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https://www.readbyqxmd.com/read/29452815/variable-versus-conventional-lung-protective-mechanical-ventilation-during-open-abdominal-surgery-provar-a-randomised-controlled-trial
#1
P M Spieth, A Güldner, C Uhlig, T Bluth, T Kiss, C Conrad, K Bischlager, A Braune, R Huhle, A Insorsi, F Tarantino, L Ball, M J Schultz, N Abolmaali, T Koch, P Pelosi, M Gama de Abreu
BACKGROUND: Experimental studies showed that controlled variable ventilation (CVV) yielded better pulmonary function compared to non-variable ventilation (CNV) in injured lungs. We hypothesized that CVV improves intraoperative and postoperative respiratory function in patients undergoing open abdominal surgery. METHODS: Fifty patients planned for open abdominal surgery lasting >3 h were randomly assigned to receive either CVV or CNV. Mean tidal volumes and PEEP were set at 8 ml kg -1 (predicted body weight) and 5 cm H 2 O, respectively...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29451804/pediatric-acute-respiratory-distress-syndrome-increase-the-peep
#2
Andrew C McKown, Lorraine B Ware
No abstract text is available yet for this article.
February 16, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29447205/aggressive-fluid-accumulation-is-associated-with-acute-kidney-injury-and-mortality-in-a-cohort-of-patients-with-severe-pneumonia-caused-by-influenza-a-h1n1-virus
#3
Gustavo Alejandro Casas-Aparicio, Isabel León-Rodríguez, Rafael de Jesús Hernández-Zenteno, Manuel Castillejos-López, Claudia Alvarado-de la Barrera, Christopher E Ormsby, Gustavo Reyes-Terán
INTRODUCTION: Fluid accumulation is associated with adverse outcomes such as acute kidney injury (AKI) in critically ill patients. This study aimed to describe the factors associated with AKI in individuals with influenza A H1N1 severe pneumonia, and explore the relation of fluid accumulation with AKI and mortality. MATERIAL AND METHODS: We reviewed medical records of individuals with influenza A H1N1 severe pneumonia and no history of chronic kidney disease, attending a national referral center for respiratory diseases between November 2014 and May 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29445887/lung-volumes-and-lung-volume-recruitment-in-ards-a-comparison-between-supine-and-prone-position
#4
Hernan Aguirre-Bermeo, Marta Turella, Maddalena Bitondo, Juan Grandjean, Stefano Italiano, Olimpia Festa, Indalecio Morán, Jordi Mancebo
BACKGROUND: The use of positive end-expiratory pressure (PEEP) and prone position (PP) is common in the management of severe acute respiratory distress syndrome patients (ARDS). We conducted this study to analyze the variation in lung volumes and PEEP-induced lung volume recruitment with the change from supine position (SP) to PP in ARDS patients. METHODS: The investigation was conducted in a multidisciplinary intensive care unit. Patients who met the clinical criteria of the Berlin definition for ARDS were included...
February 14, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29435738/alveolar-tidal-recruitment-derecruitment-and-overdistension-during-four-levels-of-end-expiratory-pressure-with-protective-tidal-volume-during-anesthesia-in-a-murine-lung-healthy-model
#5
Joao Henrique Neves Soares, Alysson Roncally Carvalho, Bruno Curty Bergamini, Maria Alice Kuster Gress, Frederico Caetano Jandre, Walter Araujo Zin, Antonio Giannella-Neto
PURPOSE: We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. METHODS: Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs × V(t) + R rs × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1 + E 2 × V(t)) × V(t) + (K 1 + K 2 × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2 × F are flow-independent and flow-dependent R rs , respectively...
February 12, 2018: Lung
https://www.readbyqxmd.com/read/29432712/expiratory-flow-limitation-during-mechanical-ventilation
#6
REVIEW
Detajin Junhasavasdikul, Irene Telias, Domenico Luca Grieco, Lu Chen, Cinta Millan Gutierrez, Thomas Piraino, Laurent Brochard
Expiratory flow limitation (EFL) is present when the flow cannot rise despite an increase of the expiratory driving pressure. The mechanisms of EFL are debated but are thought to be related to the collapsibility of small airways. In mechanically ventilated patients, EFL can exist during tidal ventilation, representing an extreme situation where lung volume cannot decrease whatever the expiratory driving forces. It is a key factor for the generation of auto- or intrinsic positive end-expiratory pressure (auto-PEEP or PEEPi) and requires specific management such as positioning and adjustment of external PEEP...
