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Ventilatory support

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https://www.readbyqxmd.com/read/29643669/which-is-better-a-standalone-ventilation-or-perfusion-scan-or-combined-imaging-to-predict-postoperative-fev-1-in-one-seconds-in-patients-posted-for-lung-surgeries-with-borderline-pulmonary-reserve
#1
Padma Subramanyam, P Shanmuga Sundaram
Introduction: Forced expiratory volume in one second (FEV1 ) is an independent predictor for respiratory morbidity. Reports are varied and controversial substantiating the use of either lung perfusion (Q) or ventilation (V) scintigraphy as a single stage investigation to predict postoperative (ppo) FEV1 in patients scheduled for lung resection surgeries. It is said that there is no additional benefit by performing both V/Q scan. As per one of the recommendations, no further respiratory function tests are required for a lobectomy if the postbronchodilator FEV1 is >1...
April 2018: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/29628475/prognostic-improvement-of-acute-necrotizing-eosinophilic-myocarditis-anem-through-a-rapid-pathological-diagnosis-and-appropriate-therapy
#2
Akihiko Yonenaga, Eriko Hasumi, Katsuhito Fujiu, Aya Ushiku, Masaru Hatano, Jiro Ando, Hiroyuki Morita, Masafumi Watanabe, Issei Komuro
We present the case of a patient with acute necrotizing eosinophilic myocarditis (ANEM) who rapidly recovered after receiving high-dose corticosteroid therapy. A previously healthy 29-year-old woman presented to our hospital with abdominal pain, nausea, and fever that had lasted for two days. Her clinical condition progressively declined and she ultimately presented with cardiogenic shock due to fulminant heart failure and atrioventricular dissociation due to sinus bradycardia, which required inotropic and ventilatory support...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29627403/ventilatory-practices-in-extremely-low-birth-weight-infants-in-a-level-iii-neonatal-intensive-care-unit
#3
S Abreu-Pereira, R Pinto-Lopes, F Flôr-de-Lima, G Rocha, H Guimarães
INTRODUCTION: Although non-invasive forms of ventilation have recently spread in neonatology, invasive ventilation still plays a key role in the support of extremely low birth weight (ELBW) infants. The purpose of this study was to assess changes in neonatal ventilation practices for ELBW infants and compare outcomes between two epochs (2005-2009 vs. 2010-2015) to analyze progression stemming from the implementation of newer clinical guidelines. MATERIALS AND METHODS: We conducted a retrospective study with data collection from all ELBW infants born between 2005 and 2015 in our center through their individual clinical records...
April 4, 2018: Pulmonology
https://www.readbyqxmd.com/read/29602482/-neurofibromatosis-as-a-cause-of-breathlessness
#4
A Palot, C Ferrandez, K Alagha, A Ilstad-Minnihan, C Tummino, M Gouitaa, D Charpin, P Chanez
INTRODUCTION: Type 1 neurofibromatosis, also called "Recklinghausen's disease" is among the most frequent autosomal dominant genetic disorders, with an incidence of 1:3500 births. It mainly affects the skin and peripheral nervous system. However, in its less frequent manifestations, are tumors such as meningocele and skeletal dysplasias leading to severe clinical presentation. CASE REPORT: We report the case of a 55-year-old patient with type 1 neurofibromatosis and dyspnea due to a large left thoracic meningocele combined with a significant kyphoscoliosis, causing a severe restrictive ventilatory defect, complicated by chronic respiratory failure and pulmonary hypertension...
March 27, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29593993/fetal-primary-hydrothorax-with-spontaneous-resolution
#5
Vera Trocado, J P Coutinho-Borges, Mariana Carlos-Alves, Joaquim Santos, Paula Pinheiro
Fetal primary hydrothorax is a rare congenital anomaly with an estimated incidence of 1:10.000-15.000 pregnancies, with an unpredictable clinical course, ranging from spontaneous resolution to fetal death. We present a case of a unilateral fetal pleural effusion identified at 35th gestational week. A 37 year-old woman (G2P1) presented to our routine term pregnancy evaluation. The pregnancy had been otherwise uneventful. At ecographic evaluation a large anechogenic fluid collection was identified in the right fetal hemithorax, with atelectasis of right lung, displacing the heart and mediastinal structures to the contralateral hemithorax...
