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respiratory physiology ventilation

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https://www.readbyqxmd.com/read/29434147/what-is-the-impact-of-mildly-altered-consciousness-on-acute-hypoxemic-respiratory-failure-with-non-invasive-ventilation
#1
Mariko Kogo, Kazuma Nagata, Takeshi Morimoto, Jiro Ito, Daichi Fujimoto, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
Objective A severely altered level of consciousness (ALC) is considered to be a possible contraindication to non-invasive ventilation (NIV). We investigated the association between mild ALC and NIV failure in patients with hypoxemic respiratory failure. Methods A retrospective study was conducted by reviewing the medical charts of patients with de novo hypoxemic respiratory failure who received NIV treatment. The clinical background and the outcomes of patients with and without ALC were compared. Patients or Materials Patients who were admitted to our hospital for acute hypoxemic respiratory failure between July 2011 and May 2015 were included in the present study...
February 9, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29430450/diagnosis-of-acute-respiratory-distress-syndrome-by-exhaled-breath-analysis
#2
REVIEW
Lieuwe D J Bos
The acute respiratory distress syndrome (ARDS) is a complication of critical illness that is characterized by acute onset, protein rich, pulmonary edema. There is no treatment for ARDS, other than the reduction of additional ventilator induced lung injury. Prediction or earlier recognition of ARDS could result in preventive measurements and might decrease mortality and morbidity. Exhaled breath contains volatile organic compounds (VOCs), a collection of hundreds of small molecules linked to several physiological and pathophysiological processes...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430442/effects-of-peep-on-lung-injury-pulmonary-function-systemic-circulation-and-mortality-in-animals-with-uninjured-lungs-a-systematic-review
#3
REVIEW
Anna Geke Algera, Luigi Pisani, Renato Carneiro de Freitas Chaves, Thiago Chaves Amorim, Thomas Cherpanath, Rogier Determann, Dave A Dongelmans, Frederique Paulus, Pieter Roel Tuinman, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz, Ary Serpa Neto
It is well-known that positive end-expiratory pressure (PEEP) can prevent ventilator-induced lung injury (VILI) and improve pulmonary physiology in animals with injured lungs. It's uncertain whether PEEP has similar effects in animals with uninjured lungs. A systematic review of randomized controlled trials (RCTs) comparing different PEEP levels in animals with uninjured lungs was performed. Trials in animals with injured lungs were excluded, as were trials that compared ventilation strategies that also differed with respect to other ventilation settings, e...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29430405/respiratory-mechanics-ventilator-associated-pneumonia-and-outcomes-in-intensive-care-unit
#4
Kelser de Souza Kock, Rosemeri Maurici
AIM: To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit (ICU) of a hospital in southern Brazil. METHODS: A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes in the 1 st and 5 th days of hospitalization were performed to monitor respiratory mechanics...
February 4, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29419414/motor-neuron-degeneration-correlates-with-respiratory-dysfunction-in-sca1
#5
James P Orengo, Meike E van der Heijden, Shuang Hao, Jianrong Tang, Harry T Orr, Huda Y Zoghbi
Spinocerebellar ataxia type 1 (SCA1) is characterized by adult-onset cerebellar degeneration with attendant loss of motor coordination. Bulbar function is eventually impaired, and patients tend to die from inability to clear the airway. We asked whether motor neuron degeneration is at the root of bulbar dysfunction by studying SCA1 knock-in mice. We analyzed spinal cord and brainstem motor neurons in SCA1 knock-in (Atxn1154Q) mice at 1, 3, and 6 months of age. Specifically, we assessed breathing physiology, diaphragm histology and electromyography, and motor neuron histology and immunohistochemistry...
January 29, 2018: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/29413724/characteristics-incidence-and-outcome-of-patients-admitted-to-intensive-care-unit-with-guillain-barre-syndrome-in-australia-and-new-zealand
#6
Paolo Ancona, Michael Bailey, Rinaldo Bellomo
PURPOSE: To describe characteristics, incidence and outcome of patients with Guillain-Barre syndrome (GBS) admitted to ICU. METHODS: We conducted a binational, retrospective, observational, epidemiological study. We compared the baseline characteristics, physiological conditions and outcomes for GBS patients with or without mechanical ventilation (MV) and of survivors and non-survivors. RESULTS: We studied 711 patients admitted to 173 ICUs between 2005 and 2015...
