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Pierre Bou-Khalil, Salah Zeineldine, Robert Chatburn, Chakib Ayyoub, Farouk Elkhatib, Imad Bou-Akl, Mohamad El-Khatib
Simple and accurate expressions describing the PaO2-FiO2 relationship in mechanically ventilated patients are lacking. The current study aims to validate a novel mathematical expression for accurate prediction of the fraction of inspired oxygen that will result in a targeted arterial oxygen tension in non-smoking and smoking patients receiving mechanical ventilation following open heart surgeries. One hundred PaO2-FiO2 data pairs were obtained from 25 non-smoking patients mechanically ventilated following open heart surgeries...
October 24, 2016: Journal of Clinical Monitoring and Computing
M-C Pintado, R de Pablo, M Trascasa, J-M Milicua, M Sánchez-García
OBJECTIVE: To study the effect of setting positive end-expiratory pressure (PEEP) in an individualized manner (based on highest static compliance) compared to setting PEEP according to FiO2 upon mortality at 28 and 90 days, in patients with different severity acute respiratory distress syndrome (ARDS). SETTING: A Spanish medical-surgical ICU. DESIGN: A post hoc analysis of a randomized controlled pilot study. PATIENTS: Patients with ARDS...
October 21, 2016: Medicina Intensiva
Luigi Olper, Elena Bignami, Ambra L Di Prima, Santina Albini, Simona Nascimbene, Luca Cabrini, Giovanni Landoni, Ottavio Alfieri
BACKGROUND: Noninvasive ventilation (NIV) is a common technique to manage patients with acute respiratory failure in the intensive care unit. However, use of NIV in general wards is less well described. The authors' aim was to demonstrate efficacy of NIV, applied in a cardiac surgery ward, in improving oxygenation in patients who developed hypoxemic acute respiratory failure after being discharged from the intensive care unit. DESIGN: Randomized, open-label trial...
August 10, 2016: Journal of Cardiothoracic and Vascular Anesthesia
John G Laffey, Giacomo Bellani, Tài Pham, Eddy Fan, Fabiana Madotto, Ednan K Bajwa, Laurent Brochard, Kevin Clarkson, Andres Esteban, Luciano Gattinoni, Frank van Haren, Leo M Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Anders Larsson, Daniel F McAuley, Lia McNamee, Nicolas Nin, Haibo Qiu, Marco Ranieri, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
PURPOSE: To improve the outcome of the acute respiratory distress syndrome (ARDS), one needs to identify potentially modifiable factors associated with mortality. METHODS: The large observational study to understand the global impact of severe acute respiratory failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across five continents...
October 18, 2016: Intensive Care Medicine
Nan Liu, Wei Zhang, Weiguo Ma, Wei Shang, Jun Zheng, Lizhong Sun
OBJECTIVES: To identify the risk factors for hypoxaemia following surgical repair of acute type A aortic dissection. METHODS: This was a retrospective study of patients treated between October 2013 and December 2014 at the Department of Cardiovascular Surgery, Anzhen Hospital, China. Univariable and multivariable analyses were performed on the clinical data of 160 patients with acute type A dissection and who underwent ascending aortic and arch replacement under deep hypothermic circulatory arrest...
October 17, 2016: Interactive Cardiovascular and Thoracic Surgery
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Marc Jubeau, Thomas Rupp, John Temesi, Stéphane Perrey, Bernard Wuyam, Guillaume Y Millet, Samuel Verges
PURPOSE: Prolonged cycling exercise performance in normoxia is limited due to both peripheral and central neuromuscular impairments. It has been reported that cerebral perturbations are greater during short-duration exercise in hypoxia compared to normoxia. The purpose of this study was to test the hypothesis that central deficits are accentuated in hypoxia compared to normoxia during prolonged (3 bouts of 80 min separated by 25 min) whole-body exercise at the same relative intensity...
