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non invasive mechanical ventilation

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https://www.readbyqxmd.com/read/28103448/bedside-contribution-of-electrical-impedance-tomography-to-set-positive-end-expiratory-pressure-for-ecmo-treated-severe-ards-patients
#1
Guillaume Franchineau, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Charles-Edouard Luyt, Alain Combes, Matthieu Schmidt
RATIONALE: Optimal positive end-expiratory pressure (PEEP) is unknown in severe acute respiratory distress syndrome (ARDS) patients on extracorporeal membrane oxygenation (ECMO) receiving mechanical ventilation with very low tidal volume. OBJECTIVES: To evaluate electrical impedance tomography's (EIT) ability to monitor a PEEP trial and to derive from EIT the best compromise PEEP in this setting. METHODS: A decremental PEEP trial (20-0 cmH2O) in 5 cmH2O steps was monitored by EIT, with lung images divided into four ventral-to-dorsal horizontal regions of interest...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28093269/invasive-disease-versus-urinary-antigen-confirmed-pneumococcal-community-acquired-pneumonia
#2
Adrian Ceccato, Antoni Torres, Catia Cilloniz, Rosanel Amaro, Albert Gabarrus, Eva Polverino, Elena Prina, Carolina Garcia-Vidal, Eva Muñoz-Conejero, Cristina Mendez, Isabel Cifuentes, Jorge Puig de la Bella Casa, Rosario Menendez, Michael S Niederman
OBJECTIVES: The burden of pneumococcal disease is measured only through patients with invasive pneumococcal disease. The urinary antigen test (UAT) for pneumococcus has exhibited a high sensitivity and specificity. We aimed to compare the pneumococcal pneumonias diagnosed as invasive disease with pneumococcal pneumonias defined by UAT. METHODS: Prospective observational study on consecutive non-immunosuppressed patients with community-acquired pneumonia from January 2000 to December 2014...
January 13, 2017: Chest
https://www.readbyqxmd.com/read/28092235/hospital-cost-and-length-of-stay-in-idiopathic-pulmonary-fibrosis
#3
Joshua J Mooney, Karina Raimundo, Eunice Chang, Michael S Broder
OBJECTIVE: To provide a detailed picture of the economic impact of hospitalization in idiopathic pulmonary fibrosis (IPF) and to identify factors associated with cost and length of stay (LOS). METHODS: In this retrospective cross-sectional study using the Nationwide Inpatient Sample (NIS), we included hospitalizations for IPF (ICD-9-CM 516.3) with a principal diagnosis of respiratory disease (ICD-9-CM 460-519) from 2009-2011; lung transplant admissions were excluded...
January 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#4
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28072907/symptomatic-treatments-for-amyotrophic-lateral-sclerosis-motor-neuron-disease
#5
REVIEW
Louisa Ng, Fary Khan, Carolyn A Young, Mary Galea
BACKGROUND: Motor neuron disease (MND), which is also known as amyotrophic lateral sclerosis (ALS), causes a wide range of symptoms but the evidence base for the effectiveness of the symptomatic treatment therapies is limited. OBJECTIVES: To summarise the evidence from Cochrane Systematic Reviews of all symptomatic treatments for MND. METHODS: We searched the Cochrane Database of Systematic Reviews (CDSR) on 15 November 2016 for systematic reviews of symptomatic treatments for MND...
January 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28068288/monitoring-of-breath-vocs-and-electrical-impedance-tomography-under-pulmonary-recruitment-in-mechanically-ventilated-patients
#6
Beate Brock, Svend Kamysek, Josephine Silz, Phillip Trefz, Jochen K Schubert, Wolfram Miekisch
Analysis of exhaled VOCs can provide information on physiology, metabolic processes, oxidative stress and lung diseases. In critically ill patients, VOC analysis may be used to gain complimentary information beyond global clinical parameters. This seems especially attractive in mechanically ventilated patients frequently suffering from impairment of gas exchange. This study was intended to assess (a) the effects of recruitment maneuvers onto VOC profiles, (b) the correlations between electrical impedance tomography (EIT) data and VOC profiles and (c) the effects of recruitment onto distribution of ventilation...
