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Mechanical ventilation one lung

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https://www.readbyqxmd.com/read/29323413/extracorporeal-membrane-oxygenation-for-refractory-severe-respiratory-failure-in-acute-interstitial-pneumonia
#1
Gabriela Gonçalves-Venade, Nuno Lacerda-Príncipe, Roberto Roncon-Albuquerque, José Artur Paiva
Acute interstitial pneumonia (AIP) is a rare idiopathic interstitial lung disease with rapid progressive respiratory failure and high mortality. In the present report, three cases of AIP complicated by refractory respiratory failure supported with extracorporeal membrane oxygenation (ECMO) are presented. One male and two female patients (ages 27-59) were included. Venovenous ECMO support was provided using miniaturized systems, with two-site femoro-jugular circuit configuration. Despite lung protective ventilation, prone position and neuromuscular blockade, refractory respiratory failure of unknown etiology supervened (ratio of arterial oxygen partial pressure to fractional inspired oxygen 46-130) and ECMO was initiated after 3-7 days of mechanical ventilation...
January 11, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29319770/factors-associated-with-hospital-mortality-in-renal-transplant-patients-admitted-to-the-intensive-care-unit-with-acute-respiratory-failure
#2
Rafael Mendes da Silva, Flavio Geraldo Rezende de Freitas, Antonio Tonete Bafi, Hélio Tedesco Silva Junior, Bartira de Aguiar Roza
INTRODUCTION: The lungs are often involved in a variety of complications after kidney transplantation. Acute respiratory failure (ARF) is one of the most serious manifestations of pulmonary involvement. OBJECTIVE: To describe the main causes of ARF in kidney transplant patients who require intensive care and identify the factors associated with mortality. METHODS: This retrospective study evaluated adult patients with ARF admitted to the intensive care unit of a center with high volume of transplants from August 2013 to August 2015...
October 2017: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29300236/contemporary-risk-factors-and-outcomes-of-transfusion-associated-circulatory-overload
#3
Nareg H Roubinian, Jeanne E Hendrickson, Darrell J Triulzi, Jerome L Gottschall, Michael Michalkiewicz, Dhuly Chowdhury, Daryl J Kor, Mark R Looney, Michael A Matthay, Steven H Kleinman, Donald Brambilla, Edward L Murphy
OBJECTIVES: Transfusion-associated circulatory overload is characterized by hydrostatic pulmonary edema following blood transfusion. Restrictive transfusion practice may affect the occurrence and severity of transfusion-associated circulatory overload in critically ill patients. We sought to examine contemporary risk factors and outcomes for transfusion-associated circulatory overload. DESIGN: Case-control study. SETTING: Four tertiary care hospitals...
January 3, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#4
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29221302/the-society-for-translational-medicine-clinical-practice-guidelines-for-mechanical-ventilation-management-for-patients-undergoing-lobectomy
#5
REVIEW
Shugeng Gao, Zhongheng Zhang, Alessandro Brunelli, Chang Chen, Chun Chen, Gang Chen, Haiquan Chen, Jin-Shing Chen, Stephen Cassivi, Ying Chai, John B Downs, Wentao Fang, Xiangning Fu, Martínez I Garutti, Jianxing He, Jie He, Jian Hu, Yunchao Huang, Gening Jiang, Hongjing Jiang, Zhongmin Jiang, Danqing Li, Gaofeng Li, Hui Li, Qiang Li, Xiaofei Li, Yin Li, Zhijun Li, Chia-Chuan Liu, Deruo Liu, Lunxu Liu, Yongyi Liu, Haitao Ma, Weimin Mao, Yousheng Mao, Juwei Mou, Calvin Sze Hang Ng, René H Petersen, Guibin Qiao, Gaetano Rocco, Erico Ruffini, Lijie Tan, Qunyou Tan, Tang Tong, Haidong Wang, Qun Wang, Ruwen Wang, Shumin Wang, Deyao Xie, Qi Xue, Tao Xue, Lin Xu, Shidong Xu, Songtao Xu, Tiansheng Yan, Fenglei Yu, Zhentao Yu, Chunfang Zhang, Lanjun Zhang, Tao Zhang, Xun Zhang, Xiaojing Zhao, Xuewei Zhao, Xiuyi Zhi, Qinghua Zhou
