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invasive mechanical ventilation

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https://www.readbyqxmd.com/read/28931394/the-efficacy-of-initial-ventilation-strategy-for-adult-immunocompromised-patients-with-severe-acute-hypoxemic-respiratory-failure-study-protocol-for-a-multicentre-randomized-controlled-trial-venim
#1
Tao Wang, Gang Liu, Kun He, Xin Lu, Xianquan Liang, Meng Wang, Rong Zhu, Zongru Li, Feng Chen, Jun Ke, Qingming Lin, Chuanyun Qian, Bo Li, Jie Wei, Jingjun Lv, Li Li, Yanxia Gao, Guofeng Wu, Xiaohong Yu, Weiqin Wei, Ying Deng, Fengping Wang, Hong Zhang, Yun Zheng, Hong Zhan, Jinli Liao, Yingping Tian, Dongqi Yao, Jingsong Zhang, Xufeng Chen, Lishan Yang, Jiali Wu, Yanfen Chai, Songtao Shou, Muming Yu, Xudong Xiang, Dongshan Zhang, Fengying Chen, Xiufeng Xie, Yong Li, Bo Wang, Wenzhong Zhang, Yongli Miao, Michael Eddleston, Jianqiang He, Yong Ma, Shengyong Xu, Yi Li, Huadong Zhu, Xuezhong Yu
BACKGROUND: Acute respiratory failure (ARF) is still one of the most severe complications in immunocompromised patients. Our previous systematic review showed noninvasive mechanical ventilation (NIV) reduced mortality, length of hospitalization and ICU stay in AIDS/hematological malignancy patients with relatively less severe ARF, compared to invasive mechanical ventilation (IMV). However, this systematic review was based on 13 observational studies and the quality of evidence was low to moderate...
September 20, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28930916/peripheral-muscle-near-infrared-spectroscopy-nirs-variables-are-altered-early-in-septic-shock
#2
Diego Orbegozo, Fuhong Su, Keliang Xie, Lokmane Rahmania, Fabio Silvio Taccone, Daniel De Backer, Jean-Louis Vincent, Jacques Creteur
BACKGROUND: Non-invasive evaluation of muscle perfusion using near infrared spectroscopy (NIRS) coupled with a vascular occlusion test (VOT) may provide an early and simple marker of altered perfusion and microcirculatory function in sepsis. OBJECTIVE: To compare the time-course of NIRS-derived variables with systemic measures of perfusion in an experimental model of peritonitis. METHODS: Peritonitis was induced in eight anesthetized, mechanically ventilated, adult sheep (24-34 Kg), by injecting autologous feces into the peritoneal cavity...
September 19, 2017: Shock
https://www.readbyqxmd.com/read/28930478/mechanical-ventilation-induced-diaphragm-atrophy-strongly-impacts-clinical-outcomes
#3
Ewan C Goligher, Martin Dres, Eddy Fan, Gordon D Rubenfeld, Damon C Scales, Margaret S Herridge, Stefannie Vorona, Michael C Sklar, Nuttapol Rittayamai, Ashley Lanys, Alistair Murray, Deborah Brace, Cristian Urrea, W Darlene Reid, George Tomlinson, Arthur S Slutsky, Brian P Kavanagh, Laurent J Brochard, Niall D Ferguson
Rationale Diaphragm dysfunction worsens outcomes in mechanically ventilated patients but the clinical impact of potentially preventable changes in diaphragm structure and function due to mechanical ventilation is unknown. Objectives To determine whether diaphragm atrophy developing during mechanical ventilation leads to prolonged ventilation. Methods Diaphragm thickness was measured daily by ultrasound in adults requiring invasive mechanical ventilation; inspiratory effort was assessed by thickening fraction...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28925377/applied-upper-airway-resistance-instantly-affects-breath-components-a-unique-insight-into-pulmonary-medicine
#4
Pritam Sukul, Jochen Schubert, Svend Kamysek, Phillip Trefz, Wolfram Miekisch
Respiratory parameters such as flow or rate have complex effects onto exhalation of volatile substances and can hamper clinical interpretation of breath biomarkers. We investigated effects of progressively applied upper-airway resistances onto exhalation of volatile organic compounds (VOCs) in healthy humans. We performed real-time mass-spectrometric determination of breath volatiles in 50 subjects with parallel non-invasive hemodynamic monitoring, breath-resolved spirometry and capnometry during controlled tidal breathing (12 breaths/min)...
