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Adaptive support ventilation

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https://www.readbyqxmd.com/read/29713734/advances-in-critical-care-management-of-patients-undergoing-cardiac-surgery
#1
REVIEW
Anders Aneman, Nicholas Brechot, Daniel Brodie, Frances Colreavy, John Fraser, Charles Gomersall, Peter McCanny, Peter Hasse Moller-Sorensen, Jukka Takala, Kamen Valchanov, Michael Vallely
Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management. This narrative review describes standard care, recent advances, and future areas of research in the critical care management of patients undergoing cardiac surgery...
April 30, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29684979/the-degree-of-arm-elevation-impacts-the-endurance-and-cardiopulmonary-adaptations-of-copd-patients-performing-upper-limb-exercise-a-cross-over-study
#2
Mara Paneroni, Carla Simonelli, Pierantonio Laveneziana, Massimiliano Gobbo, Manuela Saleri, Luca Bianchi, Michele Vitacca
BACKGROUND: In Chronic Obstructive Pulmonary Disease (COPD), upper limb exercise is widely recommended. However, how the degree of shoulder flexion may influence the exercise response is unknown. AIM: We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation. DESIGN: Randomized cross-over study. SETTING: Pulmonary Pathophysiology Service in an Italian Respiratory Rehabilitative Division, in-patients were enrolled...
April 20, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#3
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29555789/targeting-skeletal-muscle-tissue-oxygenation-sto-2-in-adults-with-severe-sepsis-and-septic-shock-a-randomised-controlled-trial-oto-sts-study
#4
Olivier Nardi, Elizabeth Zavala, Claude Martin, Serafim Nanas, Thomas Scheeren, Andrea Polito, Xavi Borrat, Djillali Annane
OBJECTIVE: Evaluation of the ratio of oxyhaemoglobin to total haemoglobin in skeletal muscle (StO2 ) using near-infrared spectroscopy may aid in the monitoring of patients with sepsis. This study assessed the benefits and risks of targeting StO2 in adults with severe sepsis or septic shock. DESIGN: A European randomised controlled trial was performed on two parallel groups. SETTING: Five intensive care units (ICU) in France, Greece, Spain and Germany were used for the study...
March 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29543684/effect-of-a-sepsis-educational-intervention-on-hospital-stay
#5
Jaime Fernández-Sarmiento, Joseph A Carcillo, Claudia M Salinas, Edgar F Galvis, Paula A López, Andrés Jagua-Gualdrón
OBJECTIVES: To evaluate adherence to the sepsis bundle before and after an educational strategy and its impact on hospital stay. DESIGN: A prospective, analytic, before-and-after study of children with severe sepsis and septic shock who presented to the emergency department. SETTING: Carried out from January to December 2014 in the emergency department of a quaternary care hospital. PATIENTS: Of a total of 19,836 children who presented to the emergency department, 4,383 had an infectious pathology, with 203 of these showing severe sepsis and septic shock (124 pre intervention, and 79 post intervention)...
March 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29471442/estimation-of-adaptive-ventilation-success-and-failure-using-polysomnogram-and-outpatient-therapy-biomarkers
#6
Stacey Gunn, Sreelatha Naik, Matt Travis Bianchi, Robert Joseph Thomas
Study Objectives: Adaptive servo ventilation (ASV) devices provide anti-cyclic pressure support for treatment of central/complex sleep apnea, including in heart failure patients. Variability in responses in the clinic and negative clinical trials motivated assessment of standard and novel signal biomarkers for ASV efficacy. Methods: Multiple clinical databases were queried to assess potential signal biomarkers of ASV effectiveness, including 1) Attended laboratory adaptive ventilation titrations: 108, of which 66 had mainstream ETCO2 measurements...
February 17, 2018: Sleep
https://www.readbyqxmd.com/read/29455226/respiratory-support-attitudes-among-pediatric-intensive-care-staff-for-spinal-muscular-atrophy-patients-in-saudi-arabia
#7
Mohamad-Hani A Temsah, Fahad M Al-Sohime, Fahad A Bashiri, Ayman A Al-Eyadhy, Gamal M Hasan, Ali A Alhaboob
OBJECTIVE: To explore therapeutic attitude of healthcare providers practicing in pediatric critical care in Saudi Arabia toward patients with Spinal Muscular Atroph (SMA) Type I, and to explore their awareness about the International Consensus statement for SMA care. METHODS: A cross-sectional survey was conducted in April 2015 during 6th Saudi Critical Care Conference, targeting physicians and respiratory therapists practicing in Pediatric Critical Care. RESULTS: Sixty participants accepted to participate in this survey...
