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High frequency oscillatory ventilation

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https://www.readbyqxmd.com/read/29217332/revisiting-high-frequency-oscillatory-ventilation-in-vitro-and-in-silico-in-neonatal-conductive-airways
#1
REVIEW
Katrin Bauer, Eliram Nof, Josué Sznitman
BACKGROUND: High frequency oscillatory ventilation is often used for lung support in premature neonates suffering from respiratory distress syndrome. Despite its broad use in neonatal intensive care units, there are to date no accepted protocols for the choice of appropriate ventilation parameter settings. In this context, the underlying mass transport mechanisms are still not fully understood. METHODS: We revisit the question of flow phenomena under conventional mechanical ventilation and high frequency oscillatory ventilation in an anatomically-inspired model of neonatal conductive airways spanning the first few airway generations...
November 28, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/29214783/effective-tidal-volume-for-normocapnia-in-very-low-birth-weight-infants-using-high-frequency-oscillatory-ventilation
#2
Seul Mi Lee, Ran Namgung, Ho Sun Eun, Soon Min Lee, Min Soo Park, Kook In Park
PURPOSE: Removal of CO₂ is much efficient during high-frequency oscillatory ventilation (HFOV) for preterm infants. However, an optimal carbon dioxide diffusion coefficient (DCO₂) and tidal volume (VT) have not yet been established due to much individual variance. This study aimed to analyze DCO₂ values, VT, and minute volume in very-low-birth-weight (VLBW) infants using HFOV and correlates with plasma CO₂ (pCO₂). MATERIALS AND METHODS: Daily respiratory mechanics and ventilator settings from twenty VLBW infants and their two hundred seventeen results of blood gas analysis were collected...
January 2018: Yonsei Medical Journal
https://www.readbyqxmd.com/read/29192891/comparison-of-different-functional-eit-approaches-to-quantify-tidal-ventilation-distribution
#3
Zhanqi Zhao, Po-Jen Yun, Yen-Liang Kuo, Feng Fu, Meng Dai, Inez Frerichs, Knut Moeller
The aim of the study was to examine the pros and cons of different types of functional EIT (fEIT) to quantify tidal ventilation distribution in a clinical setting. Approach: fEIT images were calculated with (1) standard deviation of pixel time curve, (2) regression coefficients of global and local impedance time curves, or (3) mean tidal variations. To characterize temporal heterogeneity of tidal ventilation distribution, another fEIT image of pixel inspiration times is also proposed. Main results: fEIT - regression is very robust to signals with different phase information...
December 1, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/29099443/association-of-response-to-inhaled-nitric-oxide-and-duration-of-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#4
Jasmine C Dowell, Neal J Thomas, Nadir Yehya
OBJECTIVES: Literature regarding appropriate use of inhaled nitric oxide for pediatric acute respiratory distress syndrome is sparse. This study aims to determine if positive response to inhaled nitric oxide is associated with decreased mortality and duration of mechanical ventilation in pediatric acute respiratory distress syndrome. DESIGN: Retrospective cohort study. SETTING: Large pediatric academic medical center. PATIENTS OR SUBJECTS: One hundred sixty-one children with pediatric acute respiratory distress syndrome and inhaled nitric oxide exposure for greater than or equal to 1 hour within 3 days of pediatric acute respiratory distress syndrome onset...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29090947/might-high-frequency-oscillatory-ventilation-improve-prognosis-of-more-severe-acute-respiratory-distress-syndrome-not-so-sure
#5
Didier Dreyfuss, Stéphane Gaudry
No abstract text is available yet for this article.
November 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29090945/reply-to-might-high-frequency-oscillatory-ventilation-improve-prognosis-of-more-severe-acute-respiratory-distress-syndrome-not-so-sure
#6
Maureen O Meade, Duncan Young, Niall D Ferguson
No abstract text is available yet for this article.
November 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#7
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29064166/non-invasive-high-frequency-oscillatory-ventilation-for-preterm-newborns-the-time-has-come-for-consideration
#8
EDITORIAL
Jean-Paul Praud, Étienne Fortin-Pellerin
No abstract text is available yet for this article.
