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Lung-protective ventilation

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https://www.readbyqxmd.com/read/29050431/a-study-on-the-sternum-growth-and-mineralization-kinetic-of-meat-duck-from-35-to-63-days-of-age
#1
H Y Zhang, H Liao, Q F Zeng, J P Wang, X M Ding, S P Bai, K Y Zhang
The sternum as an important part of the skeleton and not only provides a crucial attachment site for the pectoral muscles and protects internal organs such as the heart and lungs for meat duck, but may also be considered as the primary ventilator in the avian respiratory system. Therefore, this study focuses on the sternum growth and mineralization kinetics of ducks from 35 d to 63 d of age. A total of 72 one-d-old males and 72 females were chosen and fed with the same diet until the age of 9 weeks. The sternum and serum were harvested at 35 d, 42 d, 49 d, 56d, and 63 d of feeding...
September 1, 2017: Poultry Science
https://www.readbyqxmd.com/read/29049686/national-practice-variation-in-pneumonectomy-perioperative-care-among-canadian-thoracic-surgeons
#2
Biniam Kidane, John K Peel, Andrew Seely, Richard A Malthaner, Christian Finley, Sean Grondin, Brian E Louie, Sadeesh Srinathan, Gail E Darling
OBJECTIVES: Our objective was to assess perioperative pneumonectomy practices among Canadian thoracic surgeons as part of a quality-improvement initiative to determine practice variability and identify areas for study/improvement. METHODS: After several rounds of survey development and piloting, a 29-item survey was distributed using the Dillman method to all practicing members of the Canadian Association of Thoracic Surgeons. RESULTS: The response rate was 87% (62 of 71)...
July 28, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#3
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29043832/high-frequency-oscillation-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#4
Ewan Goligher, Laveena Munshi, Neill Kj Adhikari, Maureen O Meade, Carol Hodgson, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: By minimizing tidal lung strain and maintaining alveolar recruitment, high frequency oscillatory ventilation (HFOV) may protect against ventilator-induced lung injury. OBJECTIVES: To summarize the current evidence in support of the use of HFOV in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mortality rates with the use of HFOV vs. conventional mechanical ventilation for adult patients with acute respiratory distress syndrome...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28990225/feasibility-of-diaphragm-pacing-in-patients-after-bilateral-lung-transplantation
#5
Dries Testelmans, Philippe Nafteux, Sophie Van Cromphaut, Bart Vrijsen, Robin Vos, Paul De Leyn, Herbert Decaluwé, Dirk Van Raemdonck, Geert M Verleden, Bertien Buyse
Recent animal studies and intra-operative studies in humans suggested that phrenic nerve stimulation could attenuate ventilator-induced diaphragm dysfunction. The purpose of the present study is to examine the safety and feasibility of diaphragm pacing during the weaning process after bilateral lung transplantation. Four patients, suffering from chronic pulmonary disease, were included, and diaphragm pacing was evaluated after lung transplantation. Implantation of electrodes at the end of the lung transplant procedure was possible in three of the four patients...
October 9, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28986821/endothelial-glycocalyx-degradation-is-more-severe-in-patients-with-non-pulmonary-sepsis-compared-to-pulmonary-sepsis-and-associates-with-risk-of-ards-and-other-organ-dysfunction
#6
Laura S Murphy, Nancy Wickersham, J Brennan McNeil, Ciara M Shaver, Addison K May, Julie A Bastarache, Lorraine B Ware
BACKGROUND: Disruption of the endothelial glycocalyx contributes to acute lung injury in experimental sepsis but has not been well studied in humans. To study glycocalyx degradation in sepsis-induced ARDS, we measured plasma levels of syndecan-1, a marker for glycocalyx degradation. METHODS: The present study is a retrospective observational study of 262 ventilated medical ICU patients at risk of ARDS due to severe sepsis and APACHE II ≥ 25. Plasma syndecan-1 was measured at study enrollment...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28981603/high-mobility-group-box-1-protein-is-involved-in-the-protective-effect-of-saquinavir-on-ventilation-induced-lung-injury-in-mice
#7
Xin Wang, Renlingzi Zhang, Yao Tong, Xibing Ding, Shuqing Jin, Xiang Zhao, Jiaying Zong, Zhixia Chen, Timothy R Billiar, Quan Li
Saquinavir (SQV) is the first FDA approved HIV protease inhibitor. Previous studies showed that SQV can limit Toll-like receptor-4 (TLR4)-mediated inflammatory pathway and nuclear factor-κB (NF-κB) activation, thereby playing a protective role in many kinds of diseases. High-mobility group box 1 (HMGB1) has been identified as an inflammatory mediator and it might express its toxicity in a short period of time in ventilator-induced lung injury (VILI). In this study, C57BL/6 mice were randomly divided into four groups (n = 10): control group and control with SQV group (Con + SQV) were spontaneous breath...
