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Lung protective ventilation

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https://www.readbyqxmd.com/read/28810549/dexmedetomidine-preconditioning-protects-against-lung-injury-induced-by-ischemia-reperfusion-through-inhibition-of-autophagy
#1
Wei Zhang, Jiaqiang Zhang
The present study aimed to evaluate the role of autophagy in the protective effect of dexmedetomidine in lung injury caused by ischemia-reperfusion (IR) in rats. In total 48 adult male Sprague-Dawley rats were randomly divided into 6 groups (n=8) as follows: i) Sham group; ii) the IR group; iii) IR + 1 µg/kg dexmedetomidine preconditioning group (pre-LD); iv) IR + 10 µg/kg dexmedetomidine preconditioning group (pre-HD); v) IR + 1 µg/kg dexmedetomidine postconditioning group (post-LD); and vi) IR + 10 µg/kg dexmedetomidine postconditioning group (post-HD)...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#2
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28797053/the-epidemiology-of-medically-attended-respiratory-syncytial-virus-in-older-adults-in-the-united-states-a-systematic-review
#3
Ann D Colosia, Jin Yang, Eric Hillson, Josephine Mauskopf, Catherine Copley-Merriman, Vivek Shinde, Jeffrey Stoddard
OBJECTIVE: This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. DESIGN: A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. METHODS: A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years...
2017: PloS One
https://www.readbyqxmd.com/read/28795334/mathematical-modeling-of-extracorporeal-co2-removal-therapy-a-validation-carried-out-on-ten-pigs
#4
Simon Habran, Thomas Desaive, Philippe Morimont, Bernard Lambermont, Pierre Dauby
The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syndrome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The simulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model...
August 9, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28795220/achieving-and-maintaining-lung-volume-in-the-preterm-infant-from-the-first-breath-to-the-nicu
#5
REVIEW
Gianluca Lista, Andrés Maturana, Fernando R Moya
Please check if statements under Abstract section are presented correctly.The main goal for the neonatologist is to facilitate the adaptation to extra-uterine life during initial transition, while minimizing lung injury opening and protecting the premature lung from the first breath onwards. An appropriate management from birth should lead to the achievement of an early functional residual capacity (FRC), and the following steps should aim at maintaining an adequate lung volume. To date, different strategies are available to optimize fetal-neonatal transition and promote lung recruitment...
August 10, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28790180/pseudomonas-aeruginosa-lasb-protease-impairs-innate-immunity-in-mice-and-humans-by-targeting-a-lung-epithelial-cystic-fibrosis-transmembrane-regulator-il-6-antimicrobial-repair-pathway
#6
Vinciane Saint-Criq, Bérengère Villeret, Fabien Bastaert, Saadé Kheir, Aurélie Hatton, Aurélie Cazes, Zhou Xing, Isabelle Sermet-Gaudelus, Ignacio Garcia-Verdugo, Aleksander Edelman, Jean-Michel Sallenave
BACKGROUND: Pseudomonas aeruginosa lung infections are a huge problem in ventilator-associated pneumonia, cystic fibrosis (CF) and in chronic obstructive pulmonary disease (COPD) exacerbations. This bacterium secretes virulence factors that may subvert host innate immunity. OBJECTIVE: We evaluated the effect of P. aeruginosa elastase LasB, an important virulence factor secreted by the type II secretion system, on ion transport, innate immune responses and epithelial repair, both in vitro and in vivo...
August 8, 2017: Thorax
https://www.readbyqxmd.com/read/28759484/impact-of-different-ventilation-strategies-on-driving-pressure-mechanical-power-and-biological-markers-during-open-abdominal-surgery-in-rats
#7
Lígia de A Maia, Cynthia S Samary, Milena V Oliveira, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Marcelo M Morales, Marcus J Schulz, Marcelo G Abreu, Paolo Pelosi, Pedro L Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757912/lung-protective-ventilation-strategies-for-relief-from-ventilator-associated-lung-injury-in-patients-undergoing-craniotomy-a-bicenter-randomized-parallel-and-controlled-trial
#8
Chaoliang Tang, Juan Li, Shaoqing Lei, Bo Zhao, Zhetao Zhang, Wenting Huang, Si Shi, Xiaoqing Chai, Chaoshi Niu, Zhongyuan Xia
Current evidence indicates that conventional mechanical ventilation often leads to lung inflammatory response and oxidative stress, while lung-protective ventilation (LPV) minimizes the risk of ventilator-associated lung injury (VALI). This study evaluated the effects of LPV on relief of pulmonary injury, inflammatory response, and oxidative stress among patients undergoing craniotomy. Sixty patients undergoing craniotomy received either conventional mechanical (12 mL/kg tidal volume [VT] and 0 cm H2O positive end-expiratory pressure [PEEP]; CV group) or protective lung (6 mL/kg VT and 10 cm H2O PEEP; PV group) ventilation...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28749608/prone-position-ventilation-support-for-acute-exacerbation-of-interstitial-lung-disease
#9
Yuanda Xu, Qingwen Sun, Yuheng Yu, Weibo Liang, Xuesong Liu, Chun Yang, Yonghao Xu, Lingbo Nong, Sibei Chen, Weiqun He, Xiaoqing Liu, Yimin Li, Nanshan Zhong
INTRODUCTION: Prone position ventilation (PPV) has been shown to improve oxygenation and decrease pulmonary vascular resistance and mortality in patients with severe acute respiratory distress syndrome (ARDS). Whether these benefits of PPV occur similarly in acute exacerbations of interstitial lung disease (ILD) is not clear. We retrospectively explored the use of PPV in acute exacerbation with ILD versus those with severe acute respiratory distress syndrome (severe ARDS). METHODS: Retrospective study of the application of PPV in 17 patients with acute exacerbations of ILD and in 19 patients with severe ARDS...
