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https://www.readbyqxmd.com/read/29676628/increasing-the-resolution-of-chronic-obstructive-pulmonary-disease-definition-lessons-from-a-cohort-with-remote-but-extensive-exposure-to-secondhand-tobacco-smoke
#1
Mehrdad Arjomandi, Siyang Zeng, Paul D Blanc, Warren M Gold
RATIONALE: The Global Initiative for Chronic Obstructive Lung Disease criteria require a ratio of forced expiratory volume in 1 second (FEV1 ) to forced vital capacity (FVC) (FEV1 /FVC) of less than 0.70 for the diagnosis of chronic obstructive pulmonary disease, whereas other criteria emphasize a lower limit of normal approach. However, the use of Global Initiative for Chronic Obstructive Lung Disease (or lower limit of normal) criteria may result in classification of many smokers with respiratory morbidities as not having chronic obstructive pulmonary disease...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29671605/effects-of-budesonide-and-surfactant-in-preterm-fetal-sheep
#2
T Brett Kothe, Emily Royse, Matthew W Kemp, Augusto F Schmidt, Fabrizio Salomone, Masatoshi Saito, Haruo Usuda, Shimpei Watanabe, Gabrielle C Musk, Alan H Jobe, Noah H Hillman
BACKGROUND: Mechanical ventilation causes lung injury and systemic inflammatory responses in preterm sheep, and is associated with bronchopulmonary dysplasia (BPD) in preterm infants. Budesonide added to surfactant decreased BPD by 20% in infants. OBJECTIVE: Determine the effects of budesonide and surfactant on injury from high tidal volume (VT) ventilation in preterm lambs. METHODS: Ewes at 125 {plus minus} 1 day GA had fetal surgery to expose fetal head and chest with placental circulation intact...
April 19, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29670906/desflurane-attenuates-ventilator-induced-lung-injury-in-rats-with-acute-respiratory-distress-syndrome
#3
Xue Lin, Ying-Nan Ju, Wei Gao, Dong-Mei Li, Chang-Chun Guo
Ventilator-induced lung injury aggravates the existing lung injury. This study investigated the effect of desflurane on VILI in a rat model of acute respiratory distress syndrome. Forty-eight rats were randomized into a sham (S) group, control (C) group, lipopolysaccharide/ventilation (LV) group, lipopolysaccharide/ventilation/desflurane (LVD) group, or lipopolysaccharide/low ventilation with and without desflurane (LLV and LLVD) groups. Rats in the S group received anesthesia only. Rats in the LV and LVD groups received lipopolysaccharide and were ventilated with a high tidal volume...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29670537/impact-of-different-tidal-volume-levels-at-low-mechanical-power-on-ventilator-induced-lung-injury-in-rats
#4
Lillian Moraes, Pedro L Silva, Alessandra Thompson, Cintia L Santos, Raquel S Santos, Marcos V S Fernandes, Marcelo M Morales, Vanessa Martins, Vera L Capelozzi, Marcelo G de Abreu, Paolo Pelosi, Patricia R M Rocco
Tidal volume (VT ) has been considered the main determinant of ventilator-induced lung injury (VILI). Recently, experimental studies have suggested that mechanical power transferred from the ventilator to the lungs is the promoter of VILI. We hypothesized that, as long as mechanical power is kept below a safe threshold, high VT should not be injurious. The present study aimed to investigate the impact of different VT levels and respiratory rates (RR) on lung function, diffuse alveolar damage (DAD), alveolar ultrastructure, and expression of genes related to inflammation [interleukin (IL)-6], alveolar stretch (amphiregulin), epithelial [club cell secretory protein (CC)16] and endothelial [intercellular adhesion molecule (ICAM)-1] cell injury, and extracellular matrix damage [syndecan-1, decorin, and metalloproteinase (MMP)-9] in experimental acute respiratory distress syndrome (ARDS) under low-power mechanical ventilation...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29666293/fast-or-slow-rescue-ventilations-a-predictive-model-of-gastric-inflation
#5
John R Fitz-Clarke
