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https://www.readbyqxmd.com/read/28099321/preoxygenation-physiologic-basis-benefits-and-potential-risks
#1
Usharani Nimmagadda, M Ramez Salem, George J Crystal
Preoxygenation before anesthetic induction and tracheal intubation is a widely accepted maneuver, designed to increase the body oxygen stores and thereby delay the onset of arterial hemoglobin desaturation during apnea. Because difficulties with ventilation and intubation are unpredictable, the need for preoxygenation is desirable in all patients. During emergence from anesthesia, residual effects of anesthetics and inadequate reversal of neuromuscular blockade can lead to hypoventilation, hypoxemia, and loss of airway patency...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#2
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28089799/positive-airway-pressure-therapies-and-hospitalization-in-chronic-obstructive-pulmonary-disease
#3
Monica M Vasquez, Leslie A McClure, Duane L Sherrill, Sanjay R Patel, Jerry Krishnan, Stefano Guerra, Sairam Parthasarathy
BACKGROUND: Hospitalization of patients with chronic obstructive pulmonary disease (COPD) places a huge healthcare burden. Positive airway pressure (PAP) therapy is sometimes used in COPD patients, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of COPD patients before and after initiation of various PAP therapies in a "real-world" bioinformatics study. METHODS: We performed a retrospective analysis of administrative claims data of hospitalizations in patients with COPD who received or did not receive PAP therapy - continuous PAP, bilevel PAP, and non-invasive positive pressure ventilation using a home ventilator (NIPPV)...
January 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#4
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28054235/heated-humidified-high-flow-nasal-cannula-for-prevention-of-extubation-failure-in-preterm-infants
#5
Sasivimon Soonsawad, Buranee Swatesutipun, Anchalee Limrungsikul, Pracha Nuntnarumit
OBJECTIVES: To compare extubation failure rate between the heated humidified high-flow nasal cannula (HHHFNC) and continuous positive airway pressure (CPAP) groups. METHODS: Intubated infants with gestational age (GA) <32 wk, who were ready to extubate, were randomized to receive respiratory support with either CPAP or HHHFNC after extubation. In CPAP group, nasal mask CPAP with preset pressure and fraction of inspired oxygen (FiO2) equal to positive end-expiratory pressure (PEEP) and FiO2 of ventilator before extubation was applied...
January 5, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/27939229/adjunctive-use-of-noninvasive-ventilation-during-exercise-in-patients-with-decompensated-heart-failure
#6
Igor Gutierrez Moraes, Karen Mota Kimoto, Marcos Brandmuller Fernandes, Samantha Torres Grams, Wellington Pereira Yamaguti
Noninvasive ventilation (NIV) as an adjunct strategy for increasing exercise tolerance has been widely investigated in patients with pulmonary diseases. To our knowledge, there are no studies that have used NIV during exercise in patients with decompensated heart failure (HF). The aim of this study was to evaluate the effects of NIV on exercise tolerance in hospitalized patients with decompensated HF. Thirteen patients (77 ± 15 years) with a mean left ventricular ejection fraction of 35 ± 15% were included...
February 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27899105/non-invasive-mechanical-ventilation-after-heart-surgery-in-children
#7
Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27835720/a-novel-therapy-for-chronic-sleep-onset-insomnia-a-retrospective-nonrandomized-controlled-study-of-auto-adjusting-dual-level-positive-airway-pressure-technology
#8
Barry Krakow, Victor A Ulibarri, Natalia D McIver, Michael R Nadorff
Objective: Evidence indicates that behavioral or drug therapy may not target underlying pathophysiologic mechanisms for chronic insomnia, possibly due to previously unrecognized high rates (30%-90%) of sleep apnea in chronic insomnia patients. Although treatment studies with positive airway pressure (PAP) demonstrate decreased severity of chronic sleep maintenance insomnia in patients with co-occurring sleep apnea, sleep-onset insomnia has not shown similar results. We hypothesized advanced PAP technology would be associated with decreased sleep-onset insomnia severity in a sample of predominantly psychiatric patients with comorbid sleep apnea...
September 29, 2016: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/27720457/positive-airway-pressure-therapy-for-obstructive-sleep-apnea
#9
REVIEW
Pnina Weiss, Meir Kryger
Positive airway pressure (PAP) is considered first-line therapy for moderate to severe obstructive sleep apnea and may also be considered for mild obstructive sleep apnea, particularly if it is symptomatic or there are concomitant cardiovascular disorders. Continuous PAP is most commonly used. Other modes, such as bilevel airway pressure, autotitrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation, play important roles in the management of sleep-related breathing disorders...
