory-distress-syndrome
#1
Alice Grassi, Giuseppe Foti, John G Laffey, Giacomo Bellani
Non invasive ventilation (NIV) has a well established role in the treatment of acute-on-chronic respiratory failure and cardiogenic pulmonary oedema. Its role in acute hypoxaemic respiratory failure has been increasingly investigated, but its impact on the management and the outcome of the subset of patients affected by acute respiratory distress syndrome (ARDS) is still to be determined. ARDS could be a risk factor for NIV failure and in these patient delayed endotracheal intubation can lead to an increased mortality...
August 17, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28819793/the-mechanisms-underlying-the-production-of-discontinuous-gas-exchange-cycles-in-insects
#2
REVIEW
Philip G D Matthews
This review examines the control of gas exchange in insects, specifically examining what mechanisms could explain the emergence of discontinuous gas exchange cycles (DGCs). DGCs are gas exchange patterns consisting of alternating breath-hold periods and bouts of gas exchange. While all insects are capable of displaying a continuous pattern of gas exchange, this episodic pattern is known to occur within only some groups of insects and then only sporadically or during certain phases of their life cycle. Investigations into DGCs have tended to emphasise the role of chemosensory thresholds in triggering spiracle opening as critical for producing these gas exchange patterns...
August 17, 2017: Journal of Comparative Physiology. B, Biochemical, Systemic, and Environmental Physiology
https://www.readbyqxmd.com/read/28818610/surfactant-and-continuous-positive-airway-pressure-for-the-prevention-of-chronic-lung-disease-history-reality-and-new-challenges
#3
REVIEW
Hany Aly, Mohamed A Mohamed, Jen-Tien Wung
The discovery of surfactant was one of the most significant research events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered non-viable. However, the prevention of chronic lung disease did not progress and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. A dilemma exists over the priorities in premature management to intubate and administer surfactant or not to intubate and support these infants non-invasively with the use of continuous positive airway pressure...
August 14, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28818484/the-physiology-of-submaximal-exercise-the-steady-state-concept
#4
REVIEW
Guido Ferretti, Nazzareno Fagoni, Anna Taboni, Paolo Bruseghini, Giovanni Vinetti
The steady state concept implies that the oxygen flow is invariant and equal at each level along the respiratory system. The same is the case with the carbon dioxide flow. This condition has several physiological consequences, which are analysed. First, we briefly discuss the mechanical efficiency of exercise and the energy cost of human locomotion, as well as the roles played by aerodynamic work and frictional work. Then we analyse the equations describing the oxygen flow in lungs and in blood, the effects of ventilation and of the ventilation - perfusion inequality, and the interaction between diffusion and perfusion in the lungs...
August 14, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28815665/pharmacological-modulation-of-c-x-c-motif-chemokine-receptor-4-influences-development-of-acute-respiratory-distress-syndrome-after-lung-ischemia-reperfusion-injury
#5
Sean P Nassoiy, Favin S Babu, Heather M LaPorte, Matthias Majetschak
Activation of CXC motif chemokine receptor 4 (CXCR4) has been reported to result in lung protective effects in various experimental models. The effects of pharmacological CXCR4 modulation on the development of acute respiratory distress syndrome (ARDS) after lung injury, however, are unknown. Thus, we studied whether blockade and activation of CXCR4 influences development of ARDS in a unilateral lung ischemia-reperfusion injury rat model. Anesthetized, mechanically ventilated animals underwent right lung ischemia (series 1: 30 min; series 2: 60 min) followed by reperfusion for 300 min...
August 16, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28814848/pathophysiological-mechanism-of-long-term-noninvasive-ventilation-in-stable-hypercapnic-patients-with-copd-using-functional-respiratory-imaging
#6
Bita Hajian, Jan De Backer, Claire Sneyers, Francisca Ferreira, Katherine C Barboza, Glenn Leemans, Wim Vos, Wilfried De Backer
INTRODUCTION: Patients with severe COPD often develop chronic hypercapnic respiratory failure. Their prognosis worsens and they are more likely to develop exacerbations. This has major influence on the health-related quality of life. Currently, there is no information about the success of long-term noninvasive ventilation (NIV) among patients who receive NIV in acute settings. Also, little is known about the pathophysiological mechanism of NIV. METHODS: Ten Global Initiative for Obstructive Lung Disease stage III and IV COPD patients with respiratory failure who were hospitalized following acute exacerbation were treated with NIV using a Synchrony BiPAP device for 6 months...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28814632/intermittent-apnea-elicits-inactivity-induced-phrenic-motor-facilitation-via-a-retinoic-acid-and-protein-synthesis-dependent-pathway
#7
Nathan A Baertsch, Tracy L Baker
Respiratory motoneuron pools must provide rhythmic inspiratory drive that is robust and reliable, yet dynamic enough to respond to respiratory challenges. One form of plasticity that is hypothesized to contribute to motor output stability by sensing and responding to inadequate respiratory neural activity is inactivity-induced phrenic motor facilitation (iPMF), an increase in inspiratory output triggered by a reduction in phrenic synaptic inputs. Evidence suggests that mechanisms giving rise to iPMF differ depending on the pattern of reduced respiratory neural activity (i...
