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https://www.readbyqxmd.com/read/28338504/ventilation-with-high-or-low-tidal-volume-with-peep-does-not-influence-lung-function-after-spinal-surgery-in-prone-position-a-randomized-controlled-trial
#1
Sarah Soh, Jae-Kwang Shim, Yoon Ha, Young-Sam Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: Spinal surgery in the prone position is accompanied by increased intrathoracic pressure and decreased respiratory compliance. This study investigated whether intraoperative lung protective mechanical ventilation improved lung function evaluated with pulmonary function tests in patients at risk of postoperative pulmonary complications (PPCs) after major spinal surgery in the prone position. METHODS: Seventy-eight patients at potential risk of PPCs were randomly assigned to the protective group (tidal volume; 6 mL/kg predicted body weight, 6 cm H2O positive end-expiratory pressure with recruitment maneuvers) or the conventional group (10 mL/kg predicted body weight, no positive end-expiratory pressure)...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#2
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28323236/rationale-study-design-and-analysis-plan-of-the-lung-imaging-morphology-for-ventilator-settings-in-acute-respiratory-distress-syndrome-study-live-study-study-protocol-for-a-randomised-controlled-trial
#3
Matthieu Jabaudon, Thomas Godet, Emmanuel Futier, Jean-Etienne Bazin, Vincent Sapin, Laurence Roszyk, Bruno Pereira, Jean-Michel Constantin
Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study)...
March 17, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28315940/a-multi-faceted-strategy-to-reduce-ventilation-associated-mortality-in-brain-injured-patients-the-bi-vili-project-a-nationwide-quality-improvement-project
#4
Karim Asehnoune, Ségolène Mrozek, Pierre François Perrigault, Philippe Seguin, Claire Dahyot-Fizelier, Sigismond Lasocki, Anne Pujol, Mathieu Martin, Russel Chabanne, Laurent Muller, Jean Luc Hanouz, Emmanuelle Hammad, Bertrand Rozec, Thomas Kerforne, Carole Ichai, Raphael Cinotti, Thomas Geeraerts, Djillali Elaroussi, Paolo Pelosi, Samir Jaber, Marie Dalichampt, Fanny Feuillet, Véronique Sebille, Antoine Roquilly
PURPOSE: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed...
March 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#5
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28306327/fifty-years-of-research-in-ards-respiratory-mechanics-in-acute-respiratory-distress-syndrome
#6
William R Henderson, Lu Chen, Marcelo B P Amato, Laurent J Brochard
Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, while lifesaving, is associated with new iatrogenic injury. Current best practice involves the use of small tidal volumes, low plateau and driving pressures, and high levels of positive end expiratory pressure. Collectively, these interventions are termed "lung protective ventilation". Recent investigations suggest that individualized measurements of pulmonary mechanical variables rather than population based ventilation prescriptions may be used to set the ventilator with the potential to improve outcomes beyond those achieved with standard lung protective ventilation...
March 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28301417/inhaled-sedation-in-patients-with-acute-respiratory-distress-syndrome-undergoing-extracorporeal-membrane-oxygenation
#7
Andreas Meiser, Hagen Bomberg, Philipp M Lepper, Franziska C Trudzinski, Thomas Volk, Heinrich V Groesdonk
Six patients suffering from acute respiratory distress syndrome with the need for extracorporeal membrane oxygenation (ECMO) therapy in deep sedation were included. Isoflurane sedation with the AnaConDa system was initiated within 24 hours after initiation of ECMO therapy and resulted in a satisfactory sedation (Richmond Agitation-Sedation Scale -4 to -5). Despite deep sedation, spontaneous breathing was possible in 6 of 6 patients. We observed a reduced need for vasopressor therapy and improved lung function (PaO2, PaCO2, delta P, and tidal volume) during isoflurane sedation...
March 15, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28298466/respiratory-mechanics-of-eleven-avian-species-resident-at-high-and-low-altitude
#8
Julia M York, Beverly A Chua, Catherine M Ivy, Luis Alza, Rebecca Cheek, Graham R Scott, Kevin G McCracken, Peter B Frappell, Neal J Dawson, Sabine L Laguë, William K Milsom
The metabolic cost of breathing at rest has never been successfully measured in birds, but has been hypothesized to be higher than in mammals of a similar size because of the rocking motion of the avian sternum being encumbered by the pectoral flight muscles. To measure the cost and work of breathing, and to investigate whether species resident at high altitude exhibit morphological or mechanical changes that alter the work of breathing, we studied 11 species of waterfowl: five from high altitudes (>3000 m) in Perú, and six from low altitudes in Oregon, USA...
