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https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#1
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29787412/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#2
Xiang Si, Hailin Xu, Zimeng Liu, Jianfeng Wu, Daiyin Cao, Juan Chen, Minying Chen, Yongjun Liu, Xiangdong Guan
BACKGROUND: We performed a systematic review and meta-analysis of studies investigating the diagnostic accuracy of respiratory variation in inferior vena cava diameter (ΔIVC) for predicting fluid responsiveness in patients receiving mechanical ventilation. METHODS: MEDLINE, EMBASE, the Cochrane Library, and Web of Science were screened from inception to February 2017. The meta-analysis assessed the pooled sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787304/deterioration-of-regional-lung-strain-and-inflammation-during-early-lung-injury
#3
Gabriel C Motta-Ribeiro, Soshi Hashimoto, Tilo Winkler, Rebecca M Baron, Kira Grogg, Luís F S C Paula, Arnoldo Santos, Congli Zeng, Kathryn Hibbert, Robert S Harris, Ednan Bajwa, Marcos F Vidal Melo
RATIONALE: The contribution of aeration heterogeneity to lung injury during early mechanical ventilation of uninjured lungs is unknown. OBJECTIVE: Test the hypotheses that a strategy consistent with clinical practice does not protect from worsening in lung strains during the first 24h of ventilation of initially normal lungs exposed to mild systemic endotoxemia in supine versus prone position, and that local neutrophilic inflammation is associated with local strain and blood volume at global strains below a proposed injurious threshold...
May 22, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29785504/impact-of-a-vap-bundle-in-belgian-intensive-care-units
#4
Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux, Pierre Damas
BACKGROUND: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. METHODS: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients...
May 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29785103/chinese-version-of-the-severe-respiratory-insufficiency-questionnaire-for-patients-with-copd-receiving-long-term-oxygen-therapy
#5
Lili Guan, Jiawen Xu, Weiliang Wu, Jianhua Chen, Xiaoying Li, Bingpeng Guo, Yuqiong Yang, Yating Huo, Luqian Zhou, Rongchang Chen
Purpose: Patients with advanced-stage COPD often experience severe hypoxemia. Treatment with long-term oxygen therapy (LTOT) may relieve patients' symptoms and increase survival. As COPD is incurable, improving patients' health-related quality of life is important. The Chinese version of the Severe Respiratory Insufficiency Questionnaire (SRI) is valid for patients with hypercapnic COPD undergoing noninvasive positive airway pressure ventilation at home. However, the reliability and validity of the Chinese SRI for patients with COPD undergoing LTOT have not been investigated...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29779887/pulmonary-capillary-hemorrhage-induced-by-diagnostic-ultrasound-in-ventilated-rats
#6
Douglas L Miller, Zhihong Dong, Chunyan Dou, Krishnan Raghavendran
Pulmonary capillary hemorrhage (PCH) can be induced by diagnostic ultrasound-a potential safety issue. Anesthetized rats were intubated for intermittent positive-pressure ventilation (IPPV) with 0 end-expiratory pressure, +4 cm H2 O end-expiratory pressure (PEEP) and -4 cm H2 O end-expiratory pressure (NEEP). Rats were imaged at 7.6 MHz with a Philips HDI 5000 ultrasound machine. The output was low (mechanical index [MI] = 0.22) for aiming and then was raised for 5 min in 20 different exposure groups with n = 8...
May 17, 2018: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29779591/sleep-disordered-breathing-in-neuromuscular-and-chest-wall-diseases
#7
REVIEW
Janet Hilbert
Neuromuscular and chest wall diseases include a diverse group of conditions that share common risk factors for sleep-disordered breathing, including respiratory muscle weakness and/or thoracic restriction. Sleep-disordered breathing results from both the effects of normal sleep on ventilation and the additional challenges imposed by the underlying disorders. Patterns of sleep- disordered breathing vary with the specific diagnosis and stage of disease. Sleep hypoventilation precedes diurnal respiratory failure and may be difficult to recognize clinically because symptoms are nonspecific...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29778994/heart-rate-changes-during-positive-pressure-ventilation-after-asphyxia-induced-bradycardia-in-a-porcine-model-of-neonatal-resuscitation
#8
Maria Liza Espinoza, Po-Yin Cheung, Tze-Fun Lee, Megan O'Reilly, Georg M Schmölzer
BACKGROUND: The Neonatal Resuscitation Program (NRP) states that if adequate positive pressure ventilation (PPV) was given for a low heart rate (HR), the infant's HR should increase within the first 15 s of PPV. OBJECTIVE: To assess changes in HR in piglets with asphyxia-induced bradycardia. METHODS: Term newborn piglets (n=30) were anaesthetised, intubated, instrumented and exposed to 50 min normocapnic hypoxia followed by asphyxia. Asphyxia was achieved by clamping the tube until severe bradycardia (defined as HR at <u><</u>25% of baseline)...
