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respiratory physiology ventilation

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https://www.readbyqxmd.com/read/28432665/systemic-and-microcirculatory-effects-of-blood-transfusion-in-experimental-hemorrhagic-shock
#1
Gonzalo Ferrara, Vanina S Kanoore Edul, Héctor S Canales, Enrique Martins, Carlos Canullán, Gastón Murias, Mario O Pozo, Juan F Caminos Eguillor, María G Buscetti, Can Ince, Arnaldo Dubin
BACKGROUND: The microvascular reperfusion injury after retransfusion has not been completely characterized. Specifically, the question of heterogeneity among different microvascular beds needs to be addressed. In addition, the identification of anaerobic metabolism is elusive. The venoarterial PCO2 to arteriovenous oxygen content difference ratio (Pv-aCO2/Ca-vO2) might be a surrogate for respiratory quotient, but this has not been validated. Therefore, our goal was to characterize sublingual and intestinal (mucosal and serosal) microvascular injury after blood resuscitation in hemorrhagic shock and its relation with O2 and CO2 metabolism...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28421269/thermal-balance-of-nellore-cattle
#2
Cíntia Carol de Melo Costa, Alex Sandro Campos Maia, Sheila Tavares Nascimento, Carolina Cardoso Nagib Nascimento, Marcos Chiquitelli Neto, Vinícius de França Carvalho Fonsêca
This work aimed at characterizing the thermal balance of Nellore cattle from the system of indirect calorimetry using a facial mask. The study was conducted at the Animal Biometeorology Laboratory of the São Paulo State University, Jaboticabal, Brazil. Five male Nellore weighing 750 ± 62 kg, at similar ages and body conditions were distributed in four 5 × 5 Latin squares (5 days of records and five schedules) during 20 days. Physiological and environmental measurements were obtained from the indirect calorimetry system using a facial mask...
April 18, 2017: International Journal of Biometeorology
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#3
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#4
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#5
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-non-invasive-neurally-adjusted-ventilatory-assist-niv-nava-in-preterm-infants
#6
Christopher Gibu, Phillip Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BACKGROUND: Non-invasive Neurally Adjusted Ventilator Assist (NIV-NAVA) was introduced to our clinical practice via a pilot and a randomized observational study to assess its safety, feasibility, and short term physiological effects. METHODS: The pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula (HFNC), or nasal IMV (NIMV), in multiple 2-4 h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational cross-over study in 8 additional infants to compare the physiological effects of NIV-NAVA to NIMV during 2-hour steady state conditions...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28394022/limited-versus-full-sternotomy-for-aortic-valve-replacement
#7
REVIEW
Bilal H Kirmani, Sion G Jones, S C Malaisrie, Darryl A Chung, Richard Jnn Williams
BACKGROUND: Aortic valve disease is a common condition that is easily treatable with cardiac surgery. This is conventionally performed by opening the sternum longitudinally down the centre ("median sternotomy") and replacing the valve under cardiopulmonary bypass. Median sternotomy is generally well tolerated, but as less invasive options have become available, the efficacy of limited incisions has been called into question. In particular, the effects of reducing the visibility and surgical access has raised safety concerns with regards to the placement of cannulae, venting of the heart, epicardial wire placement, and de-airing of the heart at the end of the procedure...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28385915/physiology-in-medicine-understanding-dynamic-alveolar-physiology-to-minimize-ventilator-induced-lung-injury-vili
#8
Gary F Nieman, Joshua Satalin, Michaela Kollisch-Singule, Penny L Andrews, Hani Aiash, Nader M Habashi, Louis A Gatto
The acute respiratory distress syndrome (ARDS) remains a serious clinical problem with the main treatment being supportive in the form of mechanical ventilation. However, mechanical ventilation can be a double edge sword, if set improperly can exacerbate the tissue damage caused by ARDS and is known as ventilator induced lung injury (VILI). In order to minimize VILI we must understand the pathophysiologic mechanisms of tissue damage at the alveolar level. In this Physiology in Medicine paper the dynamic physiology of alveolar inflation and deflation during mechanical ventilation will be reviewed...
