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Recruitment maneuver

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https://www.readbyqxmd.com/read/27924200/effect-of-recruitment-maneuver-on-arterial-oxygenation-in-patients-undergoing-robot-assisted-laparoscopic-prostatectomy-with-intraoperative-15-cmh2o-positive-end-expiratory-pressure
#1
Sowoon Ahn, Sung Hye Byun, Haeyoon Chang, Young Bin Koo, Jong Chan Kim
BACKGROUND: This randomized, controlled study was designed to compare the effects of recruitment maneuvers (RMs) with a 15 cmH2O positive end-expiratory pressure (PEEP) on the systemic oxygenation and lung compliance of patients with healthy lungs following robot-assisted laparoscopic prostatectomy (RALP). METHODS: Sixty patients undergoing a RALP with an intraoperative 15 cmH2O PEEP were randomly allocated to an RM or a Control group. The patients in the RM group received a single RM through the application of a continuous positive airway pressure of 40 cmH2O for 40 s 15 min after being placed in the Trendelenburg position...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27922547/changes-in-stroke-volume-induced-by-lung-recruitment-maneuver-predict-fluid-responsiveness-in-mechanically-ventilated-patients-in-the-operating-room
#2
Matthieu Biais, Romain Lanchon, Musa Sesay, Lisa Le Gall, Bruno Pereira, Emmanuel Futier, Karine Nouette-Gaulain
BACKGROUND: Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. METHODS: Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0...
December 5, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#3
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#4
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27889667/the-impact-of-a-pulmonary-recruitment-maneuver-to-reduce-post-laparoscopic-shoulder-pain-a-randomized-controlled-trial
#5
Kyoungho Ryu, Wonjun Choi, Jaegeum Shim, Taejong Song
OBJECTIVE: A pulmonary recruitment maneuver (PRM) can effectively reduce post-laparoscopic shoulder pain (PLSP). However, a high-pressure PRM may cause pulmonary barotrauma. This study aimed to evaluate the efficacy and safety of a PRM using two different maximum inspiratory pressures (40 and 60cmH2O) for reducing PLSP. STUDY DESIGN: Patients undergoing gynecologic laparoscopy were randomly allocated to a control group (n=30), a 40 cmH2O PRM group (n=30), and a 60 cmH2O PRM group (n=30)...
November 16, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27819002/diagnosis-accuracy-of-mean-arterial-pressure-variation-during-a-lung-recruitment-maneuver-to-predict-fluid-responsiveness-in-thoracic-surgery-with-one-lung-ventilation
#6
Woon-Seok Kang, Chung-Sik Oh, Chulmin Park, Bo Mi Shin, Tae-Gyoon Yoon, Ka-Young Rhee, Nam-Sik Woo, Seong-Hyop Kim
: Background. Lung recruitment maneuver (LRM) during thoracic surgery can reduce systemic venous return and resulting drop in systemic blood pressure depends on the patient's fluid status. We hypothesized that changes in systemic blood pressure during the transition in LRM from one-lung ventilation (OLV) to two-lung ventilation (TLV) may provide an index to predict fluid responsiveness. Methods. Hemodynamic parameters were measured before LRM (T0); after LRM at the time of the lowest mean arterial blood pressure (MAP) (T1) and at 3 minutes (T2); before fluid administration (T3); and 5 minutes after ending it (T4)...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27812631/bronchodilator-response-cut-off-points-and-fev-0-75-reference-values-for-spirometry-in-preschoolers
#7
Edjane Figueiredo Burity, Carlos Alberto de Castro Pereira, Marcus Herbert Jones, Larissa Bouwman Sayão, Armèle Dornelas de Andrade, Murilo Carlos Amorim de Britto
Objective: To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. Methods: This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27805443/use-of-manual-alveolar-recruitment-maneuvers-to-eliminate-atelectasis-artifacts-identified-during-thoracic-computed-tomography-of-healthy-neonatal-foals
#8
Kara M Lascola, Stuart C Clark-Price, Stephen K Joslyn, Mark A Mitchell, Robert T O'Brien, Susan K Hartman, Kevin H Kline
OBJECTIVE To evaluate use of single manual alveolar recruitment maneuvers (ARMs) to eliminate atelectasis during CT of anesthetized foals. ANIMALS 6 neonatal Standardbred foals. PROCEDURES Thoracic CT was performed on spontaneously breathing anesthetized foals positioned in sternal (n = 3) or dorsal (3) recumbency when foals were 24 to 36 hours old (time 1), 4 days old (time 2), 7 days old (time 3), and 10 days old (time 4). The CT images were collected without ARMs (all times) and during ARMs with an internal airway pressure of 10, 20, and 30 cm H2O (times 2 and 3)...
