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https://www.readbyqxmd.com/read/28542443/effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-damage-in-a-model-of-mild-extrapulmonary-acute-lung-injury-with-intra-abdominal-hypertension
#1
Cintia L Santos, Raquel S Santos, Lillian Moraes, Cynthia S Samary, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Robert Huhle, Marcelo G Abreu, Alberto Schanaider, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH...
2017: PloS One
https://www.readbyqxmd.com/read/28536282/predicting-survival-after-extracorporeal-membrane-oxygenation-for-ards-an-external-validation-of-resp-and-preserve-scores
#2
Jennifer Brunet, Xavier Valette, Dimitrios Buklas, Philippe Lehoux, Pierre Verrier, Bertrand Sauneuf, Calin Ivascau, Yves Dalibert, Amélie Seguin, Nicolas Terzi, Gérard Babatasi, Damien du Cheyron, Jean-Jacques Parienti, Cédric Daubin
BACKGROUND: We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. METHODS: All consecutive patients treated with ECMO for refractory ARDS, regardless of cause, in the Caen University Hospital in northwestern France over the last decade were included in a retrospective cohort study. The receiver operating characteristic curves of each score were plotted, and the area under the curve was computed to assess their performance in predicting mortality (c-index)...
May 23, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28535788/endexpiratory-lung-volume-measurement-correlates-with-the-ventilation-perfusion-mismatch-in-lung-injured-pigs
#3
Jens Kamuf, Andreas Garcia-Bardon, Bastian Duenges, Tanghua Liu, Antje Jahn-Eimermacher, Florian Heid, Matthias David, Erik K Hartmann
BACKGROUND: In acute respiratory respiratory distress syndrome (ARDS) a sustained mismatch of alveolar ventilation and perfusion (VA/Q) impairs the pulmonary gas exchange. Measurement of endexpiratory lung volume (EELV) by multiple breath-nitrogen washout/washin is a non-invasive, bedside technology to assess pulmonary function in mechanically ventilated patients. The present study examines the association between EELV changes and VA/Q distribution and the possibility to predict VA/Q normalization by means of EELV in a porcine model...
May 23, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28535074/synchrotron-imaging-shows-effect-of-ventilator-settings-on-intra-breath-cyclic-changes-in-pulmonary-blood-volume
#4
Liisa Porra, Ludovic Broche, Loïc Dégrugilliers, Gergely Albu, Iliona Malaspinas, Camille Doras, Mats Wallin, Magnus Hallbäck, Walid Habre, Sam Bayat
RATIONALE: Despite the importance of dynamic changes in the regional distributions of gas and blood during the breathing cycle for lung function in the mechanically ventilated patient, no quantitative data on such cyclic changes is currently available. METHODS: We used a novel gated synchrotron CT-imaging to quantitatively image regional lung gas (Vg), tissue density and blood volume (Vb) in 6 anaesthetized, paralyzed and mechanically ventilated rabbits with normal lungs...
May 23, 2017: American Journal of Respiratory Cell and Molecular Biology
https://www.readbyqxmd.com/read/28529122/shared-decision-making-a-buzz-word-in-the-netherlands-the-pace-quickens-towards-nationwide-implementation%C3%A2
#5
Trudy van der Weijden, Heleen Post, Paul L P Brand, Haske van Veenendaal, Ton Drenthen, Linda Aj van Mierlo, Peep Stalmeier, Olga C Damman, Anne Stiggelbout
Currently, shared decision making (SDM) is on the agenda among target patient representative groups, policy makers and professional bodies. Although the International Conference for Shared Decision Making (ISDM) 2011 generated a positive boost, hesitation was also felt among Dutch clinicians, who are challenged by many new tasks. No hesitation is seen among the majority of patients, opting mostly for the SDM model. We haven't reached these patients' needs fully yet, given disappointing research data on patients' experiences and professional behaviour...
