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https://www.readbyqxmd.com/read/28393258/intermittent-noninvasive-ventilation-after-extubation-in-patients-with-chronic-respiratory-disorders-a-multicenter-randomized-controlled-trial-vhyper
#1
Frédéric Vargas, Marc Clavel, Pascale Sanchez-Verlan, Sylvain Garnier, Alexandre Boyer, Hoang-Nam Bui, Benjamin Clouzeau, Charline Sazio, Aissa Kerchache, Olivier Guisset, Antoine Benard, Julien Asselineau, Bernard Gauche, Didier Gruson, Stein Silva, Philippe Vignon, Gilles Hilbert
PURPOSE: Early noninvasive ventilation (NIV) after extubation decreases the risk of respiratory failure and lowers 90-day mortality in patients with hypercapnia. Patients with chronic respiratory disease are at risk of extubation failure. Therefore, it could be useful to determine the role of NIV with a discontinuous approach, not limited to patients with hypercapnia. We assessed the efficacy of early NIV in decreasing respiratory failure after extubation in patients with chronic respiratory disorders...
April 9, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28377920/automated-weaning-from-mechanical-ventilation-after-off-pump-coronary-artery-bypass-grafting
#2
Evgenia V Fot, Natalia N Izotova, Angelika S Yudina, Aleksei A Smetkin, Vsevolod V Kuzkov, Mikhail Y Kirov
BACKGROUND: The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28374969/randomized-cross-over-trial-of-ventilator-modes-during-non-invasive-ventilation-titration-in-amyotrophic-lateral-sclerosis
#3
Bart Vrijsen, Bertien Buyse, Catharina Belge, Goele Vanpee, Philip Van Damme, Dries Testelmans
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves survival, quality of life and sleep in patients with amyotrophic lateral sclerosis (ALS). Nevertheless, NIV titration is conducted in different ways. We aim to provide more insight into NIV titration by comparing the effects of a spontaneous (S) and spontaneous-timed (ST) modes on gas exchange, sleep architecture and patient-ventilator asynchronies (PVAs). METHODS: After an initial night of NIV titration, patients were randomized to S or ST mode in a cross-over design...
April 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28349529/continuous-chest-compression-versus-interrupted-chest-compression-for-cardiopulmonary-resuscitation-of-non-asphyxial-out-of-hospital-cardiac-arrest
#4
REVIEW
Lei Zhan, Li J Yang, Yu Huang, Qing He, Guan J Liu
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Cardiac arrest can be subdivided into asphyxial and non asphyxial etiologies. An asphyxia arrest is caused by lack of oxygen in the blood and occurs in drowning and choking victims and in other circumstances. A non asphyxial arrest is usually a loss of functioning cardiac electrical activity. Cardiopulmonary resuscitation (CPR) is a well-established treatment for cardiac arrest. Conventional CPR includes both chest compressions and 'rescue breathing' such as mouth-to-mouth breathing...
March 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28349526/pushing-bearing-down-methods-for-the-second-stage-of-labour
#5
REVIEW
Andrea Lemos, Melania Mr Amorim, Armele Dornelas de Andrade, Ariani I de Souza, José Eulálio Cabral Filho, Jailson B Correia
BACKGROUND: Maternal pushing during the second stage of labour is an important and indispensable contributor to the involuntary expulsive force developed by uterine contraction. There is no consensus on an ideal strategy to facilitate these expulsive efforts and there are contradictory results about the influence on the mother and fetus. OBJECTIVES: To evaluate the benefits and possible disadvantages of different kinds of techniques regarding maternal pushing/breathing during the expulsive stage of labour on maternal and fetal outcomes...
March 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28344733/an-acute-bout-of-a-controlled-breathing-frequency-lowers-sympathetic-neural-outflow-but-not-blood-pressure-in-healthy-normotensive-subjects
#6
Shannon L McClain, Alexa M Brooks, Sara S Jarvis
Controlled or paced breathing is often used as a stress reduction technique but the impact on blood pressure (BP) and sympathetic outflow have not been consistently reported. The purpose of this study was to determine whether a controlled breathing (12 breaths/min, CB) rate would be similar to an individual's spontaneous breathing (SB) rate. Secondly, would a CB rate of 12 breaths/min alter heart rate (HR), BP, and indices of muscle sympathetic nerve activity (MSNA). Twenty-one subjects (10 women, 11 men) performed two trials: SB, where the subject chose a comfortable breathing rate; and CB, where the subject breathed at a pace of 12 breaths/min...
