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https://www.readbyqxmd.com/read/29452802/moving-to-human-trials-for-argon-neuroprotection-in-neurological-injury-a-narrative-review
#1
REVIEW
A J Gardner, D K Menon
Despite the global burden of brain injury, neuroprotective agents remain elusive. There are no clinically effective therapies which reduce mortality or improve long-term cognitive outcome. Ventilation could be an easily modifiable variable in resuscitation; gases are relatively simple to administer. Xenon is the prototypic agent of a new generation of experimental treatments which show promise. However, use is hindered by its prohibitive cost and anaesthetic properties. Argon is an attractive option, being cheaper, easy to transport, non-sedating, and mechanistically distinct from xenon...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29431700/influence-of-tidal-volume-and-positive-end-expiratory-pressure-on-ventilation-distribution-and-oxygenation-during-one-lung-ventilation
#2
Zhanqi Zhao, Wei Wang, Zuojing Zhang, Meiying Xu, Inez Frerichs, Jing-Xiang Wu, Knut Moeller
The aim of the study was to explore the feasibility of titrating tidal volume (VT) and positive end-expiratory pressure (PEEP) during one-lung ventilation (OLV) based on ventilation distribution and oxygenation. Approach: Twenty four consecutive patients requiring intubation with a double-lumen tube and subsequent OLV for thoracic surgical procedures were examined prospectively in lateral posture. Electrical impedance tomography (EIT), blood gases, respiratory mechanics were successfully measured in 21 patients at various combinations of VT (4 ml/kg, 6 ml/kg, 8 ml/kg body weight) and PEEP (0 cmH2O, 4 cmH2O, 8 cmH2O) during OLV...
February 12, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29428372/comparative-study-on-the-analgesic-effect-of-acute-ipsilateral-shoulder-pain-after-open-thoracotomy-between-preoperative-ultrasound-guided-suprascapular-nerve-block-snb-and-intraoperative-phrenic-nerve-infiltration-pni-in-cancer-lung-patients
#3
Bassel M Elfokery, Sahar A Tawfic, Abdelrahman M Abdelrahman, Dina N Abbas, Ikramy M Abdelghaffar
INTRODUCTION: Acute ipsilateral shoulder pain (ISP) is a common complaint in patients after thoracotomy. The incidence ranges from 21% to 97%. Unfortunately, clinical studies did not put enough focus on ISP post thoracic surgery. AIM OF THE WORK: This study was designed to compare the effectiveness of suprascapular nerve block (SNB) and phrenic nerve infiltration (PNI) for controlling ISP. PATIENTS AND METHODS: One hundred and thirty-five lung cancer patients (135) scheduled for open-lung surgery were randomly allocated into three equal groups; control group: received thoracic epidural with general anesthesia, suprascapular group: (SNB) one hour before the operation with 10 ml bupivacaine plus thoracic epidural with general anesthesia and phrenic nerve group: (PNI) was performed by the operating surgeon with 10 ml bupivacaine plus thoracic epidural with general anesthesia...
February 7, 2018: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29414454/recognition-of-unprovoked-idiopathic-pulmonary-embolism-prospective-observational-study
#4
Natalia Stoeva, Galina Kirova, Milena Staneva, Diana Lekova, Anton Penev, Rumiana Bakalova
BACKGROUND: The assessment of the clinical symptoms is the weakest link of the pulmonary embolism (PE) diagnostic algorithm. Despite the presence of highly sensitive and specific imaging methods, verifying PE remains difficult due to nonspecific clinical symptoms and frequently its subclinical course. OBJECTIVE: The aim of this study is to improve the recognition of PE by investigating the clinical presentation and short-term prognosis of unprovoked PE in comparison to provoked PE...
