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https://www.readbyqxmd.com/read/28921478/interstitial-pneumonia-with-autoimmune-features-an-additional-risk-factor-for-ards
#1
Giacomo Grasselli, Beatrice Vergnano, Maria Rosa Pozzi, Vittoria Sala, Gabriele D'Andrea, Vittorio Scaravilli, Marco Mantero, Alberto Pesci, Antonio Pesenti
BACKGROUND: Interstitial pneumonia with autoimmune features (IPAF) identifies a recently recognized autoimmune syndrome characterized by interstitial lung disease and autoantibodies positivity, but absence of a specific connective tissue disease diagnosis or alternative etiology. We retrospectively reviewed the clinical presentation, diagnostic workup and management of seven critically ill patients who met diagnostic criteria for IPAF. We compared baseline characteristics and clinical outcome of IPAF patients with those of the population of ARDS patients admitted in the same period...
September 18, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28913327/in-vivo-evaluation-of-the-acute-pulmonary-response-to-poractant-alfa-and-bovactant-treatments-in-lung-lavaged-adult-rabbits-and-in-preterm-lambs-with-respiratory-distress-syndrome
#2
Francesca Ricci, Fabrizio Salomone, Elke Kuypers, Daan Ophelders, Maria Nikiforou, Monique Willems, Tobias Krieger, Xabier Murgia, Matthias Hütten, Boris W Kramer, Federico Bianco
BACKGROUND: Poractant alfa (Curosurf(®)) and Bovactant (Alveofact(®)) are two animal-derived pulmonary surfactants preparations approved for the treatment of neonatal respiratory distress syndrome (nRDS). They differ in their source, composition, pharmaceutical form, and clinical dose. How much these differences affect the acute pulmonary response to treatment is unknown. OBJECTIVES: Comparing these two surfactant preparations in two different animal models of respiratory distress focusing on the short-term response to treatment...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28910340/successful-1-1-proportion-ventilation-with-a-unique-device-for-independent-lung-ventilation-using-a-double-lumen-tube-without-complications-in-the-supine-and-lateral-decubitus-positions-a-pilot-study
#3
Michał Kowalczyk, Sławomir Sawulski, Wojciech Dąbrowski, Luiza Grzycka-Kowalczyk, Edyta Kotlińska-Hasiec, Agnieszka Wrońska-Sewruk, Artur Florek, Rafał Rutyna
INTRODUCTION: Adequate blood oxygenation and ventilation/perfusion matching should be main goal of anaesthetic and intensive care management. At present, one of the methods of improving gas exchange restricted by ventilation/perfusion mismatching is independent ventilation with two ventilators. Recently, however, a unique device has been developed, enabling ventilation of independent lungs in 1:1, 2:1, 3:1, and 5:1 proportions. The main goal of the study was to evaluate the device's utility, precision and impact on pulmonary mechanics...
2017: PloS One
https://www.readbyqxmd.com/read/28898345/-endoscopic-lung-volume-reduction-in-advanced-pulmonary-emphysema-initial-experience-in-chile
#4
Sebastián Fernández-Bussy, Gonzalo Labarca, Iván Caviedes, Hiren J Mehta, Michael Jantz, Adnan Majid
Chronic obstructive pulmonary disease (COPD) has no curative treatment, and in moderate to advanced stages, functional parameters and quality of life are affected. Lung volume reduction improves respiratory parameters and quality of life of these patients. Endoscopic lung volume reduction is a minimally invasive procedure that uses endobronchial valves or coils. Valves are unidirectional, blocking the air from entering the target lobe during inspiration, allowing the exit of air and secretions during expiration...
May 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28889192/the-economic-impact-of-prematurity-and-bronchopulmonary-dysplasia
#5
María Álvarez-Fuente, Luis Arruza, Marta Muro, Carlos Zozaya, Alejandro Avila, Paloma López-Ortego, Carmen González-Armengod, Alba Torrent, Jose Luis Gavilán, María Jesús Del Cerro
Bronchopulmonary dysplasia (BPD) is one of the most serious chronic lung diseases in infancy and one of the most important sequels of premature birth (prevalence of 15-50%). Our objective was to estimate the cost of BPD of one preterm baby, with no other major prematurity-related complications, during the first 2 years of life in Spain. Data from the Spanish Ministry of Health regarding costs of diagnosis-related group of preterm birth, hospital admissions and visits, palivizumab administration, and oxygen therapy in the year 2013 were analyzed...
September 9, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28882385/lung-deposition-and-systemic-bioavailability-of-different-aerosol-devices-with-and-without-humidification-in-mechanically-ventilated-patients
#6
Islam O F Moustafa, Mohammed R A-A Ali, Moataz Al Hallag, Hoda Rabea, James B Fink, Patricia Dailey, Mohamed E A Abdelrahim
BACKGROUND: During mechanical ventilation medical aerosol delivery has been reported to be upto two fold greater with dry inhaled gas than with heated humidity. Urine levels at 0.5 h post dose (URSAL0.5%) has been confirmed as an index of lung deposition and 24 h (URSAL24%) as index of systemic absorption. Our aim was to determine the effect of humidification and aerosol device type on drug delivery to ventilated patients using urine levels. METHODS: In a randomized crossover design, 36 (18female) mechanically ventilated patients were assigned to one of three groups...