January 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29282259/exercise-response-in-parkinson-s-disease-insights-from-a-cross-sectional-comparison-with-sedentary-controls-and-a-per-protocol-analysis-of-a-randomised-controlled-trial
#8
Foteini Mavrommati, Johnny Collett, Marloes Franssen, Andy Meaney, Claire Sexton, Andrea Dennis-West, Jill F Betts, Hooshang Izadi, Marko Bogdanovic, Martin Tims, Andrew Farmer, Helen Dawes
OBJECTIVES: To investigate the acute and adaptation cardiovascular and metabolic training responses in people with Parkinson's disease (pwP). DESIGN: (1) A cross-sectional study of exercise response of pwP compared with sedentary controls and (2) an interventional study of exercise training in pwP. SETTING: Community leisure facilities. PARTICIPANTS: pwP (n=83) and sedentary controls (n=55). INTERVENTIONS: Study 1 included participants from a two-arm-parallel single-blind phase II randomised controlled trial (RCT), that undertook a baseline maximal incremental exercise test and study 2 included those randomised to the exercise group in the RCT, who completed a 6-month weekly exercise programme (n=37)...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29181786/early-therapeutic-effects-of-adaptive-servo-ventilation-on-cardiac-sympathetic-nervous-function-in-patients-with-heart-failure-evaluated-using-a-combination-of-11-c-hed-pet-and-123-i-mibg-spect
#9
Yusuke Tokuda, Mamoru Sakakibara, Keiichiro Yoshinaga, Shiro Yamada, Kiwamu Kamiya, Naoya Asakawa, Takashi Yoshitani, Keiji Noguchi, Osamu Manabe, Nagara Tamaki, Hiroyuki Tsutsui
RATIONALE: Adaptive servo-ventilation (ASV), a novel respiratory support therapy for sleep disorders, may improve cardiac function in heart failure (HF). However, the reasons that ASV improves cardiac function have not been fully studied especially in sympathetic nervous function (SNF). The purpose of the present study was to investigate the effects of ASV therapy on cardiac SNF in patients with HF. METHODS: We evaluated ASV therapeutic effects before and 6 months after ASV therapy in 9 HF patients [57...
November 27, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29108606/positive-airway-pressure-device-technology-past-and-present-what-s-in-the-black-box
#10
REVIEW
Lee K Brown, Shahrokh Javaheri
Since the introduction of continuous positive airway pressure (PAP) for the treatment of obstructive sleep apnea (OSA) in 1981, PAP technology has diversified exponentially. Compact and quiet fixed continuous PAP flow generators, autotitrating PAP devices, and bilevel PAP devices that can treat multiple sleep-disordered breathing phenotypes including OSA, central sleep apnea (CSA), combinations of OSA and CSA, and hypoventilation are available. Adaptive servo-ventilators can suppress Hunter-Cheyne-Stokes breathing and CSA and treat coexisting obstructive events...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/28975076/comparing-the-effect-of-adaptive-support-ventilation-asv-and-synchronized-intermittent-mandatory-ventilation-simv-on-respiratory-parameters-in-neurosurgical-icu-patients
#11
Mohammadreza Ghodrati, Alireza Pournajafian, Ali Khatibi, Mohammad Niakan, Mohammad Hosein Hemadi, Mohammad Mahdi Zamani
BACKGROUND: Various modes of mechanical ventilation have different effects on respiratory variables. Lack of patients' neuro-ventilatory coordination and increasing the work of breathing are major disadvantages in mechanically ventilated patients. OBJECTIVES: This study is conducted to compare the respiratory parameters differences in Adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) modes in neurosurgical ICU patients...
December 2016: Anesthesiology and Pain 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/28875324/-extreme-obesity-particular-aspect-of-invasive-and-noninvasive-ventilation
#13
REVIEW
M Deppe, P Lebiedz
The obesity rate is increasing worldwide and the percentage of obese patients in the intensive care unit (ICU) is rising concomitantly. Ventilatory support strategies in obese patients must take into account the altered pathophysiological conditions. Unfortunately, prospective randomized multicenter trials on this subject are lacking. Therefore, current strategies are based on the individual experiences of ICU physicians and single-center studies. Noninvasive ventilation (NIV) in critically ill patients with acute respiratory failure and obesity hypoventilation syndrome (OHS) is an efficient treatment option and should be provided as early as possible is an effort to avoid intubation...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28870157/ten-important-articles-on-noninvasive-ventilation-in-critically-ill-patients-and-insights-for-the-future-a-report-of-expert-opinions
#14
A Cortegiani, V Russotto, M Antonelli, E Azoulay, A Carlucci, G Conti, A Demoule, M Ferrer, N S Hill, S Jaber, P Navalesi, P Pelosi, R Scala, C Gregoretti
BACKGROUND: Noninvasive ventilation is used worldwide in many settings. Its effectiveness has been proven for common clinical conditions in critical care such as cardiogenic pulmonary edema and chronic obstructive pulmonary disease exacerbations. Since the first pioneering studies of noninvasive ventilation in critical care in the late 1980s, thousands of studies and articles have been published on this topic. Interestingly, some aspects remain controversial (e.g. its use in de-novo hypoxemic respiratory failure, role of sedation, self-induced lung injury)...