November 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27790273/clinical-practice-guideline-of-acute-respiratory-distress-syndrome
#9
REVIEW
Young-Jae Cho, Jae Young Moon, Ein-Soon Shin, Je Hyeong Kim, Hoon Jung, So Young Park, Ho Cheol Kim, Yun Su Sim, Chin Kook Rhee, Jaemin Lim, Seok Jeong Lee, Won-Yeon Lee, Hyun Jeong Lee, Sang Hyun Kwak, Eun Kyeong Kang, Kyung Soo Chung, Won-Il Choi
There is no well-stated practical guideline for mechanically ventilated patients with or without acute respiratory distress syndrome (ARDS). We generate strong (1) and weak (2) grade of recommendations based on high (A), moderate (B) and low (C) grade in the quality of evidence. In patients with ARDS, we recommend low tidal volume ventilation (1A) and prone position if it is not contraindicated (1B) to reduce their mortality. However, we did not support high-frequency oscillatory ventilation (1B) and inhaled nitric oxide (1A) as a standard treatment...
October 2016: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27782908/optimization-of-mechanical-ventilation-in-a-31-year-old-morbidly-obese-man-with-refractory-hypoxemia
#10
Changsheng Zhang, Massimiliano Pirrone, David A E Imber, Jeanne B Ackman, Jacopo Fumagalli, Robert M Kacmarek, Lorenzo Berra
Morbidly obese, critically ill patients are prone to develop hypoxemic respiratory failure and ventilator dependency. The best method for recruiting the lungs of these patients and keeping alveoli open without causing injury remains unclear. We present the case of a 31-year-old patient with severe refractory hypoxemia reversed by lung recruitment maneuvers and subsequent application of positive end-expiratory pressure (PEEP) at a level determined by a decremental PEEP trial. The patient was extubated at a high PEEP level of 22 cm H2O followed by noninvasive ventilatory support after extubation...
October 24, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27746566/comparison-of-modified-chin-lift-technique-with-ec-technique-for-mask-ventilation-in-adult-apneic-patients
#11
Geetha C Rajappa, Leena Harshad Parate, C A Tejesh, P T Prathima
BACKGROUND: Mask ventilation (MV) is an essential basic life support skill. We used chin lift maneuver for MV and named as modified chin lift technique (MCL). EC technique is most common technique used for MV. AIMS: The aim of this study is to compare the efficacy of both techniques for MV in term of expired tidal volume (TV). Secondarily, we also assessed the effect of experience on the performance of these both techniques. SETTINGS AND DESIGN: The study area was operation theater of our hospital...
September 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27741306/diabetic-cardiovascular-autonomic-neuropathy-predicts-recurrent-cardiovascular-diseases-in-patients-with-type-2-diabetes
#12
Seon-Ah Cha, Jae-Seung Yun, Tae-Seok Lim, Kyoungil Min, Ki-Ho Song, Ki-Dong Yoo, Yong-Moon Park, Yu-Bae Ahn, Seung-Hyun Ko
Cardiovascular autonomic neuropathy (CAN) is a risk factor for cardiovascular disease (CVD) and mortality in patients with type 2 diabetes. This study evaluated the relationship between CAN and recurrent CVD in type 2 diabetes. A total of 206 patients with type 2 diabetes who had a history of CVD within 3 years of enrollment were consecutively recruited from January 2001 to December 2009 and followed-up until December 2015. Cardiovascular autonomic function tests were performed using the following heart rate variability parameters: expiration-to-inspiration ratio, response to Valsalva maneuver and standing...
2016: PloS One
https://www.readbyqxmd.com/read/27734180/assessment-of-autonomic-symptoms-in-a-medically-complex-urban-patient-population
#13
Jessica Robinson-Papp, Sandeep K Sharma, Mary Catherine George, David M Simpson
PURPOSE: Urban, minority communities are disproportionately affected by the chronic diseases associated with autonomic neuropathy; however validated measures of autonomic symptoms have not been studied in these complex populations. We sought to validate the Autonomic Symptom Profile (ASP) in a low income, medically complex, urban patient population. METHODS: Ninety-seven adults were recruited from the outpatient neurology clinic of an academic medical center serving the East Harlem neighborhood of New York City...