September 4, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28865973/recovery-of-pulmonary-function-after-allogeneic-hematopoietic-cell-transplantation-in-children-is-associated-with-improved-survival
#7
Ashok Srinivasan, Anusha Sunkara, William Mitchell, Sudeep Sunthankar, Guolian Kang, Dennis C Stokes, Saumini Srinivasan
Abnormal pulmonary function is prevalent in survivors of allogeneic hematopoietic cell transplantation. Post-transplant recovery of pulmonary function, and its effect on survival in children is not known. This is a retrospective cohort study of 308 children followed for 10 years after transplantation at a single institution. There were 2 groups of patients. Group 1 included 188 patients with 3 or more pulmonary function test (PFT) results, of which at least 1 was abnormal, group 2 included 120 patients with 3 or more PFTs, all of which were normal...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28864030/a-fatal-outbreak-of-st11-carbapenem-resistant-hypervirulent-klebsiella-pneumoniae-in-a-chinese-hospital-a-molecular-epidemiological-study
#8
Danxia Gu, Ning Dong, Zhiwei Zheng, Di Lin, Man Huang, Lihua Wang, Edward Wai-Chi Chan, Lingbin Shu, Jiang Yu, Rong Zhang, Sheng Chen
BACKGROUND: Hypervirulent Klebsiella pneumoniae strains often cause life-threatening community-acquired infections in young and healthy hosts, but are usually sensitive to antibiotics. In this study, we investigated a fatal outbreak of ventilator-associated pneumonia caused by a new emerging hypervirulent K pneumoniae strain. METHODS: The outbreak occurred in the integrated intensive care unit of a new branch of the Second Affiliated Hospital of Zhejiang University (Hangzhou, China)...
August 29, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28828363/positive-end-expiratory-pressure-how-to-set-it-at-the-individual-level
#9
REVIEW
Luciano Gattinoni, Francesca Collino, Giorgia Maiolo, Francesca Rapetti, Federica Romitti, Tommaso Tonetti, Francesco Vasques, Michael Quintel
The positive end-expiratory pressure (PEEP), since its introduction in the treatment of acute respiratory failure, up to the 1980s was uniquely aimed to provide a viable oxygenation. Since the first application, a large debate about the criteria for selecting the PEEP levels arose within the scientific community. Lung mechanics, oxygen transport, venous admixture thresholds were all proposed, leading to PEEP recommendations from 5 up to 25 cmH2O. Throughout this period, the main concern was the hemodynamics...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828361/driving-pressure-and-mechanical-power-new-targets-for-vili-prevention
#10
REVIEW
Tommaso Tonetti, Francesco Vasques, Francesca Rapetti, Giorgia Maiolo, Francesca Collino, Federica Romitti, Luigi Camporota, Massimo Cressoni, Paolo Cadringher, Michael Quintel, Luciano Gattinoni
Several factors have been recognized as possible triggers of ventilator-induced lung injury (VILI). The first is pressure (thus the 'barotrauma'), then the volume (hence the 'volutrauma'), finally the cyclic opening-closing of the lung units ('atelectrauma'). Less attention has been paid to the respiratory rate and the flow, although both theoretical considerations and experimental evidence attribute them a significant role in the generation of VILI. The initial injury to the lung parenchyma is necessarily mechanical and it could manifest as an unphysiological distortion of the extracellular matrix and/or as micro-fractures in the hyaluronan, likely the most fragile polymer embedded in the matrix...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828360/transpulmonary-pressure-importance-and-limits
#11
REVIEW
Domenico Luca Grieco, Lu Chen, Laurent Brochard
Transpulmonary pressure (PL) is computed as the difference between airway pressure and pleural pressure and separates the pressure delivered to the lung from the one acting on chest wall and abdomen. Pleural pressure is measured as esophageal pressure (PES) through dedicated catheters provided with esophageal balloons. We discuss the role of PL in assessing the effects of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). In the supine position, directly measured PL represents the pressure acting on the alveoli and airways...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828357/definition-and-epidemiology-of-acute-respiratory-distress-syndrome
#12
REVIEW
Emanuele Rezoagli, Roberto Fumagalli, Giacomo Bellani
Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28825930/simulation-training-for-residents-focused-on-mechanical-ventilation-a-randomized-trial-using-mannequin-based-versus-computer-based-simulation
#13
Savino Spadaro, Dan Stieper Karbing, Alberto Fogagnolo, Riccardo Ragazzi, Francesco Mojoli, Luca Astolfi, Antonio Gioia, Elisabetta Marangoni, Stephen Edward Rees, Carlo Alberto Volta
INTRODUCTION: Advances in knowledge regarding mechanical ventilation (MV), in particular lung-protective ventilation strategies, have been shown to reduce mortality. However, the translation of these advances in knowledge into better therapeutic performance in real-life clinical settings continues to lag. High-fidelity simulation with a mannequin allows students to interact in lifelike situations; this may be a valuable addition to traditional didactic teaching. The purpose of this study is to compare computer-based and mannequin-based approaches for training residents on MV...