September 19, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28924310/use-of-corticosteroids-in-acute-respiratory-distress-syndrome-perspective-from-an-indian-intensive-care-unit
#5
Naveen G S Chandra, Saraschandra Vallabhajosyula, Barkur A Shastry, Shashaank Vallabhajosyula, Saarwaani Vallabhajosyula, Kavita Saravu
BACKGROUND: Acute respiratory distress syndrome (ARDS) causes overwhelming inflammation, which serves as a potential target for corticosteroids. Despite extensive Western literature, there are no Indian studies evaluating steroids in ARDS. METHODS: This was a retrospective study at an Indian intensive care unit (ICU) on ARDS patients. Demographic, clinical, laboratory, and imaging parameters were collected. Patients were divided into cohorts based on steroid use, and some received high-dose (2 mg/kg/day), whereas others received low-dose (1 mg/kg/day) steroids...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#6
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920633/noninvasive-ventilation-in-difficult-endotracheal-intubation-systematic-and-review-analysis
#7
Igor Barjaktarevic, Antonio M Esquinas, Frances Mae West, Jeffrey Albores, David Berlin
Noninvasive ventilation has been widely used in the management of acute respiratory failure in appropriate clinical settings. In addition to known benefit of alleviating the need for invasive mechanical ventilation, recent literature suggested its beneficial use in the process of endotracheal intubation. Search of the PubMed database and manual review of selected articles investigating the methods and outcomes of endotracheal intubation in difficult airway due to hypoxemic respiratory failure and the role of noninvasive ventilation in this process...
September 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28920047/the-effects-of-endotracheal-tube-and-i-gel%C3%A2-supraglottic-airway-device-on-respiratory-impedance-a-prospective-observational-study
#8
Shoko Nakano, Junko Nakahira, Yosuke Kuzukawa, Toshiyuki Sawai, Toshiaki Minami
BACKGROUND: The forced oscillation technique (FOT) is a non-invasive means of measuring respiratory resistance and reactance. We tested our hypothesis that endotracheal intubation would cause more substantial preoperative increases in FOT parameters than a supraglottic airway device (SGD). METHODS: Forty patients requiring general anesthesia and mechanical ventilation for transurethral bladder tumor resection underwent spirometry the day before surgery. Forced oscillation was measured using a MostGraph-01 device the day before surgery and immediately after removal of the airway adjunct...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28915393/the-comparative-effectiveness-of-noninvasive-and-invasive-ventilation-in-patients-with-pneumonia
#9
Mihaela S Stefan, Aruna Priya, Penelope S Pekow, Tara Lagu, Jay S Steingrub, Nicholas S Hill, Brian H Nathanson, Peter K Lindenauer
PURPOSE: To compare the outcomes of patients hospitalized with pneumonia treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV). MATERIALS AND METHODS: Using the HealthFacts multihospital electronic medical record database, we included patients hospitalized with a diagnosis of pneumonia and treated with NIV or IMV. We developed a propensity model for receipt of initial NIV and assessed the outcomes in a propensity-matched cohort, and in a covariate adjusted and propensity score weighted models...
May 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28912876/effect-of-intercostal-nerve-block-combined-with-general-anesthesia-on-the-stress-response-in-patients-undergoing-minimally-invasive-mitral-valve-surgery
#10
Yanping Zhan, Guo Chen, Jian Huang, Benchao Hou, Weicheng Liu, Shibiao Chen
The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28906362/are-we-ever-too-old-characteristics-and-outcome-of-octogenarians-admitted-to-a-medical-intensive-care-unit
#11
Johanna Maria Muessig, Maryna Masyuk, Amir Movahed Nia, Marcus Franz, Bjoern Kabisch, Malte Kelm, Christian Jung
The aging population increases the demand of intensive care unit (ICU) treatments. However, the availability of ICU beds is limited. Thus, ICU admission of octogenarians is considered controversial. The population above 80 years is a very heterogeneous group though, and age alone might not be the best predictor. Aim of this study was to analyze resource consumption and outcome of octogenarians admitted to a medical ICU to identify reliable survival predictors in a senescent society.This retrospective observational study analyzes 930 octogenarians and 5732 younger patients admitted to a medical ICU...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28905374/heat-and-moisture-exchangers-versus-heated-humidifiers-for-mechanically-ventilated-adults-and-children
#12
REVIEW
Donna Gillies, David A Todd, Jann P Foster, Bisanth T Batuwitage
BACKGROUND: Invasive ventilation is used to assist or replace breathing when a person is unable to breathe adequately on their own. Because the upper airway is bypassed during mechanical ventilation, the respiratory system is no longer able to warm and moisten inhaled gases, potentially causing additional breathing problems in people who already require assisted breathing. To prevent these problems, gases are artificially warmed and humidified. There are two main forms of humidification, heat and moisture exchangers (HME) or heated humidifiers (HH)...
September 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28904810/nasal-high-flow-treatment-in-preterm-infants
#13
REVIEW
Calum T Roberts, Kate A Hodgson
Nasal High Flow (HF) is a mode of 'non-invasive' respiratory support for preterm infants, with several potential modes of action, including generation of distending airway pressure, washout of the nasopharyngeal dead space, reduction of work of breathing, and heating and humidification of inspired gas. HF has several potential advantages over continuous positive airway pressure (CPAP), the most commonly applied form of non-invasive support, such as reduced nasal trauma, ease of use, and infant comfort, which has led to its rapid adoption into neonatal care...
