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Rakesh Bhattacharjee, Abdelnaby Khalyfa, Ahamed A Khalyfa, Babak Mokhlesi, Leila Kheirandish-Gozal, Isaac Almendros, Eduard Peris, Atul Malhotra, David Gozal
STUDY OBJECTIVES: Longitudinal studies support the usage of positive airway pressure (PAP) therapy in treating obstructive sleep apnea (OSA) to improve cardiovascular disease. However, the anticipated benefit is not ubiquitous. In this study, we elucidate whether PAP therapy leads to immediate improvements on endothelial function, a subclinical marker of cardiovascular status, by examining the effect of circulating exosomes, isolated from patients before and after PAP therapy, on naive endothelial cells...
April 30, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Gul Gursel, Avsar Zerman, Burcu Basarik, Kamil Gonderen, Muge Aydogdu, Serriyye Memmedova
Auto-titrating noninvasive ventilation (NIV) has been developed as a new mode applying variable expiratory-positive airway pressure (EPAP) in addition to variable inspiratory pressures (IPAP), both to deliver targeted tidal volume (VT) and to eliminate upper airway resistance. The purpose of this study is to evaluate whether NIV with auto-titrating mode will decrease more PaCO2 within a shorter time compared to volume-assured mode in hypercapnic intensive care unit (ICU) patients. The hypercapnic respiratory failure patients treated with average volume assured pressure support- automated EPAP mode (group1) were compared with those treated with average volume-assured pressure support mode (group2)...
April 2018: Internal and Emergency Medicine
Murat Türk, Müge Aydoğdu, Gül Gürsel
OBJECTIVES: Different outcomes and success rates of non-invasive positive pressure ventilation (NPPV) in patients with acute hypercapnic respiratory failure (AHRF) still pose a significant problem in intensive care units. Previous studies investigating different modes, body positioning, and obesity-associated hypoventilation in patients with chronic respiratory failure showed that these factors may affect ventilator mechanics to achieve a better minute ventilation. This study tried to compare pressure support (BiPAP-S) and average volume targeted pressure support (AVAPS-S) modes in patients with acute or acute-on-chronic hypercapnic respiratory failure...
January 2018: Turkish Thoracic Journal
Xiang You, Adriaan van Heiningen, Herbert Sixta, Mikhail Iakovlev
Lignin and ash material balances of SO2-ethanol-water (AVAP®) fractionation of sugarcane (SC) straw were thoroughly studied at various conditions. Most of straw lignin and ash dissolve in the liquor and 40-80% of lignin is precipitated after ethanol removal as a pure (∼99%) and sulfur-lean (<2%) fraction. Most of the acid-soluble ash and its elements (Na, K, Fe, Al) as well as large portion of silica are removed from the fiber phase. Straw lignin behavior exhibited differences compared to wood lignin including high apparent content in fiber, higher degree of sulfonation of dissolved lignin, and dense char-like precipitate formation upon ethanol removal...
November 2017: Bioresource Technology
Xiang You, Adriaan van Heiningen, Herbert Sixta, Mikhail Iakovlev
The sulfur balance of SO2-ethanol-water (AVAP®) fractionation of sugarcane (SC) straw was investigated. Hydrogen sulfite and sulfite anions are nearly absent in the liquors, despite cations present in straw, whose effect is thus limited to neutralization of lignosulfonic acids decreasing the acidity. Higher degree of sulfonation was observed for dissolved straw lignin compared to wood lignin (0.8-0.9 vs. 0.25 S/C9). Sulfur dioxide amounts of 0.9-1.2, 4.1-4.3 and 44-49g per straw were bound to pulp, precipitated lignin and lignosulfonic acid, respectively, while the rest of SO2 was recovered by distillation from the spent fractionation suspensions...
October 2017: Bioresource Technology
Xiang You, Adriaan van Heiningen, Herbert Sixta, Mikhail Iakovlev
Kinetics of SO2-ethanol-water (AVAP®) fractionation was determined for sugarcane (SC) straw in terms of pulp composition (non-carbohydrate components, cellulose, hemicelluloses) and properties (kappa number, pulp intrinsic viscosity in CED and cellulose degree of polymerization). Effect of temperature (135-165°C) and time (18-118min) was studied at fixed liquor composition (SO2/ethanol/water=12:22.5:65.5, w/w) and a liquor-to-solid ratio (4Lkg(-1)). Interpretation is given in terms of major fractionation reactions, removal of non-carbohydrate components and xylan, as well as acid hydrolysis of cellulose, and is compared to other lignocellulosic substrates (beech, spruce and wheat straw)...
July 2016: Bioresource Technology
Natalie Gentin, Bruce Williamson, Ganesh Thambipillay, Arthur Teng
This is a case report of the effective use of bi-level positive airway pressure support (BPAP) using the volume-assured pressure support feature in a pediatric patient with a congenital myopathy and significant nocturnal hypoventilation. Our patient was started on nocturnal nasal mask BPAP but required high pressures to improve her oxygen saturations and CO2 baseline. She was then trialed on a BPAP machine with the volume-assured pressure support feature on. The ability of this machine to adjust inspiratory pressures to give a targeted tidal volume allowed the patient to be on lower pressure settings for periods of the night, with the higher pressures only when required...