October 1, 2017: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/28979565/protective-ventilation-with-veno-venous-lung-assist-in-respiratory-failure-a-protocol-for-a-multicentre-randomised-controlled-trial-of-extracorporeal-carbon-dioxide-removal-in-patients-with-acute-hypoxaemic-respiratory-failure
#8
J J McNamee, M A Gillies, N A Barrett, A M Agus, R Beale, A Bentley, A Bodenham, S J Brett, D Brodie, S J Finney, A J Gordon, M Griffiths, D Harrison, C Jackson, C McDowell, C McNally, G D Perkins, W Tunnicliffe, A Vuylsteke, T S Walsh, M P Wise, D Young, D F McAuley
One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28979556/protective-mechanical-ventilation-in-united-kingdom-critical-care-units-a-multicentre-audit
#9
Christopher P Newell, Matthew J Martin, Neil Richardson, Christopher P Bourdeaux
Lung protective ventilation is becoming increasingly used for all critically ill patients being mechanically ventilated on a mandatory ventilator mode. Compliance with the universal application of this ventilation strategy in intensive care units in the United Kingdom is unknown. This 24-h audit of ventilation practice took place in 16 intensive care units in two regions of the United Kingdom. The mean tidal volume for all patients being ventilated on a mandatory ventilator mode was 7.2(±1.4) ml kg(-1) predicted body weight and overall compliance with low tidal volume ventilation (≤6...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977263/does-the-use-of-high-peep-levels-prevent-ventilator-induced-lung-injury
#10
Guillermo Bugedo, Jaime Retamal, Alejandro Bruhn
Overdistention and intratidal alveolar recruitment have been advocated as the main physical mechanisms responsible for ventilator-induced lung injury. Limiting tidal volume has a demonstrated survival benefit in patients with acute respiratory distress syndrome and is recognized as the cornerstone of protective ventilation. In contrast, the use of high positive end-expiratory pressure levels in clinical trials has yielded conflicting results and remains controversial. In the present review, we will discuss the benefits and limitations of the open lung approach and will discuss some recent experimental and clinical trials on the use of high versus low/moderate positive end-expiratory pressure levels...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28972662/single-center-experience-in-urgent-lung-transplantation-program-in-a-country-with-a-shortage-of-donors-does-the-end-justify-the-means
#11
Marco Schiavon, Giulio Faggi, Guido Di Gregorio, Calabrese Francesca, Francesca Lunardi, Giuseppe Marulli, Paolo Feltracco, Monica Loy, Marco Damin, Emanuele Cozzi, Dario Gregori, Fiorella Calabrese, Federico Rea
In rapidly deteriorating patients awaiting lung transplantation (LT), supportive strategies are only temporary and Urgent LT (ULT) remains the last option. The few publications on this topic report conflicting results. According to the Italian national program, patients on mechanical ventilation and/or extracorporeal membrane oxygenation may be included in urgent list. We reviewed our experience from January 2012 to December 2014 with ULT and Elective LT (ELT), focusing on outcomes. In the study period, 16 patients received ULT, while 51 received ELT...
October 3, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28967868/respiratory-mechanics-to-understand-ards-and-guide-mechanical-ventilation
#12
Tommaso Mauri, Marta Lazzeri, Giacomo Bellani, Alberto Zanella, Giacomo Grasselli
As precision medicine is becoming standard of care to select tailored rather than average treatments, physiological measurements might represent the first step to apply personalized therapy in the intensive care unit (ICU). Systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step towards this direction for two main reasons. On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient...
October 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28967439/new-evidence-in-one-lung-ventilation
#13
H Meleiro, I Correia, P Charco Mora
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included...