December 2016: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27707439/factors-associated-with-changes-in-invasive-and-noninvasive-positive-airway-pressure-therapy-settings-during-pediatric-polysomnograms
#10
Gyambo Sithey, Li Ming Wen, Patrick Kelly, Mu Li
STUDY OBJECTIVES: Our aim was to identify clinical predictors associated with changes in settings for pediatric invasive and noninvasive positive airway pressure therapy, which could help inform the allocation of limited polysomnogram (PSG) resources. METHODS: A retrospective review was conducted in children who underwent one or more PSGs for technology titration. Children were included if they were using continuous positive airway pressure (CPAP) therapy, bilevel positive airway pressure (BPAP) therapy, or invasive positive pressure ventilation (IPPV) the night of the PSG...
September 29, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27532363/heated-humidified-high-flow-nasal-cannula-vs-nasal-continuous-positive-airway-pressure-for-respiratory-distress-syndrome-of-prematurity-a-randomized-clinical-noninferiority-trial
#11
Anna Lavizzari, Mariarosa Colnaghi, Francesca Ciuffini, Chiara Veneroni, Stefano Musumeci, Ivan Cortinovis, Fabio Mosca
Importance: Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Objective: To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks' gestational age (GA)...
August 8, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27366506/comparison-and-evaluation-of-the-effects-of-administration-of-postoperative-non-invasive-mechanical-ventilation-methods-cpap-and-bipap-on-respiratory-mechanics-and-gas-exchange-in-patients-undergoing-abdominal-surgery
#12
Hatice Yağlıoğlu, Güniz Meyancı Köksal, Emre Erbabacan, Birsel Ekici
OBJECTIVE: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery. METHODS: Eighty patients undergoing elective abdominal surgery with laparotomy, between the age of 25 and 75 years and American Society of Anesthesiologists Physical Status score (ASA) II-III with chronic obstructive pulmonary disease (COPD) diagnosis were included to the study...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/27310926/in-vitro-comparison-of-a-vibrating-mesh-nebulizer-operating-in-inspiratory-synchronized-and-continuous-nebulization-modes-during-noninvasive-ventilation
#13
Jean-Bernard Michotte, Enrico Staderini, Deborah Le Pennec, Jonathan Dugernier, Rares Rusu, Jean Roeseler, Laurent Vecellio, Giuseppe Liistro, Grégory Reychler
UNLABELLED: Backround: Coupling nebulization with noninvasive ventilation (NIV) has been shown to be effective in patients with respiratory diseases. However, a breath-synchronized nebulization option that could potentially improve drug delivery by limiting drug loss during exhalation is currently not available on bilevel ventilators. The aim of this in vitro study was to compare aerosol delivery of amikacin with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes...
2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/27307723/nasal-highflow-improves-ventilation-in-patients-with-copd
#14
Jens Bräunlich, Marcus Köhler, Hubert Wirtz
BACKGROUND: Nasal highflow (NHF) provides a warmed and humidified air stream up to 60 L/min. Recent data demonstrated a positive effect in patients with acute hypoxemic respiratory failure, especially when caused by pneumonia. Preliminary data show a decrease in hypercapnia in patients with COPD. Therefore, NHF should be evaluated as a new ventilatory support device. This study was conducted to assess the impact of different flow rates on ventilatory parameters in patients with COPD. MATERIALS AND METHODS: This interventional clinical study was performed with patients suffering from severe COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27266279/approach-of-pulmonologists-in-turkey-to-noninvasive-mechanical-ventilation-use-at-home-for-chronic-respiratory-failure
#15
Aylin Özsancak Uğurlu, Huriye Berk Takır, Begüm Ergan, Erdal İn, Ezgi Özyilmaz, Özlem Ertan Edipoğlu, Eylem Acartürk, Ege Güleç Balbay, Aslı Görek Dilektaşlı, Tülay Kıvanç, Pervin Korkmaz Ekren, Sevinç Sarınç Ulaşlı, Ilgaz Doğrul, Elif Yılmazel Uçar, Şehnaz Olgun, Özkan Devran, Recai Ergun, Zuhal Karakurt
INTRODUCTION: To define approach of pulmonologists in Turkey to noninvasive mechanical ventilation (NIV) use for chronic respiratory failure (CRF), the most currently applied technique for home mechanical ventilation. PATIENTS AND METHODS: A 38-question survey, developed and tested by the authors, was distributed throughout Turkey to 2205 pulmonologists by e-mail. RESULT: Twenty-seven percent of the pulmonologists responded (n=596). Domiciliary NIV was reported to be prescribed by 340 physicians [57...