April 6, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28377402/assessing-initial-response-to-high-frequency-jet-ventilation-in-premature-infants-with-hypercapnic-respiratory-failure
#9
Craig R Wheeler, Craig D Smallwood, Iris O'Donnell, Daniel Gagner, Martha C Sola-Visner
BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for infants with respiratory failure. We sought to identify parameters that were associated with successful application of HFJV in patients with hypercapnic respiratory failure. METHODS: A single-center, retrospective review of infants who received HFJV was conducted. Subjects were enrolled if birthweight was ≤2,000 g and capillary PCO2 was ≥55 mm Hg...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#10
Lu Chen, Guang-Qiang Chen, Kevin Shore, Orest Shklar, Concetta Martins, Brian Devenyi, Paul Lindsay, Heather McPhail, Ashley Lanys, Ibrahim Soliman, Mazin Tuma, Michael Kim, Kerri Porretta, Pamela Greco, Hilary Every, Chris Hayes, Andrew Baker, Jan O Friedrich, Laurent Brochard
BACKGROUND: Despite their potential interest for clinical management, measurements of respiratory mechanics in patients with acute respiratory distress syndrome (ARDS) are seldom performed in routine practice. We introduced a systematic assessment of respiratory mechanics in our clinical practice. After the first year of clinical use, we retrospectively assessed whether these measurements had any influence on clinical management and physiological parameters associated with clinical outcomes by comparing their value before and after performing the test...
April 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28368706/resting-physiological-correlates-of-reduced-exercise-capacity-in-smokers-with-mild-airway-obstruction
#11
Amany F Elbehairy, Azmy Faisal, Jordan A Guenette, Dennis Jensen, Katherine A Webb, Rashid Ahmed, J Alberto Neder, Denis E O'Donnell
Smokers with minor spirometric abnormalities can experience persistent activity-related dyspnea and exercise intolerance. Additional resting tests can expose heterogeneous physiological abnormalities, but their relevance and association with clinical outcomes remain uncertain. Subjects included sixty-two smokers (≥20 pack-years), with cough and/or dyspnea and minor airway obstruction [forced expiratory volume in one-second (FEV1) ≥80% predicted and >5th percentile lower limit of normal (LLN) (i.e., z-score >-1...
April 3, 2017: COPD
https://www.readbyqxmd.com/read/28365648/passive-leg-raising-and-prediction-of-fluid-responsiveness-systematic-review
#12
Joya D Pickett, Elizabeth Bridges, Patricia A Kritek, JoAnne D Whitney
Fluid boluses are often administered with the aim of improving tissue hypoperfusion in shock. However, only approximately 50% of patients respond to fluid administration with a clinically significant increase in stroke volume. Fluid overload can exacerbate pulmonary edema, precipitate respiratory failure, and prolong mechanical ventilation. Therefore, it is important to predict which hemodynamically unstable patients will increase their stroke volume in response to fluid administration, thereby avoiding deleterious effects...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28359608/changes-in-ventilatory-response-to-exercise-in-trained-athletes-respiratory-physiological-benefits-beyond-cardiovascular-performance
#13
Adriano di Paco, Bruno-Pierre Dubé, Pierantonio Laveneziana
INTRODUCTION: The beneficial impact of an 8-month competitive season on the ventilatory profile response to exercise in soccer players has never been evaluated. MATERIAL AND METHODS: Ventilatory profile (evaluated by determining individual tidal volume [VT] relative to minute ventilation [VE] inflection points during exercise) and metabolic responses to incremental exercise were evaluated in 2 professional soccer teams before and after an 8-month competitive season...
March 27, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28358634/effects-of-alfaxalone-administered-intravenously-to-healthy-yearling-loggerhead-sea-turtles-caretta-caretta-at-three-different-doses
#14
Brianne E Phillips, Lysa P Posner, Gregory A Lewbart, Emily F Christiansen, Craig A Harms
OBJECTIVE To compare physiologic and anesthetic effects of alfaxalone administered IV to yearling loggerhead sea turtles (Caretta caretta) at 3 different doses. DESIGN Randomized crossover study. ANIMALS 9 healthy yearling loggerhead sea turtles. PROCEDURES Animals received each of 3 doses of alfaxalone (3 mg/kg [1.4 mg/lb], 5 mg/kg [2.3 mg/lb], or 10 mg/kg [4.5 mg/lb]) administered IV in randomly assigned order, with a minimum 7-day washout period between doses. Endotracheal intubation was attempted following anesthetic induction, and heart rate, sedation depth, cloacal temperature, and respirations were monitored...
