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respiratory physiology ventilation

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https://www.readbyqxmd.com/read/29043834/higher-peep-versus-lower-peep-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#1
Allan J Walkey, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. OBJECTIVE: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. METHODS: We performed a systematic review and meta-analysis of clinical trials investigating mechanical ventilation strategies using higher versus lower PEEP levels...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29041985/simplified-prognostic-model-for-critically-ill-patients-in-resource-limited-settings-in-south-asia
#2
Rashan Haniffa, Mavuto Mukaka, Sithum Bandara Munasinghe, Ambepitiyawaduge Pubudu De Silva, Kosala Saroj Amarasiri Jayasinghe, Abi Beane, Nicolette de Keizer, Arjen M Dondorp
BACKGROUND: Current critical care prognostic models are predominantly developed in high-income countries (HICs) and may not be feasible in intensive care units (ICUs) in lower- and middle-income countries (LMICs). Existing prognostic models cannot be applied without validation in LMICs as the different disease profiles, resource availability, and heterogeneity of the population may limit the transferability of such scores. A major shortcoming in using such models in LMICs is the unavailability of required measurements...
October 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29038746/influence-of-exercise-duration-on-cardiorespiratory-responses-energy-cost-and-tissue-oxygenation-within-a-6-hour-treadmill-run
#3
Hugo A Kerhervé, Scott McLean, Karen Birkenhead, David Parr, Colin Solomon
PURPOSE: The physiological mechanisms for alterations in oxygen utilization ([Formula: see text]) and the energy cost of running (Cr ) during prolonged running are not completely understood, and could be linked with alterations in muscle and cerebral tissue oxygenation. METHODS: Eight trained ultramarathon runners (three women; mean ± SD; age 37 ± 7 yr; maximum [Formula: see text] 60 ± 15 mL min(-1) kg(-1)) completed a 6 hr treadmill run (6TR), which consisted of four modules, including periods of moderate (3 min at 10 km h(-1), 10-CR) and heavy exercise intensities (6 min at 70% of maximum [Formula: see text], HILL), separated by three, 100 min periods of self-paced running (SP)...
2017: PeerJ
https://www.readbyqxmd.com/read/29033395/perioperative-changes-in-exhaled-nitric-oxide-during-oesophagectomy
#4
Piers Boshier, Alison Knaggs, George B Hanna, Nandor Marczin
Introduction Oesophagectomy is a major surgical procedure, associated with high rates of postoperative cardiopulmonary morbidity, that is in part due to the frequent requirement for periods of intraoperative one lung ventilation (OLV). The current pilot study aims to investigate variation in exhaled NO levels during oesophagectomy with emphasis on the response to OLV and correlation to physiological variables and clinical outcomes. Methods Breath-to-breath concentrations of NO were analysed in patients undergoing oesophagectomy at various stages of two lung ventilation...
October 16, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28993264/sensory-mechanical-effects-of-a-dual-bronchodilator-and-its-anticholinergic-component-in-copd
#5
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, J Alberto Neder, Katherine A Webb
This randomized, double-blind, crossover study examined the physiological rationale for using a dual long-acting bronchodilator (umeclidinium/vilanterol (UME/VIL)) versus its muscarinic-antagonist component (UME) as treatment for dyspnea and exercise intolerance in moderate COPD. After each 4-week treatment period, subjects performed pulmonary function and symptom-limited constant-work rate cycling tests with diaphragm electromyogram (EMGdi), esophageal (Pes), gastric (Pga) and transdiaphragmatic (Pdi) pressure measurements...
October 7, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28986852/effect-of-inspiratory-synchronization-during-pressure-controlled-ventilation-on-lung-distension-and-inspiratory-effort
#6
Nuttapol Rittayamai, François Beloncle, Ewan C Goligher, Lu Chen, Jordi Mancebo, Jean-Christophe M Richard, Laurent Brochard
BACKGROUND: In pressure-controlled (PC) ventilation, tidal volume (V T) and transpulmonary pressure (P L ) result from the addition of ventilator pressure and the patient's inspiratory effort. PC modes can be classified into fully, partially, and non-synchronized modes, and the degree of synchronization may result in different V T and P L despite identical ventilator settings. This study assessed the effects of three PC modes on V T, P L , inspiratory effort (esophageal pressure-time product, PTPes), and airway occlusion pressure, P 0...