May 18, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#6
Lorenzo Ball, Federico Costantino, Giulia Orefice, Karthikka Chandrapatham, Paolo Pelosi
Mechanical ventilation is a cornerstone of the intraoperative management of the surgical patient and is still mandatory in several surgical procedures. In the last decades, research focused on preventing postoperative pulmonary complications (PPCs), both improving risk stratification through the use of predictive scores and protecting the lung adopting so-called protective ventilation strategies. The aim of this review is to give an up-to-date overview of the currently suggested intraoperative ventilation strategies, along with their pathophysiologic rationale, with a focus on challenging conditions, such as obesity, one-lung ventilation and cardiopulmonary bypass...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28516320/how-does-the-presence-of-a-conspecific-individual-change-the-behavioral-game-that-a-predator-plays-with-its-prey
#7
Reut Vardi, Zvika Abramsky, Burt P Kotler, Ofir Altstein, Michael L Rosenzweig
Behavioral games predators play among themselves may have profound effects on behavioral games predators play with their prey. We studied the behavioral game between predators and prey within the framework of social foraging among predators. We tested how conspecific interactions among predators (little egret) change the predator-prey behavioral game and foraging success. To do so, we examined foraging behavior of egrets alone and in pairs (male and female) in a specially designed aviary consisting of three equally spaced pools with identical initial prey (comet goldfish) densities...
May 17, 2017: Oecologia
https://www.readbyqxmd.com/read/28512431/variable-ventilation-improved-respiratory-system-mechanics-and-ameliorated-pulmonary-damage-in-a-rat-model-of-lung-ischemia-reperfusion
#8
André Soluri-Martins, Lillian Moraes, Raquel S Santos, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Paolo Pelosi, Pedro L Silva, Marcelo Gama de Abreu, Patricia R M Rocco
Lung ischemia-reperfusion injury remains a major complication after lung transplantation. Variable ventilation (VV) has been shown to improve respiratory function and reduce pulmonary histological damage compared to protective volume-controlled ventilation (VCV) in different models of lung injury induced by endotoxin, surfactant depletion by saline lavage, and hydrochloric acid. However, no study has compared the biological impact of VV vs. VCV in lung ischemia-reperfusion injury, which has a complex pathophysiology different from that of other experimental models...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28506940/cool-ami-eu-pilot-trial-a-multicentre-prospective-randomised-controlled-trial-to-assess-cooling-as-an-adjunctive-therapy-to-percutaneous-intervention-in-patients-with-acute-myocardial-infarction
#9
Marko Noc, David Erlinge, Aleksandar N Neskovic, Srdjan Kafedzic, Béla Merkely, Endre Zima, Misa Fister, Milovan Petrović, Milenko Čanković, Gábor Veress, Peep Laanmets, Teele Pern, Vladan Vukcevic, Vladimir Dedovic, Beata Średniawa, Andrzej Świątkowski, Thomas R Keeble, John R Davies, Alexandra-Maria Warenits, Göran Olivecrona, Jan Zbigniew Peruga, Michal Ciszewski, Ivan Horvath, Istvan Edes, Gergely Gyorgy Nagy, Daniel Aradi, Michael Holzer
AIMS: We aimed to investigate the rapid induction of therapeutic hypothermia using the ZOLL Proteus Intravascular Temperature Management System in patients with anterior ST-elevation myocardial infarction (STEMI) without cardiac arrest. METHODS AND RESULTS: A total of 50 patients were randomised; 22 patients (88%; 95% confidence interval [CI]: 69-97%) in the hypothermia group and 23 patients (92%; 95% CI: 74-99) in the control group completed cardiac magnetic resonance imaging at four to six days and 30-day follow-up...
May 17, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28493943/open-lung-approach-versus-standard-protective-strategies-effects-on-driving-pressure-and-ventilatory-efficiency-during-anesthesia-a-pilot-randomized-controlled-trial
#10
Carlos Ferrando, Fernando Suarez-Sipmann, Gerardo Tusman, Irene León, Esther Romero, Estefania Gracia, Ana Mugarra, Blanca Arocas, Natividad Pozo, Marina Soro, Francisco J Belda
BACKGROUND: Low tidal volume (VT) during anesthesia minimizes lung injury but may be associated to a decrease in functional lung volume impairing lung mechanics and efficiency. Lung recruitment (RM) can restore lung volume but this may critically depend on the post-RM selected PEEP. This study was a randomized, two parallel arm, open study whose primary outcome was to compare the effects on driving pressure of adding a RM to low-VT ventilation, with or without an individualized post-RM PEEP in patients without known previous lung disease during anesthesia...