September 2015: Respirology Case Reports
A Couillard, J-L Pepin, C Rabec, A Cuvelier, A Portmann, J-F Muir
Noninvasive ventilation is recommended to correct the nocturnal hypoventilation and relieve the symptoms of patients with the obesity-hypoventilation syndrome (OHS). The benefits of fixed pressure ventilation (S/T technology) are recognized but limited on account of the variability of nocturnal ventilatory requirements. The new technique AVAPS-AE (automatic EPAP) allows adjustment of the pressure according to the volume currently targeted. Its efficacy has not yet been evaluated. Our objectives are to evaluate firstly, whether AVAPS-AE optimizes the benefits of S/T technology on sleep architecture and quality, secondly, whether these benefits are associated with an improvement in gas exchange, symptoms, exercise tolerance, level of physical activity and quality of life of patients with OHS...
March 2015: Revue des Maladies Respiratoires
Steven Coughlin, Wei E Liang, Sairam Parthasarathy
BACKGROUND: Healthcare systems are attempting to reduce hospital readmissions due to chronic obstructive pulmonary disease (COPD). METHODS: A retrospective study of a quality improvement (QI) program performed at a single center whose multifaceted intervention included nocturnal administration of advanced positive airway pressure (PAP) modality (or noninvasive positive pressure ventilation [NIPPV]) called averaged volume assured pressure support (AVAPS-AE) initiation by a respiratory therapist (RT), medication reconciliation by a pharmacist, adequate provision of oxygen, and ongoing RT-led care...
June 15, 2015: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
P Piesiak, A Brzecka, M Kosacka, R Jankowska
Severe kyphoscoliosis can cause chronic respiratory failure. Noninvasive mechanical ventilation (NIMV) is a new optional treatment for such patients. The aim of this study was to evaluate the effectiveness of average volume-assured pressure support (AVAPS) NIMV in patients with kyphoscoliotic chronic respiratory failure. The study was performed in 12 patients (mean age 49±11 years and body mass index 27.5±7.9 kg/m2) with advanced kyphoscoliosis complicated by severe respiratory failure (PaO2 6.68±0.34 kPa, SaO2 81...
2015: Advances in Experimental Medicine and Biology
Yu-Ming Wang, Feng-Juan Wu, Lei Du, Guo-Yun Li, Koretaro Takahashi, Yong Xue, Chang-Hu Xue
Three polysaccharides, AAP, AVAP I, and AVAP II, were isolated from abalone Haliotis discus hannai Ino. The polysaccharides' compositions were analysed, and their effects on HepG2 cell proliferation were assessed. AVAP I had a greater growth-stimulatory effect than AAP or AVAP II. The oligosaccharide of AVAP I (Oli-AVAP I) exhibited the same growth effects, but rhamnose, the primary monosaccharide of AVAP I and Oli-AVAP I, did not exhibit this activity. Moreover, AVAP I dramatically reduced the mRNA levels of CDK6 and Cyclin E1 but significantly increased Cyclin B1, CDK1 and Cyclin F...
May 2014: International Journal of Biological Macromolecules
Wei He, Xiang-Hong Jing, Bing Zhu, Xin-Long Zhu, Liang Li, Wan-Zhu Bai, Hui Ben
BACKGROUND: The afferent projections from the auricular branch of the vagus nerve (ABVN) to the nucleus tractus solitaries (NTS) have been proposed as the anatomical basis for the increased parasympathetic tone seen in auriculo-vagal reflexes. As the afferent center of the vagus nerve, the NTS has been considered to play roles in the anticonvulsant effect of cervical vagus nerve stimulation (VNS). Here we proposed an "auriculo-vagal afferent pathway" (AVAP), by which transcutaneous auricular vagus nerve stimulation (ta-VNS) suppresses pentylenetetrazol (PTZ)-induced epileptic seizures by activating the NTS neurons in rats...
2013: BMC Neuroscience
Killen Harold Briones Claudett, Monica Briones Claudett, Miguel Chung Sang Wong, Alberto Nuques Martinez, Ricardo Soto Espinoza, Mayra Montalvo, Antonio Esquinas Rodriguez, Gumersindo Gonzalez Diaz, Michelle Grunauer Andrade
BACKGROUND: Non-invasive mechanical ventilation (NIV) in patients with acute respiratory failure has been traditionally determined based on clinical assessment and changes in blood gases, with NIV support pressures manually adjusted by an operator. Bilevel positive airway pressure-spontaneous/timed (BiPAP S/T) with average volume assured pressure support (AVAPS) uses a fixed tidal volume that automatically adjusts to a patient's needs. Our study assessed the use of BiPAP S/T with AVAPS in patients with chronic obstructive pulmonary disease (COPD) and hypercapnic encephalopathy as compared to BiPAP S/T alone, upon immediate arrival in the Emergency-ICU...