BACKGROUND: Rescue ventilations are given during respiratory and cardiac arrest. Tidal volume must assure oxygen delivery; however, excessive pressure applied to an unprotected airway can cause gastric inflation, regurgitation, and pulmonary aspiration. The optimal technique provides mouth pressure and breath duration that minimize gastric inflation. It remains unclear if breath delivery should be fast or slow, and how inflation time affects the division of gas flow between the lungs and esophagus...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29609546/high-frequency-power-of-heart-rate-variability-can-predict-the-outcome-of-thoracic-surgical-patients-with-acute-respiratory-distress-syndrome-on-admission-to-the-intensive-care-unit-a-prospective-single-centric-case-controlled-study
#6
I-Chen Chen, Chew-Teng Kor, Ching-Hsiung Lin, Jane Kuo, Jang-Zern Tsai, Wen-Je Ko, Cheng-Deng Kuo
BACKGROUND: The morbidity and mortality of acute respiratory distress syndrome (ARDS) remains high, and the strategic focus of ARDS research has shifted toward identifying patients at high risk of mortality early in the course of illness. This study intended to identify the heart rate variability (HRV) measure that can predict the outcome of patients with ARDS on admission to the surgical intensive care unit (SICU). METHODS: Patients who had lung or esophageal cancer surgery were included either in the ARDS group (n = 21) if they developed ARDS after surgery or in the control group (n = 11) if they did not...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29606090/application-of-intraoperative-lung-protective-ventilation-varies-in-accordance-with-the-knowledge-of-anaesthesiologists-a-single-centre-questionnaire-study-and-a-retrospective-observational-study
#7
Seung Hyun Kim, Sungwon Na, Woo Kyung Lee, Hyunwoo Choi, Jeongmin Kim
BACKGROUND: The benefits of lung-protective ventilation (LPV) with a low tidal volume (6 mL/kg of ideal body weight [IBW]), limited plateau pressure (< 28-30 cm H2 O), and appropriate positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome have become apparent and it is now widely adopted in intensive care units. Recently evidence for LPV in general anaesthesia has been accumulated, but it is not yet generally applied by anaesthesiologists in the operating room...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29600057/neutrophil-to-lymphocyte-ratio-as-a-prognostic-marker-in-acute-respiratory-distress-syndrome-patients-a-retrospective-study
#8
Ying Wang, Mohan Ju, Cuicui Chen, Dong Yang, Dongni Hou, Xinjun Tang, Xiaodan Zhu, Donghui Zhang, Lilin Wang, Shimeng Ji, Jinjun Jiang, Yuanlin Song
Background: Acute respiratory distress syndrome (ARDS) is the leading cause of high mortality in intensive care units (ICUs) worldwide. An effective marker for prognosis in ARDS is particularly important given the absence of effective treatment strategies aside from small tidal volume ventilation. Previous studies identified an association between the neutrophil-to-lymphocyte ratio (NLR) and prognosis in critical patients. In this study, we explored the prognostic and predictive value of the NLR in ARDS patients...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29599209/optimal-ventilator-strategies-for-trauma-related-ards
#9
REVIEW
Giles Goatly, N Guidozzi, M Khan
BACKGROUND: Acute respiratory distress syndrome (ARDS) was first described in the 1960s and has become a major area of research due to the mortality and morbidity associated with it. ARDS is currently defined using the Berlin Consensus; however, this is not wholly applicable for trauma-related ARDS. METHODS: A systematic review of the literature was undertaken using the Preferred Reporting for Systematic Reviews and Meta Analyses methodology. The Ovid Medline, Web of Science and PubMed online databases were interrogated for papers published between 1 January 1995 and 31 December 2017...
March 29, 2018: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29596290/use-of-recruitment-maneuvers-in-patients-with-acute-respiratory-distress-syndrome
#10
Angela Nguyen
Acute respiratory distress syndrome (ARDS) is a deadly complication in critically ill patients that causes significant morbidity and mortality. Patients with ARDS are seen across intensive care unit settings, with treatment being largely supportive involving techniques through mechanical ventilation. Using low-tidal-volume ventilation is a standard of practice for patients with ARDS, as a lung protection strategy; however, alveolar decruitment may occur. Recruitment maneuvers can recruit collapsed alveoli and promote oxygenation...