October 6, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28979560/a-case-study-of-likely-wild-type-cardiac-transthyretin-amyloidosis-causing-rapid-deterioration
#7
Thomas Davies, Aarash Saleh, Gerry Coghlan, Carol Whelan, Banwari Agarwal
We present the case of an 88-year-old gentleman who presented to hospital septic with bilateral leg cellulitis, pulmonary oedema and hypotension. He had no history of heart disease but had had bilateral carpal tunnel releases. His condition deteriorated with refractory hypotension in spite of fluid filling, inotropic and vasopressor support. His echocardiogram showed an infiltrative cardiomyopathy with a speckled myocardium, severe concentric left and right ventricular increased wall thickness, diastolic dysfunction, biatrial dilatation and restrictive physiology in keeping with cardiac amyloidosis...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28967868/respiratory-mechanics-to-understand-ards-and-guide-mechanical-ventilation
#8
Tommaso Mauri, Marta Lazzeri, Giacomo Bellani, Alberto Zanella, Giacomo Grasselli
As precision medicine is becoming standard of care to select tailored rather than average treatments, physiological measurements might represent the first step to apply personalized therapy in the intensive care unit (ICU). Systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step towards this direction for two main reasons. On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient...
October 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28966692/wearable-technology-role-in-respiratory-health-and-disease
#9
REVIEW
Andrea Aliverti
In the future, diagnostic devices will be able to monitor a patient's physiological or biochemical parameters continuously, under natural physiological conditions and in any environment through wearable biomedical sensors. Together with apps that capture and interpret data, and integrated enterprise and cloud data repositories, the networks of wearable devices and body area networks will constitute the healthcare's Internet of Things. In this review, four main areas of interest for respiratory healthcare are described: pulse oximetry, pulmonary ventilation, activity tracking and air quality assessment...
June 2017: Breathe
https://www.readbyqxmd.com/read/28966145/how-important-is-the-co2-chemoreflex-for-the-control-of-breathing-environmental-and-evolutionary-considerations
#10
REVIEW
Joseph M Santin
Haldane and Priestley (1905) discovered that the ventilatory control system is highly sensitive to CO2. This "CO2 chemoreflex" has been interpreted to dominate control of resting arterial PCO2/pH (PaCO2/pHa) by monitoring PaCO2/pHa and altering ventilation through negative feedback. However, PaCO2/pHa varies little in mammals as ventilation tightly couples to metabolic demands, which may minimize chemoreflex control of PaCO2. The purpose of this synthesis is to (1) interpret data from experimental models with meager CO2 chemoreflexes to infer their role in ventilatory control of steady-state PaCO2, and (2) identify physiological causes of respiratory acidosis occurring normally across vertebrate classes...
September 29, 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/28965157/the-effect-of-listening-to-holy-quran-recitation-on-weaning-patients-receiving-mechanical-ventilation-in-the-intensive-care-unit-a-pilot-study
#11
Mohammad Yadak, Khalid Aziz Ansari, Hatem Qutub, Hajed Al-Otaibi, Omar Al-Omar, Nawal Al-Onizi, Faraz Ahmed Farooqi
Mechanical ventilation (MV) causes high level of stress in hospitalized patients. Weaning is the gradual process of decreasing ventilator support that in turn lead to termination of MV and increased respiratory effort, which may exacerbate symptoms and prolong MV. This study aimed to investigate the effect of listening to Holy Quran recitation (HQR) as a non-pharmacological intervention in patients during weaning from mechanical ventilation. This is a randomized controlled trial in which 55 patients admitted in the intensive care unit (ICU) and on mechanical ventilation were recruited...
September 30, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28961282/physiologic-effects-of-alveolar-recruitment-and-inspiratory-pauses-during-moderately-high-frequency-ventilation-delivered-by-a-conventional-ventilator-in-a-severe-lung-injury-model
#12
Ricardo Luiz Cordioli, Eduardo Leite Vieira Costa, Luciano Cesar Pontes Azevedo, Susimeire Gomes, Marcelo Britto Passos Amato, Marcelo Park
BACKGROUND AND AIMS: To investigate whether performing alveolar recruitment or adding inspiratory pauses could promote physiologic benefits (VT) during moderately-high-frequency positive pressure ventilation (MHFPPV) delivered by a conventional ventilator in a porcine model of severe acute respiratory distress syndrome (ARDS). METHODS: Prospective experimental laboratory study with eight pigs. Induction of acute lung injury with sequential pulmonary lavages and injurious ventilation was initially performed...