May 19, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29775005/-determination-and-significance-of-serum-mpo-and-amylin-in-adult-patients-with-osahs-after-short-range-noninvasive-positive-pressure-ventilation
#9
X H Chen, P J Chen, Y Long, Q P Huang
Objective: The aim of this study to investigate the determination and significance of serum MPO and amylin in adult patients with OSAHS after short-range noninvasive positive pressure ventilation. Method: Eighty-seven OSAHS patients were divided into severe group (30 cases), moderate group (30 cases) and mild group (27 cases) according to the AHI range. Twenty-seven outpatient health persons were selected as the control group. Serum amylin and myeloperoxidase were measured by ELISA; Amyloid and myeloperoxidase were reassessed in 30 patients with severe OSAHS after 6 months of combined therapy, and the relationship between amylin, myeloperoxidase and PSG was analyzed...
June 5, 2017: Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery
https://www.readbyqxmd.com/read/29769151/real-time-automated-detection-of-ventilator-associated-events-avoiding-missed-detections-misclassifications-and-false-detections-due-to-human-error
#10
Erica S Shenoy, Eric S Rosenthal, Yu-Ping Shao, Siddharth Biswal, Manohar Ghanta, Erin E Ryan, Dolores Suslak, Nancy Swanson, Valdery Moura Junior, David C Hooper, M Brandon Westover
OBJECTIVETo validate a system to detect ventilator associated events (VAEs) autonomously and in real time.DESIGNRetrospective review of ventilated patients using a secure informatics platform to identify VAEs (ie, automated surveillance) compared to surveillance by infection control (IC) staff (ie, manual surveillance), including development and validation cohorts.SETTINGThe Massachusetts General Hospital, a tertiary-care academic health center, during January-March 2015 (development cohort) and January-March 2016 (validation cohort)...
May 17, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29767416/utility-of-electrical-velocimetry-based-noninvasive-stroke-volume-variation-in-predicting-fluid-responsiveness-under-different-ventilation-modes-in-anaesthetized-dogs
#11
Kazumasu Sasaki, Tatsushi Mutoh, Shuzo Yamamoto, Yasuyuki Taki, Ryuta Kawashima
We evaluated the utility of noninvasive stroke volume variation (SVV) as a functional haemodynamic predictor for fluid responsiveness under different ventilation modes [assist control (A/C), synchronized intermittent mandatory ventilation (SIMV), and continuous positive airway pressure (CPAP)] in 45 anaesthetized dogs, using an electrical velocimetry device. Receiver operating curve analysis confirmed the best predictive value during SVVA /C (12.5% of cut-off value; 75% sensitivity and 86% specificity) followed by SVVSIMV (13...
May 16, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29759277/effects-of-chronic-opioid-use-on-sleep-and-wake
#12
REVIEW
Michelle Cao, Shahrokh Javaheri
Chronic use of opioids negatively affects sleep on 2 levels: sleep architecture and breathing. Patients suffer from a variety of daytime sequelae. There may be a bidirectional relationship between poor sleep quality, sleep-disordered breathing, and daytime function. Opioids are a potential cause of incident depression. The best therapeutic option is withdrawal of opioids, which proves difficult. Positive airway pressure devices are considered first-line treatment for sleep-related breathing disorders. New generation positive pressure servo ventilators are increasingly popular as a treatment option for opioid-induced sleep-disordered breathing...
June 2018: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29755078/-re-expansion-pulmonary-edema-after-surgery-for-spontaneous-tension-hemopneumothorax-report-of-a-case
#13
Masanobu Hayakawa, Kazuyuki Oda
A 23-year-old man was admitted to our hospital because of chest pain and dyspnea. X-ray and computed tomography showed left tension hemopneumothorax. After the emergent surgery, re-expansion pulmonary edema (RPE) occurred. Non-invasive positive pressure ventilation (NPPV) was applied to control RPE and RPE was successfully recovered. NPPV may be useful in managing RPE.