July 2017: Case Reports in Women's Health
https://www.readbyqxmd.com/read/29593914/rituximab-induced-pulmonary-edema-managed-with-extracorporeal-life-support
#6
Jacob R Miller, Warren Isakow, Muhammad F Masood, Patrick Aguilar, Kristen M Sanfilippo, Keki R Balsara, Akinobu Itoh
Though rare, rituximab has been reported to induce severe pulmonary edema. We describe the first report of ECLS utilization for this indication. A 31-year-old female with severe thrombotic thrombocytopenic purpura developed florid pulmonary edema after rituximab infusion. Despite advanced ventilatory settings, she developed severe respiratory acidosis and remained hypoxemic with a significant vasopressor requirement. Since her pulmonary insult was likely transient, ECLS was considered. Due to combined cardiorespiratory failure, she received support with peripheral venoarterial ECLS...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29575957/ventilator-induced-lung-injury-during-controlled-ventilation-in-patients-with-acute-respiratory-distress-syndrome-less-is-probably-better
#7
Fernanda Ferreira Cruz, Lorenzo Ball, Patricia Rieken Macedo Rocco, Paolo Pelosi
Mechanical ventilation is required to support respiratory function in the acute respiratory distress syndrome (ARDS), but it may promote lung damage, a phenomenon known as ventilator-induced lung injury (VILI). Areas covered: Several mechanisms of VILI have been described, such as: inspiratory and/or expiratory stress inducing overdistension (volutrauma); interfaces between collapsed or edema-filled alveoli with surrounding open alveoli, acting as stress raisers; alveoli that repetitively open and close during tidal breathing (atelectrauma); and peripheral airway dynamics...
March 26, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29570493/does-anthrax-antitoxin-therapy-have-a-role-in-the-treatment-of-inhalational-anthrax
#8
Nicholas J Vietri
PURPOSE OF REVIEW: Inhalational anthrax is a rare disease and Bacillus anthracis is a likely pathogen to be used in a biological attack. The lack of clinical experience with anthrax has led experts to develop treatment guidelines. These guidelines recommend anthrax antitoxin to be used in conjunction with antibiotics for the treatment of patients with systemic anthrax infection, yet there is still a lack of human or animal data to support this recommendation. RECENT FINDINGS: The U...
March 22, 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29564726/potentially-modifiable-respiratory-variables-contributing-to-outcome-in-icu-patients-without-ards-a-secondary-analysis-of-provent
#9
Fabienne D Simonis, Carmen S V Barbas, Antonio Artigas-Raventós, Jaume Canet, Rogier M Determann, James Anstey, Goran Hedenstierna, Sabrine N T Hemmes, Greet Hermans, Michael Hiesmayr, Markus W Hollmann, Samir Jaber, Ignacio Martin-Loeches, Gary H Mills, Rupert M Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Roger Smith, Tanja A Treschan, Edda M Tschernko, Marcos F Vidal Melo, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz, Ary Serpa Neto
BACKGROUND: The majority of critically ill patients do not suffer from acute respiratory distress syndrome (ARDS). To improve the treatment of these patients, we aimed to identify potentially modifiable factors associated with outcome of these patients. METHODS: The PRoVENT was an international, multicenter, prospective cohort study of consecutive patients under invasive mechanical ventilatory support. A predefined secondary analysis was to examine factors associated with mortality...
March 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29559539/ventilator-boot-camp-improves-the-knowledge-and-skills-associated-with-mechanical-ventilator-use-during-interfacility-transport-of-intubated-pediatric-patients
#10
Jennifer L Walton, Diane K Dunn, Nhi Y Haines, Ilana Heisler, Michael T Bigham, Teresa A Volsko
BACKGROUND: The American Academy of Pediatrics Section on Transport recommends the use of portable ventilators during the transport of patients with advanced airways. We sought to identify knowledge gaps and evaluate the effectiveness of a transport ventilator competency boot camp. METHODS: Electronic health records of children requiring ventilatory support during air and ground interfacility transport from January 1 through December 31, 2015, were reviewed to determine when manual ventilation was used in lieu of a portable ventilator, and simulations were constructed from commonly occurring scenarios...