2017: International Journal of Exercise Science
https://www.readbyqxmd.com/read/28341400/the-breath-of-life-patients-experiences-of-breathing-during-and-after-mechanical-ventilation
#7
Hege S Haugdahl, Helena Dahlberg, Pål Klepstad, Sissel L Storli
INTRODUCTION: Breathlessness is a prevalent and distressing symptom in intensive care, underestimated by nurses and physicians. Therefore, to develop a more comprehensive understanding of this problem, the study had two aims: to compare patients' self-reported scores of breathlessness obtained during mechanical ventilation (MV) with experiences of breathlessness later recalled by patients and: to explore the lived experience of breathing during and after MV. METHOD: A qualitatively driven sequential mixed method design combining prospective observational breathlessness data at the end of a spontaneous breathing trial (SBT) and follow up data from 11 post-discharge interviews...
March 21, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#8
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28316317/direct-two-minute-unassisted-breathing-evaluation-dtube-is-an-attractive-alternative-to-longer-spontaneous-breathing-trials-a-prospective-observational-study
#9
Matthew B Bloom, Jonathan Lu, Tri Tran, Marko Bukur, Rex Chung, Eric J Ley, Nicolas Melo, Ali Salim, Daniel R Margulies
We sought to identify a simple bedside method to predict successful extubation outcomes that might be used during rounds. We hypothesized that a direct 2-minute unassisted breathing evaluation (DTUBE) could replace a longer spontaneous breathing trial (SBT). Data were prospectively collected on all patients endotracheally intubated for >48 hours nearing extubation in a tertiary center's mixed trauma/surgical intensive care unit from August 2012 to August 2013. The SBT was performed for at least 30 minutes at 40 per cent FiO2, PEEP 5, and PS 8...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28294957/regional-ventilation-redistribution-measured-by-electrical-impedance-tomography-during-spontaneous-breathing-trial-with-automatic-tube-compensation
#10
Yeong-Long Hsu, Ai-Jia Tien, Mei-Yun Chang, Hao-Tai Chang, Knut Moeller, Inez Frerichs, Zhanqi Zhao
Automatic tube compensation (ATC) was developed to overcome the flow resistance of endotracheal tube and decrease the imposed work of breathing. Although ATC is used as an evidence-based strategy to predict successful weaning from assisted ventilation, the changes in regional ventilation distribution induced by this technique are not known. We hypothesized that continuous positive airway pressure plus ATC (CPAP+100%ATC) could reactivate the respiratory muscles in patients with prolonged mechanical ventilation (PMV) more effectively than volume assist-control mandatory ventilation (ACMV)...
March 15, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28272202/effects-of-combined-epidural-and-general-anesthesia-on-intraoperative-hemodynamic-responses-postoperative-cellular-immunity-and-prognosis-in-patients-with-gallbladder-cancer-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Jun Zhu, Xue-Rong Zhang, Hu Yang
BACKGROUND: This study is supposed to investigate the effects of combined epidural and general anesthesia on intraoperative hemodynamic responses, postoperative cellular immunity, and prognosis in patients with gallbladder cancer (GBC). METHODS: One hundred forty-four GBC patients were selected and randomly divided into the general anesthesia (GA) group and the combined epidural-general anesthesia (CEGA) group. Before anesthesia induction (t0), at intubation (t1), at the beginning of surgery (t2), 5 minutes after pneumoperitoneum (t3), at the end of surgery (t4), after recovery of spontaneous breathing (t5), after regaining consciousness (t6), and after extubation (t7), the heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the depth of anesthesia (bispectral index [BIS]) were detected...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267947/ambu%C3%A2-auragain%C3%A2-versus-lma-supreme%C3%A2-second-seal%C3%A2-a-randomised-controlled-trial-comparing-oropharyngeal-leak-pressures-and-gastric-drain-functionality-in-spontaneously-breathing-patients
#12
I I Shariffuddin, W H Teoh, Ebk Tang, Nhm Hashim, P S Loh
Newer second generation supraglottic airway devices may perform differently in vivo due to material and design modifications. We compared performance characteristics of the Ambu® AuraGain™ and LMA Supreme™ Second Seal™ in 100 spontaneously breathing anaesthetised patients in this randomised controlled study. We studied oropharyngeal leak pressures (OLP) (primary outcome) and secondarily, ease of insertion, success rates, haemodynamic response, time to insertion, and complications of usage. We found no significant difference in OLP between the AuraGain versus the LMA Supreme, mean (standard deviation, SD) 24...
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28246308/use-of-cough-peak-flow-measured-by-a-ventilator-to-predict-re-intubation-when-a-spirometer-is-unavailable
#13
Bai Linfu, Jun Duan
BACKGROUND: A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. METHODS: Endotracheally intubated subjects who passed a spontaneous breathing trial were enrolled. Before extubation, CPF was measured by a spirometer and a ventilator, respectively. Re-intubation was recorded at 72 h after extubation. RESULTS: A total of 126 subjects were enrolled...
