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https://www.readbyqxmd.com/read/29746613/aging-effects-on-alveolar-sacs-under-mechanical-ventilation
#1
Parya Aghasafari, Rebeca L Heise, Angela Reynolds, Ramana Pidaparti
Alveolar sacs are primarily responsible for gas exchange in the human respiratory system and lose their functionality with aging. Three-dimensional (3D) models of young and old human alveolar sacs were constructed and fluid-solid interaction (FSI) was employed to investigate the contribution of age-related changes to decline in alveolar sacs function under mechanical ventilation (MV). Simulations results illustrated that compliance and pressure reduced in the alveolar sacs of the elderly, and they have to work harder to breathe...
May 9, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29746270/evidence-regarding-the-use-of-bubble-continuous-positive-airway-pressure-in-the-extremely-low-birth-weight-infant-benefits-challenges-and-implications-for-nursing-practice
#2
Samantha Alessi
BACKGROUND: Gentle ventilation with optimal oxygenation is integral to prevention of chronic lung disease in the extremely low birth-weight (ELBW) infant. Various types of noninvasive ventilation are used in neonatal intensive care units worldwide. Bubble continuous positive airway pressure (BCPAP) has been in use in newborn intensive care since 1975. PURPOSE: To synthesize the current evidence on the use of BCPAP in the ELBW infant and its relationship to outcomes, particularly morbidity and mortality...
May 9, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29744563/diagnostic-workup-etiologies-and-management-of-acute-right-ventricle-failure-a-state-of-the-art-paper
#3
REVIEW
Antoine Vieillard-Baron, R Naeije, F Haddad, H J Bogaard, T M Bull, N Fletcher, T Lahm, S Magder, S Orde, G Schmidt, M R Pinsky
INTRODUCTION: This is a state-of-the-art article of the diagnostic process, etiologies and management of acute right ventricular (RV) failure in critically ill patients. It is based on a large review of previously published articles in the field, as well as the expertise of the authors. RESULTS: The authors propose the ten key points and directions for future research in the field. RV failure (RVF) is frequent in the ICU, magnified by the frequent need for positive pressure ventilation...
May 9, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29744245/reliability-of-passive-leg-raising-stroke-volume-variation-and-pulse-pressure-variation-to-predict-fluid-responsiveness-during-weaning-from-mechanical-ventilation-after-cardiac-surgery-a-prospective-observational-study
#4
Christoph Karl Hofer, Martin Geisen, Sonja Hartnack, Omer Dzemali, Michael Thomas Ganter, Andreas Zollinger
Objective: During assisted ventilation and spontaneous breathing, functional haemodynamic parameters, including stroke volume variation (SVV) and pulse pressure variation (PPV), are of limited value to predict fluid responsiveness, and the passive leg raising (PLR) manoeuvre has been advocated as a surrogate method. We aimed to study the predictive value of SVV, PPV and PLR for fluid responsiveness during weaning from mechanical ventilation after cardiac surgery. Methods: Haemodynamic variables and fluid responsiveness were assessed in 34 patients...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29743774/indolent-systemic-mastocytosis-manifesting-as-protracted-anaphylactic-shock
#5
Manidipam Chatterjee, Saikat Sengupta, Chandrashish Chakravarty, Suresh Ramasubban, Shilpa Bhartia, Sujoy Khan, Vikash Kumar Agarwal
Systemic mastocytosis is a rare disease due to abnormal proliferation of mast cells (MCs). A case of indolent systemic mastocytosis is presented here. After anesthetic induction for elective thyroid swelling with propofol and atracurium followed by endotracheal intubation, a 57-year-old female patient developed acute hypotension, sinus tachycardia, red rashes, increased airway pressure along with difficult ventilation, and desaturation. She developed multiorgan failure subsequently. MC tryptase level was persistently high...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742448/linking-lung-function-to-structural-damage-of-alveolar-epithelium-in-ventilator-induced-lung-injury
#6
Katharine L Hamlington, Bradford J Smith, Celia M Dunn, Chantel M Charlebois, Gregory S Roy, Jason H T Bates
Understanding how the mechanisms of ventilator-induced lung injury (VILI), namely atelectrauma and volutrauma, contribute to the failure of the blood-gas barrier and subsequent intrusion of edematous fluid into the airspace is essential for the design of mechanical ventilation strategies that minimize VILI. We ventilated mice with different combinations of tidal volume and positive end-expiratory pressure (PEEP) and linked degradation in lung function measurements to injury of the alveolar epithelium observed via scanning electron microscopy...