March 12, 2013: BMC Pulmonary Medicine
Wei He, Xiaoyu Wang, Hong Shi, Hongyan Shang, Liang Li, Xianghong Jing, Bing Zhu
Auricular acupuncture has been utilized in the treatment of diseases for thousands of years. Dr. Paul Nogier firstly originated the concept of an inverted fetus map on the external ear. In the present study, the relationship between the auricular acupuncture and the vagal regulation has been reviewed. It has been shown that auricular acupuncture plays a role in vagal activity of autonomic functions of cardiovascular, respiratory, and gastrointestinal systems. Mechanism studies suggested that afferent projections from especially the auricular branch of the vagus nerve (ABVN) to the nucleus of the solitary tract (NTS) form the anatomical basis for the vagal regulation of auricular acupuncture...
2012: Evidence-based Complementary and Alternative Medicine: ECAM
Bernardo J Selim, Mithri R Junna, Timothy I Morgenthaler
• Primary Central Sleep Apnea (CSA): We would recommend a trial of Positive Airway Pressure (PAP), acetazolamide, or zolpidem based on thorough consideration of risks and benefits and incorporation of patient preferences.• Central Sleep Apnea Due to Cheyne-Stokes Breathing Pattern in Congestive Heart Failure (CSR-CHF): We would recommend PAP devices such as continuous positive airway pressure (CPAP) or adaptive servo-ventilation (ASV) to normalize sleep-disordered breathing after optimizing treatment of heart failure...
October 2012: Current Treatment Options in Neurology
Patrick Brian Murphy, Craig Davidson, Matthew David Hind, Anita Simonds, Adrian J Williams, Nicholas S Hopkinson, John Moxham, Michael Polkey, Nicholas Hart
INTRODUCTION: Automatic titration modes of non-invasive ventilation, including average volume assured pressure support (AVAPS), are hybrid technologies that target a set volume by automated adjustment of pressure support (PS). These automated modes could offer potential advantages over fixed level PS, in particular, in patients who are super obese. METHODS: Consecutive patients with obesity hypoventilation syndrome were enrolled in a two-centre prospective single-blind randomised controlled trial of AVAPS versus fixed-level PS using a strict protocolised setup...
August 2012: Thorax
Emmanouil Vagiakis, Ioannis Koutsourelakis, Eleni Perraki, Charis Roussos, Zafeiria Mastora, Spyros Zakynthinos, Anastasia Kotanidou
Congenital central hypoventilation syndrome (CCHS) is an uncommon disorder characterized by the absence of adequate autonomic control of respiration, which results in alveolar hypoventilation and decreased sensitivity to hypercarbia and hypoxemia, especially during sleep. Patients with CCHS need lifelong ventilatory support. The treatment options for CCHS include intermittent positive pressure ventilation administered via tracheostomy, noninvasive positive pressure ventilation, negative-pressure ventilation by body chamber or cuirass, and phrenic nerve pacing...
December 15, 2010: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Raquel del Valle-Fernández, Vladimir Jelnin, Georgia Panagopoulos, Yuriy Dudiy, Laurence Schneider, Peter T de Jaegere, Carl Schultz, Patrick W Serruys, Eberhard Grube, Carlos E Ruiz
AIMS: Reliable assessment of the aortic valvar apparatus (AVAp) is essential as it may facilitate consistent outcomes with percutaneous aortic valvar therapies. The commonly referenced aortic annulus is problematic since this measurement does not correspond to any actual anatomic structure. We aim to describe a reliable method of measuring relevant structures of the AVAp based on widely available computed tomography analyses. METHODS AND RESULTS: Retrospective analysis of computed tomograms of 75 patients with severe aortic stenosis (45 females, age 81...
September 2010: European Heart Journal
Ernesto Crisafulli, Giuseppe Manni, Marika Kidonias, Ludovico Trianni, Enrico M Clini
The aim of this short-term, single-blind, randomized, crossover study was to evaluate night-time efficacy of and compliance and physiological responses to average volume assured pressure support (AVAPS) versus pressure support (PS) ventilation. AVAPS or PS ventilation was delivered to nine stable hypercapnic COPD patients via a mask over two 5-day periods during consecutive weeks. The Synchrony ventilator was used to deliver mask ventilation as follows: 8 ml/kg of ideal body weight (as the targeted inspiratory tidal volume) with IPAP ranging from EPAP up to 30 cmH(2)O for AVAPS, and the patient's highest tolerated IPAP level for PS...
September 2009: Lung
Cristina Ambrogio, Xazmin Lowman, Ming Kuo, Joshua Malo, Anil R Prasad, Sairam Parthasarathy
OBJECTIVE: Noninvasive ventilation with pressure support (NIV-PS) therapy can augment ventilation; however, such therapy is fixed and may not adapt to varied patient needs. We tested the hypothesis that in patients with chronic respiratory insufficiency, a newer mode of ventilation [averaged volume assured pressure support (AVAPS)] and lateral decubitus position were associated with better sleep efficiency than NIV-PS and supine position. Our secondary aim was to assess the effect of mode of ventilation, body position, and sleep-wakefulness state on minute ventilation (V(E)) in the same patients...
February 2009: Intensive Care Medicine
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