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https://www.readbyqxmd.com/read/28814848/pathophysiological-mechanism-of-long-term-noninvasive-ventilation-in-stable-hypercapnic-patients-with-copd-using-functional-respiratory-imaging
#1
Bita Hajian, Jan De Backer, Claire Sneyers, Francisca Ferreira, Katherine C Barboza, Glenn Leemans, Wim Vos, Wilfried De Backer
INTRODUCTION: Patients with severe COPD often develop chronic hypercapnic respiratory failure. Their prognosis worsens and they are more likely to develop exacerbations. This has major influence on the health-related quality of life. Currently, there is no information about the success of long-term noninvasive ventilation (NIV) among patients who receive NIV in acute settings. Also, little is known about the pathophysiological mechanism of NIV. METHODS: Ten Global Initiative for Obstructive Lung Disease stage III and IV COPD patients with respiratory failure who were hospitalized following acute exacerbation were treated with NIV using a Synchrony BiPAP device for 6 months...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28808493/pulmonary-consequences-of-hypothyroidism
#2
Samiaa Hamdy Sadek, Walaa Anwar Khalifa, Ahmad Metwally Azoz
BACKGROUND: Although hypothyroidism has an insidious onset and relatively asymptomatic, exertional dyspnea and fatigue can be the presenting complaints. OBJECTIVES: The aim is to assess functional lung impairment in hypothyroid patients both at rest and during exercise. METHODS: A case-control study was carried out on 42 patients with newly diagnosed hypothyroidism and 12 control subjects. Hypothyroidism was diagnosed based on high value of thyroid stimulating hormone (TSH) ≥6 μIU/ml, and low value of free thyroxin (FT4) ≤0...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28806492/evaluation-of-gastric-and-bladder-tonometry-as-indicators-of-tissue-perfusion-in-induced-hypotension-in-dogs
#3
Juan Morgaz, Lidia Espigares-Rodríguez, Pilar Muñoz-Rascón, Rocío Navarrete, Jose Andrés Fernández-Sarmiento, María Del Mar Granados Machuca
OBJECTIVE: To evaluate the use of gastric (PgCO2 ) and bladder (PbCO2 ) tonometry for assessing tissue hypoperfusion in dogs during sevoflurane-induced hypotension, and to compare these measurements with delivery of oxygen, arterial oxygen content, and plasma lactate concentration. DESIGN: Prospective experimental trial. SETTING: University veterinary teaching hospital. ANIMALS: Fourteen adult Beagle dogs. INTERVENTIONS: Anesthetic induction was performed by mask with sevoflurane and oxygen...
August 14, 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28803335/intraoperative-ventilation-during-thoracoscopic-repair-of-neonatal-congenital-diaphragmatic-hernia
#4
Tadaharu Okazaki, Manabu Okawada, Junya Ishii, Hiroyuki Koga, Go Miyano, Takashi Doi, Yuki Ogasawara, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: To evaluate the optimal ventilation mode during thoracoscopic repair (TR) of neonatal congenital diaphragmatic hernia (CDH), we compared high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV). METHODS: Twenty-three neonatal CDH cases who underwent TR without intraoperative inhalation of nitric oxide at our institution between 2007 and 2016 were reviewed. Patients were initially ventilated with HFOV, which was converted to CMV if the HFOV settings were decreased to FiO2 <0...
