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https://www.readbyqxmd.com/read/28231028/high-flow-oxygen-peep-and-the-berlin-definition-of-ards-are-they-mutually-exclusive
#1
Jason Chertoff
No abstract text is available yet for this article.
February 23, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28209038/-a-comparison-of-leak-compensation-in-six-acute-care-ventilators-during-non-invasive-ventilation
#2
X S Hu, Y Wang, Z T Wang, P Yan, X G Zhang, S F Zhao, F Xie, H J Gu, L X Xie
Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0...
February 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28208947/delayed-uterine-necrosis-rare-cause-of-nonhealing-wound
#3
Aruna Nigam, Neha Gupta, Arifa A Elahi, Zeeba S Jairajpuri, Swaraj Batra
Uterine necrosis is a very rare condition and most of the reported cases occurred after pelvic arterial embolization for post-partum haemorrhage, embolization of fibroid uterus or application of B-Lynch sutures. A case of delayed myometrial necrosis is reported in post-cesarean patient where no embolization or uterine compression sutures have been applied. Patient presented with foul smelling discharge from the gaped abdominal wound following caesarean section. Abdomen was closed after exploration and lavage...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28195072/complement-activation-contributes-to-ventilator-induced-lung-injury-in-rats
#4
B Petersen, T Busch, J Gaertner, J J Haitsma, S Krabbendam, M Ebsen, B Lachmann, U X Kaisers
The complement system contributes to ventilator induced lung injury (VILI). We hypothesized that pretreatment with the C1 esterase inhibitor (C1INH) Berinert® constrains complement activation consecutively inducing improvements in arterial oxygenation and histological pulmonary damage. At baseline, male Sprague-Dawley rats underwent mechanical ventilation in a conventional mode (PIP 13 cm H2O, PEEP 3 cm H2O). In the Control group, the ventilator setting was maintained (Control, n = 15). The other animals randomly received intravenous pretreatment with either 100 units/kg of the C1-INH Berinert® (VILI-C1INH group, n = 15) or 1 ml saline solution (VILI-C group, n = 15)...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28190374/the-use-of-quality-adjusted-life-years-in-cost-effectiveness-analyses-in-palliative-care-mapping-the-debate-through-an-integrative-review
#5
Anne B Wichmann, Eddy Mm Adang, Peep Fm Stalmeier, Sinta Kristanti, Lieve Van den Block, Myrra Jfj Vernooij-Dassen, Yvonne Engels
BACKGROUND: In cost-effectiveness analyses in healthcare, Quality-Adjusted Life Years are often used as outcome measure of effectiveness. However, there is an ongoing debate concerning the appropriateness of its use for decision-making in palliative care. AIM: To systematically map pros and cons of using the Quality-Adjusted Life Year to inform decisions on resource allocation among palliative care interventions, as brought forward in the debate, and to discuss the Quality-Adjusted Life Year's value for palliative care...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28187051/kinetics-of-plasma-biomarkers-of-inflammation-and-lung-injury-in-surgical-patients-with-or-without-postoperative-pulmonary-complications
#6
Ary Serpa Neto, Pedro P Z A Campos, Sabrine N T Hemmes, Lieuwe D Bos, Thomas Bluth, Marion Ferner, Andreas Güldner, Markus W Hollmann, Inmaculada India, Thomas Kiss, Rita Laufenberg-Feldmann, Juraj Sprung, Demet Sulemanji, Carmen Unzueta, Marcos F Vidal Melo, Toby N Weingarten, Anita M Tuip-de Boer, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz
BACKGROUND: Postoperative pulmonary complications (PPCs) are common after major abdominal surgery. The kinetics of plasma biomarkers could improve identification of patients developing PPCs, but the kinetics may depend on intraoperative ventilator settings. OBJECTIVE: To test whether the kinetics of plasma biomarkers are capable of identifying patients who will develop PPCs, and whether the kinetics depend on the intraoperative level of positive end-expiratory pressure (PEEP)...
February 9, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28185039/cultural-values-can-they-explain-self-reported-health
#7
Bram Roudijk, Rogier Donders, Peep Stalmeier
PURPOSE: Self-reported health (SRH) is a measure widely used in health research and population studies. Differences in SRH have been observed between countries and cultural values have been hypothesized to partly explain such differences. Cultural values can be operationalized by two cultural dimensions using the World Values Survey (WVS), namely the traditional/rational-secular and the survival/self-expression dimension. We investigate whether there is an association between the WVS cultural dimensions and SRH, both within and between countries...