August 16, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28813446/variable-stretch-reduces-the-pro-inflammatory-response-of-alveolar-epithelial-cells
#8
Ines Rentzsch, Cíntia L Santos, Robert Huhle, Jorge M C Ferreira, Thea Koch, Christian Schnabel, Edmund Koch, Paolo Pelosi, Patricia R M Rocco, Marcelo Gama de Abreu
Mechanical ventilation has the potential to increase inflammation in both healthy and injured lungs. Several animal studies have shown that variable ventilation recruits the lungs and reduces inflammation. However, it is unclear which cellular mechanisms are involved in those findings. We hypothesized that variable stretch of LPS-stimulated alveolar epithelial cells (AECs) reduces the production of pro-inflammatory cytokines compared to non-variable stretch. AECs were subjected to non-variable or variable cyclic stretch (sinusoidal pattern), with and without LPS stimulation...
2017: PloS One
https://www.readbyqxmd.com/read/28811944/successful-resuscitation-of-a-patient-with-life-threatening-metabolic-acidosis-by-hemodialysis-a-case-of-ethylene-glycol-intoxication
#9
Ikuyo Narita, Michiko Shimada, Norio Nakamura, Reiichi Murakami, Takeshi Fujita, Wakako Fukuda, Hirofumi Tomita
BACKGROUND: Ethylene glycol intoxication causes severe metabolic acidosis and acute kidney injury. Fomepizole has become available as its antidote. Nevertheless, a prompt diagnosis is not easy because patients are often unconscious. Here we present a case of ethylene glycol intoxication who successfully recovered with prompt hemodialysis. CASE PRESENTATION: A 52-year-old Japanese male was admitted to a local hospital due to suspected food poisoning. The patient presented with nausea and vomiting, but his condition rapidly deteriorated, with worsening conscious level, respiratory distress requiring mechanical ventilation, hypotension, and severe acute kidney injury...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28811766/prognostic-factors-determining-morbidity-and-mortality-in-organophosphate-poisoning
#10
Ayca Acikalin, Nezihat Rana Dişel, Selcuk Matyar, Ahmet Sebe, Zeynep Kekec, Yuksel Gokel, Emre Karakoc
OBJECTIVE: Our aim in this retrospective study was to determine the factors affecting poor prognosis and mortality of organophosphate (OP) poisoning by reviewing patient data. We also reviewed present knowledge to make conclusions on certain longstanding debates in light of the literature. METHODS: In this retrospective descriptive study, patients who were admitted to and hospitalized in the emergency department (ED) or intensive care unit (ICU) of a university hospital with the diagnosis of OP poisoning between December 2010 and December 2015 were evaluated...
May 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28810277/-concepts-to-optimize-home-care-of-patients-with-mechanical-ventilation
#11
Miranda Nafe, Kristian Herberger, Barbara Wiesner, Christian Grohé
The care of patients with extraclinical mechanical ventilation has to be improved particularly with regard to their specialist care. One care option is the empowering of clinicians at the respiratory centers to enable ambulant care of patients and home visits. An intersectoral linkage in the form of transfer management is the basis for competent coordination. Aim is to ensure the necessary multidisciplinary collaboration in the outpatient care of multimorbid chronically ill patients. For the optimal care of chronically ill patients, sectoral limits should become more permeable...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810276/-home-mechanical-ventilation-concepts-and-therapy-recommendations
#12
Sarah Bettina Schwarz, Friederike Sophie Magnet, Bernd Schönhofer, Wolfram Windisch
The prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28808861/epidemiology-of-sleep-disordered-breathing-and-heart-failure-what-drives-what
#13
REVIEW
Sushma M Dharia, Lee K Brown
PURPOSE OF REVIEW: The bidirectional relationships that have been demonstrated between heart failure (HF) and central sleep apnea (CSA) demand further exploration with respect to the implications that each condition has for the other. This review discusses the body of literature that has accumulated on these relationships and how CSA and its potential treatment may affect outcomes in patients with CSA. RECENT FINDINGS: Obstructive sleep apnea (OSA) can exacerbate hypertension, type 2 diabetes, obesity, and atherosclerosis, which are known predicates of HF...