March 15, 2017: Journal of Experimental Biology
https://www.readbyqxmd.com/read/28292973/evaluation-of-functional-characteristics-of-4-oscillatory-positive-pressure-devices-in-a-simulated-cystic-fibrosis-model
#9
Hillary Van Fleet, Diane K Dunn, Neil L McNinch, Teresa A Volsko
BACKGROUND: Oscillatory positive expiratory pressure (OPEP) is an airway clearance therapy that delivers positive pressure and air-flow oscillations during exhalation. This study described functional characteristic differences of 4 OPEP devices during an active exhalation in a simulated model. We hypothesized peak pressure (Ppeak), positive expiratory pressure (PEP), oscillatory frequency (f), and pressure amplitude will differ, depending upon the device used, device resistance setting, and time (repeated consecutive active exhalations through the device)...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28284927/apneic-oxygenation-versus-low-tidal-volume-ventilation-in-anesthetized-cardiac-surgical-patients-a-prospective-single-center-randomized-controlled-trial
#10
Laura Machan, Leonid Churilov, Raymond Hu, Philip Peyton, Chong Tan, Param Pillai, Louise Ellard, Ian Harley, David Story, Philip Hayward, George Matalanis, Nicholas Roubos, Sivendran Seevanayagam, Laurence Weinberg
OBJECTIVES: To compare the physiology of apneic oxygenation with low-tidal-volume (VT) ventilation during harvesting of the left internal mammary artery. DESIGN: Prospective, single-center, randomized trial. SETTING: Single-center teaching hospital. PARTICIPANTS: The study comprised 24 patients who underwent elective coronary artery bypass grafting surgery. INTERVENTIONS: Apneic oxygenation (apneic group: 12 participants) and low-VT ventilation (low-VT group: 12 participants) (2...
December 30, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28277322/utilizing-forced-vital-capacity-to-predict-low-lung-compliance-and-select-intraoperative-tidal-volume-during-thoracic-surgery
#11
Nir Hoftman, Eric Eikermann, John Shin, Jack Buckley, Kaveh Navab, Fereidoun Abtin, Tristan Grogan, Maxime Cannesson, Aman Mahajan
BACKGROUND: Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. METHODS: One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT)...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28275225/low-flow-veno-venous-extracorporeal-co2-removal-for-acute-hypercapnic-respiratory-failure
#12
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
BACKGROUND: Ventilation with low tidal volume and airway pressure results in a survival benefit in ARDS patients. Previous research suggests that avoiding mechanical ventilation altogether may be beneficial in some cases of respiratory failure. Our hypothesis was that low flow veno-venous extracorporeal CO2 removal (ECCO2R) enables maintenance of a lung protective ventilation strategy or awake spontaneous ventilation despite severe hypercapnic respiratory failure (HRF). METHODS: Twenty patients with HRF were investigated while mechanically ventilated (n=14) or breathing spontaneously close to respiratory exhaustion (n=6)...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28268159/protective-lung-strategies-a-cross-sectional-survey-of-nurses-knowledge-and-use-in-the-emergency-department
#13
Sarah Cornish, Rochelle Wynne, Sharon Klim, Anne-Maree Kelly
BACKGROUND: Mechanical ventilation (MV) is commonly used in emergency departments (EDs). Protective lung strategies (PLS), comprising of low tidal volume (6mL/kg), control of oxygen and plateau pressures, and administration of positive end expiratory pressure (PEEP) has been shown to reduces the risks associated with MV but there is little evidence exists about nurses' knowledge or application of PLS. Our aim was to explore nurses knowledge and application of PLS in Australian EDs. METHODS: Descriptive, exploratory design utilising an online questionnaire...
March 3, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28267376/favorable-neurocognitive-outcome-with-low-tidal-volume-ventilation-after-cardiac-arrest
#14
Jeremy R Beitler, Tiffany Bita Ghafouri, Sayuri P Jinadasa, Ariel Mueller, Leeyen Hsu, Ryan J Anderson, Jisha Joshua, Sanjeev Tyagi, Atul Malhotra, Rebecca E Sell, Daniel Talmor
RATIONALE: Neurocognitive outcome after out-of-hospital cardiac arrest (OHCA) often is poor even when initial resuscitation succeeds. Lower tidal volumes (VT) attenuate extrapulmonary organ injury in other disease states and are neuro-protective in preclinical models of critical illness. OBJECTIVE: To evaluate the association between VT and neurocognitive outcome following OHCA. METHODS: Propensity-adjusted analysis of two-center retrospective cohort of OHCA patients who received mechanical ventilation for at least the first 48 hours of hospitalization...