May 6, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29739430/relax-restricted-versus-liberal-positive-end-expiratory-pressure-in-patients-without-ards-protocol-for-a-randomized-controlled-trial
#7
Anna Geke Algera, Luigi Pisani, Dennis C J Bergmans, Sylvia den Boer, Corianne A J de Borgie, Frank H Bosch, Karina Bruin, Thomas G Cherpanath, Rogier M Determann, Arjen M Dondorp, Dave A Dongelmans, Henrik Endeman, Jasper J Haringman, Janneke Horn, Nicole P Juffermans, David M van Meenen, Nardo J van der Meer, Maruschka P Merkus, Hazra S Moeniralam, Ilse Purmer, Pieter Roel Tuinman, Mathilde Slabbekoorn, Peter E Spronk, Alexander P J Vlaar, Marcelo Gama de Abreu, Paolo Pelosi, Ary Serpa Neto, Marcus J Schultz, Frederique Paulus
BACKGROUND: Evidence for benefit of high positive end-expiratory pressure (PEEP) is largely lacking for invasively ventilated, critically ill patients with uninjured lungs. We hypothesize that ventilation with low PEEP is noninferior to ventilation with high PEEP with regard to the number of ventilator-free days and being alive at day 28 in this population.  METHODS/DESIGN: The "REstricted versus Liberal positive end-expiratory pressure in patients without ARDS" trial (RELAx) is a national, multicenter, randomized controlled, noninferiority trial in adult intensive care unit (ICU) patients with uninjured lungs who are expected not to be extubated within 24 h...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#8
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#9
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29705089/effective-ventilation-the-most-critical-intervention-for-successful-delivery-room-resuscitation
#10
REVIEW
Elizabeth E Foglia, Arjan B Te Pas
Lung aeration is the critical first step that triggers the transition from fetal to postnatal cardiopulmonary physiology after birth. When an infant is apneic or does not breathe sufficiently, intervention is needed to support this transition. Effective ventilation is therefore the cornerstone of neonatal resuscitation. In this article, we review the physiology of cardiopulmonary transition at birth, with particular attention to factors the caregiver should consider when providing ventilation. We then summarize the available clinical evidence for strategies to monitor and perform positive pressure ventilation in the delivery room setting...
April 17, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29702725/effects-of-the-kv7-voltage-activated-potassium-channel-inhibitor-linopirdine-in-rat-models-of-hemorrhagic-shock
#11
Sean P Nassoiy, Favin S Babu, Heather M LaPorte, Kenneth L Byron, Matthias Majetschak
Recently, we demonstrated that Kv7 voltage-activated potassium channel inhibitors reduce fluid resuscitation requirements in short-term rat models of hemorrhagic shock. The aim of the present study was to further delineate the therapeutic potential and side effect profile of the Kv7 channel blocker linopirdine in various rat models of severe hemorrhagic shock over clinically relevant time periods. Intravenous administration of linopirdine, either before (1 or 3 mg/kg) or after (3 mg/kg) a 40% blood volume hemorrhage, did not affect blood pressure and survival in lethal hemorrhage models without fluid resuscitation...
April 27, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29702222/pressure-support-ventilation-vs-continuous-positive-airway-pressure-for-treating-of-acute-cardiogenic-pulmonary-edema-a-pilot-study
#12
Antonio Pagano, Fabio G Numis, Valerio Rosato, Teresa Russo, Giovanni Porta, Giorgio Bosso, Claudia Serra, Mario Masarone, Giuseppe Visone, Fiorella Paladino
Non-invasive ventilation is usually adopted as a support to medical therapy in patients with acute pulmonary edema, but which modality between Pressure Support Ventilation (PSV) and Continuous Positive Airway Pressure (CPAP) has better favourable effects is not been yet well known. Aim of this observational study was to provide data on these different non-invasive ventilation modalities in the management of acute cardiogenic pulmonary edema. One-hundred-fifty-three patients consecutively admitted to the Emergency Room of two different Center were enrolled and randomly assigned to CPAP or PSV...
April 24, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29700664/halving-the-volume-of-anaconda-initial-clinical-experience-with-a-new-small-volume-anaesthetic-reflector-in-critically-ill-patients-a-quality-improvement-project
#13
Hagen Bomberg, Franziska Meiser, Sarah Zimmer, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
AnaConDa-100 ml (ACD-100, Sedana Medical, Uppsala, Sweden) is well established for inhalation sedation in the intensive care unit. But because of its large dead space, the system can retain carbon dioxide (CO2 ) and increase ventilatory demands. We therefore evaluated whether AnaConDa-50 ml (ACD-50), a device with half the internal volume, reduces CO2 retention and ventilatory demands during sedation of invasively ventilated, critically ill patients. Ten patients participated in this cross-over protocol. After sedation with isoflurane via ACD-100 for 24 h, the 5-h observation period started...