February 9, 2018: Chest
https://www.readbyqxmd.com/read/29432138/characteristics-of-subjects-who-failed-a-120-minute-spontaneous-breathing-trial
#7
Guopeng Liang, Tingting Liu, Yihua Zeng, Yunfeng Shi, Wei Yang, Yunqin Yang, Yan Kang
BACKGROUND: The objective of this work was to identify the unique characteristics of patients who experienced success in a 30-min spontaneous breathing trial (SBT) but failed at 120 min. METHODS: Patients who had received mechanical ventilation for >24 h were eligible for inclusion in this study. The SBT was performed by 7 cm H 2 O of pressure support with zero PEEP. After a successful 120-min SBT, weaning from mechanical ventilation was performed. Data were collected at 30 and 120 min or at the failure of the SBT...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29431700/influence-of-tidal-volume-and-positive-end-expiratory-pressure-on-ventilation-distribution-and-oxygenation-during-one-lung-ventilation
#8
Zhanqi Zhao, Wei Wang, Zuojing Zhang, Meiying Xu, Inez Frerichs, Jing-Xiang Wu, Knut Moeller
The aim of the study was to explore the feasibility of titrating tidal volume (VT) and positive end-expiratory pressure (PEEP) during one-lung ventilation (OLV) based on ventilation distribution and oxygenation. Approach: Twenty four consecutive patients requiring intubation with a double-lumen tube and subsequent OLV for thoracic surgical procedures were examined prospectively in lateral posture. Electrical impedance tomography (EIT), blood gases, respiratory mechanics were successfully measured in 21 patients at various combinations of VT (4 ml/kg, 6 ml/kg, 8 ml/kg body weight) and PEEP (0 cmH2O, 4 cmH2O, 8 cmH2O) during OLV...
February 12, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29430443/electrical-impedance-tomography
#9
REVIEW
Beatriz Lobo, Cecilia Hermosa, Ana Abella, Federico Gordo
Continuous assessment of respiratory status is one of the cornerstones of modern intensive care unit (ICU) monitoring systems. Electrical impedance tomography (EIT), although with some constraints, may play the lead as a new diagnostic and guiding tool for an adequate optimization of mechanical ventilation in critically ill patients. EIT may assist in defining mechanical ventilation settings, assess distribution of tidal volume and of end-expiratory lung volume (EELV) and contribute to titrate positive end-expiratory pressure (PEEP)/tidal volume combinations...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430442/effects-of-peep-on-lung-injury-pulmonary-function-systemic-circulation-and-mortality-in-animals-with-uninjured-lungs-a-systematic-review
#10
REVIEW
Anna Geke Algera, Luigi Pisani, Renato Carneiro de Freitas Chaves, Thiago Chaves Amorim, Thomas Cherpanath, Rogier Determann, Dave A Dongelmans, Frederique Paulus, Pieter Roel Tuinman, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz, Ary Serpa Neto
It is well-known that positive end-expiratory pressure (PEEP) can prevent ventilator-induced lung injury (VILI) and improve pulmonary physiology in animals with injured lungs. It's uncertain whether PEEP has similar effects in animals with uninjured lungs. A systematic review of randomized controlled trials (RCTs) comparing different PEEP levels in animals with uninjured lungs was performed. Trials in animals with injured lungs were excluded, as were trials that compared ventilation strategies that also differed with respect to other ventilation settings, e...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29426051/-respiratory-failure-innovations-in-diagnostics-and-therapy
#11
Gunther Hempel, Philipp Simon, Peter Salz, Hermann Wrigge
Acute and chronic respiratory failures require immediate diagnosis and preferably individualized ventilation therapy. If possible, non-invasive ventilation should be considered to avoid complications of invasive mechanical ventilation. Especially in patients with ARDS and moderate to severe cases, non-invasive ventilation may not be suitable and should not be used uncritically.Invasive mechanical ventilation parameters should be adjusted individually. In the future, additional parameters such as transpulmonary pressure, monitoring of regional ventilation using electrical impedance tomography could help to individualize ventilator settings...
February 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29420904/unstable-inflation-causing-injury-insight-from-prone-position-and-paired-ct-scans
#12
Yi Xin, Maurizio Cereda, Hooman Hamedani, Mehrdad Pourfathi, Sarmad Siddiqui, Natalie Meeder, Stephen Kadlecek, Ian Duncan, Harrilla Profka, Jennia Rajaei, Nicholas J Tustison, James C Gee, Brian P Kavanagh, Rahim R Rizi
BACKGROUND: It remains unclear how prone positioning improves survival in acute respiratory distress syndrome (ARDS). Using serial computed tomography (CT), we previously reported that 'unstable' inflation, i.e. partial aeration with large tidal density swings (indicating increased local strain) is associated with injury progression. We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation. METHODS: Injury was induced by tracheal hydrochloric acid (HCl) in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low PEEP...