May 2018: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/29595918/dynamic-cerebral-autoregulation-is-preserved-during-isometric-handgrip-and-head-down-tilt-in-healthy-volunteers
#11
Maria Skytioti, Signe Søvik, Maja Elstad
In healthy humans, cerebral blood flow (CBF) is autoregulated against changes in arterial blood pressure. Spontaneous fluctuations in mean arterial pressure (MAP) and CBF can be used to assess cerebral autoregulation. We hypothesized that dynamic cerebral autoregulation is affected by changes in autonomic activity, MAP, and cardiac output (CO) induced by handgrip (HG), head-down tilt (HDT), and their combination. In thirteen healthy volunteers, we recorded blood velocity by ultrasound in the internal carotid artery (ICA), HR, MAP and CO-estimates from continuous finger blood pressure, and end-tidal CO2 ...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29595185/acute-respiratory-distress-syndrome-challenge-for-diagnosis-and-therapy
#12
REVIEW
Chun Pan, Ling Liu, Jian-Feng Xie, Hai-Bo Qiu
Objective: Acute respiratory distress syndrome (ARDS) is a devastating clinical syndrome whose diagnosis and therapy are still in question. The aim of this review was to discuss the current challenge for the diagnosis and treatment of ARDS. Data Sources: Data sources were the published articles in English through December 2017 in PubMed using the following key words: "acute respiratory distress syndrome," "definition", "diagnosis," "therapy," "lung protective strategy," "right ventricular dysfunction," and "molecular mechanism...
March 27, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29582414/the-novel-%C3%AE-opioid-receptor-agonist-pzm21-depresses-respiration-and-induces-tolerance-to-antinociception
#13
Rob Hill, Alex Disney, Alex Conibear, Katy Sutcliffe, William Dewey, Stephen Husbands, Chris Bailey, Eamonn Kelly, Graeme Henderson
BACKGROUND AND PURPOSE: PZM21 is a novel μ-opioid receptor (MOPr) ligand that has been reported to induce minimal arrestin recruitment and be devoid of the respiratory depressant effects characteristic of classical μ-opioid ligands such as morphine. We have re-examined the signalling profile of PZM21 and its ability to depress respiration. EXPERIMENTAL APPROACH: G protein (Gi ) activation and arrestin-3 translocation were measured in vitro in MOPr expressing HEK 293 cells using BRET assays...
March 26, 2018: British Journal of Pharmacology
https://www.readbyqxmd.com/read/29578124/role-of-glutamine-in-the-mediation-of-e-cadherin-p120-catenin-and-inflammation-in-ventilator-induced-lung-injury
#14
Jian-Lei Qiu, Bai-Ling Song, Yu-Juan Wang, Fu-Tao Zhang, Yue-Lan Wang
Background: Ventilator-induced lung injury (VILI) is commonly associated with barrier dysfunction and inflammation reaction. Glutamine could ameliorate VILI, but its role has not been fully elucidated. This study examined the relationship between inflammatory cytokines (interleukin [IL]-6, tumor necrosis factor [TNF]-α, and IL-10) and adherens junctions (E-cadherin, p120-catenin), which were ameliorated by glutamine in VILI, both in vitro and in vivo. Methods: For the in vivo study, 30 healthy C57BL/6 mice weighing 25-30 g were randomly divided into five groups with random number table (n = 6 in each group): control (Group C); low tidal volume (Group L); low tidal volume + glutamine (Group L + G); high tidal volume (Group H); and high tidal volume + glutamine (Group H + G)...
April 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#15
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29576824/ventilator-management-for-acute-respiratory-distress-syndrome-associated-with-avian-influenza-a-h7n9-virus-infection-a-case-series
#16
Hui Xie, Zhi-Gang Zhou, Wei Jin, Cheng-Bin Yuan, Jiang Du, Jian Lu, Rui-Lan Wang
BACKGROUND: Data on the mechanical ventilation (MV) characteristics and radiologic features for the cases with H7N9-induced ARDS were still lacking. METHODS: We describe the MV characteristics and radiologic features of adult patients with ARDS due to microbiologically confirmed H7N9 admitted to our ICU over a 3-month period. RESULTS: Eight patients (mean age 57.38±16.75; 5 male) were diagnosed with H7N9 in the first quarter of 2014. All developed respiratory failure complicated by acute respiratory distress syndrome (ARDS), which required MV in ICU...