February 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29413499/pulmonary-function-predicts-mortality-and-hospitalizations-in-outpatients-with-heart-failure-and-preserved-ejection-fraction
#5
Rut Andrea, Alejandra López-Giraldo, Carlos Falces, Teresa López, Laura Sanchis, Concepción Gistau, Manel Sabaté, Marta Sitges, Josep Brugada, Àlvar Agustí
BACKGROUND: Heart failure with preserved ejection fraction (HFPEF) is the most frequent form of heart failure in ambulatory patients with new-onset symptoms. We previously showed that lung function abnormalities are highly prevalent in HFPEF patients. In this observational, longitudinal study, we tested the hypothesis that the presence of airflow limitation and/or arterial hypoxemia predicts mortality and/or cardiovascular hospitalizations during follow-up in HFPEF outpatients. MATERIALS AND METHODS: HFPEF was diagnosed following the international recommendations...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29395564/-cohort-of-patients-initiated-to-home-ventilation-observational-and-prospective-study
#6
C Rabec, J Gonzalez-Bermejo, A Cuvelier, P Cervantes, D Foret, L Mounier, B Melloni, J-F Muir
Cohort of patients initiated to home ventilation. Observational and prospective study. The effectiveness of home noninvasive ventilation (NIV) for chronic respiratory failure (CRF) is well established. However, few data are available about home NIV prescription and utilization according to the different etiologies of respiratory failure. The ANTADIR Federation, in partnership with the Ventilatory Support Group of the French Speaking Pulmonary Society, has set up a national, observational and multicenter cohort study...
January 29, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29364487/prophylactic-use-of-non-invasive-mechanical-ventilation-in-lung-resection
#7
E Guerra Hernández, A Rodríguez Pérez, J Freixinet Gilard, M N Martín Álamo, M Escudero Socorro, P Rodríguez Suárez, A M Esquinas
OBJECTIVE: To evaluate if the prophylactic application of BiPAP previous to lung resection and 17 hours postoperatively improves respiratory function. In order to do this, we studied the results of arterial blood gases and portable spirometry in the immediate postoperative period and at the first and third postoperative day. Secondary objectives included evaluating whether this same pattern decreases the incidence of postoperative pulmonary complications (PPC) and hospital stay. PATIENTS AND METHODS: This was a prospective, randomized clinical study...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29354672/impact-of-heated-humidified-high-flow-air-via-nasal-cannula-on-respiratory-effort-in-patients-with-chronic-obstructive-pulmonary-disease
#8
Charles W Atwood, Sharon Camhi, Kathryn C Little, Colleen Paul, Hobart Schweikert, Nicholas J Macmillan, Thomas L Miller
Background: High flow nasal cannula therapy (HFNC) has been widely adopted for respiratory distress, and evidence suggests that purging dead space of the upper airway improves gas fractions in the lung. This study tests the hypothesis that HFNC with room air could be as effective as low flow oxygen in chronic obstructive pulmonary disease (COPD). Methods: Thirty-two COPD patients prescribed 1 - 2 L/min of oxygen were studied. The conditions tested consisted of a control (CTRL; no therapy), then in random order HFNC and prescribed low flow oxygen (LFO)...
August 15, 2017: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29339921/cardiopulmonary-exercise-test-and-pao2-in-evaluation-of-pulmonary-hypertension-in-copd
#9
Ingunn Skjørten, Janne Mykland Hilde, Morten Nissen Melsom, Jonny Hisdal, Viggo Hansteen, Kjetil Steine, Sjur Humerfelt
Background: Exercise tolerance decreases as COPD progresses. Pulmonary hypertension (PH) is common in COPD and may reduce performance further. COPD patients with and without PH could potentially be identified by cardiopulmonary exercise test (CPET). However, results from previous studies are diverging, and a unified conclusion is missing. We hypothesized that CPET combined with arterial blood gases is useful to discriminate between COPD outpatients with and without PH. Methods: In total, 93 COPD patients were prospectively included...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29324568/effects-of-pressure-support-ventilation-on-ventilator-induced-lung-injury-in-mild-acute-respiratory-distress-syndrome-depend-on-level-of-positive-end-expiratory-pressure
#10
Paulo A F Magalhães, Gisele de A Padilha, Lillian Moraes, Cíntia L Santos, Ligia de A Maia, Cassia L Braga, Maria do Carmo M B Duarte, Lívia B Andrade, Alberto Schanaider, Vera L Capellozzi, Robert Huhle, Marcelo Gama de Abreu, Paolo Pelosi, Patricia R M Rocco, Pedro L Silva
BACKGROUND: Harmful effects of spontaneous breathing have been shown in experimental severe acute respiratory distress syndrome (ARDS). However, in the clinical setting, spontaneous respiration has been indicated only in mild ARDS. To date, no study has compared the effects of spontaneous assisted breathing with those of fully controlled mechanical ventilation at different levels of positive end-expiratory pressure (PEEP) on lung injury in ARDS. OBJECTIVE: To compare the effects of assisted pressure support ventilation (PSV) with pressure-controlled ventilation (PCV) on lung function, histology and biological markers at two different PEEP levels in mild ARDS in rats...