February 10, 2017: Quality of Life Research
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/28150228/personalizing-mechanical-ventilation-according-to-physiologic-parameters-to-stabilize-alveoli-and-minimize-ventilator-induced-lung-injury-vili
#9
REVIEW
Gary F Nieman, Joshua Satalin, Penny Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
It has been shown that mechanical ventilation in patients with, or at high-risk for, the development of acute respiratory distress syndrome (ARDS) can be a double-edged sword. If the mechanical breath is improperly set, it can amplify the lung injury associated with ARDS, causing a secondary ventilator-induced lung injury (VILI). Conversely, the mechanical breath can be adjusted to minimize VILI, which can reduce ARDS mortality. The current standard of care ventilation strategy to minimize VILI attempts to reduce alveolar over-distension and recruitment-derecruitment (R/D) by lowering tidal volume (Vt) to 6 cc/kg combined with adjusting positive-end expiratory pressure (PEEP) based on a sliding scale directed by changes in oxygenation...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28149559/a-bench-evaluation-of-fraction-of-oxygen-in-air-delivery-and-tidal-volume-accuracy-in-home-care-ventilators-available-for-hospital-use
#10
Loredana Baboi, Fabien Subtil, Claude Guérin
BACKGROUND: Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). METHODS: We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000)...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28146639/fifty-years-of-research-in-ards-setting-positive-end-expiratory-pressure-in-the-acute-respiratory-distress-syndrome
#11
Sarina K Sahetya, Ewan C Goligher, Roy G Brower
Positive end-expiratory pressure (PEEP) has been utilized during mechanical ventilation since the first description of the acute respiratory distress syndrome (ARDS). In the subsequent decades, many different strategies for optimally titrating PEEP have been proposed. Higher PEEP can improve arterial oxygenation, reduce tidal lung stress and strain, and promote more homogenous ventilation by preventing alveolar collapse at end expiration. However, PEEP may also cause circulatory depression and contribute to ventilator-induced lung injury through alveolar overdistention...
February 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28145966/comparison-of-the-effects-of-different-positive-end-expiratory-pressure-levels-on-cerebral-oxygen-saturation-with-near-infrared-spectroscopy-during-laparoscopic-cholecystectomy
#12
Mehmet Sargin, Mehmet Selçuk Uluer, Sadik Özmen
PURPOSE: Although positive end-expiratory pressure (PEEP) is commonly used to improve respiratory mechanics and oxygenation during pneumoperitoneum (PP), the effect of PEEP on cerebral homeostasis during carbon dioxide PP remains uncertain. This study investigated the changes in regional cerebral oxygen saturation (rSO2) associated with 0, 5, and 10 cm H2O PEEP during PP while undergoing laparoscopic cholecystectomy under sevoflurane anesthesia. MATERIALS AND METHODS: In total, 105 patients between the ages of 18 to 60 years, scheduled to undergo laparoscopic cholecystectomy under general anesthesia, were studied...
February 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28142154/a-quality-improvement-initiative-to-reduce-the-need-for-mechanical-ventilation-in-extremely-low-gestational-age-neonates
#13
Ludivine Templin, Camille Grosse, Virginie Andres, Clotilde Des Robert, Laurence Fayol, Umberto Simeoni, Farid Boubred
Objective Limiting early intubation and mechanical ventilation in extremely low gestational age neonates (ELGAN) may decrease neonatal morbidity and mortality. The aim of our study was to demonstrate the feasibility, efficacy, and tolerability of a delivery room respiratory management protocol, including delayed umbilical cord clamping (DUCC) in combination with optimized nCPAP with high PEEP levels and less invasive surfactant administration (LISA). Study Design This cohort quality improvement study analyzed the respiratory and neonatal outcomes of all consecutive infants born between 24(+0) and 26(+6) weeks' gestation before (period 1, n = 40) and after (period 2, n = 52) implementing the new protocol...
January 31, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/28137269/a-diaphragmatic-electrical-activity-based-optimization-strategy-during-pressure-support-ventilation-improves-synchronization-but-does-not-impact-work-of-breathing
#14
Francois Beloncle, Lise Piquilloud, Nuttapol Rittayamai, Christer Sinderby, Hadrien Rozé, Laurent Brochard
BACKGROUND: Poor patient-ventilator synchronization is often observed during pressure support ventilation (PSV) and has been associated with prolonged duration of mechanical ventilation and poor outcome. Diaphragmatic electrical activity (Eadi) recorded using specialized nasogastric tubes is a surrogate of respiratory brain stem output. This study aimed at testing whether adapting ventilator settings during PSV using a protocolized Eadi-based optimization strategy, or Eadi-triggered and -cycled assisted pressure ventilation (or PSVN) could (1) improve patient-ventilator interaction and (2) reduce or normalize patient respiratory effort as estimated by the work of breathing (WOB) and the pressure time product (PTP)...
