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https://www.readbyqxmd.com/read/29040312/end-tidal-carbon-dioxide-measurement-in-preterm-infants-with-low-birth-weight
#1
Hsin-Ju Lin, Ching-Tzu Huang, Hsiu-Feng Hsiao, Ming-Chou Chiang, Mei-Jy Jeng
OBJECTIVE: There are conflicting data regarding the use of end-tidal carbon dioxide (PetCO2) measurement in preterm infants. The aim of this study was to evaluate the effects of different dead space to tidal volume ratios (VD/VT) on the correlation between PetCO2 and arterial carbon dioxide pressure (PaCO2) in ventilated preterm infants with respiratory distress syndrome (RDS). METHODS: We enrolled ventilated preterm infants (with assist control mode or synchronous intermittent mandatory mode) with RDS who were treated with surfactant in this prospective study...
2017: PloS One
https://www.readbyqxmd.com/read/29019893/rescue-therapeutic-strategy-combining-ultra-protective-mechanical-ventilation-with-extracorporeal-co2-removal-membrane-in-near-fatal-asthma-with-severe-pulmonary-barotraumas-a-case-report
#2
Arthur Pavot, Jihad Mallat, Nicolas Vangrunderbeeck, Didier Thevenin, Malcolm Lemyze
RATIONALE: Mechanical ventilation of severe acute asthma is still considered a challenging issue, mainly because of the gas trapping phenomenon with the potential for life-threatening barotraumatic pulmonary complications. PATIENT CONCERNS: Herein, we describe 2 consecutive cases of near-fatal asthma for whom the recommended protective mechanical ventilation approach using low tidal volume of 6 mL/kg and small levels of PEEP was rapidly compromised by giant pneumomediastinum with extensive subcutaneousemphysema...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28993038/capnography-in-the-emergency-department-a-review-of-uses-waveforms-and-limitations
#3
Brit Long, Alex Koyfman, Michael A Vivirito
BACKGROUND: Capnography has many uses in the emergency department (ED) and critical care setting, most commonly cardiac arrest and procedural sedation. OBJECTIVE OF THE REVIEW: This review evaluates several indications concerning capnography beyond cardiac arrest and procedural sedation in the ED, as well as limitations and specific waveforms. DISCUSSION: Capnography includes the noninvasive measurement of CO2, providing information on ventilation, perfusion, and metabolism in intubated and spontaneously breathing patients...
October 6, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28979556/protective-mechanical-ventilation-in-united-kingdom-critical-care-units-a-multicentre-audit
#4
Christopher P Newell, Matthew J Martin, Neil Richardson, Christopher P Bourdeaux
Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg(-1) predicted body weight and overall compliance with low tidal volume ventilation (≤6...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977760/sediment-trapping-in-estuaries
#5
Hans Burchard, Henk M Schuttelaars, David K Ralston
Estuarine turbidity maxima (ETMs) are generated by a large suite of hydrodynamic and sediment dynamic processes, leading to longitudinal convergence of cross-sectionally integrated and tidally averaged transport of cohesive and noncohesive suspended particulate matter (SPM). The relative importance of these processes for SPM trapping varies substantially among estuaries depending on topography, fluvial and tidal forcing, and SPM composition. The high-frequency dynamics of ETMs are constrained by interactions with the low-frequency dynamics of the bottom pool of easily erodible sediments...
October 4, 2017: Annual Review of Marine Science
https://www.readbyqxmd.com/read/28977263/does-the-use-of-high-peep-levels-prevent-ventilator-induced-lung-injury
#6
Guillermo Bugedo, Jaime Retamal, Alejandro Bruhn
Overdistention and intratidal alveolar recruitment have been advocated as the main physical mechanisms responsible for ventilator-induced lung injury. Limiting tidal volume has a demonstrated survival benefit in patients with acute respiratory distress syndrome and is recognized as the cornerstone of protective ventilation. In contrast, the use of high positive end-expiratory pressure levels in clinical trials has yielded conflicting results and remains controversial. In the present review, we will discuss the benefits and limitations of the open lung approach and will discuss some recent experimental and clinical trials on the use of high versus low/moderate positive end-expiratory pressure levels...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28967868/respiratory-mechanics-to-understand-ards-and-guide-mechanical-ventilation
#7
Tommaso Mauri, Marta Lazzeri, Giacomo Bellani, Alberto Zanella, Giacomo Grasselli
As precision medicine is becoming standard of care to select tailored rather than average treatments, physiological measurements might represent the first step to apply personalized therapy in the intensive care unit (ICU). Systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step towards this direction for two main reasons. On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient...