March 2018: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29754942/dead-space-analysis-at-different-levels-of-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-patients
#14
Emiliano Gogniat, Marcela Ducrey, José Dianti, Matías Madorno, Nicolás Roux, Alejandro Midley, Julio Raffo, Sergio Giannasi, Eduardo San Roman, Fernando Suarez-Sipmann, Gerardo Tusman
PURPOSE: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr /VT) in patients with acute respiratory distress syndrome (ARDS). MATERIAL AND METHODS: Fourteen ARDS patients under lung protective ventilation settings were submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH2 O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step. RESULTS: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (∆P˃15% , n = 7, p = ...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29750475/effects-of-losartan-and-allopurinol-on-cardiorespiratory-regulation-in-obstructive-sleep-apnoea
#15
Barbara J Morgan, Mihaela Teodorescu, David F Pegelow, Emily R Jackson, Devin L Schneider, David T Plante, James P Gapinski, Scott J Hetzel, John M Dopp
Chemoreflex sensitization produced by chronic intermittent hypoxia (CIH) in rats is attenuated by angiotensin II type 1 receptor (AT1 R) blockade. AT1 R blockade and xanthine oxidase inhibition both ameliorate CIH-induced endothelial dysfunction. We hypothesized treatment with losartan and allopurinol would reduce chemoreflex sensitivity and improve hypoxic vasodilation in patients with obstructive sleep apnoea (OSA). Eighty-six hypertensive patients with apnoea-hypopnoea index ≥25 events/hr and no other cardiovascular, pulmonary, renal, or metabolic disease were randomly assigned to receive allopurinol, losartan, or placebo for 6 weeks...
May 11, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29746270/evidence-regarding-the-use-of-bubble-continuous-positive-airway-pressure-in-the-extremely-low-birth-weight-infant-benefits-challenges-and-implications-for-nursing-practice
#16
Samantha Alessi
BACKGROUND: Gentle ventilation with optimal oxygenation is integral to prevention of chronic lung disease in the extremely low birth-weight (ELBW) infant. Various types of noninvasive ventilation are used in neonatal intensive care units worldwide. Bubble continuous positive airway pressure (BCPAP) has been in use in newborn intensive care since 1975. PURPOSE: To synthesize the current evidence on the use of BCPAP in the ELBW infant and its relationship to outcomes, particularly morbidity and mortality...
May 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29744774/performance-and-applications-of-bedside-visual-inspection-of-airway-pressure-time-curve-profiles-for-estimating-stress-index-in-patients-with-acute-respiratory-distress-syndrome
#17
Phunsup Wongsurakiat, Nadwipa Yuangtrakul
To determine the performance of bedside visual inspection of airway pressure-time (Paw-t) curve profiles (VI) for estimating stress index (SI) in patients with acute respiratory distress syndrome (ARDS). A prospective study in 30 subjects with ARDS receiving mechanical ventilation at two peak inspiratory flow (PIF) settings: 60 or 40 L/min. For each study session, two physicians inspected real-time Paw-t waveforms from mechanical ventilator's monitoring screens at bedside for 30 s and interpreted which of the three patterns (tidal recruitment, noninjurious ventilation or tidal overdistension) the Paw-t curve profile was compatible with...
May 9, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#18
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29744245/reliability-of-passive-leg-raising-stroke-volume-variation-and-pulse-pressure-variation-to-predict-fluid-responsiveness-during-weaning-from-mechanical-ventilation-after-cardiac-surgery-a-prospective-observational-study
#19
Christoph Karl Hofer, Martin Geisen, Sonja Hartnack, Omer Dzemali, Michael Thomas Ganter, Andreas Zollinger
Objective: During assisted ventilation and spontaneous breathing, functional haemodynamic parameters, including stroke volume variation (SVV) and pulse pressure variation (PPV), are of limited value to predict fluid responsiveness, and the passive leg raising (PLR) manoeuvre has been advocated as a surrogate method. We aimed to study the predictive value of SVV, PPV and PLR for fluid responsiveness during weaning from mechanical ventilation after cardiac surgery. Methods: Haemodynamic variables and fluid responsiveness were assessed in 34 patients...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#20
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
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