Patients undergoing lobectomy are at significantly increased risk of lung injury. One-lung ventilation is the most commonly used technique to maintain ventilation and oxygenation during the operation. It is a challenge to choose an appropriate mechanical ventilation strategy to minimize the lung injury and other adverse clinical outcomes. In order to understand the available evidence, a systematic review was conducted including the following topics: (I) protective ventilation (PV); (II) mode of mechanical ventilation [e...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29221272/goal-directed-fluid-restriction-using-stroke-volume-variation-and-cardiac-index-during-one-lung-ventilation-a-randomized-controlled-trial
#6
Hui Xu, Shu-Hua Shu, Di Wang, Xiao-Qing Chai, Yan-Hu Xie, Wei-De Zhou
Background: Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). Methods: A Total of 168 patients scheduled for elective thoracoscopic lobectomy under OLV were randomized into the GDFR protocol (group G) or conventional fluid therapy groups (group C)...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29219945/vats-plication-of-the-diaphragm-a-descriptive-observational-10-year-southampton-experience
#7
Rhona J Taberham, Adnan Raza, Aiman Alzetani, Edwin B Woo, Martin H Chamberlain, George Koulaxouzidis, Khalid M Amer
OBJECTIVE: The aim of the study was to report the safety and efficacy of video-assisted thoracoscopic (VATS) plication of the diaphragm at our institution between 2006 and 2016. METHODS: Adult patients selected on etiology and combination of investigations including plain chest x-ray, computed tomography of chest and abdomen, lung functions in supine and sitting positions, radiological/ultrasonic screening for diaphragmatic movement, and phrenic nerve conduction studies...
December 6, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29215365/physiologic-evaluation-of-ventilation-perfusion-mismatch-and-respiratory-mechanics-at-different-positive-end-expiratory-pressure-in-patients-undergoing-protective-one-lung-ventilation
#8
Savino Spadaro, Salvatore Grasso, Dan Stieper Karbing, Alberto Fogagnolo, Marco Contoli, Giacomo Bollini, Riccardo Ragazzi, Gilda Cinnella, Marco Verri, Narciso Giorgio Cavallesco, Stephen Edward Rees, Carlo Alberto Volta
BACKGROUND: Arterial oxygenation is often impaired during one-lung ventilation, due to both pulmonary shunt and atelectasis. The use of low tidal volume (VT) (5 ml/kg predicted body weight) in the context of a lung-protective approach exacerbates atelectasis. This study sought to determine the combined physiologic effects of positive end-expiratory pressure and low VT during one-lung ventilation. METHODS: Data from 41 patients studied during general anesthesia for thoracic surgery were collected and analyzed...
December 6, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29199768/invasive-versus-non-invasive-ventilation-for-acute-respiratory-failure-in-neuromuscular-disease-and-chest-wall-disorders
#9
REVIEW
Fang Luo, Djillali Annane, David Orlikowski, Li He, Mi Yang, Muke Zhou, Guan J Liu
BACKGROUND: Acute respiratory failure is a common life-threatening complication of acute onset neuromuscular diseases, and may exacerbate chronic hypoventilation in patients with neuromuscular disease or chest wall disorders. Standard management includes oxygen supplementation, physiotherapy, cough assistance, and, whenever needed, antibiotics and intermittent positive pressure ventilation. Non-invasive mechanical ventilation (NIV) via nasal, buccal or full-face devices has become routine practice in many centres...
