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Lung-protective ventilation

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https://www.readbyqxmd.com/read/29243798/effects-of-propofol-or-sevoflurane-anesthesia-on-the-perioperative-inflammatory-response-pulmonary-function-and-cognitive-function-in-patients-receiving-lung-cancer-resection
#1
H-T Tian, X-H Duan, Y-F Yang, Y Wang, Q-L Bai, X Zhang
OBJECTIVE: To investigate the effects of propofol and sevoflurane anesthesia on the inflammatory response, pulmonary function and cognitive function of patients undergoing lung cancer resection and their differences. PATIENTS AND METHODS: 62 patients with lung cancer who underwent pulmonary lobectomy from January 2014 to January 2016 in Jining First People's Hospital were selected and randomly divided into two groups: the propofol group (n=31) and the sevoflurane group (n=31)...
December 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29236845/comparison-between-conventional-protective-mechanical-ventilation-and-high-frequency-oscillatory-ventilation-associated-with-the-prone-position
#2
José Roberto Fioretto, Susiane Oliveira Klefens, Rafaelle Fernandes Pires, Cilmery Suemi Kurokawa, Mario Ferreira Carpi, Rossano César Bonatto, Marcos Aurélio Moraes, Carlos Fernando Ronchi
OBJECTIVE: To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. METHODS: Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15)...
December 7, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29227313/intraoperative-lung-protective-ventilation
#3
Jayashree K Raikhelkar, James M Blum
No abstract text is available yet for this article.
2018: International Anesthesiology Clinics
https://www.readbyqxmd.com/read/29221302/the-society-for-translational-medicine-clinical-practice-guidelines-for-mechanical-ventilation-management-for-patients-undergoing-lobectomy
#4
REVIEW
Shugeng Gao, Zhongheng Zhang, Alessandro Brunelli, Chang Chen, Chun Chen, Gang Chen, Haiquan Chen, Jin-Shing Chen, Stephen Cassivi, Ying Chai, John B Downs, Wentao Fang, Xiangning Fu, Martínez I Garutti, Jianxing He, Jie He, Jian Hu, Yunchao Huang, Gening Jiang, Hongjing Jiang, Zhongmin Jiang, Danqing Li, Gaofeng Li, Hui Li, Qiang Li, Xiaofei Li, Yin Li, Zhijun Li, Chia-Chuan Liu, Deruo Liu, Lunxu Liu, Yongyi Liu, Haitao Ma, Weimin Mao, Yousheng Mao, Juwei Mou, Calvin Sze Hang Ng, René H Petersen, Guibin Qiao, Gaetano Rocco, Erico Ruffini, Lijie Tan, Qunyou Tan, Tang Tong, Haidong Wang, Qun Wang, Ruwen Wang, Shumin Wang, Deyao Xie, Qi Xue, Tao Xue, Lin Xu, Shidong Xu, Songtao Xu, Tiansheng Yan, Fenglei Yu, Zhentao Yu, Chunfang Zhang, Lanjun Zhang, Tao Zhang, Xun Zhang, Xiaojing Zhao, Xuewei Zhao, Xiuyi Zhi, Qinghua Zhou
Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29216437/epha2-modulation-associates-with-protective-effect-of-prone-position-in-ventilator-induced-lung-injury
#5
Byung Hoon Park, Mi Hwa Shin, Ivor S Douglas, Kyung Soo Chung, Joo Han Song, Song Yee Kim, Eun Young Kim, Ji Ye Jung, Young Ae Kang, Joon Chang, Young Sam Kim, Moo Suk Park
The erythropoietin-producing hepatoma receptor tyrosine kinase A2 (EphA2) and its ligand ephrinA1 play a pivotal role in inflammation and tissue injury by modulating the epithelial and endothelial barrier integrity. Therefore, EphA2 receptor may be a potential therapeutic target for modulating ventilator-induced lung injury (VILI). To support this hypothesis, here we analyzed EphA2/ephrinA1 signaling in the process of VILI and determined the role of EphA2/ephrinA1 signaling in the protective mechanism of prone positioning in a VILI model...