August 12, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28801434/comparative-effectiveness-of-six-chinese-herb-formulas-for-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-protocol-for-systematic-review-and-network-meta-analysis
#5
Shaonan Liu, Jing Chen, Yihan He, Lei Wu, Jiaqi Lai, Jinhong Zuo, Lihong Yang, Xinfeng Guo
INTRODUCTION: Chinese medicine is commonly used to combine with pharmacotherapy for the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Six Chinese herb formulas involving Weijing decoction, Maxingshigan decoction, Yuebijiabanxia decoction, Qingqihuatan decoction, Dingchuan decoction and Sangbaipi decoction are recommended in Chinese medicine clinical guideline or textbook, to relieve patients with phlegm-heat according to Chinese syndrome differentiation...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28797752/efficacy-of-continuous-positive-airway-pressure-and-incentive-spirometry-on-respiratory-functions-during-the-postoperative-period-following-supratentorial-craniotomy-a-prospective-randomized-controlled-study
#6
Hulya Kahraman Sah, Eren Fatma Akcil, Yusuf Tunali, Hayriye Vehid, Ozlem Korkmaz Dilmen
STUDY OBJECTIVE: Volume controlled ventilation with low PEEP is used in neuro-anesthesia to provide constant PaCO2 levels and prevent raised intracranial pressure. Therefore, neurosurgery patients prone to atelectasis formation, however, we could not find any study that evaluates prevention of postoperative pulmonary complications in neurosurgery. DESIGN: A prospective, randomized controlled study. SETTING: Intensive care unit in a university hospital in Istanbul...
August 7, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28781205/psoas-compartment-and-sacral-plexus-block-via-electrostimulation-for-pelvic-limb-amputation-in-dogs
#7
Jonathon M Congdon, Pedro Boscan, Clara S S Goh, Marlis Rezende
OBJECTIVE: To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). METHODS: Dogs were administered morphine (0.5 mg kg(-1)) and atropine (0.02 mg kg(-1)); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2...
March 22, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28775380/rage-inhibition-reduces-acute-lung-injury-in-mice
#8
Raiko Blondonnet, Jules Audard, Corinne Belville, Gael Clairefond, Jean Lutz, Damien Bouvier, Laurence Roszyk, Christelle Gross, Marilyne Lavergne, Marianne Fournet, Loic Blanchon, Caroline Vachias, Christelle Damon-Soubeyrand, Vincent Sapin, Jean-Michel Constantin, Matthieu Jabaudon
The receptor for advanced glycation end-products (RAGE) is involved in inflammatory response during acute respiratory distress syndrome (ARDS). Growing body of evidence support strategies of RAGE inhibition in experimental lung injury, but its modalities and effects remain underinvestigated. Anesthetised C57BL/6JRj mice were divided in four groups; three of them underwent orotracheal instillation of acid and were treated with anti-RAGE monoclonal antibody (mAb) or recombinant soluble RAGE (sRAGE), acting as a decoy receptor...
August 3, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28762565/influence-of-lung-volume-on-the-interaction-between-cardiac-output-and-cerebrovascular-regulation-during-extreme-apnoea
#9
Mike Stembridge, Ryan L Hoiland, Anthony R Bain, Otto F Barak, Ivan Drvis, David B MacLeod, Douglas M MacLeod, Dennis Madden, Tonci Batinic, Peter O'Donoghue, Rob Shave, Zeljko Dujic, Philip N Ainslie
We investigated the role of lung volume-induced changes in cardiac output (Q̇) on cerebrovascular regulation during prolonged apnoea. Fifteen elite apnoea divers (1F; 185 ± 7 cm, 82 ± 12 kg, 29 ± 7 years) attended the laboratory on two separate occasions and completed maximal breath-holds at total lung capacity (TLC) and functional residual capacity (FRC) to elicit disparate cardiovascular responses. Mean arterial pressure (MAP), internal jugular venous pressure (IJVP) and arterial blood gases were measured via cannulation, global cerebral blood flow (gCBF) was quantified by ultrasound and cardiac output via photoplethysmography...
August 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28762180/optimum-support-by-high-flow-nasal-cannula-in-acute-hypoxemic-respiratory-failure-effects-of-increasing-flow-rates
#10
Tommaso Mauri, Laura Alban, Cecilia Turrini, Barbara Cambiaghi, Eleonora Carlesso, Paolo Taccone, Nicola Bottino, Alfredo Lissoni, Savino Spadaro, Carlo Alberto Volta, Luciano Gattinoni, Antonio Pesenti, Giacomo Grasselli
PURPOSE: Limited data exist on the correlation between higher flow rates of high-flow nasal cannula (HFNC) and its physiologic effects in patients with acute hypoxemic respiratory failure (AHRF). We assessed the effects of HFNC delivered at increasing flow rate on inspiratory effort, work of breathing, minute ventilation, lung volumes, dynamic compliance and oxygenation in AHRF patients. METHODS: A prospective randomized cross-over study was performed in non-intubated patients with patients AHRF and a PaO2/FiO2 (arterial partial pressure of oxygen/fraction of inspired oxygen) ratio of ≤300 mmHg...
