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One-lung ventilation

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https://www.readbyqxmd.com/read/29785297/determination-of-the-intersegmental-plane-using-the-slip-knot-method
#1
Makoto Endoh, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Kenta Nakahashi, Mitsuaki Sadahiro
Background: Visualization of intersegmental planes in the lung is desirable for precise anatomical lung segmentectomy. We developed the slip-knot method for creating inflation-deflation lines. This study aimed to assess relevant data for thoracoscopic segmentectomy performed using this method. Methods: In the slip-knot method, the objective segmental bronchus is looped with a monofilament thread. One end of the thread is then pulled during temporary bilateral ventilation, causing the knot to slip toward the bronchus...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29778333/radiotracer-localization-of-nonpalpable-pulmonary-nodules-a-single-center-experience
#2
Sandra L Starnes, Michael Wolujewicz, Julian Guitron, Valerie Williams, Jennifer Scheler, Ross Ristagno
OBJECTIVE: Multiple localization techniques to facilitate intraoperative identification of small or nonsolid pulmonary nodules have been developed. Radiotracer localization using technetium-labeled macroaggregated albumin has been our preferred localization method since 2009. We report our experience, including technical pitfalls and modifications, of our initial 77 patients who underwent this technique. METHODS: All patients undergoing preoperative radiotracer localization were identified from a prospective database...
April 11, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29776385/generation-of-ventilation-perfusion-ratio-map-in-surgical-patients-by-dual-energy-ct-after-xenon-inhalation-and-intravenous-contrast-media
#3
Kohei Aoki, Yotaro Izumi, Wataru Watanabe, Yuji Shimizu, Hisato Osada, Norinari Honda, Toshihide Itoh, Mitsuo Nakayama
BACKGROUND: While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results, there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before versus after lung resection. In the present pilot study, we evaluated if V/Q mapping can be constructed using dual energy CT images. METHODS: Thirty-one lung cancer patients planned for pulmonary resection were included in this study...
May 18, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29765004/a-comparison-of-the-adjustable-ranges-of-inspiratory-pressurization-during-pressure-controlled-continuous-mandatory-ventilation-of-5-icu-ventilators
#4
Yukiko Koyama, Akinori Uchiyama, Junko Yoshida, Takeshi Yoshida, Tomonori Yamashita, Yuji Fujino
BACKGROUND: Faster inspiratory pressurization can improve patient-ventilator synchrony and reduce the patient's work of breathing during pressure controlled continuous mandatory (PC-CMV) ventilation. The characteristics of the pressurization ramp settings are not standardized across ventilators from different manufacturers. We performed a bench test of 5 models of ICU ventilators to examine the effects of pressurization ramp settings on the actual pressurization. METHODS: A twin-bellows lung model was used, in which one bellow simulates inspiratory muscle activity and the other simulates an adult normal lung model...
May 15, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29762231/surfactant-administration-during-pediatric-cardiac-extracorporeal-membrane-oxygenation
#5
Constantinos Chrysostomou, Timothy Maul, Filip Istvanic, Peter Wearden
We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2)...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29756744/monitoring-the-oxygen-reserve-index-can-contribute-to-the-early-detection-of-deterioration-in-blood-oxygenation-during-one-lung-ventilation
#6
Wakana Koishi, Motoi Kumagai, Shohei Ogawa, Shuhei Hongo, Kenji Suzuki
BACKGROUND: Hypoxemia can occur during one-lung ventilation (OLV), but monitoring blood oxygenation using percutaneous oxygen saturation (SpO2) can be limited by detection latency, and SpO2 sometimes does not change during OLV. The Oxygen Reserve Index (ORiTM) is a novel index reported to detect impending desaturation before this is observed with SpO2 monitoring. This study assessed whether the ORi decreased earlier than SpO2 during OLV and evaluated its correlation with the partial pressure of arterial oxygen (PaO2) during OLV...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#7
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29742703/nebulized-heparin-and-n-acetylcysteine-for-smoke-inhalational-injury-a-case-report
#8
Umair Ashraf, Bharat Bajantri, Gabriella Roa-Gomez, Sindhaghatta Venkatram, Amanda Cantin, Gilda Diaz-Fuentes
RATIONALE: Every year, ∼40,000 people suffer burn-related injuries in the United States. Despite recent advances, the odds of dying from exposure to fire, flames, or smoke are one in ∼1500. Smoke inhalation causes injury to the airways via a complex physiological process, and the treatment is mainly supportive. Many recent interventions aim to decrease the formation of fibrin casts, the main cause of airway damage in these patients. Among these, treatment with a combination of nebulized heparin and N-acetylcysteine (NAC) has shown benefit...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29728414/t-piece-resuscitators-how-do-they-compare
#9
Murray Hinder, Alistair McEwan, Thomas Drevhammer, Snorri Donaldson, Mark Brian Tracy
BACKGROUND: The T-piece resuscitator (TPR) has seen increased use as a primary resuscitation device with newborns. Traditional TPR design uses a high resistance expiratory valve to produce positive end expiratory pressure (PEEP) or continuous positive airway pressure (CPAP) at resuscitation. A new TPR device that uses a dual flow ratio valve (fluidic flip) to produce PEEP/CPAP is now available (rPAP). We aimed to compare the measured ventilation performance of different TPR devices in a controlled bench test study...