February 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28236395/nursing-strategies-for-effective-weaning-of-the-critically-ill-mechanically-ventilated-patient
#14
REVIEW
Darian Ward, Paul Fulbrook
The risks imposed by mechanical ventilation can be mitigated by nurses' use of strategies that promote early but appropriate reduction of ventilatory support and timely extubation. Weaning from mechanical ventilation is confounded by the multiple impacts of critical illness on the body's systems. Effective weaning strategies that combine several interventions that optimize weaning readiness and assess readiness to wean, and use a weaning protocol in association with spontaneous breathing trials, are likely to reduce the requirement for mechanical ventilatory support in a timely manner...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28219811/stress-echocardiography-in-patients-who-experienced-mechanical-ventilation-weaning-failure
#15
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana Castillo-Rivera, María Dolores Pola-Gallego-de-Guzmán, Antonio Cárdenas-Cruz, Antonio Martínez-Amat, María Sevilla-Martínez, Clara Hernández-Caballero
INTRODUCTION: Critically ill patients may suffer varying degrees of temporary myocardial dysfunction during respiratory weaning that could play an important role in weaning failure. OBJECTIVES: In this study, we tried to assess the existence of temporary diastolic dysfunction during respiratory weaning. METHODS: Inclusion period is from 2006 to 2015. In this study, we included 181 ventilated patients with cardiogenic shock that were being weaned from mechanical ventilation...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28215134/drainage-of-pleural-effusion-improves-diaphragmatic-function-in-mechanically-ventilated-patients
#16
Michele Umbrello, Giovanni Mistraletti, Andrea Galimberti, Ilaria R Piva, Ottavia Cozzi, Paolo Formenti
BACKGROUND: Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. OBJECTIVE: To investigate the effect of drainage of unilateral pleural effusion on diaphragmatic function...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28212205/spontaneous-breathing-during-extracorporeal-membrane-oxygenation-in-acute-respiratory-failure
#17
Stefania Crotti, Nicola Bottino, Giulia Maria Ruggeri, Elena Spinelli, Daniela Tubiolo, Alfredo Lissoni, Alessandro Protti, Luciano Gattinoni
BACKGROUND: We evaluate the clinical feasibility of spontaneous breathing on extracorporeal membrane oxygenation and the interactions between artificial and native lungs in patients bridged to lung transplant or with acute exacerbation of chronic obstructive pulmonary disease (COPD) or acute respiratory distress syndrome. METHODS: The clinical course of a total of 48 patients was analyzed. Twenty-three of 48 patients were enrolled in the prospective study (nine bridged to lung transplant, six COPD, and eight acute respiratory distress syndrome)...
April 2017: Anesthesiology
https://www.readbyqxmd.com/read/28198753/mechanical-ventilation-weaning-practices-and-decision-making-in-european-picus
#18
Lyvonne N Tume, Martin C J Kneyber, Bronagh Blackwood, Louise Rose
OBJECTIVES: This survey had three key objectives: 1) To describe responsibility for key ventilation and weaning decisions in European PICUs and explore variations across Europe; 2) To describe the use of protocols, spontaneous breathing trials, noninvasive ventilation, high-flow nasal cannula use, and automated weaning systems; and 3) To describe nurse-to-patient staffing ratios and perceived nursing autonomy and influence over ventilation decision making. DESIGN: Cross-sectional electronic survey...
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28181336/impact-of-high-concentrations-of-sevoflurane-on-laryngeal-reflex-responses
#19
Thomas O Erb, Britta S von Ungern-Sternberg, Jens Moll, Franz J Frei
BACKGROUND: Exaggerated defensive upper airway reflexes, particularly laryngospasm, may cause hypoxemic damage, especially in children. General clinical experience suggests that laryngeal reflex responses are more common under light levels of anesthesia, and previous clinical studies have shown an inverse correlation between laryngeal responsiveness and depth of hypnosis. However, this seems to be less obvious in children anesthetized with sevoflurane. The aim of this study was to assess the impact of high concentrations of sevoflurane on laryngeal and respiratory reflex responses in spontaneously breathing children...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28157394/how-prepared-are-medical-and-nursing-students-to-identify-common-hazards-in-the-intensive-care-unit
#20
Alison S Clay, Saumil M Chudgar, Kathleen M Turner, Jacqueline Vaughn, Nancy W Knudsen, Jeanne M Farnan, Vineet M Arora, Margory A Molloy
RATIONALE: Care in the hospital is hazardous. Harm in the hospital may prolong hospitalization, increase suffering, result in death, and increase costs of care. Although the interprofessional team is critical to eliminating hazards that may result in adverse events to patients, professional students' formal education may not prepare them adequately for this role. OBJECTIVES: To determine if medical and nursing students can identify hazards of hospitalization that could result in harm to patients and to detect differences between professions in the types of hazards identified...
April 2017: Annals of the American Thoracic Society
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