January 31, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28125527/an-open-lung-strategy-in-the-management-of-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#15
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/28118641/effects-of-breathing-and-apnoea-during-sustained-inflations-in-resuscitation-of-preterm-infants
#16
Gianluca Lista, Francesco Cavigioli, Paola Azzurra La Verde, Francesca Castoldi, Ilia Bresesti, Colin J Morley
BACKGROUND: A sustained inflation (SI) at birth in preterm babies may be ineffective unless the infants breathe. Gain in lung volume is associated with breathing during delivery room non-invasive management. OBJECTIVE: To describe the breathing patterns of preterm infants during an SI and correlate to a calculated gain in lung volume. METHODS: Retrospective observational study. Data collected from a respiratory function monitor during SI (25 cmH2O for 15 s then PEEP at 5 cmH2O) through a face mask in preterm infants (gestational age [GA] ≤31 weeks)...
January 25, 2017: Neonatology
https://www.readbyqxmd.com/read/28107408/effect-of-positive-end-expiratory-pressure-on-the-sonographic-optic-nerve-sheath-diameter-as-a-surrogate-for-intracranial-pressure-during-robot-assisted-laparoscopic-prostatectomy-a-randomized-controlled-trial
#17
Ji-Hyun Chin, Wook-Jong Kim, Joonho Lee, Yun A Han, Jinwook Lim, Jai-Hyun Hwang, Seong-Sik Cho, Young-Kug Kim
BACKGROUND: Positive end-expiratory pressure (PEEP) can increase intracranial pressure. Pneumoperitoneum and the Trendelenburg position are associated with an increased intracranial pressure. We investigated whether PEEP ventilation could additionally influence the sonographic optic nerve sheath diameter as a surrogate for intracranial pressure during pneumoperitoneum combined with the Trendelenburg position in patients undergoing robot-assisted laparoscopic prostatectomy. METHODS: After anesthetic induction, 38 patients were randomly allocated to a low tidal volume ventilation (8 ml/kg) without PEEP group (zero end-expiratory pressure [ZEEP] group, n = 19) or low tidal volume ventilation with 8 cmH2O PEEP group (PEEP group, n = 19)...
2017: PloS One
https://www.readbyqxmd.com/read/28103448/bedside-contribution-of-electrical-impedance-tomography-to-set-positive-end-expiratory-pressure-for-ecmo-treated-severe-ards-patients
#18
Guillaume Franchineau, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Charles-Edouard Luyt, Alain Combes, Matthieu Schmidt
RATIONALE: Optimal positive end-expiratory pressure (PEEP) is unknown in severe acute respiratory distress syndrome (ARDS) patients on extracorporeal membrane oxygenation (ECMO) receiving mechanical ventilation with very low tidal volume. OBJECTIVES: To evaluate electrical impedance tomography's (EIT) ability to monitor a PEEP trial and to derive from EIT the best compromise PEEP in this setting. METHODS: A decremental PEEP trial (20-0 cmH2O) in 5 cmH2O steps was monitored by EIT, with lung images divided into four ventral-to-dorsal horizontal regions of interest...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28100723/a-respiratory-gated-micro-ct-comparison-of-respiratory-patterns-in-free-breathing-and-mechanically-ventilated-rats
#19
Nancy L Ford, Lynda McCaig, Andrew Jeklin, James F Lewis, Ruud A W Veldhuizen, David W Holdsworth, Maria Drangova
In this study, we aim to quantify the differences in lung metrics measured in free-breathing and mechanically ventilated rodents using respiratory-gated micro-computed tomography. Healthy male Sprague-Dawley rats were anesthetized with ketamine/xylazine and scanned with a retrospective respiratory gating protocol on a GE Locus Ultra micro-CT scanner. Each animal was scanned while free-breathing, then intubated and mechanically ventilated (MV) and rescanned with a standard ventilation protocol (56 bpm, 8 mL/kg and PEEP of 5 cm H2O) and again with a ventilation protocol that approximates the free-breathing parameters (88 bpm, 2...
January 2017: Physiological Reports
https://www.readbyqxmd.com/read/28100526/comparison-of-different-techniques-of-central-venous-pressure-measurement-in-mechanically-ventilated-critically-ill-patients
#20
C Roger, L Muller, B Riou, N Molinari, B Louart, H Kerbrat, J-L Teboul, J-Y Lefrant
BACKGROUND: Several techniques exist for measuring central venous pressure (CVP) but little information is available about the accuracy of each method. The aim of this study was to compare different methods of CVP measurements in mechanically ventilated patients. METHODS: CVP was measured in mechanically ventilated patients without spontaneous breathing using four different techniques: 1) end expiratory CVP measurement at the base of the" c" wave (CVPMEASURED), chosen as the reference method; 2) CVP measurement from the monitor averaging CVP over the cardiac and respiratory cycles (CVPMONITOR); 3) CVP measurement after a transient withdrawing of mechanical ventilation (CVPNADIR); 4) CVP measurement corrected for the transmitted respiratory pressure induced by intrinsic PEEP (calculated CVP: CVPCALCULATED)...
February 2017: British Journal of Anaesthesia
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