February 8, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29417182/simultaneous-common-bile-duct-clearance-and-laparoscopic-cholecystectomy-experience-of%C3%A2-a-one-stage-approach
#13
Shahin Mohseni, John Ivarsson, Rebecka Ahl, Sinan Dogan, Sten Saar, Arvo Reinsoo, Teesi Sepp, Karl-Gunnar Isand, Edvard Garder, Ilmar Kaur, Heiti Ruus, Peep Talving
INTRODUCTION: The timing and optimal method for common bile duct (CBD) clearance and laparoscopic cholecystectomy remains controversial. Several different approaches are available in clinical practice. The current study presents the experience of two European hospitals of simultaneous laparoscopic cholecystectomy (LC) and intra-operative endoscopic retrograde cholangiopacreatography (IO-ERCP) done by surgeons. METHODS: Retrospective analysis of all consecutive patients subjected to LC + IO-ERCP during their index admission between 4/2014 and 9/2016...
February 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29416555/raising-concerns-about-the-sepsis-3-definitions
#14
REVIEW
Massimo Sartelli, Yoram Kluger, Luca Ansaloni, Timothy C Hardcastle, Jordi Rello, Richard R Watkins, Matteo Bassetti, Eleni Giamarellou, Federico Coccolini, Fikri M Abu-Zidan, Abdulrashid K Adesunkanmi, Goran Augustin, Gian L Baiocchi, Miklosh Bala, Oussema Baraket, Marcelo A Beltran, Asri Che Jusoh, Zaza Demetrashvili, Belinda De Simone, Hamilton P de Souza, Yunfeng Cui, R Justin Davies, Sameer Dhingra, Jose J Diaz, Salomone Di Saverio, Agron Dogjani, Mutasim M Elmangory, Mushira A Enani, Paula Ferrada, Gustavo P Fraga, Sabrina Frattima, Wagih Ghnnam, Carlos A Gomes, Souha S Kanj, Aleksandar Karamarkovic, Jakub Kenig, Faryal Khamis, Vladimir Khokha, Kaoru Koike, Kenneth Y Y Kok, Arda Isik, Francesco M Labricciosa, Rifat Latifi, Jae G Lee, Andrey Litvin, Gustavo M Machain, Ramiro Manzano-Nunez, Piotr Major, Sanjay Marwah, Michael McFarlane, Ziad A Memish, Cristian Mesina, Ernest E Moore, Frederick A Moore, Noel Naidoo, Ionut Negoi, Richard Ofori-Asenso, Iyiade Olaoye, Carlos A Ordoñez, Mouaqit Ouadii, Ciro Paolillo, Edoardo Picetti, Tadeja Pintar, Alfredo Ponce-de-Leon, Guntars Pupelis, Tarcisio Reis, Boris Sakakushev, Hossein Samadi Kafil, Norio Sato, Jay N Shah, Boonying Siribumrungwong, Peep Talving, Cristian Tranà, Jan Ulrych, Kuo-Ching Yuan, Fausto Catena
The Global Alliance for Infections in Surgery appreciates the great effort of the task force who derived and validated the Sepsis-3 definitions and considers the new definitions an important step forward in the evolution of our understanding of sepsis. Nevertheless, more than a year after their publication, we have a few concerns regarding the use of the Sepsis-3 definitions.
2018: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29413551/cardiovascular-and-respiratory-mechanics-effects-during-an-alveolar-recruitment-maneuver-followed-by-a-positive-end-expiratory-pressure-peep-titration-in-dogs-anesthetized-with-isoflurane
#15
J Soares, N Pavlisko, N Henao-Guerrero, A Williamson, A Giannella-Neto, A Carvalho
No abstract text is available yet for this article.