January 10, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29290897/dose-related-effects-of-dexmedetomidine-on-immunomodulation-and-mortality-to-septic-shock-in-rats
#11
Yan Ma, Xiang-You Yu, Yi Wang
BACKGROUND: Dexmedetomidine has already been used in septic patients as a new sedative agent, few studies have examined its effects on immunomodulation. Therefore, the authors have designed a controlled experimental study to characterize the immunomodulation effects of dexmedetomidine in the cecal ligation and puncture (CLP) model in rats. METHODS: After CLP, 48 Wistar rats were randomly allocated into four groups: (1) CLP group; (2) small-dose treatment group (2...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29284866/does-pulmonary-artery-systolic-pressure-as-estimated-by-transthoracic-echocardiography-alter-the-effect-of-positive-end-expiratory-pressure-on-arterial-blood-gases-and-hemodynamics-in-morbidly-obese-patients
#12
Dipti Saxena, Priyank Singh, Atul Dixit, Bipin Arya, Mohit Bhandari, Sadhana Sanwatsarkar
Background: Positive end-expiratory pressure (PEEP) at the time of induction increases oxygenation by preventing lung atelectasis. However, PEEP may not prove beneficial in all cases. Factors affecting the action of PEEP have not been elucidated well and remain controversial. Pulmonary vasculature has direct bearing on the action of PEEP as has been proven in the previous studies. Thus, this prospective study was planned to evaluate the action of PEEP on the basis of pulmonary artery systolic pressure (PASP) which is noninvasive and easily measured by transthoracic echocardiography...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284503/bronchoscopy-versus-an-endotracheal-tube-mounted-camera-for-the-peri-interventional-visualization-of-percutaneous-dilatational-tracheostomy-a-prospective-randomized-trial-vivapdt
#13
Jörn Grensemann, Lars Eichler, Sophie Kähler, Dominik Jarczak, Marcel Simon, Hans O Pinnschmidt, Stefan Kluge
BACKGROUND: Percutaneous dilatational tracheostomy (PDT) in critically ill patients often involves bronchoscopic optical guidance. However, this procedure is not without disadvantages. Therefore, we aimed to study a recently introduced endotracheal tube-mounted camera (VivaSightTM-SL tube [VST]; ETView, Misgav, Israel) for guiding PDT. METHODS: This was a randomized controlled trial involving 46 critically ill patients who received PDT using optical guidance with a VST or with bronchoscopy...
December 29, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29279363/lack-of-benefit-of-heliox-during-mechanical-ventilation-of-subjects-with-severe-air-flow-obstruction
#14
James W Leatherman, Ramiro Saavedra Romero, Robert S Shapiro
BACKGROUND: The value of heliox (helium-oxygen mixture) for patients with severe air-flow obstruction is uncertain. The purpose of this study was to determine whether heliox could reduce the degree of hyperinflation and hypercapnia in mechanically ventilated patients with severe air-flow obstruction. METHODS: This was a single-center, prospective observational study conducted in a medical ICU of an academic medical center. We assessed the impact of heliox (65-70% helium, 30-35% oxygen) on airway pressures and arterial blood gases of 13 subjects undergoing mechanical ventilation for severe asthma (n = 8) or exacerbation of COPD (n = 5)...