December 7, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#6
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29210790/management-of-1-lung-ventilation-variation-and-trends-in-clinical-practice-a-report-from-the-multicenter-perioperative-outcomes-group
#7
Douglas A Colquhoun, Bhiken I Naik, Marcel E Durieux, Amy M Shanks, Sachin Kheterpal, S Patrick Bender, Randal S Blank
BACKGROUND: Lung-protective ventilation (LPV) has been demonstrated to improve clinical outcomes in surgical patients. There are very limited data on the current use of LPV for patients undergoing 1-lung ventilation (1LV) despite evidence that 1LV may be a particularly important setting for its use. In this multicenter study, we report trends in ventilation practice for patients undergoing 1LV. METHODS: The Multicenter Perioperative Outcomes Group database was used to identify patients undergoing 1LV...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29207907/implementation-of-a-goal-directed-mechanical-ventilation-order-set-driven-by-respiratory-therapists-improves-compliance-with-best-practices-for-mechanical-ventilation
#8
Misty A Radosevich, Brendan T Wanta, Todd J Meyer, Verlin W Weber, Daniel R Brown, Nathan J Smischney, Daniel A Diedrich
PURPOSE: Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29206492/intravenous-controlled-release-hydrogen-sulfide-protects-against-ventilator-induced-lung-injury
#9
Lifeng Wang, Hao Yu, Yana Zhang, Caiyu Dong, Bo Liu
BACKGROUND: Despite its critical utility in providing life support to patients with impaired respiratory functions, prolonged mechanical ventilation has been found to cause a series of pathological changes in the lung that are collectively referred to as ventilator-induced lung injury (VILI). This study aims to investigate the therapeutic effects of mesoporous silica nanoparticles (DATS-MSN), which is capable of releasing H2S in a slow and controlled manner, on VILI. METHODS: A murine VILI model was generated...
December 5, 2017: Experimental Lung Research
https://www.readbyqxmd.com/read/29204685/methylene-blue-protects-the-isolated-rat-lungs-from-ischemia-reperfusion-injury-by-attenuating-mitochondrial-oxidative-damage
#10
Wen-Fang Tian, Si Zeng, Qiong Sheng, Jun-Liang Chen, Ping Weng, Xiao-Tong Zhang, Jia-Jia Yuan, Qing-Feng Pang, Zhi-Qiang Wang
INTRODUCTION: Impaired mitochondrial function is a key factor attributing to the lung ischemia reperfusion injury (LIRI). Methylene blue (MB) has been reported to attenuate brain and renal ischemia-reperfusion injury. We hypothesized that MB also could have a protective effect against LIRI by preventing mitochondrial oxidative damage. METHODS: Isolated rat lungs were assigned to the following four groups (n = 6): a sham group: perfusion for 105 min without ischemia; I/R group: shutoff of perfusion and ventilation for 45 min followed by reperfusion for 60 min; and I/R + MB group and I/R + glutathione (GSH) group: 2 mg/kg MB or 4 μM glutathione were intraperitoneally administered for 2 h, and followed by 45 min of ischemia and 60 min of reperfusion...
December 4, 2017: Lung
https://www.readbyqxmd.com/read/29200060/changing-default-ventilator-settings-on-anesthesia-machines-improves-adherence-to-lung-protective-ventilation-measures
#11
Sunny S Chiao, Douglas A Colquhoun, Bhiken I Naik, Jennie Z Ma, Edward C Nemergut, Marcel E Durieux, Randal S Blank, Katherine T Forkin
Perioperative lung-protective ventilation (LPV) can reduce perioperative pulmonary morbidity. We hypothesized that modifying default anesthesia machine ventilator settings would increase the use of intraoperative LPV. Default tidal volume settings on our anesthesia machines were decreased from 600 to 400 mL, and default positive end-expiratory pressure was increased from 0 to 5 cm H2O. This modification increased mean positive end-expiratory pressure from 3.1 to 5.0 cm H2O and decreased mean tidal volume from 8...
November 30, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29199052/protective-invasive-ventilation-in-cardiac-surgery-a-systematic-review-with-a-focus-on-acute-lung-injury-in-adult-cardiac-surgical-patients
#12
REVIEW
Vasileios Zochios, Andrew A Klein, Fang Gao
No abstract text is available yet for this article.
November 30, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29194916/the-impact-of-obesity-in-cirrhotic-patients-with-septic-shock-a-retrospective-cohort-study
#13
Beverley Kok, Constantine J Karvellas, Juan G Abraldes, Rajiv Jalan, Vinay Sundaram, David Gurka, Sean Keenan, Aseem Kumar, Greg Martinka, Brian Bookatz, Gordon Wood, Anand Kumar
BACKGROUND & AIMS: The prevalence of obesity in cirrhosis is rising. The impact of obesity in the critically-ill cirrhotic patient with sepsis/septic shock has not been evaluated. This study aimed to examine the relationship between obesity and mortality in cirrhotic patients admitted to the intensive care unit with septic shock. METHODS: A retrospective cohort study of all cirrhotic patients with septic shock (n=362) and a recorded body mass index (BMI) from an international, multicenter (CATTS) database (1996-2015) was performed...
December 1, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29180335/-pathogenic-role-of-leukotriene-b4-in-pulmonary-microvascular-endothelial-cell-hyper-permeability-induced-by-one-lung-ventilation-in-rabbits
#14
Li-Sha Li, Yong Yang, Xin-Ling Liu, Chuan-Rao Zhang, Qing-Yan Ye, Wen-Jun Hou, Yan-Hua Zhao, Gao-Peng Xiao, Xin-Nan Li, Yan-Hua Li, Rui Liu
OBJECTIVE: To elucidate the pathogenic role of leukotriene B4 (LTB4) in increased pulmonary microvascular endothelial cell permeability induced by one lung ventilation (OLV) in rabbits. METHODS: Forty-eight healthy Japanese white rabbits were randomly divided into control group (group C), saline pretreatment group (group S), bestatin (a leukotriene A4 hydrolase (LTA4H) inhibitor) plus saline pretreatment group (group B), OLV group (group O), saline pretreatment plus OLV group (group SO) and bestatin plus saline pretreatment with OLV group (group BO)...