July 31, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28750686/carbon-dioxide-narcosis-due-to-inappropriate-oxygen-delivery-a-case-report
#11
Thomas Herren, Eva Achermann, Thomas Hegi, Adrian Reber, Max Stäubli
BACKGROUND: Oxygen delivery to patients with chronic obstructive pulmonary disease may be challenging because of their potential hypoxic ventilatory drive. However, some oxygen delivery systems such as non-rebreathing face masks with an oxygen reservoir bag require high oxygen flow for adequate oxygenation and to avoid carbon dioxide rebreathing. CASE PRESENTATION: A 72-year-old Caucasian man with severe chronic obstructive pulmonary disease was admitted to the emergency department because of worsening dyspnea and an oxygen saturation of 81% measured by pulse oximetry...
July 28, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28729347/lethal-avian-influenza-a-h5n1-virus-induces-ataxic-breathing-in-mice-with-apoptosis-of-pre-botzinger-complex-neurons-expressing-neurokinin-1-receptor
#12
Jianguo Zhuang, Na Zang, Chunyan Ye, Fadi Xu
BACKGROUND: Lethal influenza A (H5N1) induces respiratory failure in humans. Although it also causes death at 7 day postinfection (dpi) in mice, the development of the respiratory failure and the viral impact on pre-Botzinger complex (PBC) neurons expressing neurokinin 1 receptor (NK1R), the respiratory rhythm-generator, have not been explored. METHODS: Body temperature, weight, ventilation, arterial blood pH and gases were measured at 0, 2, 4, and 6 dpi in control, lethal HK483 and non-lethal HK486 viral infected mice...
July 20, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28707173/intraoperative-ventilation-of-morbidly-obese-patients-guided-by-transpulmonary-pressure
#13
Lars Eichler, Katarzyna Truskowska, A Dupree, P Busch, Alwin E Goetz, Christian Zöllner
BACKGROUND: Bariatric surgery has proven a successful approach in the treatment of morbid obesity and its concomitant diseases such as diabetes mellitus and arterial hypertension. Aiming for optimal management of this challenging patient cohort, tailored concepts directly guided by individual patient physiology may outperform standardized care. Implying esophageal pressure measurement and electrical impedance tomography-increasingly applied monitoring approaches to individually adjust mechanical ventilation in challenging circumstances like acute respiratory distress syndrome (ARDS) and intraabdominal hypertension-we compared our institutions standard ventilator regimen with an individually adjusted positive end expiratory pressure (PEEP) level aiming for a positive transpulmonary pressure (P L) throughout the respiratory cycle...
July 14, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#14
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28699679/one-session-of-remote-ischemic-preconditioning-does-not-improve-vascular-function-in-acute-normobaric-and-chronic-hypobaric-hypoxia
#15
Mathew G Rieger, Ryan L Hoiland, Joshua C Tremblay, Mike Stembridge, Anthony R Bain, Daniela Flück, Prajan Subedi, James D Anholm, Philip N Ainslie
Application of repeated short duration bouts of ischemia to the limbs, termed remote ischemic preconditioning (RIPC), is a novel technique that may have protective effects on vascular function during hypoxic exposures. In separate parallel-design studies, at sea-level (SL; n = 16), and after 8-12 days at high-altitude (HA; n = 12; White Mountain, 3800 m), participants underwent either a sham protocol or one session of 4 × 5 minutes of dual-thigh cuff occlusion with 5 minutes recovery. Brachial artery flow-mediated dilation (FMD; ultrasound), pulmonary artery systolic pressure (PASP; echocardiography), and internal carotid artery flow (ICA; ultrasound) were measured at SL in normoxia and isocapnic hypoxia [end-tidal PO₂ (PETO₂) maintained to 50 mmHg], and during normal breathing at HA...