September 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28951801/occupational-tasks-influencing-lung-function-and-respiratory-symptoms-among-charcoal-production-workers-a-time-series-study
#14
Walaiporn Pramchoo, Alan F Geater, Silom Jamulitrat, Sarayut L Geater, Boonsin Tangtrakulwanich
BACKGROUND: Tasks involved in traditional charcoal production expose workers to various levels of charcoal dust and wood smoke. This study aimed to identify specific tasks influencing lung function and respiratory symptoms. METHODS: Interviews, direct observation, and task/symptom checklists were used to collect data from 50 charcoal-production workers on 3 nonwork days followed by 11 workdays. The peak expiratory flow rate (PEFR) was measured four times per day...
September 2017: Safety and Health At Work
https://www.readbyqxmd.com/read/28941533/pathophysiology-and-management-of-acute-respiratory-distress-syndrome-in-children
#15
REVIEW
Sabrina M Heidemann, Alison Nair, Yonca Bulut, Anil Sapru
Acute respiratory distress syndrome (ARDS) is a syndrome of noncardiogenic pulmonary edema and hypoxia that accompanies up to 30% of deaths in pediatric intensive care units. Pediatric ARDS (PARDS) is diagnosed by the presence of hypoxia, defined by oxygenation index or Pao2/Fio2 ratio cutoffs, and new chest infiltrate occurring within 7 days of a known insult. Hallmarks of ARDS include hypoxemia and decreased lung compliance, increased work of breathing, and impaired gas exchange. Mortality is often accompanied by multiple organ failure...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28940836/small-airway-involvement-in-the-late-allergic-response-in-asthma
#16
Henning Stenberg, Zuzana Diamant, Jaro Ankerst, Leif Bjermer, Ellen Tufvesson
BACKGROUND: Allergy and asthma are closely linked. Inhalation of allergen induces an early allergic response (EAR) within the airways of allergic asthmatic subjects, which is followed by a late allergic response (LAR) in approximately 50% of the subjects. The LAR is defined as a drop in forced expiratory volume in 1 s (FEV1 ) from baseline usually occurring 4-8 h after exposure, and is believed to affect small airways. However, FEV1 is insensitive to changes in small airway physiology...
September 21, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28936967/-effect-of-sedation-on-respiratory-function-of-patients-undergoing-mechanical-ventilation
#17
Jie Yang, Yan Kang
Sedation and analgesia for ventilated patients is an important treatment in intensive care unit (ICU). Patients receiving mechanical ventilation therapy comfortably and safely can improve patient-ventilator synchrony, reduce ventilation-related lung injury (VILI), improve compliance, decrease oxygen consumption and stress, prevent accidents, and reduce the incidence of complications and mortality in critical patients. Although sedation may protect lung function, it also has a greater impact on respiratory function...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936695/early-application-of-airway-pressure-release-ventilation-may-reduce-the-duration-of-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#18
Yongfang Zhou, Xiaodong Jin, Yinxia Lv, Peng Wang, Yunqing Yang, Guopeng Liang, Bo Wang, Yan Kang
PURPOSE: Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28932514/-lung-protective-ventilation-in-acute-respiratory-distress-syndrome-still-a-challenge
#19
EDITORIAL
Flavia Julie do Amaral Pfeilsticker, Ary Serpa Neto
No abstract text is available yet for this article.
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28931657/neutrophil-transfer-of-mir-223-to-lung-epithelial-cells-dampens-acute-lung-injury-in-mice
#20
Viola Neudecker, Kelley S Brodsky, Eric T Clambey, Eric P Schmidt, Thomas A Packard, Bennett Davenport, Theodore J Standiford, Tingting Weng, Ashley A Fletcher, Lea Barthel, Joanne C Masterson, Glenn T Furuta, Chunyan Cai, Michael R Blackburn, Adit A Ginde, Michael W Graner, William J Janssen, Rachel L Zemans, Christopher M Evans, Ellen L Burnham, Dirk Homann, Marc Moss, Simone Kreth, Kai Zacharowski, Peter M Henson, Holger K Eltzschig
Intercellular transfer of microRNAs can mediate communication between critical effector cells. We hypothesized that transfer of neutrophil-derived microRNAs to pulmonary epithelial cells could alter mucosal gene expression during acute lung injury. Pulmonary-epithelial microRNA profiling during coculture of alveolar epithelial cells with polymorphonuclear neutrophils (PMNs) revealed a selective increase in lung epithelial cell expression of microRNA-223 (miR-223). Analysis of PMN-derived supernatants showed activation-dependent release of miR-223 and subsequent transfer to alveolar epithelial cells during coculture in vitro or after ventilator-induced acute lung injury in mice...
September 20, 2017: Science Translational Medicine
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