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Pressure support ventilation

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https://www.readbyqxmd.com/read/28327493/noninvasive-ventilation-open-issues-for-nursing-research
#1
Stefano Bambi, Enrica Mati, Christian De Felippis, Alberto Lucchini
According to the current literature, Noninvasive Ventilation (NIV) is a well-recognized respiratory support technique for patients affected by Acute Respiratory Failure (ARF). As highlighted by recent meta-analysis, a tight adherence to protocols regarding patients' selection criteria, relative or absolute contraindications, plus highly skilled and experienced operators, can positively affect the NIV performance and mortality rates. Positive outcome from NIV respiratory support is dependent from: patient's clinical condition and education needs; confidence of the staff with NIV technology; choice and management of the most suitable interface available prevention of interface complications; nutritional assessment (artificial feeding if required) and conditioning of medical gas...
March 14, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#2
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28314671/a-case-of-pulmonary-hypertension-due-to-fistulas-between-multiple-systemic-arteries-and-the-right-pulmonary-artery-in-an-adult-discovered-for-occulted-dyspnoea
#3
Ji-Feng Li, Zhen-Guo Zhai, Tu-Guang Kuang, Min Liu, Zhan-Hong Ma, Yi-Dan Li, Yuan-Hua Yang
BACKGROUND: Pulmonary hypertension (PH) can be caused by a fistula between the systemic and pulmonary arteries. Here, we report a case of PH due to multiple fistulas between systemic arteries and the right pulmonary artery where the ventilation/perfusion scan showed no perfusion in the right lung. METHODS: A 32-year-old male patient was hospitalised for community-acquired pneumonia. After treatment with antibiotics, the pneumonia was alleviated but dyspnoea persisted...
February 22, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28292482/cost-savings-from-reduced-hospitalizations-with-use-of-home-noninvasive-ventilation-for-copd
#4
Steven Coughlin, Fred W Peyerl, Sibyl H Munson, Aditi J Ravindranath, Teofilo L Lee-Chiong
BACKGROUND: Although evidence suggests significant clinical benefits of home noninvasive ventilation (NIV) for management of severe chronic obstructive pulmonary disease (COPD), economic analyses supporting the use of this technology are lacking. OBJECTIVES: To evaluate the economic impact of adopting home NIV, as part of a multifaceted intervention program, for severe COPD. METHODS: An economic model was developed to calculate savings associated with the use of Advanced NIV (averaged volume assured pressure support with autoexpiratory positive airway pressure; Trilogy100, Philips Respironics, Inc...
March 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28290962/the-application-of-biphasic-extrathoracic-cuirass-assisted-ventilation-in-normal-subjects-wearing-chemical-biological-radiological-nuclear-cbrn-gas-masks
#5
Ilan Gur, Arik Eisenkraft, Ephraim Bar-Yishay
OBJECTIVE: Mobile RTX (MRTX), a portable light-weighted ventilator, provides noninvasive respiratory support using biphasic extrathoracic cuirass-assisted ventilation. Despite the effectiveness of chemical-biological-radiological-nuclear (CBRN) gas masks, they cause respiratory loading as a result of added dead space and resistance. This prospective comparative pilot study was conducted to investigate the safety and efficacy of assisted ventilation provided by MRTX in healthy adult volunteers wearing CBRN gas masks at rest...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28283699/opening-pressures-and-atelectrauma-in-acute-respiratory-distress-syndrome
#6
Massimo Cressoni, Davide Chiumello, Ilaria Algieri, Matteo Brioni, Chiara Chiurazzi, Andrea Colombo, Angelo Colombo, Francesco Crimella, Mariateresa Guanziroli, Ivan Tomic, Tommaso Tonetti, Giordano Luca Vergani, Eleonora Carlesso, Vladimir Gasparovic, Luciano Gattinoni
PURPOSE: Open lung strategy during ARDS aims to decrease the ventilator-induced lung injury by minimizing the atelectrauma and stress/strain maldistribution. We aim to assess how much of the lung is opened and kept open within the limits of mechanical ventilation considered safe (i.e., plateau pressure 30 cmH2O, PEEP 15 cmH2O). METHODS: Prospective study from two university hospitals. Thirty-three ARDS patients (5 mild, 10 moderate, 9 severe without extracorporeal support, ECMO, and 9 severe with it) underwent two low-dose end-expiratory CT scans at PEEP 5 and 15 cmH2O and four end-inspiratory CT scans (from 19 to 40 cmH2O)...
March 10, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28277372/one-hit-models-of-ventilator-induced-lung-injury-benign-inflammation-versus-inflammation-as-a-by-product
#7
Dennis Lex, Stefan Uhlig
BACKGROUND: One important explanation for the detrimental effects of conventional mechanical ventilation is the biotrauma hypothesis that ventilation may trigger proinflammatory responses that subsequently cause lung injury. This hypothesis has frequently been studied in so-called one-hit models (overventilation of healthy lungs) that so far have failed to establish an unequivocal link between inflammation and hypoxemic lung failure. This study was designed to develop a one-hit biotrauma model...