October 6, 2016: Medicine and Science in Sports and Exercise
Giacomo Bellani, John G Laffey, Tài Pham, Fabiana Madotto, Eddy Fan, Laurent Brochard, Andres Esteban, Luciano Gattinoni, Vesna Bumbasirevic, Lise Piquilloud, Frank van Haren, Anders Larsson, Daniel F McAuley, Philippe R Bauer, Yaseen M Arabi, Marco Ranieri, Massimo Antonelli, Gordon D Rubenfeld, B Taylor Thompson, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Non-invasive ventilation (NIV) is increasingly used in patients with Acute Respiratory Distress Syndrome (ARDS). Whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful is unknown. The evidence supporting NIV use in patients with ARDS remains relatively sparse. METHODS: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study described the management of patients with ARDS...
October 18, 2016: American Journal of Respiratory and Critical Care Medicine
Lourdes A Blanco Esquivel, Jorge Macia Urbina, Hugo Mendieta Zerón
BACKGROUND: Severe obstetric morbidity constitutes a serious problem worldwide; however, an effective obstetrical prognosis scale is still missing. OBJECTIVE: To propose a modified Sequential Organ Failure Assessment Score (SOFA) score based on time before reaching specialized medical attention. METHOD: This was an ambispective, descriptive study, including all women treated at the Obstetrical Intensive Care Unit (OICU) of the "Mónica Pretelini Sáenz" Maternal-Perinatal Hospital (HMPMPS), Toluca, Mexico, from June 2009 to June 2013...
September 2016: Ghana Medical Journal
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Folafoluwa O Odetola, Renee R Anspach, Yong Y Han, Sarah J Clark
PURPOSE: To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care. METHODS: Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao2)/Fio2 (32%), and inflation pressure (16%)...
October 4, 2016: Journal of Critical Care
Toshiyuki Ohya, Ryo Yamanaka, Hayato Ohnuma, Masahiro Hagiwara, Yasuhiro Suzuki
BACKGROUND: Some endurance athletes exhibit exercise-induced arterial hypoxemia during high-intensity exercise. Inhalation of hyperoxic gas during exercise has been shown to counteract this exercise-associated reduction in hemoglobin oxygen saturation (SaO2), but the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent exercise remain unclear. This study investigated the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent cycling exercise...
December 2016: Sports Medicine—Open
Eric Hermand, François J Lhuissier, Nicolas Voituron, Jean-Paul Richalet
We evaluated the mechanisms responsible for the instability of ventilation control system under simultaneous metabolic (exercise) and environmental (hypoxia) stresses, promoting the genesis of periodic breathing. A model following the main concepts of ventilatory control has been tested, including cardiovascular and respiratory parameters, characteristics of peripheral and central chemoreceptors, at mild exercise in hypoxia (FIO2=0.145). Interaction between O2 and CO2 sensing was introduced following three different modalities...
October 12, 2016: Journal of Theoretical Biology
Tariq Yousuf, Taylor Brinton, Ghulam Murtaza, Daniel Wozniczka, Khansa Ahmad, Joy Iskandar, Raju Mehta, Hesam Keshmiri, Tabassum Hanif
End-tidal carbon dioxide (ETCO2) monitoring is useful in many situations. However, ETCO2 monitoring is unreliable in patients with acute respiratory distress syndrome (ARDS) due to widespread lung inflammation. In our study, we attempt to establish the gradient between the arterial pressure of carbon dioxide (PaCO2) and ETCO2 in patients with ARDS, which we defined as the PaETCO2 gradient. The main objective of the study was to establish a PaETCO2 gradient in each severity of ARDS. We analyzed 35 patients with ARDS and a total of 88 arterial blood gases were included...
