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Pressure support ventilation

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https://www.readbyqxmd.com/read/28528537/intraoperative-mechanical-ventilation-state-of-the-art
#1
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/28526862/significant-clinical-factors-associated-with-long-term-mortality-in-critical-cancer-patients-requiring-prolonged-mechanical-ventilation
#2
Li-Ta Keng, Kuei-Pin Chung, Shu-Yung Lin, Sheng-Kai Liang, Jui-Chen Cheng, I-Chun Chen, Yen-Fu Chen, Hou-Tai Chang, Chia-Lin Hsu, Jih-Shuin Jerng, Hao-Chien Wang, Ping-Hung Kuo, Huey-Dong Wu, Jin-Yuan Shih, Chong-Jen Yu
Studies about prognostic assessment in cancer patients requiring prolonged mechanical ventilation (PMV) for post-intensive care are scarce. We retrospectively enrolled 112 cancer patients requiring PMV support who were admitted to the respiratory care center (RCC), a specialized post-intensive care weaning facility, from November 2009 through September 2013. The weaning success rate was 44.6%, and mortality rates at hospital discharge and after 1 year were 43.8% and 76.9%, respectively. Multivariate logistic regression showed that weaning failure, in addition to underlying cancer status, was significantly associated with an increased 1-year mortality (odds ratio, 6...
May 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#3
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28522369/electroencephalographic-monitoring-during-sevoflurane-anaesthesia-in-an-amyotrophic-lateral-sclerosis-patient-with-locked-in-state
#4
Kazuko Hayashi, Ryuhei Araki, Akiko Tanaka
Recently, the cognitive abilities of patients with amyotrophic lateral sclerosis (ALS) have been found to be impaired along with the neurodegeneration of motor neurons. Electroencephalography (EEG) of end-stage ALS patients has reportedly shown specific features based on neuronal network modulations, differing from EEG of other patients with cognitive failure and dementia. However, EEG of end-stage ALS patients during anaesthesia has not yet been reported. A 64-year-old male ALS patient with locked-in state (LIS), supported by tracheostomy positive-pressure ventilation (TPPV) and enteral nourishment for 9years, underwent scheduled general anaesthesia for repair of a fractured mandible...
May 15, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28520106/prophylactic-sustained-inflation-is-just-one-step-to-preventing-bronchopulmonary-dysplasia
#5
G Lista, I Bresesti
I am glad to see that the Sustained Lung Inflation (SLI) trial (1) still draws a great deal of attention and I would like to clarify some aspects of the trial, in response to the comments by Gupta and Argarwal (2) in Acta Paediatrica. A meta-analysis carried out in 2016 demonstrated that starting non-invasive respiratory support from birth could reduce the incidence of bronchopulmonary dysplasia and death. However, about 50% of very low birth weight infants who are initially on nasal continuous positive airway pressure need subsequent intubation and mechanical ventilation...
May 18, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28515710/resistant-hypertension-after-hypertensive-intracerebral-hemorrhage-is-associated-with-more-medical-interventions-and-longer-hospital-stays-without-affecting-outcome
#6
Daojun Hong, Dana Stradling, Cyrus K Dastur, Yama Akbari, Leonid Groysman, Lama Al-Khoury, Jefferson Chen, Steven L Small, Wengui Yu
BACKGROUND: Hypertension (HTN) is the most common cause of spontaneous intracerebral hemorrhage (ICH). The aim of this study is to investigate the role of resistant HTN in patients with ICH. METHODS AND RESULTS: We conducted a retrospective study of all consecutive ICH admissions at our medical center from November 2013 to October 2015. The clinical features of patients with resistant HTN (requiring four or more antihypertensive agents to keep systolic blood pressure <140 mm Hg) were compared with those with responsive HTN (requiring three or fewer agents)...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28510504/cardiopulmonary-exercise-testing-basics-of-methodology-and-measurements
#7
Alessandro Mezzani
Cardiopulmonary exercise testing adds measurement of ventilation and volume of oxygen uptake and exhaled carbon dioxide to routine physiological and performance parameters obtainable from conventional exercise testing, furnishing an all-round vision of the systems involved in both oxygen transport from air to mitochondria and its utilization during exercise. Peculiarities of cardiopulmonary exercise testing methodology are the use of ramp protocols and calibration procedures for flow meters and gas analyzers...