March 9, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28275225/low-flow-veno-venous-extracorporeal-co2-removal-for-acute-hypercapnic-respiratory-failure
#8
Matthias P Hilty, Thomas Riva, Silvia R Cottini, Eva-Maria Kleinert, Alessandra Maggiorini, Marco Maggiorini
BACKGROUND: Ventilation with low tidal volume and airway pressure results in a survival benefit in ARDS patients. Previous research suggests that avoiding mechanical ventilation altogether may be beneficial in some cases of respiratory failure. Our hypothesis was that low flow veno-venous extracorporeal CO2 removal (ECCO2R) enables maintenance of a lung protective ventilation strategy or awake spontaneous ventilation despite severe hypercapnic respiratory failure (HRF). METHODS: Twenty patients with HRF were investigated while mechanically ventilated (n=14) or breathing spontaneously close to respiratory exhaustion (n=6)...
March 8, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28273238/evaluation-of-self-perception-of-mechanical-ventilation-knowledge-among-brazilian-final-year-medical-students-residents-and-emergency-physicians
#9
Fernando Sabia Tallo, Simone de Campos Vieira Abib, Alexandre Jorgi de Andrade Negri, Paulo Cesar, Renato Delascio Lopes, Antônio Carlos Lopes
OBJECTIVE: To present self-assessments of knowledge about mechanical ventilation made by final-year medical students, residents, and physicians taking qualifying courses at the Brazilian Society of Internal Medicine who work in urgent and emergency settings. METHODS: A 34-item questionnaire comprising different areas of knowledge and training in mechanical ventilation was given to 806 medical students, residents, and participants in qualifying courses at 11 medical schools in Brazil...
February 1, 2017: Clinics
https://www.readbyqxmd.com/read/28270888/how-mechanical-ventilation-measurement-cutoff-and-duration-affect-rapid-shallow-breathing-index-accuracy-a-randomized-trial
#10
Elaine Cristina Goncalves, Alessandra Fabiane Lago, Elaine Caetano Silva, Marcelo Barros de Almeida, Anibal Basile-Filho, Ada Clarice Gastaldi
BACKGROUND: Decreased accuracy of the rapid shallow breathing index (RSBI) can stem from 1) the method used to obtain this index, 2) duration of mechanical ventilation (MV), and 3) the established cutoff point. The objective was to evaluate the values of RSBI determined by three different methods, using distinct MV times and cutoff points. METHODS: This prospective study included 40 subjects. Before extubation, three different methods were employed to measure RSBI: pressure support ventilator (PSV) (PSV = 5 - 8 cm H2O; positive end-expiratory pressure (PEEP) = 5 cm H2O) (RSBI_MIN), automatic tube compensation (ATC) (PSV = 0, PEEP = 5 cm H2O, and 100% tube compensation) (RSBI_ATC), and disconnected MV (RSBI_SP)...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28269235/patient-emulator-a-tool-for-testing-mechanical-ventilation-therapies
#11
Nikolaos Karamolegkos, Antonio Albanese, Fernando Isaza, Nicolas W Chbat
Several modes of mechanical ventilation are clinically available. The differences among them in terms of efficacy and patient outcomes are not clear yet. Testing and comparison of mechanical ventilation modes via human or animal trials is a very challenging and costly process. In this paper, we present the patient emulator (PE), a novel system that can be used as a platform for in-silico testing of mechanical ventilation therapies. The system is based on a large-scale integrated mathematical model of the human cardiopulmonary system interfaced with a physical ventilator via a controlled piston-cylinder actuator...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28267272/effect-of-ventilator-mode-on-patient-ventilator-synchrony-and-work-of-breathing-in-neonatal-pigs
#12
Shayna M Wood, Tracy L Thurman, Shirley J Holt, Shasha Bai, Mark J Heulitt, Sherry E Courtney
BACKGROUND: Patient-ventilator asynchrony can result in increased work of breathing (WOB) and need for increased sedation, as well as respiratory muscle fatigue and prolonged mechanical ventilation. Different ventilator modes may result in varying degrees of asynchrony and WOB. OBJECTIVE: The objectives of this study were to assess the incidence of asynchrony and the effect of asynchrony on WOB in three modes of ventilation: pressure regulated volume control (PRVC), synchronized intermittent mandatory ventilation/volume control plus pressure support (SIMV/VC plus PS), and SIMV/PRVC plus PS...
March 7, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#13
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28252534/extracorporeal-membrane-oxygenation-for-adult-community-acquired-pneumonia-outcomes-and-predictors-of-mortality
#14
Kollengode Ramanathan, Chuen Seng Tan, Peter Rycus, Graeme Maclaren
OBJECTIVES: Extracorporeal membrane oxygenation is a rescue therapy used to support severe cardiorespiratory failure. Data on outcomes from severe community-acquired pneumonia in adults receiving rescue extracorporeal membrane oxygenation are mainly confined to single-center experiences or specific pathogens. We examined data from the Extracorporeal Life Support Organisation registry to identify risk factors for poor outcomes in adult patients with community-acquired pneumonia. DESIGN: Retrospective data analysis...