2017: PloS One
https://www.readbyqxmd.com/read/28944931/basic-concepts-of-heart-lung-interactions-during-mechanical-ventilation
#13
Martin R Grübler, Olivier Wigger, David Berger, Stefan Blöchlinger
Critically ill patients with the need for mechanical ventilation show complex interactions between respiratory and cardiovascular physiology. These interactions are important as they may guide the clinician's therapeutic decisions and, possibly, affect patient outcome. The aim of the present review is to provide the practicing physician with an overview of the concepts of heart-lung interactions during mechanical ventilation. We outline the basic cardiac and respiratory physiology during spontaneous breathing and under mechanical ventilation...
September 25, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#14
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904477/studying-the-power-of-the-integrative-weaning-index-in-predicting-the-success-rate-of-the-spontaneous-breathing-trial-in-patients-under-mechanical-ventilation
#15
Sahar Ebrahimabadi, Ahmad Bagheri Moghadam, Mohammadali Vakili, Mahnaz Modanloo, Homeira Khoddam
BACKGROUND AND AIMS: The use of weaning predictive indicators can avoid early extubation and wrongful prolonged mechanical ventilation. This study aimed to determine the power of the integrative weaning index (IWI) in predicting the success rate of the spontaneous breathing trial (SBT) in patients under mechanical ventilation. MATERIALS AND METHODS: In this prospective study, 105 patients undergoing mechanical ventilation for over 48 h were enrolled. Before weaning initiation, the IWI was calculated and based on the defined cutoff point (≥25), the success rate of the SBT was predicted...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28904405/noninvasive-high-frequency-ventilation-and-the-errors-from-the-past-designing-simple-trials-neglecting-complex-respiratory-physiology
#16
Daniele De Luca
No abstract text is available yet for this article.
September 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28904404/response-to-non-invasive-high-frequency-ventilation-and-the-errors-from-the-past-designing-simple-trials-neglecting-complex-respiratory-physiology
#17
A Mukerji, V Shah
No abstract text is available yet for this article.
September 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28880805/a-prospective-one-year-microbiologic-survey-of-combined-pneumonia-and-respiratory-failure
#18
Kristen Fisher, Tracy Trupka, Scott T Micek, Paul Juang, Marin H Kollef
BACKGROUND: Pneumonia and respiratory failure are common problems in the intensive care unit (ICU) setting, often occurring together. The relative prevalence of pneumonia types (community acquired, hospital acquired, ventilator associated) and causative pathogens is not well described in patients with respiratory failure. METHODS: This was a prospective observational cohort study conducted in the medical ICU (34 beds) of Barnes-Jewish Hospital, an academic referral center of 1,300 beds from January 2016-December 2016...
October 2017: Surgical Infections
https://www.readbyqxmd.com/read/28879449/prognostic-factors-of-mortality-in-iranian-patients-with-systemic-lupus-erythematosus-admitted-to-intensive-care-unit
#19
Alimohammad Fatemi, Somayeh Shamsaee, Ahmad Raeisi, Zahra Sayedbonakdar, Abbas Smiley
The aim was to determine the course, outcome, and determinants of mortality in patients with systemic lupus erythematosus (SLE) in intensive care unit (ICU). SLE patients admitted to ICU from 2004 to 2015 were recruited retrospectively. Demographic data, disease characteristics, causes of admission, baseline SLE disease activity index-2K (SLEDAI-2K) and Acute Physiologic and Chronic Health Evaluation II (APACHE) score, the outcome, and the causes of death were recorded. Predictors of mortality were compared between alive and dead patients by Cox regression analysis...
November 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28877748/a-pilot-clinical-trial-of-recombinant-human-angiotensin-converting-enzyme-2-in-acute-respiratory-distress-syndrome
#20
Akram Khan, Cody Benthin, Brian Zeno, Timothy E Albertson, John Boyd, Jason D Christie, Richard Hall, Germain Poirier, Juan J Ronco, Mark Tidswell, Kelly Hardes, William M Powley, Tracey J Wright, Sarah K Siederer, David A Fairman, David A Lipson, Andrew I Bayliffe, Aili L Lazaar
BACKGROUND: Renin-angiotensin system (RAS) signaling and angiotensin-converting enzyme 2 (ACE2) have been implicated in the pathogenesis of acute respiratory distress syndrome (ARDS). We postulated that repleting ACE2 using GSK2586881, a recombinant form of human angiotensin-converting enzyme 2 (rhACE2), could attenuate acute lung injury. METHODS: We conducted a two-part phase II trial comprising an open-label intrapatient dose escalation and a randomized, double-blind, placebo-controlled phase in ten intensive care units in North America...
September 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
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