May 16, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28508568/randomized-crossover-trial-of-a-pressure-sensing-visual-feedback-system-to-improve-mask-fitting-in-noninvasive-ventilation
#8
Anne-Kathrin Brill, Mohammad Moghal, Mary J Morrell, Anita K Simonds
BACKGROUND AND OBJECTIVE: A good mask fit, avoiding air leaks and pressure effects on the skin are key elements for a successful noninvasive ventilation (NIV). However, delivering practical training for NIV is challenging, and it takes time to build experience and competency. This study investigated whether a pressure sensing system with real-time visual feedback improved mask fitting. METHODS: During an NIV training session, 30 healthcare professionals (14 trained in mask fitting and 16 untrained) performed two mask fittings on the same healthy volunteer in a randomized order: one using standard mask-fitting procedures and one with additional visual feedback on mask pressure on the nasal bridge...
May 15, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28508451/the-impact-of-left-ventricular-diastolic-dysfunction-on-lung-transplant-outcome-in-patients-with-pulmonary-arterial-hypertension
#9
Avital Avriel, Anat Hershko Klement, Sindhu R Johnson, Marc de Perrot, John Granton
Diastolic dysfunction may influence perioperative outcome, early graft function and long-term survival. We compared the outcomes of DLTx for PAH patients with pre-operative LV diastolic dysfunction to those without diastolic dysfunction. Of 116 consecutive patients with PAH (who underwent transplantation between January 1995 and December 2013), 44 met our inclusion and exclusion criteria. Fourteen patients (31.8%) with diastolic dysfunction pre-LTx had a higher BMI [29 (IQR 21.5-32.6) vs. 22.4 (IRQ 19.9-25...
May 16, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28504997/lung-rest-during-extracorporeal-membrane-oxygenation-for-neonatal-respiratory-failure-practice-variations-and-outcomes
#10
Deepthi Alapati, Zubair H Aghai, Md Jobayer Hossain, Daniel R Dirnberger, Mark T Ogino, Thomas H Shaffer
OBJECTIVE: Describe practice variations in ventilator strategies used for lung rest during extracorporeal membrane oxygenation for respiratory failure in neonates, and assess the potential impact of various lung rest strategies on the duration of extracorporeal membrane oxygenation and the duration of mechanical ventilation after decannulation. DATA SOURCES: Retrospective cohort analysis from the Extracorporeal Life Support Organization registry database during the years 2008-2013...
May 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#11
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28485522/effects-of-1-month-withdrawal-of-ventilatory-support-in-hypercapnic-myotonic-dystrophy-type-1
#12
Fergal J O'Donoghue, Jean-Christian Borel, Yves Dauvilliers, Patrick Levy, Renaud Tamisier, Jean-Louis Pépin
BACKGROUND AND OBJECTIVE: The benefits of domiciliary non-invasive ventilation (NIV) in myotonic dystrophy type 1 (DM1) are unclear. We sought to determine the effects of elective discontinuation of ventilatory support for 1 month in DM1 patients receiving NIV for chronic hypercapnic respiratory failure. METHODS: At baseline, 12 patients underwent polysomnography, and assessment of subjective (Epworth Sleepiness Scale) and objective (Oxford Sleep Resistance Test) sleepiness, fatigue (Fatigue Severity Scale), respiratory function including muscle strength, arterial blood gas (ABG), hypercapnic ventilatory response (HCVR), Blood Pressure, peripheral arterial tonometry (PAT) and pulse wave velocity (PWV)...
May 9, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28485314/effects-of-propofol-on-respiratory-drive-and-patient-ventilator-synchrony-during-pressure-support-ventilation-in-postoperative-patients-a-prospective-study
#13
Ling Liu, Ai-Ping Wu, Yi Yang, Song-Qiao Liu, Ying-Zi Huang, Jian-Feng Xie, Chun Pan, Cong-Shan Yang, Hai-Bo Qiu
BACKGROUND: Propofol is increasingly used during partial support mechanical ventilation such as pressure support ventilation (PSV) in postoperative patients. However, breathing pattern, respiratory drive, and patient-ventilator synchrony are affected by the sedative used and the sedation depth. The present study aimed to evaluate the physiologic effects of varying depths of propofol sedation on respiratory drive and patient-ventilator synchrony during PSV in postoperative patients. METHODS: Eight postoperative patients receiving PSV for <24 h were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28476473/decrease-in-delivery-room-intubation-rates-after-use-of-nasal-intermittent-positive-pressure-ventilation-in-the-delivery-room-for-resuscitation-of-very-low-birth-weight-infants
#14
Manoj Biniwale, Fiona Wertheimer
BACKGROUND: The literature supports minimizing duration of invasive ventilation to decrease lung injury in premature infants. Neonatal Resuscitation Program recommended use of non-invasive ventilation (NIV) in delivery room for infants requiring prolonged respiratory support. OBJECTIVE: To evaluate the impact of implementation of non-invasive ventilation (NIV) using nasal intermittent positive pressure ventilation (NIPPV) for resuscitation in very low birth infants...