October 14, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Pablo G Sanchez, Chetan Pasrija, Matthew J Mulligan, Mandheer Wadhwa, Diana L Pratt, Tieluo Li, James S Gammie, Zachary N Kon, Si M Pham, Bartley P Griffith
OBJECTIVE: We aimed to create a reproducible lung injury model utilizing injection of mitochondrial damage-associated molecular products. Our goal was to characterize the pathophysiologic response to damage-associated molecular pattern mediated organ injury. SUMMARY BACKGROUND DATA: There remain significant gaps in our understanding of acute respiratory distress syndrome, in part due to the lack of clinically applicable animal models of this disease. Animal models of noninfectious, tissue damage-induced lung injury are needed to understand the signals and responses associated with this injury...
October 4, 2016: Annals of Surgery
Erwan d'Aranda, Julien Bordes, Boris Bourgeois, Jared Clay, Pierre Esnault, Pierre-Julien Cungi, Philippe Goutorbe, Eric Kaiser, Eric Meaudre
BACKGROUND: Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. One solution is to use a ventilator able to function with an oxygen concentrator (OC). METHODS: We tested two Elisée™ 350 ventilators paired with SeQual Integra 10-OM oxygen concentrators (OC) (Chart Industries, http://www and evaluated the delivered fraction of inspired oxygen (Fio2)...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Samir Jaber, Marion Monnin, Mehdi Girard, Matthieu Conseil, Moussa Cisse, Julie Carr, Martin Mahul, Jean Marc Delay, Fouad Belafia, Gérald Chanques, Nicolas Molinari, Audrey De Jong
PURPOSE: High-flow nasal cannula oxygen (HFNC) has the potential to provide apnoeic oxygenation. We decided to assess in a proof-of-concept study whether the addition of HFNC to non-invasive ventilation (NIV) could reduce oxygen desaturation during intubation, compared with NIV alone for preoxygenation, in severely hypoxaemic intensive care unit (ICU) patients with respiratory failure. METHODS: We conducted a randomised, controlled, single-centre trial with assessor-blinded outcome assessment in patients admitted to the ICU...
October 11, 2016: Intensive Care Medicine
Toshihiro Okamoto, David Wheeler, Qiang Liu, Cristiano Quintini, J Steven Hata, Kenneth R McCurry
BACKGROUND: Ex vivo lung perfusion (EVLP) may be an essential process for the pre-transplant evaluation of the donor lungs. Currently, the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2, or PF) ratio is the standard in the assessment of lung function in cellular EVLP, whereas other parameters, including airway and vascular parameters, have only been partially utilized. The primary purpose of this study is to assess the potential utility of other parameters as a surrogate of lung function in EVLP...
May 20, 2016: Journal of Heart and Lung Transplantation
Elisa Damiani, Alex Dyson, Lucia Zacchetti, Abele Donati, Mervyn Singer
BACKGROUND: Hypoxemia may compromise cell metabolism and organ function. Supplemental oxygen (O2) at high concentrations may prove ineffective, and issues relating to hyperoxia, barotrauma, mechanical ventilation, and extracorporeal oxygenation are well documented. Old reports suggest the potential safety and efficacy of alternative routes for O2 administration, such as intravenous or intestinal. We re-explored these routes in rat models of hypoxemia. METHODS: Hypoxemia was induced in spontaneously breathing, anesthetized rats by breathing a hypoxic gas mix (FiO2 0...
December 2016: Intensive Care Medicine Experimental
Hiroshi Nagahisa, Kazutaka Mukai, Hajime Ohmura, Toshiyuki Takahashi, Hirofumi Miyata
Hypoxic training is believed to increase endurance capacity in association with hypoxia inducible factor-1α (HIF-1α), a modulator of vascular endothelial growth factor-A (VEGF-A), and to influence activation of satellite cells (SCs). However, the effect of hypoxic training on SC activation and its relation to angiogenesis has not been thoroughly investigated. Eight Thoroughbred horses were subjected to normoxic (FIO2 = 21%) or hypoxic (FIO2 = 15%) training for 3 days/week (100%  [Formula: see text]) for 4 weeks...
2016: Oxidative Medicine and Cellular Longevity
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