January 29, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29406422/equilibration-time-required-for-respiratory-system-compliance-and-oxygenation-response-following-changes-in-positive-end-expiratory-pressure-in-mechanically-ventilated-children
#7
Craig D Smallwood, Brian K Walsh, John H Arnold, Andrew Gouldstone
OBJECTIVES: Increases in positive end-expiratory pressure are implemented to improve oxygenation through the recruitment and stabilization of collapsed alveoli. However, the time it takes for a positive end-expiratory pressure change to have maximum effect upon oxygenation and pulmonary compliance has not been adequately described in children. Therefore, we sought to quantify the time required for oxygenation and pulmonary system compliance changes in children requiring mechanical ventilation...
February 5, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29406373/creating-a-high-frequency-electronic-database-in-the-picu-the-perpetual-patient
#8
David Brossier, Redha El Taani, Michael Sauthier, Nadia Roumeliotis, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVE: Our objective was to construct a prospective high-quality and high-frequency database combining patient therapeutics and clinical variables in real time, automatically fed by the information system and network architecture available through fully electronic charting in our PICU. The purpose of this article is to describe the data acquisition process from bedside to the research electronic database. DESIGN: Descriptive report and analysis of a prospective database...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29404723/physiological-predictors-of-respiratory-and-cough-assistance-needs-after-extubation
#9
Nicolas Terzi, Frédéric Lofaso, Romain Masson, Pascal Beuret, Hervé Normand, Edith Dumanowski, Line Falaize, Bertrand Sauneuf, Cédric Daubin, Jennifer Brunet, Djillali Annane, Jean-Jacques Parienti, David Orlikowski
BACKGROUND: Identifying patients at high risk of post-extubation acute respiratory failure requiring respiratory or mechanical cough assistance remains challenging. Here, our primary aim was to evaluate the accuracy of easily collected parameters obtained before or just after extubation in predicting the risk of post-extubation acute respiratory failure requiring, at best, noninvasive mechanical ventilation (NIV) and/or mechanical cough assistance and, at worst, reintubation after extubation...
February 5, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29402365/-effect-and-mechanism-of-dexmedetomidine-on-lungs-in-patients-of-sepsis-complicated-with-acute-respiratory-distress-syndrome
#10
Xianfeng Chen, Juntao Hu, Chi Zhang, Yiping Pan, Diansheng Tian, Fafa Kuang, Zhanhong Tang
OBJECTIVE: To investigate the mechanisms of protective effects of dexmedetomidine on lungs in patients of sepsis complicated with acute respiratory distress syndrome (ARDS). METHODS: The adult patients with sepsis complicated with ARDS, the oxygenation index (PaO2/FiO2) was 150-200 mmHg (1 mmHg = 0.133 kPa), acute physiology and chronic health evaluation II (APACHE II) score was 10-20, need mechanical ventilation (MV) treatment > 72 hours, and admitted to intensive care unit (ICU) of the First Affiliated Hospital of Guangxi Medical University from September 2013 to June 2017 were enrolled...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29402357/-predictive-factors-for-failure-of-non-invasive-positive-pressure-ventilation-in-immunosuppressed-patients-with-acute-respiratory-failure
#11
Xiangli Jia, Ci Yan, Sicheng Xu, Xingli Gu, Qiufeng Wan, Xinying Hu, Jingwen Li, Guangming Liu, Shareli Caikai, Zhijin Guo
OBJECTIVE: To evaluate the predictive factors for failure of non-invasive positive pressure ventilation (NIPPV) in immunosuppressed patients with acute respiratory failure (ARF). METHODS: The clinical data of 118 immuno-deficient patients treated with NIPPV in the respiratory and intensive care unit (RICU) of the First Affiliated Hospital of Xinjiang Medical University from January 2012 to August 2017 were retrospectively analyzed. The patients were divided into a non-endotracheal intubation (ETI) group (n = 62) and ETI group (n = 56) according to whether ETI was performed during the hospitalization period or not...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29390449/predictive-factors-of-in-hospital-mortality-in-ventilated-intensive-care-unit-a-prospective-cohort-study
#12
Chiu-Hua Wang, Horng-Chyuan Lin, Yue-Cune Chang, Suh-Hwa Maa, Jong-Shyan Wang, Woung-Ru Tang
Although it is clear that ventilated intensive care unit (ICU) patients have worse outcomes than those who are not, information about the risk factors of in-hospital mortality remains important for medical groups to target interventions for these patients.The purpose of this study was to identify predictive factors of in-hospital mortality in ventilated ICU patients with an admission diagnosis of acute respiratory failure.We conducted a prospective cohort study in 3 medical ICUs in a 3600-bed university hospital...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29385861/admission-volume-is-associated-with-mortality-of-neonatal-respiratory-failure-in-emerging-neonatal-intensive-care-units
#13
Huanhuan Wang, Ying Dong, Bo Sun
OBJECTIVE: The aim of this survey was to explore the relationship between admission volume and mortality of neonates with hypoxemic respiratory failure (NRF) in emerging neonatal intensive care units (NICUs). METHODS: NRF from 55 NICUs were retrospectively included with death risk as the major outcome. Perinatal comorbidities, underlying disease severity, respiratory support, facility utilization, and economic burden in the early postnatal period were compared among five NICU admission volume categories defined by NRF incidence, with score for neonatal acute physiology perinatal extension II (SNAPPE-II) also assessed as initial severity...