November 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/29179681/low-flow-extracorporeal-co2-removal-in-ards-patients-a-prospective-short-term-crossover-pilot-study
#15
Harlinde Peperstraete, Sunny Eloot, Pieter Depuydt, Filip De Somer, Carl Roosens, Eric Hoste
BACKGROUND: Lung protective mechanical ventilation (MV) is the corner stone of therapy for ARDS. However, its use may be limited by respiratory acidosis. This study explored feasibility of, effectiveness and safety of low flow extracorporeal CO2 removal (ECCO2R). METHODS: This was a prospective pilot study, using the Abylcap® (Bellco) ECCO2R, with crossover off-on-off design (2-h blocks) under stable MV settings, and follow up till end of ECCO2R. Primary endpoint for effectiveness was a 20% reduction of PaCO2 after the first 2-h...
November 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29176330/dissipation-of-energy-during-the-respiratory-cycle-conditional-importance-of-ergotrauma-to-structural-lung-damage
#16
John J Marini
PURPOSE OF REVIEW: To describe and put into context recent conceptual advances regarding the relationship of energy load and power to ventilator-induced lung injury (VILI). RECENT FINDINGS: Investigative emphasis regarding VILI has almost exclusively centered on the static characteristics of the individual tidal cycle - tidal volume, plateau pressure, positive end-expiratory pressure, and driving pressure. Although those static characteristics of the tidal cycle are undeniably important, the 'dynamic' characteristics of ventilation must not be ignored...
November 16, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29175086/re-examining-permissive-hypercapnia-in-ards-a-narrative-review
#17
REVIEW
Tavish Barnes, Vasileios Zochios, Ken Parhar
Lung protective ventilation has become the cornerstone of management in patients with ARDS. A subset of patients are unable to tolerate lung protective ventilation without significant carbon dioxide elevation. In these patients permissive hypercapnia is used. Although thought to be benign, it is becoming increasingly evident that elevated carbon dioxide levels have significant physiological effects. In this narrative review, we highlight clinically relevant end organ effects in both animal models and clinical studies...
November 21, 2017: Chest
https://www.readbyqxmd.com/read/29173777/surgical-excision-is-the-treatment-of-choice-for-cervical-lymphatic-malformations-with-mediastinal-expansion
#18
Nader Ghaffarpour, Carmen Mesas Burgos, Tomas Wester
BACKGROUND: Lymphatic malformations (LMs) in the mediastinum are uncommon. However, cervical LMs may expand into the mediastinum. The aim of this study was to review our experience with the management of patients with LMs involving the mediastinum and to propose a treatment algorithm to guide the management of these rare malformations. MATERIAL AND METHODS: This was a descriptive retrospective chart review of all patients with LMs involving the mediastinum treated at our Institution between 2009 and 2015...
October 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29172232/review-demonstrates-that-less-invasive-surfactant-administration-in-preterm-neonates-leads-to-fewer-complications
#19
REVIEW
Ludwig Gortner, Simone S Schüller, Egbert Herting
Surfactant treatment of neonatal respiratory distress syndrome (RDS) was introduced into Europe during the 1990s. Meta-analyses have indicated that using less invasive surfactant administration (LISA) techniques on preterm neonates receiving continuous positive airway pressure (CPAP) results in improved survival rates without bronchopulmonary dysplasia. Surfactant should be administered early and ventilator settings adapted to changing oxygen requirements and lung mechanics. Side effects including initial bradycardia, oxygen desaturation, tube obstruction and isolated cases of pulmonary haemorrhage have been reported CONCLUSION: Less invasive surfactant therapy improves pulmonary outcomes in preterm neonates with RDS and should ideally be administered in combination with CPAP...
November 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29166367/smoke-free-policies-in-the-world-s-50-busiest-airports-august-2017
#20
Michael A Tynan, Elizabeth Reimels, Jennifer Tucker, Brian A King
Exposure to secondhand smoke from burning tobacco products causes premature death and disease, including coronary heart disease, stroke, and lung cancer among nonsmoking adults and sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children (1,2). The U.S. Surgeon General has concluded that there is no risk-free level of exposure to secondhand smoke (1). Previous CDC reports on airport smoke-free policies found that most large-hub airports in the United States prohibit smoking (3); however, the extent of smoke-free policies at airports globally has not been assessed...
November 24, 2017: MMWR. Morbidity and Mortality Weekly Report
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