2017: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/28900720/respiration-related-cerebral-blood-flow-variability-increases-during-control-mode-non-invasive-ventilation-in-normovolemia-and-hypovolemia
#14
Maria Skytioti, Signe Søvik, Maja Elstad
PURPOSE: Increased variability in cerebral blood flow (CBF) predisposes to adverse cerebrovascular events. Oscillations in arterial blood pressure and PaCO2 induce CBF variability. Less is known about how heart rate (HR) variability affects CBF. We experimentally reduced respiration-induced HR variability in healthy subjects, hypothesizing that CBF variability would increase. METHODS: Internal carotid artery (ICA) blood velocity was recorded by Doppler ultrasound in ten healthy subjects during baseline, control-mode, non-invasive mechanical ventilation (NIV), i...
September 12, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28898345/-endoscopic-lung-volume-reduction-in-advanced-pulmonary-emphysema-initial-experience-in-chile
#15
Sebastián Fernández-Bussy, Gonzalo Labarca, Iván Caviedes, Hiren J Mehta, Michael Jantz, Adnan Majid
Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28890204/early-caffeine-prophylaxis-and-risk-of-failure-of-initial-continuous-positive-airway-pressure-in-very-low-birth-weight-infants
#16
Ravi M Patel, Kanecia Zimmerman, David P Carlton, Reese Clark, Daniel K Benjamin, P Brian Smith
OBJECTIVE: To test the hypothesis that early caffeine treatment on the day of birth, compared with later treatment in very low birth weight (VLBW, <1500 g) infants receiving continuous positive airway pressure (CPAP) therapy, is associated with a decreased risk of CPAP failure in the first week of life. STUDY DESIGN: Multicenter, observational cohort study in 366 US neonatal intensive care units. We evaluated inborn, VLBW infants discharged from 2000 to 2014, who received only CPAP therapy without surfactant treatment on day of life (DOL) 0, had a 5-minute Apgar ≥3, and received caffeine in first week of life...
September 7, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28882385/lung-deposition-and-systemic-bioavailability-of-different-aerosol-devices-with-and-without-humidification-in-mechanically-ventilated-patients
#17
Islam O F Moustafa, Mohammed R A-A Ali, Moataz Al Hallag, Hoda Rabea, James B Fink, Patricia Dailey, Mohamed E A Abdelrahim
BACKGROUND: During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. METHODS: In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups...
September 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28874952/duration-of-mechanical-ventilation-in-the-emergency-department
#18
Lauren B Angotti, Jeremy B Richards, Daniel F Fisher, Jeffrey D Sankoff, Todd A Seigel, Haitham S Al Ashry, Susan R Wilcox
INTRODUCTION: Due to hospital crowding, mechanically ventilated patients are increasingly spending hours boarding in emergency departments (ED) before intensive care unit (ICU) admission. This study aims to evaluate the association between time ventilated in the ED and in-hospital mortality, duration of mechanical ventilation, ICU and hospital length of stay (LOS). METHODS: This was a multi-center, prospective, observational study of patients ventilated in the ED, conducted at three academic Level I Trauma Centers from July 2011 to March 2013...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28874611/how-should-aerosols-be-delivered-during-invasive-mechanical-ventilation
#19
Rajiv Dhand
The delivery of aerosols to mechanically ventilated patients presents unique challenges and differs from inhaled drug delivery in spontaneously breathing patients in several respects. Successful aerosol delivery during invasive mechanical ventilation requires careful consideration of a host of factors that influence the amount of drug inhaled by the patient. Pressurized metered-dose inhalers and nebulizers (jet, ultrasonic, and vibrating mesh) are the most commonly used aerosol delivery devices in these patients, although other delivery devices, such as dry powder inhalers, soft mist inhalers, and intratracheal nebulizing catheters, could also be adapted for in-line use...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28872714/microbial-epidemiology-of-candidemia-in-neonatal-and-pediatric-intensive-care-units-at-children-s-medical-center-tehran
#20
Arezu Charsizadeh, Hossein Mirhendi, Bahram Nikmanesh, Hamid Eshaghi, Koichi Makimura
Invasive candidiasis is a major cause of morbidity and mortality in children. However, limited data is available on the epidemiology of this infection in pediatric settings in Iran. The aim of the present study was to determine the prevalence, microbial epidemiology, risk factors, and clinical outcomes associated with candidemia in intensive care units at Children's Medical Center, Tehran, Iran. All blood and other normally sterile specimen cultures positive for Candida species, were included. Isolates were identified by morphological and molecular methods...
September 5, 2017: Mycoses
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