March 7, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28261294/influence-of-intraoperative-positive-end-expiratory-pressure-level-on-pulmonary-complications-in-emergency-major-trauma-surgery
#15
Thomas Stueber, Jan Karsten, Nikolas Voigt, Michaela Wilhelmi
INTRODUCTION: Pulmonary complications have a major impact on the morbidity and mortality of critically ill patients with multiple trauma. Intraoperative protective ventilation with low tidal volume may prevent lung injury and infection, whereas the role of positive end-expiratory pressure (PEEP) levels is unclear. The aim of this study was to evaluate the influence of different intraoperative PEEP levels on incidence of pulmonary complications after emergency trauma surgery. MATERIAL AND METHODS: We retrospectively analysed data of multiple trauma patients who underwent emergency surgery within 24 h after injury in our level I trauma centre (n = 86)...
March 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28250891/hydrogen-sulfide-prevents-formation-of-reactive-oxygen-species-through-pi3k-akt-signaling-and-limits-ventilator-induced-lung-injury
#16
Sashko Georgiev Spassov, Rosa Donus, Paul Mikael Ihle, Helen Engelstaedter, Alexander Hoetzel, Simone Faller
The development of ventilator-induced lung injury (VILI) is still a major problem in mechanically ventilated patients. Low dose inhalation of hydrogen sulfide (H2S) during mechanical ventilation has been proven to prevent lung damage by limiting inflammatory responses in rodent models. However, the capacity of H2S to affect oxidative processes in VILI and its underlying molecular signaling pathways remains elusive. In the present study we show that ventilation with moderate tidal volumes of 12 ml/kg for 6 h led to an excessive formation of reactive oxygen species (ROS) in mice lungs which was prevented by supplemental inhalation of 80 parts per million of H2S...
2017: Oxidative Medicine and Cellular Longevity
https://www.readbyqxmd.com/read/28223465/assessment-of-bohr-and-enghoff-dead-space-equations-in-mechanically-ventilated-children
#17
Pierre Bourgoin, Florent Baudin, David Brossier, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
BACKGROUND: Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead space to tidal volume ratio (VD/VT Bohr and VD/VT Enghoff, respectively). We aimed to describe the relationship between these 2 measurements in mechanically ventilated children and their significance in cases of ARDS. METHODS: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28213470/higher-mini-bal-total-protein-concentration-in-early-ards-predicts-faster-resolution-of-lung-injury-measured-by-more-ventilator-free-days
#18
Carolyn M Hendrickson, Jason Abbott, Hanjing Zhuo, Kathleen D Liu, Carolyn S Calfee, Michael A Matthay
The protein concentration of alveolar edema fluid in acute respiratory distress syndrome (ARDS) is dynamic. It reflects alveolar flooding during acute injury as well as fluid and protein clearance over time. We hypothesized that among ARDS patients treated with low tidal volume ventilation, higher concentrations of protein in mini-bronchoalveolar lavage (mBAL) samples would predict slower resolution of lung injury and worse clinical outcomes. Total protein and IgM concentrations in Day 0 mBAL samples from 79 subjects enrolled in the aerosolized albuterol (ALTA) ARDS Network Albuterol trial were measured by colorimetric assay and ELISA respectively...
February 17, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28213294/a-low-cost-simplified-and-scaleable-pneumotachograph-and-face-mask-for-neonatal-mouse-respiratory-measurements
#19
Jenny J Sun, Roshan Nanu, Russell S Ray
INTRODUCTION: Neonatal respiratory disorders are a leading cause of perinatal mortality due to complications resulting from premature births and prenatal exposure to drugs of abuse, but optimal treatments for these symptoms are still unclear due to a variety of confounds and risk factors. Mouse models present an opportunity to study the underlying mechanisms and efficacy of potential treatments of these conditions with controlled variables. However, measuring respiration in newborn mice is difficult and commercial components are expensive and often require modification, creating a barrier and limiting our understanding of the short and long-term effects of birth complications on respiratory function...
February 15, 2017: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/28212247/african-american-disparities-in-low-tidal-volume-ventilation
#20
Jason Chertoff
No abstract text is available yet for this article.
March 2017: Critical Care Medicine
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