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https://www.readbyqxmd.com/read/28413273/intraoperative-low-tidal-volume-ventilation-strategy-has-no-benefits-during-laparoscopic-cholecystectomy
#1
Vandna Arora, Asha Tyagi, Surendra Kumar, Aanchal Kakkar, Shukla Das
BACKGROUND AND AIMS: Benefits of intraoperative low tidal volume ventilation during laparoscopic surgery are not conclusively proven, even though its advantages were seen in other situations with intraoperative respiratory compromise such as one-lung ventilation. The present study compared the efficacy of intraoperative low tidal volume ventilatory strategy (6 ml/kg along with positive end-expiratory pressure [PEEP] of 10 cmH2O) versus one with higher tidal volume (10 ml/kg with no PEEP) on various clinical parameters and plasma levels of interleukin (IL)-6 in patients undergoing laparoscopic cholecystectomy...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28403395/individual-patient-data-analysis-of-tidal-volumes-used-in-three-large-randomized-control-trials-involving-patients-with-acute-respiratory-distress-syndrome
#2
J Poole, C McDowell, R Lall, G Perkins, D McAuley, F Gao, D Young
Background.: The acute respiratory distress syndrome (ARDS) is a condition with a high mortality and morbidity. Mechanical ventilation prevents immediate mortality but may further damage patients' lungs. Low tidal volume lung-protective strategies have been shown to increase survival by reducing this iatrogenic damage. Current guidelines recommend tidal volumes of 6-8 ml kg -1 of predicted body weight. We used data from three large randomized controlled trials of treatments for ARDS to determine compliance with these recommendations...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28401379/kidney-lung-pathophysiological-crosstalk-its-characteristics-and-importance
#3
REVIEW
Pilar Domenech, Tomas Perez, Agustina Saldarini, Pedro Uad, Carlos G Musso
Crosstalk between the lung and the kidney is based on the similarities that these organs share. This is why different diseases that affect one organ can have repercussions on the other. Patients with acute kidney injury can present complications such as pulmonary edema and require mechanical ventilation in respiratory failure. This interaction occurs due to the increase in systemic immune mediators that cause inflammatory reactions, oxidative stress, and an increase in vascular permeability in the lung. With regard to lung-induced renal damage, the kidney can also be affected by chemical mediators, which are translocated into the bloodstream...
April 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28398925/urgent-chemotherapy-for-life-threatening-complications-related-to-solid-neoplasms
#4
Yoann Zerbib, Antoine Rabbat, Muriel Fartoukh, Naïke Bigé, Claire Andréjak, Julien Mayaux, Nicolas De Prost, Benoît Misset, Virginie Lemiale, Fabrice Bruneel, Julien Maizel, Sylvie Ricome, Frédéric Jacobs, Caroline Bornstain, Hervé Dupont, François Baudin, Elie Azoulay, Frédéric Pène
OBJECTIVES: Solid neoplasms can be directly responsible for organ failures at the time of diagnosis or relapse. The management of such specific complications relies on urgent chemotherapy and eventual instrumental or surgical procedures, combined with advanced life support. We conducted a multicenter study to address the prognosis of this condition. DESIGN: A multicenter retrospective (2001-2015) chart review. SETTING: Medical and respiratory ICUs...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28382903/lung-transplantation-in-germany-since-the-introduction-of-the-lung-allocation-score
#5
Jens Gottlieb, Jacqueline Smits, Rene Schramm, Frank Langer, Roland Buhl, Christian Witt, Martin Strueber, Hermann Reichenspurner
BACKGROUND: The allocation of donor lungs for transplantation in Germany was changed on 10 December 2011 to a system based on the Lung Allocation Score (LAS). The aim of the present study is to determine whether this change has prolonged the survival of patients on the transplant waiting list and of those who have undergone lung transplantation (LTx). METHODS: We retrospectively compared data from the three-year periods before and after the change to an LAS-based allocation system (2009-2011 vs...
March 17, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#6
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28379133/-non-invasive-ventilation-in-patients-with-diaphragmatic-paralysis-case-report
#7
Magali Blanco, Glenda Ernst, A Salvado, V H Cambursano, E Borsini
Background Diaphragmatic paralysis (DP) is a rare disease, usually secondary to systemic processes, although idiopathic forms have been described. Aim To describe the use of non-invasive ventilation as a treatment to patients with DP. Material and methods Descriptive study about consecutive cases of DP in a general hospital. Results It has been described 4 patients, all of them with a diminished the maximum mouth pressures and vital capacity in supine position. Three patients presented hypercapnia, and one of them, required intubation with invasive mechanical ventilation...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28375655/cardiopulmonary-exercise-test-as-a-tool-to-choose-therapy-in-heart-failure
#8
Mauro Contini
Heart failure treatment can count on several drugs, all providing an improvement in outcome, but that cannot be realistically used all together in the same patient. It would be useful to have a tool that allows arranging the most appropriate therapy cocktail in each patient. The aim of this review is to show the main differences in the effects of several drugs on cardiopulmonary function in heart failure patients, both in resting condition and during exercise, and to discuss how these differences can be taken into account when choosing the most appropriate therapeutic protocol...