2017: PloS One
https://www.readbyqxmd.com/read/28489667/increasing-levels-of-positive-end-expiratory-pressure-improve-the-left-ventricular-strain
#11
Manuel Ruiz-Bailén, Jesús Cobo-Molinos, Ana M Castillo-Rivera, María C Iniesta-Carricondo, María D Pola Gallego de Guzmán, Antonio Cárdenas-Cruz
PURPOSE: The goal of this study was to evaluate possible changes in the left myocardial performance of patients with cardiogenic shock (CS) during ascending levels of positive end-expiratory pressure (PEEP) using speckle-tracking echocardiography. MATERIALS AND METHODS: This was an interventional clinical study performed on CS patients under mechanical ventilation. These patients underwent echocardiography after 15 to 30 minutes of progressive increases in PEEP (ZEEP, PEEP 5, PEEP 10, PEEP 15 cm H2O)...
May 9, 2017: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/28477341/inflation-pressures-and-times-during-initial-resuscitation-of-preterm-infants
#12
Prashanth Bhat, Katie Hunt, Christopher Harris, Vadivelam Murthy, Anthony D Milner, Anne Greenough
BACKGROUND: The optimal combination of inflation pressures and times to produce adequate expiratory tidal volumes during initial resuscitation in prematurely born infants has not been determined. Our aim was to assess combinations of inflation pressures and times and the resulting expiratory tidal volume levels using a respiratory function monitor. METHODS: Sixty-four infants born before 34 weeks of gestation were studied. The infants were divided according to whether the inflation pressures (PIP-PEEP) were less than or >20 cm H2 O during the first five inflations delivered by a face mask and those groups were subdivided according to whether the inflation times were less than or > 1...
May 6, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28466616/one-stage-laparoscopic-orchiopexy-for-the-treatment-of-intraabdominal-testis
#13
Jaber R Jawdat, Stanislav Kocherov, Boris Chertin
BACKGROUND: Laparoscopy has gradually become the gold standard for the treatment of non-palpable testicles (NPT), with different success and complication rates. OBJECTIVES: To evaluate outcomes of the one-stage laparoscopic orchiopexy for NPT in our department. METHODS: We retrospectively evaluated the medical files of patients who underwent laparoscopic orchidopexy with the identical technique. Only patients with at least one year follow-up were included...
November 2016: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28459409/-correlation-factor-analysis-on-constipation-in-long-term-ventilated-patients-in-intensive-care-unit-a-prospective-observational-cohort-study
#14
Mingying Dai, Huimin Wang, Kun Li, Bangxu Yu, Xinting Pan
OBJECTIVE: To explore the factors associated with delayed defecation in long-term ventilated patients in intensive care unit (ICU) and their potential effect on prognosis. METHODS: A prospective observational cohort study was conducted. The patients admitted to general ICU of the Affiliated Hospital of Qingdao University from October 1st in 2013 to September 30th in 2015 who underwent mechanical ventilation (MV) for ≥6 days were enrolled, and they were divided into early defecation group (< 6 days) and late defecation group (≥6 days)...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459403/-evaluation-value-of-oxygenation-index-of-mechanical-ventilation-on-the-prognosis-of-patients-with-ards-a-retrospective-analysis-with-228-patients
#15
Ziyi Jia, Xiaowei Liu, Zhi Liu
OBJECTIVE: To investigate the evaluation value of oxygenation index at different times of mechanical ventilation (MV) on the prognosis of patients with acute respiratory distress syndrome (ARDS). METHODS: A retrospectively analysis was conducted. A total of 228 patients with ARDS admitted to Department of Emergency of China Medical University Affiliated First Hospital from February 2014 to June 2016 were enrolled. All patients underwent MV treatment, and recruitment maneuver (RM) was performed by pressure-controlled ventilation (PCV) 30 minutes after the implementation of the protective ventilation strategy...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459402/-effect-of-different-transpulmonary-pressures-guided-mechanical-ventilation-on-respiratory-and-hemodynamics-of-patients-with-ards-a-prospective-randomized-controlled-trial