December 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29051332/parenchymal-strain-heterogeneity-during-oscillatory-ventilation-why-two-frequencies-are-better-than-one
#9
Jacob Herrmann, Merryn H Tawhai, David W Kaczka
High frequency oscillatory ventilation (HFOV) relies on low tidal volumes cycled at supraphysiologic rates, producing fundamentally different mechanisms for gas transport and exchange compared with conventional mechanical ventilation. Despite the appeal of using low tidal volumes to mitigate the risks of ventilator-induced lung injury (VILI), HFOV has not improved mortality for most clinical indications. This may be due to non-uniform and frequency-dependent distribution of flow throughout the lung. The goal of this study was to compare parenchymal strain heterogeneity during eucapnic HFOV when using oscillatory waveforms that consisted of either a single discrete frequency or two simultaneous frequencies...
October 19, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29043832/high-frequency-oscillation-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#10
Ewan Goligher, Laveena Munshi, Neill Kj Adhikari, Maureen O Meade, Carol Hodgson, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: By minimizing tidal lung strain and maintaining alveolar recruitment, high frequency oscillatory ventilation (HFOV) may protect against ventilator-induced lung injury. OBJECTIVES: To summarize the current evidence in support of the use of HFOV in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mortality rates with the use of HFOV vs. conventional mechanical ventilation for adult patients with acute respiratory distress syndrome...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#11
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28930815/variability-in-usual-care-mechanical-ventilation-for-pediatric-acute-respiratory-distress-syndrome-time-for-a-decision-support-protocol
#12
Christopher J L Newth, Katherine A Sward, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Richard Holubkov, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28926488/potential-acceptability-of-a-pediatric-ventilator-management-computer-protocol
#13
Katherine A Sward, Christopher J L Newth, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Allan Doctor, J Michael Dean, Richard Holobkov, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome. DESIGN: Survey/questionnaire. SETTING: The eight PICUs in the Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: One hundred twenty-two physicians (attendings and fellows). INTERVENTIONS: None...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28918395/non-invasive-high-frequency-oscillatory-ventilation-in-preterm-infants-a-randomised-controlled-cross-over-trial
#14
Daniel Klotz, Hendryk Schneider, Stefan Schumann, Benjamin Mayer, Hans Fuchs
OBJECTIVE: Non-invasive high-frequency oscillatory ventilation (nHFOV) has recently been described as a novel mode of respiratory support for premature infants. This study was designed to determine whether nHFOV decreases CO2 partial pressure (pCO2) in premature infants more effectively than non-invasive continuous positive airway pressure (nCPAP). DESIGN: Non-blinded prospective randomised controlled cross-over study. SETTING: University Medical Center tertiary neonatal intensive care unit...
September 16, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28910146/management-of-ards-and-refractory-hypoxemia-a-multicenter-observational-study
#15
Erick H Duan, Neill Kj Adhikari, Frederick D'Aragon, Deborah J Cook, Sangeeta Mehta, Waleed Alhazzani, Ewan Goligher, Emmanuel Charbonney, Yaseen M Arabi, Tim Karachi, Alexis F Turgeon, Lori Hand, Qi Zhou, Peggy Austin, Jan Friedrich, Francois Lamontagne, François Lauzier, Rakesh Patel, John Muscedere, Richard Hall, Pierre Aslanian, Thomas Piraino, Martin Albert, Sean M Bagshaw, Mike Jacka, Gordon Wood, William Henderson, Delbert Dorscheid, Niall D Ferguson, Maureen O Meade
RATIONALE: Clinicians' current practice patterns in the management of acute respiratory distress syndrome (ARDS) and refractory hypoxemia are not well described. OBJECTIVES: To describe mechanical ventilation strategies and treatment adjuncts for adults with ARDS including refractory hypoxemia. METHODS: Prospective cohort study (March 2014-February 2015) of mechanically ventilated adults with moderate-to-severe ARDS requiring FiO2 ≥0.50 in 24 ICUs...
