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Artificial ventilation

Thomas Breuer, Nima Hatam, Benjamin Grabiger, Gernot Marx, Bradley J Behnke, Joachim Weis, Ruedger Kopp, Ghislaine Gayan-Ramirez, Norbert Zoremba, Christian S Bruells
Perioperative necessity of deep sedation is inevitably associated with diaphragmatic inactivation. This study investigated 1) the feasibility of a new phrenic nerve stimulation method allowing early diaphragmatic activation even in deep sedation and, 2) metabolic changes within the diaphragm during mechanical ventilation compared to artificial activity. 12 piglets were separated into 2 groups. One group was mechanically ventilated for 12 hrs (CMV) and in the second group both phrenic nerves were stimulated via pacer wires inserted near the phrenic nerves to mimic spontaneous breathing (STIM)...
October 19, 2016: Scientific Reports
Hisao Nakai, Keiko Tsukasaki, Kaoru Kyota, Tomoya Itatani, Reiko Nihonyanagi, Yasuko Shinmei, Shizuka Yasuoka
This study investigated factors affecting disaster preparedness and evacuation intentions among home-care patients dependent on electrical power for life support. Health professionals interviewed 53 home-care patients using the Kanazawa and Kochi Disaster Preparedness Checklist. About half of the participants requiring continuous artificial ventilation or aspiration indicated that they would not or could not evacuate following a disaster-even though their lives could be at risk. The availability of emergency medical equipment for use during a power outage was positively associated with the desire to evacuate...
October 2016: Journal of Community Health Nursing
Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Olga A Lyubashina, Sergey S Panteleev, Alexey Y Sokolov
Electrical stimulation of the greater occipital nerve (GON) has recently shown promise as an effective non-pharmacological prophylactic therapy for drug-resistant chronic primary headaches, but the neurobiological mechanisms underlying its anticephalgic action are not elucidated. Considering that the spinal trigeminal nucleus (STN) is a key segmental structure playing a prominent role in pathophysiology of headaches, in the present study we evaluated the effects of GON electrical stimulation on ongoing and evoked firing of the dura-sensitive STN neurons...
September 27, 2016: Journal of Neural Transmission
Debra E Weese-Mayer, Casey M Rand, Amy Zhou, Michael S Carroll, Carl E Hunt
The "bedside-to-bench" CCHS research journey has led to increased phenotypic-genotypic knowledge regarding autonomic nervous system (ANS) regulation, and improved clinical outcomes. CCHS is a neurocristopathy characterized by hypoventilation and ANS dysregulation. Initially described in 1970, timely diagnosis and treatment remained problematic until the first large cohort report (1992), delineating clinical presentation and treatment options. A central role of ANS dysregulation (2001) emerged, precipitating evaluation of genes critical to ANS development, and subsequent 2003 identification of PHOX2B as the disease-defining gene for CCHS...
September 27, 2016: Pediatric Research
Ali Al Bshabshe, Martin R P Joseph, Ali Al Hussein, Waleed Haimour, Mohamed E Hamid
OBJECTIVE: To identify and to determine the antimicrobial susceptibility of Acinetobacter baumannii (A. baumannii) clinical isolates from ICU at Aseer Central Hospital. METHODS: The study was conducted in the Intensive Care Unit, Aseer Central Hospital, Saudi Arabia over 13 months period (2014-2015). Acinetobacter species (n = 105) were isolated from various clinical samples. Isolates were identified using selected phenotypic criteria and confirmed using the Vitek 2 automated system...
September 2016: Asian Pacific Journal of Tropical Medicine
Sandra Regina Gonzaga Mazutti, Andréia de Fátima Nascimento, Renata Rego Lins Fumis
OBJECTIVE: To estimate the incidence of limitations to Advanced Life Support in critically ill patients admitted to an intensive care unit with integrated palliative care. METHODS: This retrospective cohort study included patients in the palliative care program of the intensive care unit of Hospital Paulistano over 18 years of age from May 1, 2011, to January 31, 2014. The limitations to Advanced Life Support that were analyzed included do-not-resuscitate orders, mechanical ventilation, dialysis and vasoactive drugs...