#16
Jianqiu Li, Zhihui Luo, Xiaolei Li, Zhongyi Huang, Jie Han, Zifeng Li, Zhaoxiong Zhou, Houwang Chen
OBJECTIVE: To assess the effect of different transpulmonary pressures (Ptp) guided mechanical ventilation (MV) on respiratory function and hemodynamics parameters of patients with acute respiratory distress syndrome (ARDS), and to find out a more optimized Ptp. METHODS: A prospective randomized controlled trial (RCT) was conducted. The ventilated patients with ARDS admitted to Department of Critical Care Medicine (ICU) of Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University and Department of Emergency and Critical Care Medicine (EICU) of Shenzhen Hospital of South Medical University from February 2013 to August 2016 were enrolled...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459282/use-of-nasal-high-flow-in-stable-copd-rationale-and-physiology
#17
Lara Pisani, Maria Laura Vega
High-flow nasal cannula (HFNC) is a device able to deliver heated and humidified oxygen at high flows (up to 60 L/minutes). Potential benefits of HFNC are several and include the improvement of lung mucociliary clearance, the washout of upper airway dead space, the generation of a low level of positive airway pressure (PEEP effect), the decrease in inspiratory resistance and at the same time the increase in expiratory resistance. The present review aimed to describe the evidence surrounding the use of HFNC in stable chronic obstructive pulmonary disease patients...
May 1, 2017: COPD
https://www.readbyqxmd.com/read/28457827/ventilation-distribution-assessed-with-electrical-impedance-tomography-and-the-influence-of-tidal-volume-recruitment-and-positive-end-expiratory-pressure-in-isoflurane-anesthetized-dogs
#18
Aline M Ambrosio, Tatiana P A Carvalho-Kamakura, Keila K Ida, Barbara Varela, Felipe S R M Andrade, Lara L Facó, Denise T Fantoni
OBJECTIVE: To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Fourteen client-owned bitches weighing 26 ± 7 kg undergoing elective ovariohysterectomy. METHODS: Isoflurane-anesthetized dogs in dorsal recumbency were ventilated with 0 cmH2O PEEP and pressure-controlled ventilation by adjusting the peak inspiratory pressure (PIP) to achieve a low (7 mL kg(-1); n = 7) or a high (12 mL kg(-1); n = 7) VT...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28454590/protective-intraoperative-ventilation-with-higher-versus-lower-levels-of-positive-end-expiratory-pressure-in-obese-patients-probese-study-protocol-for-a-randomized-controlled-trial
#19
T Bluth, R Teichmann, T Kiss, I Bobek, J Canet, G Cinnella, L De Baerdemaeker, C Gregoretti, G Hedenstierna, S N Hemmes, M Hiesmayr, M W Hollmann, S Jaber, J G Laffey, M J Licker, K Markstaller, I Matot, G Müller, G H Mills, J P Mulier, C Putensen, R Rossaint, J Schmitt, M Senturk, A Serpa Neto, P Severgnini, J Sprung, M F Vidal Melo, H Wrigge, M J Schultz, P Pelosi, M Gama de Abreu
BACKGROUND: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients...
April 28, 2017: Trials
https://www.readbyqxmd.com/read/28442633/positive-end-expiratory-pressure-effect-of-3-high-flow-nasal-cannula-devices
#20
Jing-Chao Luo, Mei-Shan Lu, Zhi-Hong Zhao, Wei Jiang, Biao Xu, Li Weng, Tong Li, Bin Du
BACKGROUND: High-flow nasal cannula (HFNC) is supposed to provide additional PEEP compared with conventional oxygen therapy. However, the exact determinants of this PEEP effect are unclear. We investigated the factors that might affect the PEEP and compared PEEP performance among 3 HFNC devices. METHODS: Three available HFNC devices were evaluated: the AIRVO 2 device and 2 mechanical ventilators (SV300 and Monnal T75). A device consisting of a test lung (5600i) and an airway model (AMT(IE)) was used to simulate spontaneous breathing...
April 25, 2017: Respiratory Care
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