July 27, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28747201/intravenous-superoxide-dismutase-as-a-protective-agent-to-prevent-impairment-of-lung-function-induced-by-high-tidal-volume-ventilation
#10
Nan-Chun Wu, Fan-Ting Liao, Hao-Min Cheng, Shih-Hsien Sung, Yu-Chun Yang, Jiun-Jr Wang
BACKGROUND: Positive-pressure mechanical ventilation is essential in assisting patients with respiratory failure in the intensive care unit and facilitating oxygenation in the operating room. However, it was also recognized as a primary factor leading to hospital-acquired pulmonary dysfunction, in which pulmonary oxidative stress and lung inflammation had been known to play important roles. Cu/Zn superoxide dismutase (SOD) is an important antioxidant, and possesses anti-inflammatory capacity...
July 26, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28743335/-regulation-of-paxillin-tyrosine-phosphorylation-via-inhibition-of-c-abl-kinase-to-protect-ventilator-induce-lung-injury-in-vivo-in-rats
#11
Rong Zhong, Jun Xiao, Chunguang Dai, Zhihui Yu
OBJECTIVE: To determine whether the inhibition of paxillin tyrosine residues 31 and tyrosine residues 118 (Pxn Y31 and Pxn Y118) phosphorylation via inhibition of c-Abl kinase will effectively block its downstream effector molecules vessel endothelium-cadherin (VE-cad), and whether Rho/Rho kinase activation which will induce the vascular barrier dysfunction. METHODS: Ninety healthy male Sprague-Dawley (SD) rats were randomly divided into nine groups (each n =10)...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28742774/improving-adherence-to-intraoperative-lung-protective-ventilation-strategies-at-a-university-medical-center
#12
Sean A Josephs, Gretchen A Lemmink, Judith A Strong, Cassandra L Barry, William E Hurford
BACKGROUND: Intraoperative lung-protective ventilation (ILPV) is defined as tidal volumes <8 mL/kg ideal bodyweight and is increasingly a standard of care for major abdominal surgical procedures performed under general anesthesia. In this study, we report the result of a quality improvement initiative targeted at improving adherence to ILPV guidelines in a large academic teaching hospital. METHODS: We performed a time-series study to determine whether anesthesia provider adherence to ILPV was affected by certain improvement interventions and patient ideal body weight (IBW)...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28736528/linking-ventilator-injury-induced-leak-across-the-blood-gas-barrier-to-derangements-in-murine-lung-function
#13
Bradford J Smith, Elizabeth Bartolak-Suki, Bela Suki, Gregory S Roy, Katharine L Hamlington, Chantel M Charlebois, Jason H T Bates
Mechanical ventilation is vital to the management of acute respiratory distress syndrome, but it frequently leads to ventilator-induced lung injury (VILI). Understanding the pathophysiological processes involved in the development of VILI is an essential prerequisite for improving lung-protective ventilation strategies. The goal of this study was to relate the amount and nature of material accumulated in the airspaces to biomarkers of injury and the derecruitment behavior of the lung in VILI. Forty-nine BALB/c mice were mechanically ventilated with combinations of tidal volume and end-expiratory pressures to produce varying degrees of overdistension and atelectasis while lung function was periodically assessed...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28725223/gas-exchange-disturbances-regulate-alveolar-fluid-clearance-during-acute-lung-injury
#14
REVIEW
István Vadász, Jacob I Sznajder
Disruption of the alveolar-capillary barrier and accumulation of pulmonary edema, if not resolved, result in poor alveolar gas exchange leading to hypoxia and hypercapnia, which are hallmarks of acute lung injury and the acute respiratory distress syndrome (ARDS). Alveolar fluid clearance (AFC) is a major function of the alveolar epithelium and is mediated by the concerted action of apically-located Na(+) channels [epithelial Na(+) channel (ENaC)] and the basolateral Na,K-ATPase driving vectorial Na(+) transport...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28722695/cardiac-cycle-efficiency-and-dicrotic-pressure-variations-new-parameters-for-fluid-therapy-a-pilot-observational-study
#15