April 2018: Respiratory Care
https://www.readbyqxmd.com/read/29559484/extracorporeal-membrane-oxygenation-ecmo-for-near-fatal-asthma-refractory-to-conventional-ventilation
#11
Usman Maqsood, Nehal Patel
We describe a case of near-fatal asthma, treated successfully by initiation of extracorporeal membrane oxygenation (ECMO). A 29-year-old woman, known asthmatic on steroid inhalers, inhaled/nebulised bronchodilators, long-term oral prednisolone, theophylline and montelukast, presented with acute shortness of breath. She deteriorated following initial treatment with nebulised bronchodilators and magnesium sulfate requiring intubation and mechanical ventilation. Severe bronchospasm ensued following mechanical ventilation and peak airway pressures remained at 55 cm H2 O with intrinsic positive end expiratory pressure(PEEP) of 14 cm H2 O...
March 20, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29557596/severe-asthma-in-pediatrics-outcomes-of-the-implementation-of-a-special-health-care-protocol
#12
Verónica Giubergia, María J Ramirez Farías, Verónica Pérez, Adriana González, Nancy Crespi, Nora Fridman, Claudio Castaños
INTRODUCTION: Severe asthma accounts for 5-7% of all asthma cases. The World Health Organization proposed a follow-up protocol to classify cases into severe, treatment-resistant asthma (STRA) or severe, difficult-to-control asthma (SDCA). OBJECTIVE: To analyze the clinical, functional, and therapeutic characteristics of patients with STRA or SDCA. METHODS: Cross-sectional, observational, and analytical study to assess the diagnosis, the extent of control (clinical and functional), comorbidities, treatment adherence, inhalation technique, and environmental factors in patients with severe asthma...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29556805/serial-diaphragm-ultrasonography-to-predict-successful-discontinuation-of-mechanical-ventilation
#13
Atul Palkar, Paul Mayo, Karan Singh, Seth Koenig, Mangala Narasimhan, Anup Singh, Rivkah Darabaner, Harly Greenberg, Eric Gottesman
INTRODUCTION: Diaphragm excursion and contraction velocity measured using ultrasonography have been used to assess diaphragm function. We aimed to evaluate the performance of diaphragm ultrasonography during weaning from mechanical ventilation (MV). METHODS: Diaphragm ultrasonography was performed on 73 mechanically ventilated patients who were being considered for extubation on three separate occasions: (1) on assist control mode (A/C) during consistent patient triggered ventilation, (2) following 30 min during a spontaneous breathing trial (SBT), (3) 4-24 h following extubation...
March 19, 2018: Lung
https://www.readbyqxmd.com/read/29553480/real-time-chest-wall-motion-tracking-by-a-single-optical-fibre-grating-a-prospective-method-for-ventilator-triggering
#14
Marija D Ivanovic, Jovana Petrovic, Andrej Savic, Goran Gligoric, Marjan Miletic, Miodrag Vukcevic, Bosko Bojovic, Ljupco Hadzievski, Tom D P Allsop, David J Webb
The ventilators involved in non-invasive mechanical ventilation commonly provide ventilator support via a facemask. The interface of the mask with a patient promotes air leaks that cause errors in the feedback information provided by a pneumatic sensor and hence patient-ventilator asynchrony with multiple negative consequences. Our objective is to test the possibility of using chest-wall motion measured by an optical fibre-grating sensor as a more accurate non-invasive ventilator triggering mechanism.
 Approach: The basic premise of our approach is that the measurement accuracy can be improved by using a triggering signal that precedes pneumatic triggering in the neuro-ventilatory coupling sequence...