September 14, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28882178/differential-lung-ventilation-via-tracheostomy-using-two-endotracheal-tubes-in-an-infant-a-case-report
#16
Demet Demirkol, Yasemin Ataman, Gökhan Gündoğdu
BACKGROUND: This case report presents differential lung ventilation in an infant. The aim is to define an alternative technique for performing differential lung ventilation in children. To the best of our knowledge, this is the first report of this kind. CASE PRESENTATION: A 4.2-kg, 2.5-month-old Asian boy was referred to our facility with refractory hypoxemia and hypercarbia due to asymmetric lung disease with atelectasis of the left lung and hyperinflation of the right lung...
September 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28881101/nasal-high-frequency-oscillatory-ventilation-impairs-heated-humidification-a-neonatal-bench-study
#17
Tim L Ullrich, Christoph Czernik, Christoph Bührer, Gerd Schmalisch, Hendrik S Fischer
OBJECTIVE: Nasal high-frequency oscillatory ventilation (nHFOV) is a novel mode of non-invasive ventilation used in neonates. However, upper airway obstructions due to viscous secretions have been described as specific adverse effects. We hypothesized that high-frequency oscillations reduce air humidity in the oropharynx, resulting in upper airway desiccation. Therefore, we aimed to investigate the effects of nHFOV ventilatory settings on oropharyngeal gas conditions. METHODS: NHFOV or nasal continuous positive airway pressure (nCPAP) was applied, along with heated humidification, to a previously established neonatal bench model that simulates oropharyngeal gas conditions during spontaneous breathing through an open mouth...
November 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28803335/intraoperative-ventilation-during-thoracoscopic-repair-of-neonatal-congenital-diaphragmatic-hernia
#18
Tadaharu Okazaki, Manabu Okawada, Junya Ishii, Hiroyuki Koga, Go Miyano, Takashi Doi, Yuki Ogasawara, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: To evaluate the optimal ventilation mode during thoracoscopic repair (TR) of neonatal congenital diaphragmatic hernia (CDH), we compared high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV). METHODS: Twenty-three neonatal CDH cases who underwent TR without intraoperative inhalation of nitric oxide at our institution between 2007 and 2016 were reviewed. Patients were initially ventilated with HFOV, which was converted to CMV if the HFOV settings were decreased to FiO2 <0...
October 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28794965/efficacy-of-lung-volume-optimization-maneuver-monitored-by-optoelectronic-pletismography-in-the-management-of-congenital-diaphragmatic-hernia
#19
G Lista, I Bresesti, F Cavigioli, F Castoldi, E Lupo, A LoMauro, A Aliverti
Newborns affected by congenital diaphragmatic hernia (CDH) need cardio-respiratory stabilization before undergoing surgical repair. Open lung strategy is a well-established approach to optimize lung volume in preterm infants with Respiratory Distress Syndrome (RDS), using both High Frequency Oscillatory Ventilation (HFOV) and Conventional Mechanical Ventilation (CMV). We report a case of left CDH with severe lung hypoplasia, managed applying open lung strategy in HFOV (pre-surgery period) and in Assist-Control with Volume Guarantee (post-surgery period), guided by SpO2 changes, TcPO2 and TcPCO2 monitoring...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28757754/therapeutic-hypothermia-brings-favorable-neurologic-outcomes-in-children-with-near-drowning
#20
Ming-Chun Chen, Chia-Hsiang Chu, Ching-Feng Cheng, Jun-Song Lin, Jui-Hsia Chen, Yu-Hsun Chang
A 1-year-10-month-old boy was admitted to our pediatric intensive care unit due to near drowning with pulmonary edema. A conventional ventilator with 100% oxygen supplementation was used initially, but was shifted to high frequency oscillatory ventilation as his oxygen saturation was around 84-88%. Therapeutic hypothermia was applied due to hypoxic ischemic encephalopathy with severe acidosis. His respiratory condition improved and he was extubated successfully on the 6th hospital day. The patient had no obvious neurological defects and he was discharged in a stable condition after 17 days of hospitalization...
October 2016: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
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