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Respiratory Mechanical Ventilation

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https://www.readbyqxmd.com/read/29679387/the-pharmacokinetics-and-pharmacodynamics-of-carfentanil-after-recreational-exposure-a-case-report
#1
Uvaraj Uddayasankar, Colin Lee, Curtis Oleschuk, Gregg Eschun, Robert E Ariano
Carfentanil and related fentanyl analogues have been linked to a number of overdose deaths from drug users in several cities across North America. Diagnosis of carfentanil exposure requires a very high index of clinical suspicion, especially because available laboratory narcotic screens do not detect this agent. We describe a 34-year-old male admitted with depressed level of consciousness and in respiratory failure after recreational exposure to a white powder later inferred to contain carfentanil. Urine and whole blood samples were obtained for conventional preliminary drug screen immunoassays for unknown exposures; in addition to utilizing high pressure liquid chromatography tandem mass spectrometry assay for quantification of carfentanil and its metabolite...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29676798/afferent-neural-feedback-overrides-the-modulating-effects-of-arousal-hypercapnia-and-hypoxemia-on-neonatal-cardio-respiratory-control
#2
Kathleen J Lumb, Jennifer M Schneider, Thowfique Ibrahim, Anita Rigaux, Shabih U Hasan
KEY POINTS: Evidence at whole animal, organ-system, and cellular and molecular levels suggests that afferent volume feedback is critical for establishment of adequate ventilation at birth. Due to the irreversible nature of vagal ablation studies to date, it was difficult to quantify the roles of afferent volume input, arousal and changes in blood gas tensions on neonatal respiratory control. During reversible perineural vagal block, profound apneas, and hypoxemia and hypercarbia were observed necessitating termination of perineural blockade...
April 20, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29673563/management-of-laryngeal-cleft-in-mechanically-ventilated-children-with-severe-comorbidities
#3
Rumi Ueha, Takao Goto, Asako Kaneoka, Tomonori Takano, Taku Sato, Yoichiro Hirata, Takaharu Nito, Tatsuya Yamasoba
Laryngeal clefts are rare congenital malformations of the posterior part of the larynx. The severities are correlated with the downward extension of the cleft and can involve numerous clinical symptoms including dysphagia and respiratory distress. As significant comorbidities may be present, individual treatments depend on the child's general condition and type of cleft involved. Herein, we describe two cases of children with laryngeal clefts and severe comorbidities requiring mechanical ventilation. One child with type III laryngeal cleft was successfully managed with the lateral pharyngotomy approach...
April 16, 2018: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29671041/oropharyngeal-and-nasopharyngeal-decontamination-with-chlorhexidine-gluconate-in-lung-cancer-surgery-a-randomized-clinical-trial
#4
Xavier Benoit D'Journo, Pierre-Emmanuel Falcoz, Marco Alifano, Jean-Philippe Le Rochais, Thomas D'Annoville, Gilbert Massard, Jean Francois Regnard, Philippe Icard, Charles Marty-Ane, Delphine Trousse, Christophe Doddoli, Bastien Orsini, Sophie Edouard, Matthieu Million, Nathalie Lesavre, Anderson Loundou, Karine Baumstarck, Florence Peyron, Stephane Honoré, Stéphanie Dizier, Aude Charvet, Marc Leone, Didier Raoult, Laurent Papazian, Pascal Alexandre Thomas
PURPOSE: Respiratory complications are the leading causes of morbidity and mortality after lung cancer surgery. We hypothesized that oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate (CHG) would be an effective method to reduce these complications as reported in cardiac surgery. METHODS: In this multicenter parallel-group randomized double-blind placebo-controlled trial, we enrolled consecutive adults scheduled for anatomical pulmonary resection for lung cancer...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29670537/impact-of-different-tidal-volume-levels-at-low-mechanical-power-on-ventilator-induced-lung-injury-in-rats
#5
Lillian Moraes, Pedro L Silva, Alessandra Thompson, Cintia L Santos, Raquel S Santos, Marcos V S Fernandes, Marcelo M Morales, Vanessa Martins, Vera L Capelozzi, Marcelo G de Abreu, Paolo Pelosi, Patricia R M Rocco