April 15, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28347628/factors-affecting-pain-assessment-scores-in-patients-on-mechanical-ventilation
#15
Yumi Ito, Koji Teruya, Hiroshi Kubota, Tomoko Yorozu, Emiko Nakajima
OBJECTIVE: To determine how respiratory status and other aspects of the patients' condition affect pain assessments. METHODS:  Pain was assessed in 20 patients aged ≥20 years who underwent cardiovascular surgery, and required postoperative mechanical ventilation in an intensive care unit using the Behavioral Pain Scale (BPS). A BPS score of ≥6 (pain) versus <6 (no pain) was the dependent variable for determining the effect on pain. RESULTS:  Multiple logistic regression analysis showed that in 99 observations made at rest, pre- and post-turning and pre- and post-tracheal suctioning, the BPS score was significantly affected by gender, the Acute Physiology and Chronic Health Evaluation (APACHE) II score, Richmond Agitation-Sedation Scale score, PaCO2, and HCO3(-)...
March 24, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28345959/ventilatory-inefficiency-and-exertional-dyspnea-in-early-chronic-obstructive-pulmonary-disease
#16
J Alberto Neder, Danilo C Berton, Paulo de Tarso Müller, Amany F Elbehairy, Alcides Rocha, Paolo Palange, Denis E O'Donnell
Exertional dyspnea is present across the spectrum of chronic obstructive pulmonary disease (COPD) severity. However, without realizing it themselves, patients may decrease daily physical activity to avoid distressing respiratory sensations. Dyspnea also may be associated with deconditioning. Cardiopulmonary exercise testing can uncover exertional dyspnea and its physiological determinants in patients with preserved or only mildly-reduced FEV1. Dyspnea in mild COPD can largely be explained by increased "wasted" ventilation in the physiological dead space which heightens the drive to breathe and worsens the inspiratory mechanical constraints...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28341260/the-effect-of-preexisting-respiratory-co-morbidities-on-burn-outcomes
#17
Laquanda T Knowlin, Lindsay B Stanford, Bruce A Cairns, Anthony G Charles
INTRODUCTION: Burns cause physiologic changes in multiple organ systems in the body. Burn mortality is usually attributable to pulmonary complications, which can occur in up to 41% of patients admitted to the hospital after burn. Patients with preexisting comorbidities such as chronic lung diseases may be more susceptible. We therefore sought to examine the impact of preexisting respiratory disease on burn outcomes. METHODS: A retrospective analysis of patients admitted to a regional burn center from 2002-2012...
March 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#18
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28333706/video-based-physiologic-monitoring-during-an-acute-hypoxic-challenge-heart-rate-respiratory-rate-and-oxygen-saturation
#19
Paul S Addison, Dominique Jacquel, David M H Foo, André Antunes, Ulf R Borg
BACKGROUND: The physiologic information contained in the video photoplethysmogram is well documented. However, extracting this information during challenging conditions requires new analysis techniques to capture and process the video image streams to extract clinically useful physiologic parameters. We hypothesized that heart rate, respiratory rate, and oxygen saturation trending can be evaluated accurately from video information during acute hypoxia. METHOD: Video footage was acquired from multiple desaturation episodes during a porcine model of acute hypoxia using a standard visible light camera...
March 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28328592/status-asthmaticus-and-central-herniation-a-case-for-multidisciplinary-critical-care
#20
Joelle B Karlik, Tristan Stani, Stephanie Nonas, Aclan Dogan, Ansgar Brambrink
A 24-year-old woman with history of asthma was intubated emergently for acute status asthmaticus triggered by acute respiratory syncytial virus infection and treated with permissive hypercapnia. Her ventilation was complicated by auto-positive end-expiratory pressure and elevated peak airway, plateau, and central venous pressures. On hospital day 2, she was noted to have anisocoria. Imaging showed diffuse cerebral edema with central herniation. Difficult ventilation and hypercapnia directly contributed to her severe cerebral edema...
March 15, 2017: A & A Case Reports
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