October 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28967439/new-evidence-in-one-lung-ventilation
#8
H Meleiro, I Correia, P Charco Mora
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included...
September 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28962107/experimental-study-of-airway-pressure-release-ventilation-in-the-treatment-of-acute-respiratory-distress-syndrome
#9
Guan-Jie Han, Jia-Qiong Li, Cui-Gai Pan, Jing-Xi Sun, Zai-Xiang Shi, Ji-Yuan Xu, Mao-Qin Li
Airway pressure release ventilation (APRV) is a ventilator mode which has demonstrated potential benefits in acute respiratory distress syndrome (ARDS) patients. We therefore sought to compare relevant pulmonary data and safety outcomes of this mode to the conventional ventilation and sustained inflation. Canines admitted after intravenous injection of oleic acid requiring mechanical ventilation were randomly divided into 3 groups (n=6), namely conventional ventilation group, low tidal volume ventilation with recruitment group (LTV+SI) and APRV group...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28936966/-progress-of-mechanical-ventilation-during-cardiopulmonary-resuscitation
#10
Cai Wen, Tao Yu, Lixiang Wang
Mechanical ventilation is regarded as an effective means of replacing artificial ventilation during cardiopulmonary resuscitation (CPR), and has been widely used in the treatment of cardiac arrest (CA) patients. However, there are still some controversial issues remaining to be settled, such as the assessment of the effectiveness of mechanical ventilation, the selection of the optimal oxygen concentration (FiO2), tidal volume (VT), respiratory frequency, and mode of ventilation during the CPR process. The pros and cons of positive pressure ventilation are also inconclusive...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936695/early-application-of-airway-pressure-release-ventilation-may-reduce-the-duration-of-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#11
Yongfang Zhou, Xiaodong Jin, Yinxia Lv, Peng Wang, Yunqing Yang, Guopeng Liang, Bo Wang, Yan Kang
PURPOSE: Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28886582/protective-effects-of-ghrelin-in-ventilator-induced-lung-injury-in-rats
#12
Guang Li, Jiao Liu, Wen-Fang Xia, Chen-Liang Zhou, Li-Qiong Lv
Ghrelin has exhibited potent anti-inflammatory effects on various inflammatory diseases. The aim of this study was to investigate the potential effects of ghrelin on a model of ventilator-induced lung injury (VILI) established in rats. Male Sprague-Dawley rats were randomly divided into three groups: low volume ventilation (LV, Vt=8ml/kg) group, a VILI group (Vt=30ml/kg), and a VILI group pretreated with ghrelin (GH+VILI). For the LV group, for the VILI and GH+VILI groups, the same parameters were applied except the tidal volume was increased to 40ml/kg...
November 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28875449/an-extracorporeal-carbon-dioxide-removal-ecco2r-device-operating-at-hemodialysis-blood-flow-rates
#13
R Garrett Jeffries, Laura Lund, Brian Frankowski, William J Federspiel
BACKGROUND: Extracorporeal carbon dioxide removal (ECCO2R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilation. We have developed an ultra-low-flow ECCO2R device (ULFED) capable of operating at blood flows comparable to renal hemodialysis (250 mL/min). Comparable operating conditions allow use of minimally invasive dialysis cannulation strategies with potential for direct integration to existing dialysis circuitry...
September 6, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28861863/protective-ventilation-reduces-pseudomonas-aeruginosa-growth-in-lung-tissue-in-a-porcine-pneumonia-model
#14
Jesper Sperber, Axel Nyberg, Miklos Lipcsey, Åsa Melhus, Anders Larsson, Jan Sjölin, Markus Castegren
BACKGROUND: Mechanical ventilation with positive end expiratory pressure and low tidal volume, i.e. protective ventilation, is recommended in patients with acute respiratory distress syndrome. However, the effect of protective ventilation on bacterial growth during early pneumonia in non-injured lungs is not extensively studied. The main objectives were to compare two different ventilator settings on Pseudomonas aeruginosa growth in lung tissue and the development of lung injury. METHODS: A porcine model of severe pneumonia was used...