Tidal volume (VT ) has been considered the main determinant of ventilator-induced lung injury (VILI). Recently, experimental studies have suggested that mechanical power transferred from the ventilator to the lungs is the promoter of VILI. We hypothesized that, as long as mechanical power is kept below a safe threshold, high VT should not be injurious. The present study aimed to investigate the impact of different VT levels and respiratory rates (RR) on lung function, diffuse alveolar damage (DAD), alveolar ultrastructure, and expression of genes related to inflammation [interleukin (IL)-6], alveolar stretch (amphiregulin), epithelial [club cell secretory protein (CC)16] and endothelial [intercellular adhesion molecule (ICAM)-1] cell injury, and extracellular matrix damage [syndecan-1, decorin, and metalloproteinase (MMP)-9] in experimental acute respiratory distress syndrome (ARDS) under low-power mechanical ventilation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29667376/tick-paralysis
#6
Karol Borawski, Sławomir Pancewicz, Piotr Czupryna, Joanna Zajkowska, Anna Moniuszko-Malinowska
Tick paralysis is caused by neurotoxins secreted by adult female ticks, primarily in North America and on the east coast of Australia. Sporadic illness is also recorded in Europe and Africa. In the European countries, including Poland, there are 6 species of ticks capable of causing tick paralysis. The disease occurs in people of all ages, but is most commonly diagnosed in children under 8 years of age. Paralysis can take different forms - from rare isolated cranial nerve infections to quadriplegia and respiratory muscles paralysis...
2018: Przegla̧d Epidemiologiczny
https://www.readbyqxmd.com/read/29667359/predicting-responses-to-mechanical-ventilation-for-preterm-infants-with-acute-respiratory-illness-using-artificial-neural-networks
#7
Katharine Brigham, Samir Gupta, John C Brigham
Infants born prematurely are particularly susceptible to respiratory illness due to underdeveloped lungs, which can often result in fatality. Preterm infants in acute stages of respiratory illness typically require mechanical ventilation assistance, and the efficacy of the type of mechanical ventilation and its delivery has been the subject of a number clinical studies. With recent advances in machine learning approaches, particularly deep learning, it may be possible to estimate future responses to mechanical ventilation in real-time, based on ventilation monitoring up to the point of analysis...
April 17, 2018: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29666961/a-novel-sampling-method-to-detect-airborne-influenza-and-other-respiratory-viruses-in-mechanically-ventilated-patients-a-feasibility-study
#8
Alicia B Mitchell, Benjamin Tang, Maryam Shojaei, Lachlan S Barnes, Marek Nalos, Brian G Oliver, Anthony S McLean
BACKGROUND: Respiratory viruses circulate constantly in the ambient air. The risk of opportunistic infection from these viruses can be increased in mechanically ventilated patients. The present study evaluates the feasibility of detecting airborne respiratory viruses in mechanically ventilated patients using a novel sample collection method involving ventilator filters. METHODS: We collected inspiratory and expiratory filters from the ventilator circuits of mechanically ventilated patients in an intensive care unit over a 14-month period...
April 17, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29666098/a-misplaced-peripherally-inserted-central-catheter-presenting-as-contralateral-pleural-effusion
#9
Jogender Kumar, Sudeep K C, Kanya Mukhopadhyay, Somosri Ray
A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. The baby required mechanical ventilation due to worsening of respiratory distress, and chest X-ray, as well as ultrasound conducted 12 hours, postinfusion of TPN revealed right-sided pleural effusion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29660756/use-of-palivizumab-in-germany-report-from-the-german-synagis%C3%A2-registry-2009-2016
#10
Arne Simon, Susanne Gehrmann, Gudrun Wagenpfeil, Stefan Wagenpfeil
BACKGROUND: Following national recommendations, palivizumab is administered in Germany to high-risk infants to prevent hospitalizations related to Respiratory Syncytial Virus infection. METHODS: In this post marketing observational study (German SYNAGIS™ Registry) data on risk factors and the clinical course of children, who received at least one palivizumab injection between 2009-2016 (01 September to June 30) were entered into an internet-based data entry system by the attending physicians after informed consent...