January 9, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28067830/bronchopulmonary-dysplasia-chronic-lung-disease-of-infancy-and-long-term-pulmonary-outcomes
#7
REVIEW
Lauren M Davidson, Sara K Berkelhamer
Bronchopulmonary dysplasia (BPD) is a chronic lung disease most commonly seen in premature infants who required mechanical ventilation and oxygen therapy for acute respiratory distress. While advances in neonatal care have resulted in improved survival rates of premature infants, limited progress has been made in reducing rates of BPD. Lack of progress may in part be attributed to the limited therapeutic options available for prevention and treatment of BPD. Several lung-protective strategies have been shown to reduce risks, including use of non-invasive support, as well as early extubation and volume ventilation when intubation is required...
January 6, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28060859/physiological-biochemical-and-biophysical-characterization-of-the-lung-lavaged-spontaneously-breathing-rabbit-as-a-model-for-respiratory-distress-syndrome
#8
Francesca Ricci, Chiara Catozzi, Xabier Murgia, Brenda Rosa, Davide Amidani, Luca Lorenzini, Federico Bianco, Claudio Rivetti, Silvia Catinella, Gino Villetti, Maurizio Civelli, Barbara Pioselli, Carlo Dani, Fabrizio Salomone
Nasal continuous positive airway pressure (nCPAP) is a widely accepted technique of non-invasive respiratory support in spontaneously-breathing premature infants with respiratory distress syndrome (RDS). Surfactant administration techniques compatible with nCPAP ventilation strategy are actively investigated. Our aim is to set up and validate a respiratory distress animal model that can be managed on nCPAP suitable for surfactant administration techniques studies. Surfactant depletion was induced by bronchoalveolar lavages (BALs) on 18 adult rabbits...
2017: PloS One
https://www.readbyqxmd.com/read/28060793/preterm-birth-and-ventilation-decrease-surface-density-of-glomerular-capillaries-in-lambs-regardless-of-postnatal-respiratory-support-mode
#9
Eveline Staub, Mar Janna Dahl, Calan Yost, Sydney Bowen, Toshio Aoki, Adam Blair, Zhengming Wang, Donald M Null, Bradley A Yoder, Kurt H Albertine
BACKGROUND: Prematurity is often complicated by respiratory support, including invasive mechanical ventilation (IMV) and non-invasive support (NIS). Compared to IMV, NIS reduces injury to the lung and brain. Prematurity may also disrupt glomerular architecture. Whether NIS differentially affects glomerular architecture is incompletely understood. We hypothesized that IMV would lead to greater disruption of glomerular architecture than NIS. METHODS: This is a secondary analysis of kidneys from moderately preterm lambs delivered at ~131d gestation (term ~150d) that had antenatal steroid exposure and surfactant treatment before resuscitation by IMV...