December 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29189633/lung-transplantation-as-a-therapeutic-option-in-acute-respiratory-distress-syndrome
#10
Youjin Chang, Sang Oh Lee, Tae Sun Shim, Sae Hoon Choi, Hyung Ryul Kim, Yong-Hee Kim, Dong Kwan Kim, Kyung-Hyun Do, In-Cheol Choi, Sang-Bum Hong, Seung-Il Park
BACKGROUND: Lung transplantation (LTPL) is considered as a salvage therapeutic option in patients with end-stage lung disease. However, there is a lack of sufficient data on the use of LTPL in patients with acute respiratory distress syndrome (ARDS). While there are few case reports on lung transplant for ARDS, no case series exist up to date. The aim of this study was to evaluate the clinical outcomes of patients with ARDS in accordance with the LTPL status. METHODS: Patients who had severe ARDS (PaO2/FiO2 ratio ≤ 100 mmHg with positive end expiratory pressure ≥ 5 cmH2O) and were listed for LTPL with no underlying end-stage lung disease were included in this single-center retrospective study...
November 17, 2017: Transplantation
https://www.readbyqxmd.com/read/29174662/keep-ventilating-the-lungs-while-the-heart-is-still-ejecting-on-femoro-femoral-cardiopulmonary-bypass
#11
Sisse Anette Thomassen, Dovile Leonaviciute, Poul Erik Haar, Jens Brøndum Frøkjær, Bodil Steen Rasmussen
Femoro-femoral cardiopulmonary bypass (CPB) followed by deep hypothermic circulatory arrest is one of the modalities used for ascending aortic pseudoaneurysm repair to achieve cardiac unloading and to avoid severe hemorrhage due to the risk of rupture during the sternal entry. However, due to the limited size of the cannulas, it can be challenging to achieve total cardiopulmonary support. Therefore, despite the achievement of total cardiopulmonary support, the heart may still be able to eject antegrade blood flow that meets the retrograde blood flow from the arterial side of the CPB...
October 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29152933/ventilator-induced-lung-injury-does-it-occur-in-children
#12
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/29149185/linezolid-and-atorvastatin-impact-on-pneumonia-caused-by-staphyloccocus-aureus-in-rabbits-with-or-without-mechanical-ventilation
#13
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/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#14
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
#15
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/29106495/the-impact-of-spontaneous-ventilation-on-non-operative-lung-injury-in-thoracic-surgery-a-randomized-controlled-rabbit-model-study
#16
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...
December 1, 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
#17
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
#18
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/29078668/anaesthesiology-for-uniportal-vats-double-lumen-single-lumen-and-tubeless
#19
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: Journal of visualized surgery
https://www.readbyqxmd.com/read/29070464/-relationship-between-cytoplasmic-phospholipase-a2-and-nuclear-factor-%C3%AE%C2%BAb-in-one-lung-ventilation-induced-lung-injury-in-rabbits
#20
Yong Yang, Xin Guo, Zhi-Cheng Yu, Jia-Qing Ma, Xing-Ling Liu, Li-Sha Li, Gao-Peng Xiao, Xiao-Meng Liu, Xin-Nan Li, Jin-Song Shen, Yan-Hua Li, Rui Liu
OBJECTIVE: To elucidate the mechanisms of up regulated expression of cytoplasmic phospholipase A2 (CPLA2) induced by one lung ventilation (OLV) by investigating the interactions between nuclear factor kappaB (NF-κB) and C-PLA2. METHODS: Forty-eight healthy Japanese white rabbits were randomized into control group, solvent treatment group (group S), NF-κB inhibitor (PDTC)/solvent treatment group ( group PS), C-PLA2 inhibitor (AACOCF3)/solvent treatment group (group AS), OLV group (group O), solvent treatment plus OLV group (SO group), NFκB inhibitor (PDTC)/solvent treatment plus OLV group (group PSO) and CPLA2 inhibitor (AACOCF3)/solvent treatment plus OLV group (group ASO)...
October 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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