March 1, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28251431/48%C3%A2-h-cessation-of-mechanical-ventilation-during-venovenous-extracorporeal-membrane-oxygenation-in-severe-trauma-a-case-report
#15
Justyna Swol, Yann Fülling, Christopher Ull, Matthias Bechtel, Thomas A Schildhauer
A 32-year-old motorcyclist who was hit by a tram subsequently presented with blunt force thoracic trauma, a pelvic fracture and a penetrating injury to the left lower extremity. Coagulopathy persisted following surgery of the leg and pelvic vascular intervention. Bedside thoracotomy was performed to treat pneumothorax and pneumopericardium. Severe hypoxemia secondary to lung failure ensued, which required venovenous extracorporeal membrane oxygenation (VV ECMO) support. On the third day after the trauma, ultra-protective mechanical ventilation was not possible due to non-existent lung compliance; thus, the ventilator was disconnected, and the T-piece was connected to the blocked tracheal tube left in the airway...
March 1, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28244292/humidified-high-flow-nasal-cannula-versus-nasal-continuous-positive-airway-pressure-as-an-initial-respiratory-support-in-preterm-infants-with-respiratory-distress-a-randomized-controlled-non-inferiority-trial
#16
Jeonghee Shin, Kyuhee Park, Eun Hee Lee, Byung Min Choi
Heated, humidified, high-flow nasal cannula (HHFNC) is frequently used as a noninvasive respiratory support for preterm infants with respiratory distress. But there are limited studies that compares HHFNC with nasal continuous positive airway pressure (nCPAP) only as the initial treatment of respiratory distress in preterm infants immediately after birth. The aim of this study is to assess the effectiveness and safety of HHFNC compared to nCPAP for the initial treatment of preterm infants with respiratory distress...
April 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28241090/plasma-exchange-for-guillain-barr%C3%A3-syndrome
#17
REVIEW
Sylvie Chevret, Richard Ac Hughes, Djillali Annane
BACKGROUND: Guillain-Barré syndrome (GBS) is an acute paralysing disease caused by peripheral nerve inflammation. This is an update of a review first published in 2001 and last updated in 2012. OBJECTIVES: To assess the effects of plasma exchange for treating GBS. SEARCH METHODS: On 18 January 2016 we searched the Cochrane Neuromuscular Specialised Register, CENTRAL, MEDLINE, and Embase. We also searched clinical trials registries. SELECTION CRITERIA: Randomised and quasi-randomised trials of plasma exchange versus sham exchange or supportive treatment, or comparing different regimens or techniques of plasma exchange...
February 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28227468/patient-emulator-a-tool-for-testing-mechanical-ventilation-therapies
#18
Nikolaos Karamolegkos, Antonio Albanese, Fernando Isaza, Nicolas W Chbat, Nikolaos Karamolegkos, Antonio Albanese, Fernando Isaza, Nicolas W Chbat, Nikolaos Karamolegkos, Antonio Albanese, Nicolas W Chbat, Fernando Isaza
Several modes of mechanical ventilation are clinically available. The differences among them in terms of efficacy and patient outcomes are not clear yet. Testing and comparison of mechanical ventilation modes via human or animal trials is a very challenging and costly process. In this paper, we present the patient emulator (PE), a novel system that can be used as a platform for in-silico testing of mechanical ventilation therapies. The system is based on a large-scale integrated mathematical model of the human cardiopulmonary system interfaced with a physical ventilator via a controlled piston-cylinder actuator...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223010/the-role-of-heated-humidified-high-flow-nasal-cannula-as-noninvasive-respiratory-support-in-neonates
#19
REVIEW
Ke-Yun Chao, Yi-Ling Chen, Li-Yi Tsai, Yu-Hsuan Chien, Shu-Chi Mu
Recently, heated humidified high-flow nasal cannula (HHHFNC) has been introduced and applied as a noninvasive respiratory support in neonates. Although HHHFNC is widely used in neonates presenting with respiratory distress, the efficiency and safety when compared with nasal continuous positive airway pressure or noninvasive positive pressure ventilation are still controversial. This review aims to evaluate the performance and applications of HHHFNC in neonates.
January 17, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28220822/pulmonary-outcomes-following-specialized-respiratory-management-for-acute-cervical-spinal-cord-injury-a-retrospective-analysis
#20
E C Zakrasek, J L Nielson, J J Kosarchuk, J D Crew, A R Ferguson, S L McKenna
STUDY DESIGN: Retrospective analysis. OBJECTIVES: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation. SETTING: United States regional spinal cord injury (SCI) treatment center. METHODS: Retrospective chart review of patients consecutively admitted to Santa Clara Valley Medical Center between May 2013 and December 2014 for ventilator weaning with C1-C5 American Spinal Injury Association Impairment Scale (AIS) A or B SCI, <3 months from injury and who had a tracheostomy in place...
February 21, 2017: Spinal Cord
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