April 4, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#9
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
#10
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/28339394/global-and-regional-assessment-of-sustained-inflation-pressure-volume-curves-in-patients-with-acute-respiratory-distress-syndrome
#11
Tobias Becher, Philipp Rostalski, Matthias Kott, Andy Adler, Dirk Schadler, Norbert Weiler, Inez Frerichs
Static or quasi-static pressure-volume (P-V) curves can be used to determine the lung mechanical properties of patients suffering from acute respiratory distress syndrome (ARDS). According to the traditional interpretation, lung recruitment occurs mainly below the lower point of maximum curvature (LPMC) of the inflation P-V curve. Although some studies have questioned this assumption, setting of positive end-expiratory pressure 2 cmH2O above the LPMC was part of a "lung-protective" ventilation strategy successfully applied in several clinical trials...
March 24, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28315041/positive-pressure-ventilation-in-a-patient-with-a-right-upper-lobar-bronchocutaneous-fistula-right-upper-bronchus-occlusion-using-the-cuff-of-a-left-sided-double-lumen-endobronchial-tube
#12
Chieko Omori, Hiroaki Toyama, Yusuke Takei, Yutaka Ejima, Masanori Yamauchi
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage...
March 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28314081/delirium-after-lung-transplantation-association-with-recipient-characteristics-hospital-resource-utilization-and-mortality
#13
Yelizaveta Sher, Joshua Mooney, Gundeep Dhillon, Roy Lee, José R Maldonado
BACKGROUND: Delirium is associated with increased morbidity and mortality. The factors associated with post-lung transplant delirium and its impact on outcomes are under characterized. METHODS: The medical records of 163 consecutive adult lung transplant recipients were reviewed for delirium within 5 days (early-onset) and 30 hospital days (ever-onset) post-transplantation. A multivariable logistic regression model assessed factors associated with delirium. Multivariable negative binomial regression and Cox proportional hazards models assessed the association of delirium with ventilator duration, intensive care unit (ICU) length of stay (LOS), hospital LOS, and one-year mortality...
March 17, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28306591/ventilation-with-high-versus-low-peep-levels-during-general-anaesthesia-for-open-abdominal-surgery-does-not-affect-postoperative-spirometry-a-randomised-clinical-trial
#14
Tanja A Treschan, Maximilian Schaefer, Johann Kemper, Bea Bastin, Peter Kienbaum, Benedikt Pannen, Sabrine N Hemmes, Marcelo G de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Invasive mechanical ventilation during general anaesthesia for surgery typically causes atelectasis and impairs postoperative lung function. OBJECTIVE: We investigated the effect of intraoperative ventilation with high positive end-expiratory pressure (PEEP) and recruitment manoeuvres (RMs) on postoperative spirometry. DESIGN: This was a preplanned, single-centre substudy of an international multicentre randomised controlled trial, the PROVHILO trial...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28286833/ventilator-associated-pneumonia-and-its-responsible-germs-an-epidemiological-study
#15
Rama Bozorgmehr, Vanousheh Bahrani, Alireza Fatemi
INTRODUCTION: Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. METHODS: In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28283007/-mortality-related-factors-in-patients-requiring-hospitalization-for-influenza-like-illness
#16
Lale Özışık, Mine Durusu Tanrıöver, Meral Çıblak Akçay, Kübra Yuntçu, Serhat Ünal, Selim Badur, Banu Çakır
The knowledge about the viral etiologies causing respiratory disease in adults is limited. Viral respiratory diseases may lead deterioration in certain patient populations. The aim of this study was to determine the viral etiologies of influenza-like illness among patients requiring hospitalization and to document the risk factors for mortality. This prospective study was performed in one of the 7 centers in Turkey in the context of influenza surveillance by the Global Influenza Hospital Surveillance Network...
January 2017: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28277372/one-hit-models-of-ventilator-induced-lung-injury-benign-inflammation-versus-inflammation-as-a-by-product
#17
Dennis Lex, Stefan Uhlig
BACKGROUND: One important explanation for the detrimental effects of conventional mechanical ventilation is the biotrauma hypothesis that ventilation may trigger proinflammatory responses that subsequently cause lung injury. This hypothesis has frequently been studied in so-called one-hit models (overventilation of healthy lungs) that so far have failed to establish an unequivocal link between inflammation and hypoxemic lung failure. This study was designed to develop a one-hit biotrauma model...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28277322/utilizing-forced-vital-capacity-to-predict-low-lung-compliance-and-select-intraoperative-tidal-volume-during-thoracic-surgery
#18
Nir Hoftman, Eric Eikermann, John Shin, Jack Buckley, Kaveh Navab, Fereidoun Abtin, Tristan Grogan, Maxime Cannesson, Aman Mahajan
BACKGROUND: Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. METHODS: One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT)...
March 8, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28268882/noninvasive-estimation-of-alveolar-pressure
#19
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28256331/-deep-versus-moderate-neuromuscular-block-during-one-lung-ventilation-in-lung-resection-surgery
#20
Javier Casanova, Patricia Piñeiro, Francisco De La Gala, Luis Olmedilla, Patricia Cruz, Patricia Duque, Ignacio Garutti
BACKGROUND AND OBJECTIVES: Neuromuscular relaxants are essential during general anesthesia for several procedures. Classical anesthesiology literature indicates that the use of neuromuscular blockade in thoracic surgery may be deleterious in patients in lateral decubitus position in one-lung ventilation. The primary objective of our study was to compare respiratory function according to the degree of patient neuromuscular relaxation. Secondary, we wanted to check that neuromuscular blockade during one-lung ventilation is not deleterious...
February 27, 2017: Revista Brasileira de Anestesiologia
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