August 14, 2017: Current Heart Failure Reports
https://www.readbyqxmd.com/read/28808222/perioperative-remote-acute-lung-injury-recent-update
#14
Zhaosheng Jin, Ka Chun Suen, Daqing Ma
Perioperative acute lung injury (ALI) is a syndrome characterised by hypoxia and chest radiograph changes. It is a serious post-operative complication, associated with considerable mortality and morbidity. In addition to mechanical ventilation, remote organ insult could also trigger systemic responses which induce ALI. Currently, there are limited treatment options available beyond conservative respiratory support. However, increasing understanding of the pathophysiology of ALI and the biochemical pathways involved will aid the development of novel treatments and help to improve patient outcome as well as to reduce cost to the health service...
January 19, 2017: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28807576/evaluation-of-three-tidal-volumes-10-12-and-15%C3%A2-ml%C3%A2-kg-1-in-dogs-for-controlled-mechanical-ventilation-assessed-by-volumetric-capnography-a-randomized-clinical-trial
#15
Seline Bumbacher, Johannes P Schramel, Martina Mosing
OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg(-1)) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg(-1). After induction CMV was started...
May 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28806218/hypoxemic-patients-with-bilateral-infiltrates-treated-with-high-flow-nasal-cannula-present-a-similar-pattern-of-biomarkers-of-inflammation-and-injury-to-acute-respiratory-distress-syndrome-patients
#16
Marina García-de-Acilu, Judith Marin-Corral, Antonia Vázquez, Laura Ruano, Mònica Magret, Ricard Ferrer, Joan R Masclans, Oriol Roca
OBJECTIVE: To examine whether patients with acute hypoxemia and bilateral opacities treated with high-flow nasal cannula and acute respiratory distress syndrome patients who were directly mechanically ventilated are similar in terms of lung epithelial, endothelial, and inflammatory biomarkers. DESIGN: Prospective, multicenter study. SETTING: ICUs at three university tertiary hospitals. PATIENTS: Intubated and nonintubated patients admitted to the ICU with acute hypoxemia (PaO2/FIO2 ≤ 300) and bilateral opacities...
August 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28805782/-blunt-chest-trauma-possibilities-to-stabilize-multiple-and-floating-ribs-fractures
#17
A S Benyan
AIM: To improve surgical treatment of patients with multiple and flotating ribs fractures. MATERIAL AND METHODS: A comparative analysis of two groups of victims with rib fractures was carried out. 148 patients of the control group underwent conservative treatment, mechanical ventilation, skeletal traction. In 167 patients of the main group we used advanced surgical tactics based on differentiated, stepwise and combined chest stabilization including osteosynthesis of ribs and thoracoscopy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28804862/oncological-patients-in-the-intensive-care-unit-prognosis-decision-making-therapies-and-end-of-life-care
#18
Ewelina Biskup, Fengfeng Cai, Marcus Vetter, Stephan Marsch
The effectiveness of intensive care unit (ICU) care for cancer patients remains controversial. Advances in antitumour and supportive care led to major improvements in outcomes of oncological patients in the ICU. Improved cancer therapies and supportive management of organ dysfunctions have contributed to improved survival rates. As a consequence, the number of cancer patients requiring ICU admission is rising. Frequently, cancer patients have a poor performance status and are vulnerable. It is a heterogeneous population, where the nature and curability of the neoplasm and the severity of critical illness cause a plethora of issues about ICU admissions...
August 14, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28803440/electrical-impedance-tomography-for-diagnosis-and-monitoring-of-pulmonary-function-disorders-in-the-intensive-care-unit-case-report-and-review-of-literature
#19
Szymon Białka, Maja Copik, Katarzyna Rybczyk, Hanna Misiołek
The aim of this paper is to describe the possibility of using Electrical Impedance Tomography (EIT) as a treatment monitoring tool in the ICU. It was based on case report and literature review. A 19-year-old female was admitted to ICU due to severe acute respiratory distress syndrome. Despite aggressive treatment there was no improvement. We decided to use EIT in the monitoring of treatment because of difficulties in transporting the patient to the radiology department in order to perform a control CT scan...
2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28800439/a-simplified-parametrised-model-for-lung-microstructures-capable-of-mimicking-realistic-geometrical-and-mechanical-properties
#20
Christian J Roth, Lena Yoshihara, Wolfgang A Wall
The respiratory zone of mammalian lungs contains several millions of so-called alveoli. The geometrical and mechanical properties of this microstructure are crucial for respiration and influence the macroscopic behaviour of the entire organ in health and disease. Hence, if computational models are sought to gain more insight into lung behaviour, predict lung states in certain scenarios or suggest better treatment options in early stages of respiratory dysfunction, an adequate representation of this microstructure is essential...
August 1, 2017: Computers in Biology and Medicine
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