April 26, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29689088/electrocardiogram-synchronized-pulsatile-extracorporeal-life-support-preserves-left-ventricular-function-and-coronary-flow-in-a-porcine-model-of-cardiogenic-shock
#14
Petr Ostadal, Mikulas Mlcek, Holger Gorhan, Ivo Simundic, Svitlana Strunina, Matej Hrachovina, Andreas Krüger, Dagmar Vondrakova, Marek Janotka, Pavel Hala, Martin Mates, Martin Ostadal, James C Leiter, Otomar Kittnar, Petr Neuzil
INTRODUCTION: Veno-arterial extracorporeal life support (ECLS) is increasingly being used to treat rapidly progressing or severe cardiogenic shock. However, it has been repeatedly shown that increased afterload associated with ECLS significantly diminishes left ventricular (LV) performance. The objective of the present study was to compare LV function and coronary flow during standard continuous-flow ECLS support and electrocardiogram (ECG)-synchronized pulsatile ECLS flow in a porcine model of cardiogenic shock...
2018: PloS One
https://www.readbyqxmd.com/read/29687659/effectiveness-and-safety-of-nasal-mask-versus-binasal-prongs-for-providing-continuous-positive-airway-pressure-in-preterm-infants-a-systematic-review-and-meta-analysis
#15
REVIEW
Bonny Jasani, Abu Ismail, Shripada Rao, Sanjay Patole
Continuous positive airway pressure (CPAP) delivered via binasal prongs has been the cornerstone of respiratory management in preterm infants. Though effective, the use of binasal prongs is associated with nasal trauma, and CPAP failure. To overcome these issues, nasal masks are increasingly used to deliver CPAP in preterm infants. The aim was to conduct a systematic review of randomized controlled trials (RCTs) comparing nasal mask versus binasal prongs to deliver CPAP in preterm infants. Medline, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing, and Allied Health Literature, and E-abstracts from the Pediatric Academic Society meetings were searched in May 2017...
April 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29683055/high-frequency-percussive-ventilation-rescue-therapy-in-morbidly-obese-patients-failing-conventional-mechanical-ventilation
#16
Anatoliy Korzhuk, Ashwad Afzal, Ivan Wong, Felix Khusid, Berhane Worku, Iosif Gulkarov
BACKGROUND: Morbidly obese patients with respiratory failure who do not improve on conventional mechanical ventilation (CMV) often undergo rescue therapy with extracorporeal membrane oxygenation (ECMO). We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue modality. METHODS: In a retrospective analysis from 2009 to 2016, 12 morbidly obese patients underwent HFPV after failing to wean from CMV. Data were collected regarding demographics, cause of respiratory failure, ventilation settings, and hospital course outcomes...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29679387/the-pharmacokinetics-and-pharmacodynamics-of-carfentanil-after-recreational-exposure-a-case-report
#17
Uvaraj Uddayasankar, Colin Lee, Curtis Oleschuk, Gregg Eschun, Robert E Ariano
Carfentanil and related fentanyl analogues have been linked to a number of overdose deaths from drug users in several cities across North America. Diagnosis of carfentanil exposure requires a very high index of clinical suspicion, especially because available laboratory narcotic screens do not detect this agent. We describe a 34-year-old male admitted with depressed level of consciousness and in respiratory failure after recreational exposure to a white powder later inferred to contain carfentanil. Urine and whole blood samples were obtained for conventional preliminary drug screen immunoassays for unknown exposures; in addition to utilizing high pressure liquid chromatography tandem mass spectrometry assay for quantification of carfentanil and its metabolite...
April 20, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29667019/what-is-new-in-heart-failure-management-in-2017-update-on-acc-aha-heart-failure-guidelines
#18
REVIEW
Biykem Bozkurt
PURPOSE OF REVIEW: The goal of this paper is to provide a summary of the new recommendations in the most recent 2017 ACC/AHA/HFSA Focused Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure Society of America. The intent is to provide the background and the supporting evidence for the recommendations and to provide practical guidance for management strategies in treatment of heart failure patients...
April 17, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29658860/pressure-support-breaths-triggered-by-total-artificial-heart-in-invasive-and-non-invasive-mechanical-ventilation
#19
Amit Prasad, Kai Singbartl, Behzad Soleimani, Christoph Brehm, Ali Ghodsizad
Because of the risks associated with extended mechanical ventilation, it is desirable to extubate patients as early as possible. However, weaning patients from mechanical ventilation too early has risks associated with it as well. Thus, it is important to note that in the two cases presented here, pressure-supported breaths were falsely triggered by a patient's a Syncardia® total artificial heart (TAH), influencing decisions about weaning the patient from mechanical ventilation.
March 2, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29657372/targeted-interventions-in-critically-ill-children-with-severe-dengue
#20
Suchitra Ranjit, Gokul Ramanathan, Balasubramaniam Ramakrishnan, Niranjan Kissoon
Background: The World Health Organization guidelines provide suggestions on early recognition and treatment of severe dengue (SD); however, mortality in this group can be high and is related both to disease severity and the treatment complications. Subjects and Methods: In this prospective observational study, we report our results where standard therapy (ST) was enhanced by Intensive Care Unit (ICU) supportive measures that have proven beneficial in other conditions that share similar pathophysiology of capillary leak and fluid overload...
March 2018: Indian Journal of Critical Care Medicine
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