July 12, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28697025/reboa-for-the-ivc-resuscitative-balloon-occlusion-of-the-inferior-vena-cava-rebovc-to-abate-massive-hemorrhage-in-retro-hepatic-vena-cava-injuries
#16
Cassandra L Reynolds, Adam C Celio, Lindsay C Bridges, Catalina Mosquera, Brian O'Connell, Michael R Bard, Connie M DeLa'o, Eric A Toschlog
BACKGROUND: The use of resuscitative endovascular balloon occlusion as a maneuver for occlusion of the aorta is well described. This technique has life-saving potential in other cases of traumatic hemorrhage. Retro-hepatic inferior vena cava (IVC) injuries have a high rate of mortality, in part, due to the difficulty in achieving total vascular isolation. This studies purpose was to investigate the ability of resuscitative balloon occlusion of the IVC (REBOVC) to control supra-hepatic IVC hemorrhage in a swine model of trauma...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28696966/defining-a-ventilation-strategy-for-flexible-bronchoscopy-on-mechanically-ventilated-patients-in-the-medical-intensive-care-unit
#17
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
https://www.readbyqxmd.com/read/28688178/transcriptomic-analysis-identifies-a-role-of-pi3k-akt-signalling-in-the-responses-of-skeletal-muscle-to-acute-hypoxia-in-vivo
#18
Zhuohui Gan, Frank L Powell, Alexander C Zambon, Kyle S Buchholz, Zhenxing Fu, Karen Ocorr, Rolf Bodmer, Esteban A Moya, Jennifer C Stowe, Gabriel G Haddad, Andrew D McCulloch
KEY POINTS: Changes in gene expression that occur within hours of exposure to hypoxia in in vivo skeletal muscles remain unexplored. Two hours of hypoxia caused significant down-regulation of extracellular matrix genes followed by a shift at 6 h to altered expression of genes associated with the nuclear lumen while respiratory and blood gases were stabilized. Enrichment analysis of mRNAs classified by stability rates suggests an attenuation of post-transcriptional regulation within hours of hypoxic exposure, where PI3K-Akt signalling was suggested to have a nodal role by pathway analysis...
July 8, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#19
Federico Longhini, Chun Pan, Jianfeng Xie, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Yi Yang, Paolo Navalesi, Haibo Qiu
BACKGROUND: Noninvasive ventilation (NIV) is generally delivered using pneumatically-triggered and cycled-off pressure support (PSP) through a mask. Neurally adjusted ventilatory assist (NAVA) is the only ventilatory mode that uses a non-pneumatic signal, i.e., diaphragm electrical activity (EAdi), to trigger and drive ventilator assistance. A specific setting to generate neurally controlled pressure support (PSN) was recently proposed for delivering NIV by helmet. We compared PSN with PSP and NAVA during NIV using a facial mask, with respect to patient comfort, gas exchange, and patient-ventilator interaction and synchrony...
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28682955/ringer-s-lactate-versus-normal-saline-in-urgent-cesarean-delivery-in-a-resource-limited-setting-a-pragmatic-clinical-trial
#20
Emmanuel Timarwa Ayebale, Arthur Kwizera, Cephas Mijumbi, Samuel Kizito, Anthony Michael Roche
BACKGROUND: Crystalloids are used routinely for perioperative fluid management in cesarean delivery. Few studies have determined the crystalloid of choice in obstetric anesthesia. We compared the effects of Ringer's lactate (RL) versus 0.9% normal saline (NS) on maternal and neonatal blood pH and 24-hour postoperative morbidity in urgent cesarean delivery in a low-resource setting. Our hypothesis was that RL would result in 30% less acidosis than NS. METHODS: This was a pragmatic prospective double-blind randomized controlled trial in the Mulago National Referral Hospital Labor Ward Theater from September 2011 to May 2012...
August 2017: Anesthesia and Analgesia
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