December 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29277688/ability-of-using-different-dry-powder-inhalers-during-copd-exacerbations
#15
Andriana I Papaioannou, Yiolanda Herodotou, Ioannis Tomos, Vasiliki Apollonatou, Galateia Verykokou, Evgenia Papathanasiou, Effrosyni D Manali, Stelios Loukides, Spyros A Papiris
BACKGROUND: Guidelines suggest that patients hospitalized for acute COPD exacerbations (AECOPD) are treated with short acting bronchodilators. Long acting bronchodilators, offer longer symptom relief but since they are usually administered via Dry Powder Inhalers (DPIs) it is considered that during AECOPD patients would not be able to achieve appropriate inspiratory flow (IF) to receive appropriate drug doses. The aim of the present study was to evaluate whether patients admitted to the hospital for AECOPD, are able to achieve the necessary IF using different DPIs...
December 19, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29261567/association-between-partial-pressure-of-arterial-carbon-dioxide-and-survival-to-hospital-discharge-among-patients-diagnosed-with-sepsis-in-the-emergency-department
#16
Brian W Roberts, Nicholas M Mohr, Enyo Ablordeppey, Anne M Drewry, Ian T Ferguson, Stephen Trzeciak, Marin H Kollef, Brian M Fuller
OBJECTIVE: The objective of this study was to test the association between the partial pressure of arterial carbon dioxide and survival to hospital discharge among mechanically ventilated patients diagnosed with sepsis in the emergency department. DESIGN: Retrospective cohort study of a single center trial registry. SETTING: Academic medical center. PATIENTS: Mechanically ventilated emergency department patients. INCLUSION CRITERIA: age 18 years and older, diagnosed with sepsis in the emergency department, and mechanical ventilation initiated in the emergency department...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29242121/postinduction-butorphanol-administration-alters-oxygen-consumption-to-improve-blood-gases-in-etorphine-immobilized-white-rhinoceros
#17
Peter Buss, Michele Miller, Andrea Fuller, Anna Haw, Eliza Stout, Francisco Olea-Popelka, Leith Meyer
OBJECTIVE: To investigate the effects of postinduction butorphanol administration in etorphine-immobilized white rhinoceros on respiration and blood gases. STUDY DESIGN: Randomized crossover study. ANIMALS: A group of six sub-adult male white rhinoceros. METHODS: Etorphine, or etorphine followed by butorphanol 12 minutes after recumbency, was administered intramuscularly [2.5 mg etorphine, 25 mg butorphanol (1000-1250 kg), or 3...
April 17, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29235879/experimental-studies-on-artifacts-and-tumor-enhancement-on-gadoxetic-acid-enhanced-arterial-phase-liver-mri-in-a-rabbit-vx2-tumor-model
#18
Takahiro Tsuboyama, Gregor Jost, Tonsok Kim, Masatoshi Hori, Hiromitsu Onishi, Hubertus Pietsch, Noriyuki Tomiyama
Background Rapid injection of gadoxetic acid is reported to produce more frequent artifacts and lower vascular enhancement on arterial phase liver magnetic resonance imaging (MRI). However, its effect on tumor enhancement and the mechanism of the artifacts remain unclear. Purpose To evaluate the effect of rapid injection of gadoxetic acid on artifacts and tumor enhancement during arterial phase liver MRI, and on arterial blood gases (ABGs) which may explain the cause of the artifacts. Material and Methods ABG analysis was performed in 13 free-breathing rabbits after rapid injection (1 mL/s; injection time = 0...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/29234144/umbilical-cord-milking-at-birth-for-term-newborns-with-acidosis-neonatal-outcomes
#19
Anup Katheria, Judith Mercer, Melissa Brown, Wade Rich, Katie Baker, M J Harbert, Brianna Pierce, Kasim Hassen, Neil Finer
OBJECTIVE: To determine if umbilical cord milking is detrimental in compromised term/near-term infants. STUDY DESIGN: A retrospective analysis of infants with abnormal cord gases (cord arterial or venous pH of ≤ 7.1 or base deficit > -12). We collected maternal risk factors, cord management, birth, and neonatal outcomes during hospitalization. RESULT: We found 157 infants who met the criteria for abnormal cord gases. Thirty-six of those had umbilical cord milking at delivery...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29224257/models-of-care-for-non-invasive-ventilation-in-the-acute-copd-comparison-of-three-tertiary-hospitals-act3-study
#20
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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