September 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29404202/positive-end-expiratory-pressure-in-acute-hypoxemic-respiratory-failure-due-to-community-acquired-pneumonia-do-we-need-a-personalized-approach
#16
Valentina Paolini, Paola Faverio, Stefano Aliberti, Grazia Messinesi, Giuseppe Foti, Oriol Sibila, Anna Monzani, Federica De Giacomi, Anna Stainer, Alberto Pesci
Background: Acute respiratory failure (ARF) is a life-threatening complication in patients with community acquired pneumonia (CAP). The use of non-invasive ventilation is controversial. With this prospective, observational study we aimed to describe a protocol to assess whether a patient with moderate-to-severe hypoxemic ARF secondary to CAP benefits, in clinical and laboratoristic terms, from the application of a positive end expiratory pressure (PEEP) + oxygen vs oxygen alone. Methods: Patients who benefit from PEEP application (PEEP-responders) were defined as those with partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO2/FiO2) increase >20% and/or reduction of respiratory distress during PEEP + oxygen therapy compared to oxygen therapy alone...
2018: PeerJ
https://www.readbyqxmd.com/read/29398628/association-between-oxygenation-and-ventilation-indices-with-the-time-on-invasive-mechanical-ventilation-in-infants
#17
D A Camargo Barros Rocha, F A L Marson, C C B Almeida, A A Almeida Junior, J D Ribeiro
BACKGROUND: Invasive mechanical ventilation (IMV) is a common practice in pediatric intensive care unit (PICU). However, the role of oxygenation (OI) and ventilation (VI) indices regarding the time on IMV has not been fully understood. BASIC PROCEDURES: The study was conducted with infants up to 24 months of age, hospitalized in PICU for two consecutive years. The values of ventilatory parameters, OI, VI, and blood gas of infants, collected in the first seven days in IMV, were associated with the time on IMV...
February 2, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29394907/the-effect-of-an-intraoperative-lung-protective-ventilation-strategy-in-neurosurgical-patients-undergoing-craniotomy-study-protocol-for-a-randomized-controlled-trial
#18
Liyong Zhang, Wei Xiong, Yuming Peng, Wei Zhang, Ruquan Han
BACKGROUND: Ventilator-induced lung injury is a major cause of postoperative pulmonary complications (PPCs) in patients undergoing neurosurgery after general anesthesia. However, there is no study on the effect of a lung-protective ventilation strategy in patients undergoing neurosurgery. METHODS: This is a single-center, randomized, parallel-group controlled trial which will be carried out at Beijing Tiantan Hospital, Capital Medical University. Three hundred and thirty-four patients undergoing intracranial tumor surgery will be randomly allocated to the control group and the protective-ventilation strategy group...
February 2, 2018: Trials
https://www.readbyqxmd.com/read/29386048/variation-of-poorly-ventilated-lung-units-silent-spaces-measured-by-electrical-impedance-tomography-to-dynamically-assess-recruitment
#19
Savino Spadaro, Tommaso Mauri, Stephan H Böhm, Gaetano Scaramuzzo, Cecilia Turrini, Andreas D Waldmann, Riccardo Ragazzi, Antonio Pesenti, Carlo Alberto Volta
BACKGROUND: Assessing alveolar recruitment at different positive end-expiratory pressure (PEEP) levels is a major clinical and research interest because protective ventilation implies opening the lung without inducing overdistention. The pressure-volume (P-V) curve is a validated method of assessing recruitment but reflects global characteristics, and changes at the regional level may remain undetected. The aim of the present study was to compare, in intubated patients with acute hypoxemic respiratory failure (AHRF) and acute respiratory distress syndrome (ARDS), lung recruitment measured by P-V curve analysis, with dynamic changes in poorly ventilated units of the dorsal lung (dependent silent spaces [DSSs]) assessed by electrical impedance tomography (EIT)...
January 31, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29380954/mechanical-ventilation-strategies-alter-cardiovascular-biomarkers-in-an-infant-rat-model
#20
Philipp Baumann, Susanne Wiegert, Francesco Greco, Sven Wellmann, Pietro L'Abate, Vincenzo Cannizzaro
Mechanical ventilation (MV) is routinely used in pediatric general anesthesia and critical care, but may adversely affect the cardiocirculatory system. Biomarkers are increasingly measured to assess cardiovascular status and improve clinical treatment decision-making. As the impact of mechanical ventilation strategies on cardiovascular biomarkers in ventilated infants is largely unknown, we conducted this retrospective study in a healthy in vivo infant rat ventilation model using 14-days old Wistar rats. We hypothesized that 2 h of mechanical ventilation with high and low positive end-expiratory pressure (PEEP), hyperoxemia, hypoxemia, hypercapnia, and hypocapnia would significantly impact B-type natriuretic peptide (BNP), vascular endothelial growth factor (VEGF), and endothelin-1 (ET-1)...
January 2018: Physiological Reports
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