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Adaptive support ventilation

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https://www.readbyqxmd.com/read/29108606/positive-airway-pressure-device-technology-past-and-present-what-s-in-the-black-box
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28646647/successful-maintenance-of-key-physiological-parameters-in-preterm-lambs-treated-with-ex%C3%A2-vivo-uterine-environment-therapy-for-a-period-of-1-week
#12
Haruo Usuda, Shimpei Watanabe, Yuichiro Miura, Masatoshi Saito, Gabrielle C Musk, Judith Rittenschober-Böhm, Hideyuki Ikeda, Shinichi Sato, Takushi Hanita, Tadashi Matsuda, Alan H Jobe, John P Newnham, Sarah J Stock, Matthew W Kemp
BACKGROUND: Extremely preterm infants born at the border of viability (22-24 weeks' gestation) have high rates of death and lasting disability. Ex vivo uterine environment therapy is an experimental neonatal intensive care strategy that provides gas exchange using parallel membranous oxygenators connected to the umbilical vessels, sparing the extremely preterm cardiopulmonary system from ventilation-derived injury. OBJECTIVE: In this study, we aimed to refine our ex vivo uterine environment therapy platform to eliminate fetal infection and inflammation, while simultaneously extending the duration of hemodynamically stable ex vivo uterine environment therapy to 1 week...
October 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28570269/zinc-deficiency-primes-the-lung-for-ventilator-induced-injury
#13
Francis Boudreault, Miguel Pinilla-Vera, Joshua A Englert, Alvin T Kho, Colleen Isabelle, Antonio J Arciniegas, Diana Barragan-Bradford, Carolina Quintana, Diana Amador-Munoz, Jiazhen Guan, Kyoung Moo Choi, Lynette Sholl, Shelley Hurwitz, Daniel J Tschumperlin, Rebecca M Baron
Mechanical ventilation is necessary to support patients with acute lung injury, but also exacerbates injury through mechanical stress-activated signaling pathways. We show that stretch applied to cultured human cells, and to mouse lungs in vivo, induces robust expression of metallothionein, a potent antioxidant and cytoprotective molecule critical for cellular zinc homeostasis. Furthermore, genetic deficiency of murine metallothionein genes exacerbated lung injury caused by high tidal volume mechanical ventilation, identifying an adaptive role for these genes in limiting lung injury...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28553625/the-comparison-effects-of-two-methods-of-adaptive-support-ventilation-minute-ventilation-110-and-adaptive-support-ventilation-minute-ventilation-120-on-mechanical-ventilation-and-hemodynamic-changes-and-length-of-being-in-recovery-in-intensive-care-units
#14
Babak Ali Kiaei, Parviz Kashefi, Seyed Taghi Hashemi, Daryoush Moradi, Ahmad Mobasheri
BACKGROUND: The conventional method for ventilation is supported by accommodative or adaptive support ventilation (ASV) that the latter method is done with two methods: ASV minute ventilation (mv): 110% and ASV mv: 120%. Regarding these methods this study compared the differences in duration of mechanical ventilation and hemodynamic changes during recovery and length of stay in Intensive Care Units (ICU). MATERIALS AND METHODS: In a clinical trial study, forty patients candidate for ventilation were selected and randomly divided into two groups of A and B...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28543642/bidirectional-superior-cavopulmonary-anastomosis-with-or-without-cardiopulmonary-bypass-a-randomized-study
#15
RANDOMIZED CONTROLLED TRIAL
Sachin Talwar, Anish Gupta, Ashima Nehra, Neeti Makhija, Poonam Malhotra Kapoor, Vishnubhatla Sreenivas, Shiv Kumar Choudhary, Balram Airan
OBJECTIVES: This study aims to compare the bidirectional superior cavopulmonary anastomosis (BDG) with or without cardiopulmonary bypass (CPB). METHODS: 100 patients undergoing BDG were randomized into two groups: Off-CPB or on-CPB groups. All patients underwent near-infrared spectrophotometry (NIRS) and bispectral index (BIS) monitoring and pre- and postoperative serum 100 beta protein measurements (Sβ100) and neuro-cognitive evaluation. Postoperative intensive care unit (ICU) parameters were also studied...