March 2016: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/27174926/model-based-stability-assessment-of-ventilatory-control-in-overweight-adolescents-with-obstructive-sleep-apnea-during-nrem-sleep
#16
L Nava-Guerra, W H Tran, P Chalacheva, S Loloyan, B Joshi, T G Keens, K S Nayak, S L Davidson Ward, M C K Khoo
Obstructive sleep apnea (OSA) involves the interplay of several different factors such as an unfavorable upper airway anatomy, deficiencies in pharyngeal muscle responsiveness, a low arousal threshold, and ventilatory control instability. Although the stability of ventilatory control has been extensively studied in adults, little is known about its characteristics in the pediatric population. In this study, we developed a novel experimental setup that allowed us to perturb the respiratory system during natural non-rapid eye movement (NREM) sleep conditions by manipulating the inspiratory pressure, provided by a bilevel pressure ventilator, to induce sighs after upper airway stabilization...
July 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27110447/risk-of-pneumonia-associated-with-zero-degree-head-positioning-in-acute-ischemic-stroke-patients-treated-with-intravenous-tissue-plasminogen-activator
#17
Paola Palazzo, Amy Brooks, David James, Randy Moore, Andrei V Alexandrov, Anne W Alexandrov
INTRODUCTION: In the hyperacute phase of ischemic stroke, a 0° position is recommended to increase cerebral perfusion in nonhypoxic patients able to tolerate lying flat. However, use of 0° positioning is not uniformly applied in clinical practice, most likely due to concerns of aspiration pneumonia. We aimed to determine the risk of pneumonia associated with 0° head of bed positioning in acute stroke patients treated with thrombolytic therapy. METHODS: A retrospective descriptive study was conducted using prospectively collected, consecutive acute ischemic stroke patients treated with IVtPA whose head of bed was positioned at 0° for the first 24 h...
February 2016: Brain and Behavior
https://www.readbyqxmd.com/read/27070248/sleep-disordered-breathing-in-duchenne-muscular-dystrophy-an-assessment-of-the-literature
#18
Romy Hoque
STUDY OBJECTIVES: The aim of this review is to review the literature on sleep-disordered breathing in Duchenne muscular dystrophy (DMD). METHODS: PubMed was searched with an array of search terms, including "OSA," "obstructive sleep apnea," "sleep-disordered breathing," "muscular dystrophy," "neuromuscular," "Duchenne muscular dystrophy," "polysomnography," and "portable monitoring." All relevant articles were discussed. RESULTS: Eighteen research articles and 1 consensus statement were reviewed, and assessed with relevant data presented...
June 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/26995256/the-effect-of-adaptive-servo-ventilation-asv-on-objective-and-subjective-outcomes-in-cheyne-stokes-respiration-csr-with-central-sleep-apnea-csa-in-heart-failure-hf-a-systematic-review
#19
REVIEW
Hyunju Yang, Amy M Sawyer
To summarize the current evidence for adaptive servo ventilation (ASV) in Cheyne-Stokes respiration (CSR) with central sleep apnea (CSA) in heart failure (HF) and advance a research agenda and clinical considerations for ASV-treated CSR-CSA in HF. CSR-CSA in HF is associated with higher overall mortality, worse outcomes and lower quality of life (QOL) than HF without CSR-CSA. Five databases were searched using key words (n = 234). Randomized controlled trials assessed objective sleep quality, cardiac, and self-reported outcomes in adults (≥18 years) with HF (n = 10)...
May 2016: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/26813451/effect-of-acetazolamide-on-post-niv-metabolic-alkalosis-in-acute-exacerbated-copd-patients
#20
V Fontana, S Santinelli, M Internullo, P Marinelli, L Sardo, G Alessandrini, L Borgognoni, A M Ferrazza, M Bonini, P Palange
OBJECTIVE: Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV. PATIENTS AND METHODS: Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group...
2016: European Review for Medical and Pharmacological Sciences
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