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Recruitment maneuver

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https://www.readbyqxmd.com/read/28342045/effects-of-an-alveolar-recruitment-maneuver-on-subdural-pressure-brain-swelling-and-mean-arterial-pressure-in-patients-undergoing-supratentorial-tumour-resection-a-randomized-crossover-study
#1
Alana M Flexman, Peter A Gooderham, Donald E Griesdale, Ruth Argue, Brian Toyota
PURPOSE: Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection. METHODS: In this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a "sham" maneuver (5 cm of water for 30 sec), followed by the alternative intervention after a 90-sec equilibration period...
March 24, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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
#2
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/28323717/treatment-of-lumbar-split-fracture-dislocation-with-short-segment-or-long-segment-posterior-fixation-and-anterior-fusion
#3
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the Association for the Study of Internal Fixation spine fracture classification. The axial compressive and torsional force shattered the vertebral body into 2 halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short-segment or long-segment posterior fixation and anterior fusion...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28280037/local-activation-of-p53-in-the-tumor-microenvironment-overcomes-immune-suppression-and-enhances-antitumor-immunity
#4
Gang Guo, Miao Yu, Wei Xiao, Esteban Celis, Yan Cui
Mutations in tumor suppressor p53 remain a vital mechanism of tumor escape from apoptosis and senescence. Emerging evidence suggests that p53 dysfunction also fuels inflammation and supports tumor immune evasion, thereby serving as an immunological driver of tumorigenesis. Therefore, targeting p53 in the tumor microenvironment (TME) also represents an immunologically desirable strategy for reversing immunosuppression and enhancing antitumor immunity. Using a pharmacological p53 activator nutlin-3a, we show that local p53 activation in TME comprising overt tumor infiltrating leukocytes (TILeus) induces systemic antitumor immunity and tumor regression, but not in TME with scarce TILeus, such as B16 melanoma...
March 9, 2017: Cancer Research
https://www.readbyqxmd.com/read/28229321/cerebral-endothelial-dysfunction-in-reversible-cerebral-vasoconstriction-syndrome-a-case-control-study
#5
Hyun Ah Choi, Mi Ji Lee, Chin-Sang Chung
BACKGROUND: The aim of this study is to investigate cerebral endothelial dysfunction in patients with reversible cerebral vasoconstriction syndrome (RCVS). METHODS: We prospectively recruited patients with RCVS, age-matched controls with episodic migraine, and age-matched healthy controls at Samsung Medical Center from Apr 2015 to Jul 2016. All participants underwent transcranial Doppler evaluation, with a breath-holding maneuver, for the evaluation of bilateral middle cerebral arteries (MCAs), posterior cerebral arteries (PCAs), and the basilar artery (BA)...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28224679/the-repeatability-of-tests-of-eustachian-tube-function-in-healthy-ears
#6
Matthew E Smith, Charlie C Zou, Charlotte Baker, Andrew J C Blythe, Peter J A Hutchinson, James R Tysome
OBJECTIVES/HYPOTHESIS: Many objective tests of eustachian tube (ET) function have been devised for clinical and research use but they have not been directly compared or characterized. As a first step to identifying tests to incorporate into an outcome set for ET dysfunction, we assessed repeatability of a panel of eight of these tests in healthy ears. STUDY DESIGN: Comparison of eight tests of ET function. METHODS: The following tests were investigated in combination with Valsalva, Toynbee, swallow, or sniff maneuvers: 1) patient-reported ET opening, 2) observed tympanic membrane movement, 3) continuous impedance, 4) canal manometry, 5) sonotubometry, 6) nine-step test, 7) tubomanometry, and 8) tympanometry at rest...
February 22, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28195029/the-problem-of-epistemic-jurisdiction-in-global-governance-the-case-of-sustainability-standards-for-biofuels
#7
David E Winickoff, Matthieu Mondou
While there is ample scholarly work on regulatory science within the state, or single-sited global institutions, there is less on its operation within complex modes of global governance that are decentered, overlapping, multi-sectorial and multi-leveled. Using a co-productionist framework, this study identifies 'epistemic jurisdiction' - the power to produce or warrant technical knowledge for a given political community, topical arena or geographical territory - as a central problem for regulatory science in complex governance...
