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One-lung ventilation

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https://www.readbyqxmd.com/read/29152933/ventilator-induced-lung-injury-does-it-occur-in-children
#1
Martin C Kneyber
Mechanical ventilation is one of the most practiced interventions in the paediatric intensive care unit (PICU). Although unmistakable life-saving, it can also injury the lung, a process coined ventilator induced lung injury (VILI). To date, almost all of our knowledge VILI has been obtained from studies in adults or experimental studies mimicking the adult critical care situation. This leaves the question if VILI is of importance in the paediatric context. Paediatric clinical studies did not confirm an association between large tidal volume (Vt) and adverse outcome...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29151293/-clinical-analysis-of-36-cases-of-advanced-non-small-cell-lung-cancer-nsclc-with-performance-status-ps-scores-between-2-and-4
#2
Y Y Qin, D H Zhang, X Q Lin, M Ouyang, J X Zhang, Z H Xie, Y Q Liu, S Y Li, C Z Zhou
Objective: To analyze the treatment of advanced non-small cell lung cancer (NSCLC) with performance status (PS) scores between 2 and 4, in order to improve the diagnosis and treatment of these patients. Methods: A total of 36 patients with advanced NSCLC with hypoxemia were reviewed. The clinical data of disease characteristics, etiology, complications, manifestation, therapy, progression, and secondary biopsy were collected. The clinical efficacy was graded according to the Response Evaluation Criteria In Solid Tumors (RECIST): complete response (CR), partial response (PR), stable disease (SD) and disease progression (PD)...
November 23, 2017: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/29149185/linezolid-and-atorvastatin-impact-on-pneumonia-caused-by-staphyloccocus-aureus-in-rabbits-with-or-without-mechanical-ventilation
#3
Laure-Anne Pauchard, Mathieu Blot, Rémi Bruyere, Saber-Davide Barbar, Delphine Croisier, Lionel Piroth, Pierre-Emmanuel Charles
Pneumonia may involve methicillin-resistant Staphylococcus aureus (MRSA), with elevated rates of antibiotics failure. The present study aimed to assess the effect of statins given prior to pneumonia development. Spontaneously breathing (SB) or mechanically ventilated (MV) rabbits with pneumonia received atorvastatin alone, linezolid (LNZ) alone, or a combination of both (n = 5 in each group). Spontaneously breathing and MV untreated infected animals (n = 11 in each group), as well as uninfected animals (n = 5 in each group) were used as controls...
2017: PloS One
https://www.readbyqxmd.com/read/29141315/-clinical-efficacy-of-one-lung-ventilation-in-treatment-of-children-postoperatively-intractable-atelectasis
#4
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29138038/low-dose-betamethasone-acetate-for-fetal-lung-maturation-in-preterm-sheep
#5
Augusto F Schmidt, Matthew W Kemp, Judith Rittenschober-Böhm, Paranthaman S Kannan, Haruo Usuda, Masatoshi Saito, Lucy Furfaro, Shimpei Watanabe, Sarah Stock, Boris W Kramer, John P Newnham, Suhas G Kallapur, Alan H Jobe
BACKGROUND: Antenatal steroids (ANS) are standard of care for women at risk of preterm delivery; however ANS dosing and formulation have not been adequately evaluated. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate (Beta-P+Beta-Ac) is more effective than 2 doses of Beta-P for inducing lung maturation in preterm fetal sheep. We hypothesized that the slowly-released Beta-Ac component induces similar lung maturation to Beta-P+Beta-Ac with decreased dose and fetal exposure...
November 11, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29128780/apnea-testing-using-the-oxygen-insufflation-method-for-diagnosis-of-brain-death-may-compromise-pulmonary-function
#6
Joanna Sołek-Pastuszka, Marcin Sawicki, Waldemar Iwańczuk, Klaudyna Kojder, Wojciech Saucha, Zenon Czajkowski, Kornel Chełstowski, Romuald Bohatyrewicz
INTRODUCTION: The aim of our study was to compare the reliability and safety of the classical I-AT with the continuous positive airway pressure apnea test (CPAP-AT). MATERIAL AND METHODS: In the group of 48 patients (group O), an I-AT was performed at the end of BD diagnostic procedures, and approximately 1-1.5h later CPAP-AT with 100% FiO2 and CPAP of 10cm H2O, provided by ventilator in CPAP mode. After pre‑oxygenation with 100% FiO2 for 10min, the PaO2/FiO2 ratio was recorded prior to I-AT at time-point one (T1) and prior to CPAP-AT at time-point two (T2)...