2018: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29566734/acute-exacerbation-of-idiopathic-pulmonary-fibrosis-lessons-learned-from-acute-respiratory-distress-syndrome
#17
REVIEW
Alessandro Marchioni, Roberto Tonelli, Lorenzo Ball, Riccardo Fantini, Ivana Castaniere, Stefania Cerri, Fabrizio Luppi, Mario Malerba, Paolo Pelosi, Enrico Clini
Idiopathic pulmonary fibrosis (IPF) is a fibrotic lung disease characterized by progressive loss of lung function and poor prognosis. The so-called acute exacerbation of IPF (AE-IPF) may lead to severe hypoxemia requiring mechanical ventilation in the intensive care unit (ICU). AE-IPF shares several pathophysiological features with acute respiratory distress syndrome (ARDS), a very severe condition commonly treated in this setting.A review of the literature has been conducted to underline similarities and differences in the management of patients with AE-IPF and ARDS...
March 23, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29565769/hyperadditive-ventilatory-response-arising-from-interaction-between-the-carotid-chemoreflex-and-the-muscle-mechanoreflex-in-healthy-humans
#18
Talita M Silva, Liliane C Aranda, Marcelle Paula-Ribeiro, Diogo M Oliveira, Wladimir Musetti Medeiros, Lauro C Vianna, Luiz E Nery, Bruno M Silva
Physical exercise potentiates the carotid chemoreflex control of ventilation (VE). Hyperadditive neural interactions may partially mediate the potentiation. However, some neural interactions remain incompletely explored. As the potentiation occurs even during low-intensity exercise, we tested the hypothesis that the carotid chemoreflex and the muscle mechanoreflex could interact in a hyperadditive fashion. Fourteen young healthy subjects inhaled, randomly, in separate visits, 12% O2 to stimulate the carotid chemoreflex, and 21% O2 as control...
March 22, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29564137/regional-overdistension-during-prone-positioning-in-a-patient-with-acute-respiratory-failure-who-was-ventilated-with-a-low-tidal-volume-a-case-report
#19
Toru Kotani, Masanori Hanaoka, Shinya Hirahara, Hisashi Yamanaka, Eckhard Teschner, Atsuko Shono
Background: Prone positioning may provide a uniform distribution of transpulmonary pressure and contribute to prevent ventilator-induced lung injury. However, despite moderate positive end-expiratory pressure and low tidal volumes, there is still a risk of regional overdistension. Case presentation: A man with refractory hypoxemia was mechanically ventilated with prone positioning. Although prone positioning with a plateau pressure of 18 cmH2 O and a positive end-expiratory pressure of 8 cmH2 O promptly improved oxygenation, regional ventilation monitoring using electrical impedance tomography initially detected decreased distribution in the dorsal region but increased in the ventral, suggesting overdistension...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29561278/protective-ventilation-during-anaesthesia-reduces-major-postoperative-complications-after-lung-cancer-surgery-a-double-blind-randomised-controlled-trial
#20
Emmanuel Marret, Raphael Cinotti, Laurence Berard, Vincent Piriou, Jacques Jobard, Benoit Barrucand, Dragos Radu, Samir Jaber, Francis Bonnet
BACKGROUND: Thoracic surgery for lung resection is associated with a high incidence of postoperative pulmonary complications. Controlled ventilation with a large tidal volume has been documented to be a risk factor for postoperative respiratory complications after major abdominal surgery, whereas the use of low tidal volumes and positive end-expiratory pressure (PEEP) has a protective effect. OBJECTIVE: To evaluate the effects of ventilation with low tidal volume and PEEP on major complications after thoracic surgery...
March 19, 2018: European Journal of Anaesthesiology
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