January 6, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28057053/a-pig-model-of-acute-right-ventricular-afterload-increase-by-hypoxic-pulmonary-vasoconstriction
#10
Kathrine Knai, Nils Kristian Skjaervold
BACKGROUND: The aim of this study was to construct a non-invasive model for acute right ventricular afterload increase by hypoxic pulmonary vasoconstriction. Intact animal models are vital to improving our understanding of the pathophysiology of acute right ventricular failure. Acute right ventricular failure is caused by increased afterload of the right ventricle by chronic or acute pulmonary hypertension combined with regionally or globally reduced right ventricular contractile capacity...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28043661/use-of-noninvasive-and-invasive-mechanical-ventilation-in-cardiogenic-shock-a-prospective-multicenter-study
#11
Mari Hongisto, Johan Lassus, Tuukka Tarvasmaki, Alessandro Sionis, Heli Tolppanen, Matias Greve Lindholm, Marek Banaszewski, John Parissis, Jindrich Spinar, Jose Silva-Cardoso, Valentina Carubelli, Salvatore Di Somma, Josep Masip, Veli-Pekka Harjola
BACKGROUND: Despite scarce data, invasive mechanical ventilation (MV) is widely recommended over non-invasive ventilation (NIV) for ventilatory support in cardiogenic shock (CS). We assessed the real-life use of different ventilation strategies in CS and their influence on outcome focusing on the use of NIV and MV. METHODS: 219 CS patients were categorized by the maximum intensity of ventilatory support they needed during the first 24h into MV (n=137; 63%) , NIV (n=26; 12%), and supplementary oxygen (n=56; 26%) groups...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040717/predictors-of-the-use-of-specific-critical-care-therapies-in-patients-with-metastatic-cancer
#12
Kah Poh Loh, Ankit Kansagra, Meng-Shiou Shieh, Penelope Pekow, Peter Lindenauer, Mihaela Stefan, Tara Lagu
OBJECTIVE: Understanding which factors are associated with the use of critical care therapies (CCTs) can help with clinical decision-making and goals of care discussion. The goal of this study was to describe the predictors of CCT use (eg, mechanical ventilation, tracheostomy, percutaneous endoscopic gastrostomy tube, total parenteral nutrition, acute use of dialysis) in hospitalized patients with metastatic cancer. METHODS: We used the 2010 California State Inpatient Databases sponsored by the Agency for Healthcare Research and Quality to identify all hospitalizations with a diagnosis of metastatic cancer (patients aged ≥18 years)...
January 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28040456/exhaled-breath-condensate-analysis-from-intubated-newborns-by-nano-hplc-coupled-to-high-resolution-ms
#13
A S Kononikhin, N L Starodubtseva, V V Chagovets, A Y Ryndin, A A Burov, I A Popov, A E Bugrova, R A Dautov, A O Tokareva, Y L Podurovskaya, O V Ionov, V E Frankevich, E N Nikolaev, G T Sukhikh
Invasiveness of examination and therapy methods is a serious problem for intensive care and nursing of premature infants. Exhaled breath condensate (EBC) is the most attractive biofluid for non-invasive methods development in neonatology for monitoring the status of intubated infants. The aim of the study was to propose an approach for EBC sampling and analysis from mechanically ventilated neonates. EBC collection system with good reproducibility of sampling was demonstrated. Discovery-based proteomic and metabolomic studies were performed using nano-HPLC coupled to high resolution MS...
December 23, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#14
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
December 22, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28009154/high-flow-nasal-cannula-oxygen-therapy-work-in-progress-in-respiratory-critical-care
#15
Annia Schreiber, Fabiano DI Marco, Fulvio Braido, Paolo Solidoro
After a planned extubation, the re-occurrence of acute respiratory distress needing the restoration of invasive mechanical support is a severe phenomenon associated with several important consequences, including increased morbidity, Intensive Care Unit mortality, and an enormous financial burden. So far, the most commonly used techniques to ameliorate gas exchange in the postextubation period were low-flow oxygen therapy and non-invasive ventilation (NIV). High flows through nasal cannulae (HFNC) is a system which allows increased CO2 wash-out of anatomical dead space, positive nasopharyngeal pressure, a relatively constant FiO2, and an improvement of mucociliary function...
December 2016: Minerva Medica
https://www.readbyqxmd.com/read/28003112/study-of-duchenne-muscular-dystrophy-long-term-survivors-aged-40-years-and-older-living-in-specialized-institutions-in-japan
#16
Toshio Saito, Mitsuru Kawai, En Kimura, Katsuhisa Ogata, Toshiaki Takahashi, Michio Kobayashi, Hiroto Takada, Satoshi Kuru, Takashi Mikata, Tsuyoshi Matsumura, Naohiro Yonemoto, Harutoshi Fujimura, Saburo Sakoda
The national muscular dystrophy wards database of Japan lists 118 long-term Duchenne muscular dystrophy (DMD) patients who were at least 40 years old as of October 1, 2013. To elucidate the clinical features of DMD patients aged 40 years and older, we obtained gene analysis and muscle biopsy findings, as well as medical condition information. Ninety-four of the registered patients consented to participate, of whom 55 meeting genetic or biochemical criteria confirming DMD were analyzed. The mean age at the time of the study was 43...