Antonio Messina, Salvatore M Romano, Eleonora Bonicolini, Davide Colombo, Gianmaria Cammarota, Marco Chiostri, Francesco Della Corte, Paolo Navalesi, Didier Payen, Stefano Romagnoli
BACKGROUND: During a fluid challenge, the changes in cardiac performance and peripheral circulatory tone are closely related to the position of the ventricle on the Frank-Starling curve. Some patients have a good haemodynamic response to a fluid challenge, others hardly any response. The early haemodynamic effects of a fluid challenge could predict the final response before the entire fluid volume has been administered. OBJECTIVE: To assess whether a multivariate logistic regression model, including pulse pressure variation (PPV), cardiac cycle efficiency (CCE), arterial elastance and the difference between the dicrotic pressure and both systolic and mean arterial pressure (SAP - Pdic and MAP - Pdic) can predict cardiac responsiveness early during a fluid challenge in comparison with the standard procedure described elsewhere...
June 19, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28714270/resistive-breathing-and-respiratory-muscle-fatigue-a-load-of-concern-just-expired
#16
Ken D O'Halloran
Pulmonary ventilation is a cyclical process of inhalation and exhalation of air providing dynamic tidal exchange between alveolar gas-exchanging units of the lungs and the external environment. This article is protected by copyright. All rights reserved.
July 17, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28707030/-update-acute-hypercapnic-respiratory-failure
#17
REVIEW
F Seiler, F C Trudzinski, M Kredel, C Lotz, P M Lepper, R M Muellenbach
BACKGROUND: Hypercapnic respiratory failure is a frequent problem in critical care and mainly affects patients with acute exacerbation of COPD (AECOPD) and acute respiratory distress syndrome (ARDS). In recent years, the usage of extracorporeal CO2 removal (ECCO2R) has been increasing. OBJECTIVE: Summarizing the state of the art in the management of hypercapnic respiratory failure with special regard to the role of ECCO2R. METHODS: Review based on a selective literature search and the clinical and scientific experience of the authors...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28701843/incidence-proportion-of-acute-cor-pulmonale-in-patients-with-acute-respiratory-distress-syndrome-subjected-to-lung-protective-ventilation-a-systematic-review-and-meta-analysis
#18
Saurabh Kumar Das, Nang Sujali Choupoo, Priyam Saikia, Amitabh Lahkar
INTRODUCTION: Reported incidence of acute cor pulmonale (ACP) in patients with acute respiratory distress syndrome (ARDS) varies from 10% to 84%, despite being subjected to lung protective ventilation according to the current guidelines. The objective of this review is to find pooled cumulative incidence of ACP in patients with ARDS undergoing lung protective ventilation. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILACS, and WHO Clinical Trial Registry...
June 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28697635/the-perpetuation-of-the-misconception-that-rats-receive-a-3-5-times-lower-lung-tissue-dose-than-humans-at-the-same-ozone-concentration
#19
Darrell McCant, Sabine Lange, Joseph Haney, Michael Honeycutt
This paper highlights the pervasive misconception concerning 1994 findings from Hatch et al. about ozone (O3) tissue dose in humans versus rats. That study exposed humans to 0.4 ppm and rats to 2 ppm (18)O-labeled O3 and found comparable incorporation of (18)O into bronchoalveolar lavage constituents. However, during O3 exposure humans were exercising, which increased their ventilation rate five-fold, while rats were at rest. This resulted in similar O3 tissue doses between the two species, and predominantly explained the comparable (18)O incorporation at five-fold different concentrations...
July 12, 2017: Inhalation Toxicology
https://www.readbyqxmd.com/read/28696966/defining-a-ventilation-strategy-for-flexible-bronchoscopy-on-mechanically-ventilated-patients-in-the-medical-intensive-care-unit
#20
Yonatan Y Greenstein, Eric Shakespeare, Peter Doelken, Paul H Mayo
BACKGROUND: Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. METHODS: We studied 16 subjects who were intubated on mechanical ventilation and required FB...
July 2017: Journal of Bronchology & Interventional Pulmonology
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