January 31, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29373797/does-extracorporeal-membrane-oxygenation-improve-survival-in-pediatric-acute-respiratory-failure
#14
Ryan P Barbaro, Yuejia Xu, Santiago Borasino, Edward J Truemper, R Scott Watson, Ravi R Thiagarajan, David Wypij, Martha A Q Curley
RATIONALE: Extracorporeal membrane oxygenation (ECMO) has supported gas exchange in children with severe respiratory failure for over 40 years without ECMO efficacy studies. OBJECTIVES: To compare the mortality and functional status of children with severe acute respiratory failure supported with and without ECMO. METHODS: This cohort study compared ECMO-supported children to pair-matched non-ECMO-supported controls with severe acute respiratory distress syndrome (ARDS)...
January 26, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29372630/what-can-we-apply-to-manage-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-acute-respiratory-failure
#15
REVIEW
Deog Kyeom Kim, Jungsil Lee, Ju Hee Park, Kwang Ha Yoo
Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29371025/home-non-invasive-ventilation-for-copd-how-who-and-when
#16
Patrick B Murphy, Nicholas Hart
Patients with chronic obstructive pulmonary disease (COPD) and chronic respiratory failure have high levels of morbidity and mortality. The clinical efficacy of long term home oxygen therapy has been well documented in this patient group but despite the efficacy of non-invasive ventilation (NIV) during acute decompensated respiratory failure the addition of home NIV has been associated with equivocal results. The physiological efficacy of home NIV to improve gas exchange in chronic stable hypercapnic respiratory failure has been proven in small studies but larger clinical trials failed to translate this into clinical efficacy...
January 19, 2018: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/29367408/physiology-of-the-lung-in-idiopathic-pulmonary-fibrosis
#17
REVIEW
Laurent Plantier, Aurélie Cazes, Anh-Tuan Dinh-Xuan, Catherine Bancal, Sylvain Marchand-Adam, Bruno Crestani
The clinical expression of idiopathic pulmonary fibrosis (IPF) is directly related to multiple alterations in lung function. These alterations derive from a complex disease process affecting all compartments of the lower respiratory system, from the conducting airways to the lung vasculature. In this article we review the profound alterations in lung mechanics (reduced lung compliance and lung volumes), pulmonary gas exchange (reduced diffusing capacity, increased dead space ventilation, chronic arterial hypoxaemia) and airway physiology (increased cough reflex and increased airway volume), as well as pulmonary haemodynamics related to IPF...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29353257/ethical-dilemmas-of-recording-and-reviewing-neonatal-resuscitation
#18
REVIEW
Maria C den Boer, Mirjam Houtlosser, Henriëtte Anje van Zanten, Elizabeth E Foglia, Dirk P Engberts, Arjan B Te Pas
Neonatal resuscitation is provided to approximately 3% of neonates. Adequate ventilation is often the key to successful resuscitation, but this can be difficult to provide. There is increasing evidence that inappropriate respiratory support can have severe consequences. Several neonatal intensive care units have recorded and reviewed neonatal resuscitation procedures for quality assessment, education and research; however, ethical dilemmas sometimes make it difficult to implement this review process. We reviewed the literature on the development of recording and reviewing neonatal resuscitation and have summarised the ethical concerns involved...
January 20, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29353024/outcomes-and-mortality-prediction-model-of-critically-ill-adults-with-acute-respiratory-failure-and-interstitial-lung-disease
#19
Whitney Gannon, David J Lederer, Mauer Biscotti, Azka Javaid, Nina Patel, Daniel Brodie, Matthew Bacchetta, Matthew Baldwin
BACKGROUND: We aimed to examine short- and long-term mortality in a mixed population of interstitial lung disease (ILD) patients with acute respiratory failure, and to identify those at lower versus higher risk of in-hospital death. METHODS: We conducted a single-center retrospective cohort study of 126 consecutive adults with ILD admitted to an intensive care unit (ICU) for respiratory failure at a tertiary care hospital between 2010 and 2014 who did not undergo lung transplantation during their hospitalization...
January 15, 2018: Chest
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#20
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
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