September 6, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28822739/experimental-characterization-and-model-identification-of-the-nonlinear-compressible-material-behavior-of-lung-parenchyma
#14
Anna M Birzle, Christian Martin, Lena Yoshihara, Stefan Uhlig, Wolfgang A Wall
The mechanical properties of lung parenchyma are essential both in lung function and biology; consequently, experimental methods are developed to describe the mechanical behavior of lung parenchyma. During breathing and mechanical ventilation, volume change is the physiologically dominating deformation mode of lung parenchyma; nevertheless, most studies examine lung tissue in mainly isochoric tension tests. In this paper, a novel experimental method for the quantification of the compressible material behavior at high volume changes of viable lung parenchyma is proposed...
August 5, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28820027/atelectasis-after-airway-extubation-during-veno-arterial-extracorporeal-membrane-oxygenation-support
#15
Hong Wang, Ming Jia, Bin Mao, Xiaotong Hou
Veno-arterial extracorporeal membrane oxygenation (VA ECMO) is used in cardiopulmonary failure patients to provide temporary assisted circulation. Usually, prolonged intubation and invasive mechanical ventilation are required in patients with ECMO support. We report on two cases of patients who had no pre-existing injuries of the affected lung, underwent VA ECMO support after open-heart surgery and received airway extubation (AE) or awake ECMO with the recovery of left ventricular ejection fraction. Atelectasis happened after AE and non-invasive positive pressure ventilation attenuated the atelectasis of one patient...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28818610/surfactant-and-continuous-positive-airway-pressure-for-the-prevention-of-chronic-lung-disease-history-reality-and-new-challenges
#16
REVIEW
Hany Aly, Mohamed A Mohamed, Jen-Tien Wung
The discovery of surfactant was one of the most significant research events to occur in the history of neonatology. Certainly, surfactant saved lives for premature infants who were otherwise considered non-viable. However, the prevention of chronic lung disease did not progress and it became clear that a significant portion of the help surfactant provides to the premature lung is counteracted by mechanical ventilation. A dilemma exists over the priorities in premature management to intubate and administer surfactant or not to intubate and support these infants non-invasively with the use of continuous positive airway pressure...
October 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28808576/-awake-ecco2r-superseded-intubation-in-a-near-fatal-asthma-attack
#17
Thomas-Michael Schneider, Tibor Bence, Franz Brettner
BACKGROUND: Near-fatal asthma attacks are life threatening events that often require mechanical ventilation. Extracorporeal carbon dioxide removal (ECCO2R) is, beside extracorporeal membrane oxygenation (ECMO), a well-established rescue option whenever ventilation gets to its limits. But there seems to be very rare experience with those techniques in avoiding mechanical ventilation in severe asthma attacks. CASE PRESENTATION: A 67-year-old man with a near-fatal asthma attack deteriorated under non-invasive ventilation conditions...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28808186/oxygenation-inflammatory-response-and-lung-injury-during-one-lung-ventilation-in-rabbits-using-inspired-oxygen-fraction-of-0-6-vs-1-0
#18
Zeping Xu, Lianbing Gu, Qingming Bian, Pengyi Li, Lijun Wang, Jingyuan Zhang, Yanning Qian
Maintaining adequate oxygenation during one-lung ventilation (OLV) requires high inspired oxygen fraction (FiO2). However, high FiO2 also causes inflammatory response and lung injury. Therefore, it remains a great interest to clinicians and scientists to optimize the care of patients undergoing OLV. The aim of this study was to determine and compare oxygenation, inflammatory response and lung injury during OLV in rabbits using FiO2 of 0.6 vs. 1.0. After 30 minutes of two-lung ventilation (TLV) as baseline, 30 rabbits were randomly assigned to three groups receiving mechanical ventilation for 3 hours: the sham group, receiving TLV with 0...
October 17, 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/28807576/evaluation-of-three-tidal-volumes-10-12-and-15%C3%A2-ml%C3%A2-kg-1-in-dogs-for-controlled-mechanical-ventilation-assessed-by-volumetric-capnography-a-randomized-clinical-trial
#19
Seline Bumbacher, Johannes P Schramel, Martina Mosing
OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg(-1)) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg(-1). After induction CMV was started...
May 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28794867/rapid-onset-of-amiodarone-induced-pulmonary-toxicity-after-lung-lobe-resection-a-case-report-and-review-of-recent-literature
#20
Heiko Baumann, Phillip Fichtenkamm, Thomas Schneider, Jürgen Biscoping, Michael Henrich
Amiodarone-induced pulmonary toxicity (APT) is a severe side effect that can lead to lung fibrosis or fatal respiratory failure. Usually APT occurs during long term therapy after administration of prolonged loading doses or high cumulative doses. We present the case of a 58 year old woman who underwent thoracic surgery with lobe resection. She developed atrial fibrillation with hemodynamic-instability on the first post-operative day. We initiated amiodarone therapy and four days later she developed respiratory failure...
September 2017: Annals of Medicine and Surgery
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