March 19, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29535515/home-noninvasive-ventilatory-support-for-patients-with-chronic-obstructive-pulmonary-disease-patient-selection-and-perspectives
#15
REVIEW
Jan Hendrik Storre, Jens Callegari, Friederike Sophie Magnet, Sarah Bettina Schwarz, Marieke Leontine Duiverman, Peter Jan Wijkstra, Wolfram Windisch
Long-term or home mechanical noninvasive ventilation (Home-NIV) has become a well-established form of therapy over the last few decades for chronic hypercapnic COPD patients in European countries. However, meta-analyses and clinical guidelines do not recommend Home-NIV for COPD patients on a routine basis. In particular, there is ongoing debate about Home-NIV in chronic hypercapnic COPD regarding the overall effects, the most favorable treatment strategy, the selection of eligible patients, and the time point at which it is prescribed...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29531210/living-donor-liver-transplantation-in-acute-liver-failure-patients-with-grade-iv-encephalopathy-is-deep-hepatic-coma-still-an-absolute-contraindication-a-successful-single-center-experience
#16
Horng-Ren Yang, Ashok Thorat, Long-Bin Jeng, Shih-Chao Hsu, Ping-Chun Li, Chun-Chieh Yeh, Te-Hung Chen, Kin-SHing Poon
BACKGROUND The prognosis of the patients of acute liver failure (ALF) with onset of hepatic coma is often dismal. ALF is a well-accepted indication for liver transplantation (LT) and has markedly improved the prognosis of these patients. However, its role in ALF patients with onset of hepatic coma has never been elucidated before. The aim of our study was to analyze the outcome in patients of ALF with hepatic coma who underwent LT. MATERIAL AND METHODS From January 2002 to December 2015, a total of 726 liver transplantations were done at China Medical University Hospital, Taiwan...
March 13, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29528016/liver-transplant-and-reexpansion-pulmonary-edema-a-case-report
#17
Sibel Kara, Nazan Sen, Sule Akcay, Gokhan Moray, Murat Kus, Mehmet Haberal
Hydrothorax occurs frequently in patients with endstage liver disease and usually requires drainage of pulmonary effusion during the hepatectomy phase of liver transplant. Reexpansion pulmonary edema is a rare but potentially fatal complication seen after rapid reexpansion of the collapsed lung following thoracentesis of pleural fluid or tube drainage of pneumothorax. This condition, which manifests with various degrees of clinical severity, is rarely reported following liver transplantation. Herein, we present a 62-year-old male patient who developed reexpansion pulmonary edema after drainage of massive pleural effusion, which caused a total collapse in the right hemithorax during liver transplant...
March 2018: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29519728/optimizing-risk-stratification-in-heart-failure-and-the-selection-of-candidates-for-heart-transplantation
#18
Tiago Pereira-da-Silva, Rui M Soares, Ana Luísa Papoila, Iola Pinto, Joana Feliciano, Luís Almeida-Morais, Ana Abreu, Rui Cruz Ferreira
INTRODUCTION AND AIMS: Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. METHODS: Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejection fraction ≤40% prospectively underwent a comprehensive baseline assessment including clinical, laboratory, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters...
March 5, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29514258/aortopexy-for-the-treatment-of-tracheobronchomalacia-in-100-children-a-10-year-single-centre-experience
#19
Friso M Rijnberg, Colin R Butler, Christian Bieli, Sonia Kumar, Reza Nouraei, Joshua Asto, Eimear McKavanagh, Paolo de Coppi, Nagarajan Muthialu, Martin J Elliott, Richard J Hewitt
OBJECTIVES: Our study describes and analyses the results from aortopexy for the treatment of airway malacia in children. METHODS: Demographic data, characteristics and preoperative, operative and outcome details, including the need for reintervention, were collected for children undergoing aortopexy between 2006 and 2016. RESULTS: One hundred patients [median age 8.2 months, interquartile range (IQR) 3.3-26.0 months] underwent aortopexy...
March 5, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29513620/validation-of-a-pulse-oximetry-system-for-high-altitude-waterfowl-by-examining-the-hypoxia-responses-of-the-andean-goose-chloephaga-melanoptera
#20
Catherine M Ivy, Julia M York, Sabine L Lague, Beverly A Chua, Luis Alza, Kevin G McCracken, William K Milsom, Graham R Scott
Hypoxia at high altitudes constrains O2 supply to support metabolism, thermoregulation in the cold, and exercise. High-altitude natives that somehow overcome this challenge-who live, reproduce, and sometimes perform impressive feats of exercise at high altitudes-are a powerful group in which to study the evolution of physiological systems underlying hypoxia resistance. Here, we sought to determine whether a common pulse oximetry system for rodents (MouseOx Plus) can be used reliably in studies of high-altitude birds by examining the hypoxia responses of the Andean goose...
May 2018: Physiological and Biochemical Zoology: PBZ
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