June 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28518041/stockpiling-ventilators-for-influenza-pandemics
#16
Hsin-Chan Huang, Ozgur M Araz, David P Morton, Gregory P Johnson, Paul Damien, Bruce Clements, Lauren Ancel Meyers
In preparing for influenza pandemics, public health agencies stockpile critical medical resources. Determining appropriate quantities and locations for such resources can be challenging, given the considerable uncertainty in the timing and severity of future pandemics. We introduce a method for optimizing stockpiles of mechanical ventilators, which are critical for treating hospitalized influenza patients in respiratory failure. As a case study, we consider the US state of Texas during mild, moderate, and severe pandemics...
June 2017: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/28497943/the-effects-of-over-the-counter-jaw-repositioning-mouthguards-on-aerobic-performance
#17
RANDOMIZED CONTROLLED TRIAL
Devon L Golem, Patrick M Davitt, Shawn M Arent
BACKGROUND: Though jaw-repositioning devices have been found to increase size of upper respiratory airways in individuals, the effects of jaw-repositioning mouthguards on respiratory function during exercise have not been fully explored. The purpose of this study is to determine the effects of over-the-counter (OTC) jaw-repositioning mouthguards on respiratory function and aerobic performance in male athletes. METHODS: College-aged, male athletes (N.=20) participated in this randomized, crossover, controlled study...
June 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28481126/increased-levels-of-alveolar-and-airway-exhaled-nitric-oxide-in-runners
#18
Alexandra Thornadtsson, Nikola Drca, Fabio Ricciardolo, Marieann Högman
AIM: The objective of this study was to apply extended NO analysis for measurements of NO dynamics in the lung, divided into alveolar and airway contribution, in amateur runners and marathoners. METHODS: The athletes participated in either a marathon or a half marathon. The athletes self-reported their age, weight, height, training distance per week, competing distance, cardio-pulmonary health, atopic status, and use of tobacco. Measurements of exhaled NO (FENO) with estimation of alveolar NO (CANO) and airway flux (JawNO), ventilation, pulse oximetry, and peak flow were performed before, immediately after, and 1 hour after completing the race...
June 2017: Upsala Journal of Medical Sciences
https://www.readbyqxmd.com/read/28278435/correlation-between-transition-percentage-of-minute-volume-tmv-and-outcome-of-patients-with-acute-respiratory-failure
#19
Chung-Kan Peng, Shu-Fen Wu, Shih-Hsing Yang, Chuan-Fa Hsieh, Chung-Chih Huang, Yuh-Chin T Huang, Chin-Pyng Wu
PURPOSE: We have previously shown in patients receiving adaptive support ventilation (ASV) that there existed a Transition %MinVol (TMV%) where the patient's work of breathing began to reduce. In this study, we tested the hypothesis that higher TMV% would be associated with poorer outcome in patients with acute respiratory failure. MATERIALS AND METHODS: In this prospective observational study, we recruited patients with acute respiratory failure on ASV between December 2012 and September 2013 in a mixed ICU...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28269080/convolutive-blind-source-separation-on-surface-emg-signals-for-respiratory-diagnostics-and-medical-ventilation-control
#20
Herbert Buchner, Eike Petersen, Marcus Eger, Philipp Rostalski
The electromyogram (EMG) is an important tool for assessing the activity of a muscle and thus also a valuable measure for the diagnosis and control of respiratory support. In this article we propose convolutive blind source separation (BSS) as an effective tool to pre-process surface electromyogram (sEMG) data of the human respiratory muscles. Specifically, the problem of discriminating between inspiratory, expiratory and cardiac muscle activity is addressed, which currently poses a major obstacle for the clinical use of sEMG for adaptive ventilation control...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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