October 28, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29123846/two-cases-of-cryptogenic-life-threatening-hemoptysis-identification-and-management-of-bleeding-point
#7
Kazunori Okuda, Jun Tanaka, Jun Okamoto, Fumihisa Kishi, Junichiro Nakagawa, Hiroshi Hino, Satoru Chujoh, Kazuhisa Shimadzu, Masafumi Kishimoto, Noboru Kato, Shigeru Shiono
Cases: Case 1: A 63-year-old woman was referred for coughing blood. Although cardiorespiratory dynamics were stabilized by artificial respiration under sedation, severely poor ventilation developed from asphyxia associated with massive respiratory tract hemorrhage. One-lung ventilation was temporarily secured by endotracheal tube insertion into the left main bronchus just prior to cardiopulmonary arrest.Case 2: A 72-year-old man was referred for massive hemoptysis after coughing, then intubated and placed on a respirator...
January 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29121283/postoperative-pulmonary-complications-pulmonary-and-systemic-inflammatory-responses-after-lung-resection-surgery-with-prolonged-one-lung-ventilation-randomized-controlled-trial-comparing-intravenous-and-inhalational-anaesthesia
#8
F de la Gala, P Piñeiro, A Reyes, E Vara, L Olmedilla, P Cruz, I Garutti
Background: Recent studies report the immunomodulatory lung-protective role of halogenated anaesthetics during lung resection surgery (LRS) but have not investigated differences in clinical postoperative pulmonary complications (PPCs). The main goal of the present study was to compare the effect of sevoflurane and propofol on the incidence of PPCs in patients undergoing LRS. The second aim was to compare pulmonary and systemic inflammatory responses to LRS. Methods: Of 180 patients undergoing LRS recruited, data from 174 patients were analysed...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29121081/intraoperative-ventilatory-leak-predicts-prolonged-air-leak-after-lung-resection-a-retrospective-observational-study
#9
Won Ho Kim, Hyung-Chul Lee, Ho-Geol Ryu, Hyun-Kyu Yoon, Chul-Woo Jung
Prolonged air leak (PAL), defined as air leak more than 5 days after lung resection, has been associated with various adverse outcomes. However, studies on intraoperative risk factors for PAL are not sufficient. We investigated whether the intraoperative ventilatory leak (VL) can predict PAL. A retrospective study of 1060 patients with chest tubes after lung resection was conducted. Tidal volume data were retrieved from the electronic anesthesia records. Ventilatory leak (%) was calculated as [(inspiratory tidal volume-expiratory tidal volume)/ inspiratory tidal volume × 100] and was measured after restart of two-lung ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#10
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29118301/two-incision-totally-thoracoscopic-approach-for-mitral-valve-replacement
#11
Guochang Zhao, Jie Gao, Yan Liu, Song Gu, Yulin Guo, Bin Xie, Pi Xiong Su
Totally thoracosopic mitral valve replacement (MVR) has been applied to mitral stenosis for many years. Three working ports are usually necessary, among which the longest port ranges from 6 to 8 cm. This study aimed to determine the safety and feasibility of the two-incision totally thoracoscopic approach for MVR, with the longest incision of 3 cm.From January 2014 to February 2016, 90 patients with mitral valve stenosis were retrospectively analyzed. Thirty-six (40%) patients were included in the two-incision group and 54 patients were operated on using the sternotomy approach...
November 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29112468/the-effects-of-on-pump-and-off-pump-coronary-artery-bypass-surgery-on-respiratory-function-in-the-early-postoperative-period
#12
Federica Chiarenza, Theodoros Tsoutsouras, Cesare Cassisi, Cristina Santonocito, Stephen Gerry, Marinella Astuto, Shane George, Filippo Sanfilippo
BACKGROUND: Respiratory complications are common after cardiac surgery and the use of extracorporeal circulation is one of the main causes of lung injury. We hypothesized a better postoperative respiratory function in off-pump coronary artery bypass grafting (OPCABG) as compared with "on-pump coronary artery bypass grafting" (ONCABG). METHODS: This is a retrospective, single-center study at a cardiothoracic intensive care unit (ICU) in a tertiary university hospital...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29106495/the-impact-of-spontaneous-ventilation-on-non-operative-lung-injury-in-thoracic-surgery-a-randomized-controlled-rabbit-model-study
#13
Jun Liu, Yuan Zeng, Fei Cui, Yidong Wang, Ping He, Lan Lan, Shaojuan Chen, Wei Wang, Jingpei Li, Jianxing He
OBJECTIVES: One-lung ventilation (OLV) with general anaesthesia may increase adverse effects after thoracic surgery, specifically ventilator-induced lung injury. Spontaneous ventilation (SV) has no mechanical ventilation process, thus, we established a rabbit model to assess non-operative lung injury between OLV and SV. METHODS: Thirty-six rabbits were randomly divided into 6 groups: OLV and SV (0, 2 and 4 h). Blood gas analysis was performed after thoracic surgery...