August 31, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28846440/low-tidal-volume-versus-non-volume-limited-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#15
Allan J Walkey, Ewan Goligher, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. OBJECTIVES: To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10-15 mL/kg among patients with ARDS. METHODS: Systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies...
August 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28843606/impact-of-low-tidal-volumes-during-one-lung-ventilation-a-meta-analysis-of-randomized-controlled-trials
#16
Mohamed R El Tahan, Laura Pasin, Nandor Marczin, Giovanni Landoni
OBJECTIVES: The link between ventilation strategies and perioperative outcomes remains one of the fundamental paradigms of thoracic anaesthesia. During one-lung ventilation (OLV), one lung is excluded from gas exchange and ventilation is directed at the dependent lung. The authors hypothesised that the use of low tidal volumes (VT) during OLV provides adequate gas exchange and improves postoperative outcome. DESIGN: Meta-analysis of randomized clinical trials. SETTING: Thoracic surgery...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28839101/hyperoxia-treatment-of-trek-1-trek-2-traak-deficient-mice-is-associated-with-a-reduction-in-surfactant-proteins
#17
Andreas Schwingshackl, Benjamin Lopez, Bin Teng, Charlean L Luellen, Florian Lesage, John Belperio, Riccardo Olcese, Christopher M Waters
We previously proposed a role for the 2-pore domain potassium (K2P) channel TREK-1 in hyperoxia (HO)-induced lung injury. To determine whether redundancy between the 3 TREK isoforms (TREK-1, TREK-2, TRAAK) could protect from HO-induced injury, we now examined the effect of deletion of all 3 TREK isoforms in a clinically relevant scenario of prolonged HO exposure and mechanical ventilation (MV). We exposed WT and TREK-1/TREK-2/TRAAK-deficient (triple ko) mice to either room air, 72 hours HO, MV (high and low tidal volume), or a combination of HO+MV, and measured quasi-static lung compliance, BAL protein concentration, histologic lung injury scores (LIS), cellular apoptosis, and cytokine levels...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28830928/evaluation-of-simulated-ventilation-techniques-with-the-upright-and-conventional-self-inflating-neonatal-resuscitators
#18
Indira Narayanan, Marvesh Mendhi, Pooja Bansil, Patricia S Coffey
BACKGROUND: The study assessed the impact of simulated ventilation techniques using upright and conventional self-inflating neonatal resuscitators on delivered tidal volume (VT) and pressure. METHODS: We analyzed videos of participants ventilating a manikin using an upright (upright, n = 33) and a conventional resuscitator (conventional, n = 32) under normal and low lung compliance. Mask hold, number of fingers squeezing the bag, and degree of bag squeeze were compared with VT and peak inspiratory pressure (PIP)...
August 22, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28828372/high-flow-nasal-oxygen-therapy-and-noninvasive-ventilation-in-the-management-of-acute-hypoxemic-respiratory-failure
#19
REVIEW
Jean-Pierre Frat, Rémi Coudroy, Nicolas Marjanovic, Arnaud W Thille
High-flow nasal cannula (HFNC) oxygen therapy is a recent technique delivering a high flow of heated and humidified gas. HFNC is simpler to use and apply than noninvasive ventilation (NIV) and appears to be a good alternative treatment for hypoxemic acute respiratory failure (ARF). HFNC is better tolerated than NIV, delivers high fraction of inspired oxygen (FiO2), generates a low level of positive pressure and provides washout of dead space in the upper airways, thereby improving mechanical pulmonary properties and unloading inspiratory muscles during ARF...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828364/prone-positioning-acute-respiratory-distress-syndrome-patients
#20
REVIEW
Claude Guérin
Prone position has been used in acute respiratory distress syndrome (ARDS) patients for more than 40 years in ICU. After having demonstrated its capability to significantly improve oxygenation in a large number of patients, sometimes dramatically, this procedure has been found to prevent ventilator-induced lung injury, the primary concern for the intensivists managing ARDS patients. Over the time, several trials have been done, which regularly improved and refined from each other. At the end, significant improvement in survival has been demonstrated in the most severe ARDS patients, at a threshold of 100-150 mmHg PaO2/FiO2 ratio...
July 2017: Annals of Translational Medicine
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