May 4, 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/29709437/the-effects-of-an-open-lung-approach-during-one-lung-ventilation-on-postoperative-pulmonary-complications-and-driving-pressure-a-descriptive-multicenter-national-study
#10
Javier Belda, Carlos Ferrando, Ignacio Garutti
OBJECTIVE: Thoracic surgical procedures are associated with an increased risk of postoperative pulmonary complications (PPCs), which seem to be related directly to intraoperative driving pressure. The authors conducted this study to describe the incidence of PPCs in patients in whom an individualized open-lung approach was applied during one-lung ventilation. DESIGN: This was a prospective, multicenter, national descriptive study. SETTING: Thoracic surgery patients undergoing one-lung ventilation...
March 27, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29707376/is-laryngeal-mask-airway-general-anesthesia-feasible-for-minimally-invasive-esophagectomy
#11
Rui-Xiang Zhang, Yin Li, Xian-Ben Liu, Xi-Hua Lu, Hai-Bo Sun, Zong-Fei Wang, Shi-Lei Liu, Yan Zheng, Xiao-Fei Liu, Xiu-Xia Wu
Minimally invasive esophagectomy (MIE) has been identified as an oncological method with lower mortality and morbidity. This procedure is usually performed under general anesthesia using double endotracheal tube intubation and one-lung ventilation for a good visualization like other video-assisted thoracoscopic surgery (VATS). However, it is difficult to differentiate weather the postoperative hoarseness is caused by intubation or by recurrent laryngeal nerve injury during operation, and some complications related to intubation also are the focus of thoracic surgeons...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707346/a-comparison-between-two-lung-ventilation-with-co-2-artificial-pneumothorax-and-one-lung-ventilation-during-thoracic-phase-of-minimally-invasive-esophagectomy
#12
Miao Lin, Yaxing Shen, Hao Wang, Yong Fang, Cheng Qian, Songtao Xu, Di Ge, Mingxiang Feng, Lijie Tan, Qun Wang
Background: To investigate the feasibility and safety of two lung ventilation with artificial pneumothorax in minimally invasive esophagectomy (MIE) through a comparison with conventional one lung ventilation. Methods: Eleven hundred and sixty-six patients with esophageal cancer, who underwent McKeown MIE in our center from February 2006 to December 2016, were studied retrospectively. Seven hundred and five patients who underwent one lung ventilation with double lumen endotracheal tube (DLET) were assigned to DLET group...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707341/short-term-one-lung-ventilation-does-not-influence-local-inflammatory-cytokine-response-after-lung-resection
#13
Silvia Fiorelli, Veronica Defraia, Fabiola Cipolla, Cecilia Menna, Mohsen Ibrahim, Claudio Andreetti, Maurizio Simmaco, Monica Rocco, Erino Angelo Rendina, Marina Borro, Domenico Massullo
Background: One-lung ventilation (OLV) is a ventilation procedure used for pulmonary resection which may results in lung injury. The aim of this study was to evaluate the local inflammatory cytokine response from the dependent lung after OLV and its correlation to VT. The secondary aim was to evaluate the clinical outcome of each patient. Methods: Twenty-eight consecutive patients were enrolled. Ventilation was delivered in volume-controlled mode with a VT based on predicted body weight (PBW)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707298/effects-of-volume-controlled-ventilation-vs-pressure-controlled-ventilation-on-respiratory-function-and-inflammatory-factors-in-patients-undergoing-video-assisted-thoracoscopic-radical-resection-of-pulmonary-carcinoma
#14
Jing Tan, Zhenghuan Song, Qingming Bian, Pengyi Li, Lianbing Gu
Background: The best ventilation approach for patients undergoing video-assisted thoracic surgery (ATS) for pulmonary carcinoma remains undefined. This study aimed to assess hemodynamics, airway pressure, arterial blood gas, and inflammatory factors in patients undergoing VATS for pulmonary carcinoma under volume-controlled ventilation (VCV) or pressure-controlled ventilation (PCV). Methods: This was a prospective study of 60 patients with pulmonary carcinoma treated at a tertiary center in 2015-2016...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707296/sevoflurane-did-not-show-better-protective-effect-on-endothelial-glycocalyx-layer-compared-to-propofol-during-lung-resection-surgery-with-one-lung-ventilation
#15
Hye-Jin Kim, Eunsoo Kim, Seung-Hoon Baek, Hee Young Kim, Joo-Yun Kim, Juyeon Park, Eun-Ji Choi