February 2017: Social Studies of Science
https://www.readbyqxmd.com/read/28178996/hemodynamic-effects-of-lung-recruitment-maneuvers-in-acute-respiratory-distress-syndrome
#8
Anup Das, Mainul Haque, Marc Chikhani, Oana Cole, Wenfei Wang, Jonathan G Hardman, Declan G Bates
BACKGROUND: Clinical trials have, so far, failed to establish clear beneficial outcomes of recruitment maneuvers (RMs) on patient mortality in acute respiratory distress syndrome (ARDS), and the effects of RMs on the cardiovascular system remain poorly understood. METHODS: A computational model with highly integrated pulmonary and cardiovascular systems was configured to replicate static and dynamic cardio-pulmonary data from clinical trials. Recruitment maneuvers (RMs) were executed in 23 individual in-silico patients with varying levels of ARDS severity and initial cardiac output...
February 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28168225/comparison-of-internal-jugular-vein-dilation-between-valsalva-maneuver-and-proximal-internal-jugular-vein-compression
#9
Hyeonjoo Seong, Bora Kang, Giwoon Kim
OBJECTIVE: The Valsalva maneuver is recognized as an effective method to dilate the internal jugular vein (IJV). However, this maneuver cannot be performed in many cases, such as children and unconscious patients. The aim of this study was to evaluate the effectiveness of proximal IJV compression, which can easily be performed, regardless of patient cooperation. METHODS: Healthy adult volunteers were recruited from tertiary hospital employees. Basic anatomic and physiologic data were collected...
December 2016: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28125527/an-open-lung-strategy-in-the-management-of-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#10
Jun Lu, Xing Wang, Mingqi Chen, Lu Cheng, Qiuhua Chen, Hua Jiang, Zhiguang Sun
PURPOSE: An Open lung strategy (OLS) that includes positive end expiratory pressure (PEEP) and recruitment maneuvers (RMs) during mechanical ventilation is probably an important treatment method in patients with acute respiratory distress syndrome (ARDS). However, the effect of OLS is unknown. We therefore hypothesized that patients with ARDS may benefit from OLS treatment. METHODS: We identified relevant randomized controlled trials by searching through Pubmed, Embase, Web of Science and the Cochrane Central Register of Controlled Trials updated to May 22, 2016...
January 25, 2017: Shock
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#11
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#12
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28068288/monitoring-of-breath-vocs-and-electrical-impedance-tomography-under-pulmonary-recruitment-in-mechanically-ventilated-patients
#13
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/28029800/patellofemoral-kinematics-and-tibial-tuberosity-trochlear-groove-distances-in-female-adolescents-with-patellofemoral-pain
#14
Victor R Carlson, Barry P Boden, Frances T Sheehan
BACKGROUND: Patellofemoral pain (PFP) is a prevalent disorder among female adolescents. Overuse is frequently cited as the cause of pain for this population. What is currently unclear, however, is if the patella demonstrates abnormal tracking patterns relative to the femoral trochlear groove in female adolescents with PFP. PURPOSE: The aim of this case-control study was to determine if abnormal patellar tracking patterns are present in female adolescents with PFP...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/27996371/the-simple-and-multidimensional-method-of-pain-reduction-after-laparoscopic-cholecystectomy-a-randomized-prospective-controlled-trial
#15
Eun Young Kim, Young Kyoung You, Dong Goo Kim, Tae Ho Hong
BACKGROUND: Herein, we evaluate the effect of pain relief after laparoscopic cholecystectomy (LC) of various intraoperative maneuvers through a prospective randomized study and identify the synergistic effects of combined maneuvers compared with a single maneuver that was shown to be useful in a previous report. METHODS: Fifty-one patients who were scheduled for elective LC were randomly allocated to group A (26 patients, on whom were performed the combined maneuver) or group B (25 patients, no maneuvers)...
March 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27987483/the-diagnostic-utility-of-sonographic-carotid-flow-time-in-determining-volume-responsiveness
#16
Hamid Shokoohi, Grant W Berry, Murteza Shahkolahi, Jackson King, Jordan King, Mohammad Salimian, Ameneh Poshtmashad, Ali Pourmand
OBJECTIVE: We aimed to predict volume responsiveness and to assess the diagnostic accuracy of carotid flow time (FTc) with the change in hydration status before and after a passive leg raise (PLR) maneuver. METHODS: Participants who presented at a community health fair in a dehydrated state following a prolonged fast while observing the month of Ramadan were recruited. Sonographic FTc measurements were obtained in the semi-Fowler position and after a PLR maneuver while participants were in a fasting state and repeated approximately 3 hours after breaking their fast...
April 2017: Journal of Critical Care
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
#17
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
#18
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...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#19
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
#20
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...
February 2017: Current Opinion in Critical Care
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