September 2016: Revista Brasileira de Terapia Intensiva
L A Rütter, G Keyßer, M Winkler, S Rütter
BACKGROUND AND OBJECTIVE: Very little is known about the outcome of patients with inflammatory rheumatic diseases in intensive care units (ICU). This retrospective study investigated the results of intensive medical treatment in these patients and the reliability of scoring systems used for the prediction of survival. MATERIAL AND METHODS: A case group consisting of 50 patients suffering from inflammatory rheumatic diseases was generated by analysis of patient records from the ICU at the University Hospital for Internal Medicine in Halle (Saale) in the years 2001-2010...
September 13, 2016: Zeitschrift Für Rheumatologie
Andreas Ranft, Daniel Golkowski, Tobias Kiel, Valentin Riedl, Philipp Kohl, Guido Rohrer, Joachim Pientka, Sebastian Berger, Alexander Thul, Max Maurer, Christine Preibisch, Claus Zimmer, George A Mashour, Eberhard F Kochs, Denis Jordan, Rüdiger Ilg
BACKGROUND: The neural correlates of anesthetic-induced unconsciousness have yet to be fully elucidated. Sedative and anesthetic states induced by propofol have been studied extensively, consistently revealing a decrease of frontoparietal and thalamocortical connectivity. There is, however, less understanding of the effects of halogenated ethers on functional brain networks. METHODS: The authors recorded simultaneous resting-state functional magnetic resonance imaging and electroencephalography in 16 artificially ventilated volunteers during sevoflurane anesthesia at burst suppression and 3 and 2 vol% steady-state concentrations for 700 s each to assess functional connectivity changes compared to wakefulness...
November 2016: Anesthesiology
Janiana Raíza Jentsch Matias de Oliveira, Michel Fleith Otuki, Daniela Almeida Cabrini, Indiara Brusco, Sara Marchesan Oliveira, Juliano Ferreira, Eunice André
Angiotensin-converting enzyme inhibitors (ACEIs) are widely used in the treatment of hypertension, congestive heart failure and renal disease, and are considered relatively safe and generally well-tolerated drugs. However, adverse effects of ACEIs have been reported, including non-productive cough and angioedema, which can lead to poor adherence to therapy. The mechanisms by which ACEIs promote adverse effects are not fully elucidated, although increased bradykinin plasma levels following ACEI therapy seem to play an important role...
September 7, 2016: Pulmonary Pharmacology & Therapeutics
Laura Pompermaier, Ingrid Steinvall, Mats Fredrikson, Johan Thorfinn, Folke Sjöberg
INTRODUCTION: As widely reported, the progress in burn care during recent decades has reduced the hospital mortality. The effect of the burns on long-term outcome has not received so much attention, and more study is indicated. The aim of this retrospective study was to investigate the long-time survival among patients who had been treated for burns. METHODS: We studied 1487 patients who were discharged alive from the Linköping University Hospital Burn Centre during the period 1993 until the end of December 2012...
September 6, 2016: Burns: Journal of the International Society for Burn Injuries
Amir C Dayan, Richard H Epstein
BACKGROUND: An intact pilot balloon assembly is crucial to the proper function of a cuffed tracheal tube. Disruption of the pilot balloon, transection of the inflation line, or valve incompetence results in cuff deflation, which may lead to inadequate ventilation and aspiration of secretions. Such failures typically result in tracheal tube replacement, but this may be a safety risk if a difficult reintubation is anticipated. We recently encountered such a patient who remained intubated postoperatively and in whom the inflation line was transected, causing a large leak...
September 7, 2016: Anesthesia and Analgesia
Roberto Roncon-Albuquerque, João Ferreira-Coimbra, Rodrigo Vilares-Morgado, Paulo Figueiredo, José Artur Paiva
BACKGROUND: During extracorporeal membrane oxygenation (ECMO), arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2; PF ratio reflects native and artificial lung blood oxygenation). In this study we analyzed PF ratio during ECMO support and its association with clinical outcome. METHODS: This was a single-center observational study of adult patients (n = 81) undergoing veno-venous ECMO support for severe acute respiratory distress syndrome...
September 1, 2016: Annals of Thoracic Surgery
Clemens A Strohmaier, Karolina Motloch, Christian Runge, Andrea Trost, Barbara Bogner, Alexandra Kaser-Eichberger, Falk Schrödl, Markus Lenzhofer, Herbert A Reitsamer
PURPOSE: Recent histological data suggest autonomic innervation of the central retinal artery. In the present study, we investigated the effect of electrical brain stem stimulation at the superior salivatory nucleus (SSN) on the retinal vessel diameter in rats and whether nitric oxide mediates a possible effect. METHODS: Sprague-Dawley rats (n = 12) were anesthetized using pentobarbital sodium (50 mg/kg intraperitoneally). The animals were artificially ventilated and the femoral artery and vein were cannulated for blood pressure measurement and drug administration...