May 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28475684/the-use-of-extracorporeal-membrane-oxygenation-in-neonates-with-severe-congenital-diaphragmatic-hernia-a-26-year-experience-from-a-tertiary-centre%C3%A2
#15
Ricky Vaja, Ahmed Bakr, Annabel Sharkey, Vijay Joshi, Gail Faulkner, Claire Westrope, Chris Harvey
OBJECTIVES: Neonates with severe congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation (ECMO) have a high rate of mortality. There is controversy regarding optimal time of surgical intervention. We present our data over a 26-year period. METHODS: We analysed data from our Extracorporeal Life Support Organization registry forms between 1989 and 2015, in order to determine the factors affecting survival outcome for repair of congenital diaphragmatic hernia with ECMO as a bridge to surgery and/or recovery...
May 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28468568/impact-of-low-dose-ketamine-on-the-usage-of-continuous-opioid-infusion-for-the-treatment-of-pain-in-adult-mechanically-ventilated-patients-in-surgical-intensive-care-units
#16
Jessica L Buchheit, Daniel Dante Yeh, Matthias Eikermann, Hsin Lin
BACKGROUND: Ketamine at subanesthetic doses has been shown to provide analgesic effects without causing respiratory depression and may be a viable option in mechanically ventilated patients to assist with extubation. The aim of this study was to evaluate the effects of low-dose ketamine on opioid consumption in mechanically ventilated adult surgical intensive care unit (ICU) patients. METHODS: A retrospective review of mechanically ventilated adult patients receiving low-dose ketamine continuous infusion (1-5 µcg/kg/min) for adjunctive pain control admitted to surgical ICUs was conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28460700/airways-and-injuries-protecting-our-pediatric-patients-from-respiratory-device-related-pressure-injuries
#17
REVIEW
Laura J Miske, Molly Stetzer, Melissa Garcia, Judith J Stellar
Pressure injury prevention is required in all health care environments. Respiratory technology includes invasive and noninvasive positive pressure ventilation methods of support and life-saving equipment. Pressure injury can occur from tracheostomy tubes and their securement devices, or use of noninvasive positive pressure ventilation interfaces or the head gear. Methods instituted to decrease hospital-acquired pressure injury related to noninvasive positive pressure ventilation and tracheostomy securement devices are discussed...
June 2017: Critical Care Nursing Clinics of North America
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
#18
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/28459325/ajrccm-100-year-anniversary-homeward-bound-a-centenary-of-home-mechanical-ventilation
#19
Matthew Hind, Michael I Polkey, Anita K Simonds
The evolution of home mechanical ventilation is an intertwined chronicle of negative and positive pressure modes and their role in managing ventilatory failure in neuromuscular diseases and other chronic disorders. The uptake of noninvasive positive pressure ventilation has resulted in widespread growth in home ventilation internationally and fewer patients being ventilated invasively. As with many applications of domiciliary medical technology, home ventilatory support has either led or run in parallel with acute hospital applications and has been influenced by medical and societal shifts in the approach to chronic care, the creation of community support teams, a preference of recipients to be treated at home, and economic imperatives...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28459322/fifty-years-of-research-in-ards-is-extracorporeal-circulation-the-future-of-acute-respiratory-distress-syndrome-management
#20
Alain Combes, Antonio Pesenti, V Marco Ranieri
Mechanical ventilation (MV) remains the cornerstone of acute respiratory distress syndrome (ARDS) management. It guarantees sufficient alveolar ventilation, high FiO2 concentration, and high positive end-expiratory pressure levels. However, experimental and clinical studies have accumulated, demonstrating that MV also contributes to the high mortality observed in patients with ARDS by creating ventilator-induced lung injury. Under these circumstances, extracorporeal lung support (ECLS) may be beneficial in two distinct clinical settings: to rescue patients from the high risk for death associated with severe hypoxemia, hypercapnia, or both not responding to maximized conventional MV, and to replace MV and minimize/abolish the harmful effects of ventilator-induced lung injury...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
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