October 12, 2016: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/27716165/a-randomized-prospective-controlled-trial-comparing-the-laryngeal-tube-suction-disposable-and-the-supreme-laryngeal-mask-airway-the-influence-of-head-and-neck-position-on-oropharyngeal-seal-pressure
#14
Mostafa Somri, Sonia Vaida, Gustavo Garcia Fornari, Gabriela Renee Mendoza, Pedro Charco-Mora, Naser Hawash, Ibrahim Matter, Forat Swaid, Luis Gaitini
BACKGROUND: The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions. METHODS: Eighty patients in each group had either LTS-D or SLMA for airway management...
October 6, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27679045/pulmonary-recruitment-maneuver-for-reducing-postoperative-shoulder-pain-incidence-after-laparoscopic-gynecologic-surgery-a-prospective-randomized-controlled-trial
#15
P Sutchritpongsa, M Tossamartworakul
No abstract text is available yet for this article.
November 2015: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/27642724/is-a-curved-3d-ultrasound-reconstruction-needed-to-assess-the-warped-pelvic-floor-plane
#16
Aly Youssef, Marta Cavalera, Giuseppina Pacella, Ginevra Salsi, Giovanni Morganelli, Elisa Montaguti, Ilaria Cataneo, Gianluigi Pilu, Nicola Rizzo
OBJECTIVES: Caudal distension of female pelvic floor is common and results in perineal descent and a caudally curved hiatus (so called 'warping'). All the available ultrasound techniques to date however aim to reconstruct the pelvic floor using linear techniques (flat plane reconstruction). We aimed to evaluate the feasibility, reproducibility and potential usefulness of a new 3D technique, capable of reconstructing a curved plane of the levator hiatus. METHODS: We recruited a group of primiparous women to perform a 3D/4D transperineal ultrasound 3-6 months after delivery...
September 19, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27635737/mechanical-ventilation-in-neurocritical-care-patients-a-systematic-literature-review
#17
Beatrice Borsellino, Marcus J Schultz, Marcelo Gama de Abreu, Chiara Robba, Federico Bilotta
INTRODUCTION: Neurocritical care (NCC) patients often require prolonged mechanical ventilation, and they are at high risk of respiratory complications. Therefore, the potential benefit role of protective lung ventilation (PLV), which demonstrated to reduce postoperative complications in patients with acute distress respiratory syndrome, has been suggested even on NCC patients. However, PLV can increase intracranial pressure as result of permissive hypercapnia and of high airway pressures during recruitment maneuvers...
October 2016: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/27624632/respiratory-management-of-perioperative-obese-patients
#18
REVIEW
David Ae Imber, Massimiliano Pirrone, Changsheng Zhang, Daniel F Fisher, Robert M Kacmarek, Lorenzo Berra
With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27607844/are-there-ethnic-differences-in-the-levator-hiatus-and-pelvic-organ-descent-a-prospective-observational-study
#19
Zeelha Abdool, Hans P Dietz, Gerhard B Lindeque
OBJECTIVE: To date most studies on the functional anatomy of the pelvic floor have focussed on Caucasian women. There is scant information on this topic involving other ethnic groups. This study investigates levator hiatal area and pelvic organ descent in three racially diverse ethnic groups of healthy nulliparous East Asian, Caucasian and Black South African females, using three dimensional (3D) transperineal ultrasound (TPUS). METHODS: A total of two hundred and seven nulliparous women from three different ethnic groups aged 18 to 40 years were recruited for this prospective observational study between June 2012 and April 2015...
September 8, 2016: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/27606483/use-of-alleviating-maneuvers-for-periocular-facial-dystonias
#20
Caroline L S Kilduff, Edward J Casswell, Tahrina Salam, Dov Hersh, Santiago Ortiz-Perez, Daniel Ezra
Importance: Patients with benign essential blepharospasm or hemifacial spasm are known to use botulinum toxin injections and alleviating maneuvers to help control their symptoms. The clinical correlates between the use of botulinum toxin injections and the use of alleviating maneuvers are not well established. Objective: To determine whether the use of alleviating maneuvers for benign essential blepharospasm or hemifacial spasm correlates with disease severity or botulinum toxin treatment...
September 8, 2016: JAMA Ophthalmology
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