July 3, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29096634/prediction-of-high-airway-pressure-using-a-non-linear-autoregressive-model-of-pulmonary-mechanics
#14
Ruby Langdon, Paul D Docherty, Christoph Schranz, J Geoffrey Chase
BACKGROUND: For mechanically ventilated patients with acute respiratory distress syndrome (ARDS), suboptimal PEEP levels can cause ventilator induced lung injury (VILI). In particular, high PEEP and high peak inspiratory pressures (PIP) can cause over distension of alveoli that is associated with VILI. However, PEEP must also be sufficient to maintain recruitment in ARDS lungs. A lung model that accurately and precisely predicts the outcome of an increase in PEEP may allow dangerous high PIP to be avoided, and reduce the incidence of VILI...
November 2, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/29095316/genome-wide-association-study-for-genetic-variants-related-with-maximal-voluntary-ventilation-reveals-two-novel-genomic-signals-associated-with-lung-function
#15
Yujin Suh, Chaeyoung Lee
Genome-wide association studies (GWAS) for spirometry parameters have been limited to forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and their ratio. This study examined to identify genetic variants associated with maximal voluntary ventilation (MVV), an important spirometry parameter presenting inspiratory muscle strength.A total of 8842 Korean subjects participated in the Korean Association REsource Consortium were used to identify nucleotide variants associated with MVV and other spirometry parameters through a GWAS...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29089125/particle-related-exposure-dose-and-lung-cancer-risk-of-primary-school-children-in-two-european-countries
#16
A Pacitto, L Stabile, M Viana, M Scungio, C Reche, X Querol, A Alastuey, I Rivas, M Álvarez-Pedrerol, J Sunyer, B L van Drooge, J O Grimalt, R Sozzi, P Vigo, G Buonanno
Schools represent a critical microenvironment in terms of air quality due to the proximity to outdoor particle sources and the frequent lack of proper ventilation and filtering systems. Moreover, the population exposed in schools (i.e. children) represents a susceptible population due to their age. Air quality-based studies involving students' exposure at schools are still scarce and often limited to mass-based particle metrics and may thus underestimate the possible effect of sub-micron particles and particle toxicity...
October 28, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/29078668/anaesthesiology-for-uniportal-vats-double-lumen-single-lumen-and-tubeless
#17
REVIEW
Ze-Rui Zhao, Rainbow W H Lau, Calvin S H Ng
The advent of one-lung ventilation (OLV) technique provides immobilized surgical field which is fundamental in minimally invasive thoracic surgery. Mainstem methods of achieving lung separation are either via a double-lumen endotracheal tube or placing a bronchial blocker (BB) through a single-lumen endotracheal tube. More recently, the use of non-intubated thoracic surgery (NITS) has been investigated intensively, attempting to minimise the complications that follow general anaesthesia. The aim of this review is to describe the mechanism of these techniques briefly and outlines the advantages and drawbacks of them with the comparison...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29078635/swine-model-for-training-surgeons-in-minimally-invasive-anatomic-lung-segmentectomy
#18
Hiroyuki Oizumi, Hirohisa Kato, Makoto Endoh, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Kenta Nakahashi, Mitsuaki Sadahiro
BACKGROUND: Despite the increasing demand for thoracoscopic lung segmentectomy, the appropriate training method is not well established. Therefore, we developed a swine model for anatomical thoracoscopic lung segmentectomy training. METHODS: Three-month-old pigs, weighing 40 to 45 kg, were used in this model. Anterior segmentectomy of the left cranial lobe and segmentectomy of the most anterior left caudal lobe were performed under general anesthesia and differential ventilation...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29072964/thoracoscopic-rib-resection-in-children
#19
Dheidan Mufreh Alshammari, Isabelle Talon, Julien Rod, Anne Schneider, Frederic Lavrand, Christian Piolat, Thomas Gelas, Frederic Hameury, Marina Sica, Philippe Gicquel, Valerie Flaum, François Becmeur
OBJECTIVE: The authors present a multicenter retrospective series of different benign rib lesions in children operated on using thoracoscopy. MATERIALS AND METHODS: Between 2005 and 2015, 17 rib resections were performed thoracoscopically, in four French departments of pediatric surgery. Of these 17 cases, 13 exostoses, 2 endochondromas, 1 synostosis, and 1 Cyriax's syndrome were noted. Inclusion criteria were benign tumors or rib anomalies such as synostosis, in children younger than the age of 18 years, and thoracoscopy...
October 26, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29072320/technical-note-correction-for-the-effect-of-breathing-variations-in-ct-pulmonary-ventilation-imaging
#20
Tokihiro Yamamoto, Sven Kabus
PURPOSE: The accuracy and precision of computed tomography (CT) pulmonary ventilation imaging with conventional CT scanners are limited by breathing variations. We propose a method to correct for the effect of breathing variations in CT ventilation imaging based on external respiratory signals acquired throughout a scan. METHODS: The proposed method is based on: (1) calculating voxel-by-voxel abdominal surface motion ranges using four-dimensional (4D) CT image datasets spatiotemporally correlated with external respiratory monitor data, and (2) applying the correction factor, which is defined as the ratio of the overall mean of the abdominal surface motion range in the lungs to that of each voxel, to the CT ventilation value...
October 26, 2017: Medical Physics
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