Background: The endothelial glycocalyx layer (EGL) coats the alveolar capillary endothelium and plays important roles in pulmonary vascular protection, modulation, and hemostasis. Ischemia-reperfusion, which occurs during lung resection surgery with one lung ventilation (OLV), can damage the EGL. Sevoflurane is known for its protective effect against ischemia-reperfusion injury. Therefore, we hypothesized that lung resection surgery produces EGL damage and sevoflurane protects the EGL better than the intravenous anesthetic propofol...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707293/a-population-based-analysis-of-outcomes-after-radiotherapy-in-intensive-care-unit-patients-with-lung-cancer
#16
Alexander V Louie, Lihua Li, Krista Bray Jenkyn, Britney Allen, George B Rodrigues, Andrew Warner, David A Palma, Salimah Z Shariff
Background: As the value of radiotherapy (RT) in intensive care unit (ICU) patients with lung cancer is of uncertain efficacy, we evaluated characteristics, outcomes and RT utilization for such patients in Ontario, Canada. Methods: Multiple administrative databases were linked deterministically using unique encoded identifiers to identify eligible patients between April 1, 2007, and March 31, 2014. Differences in patient, treatment, institution and tumor characteristics between RT and non-RT groups at the level of episode of care were compared...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29695988/acute-anxiety-predicts-components-of-the-cold-shock-response-on-cold-water-immersion-toward-an-integrated-psychophysiological-model-of-acute-cold-water-survival
#17
Martin J Barwood, Jo Corbett, Heather Massey, Terry McMorris, Mike Tipton, Christopher R D Wagstaff
Introduction: Drowning is a leading cause of accidental death. In cold-water, sudden skin cooling triggers the life-threatening cold shock response (CSR). The CSR comprises tachycardia, peripheral vasoconstriction, hypertension, inspiratory gasp, and hyperventilation with the hyperventilatory component inducing hypocapnia and increasing risk of aspirating water to the lungs. Some CSR components can be reduced by habituation (i.e., reduced response to stimulus of same magnitude) induced by 3-5 short cold-water immersions (CWI)...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29692351/intrapulmonary-percussive-ventilation-as-an-airway-clearance-technique-in-subjects-with-chronic-obstructive-airway-diseases
#18
REVIEW
Gregory Reychler, Emilie Debier, Olivier Contal, Nicolas Audag
BACKGROUND: Airway clearance techniques are regularly proposed as a part of the treatment in chronic obstructive airway diseases. Intrapulmonary percussive ventilation (IPV) is used as an airway clearance technique in patients affected by excessive lung secretions. The aim of this systematic review is to summarize the physiological and clinical effects related to the use of IPV as an airway clearance technique in chronic obstructive airway diseases. METHODS: This systematic review followed the PRISMA guidelines...
April 24, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29684318/does-size-matter-when-calculating-the-correct-tidal-volume-for-pediatric-mechanical-ventilation-a-hypothesis-based-on-forced-vital-capacity
#19
Gina J Kim, Christopher J L Newth, Robinder G Khemani, Suzy L Wong, Allan L Coates, Patrick A Ross
BACKGROUND: Tidal volumes standardized to predicted body weight are recommended for adult mechanical ventilation, but children are frequently ventilated using measured body weight. Our goal is to examine the difference in forced vital capacity (FVC ml/kg) using measured compared to predicted body weight in children. METHODS: Retrospective analysis of outpatient pulmonary function tests (PFTs) from two datasets. Dataset one: 6 to 19 year old children undergoing PFTs from the nationally-representative Canadian Health Measures Survey...
April 20, 2018: Chest
https://www.readbyqxmd.com/read/29664963/trpv4-inhibition-attenuates-stretch-induced-inflammatory-cellular-responses-and-lung-barrier-dysfunction-during-mechanical-ventilation
#20
N Pairet, S Mang, G Fois, M Keck, M Kühnbach, J Gindele, M Frick, P Dietl, D J Lamb
Mechanical ventilation is an important tool for supporting critically ill patients but may also exert pathological forces on lung cells leading to Ventilator-Induced Lung Injury (VILI). We hypothesised that inhibition of the force-sensitive transient receptor potential vanilloid (TRPV4) ion channel may attenuate the negative effects of mechanical ventilation. Mechanical stretch increased intracellular Ca2+ influx and induced release of pro-inflammatory cytokines in lung epithelial cells that was partially blocked by about 30% with the selective TRPV4 inhibitor GSK2193874, but nearly completely blocked with the pan-calcium channel blocker ruthenium red, suggesting the involvement of more than one calcium channel in the response to mechanical stress...
2018: PloS One
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