April 16, 2018: Klinische Pädiatrie
https://www.readbyqxmd.com/read/29659626/influence-of-respiratory-mechanics-and-drive-on-genioglossus-movement-under-ultrasound-imaging
#11
Benjamin C H Kwan, Rachel A McBain, Billy L Luu, Jane E Butler, Lynne E Bilston, Simon C Gandevia
METHODS: Twenty healthy subjects (10 males, age 28±5 years [mean ± SD]) lay supine, awake, with the head in a neutral position. Ventilation was monitored with inductance bands. Real-time B-mode ultrasound movies were analysed. We measured genioglossus motion (i) during spontaneous breathing, voluntary targeted breathing (normal tidal volume Vt), and voluntary hyperpnoea (at 1.5Vt and 2 Vt); (ii) during inspiratory flow resistive loading; (iii) with changes in end-expiratory lung volume (EELV)...
2018: PloS One
https://www.readbyqxmd.com/read/29658448/-clinical-features-and-prognosis-of-preterm-infants-with-varying-degrees-of-bronchopulmonary-dysplasia
#12
Wen-Li Li, Fa-Lin Xu, Ming Niu, Meng-Di Liu, Hui-Fang Dong
OBJECTIVE: To study the clinical features and prognosis of preterm infants with varying degrees of bronchopulmonary dysplasia (BPD). METHODS: The clinical data of 144 preterm infants with a gestational age of <32 weeks who were admitted to the neonatal intensive care unit from March 2014 to March 2016 and were diagnosed with BPD were collected. According to the severity of BPD, these preterm infants were divided into mild group with 81 infants and moderate/severe group with 63 infants...
April 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29657373/severe-varicella-pneumonia-in-adults-seven-years-single-center-experience-from-india
#13
Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, R K Soni
Context: Varicella pneumonia is a rare but a serious complication of chickenpox in adults. There is paucity of data on varicella pneumonia from India. Aims: The aim of this study is to describe the clinical manifestations, hospital course, treatment, and outcome of adult patients with severe varicella pneumonia. Settings and Design: This was a retrospective, observational study of patients with severe varicella pneumonia attending a tertiary care teaching hospital...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29656287/respiratory-management-of-extremely-preterm-infants-an-international-survey
#14
Marc Beltempo, Tetsuya Isayama, Máximo Vento, Kei Lui, Satoshi Kusuda, Liisa Lehtonen, Gunnar Sjörs, Stellan Håkansson, Mark Adams, Akihiko Noguchi, Brian Reichman, Brian A Darlow, Naho Morisaki, Dirk Bassler, Simone Pratesi, Shoo K Lee, Abhay Lodha, Neena Modi, Kjell Helenius, Prakesh S Shah
BACKGROUND: There are significant international variations in chronic lung disease rates among very preterm infants yet there is little data on international variations in respiratory strategies. OBJECTIVE: To evaluate practice variations in the respiratory management of extremely preterm infants born at < 29 weeks' gestational age (GA) among 10 neonatal networks participating in the International Network for Evaluating Outcomes (iNeo) of Neonates collaboration...