September 4, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28860014/feasibility-and-safety-of-intact-cord-resuscitation-in-newborn-infants-with-congenital-diaphragmatic-hernia-cdh
#15
Caroline Lefebvre, Thameur Rakza, Nathalie Weslinck, Pascal Vaast, Véronique Houfflin-Debarge, Sébastien Mur, Laurent Storme
BACKGROUND: Starting resuscitation before clamping the umbilical cord at birth may progressively increase pulmonary blood flow while umbilical venous blood flow is still contributing to maintenance of oxygenation and left ventricle preload. OBJECTIVE: To evaluate the feasibility, safety, and effects of intact cord resuscitation (ICR) on cardiorespiratory adaptation at birth in newborn infants with CDH. STUDY DESIGN: Prospective, observational, single-center pilot study...
November 2017: Resuscitation
https://www.readbyqxmd.com/read/28856111/adaptive-support-ventilation-reduces-the-incidence-of-atelectasis-in-patients-undergoing-coronary-artery-bypass-grafting-a-randomized-clinical-trial
#16
Seyed Tayeb Moradian, Yaser Saeid, Abbas Ebadi, Ali Hemmat, Mohammad Saeid Ghiasi
BACKGROUND: Pulmonary complications are common following cardiac surgery and can lead to increased morbidity, mortality, and healthcare costs. Atelectasis is the most common respiratory complication following cardiac surgery. One of the most important methods for reducing pulmonary complications is supportive care with protective ventilation strategies. In this study, we aimed to assess the effect of adaptive support ventilation (ASV) on atelectasis in patients undergoing cardiac surgery...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28701680/right-ventricular-end-diastolic-pressure-is-a-key-to-the-changes-in-cardiac-output-during-adaptive-servo-ventilation-support-in-patients-with-heart-failure
#17
Teruhiko Imamura, Koichiro Kinugawa
Adaptive servo-ventilation (ASV) is a recently-developed non-invasive therapy that improves the clinical course of heart failure (HF) patients. However, the precise hemodynamic response and predictors of ASV therapy remain uncertain. Overall, 69 patients with New York Heart Association HF class II-IV underwent 10-minute ASV testing along with hemodynamic studies. Among them, 21 (30%) achieved an acute response, which was defined as an increase in the cardiac index (CI) during ASV. ΔLeft ventricular end-diastolic pressure (LVEDP) did not correlate with ΔCI, whereas Δtransmural LVEDP, which was calculated by subtracting right ventricular end-diastolic pressure (RVEDP) from LVEDP, and ΔCI were positively correlated, similar to the ascending limb of Frank-Starling's law (P = 0...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28697252/association-of-positive-airway-pressure-with-cardiovascular-events-and-death-in-adults-with-sleep-apnea-a-systematic-review-and-meta-analysis
#18
REVIEW
Jie Yu, Zien Zhou, R Doug McEvoy, Craig S Anderson, Anthony Rodgers, Vlado Perkovic, Bruce Neal
Importance: Sleep apnea (obstructive and central) is associated with adverse cardiovascular risk factors and increased risks of cardiovascular disease. Positive airway pressure (PAP) provides symptomatic relief, whether delivered continuously (CPAP) or as adaptive servo-ventilation (ASV), but the associations with cardiovascular outcomes and death are unclear. Objective: To assess the association of PAP vs control with cardiovascular events and death in patients with sleep apnea...
July 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28677019/-acute-respiratory-distress-syndrome-basic-principles-and-treatment
#19
P M Spieth, A Güldner, M Gama de Abreu
Even after many years of intensive research acute respiratory distress syndrome (ARDS) is still associated with a high mortality. Epidemiologically, ARDS represents a central challenge for modern intensive care treatment. The multifactorial etiology of ARDS complicates the clear identification and evaluation of new therapeutic interventions. Lung protective mechanical ventilation and adjuvant therapies, such as the prone position and targeted extracorporeal lung support are of particular importance in the treatment of ARDS, depending on the severity of the disease...
July 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28653420/impact-of-endotracheal-tube-shortening-on-work-of-breathing-in-neonatal-and-pediatric-in-vitro-lung-models
#20
Rebecca Mohr, Jörg Thomas, Vincenzo Cannizzaro, Markus Weiss, Alexander R Schmidt
BACKGROUND: Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. AIM: The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings...
September 2017: Paediatric Anaesthesia
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