September 1, 2016: Investigative Ophthalmology & Visual Science
Lars Schröder, Gerhard Hommel, Stephan Sahm
BACKGROUND: Despite a recent statutory ruling stating the binding nature of advance directives (ADs), only a minority of the population has signed one. Yet, a majority deem it of utmost importance to ensure their wishes are followed through in case they are no longer able to decide. The reasons for this discrepancy have not yet been investigated sufficiently. PATIENTS AND METHODS: This article is based on a survey of patients using a well-established structured questionnaire...
2016: Patient Preference and Adherence
Nicola White, Fiona Reid, Adam Harris, Priscilla Harries, Patrick Stone
BACKGROUND: Prognostic accuracy in palliative care is valued by patients, carers, and healthcare professionals. Previous reviews suggest clinicians are inaccurate at survival estimates, but have only reported the accuracy of estimates on patients with a cancer diagnosis. OBJECTIVES: To examine the accuracy of clinicians' estimates of survival and to determine if any clinical profession is better at doing so than another. DATA SOURCES: MEDLINE, Embase, CINAHL, and the Cochrane Database of Systematic Reviews and Trials...
2016: PloS One
Mirko Belliato, Antonella Degani, Antonino Buffa, Fabio Sciutti, Michele Pagani, Carlo Pellegrini, Giorgio Antonio Iotti
Monitoring veno-venous extracorporeal membrane oxygenation (vvECMO) during 76 days of continuous support in a 42-years old patient with end-stage pulmonary disease, listed for double-lung transplantation. Applying a new monitor (Landing(®), Eurosets, Medolla, Italy) and describing how measured and calculated parameters can be used to understand the variable interdependency between artificial membrane lung (ML) and patient native lung (NL). During vvECMO, in order to understand how the respiratory function is shared between ML and NL, ideally we should obtain data about oxygen transfer and CO2 removal, both by ML and NL...
August 24, 2016: Journal of Clinical Monitoring and Computing
Steffen Wirth, Luc Seywert, Johannes Spaeth, Stefan Schumann
BACKGROUND: Artificial airway resistance as provided by small-lumen tracheal tubes or catheters increases the risk of intrinsic PEEP (PEEPi). We hypothesized that by active expiration assistance, larger minute volumes could be generated without causing PEEPi compared with conventional mechanical ventilation when using small-lumen tracheal tubes or a cricothyrotomy catheter. METHODS: We investigated the active expiration assistance in a physical model of the respiratory system and estimated its hypothetical performance in terms of maximal flow generated with endotracheal tubes ranging from 3...
August 23, 2016: Respiratory Care
Shunichi Gamo, Hideya Iijima, Yumika Seki, Ryo Horaguchi, Yuji Suda, Yuriko Shindoh
An atopic asthmatic of 65-year-old man who was complicated with COPD and treated with inhaled corticosteroid, long-acting β2 agonist, long-acting muscarinic antagonist, and leukotriene receptor antagonist was hospitalized with a severe asthmatic attack. He was intubated and went onto an artificial respirator. He was gradually relieved by repeated intravenous administration of high-dose corticosteroid, and a respirator was switched over to non-invasive positive pressure ventilation on 24th day. However, he repeated asthmatic attacks which needed corticosteroid to recover...
July 2016: Arerugī, [Allergy]
Ethan E Mann, Chelsea M Magin, M Ryan Mettetal, Rhea M May, MiKayla M Henry, Heather DeLoid, Justin Prater, Lauren Sullivan, John G Thomas, Mark D Twite, Albert E Parker, Anthony B Brennan, Shravanthi T Reddy
Tracheal intubation disrupts physiological homeostasis of secretion production and clearance, resulting in secretion accumulation within endotracheal tubes (ETTs). Novel in vitro and in vivo models were developed to specifically recapitulate the clinical manifestations of ETT occlusion. The novel Sharklet™ micropatterned ETT was evaluated, using these models, for the ability to reduce the accumulation of both bacterial biofilm and airway mucus compared to a standard care ETT. Novel ETTs with micropattern on the inner and outer surfaces were placed adjacent to standard care ETTs in in vitro biofilm and airway patency (AP) models...
August 17, 2016: Annals of Biomedical Engineering
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