November 25, 2016: Neuromuscular Disorders: NMD
https://www.readbyqxmd.com/read/27988055/role-of-first-line-noninvasive-ventilation-in-non-copd-subjects-with-pneumonia
#17
Gemma Rialp, Catalina Forteza, Daniel Muñiz, Maria Romero
INTRODUCTION: The use of noninvasive ventilation (NIV) in non-COPD patients with pneumonia is controversial due to its high rate of failure and the potentially harmful effects when NIV fails. The purpose of the study was to evaluate outcomes of the first ventilatory treatment applied, NIV or invasive mechanical ventilation (MV), and to identify predictors of NIV failure. METHODS: Historical cohort study of 159 non-COPD patients with pneumonia admitted to the ICU with ventilatory support...
December 14, 2016: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/27979670/trends-in-hospitalizations-for-community-acquired-pneumonia-in-spain-2004-to-2013
#18
Javier de Miguel-Díez, Rodrigo Jiménez-García, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, José M de Miguel-Yanes, Manuel Méndez-Bailón, Ana López-de-Andrés
AIM: To describe trends in the incidence and outcomes of community-acquired pneumonia (CAP) hospitalizations in Spain (2004-2013). METHODS: We used national hospital discharge data to select all hospital admissions for CAP as primary diagnosis. We analyzed incidence, Charlson comorbidity index (CCI), diagnostic and therapeutic procedures, pathogens, length of hospital stay (LOHS), in-hospital mortality (IHM) and readmission. RESULTS: We identified 959,465 admissions for CAP...
December 12, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27973930/comorbidities-and-subgroups-of-patients-surviving-severe-acute-hypercapnic-respiratory-failure-in-the-icu
#19
Dan Adler, Jean-Louis Pépin, Elise Dupuis-Lozeron, Katerina Espa-Cervena, Roselyne Merlet-Violet, Hajo Muller, Jean-Paul Janssens, Laurent Brochard
RATIONALE: No methodical assessment of the lung, cardiac and sleep function of patients surviving an acute hypercapnic respiratory failure episode requiring admission to the intensive care unit (ICU) has been reported in the literature. OBJECTIVES: To prospectively investigate the prevalence and impact of comorbidities in patients treated by mechanical ventilator support (invasive or non-invasive) for acute hypercapnic respiratory failure in the ICU. METHODS: Seventy-eight consecutive patients admitted for an episode of acute hypercapnic respiratory failure underwent an assessment of lung, cardiac and sleep function by pulmonary function tests, transthoracic echocardiography and polysomnography 3 months after ICU discharge...
December 14, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27932672/a-led-based-phosphorimeter-for-measurement-of-microcirculatory-oxygen-pressure
#20
Philippe Guerci, Yasin Ince, Paul Heeman, Dirk J Faber, Bulent Ergin, Can Ince
Quantitative measurements of microcirculatory and tissue oxygenation are of prime importance in experimental research. Non-invasive time-resolved quenching of phosphorescence has given further insight into the fundamental mechanisms of oxygen transport to healthy tissues and in models of disease. Phosphorimeters are devices dedicated to the study of phosphorescence quenching. The experimental applications of phosphorimeters range from measuring a specific oxygen partial pressure (PO2) in cellular organelles such as mitochondria, finding values of PO2 distributed over an organ or capillaries, to measuring microcirculatory PO2 changes simultaneously in several organ systems...
December 8, 2016: Journal of Applied Physiology
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