April 13, 2018: Neonatology
https://www.readbyqxmd.com/read/29652870/surveillance-for-the-identification-of-cases-of-acute-respiratory-infection-by-enterovirus-d68-in-children-in-a-tertiary-level-care-hospital-during-2014-2016
#15
Ana Estela Gamiño-Arroyo, José Luis Sánchez-Huerta, Alicia Elhaín de la Garza-López, Israel Parra-Ortega, Noé Escobar-Escamilla, Edgar Mendieta-Condado, Fabiola Garcés-Ayala, Gisela Barrera-Badillo, José Ernesto Ramírez-González, José Alberto Díaz-Quiñonez, Daniela de la Rosa-Zamboni
Background: The reemergence of enterovirus D68 (EV-D68) infections in the United States was reported from August-October 2014 (691 cases). In Mexico, an outbreak at the National Institute of Respiratory Diseases was reported (24 cases). The results of epidemiological surveillance of Enterovirus sp. (EV) and other respiratory viruses in a national pediatric tertiary care level hospital are presented. Methods: Following the alert issued by the reemergence of EV-D68 in 2014, epidemiological surveillance -which only detected respiratory viruses by PCR in patients with influenza-like illness using nasopharyngeal swabs- expanded to include children with asthma exacerbation or acute respiratory distress...
2018: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#16
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/29644402/-a-case-of-sole-supportive-care-of-severe-neuroparalytic-foodborne-botulism-due-to-homemade-pesto
#17
M Kuratle, R Baldinger, B Lienhardt Nobbe, P Dreessen, B Yuen
In this article, a case of severe foodborne botulism in a 78-year-old man due to homemade pesto is presented. His initial symptoms were gastrointestinal problems. Later he suffered of cranial nerve palsies, muscle weakness of the upper extremities and respiratory failure, so he had to be admitted to the intensive care unit for mechanical ventilation. The botulism was confirmed by serology and culture. Because of spontaneously improving neurological deficits, we decided not to treat with the botulism antitoxin and the patient had complete clinical remission...
April 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29644297/negative-pressure-in-treatment-of-persistent-post-traumatic-subcutaneous-emphysema-with-respiratory-failure-case-report-and-literature-review
#18
Jakov Mihanović, Ivan Bačić, Nina Sulen
Subcutaneous emphysema may aggravate traumatic pneumothorax treatment, especially when mechanical ventilation is required. Expectative management usually suffices, but when respiratory function is impaired surgical treatment might be indicated. Historically relevant methods are blowhole incisions and placement of various drains, often with related wound complications. Since the first report of negative pressure wound therapy for the treatment of severe subcutaneous emphysema in 2009, only few publications on use of commercially available sets were published...
February 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29643635/regional-anesthesia-is-safe-and-effective-for-lower-limb-orthopedic-surgery-in-patient-with-renal-tubular-acidosis-and-hypokalemia
#19
Indira Gurajala, Sapna Annaji Nikhar, Kavitha Jayaram, Ramachandran Gopinath
Renal tubular acidosis (RTA) with hypokalemia may precipitate acute respiratory failure and potentially fatal arrhythmias like ventricular fibrillation. Though there are random reports of respiratory failure needing mechanical ventilation and sudden death in patients with RTA and hypokalemia, the anesthetic management of these patients has not been clearly elucidated. Acidosis and hypokalemia have significant interactions with both general and local anesthetics and alter their effect substantially. Proper preoperative planning and optimization are required for the safe conduct of anesthesia in this subset of patients...
January 2018: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29629989/an-open-loop-physiologic-model-based-decision-support-system-can-provide-appropriate-ventilator-settings
#20
Dan Stieper Karbing, Savino Spadaro, Nilanjan Dey, Riccardo Ragazzi, Elisabetta Marangoni, Francesca Dalla Corte, Federico Moro, David Lodahl, Niklas Schurmann Hansen, Robert Winding, Stephen Edward Rees, Carlo Alberto Volta
OBJECTIVES: To evaluate the physiologic effects of applying advice on mechanical ventilation by an open-loop, physiologic model-based clinical decision support system. DESIGN: Prospective, observational study. SETTING: University and Regional Hospitals' ICUs. PATIENTS: Varied adult ICU population. INTERVENTIONS: Advice were applied if accepted by physicians for a period of up to 4-8 hours. MEASUREMENTS AND MAIN RESULTS: Seventy-two patients were included for data analysis...
April 6, 2018: Critical Care Medicine
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