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https://www.readbyqxmd.com/read/29787412/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-mechanically-ventilated-patients-a-systematic-review-and-meta-analysis
#1
Xiang Si, Hailin Xu, Zimeng Liu, Jianfeng Wu, Daiyin Cao, Juan Chen, Minying Chen, Yongjun Liu, Xiangdong Guan
BACKGROUND: We performed a systematic review and meta-analysis of studies investigating the diagnostic accuracy of respiratory variation in inferior vena cava diameter (ΔIVC) for predicting fluid responsiveness in patients receiving mechanical ventilation. METHODS: MEDLINE, EMBASE, the Cochrane Library, and Web of Science were screened from inception to February 2017. The meta-analysis assessed the pooled sensitivity, specificity, diagnostic odds ratio, and area under the receiver operating characteristic curve...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29763713/practice-of-mechanical-ventilation-in-cardiac-arrest-patients-and-effects-of-targeted-temperature-management-a-substudy-of-the-targeted-temperature-management-trial
#2
Matthew B A Harmon, David M P van Meenen, Annelou L I P van der Veen, Jan M Binnenkade, Josef Dankiewicz, Florian Ebner, Niklas Nielsen, Paolo Pelosi, Marcus J Schultz, Janneke Horn, Hans Friberg, Nicole P Juffermans
AIMS: Mechanical ventilation practices in patients with cardiac arrest are not well described. Also, the effect of temperature on mechanical ventilation settings is not known. The aims of this study were 1) to describe practice of mechanical ventilation and its relation with outcome 2) to determine effects of different target temperatures strategies (33 °C versus 36 °C) on mechanical ventilation settings. METHODS: This is a substudy of the TTM-trial in which unconscious survivors of a cardiac arrest due to a cardiac cause were randomized to two TTM strategies, 33 °C (TTM33) and 36 °C (TTM36)...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#3
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29743094/feasibility-and-safety-of-low-flow-extracorporeal-co-2-removal-managed-with-a-renal-replacement-platform-to-enhance-lung-protective-ventilation-of-patients-with-mild-to-moderate-ards
#4
Matthieu Schmidt, Samir Jaber, Elie Zogheib, Thomas Godet, Gilles Capellier, Alain Combes
BACKGROUND: Extracorporeal carbon-dioxide removal (ECCO2 R) might allow ultraprotective mechanical ventilation with lower tidal volume (VT) (< 6 ml/kg predicted body weight), plateau pressure (Pplat ) (< 30 cmH2 O), and driving pressure to limit ventilator-induced lung injury. This study was undertaken to assess the feasibility and safety of ECCO2 R managed with a renal replacement therapy (RRT) platform to enable very low tidal volume ventilation of patients with mild-to-moderate acute respiratory distress syndrome (ARDS)...
May 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29742448/linking-lung-function-to-structural-damage-of-alveolar-epithelium-in-ventilator-induced-lung-injury
#5
Katharine L Hamlington, Bradford J Smith, Celia M Dunn, Chantel M Charlebois, Gregory S Roy, Jason H T Bates
Understanding how the mechanisms of ventilator-induced lung injury (VILI), namely atelectrauma and volutrauma, contribute to the failure of the blood-gas barrier and subsequent intrusion of edematous fluid into the airspace is essential for the design of mechanical ventilation strategies that minimize VILI. We ventilated mice with different combinations of tidal volume and positive end-expiratory pressure (PEEP) and linked degradation in lung function measurements to injury of the alveolar epithelium observed via scanning electron microscopy...
May 6, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29739857/how-ventilation-is-delivered-during-cardiopulmonary-resuscitation-an-international-survey
#6
Ricardo Luiz Cordioli, Laurent Brochard, Laurent Suppan, Aissam Lyazidi, François Templier, Abdo Khoury, Stephane Delisle, Dominique Savary, Jean-Christophe Richard
BACKGROUND: Recommendations regarding ventilation during cardiopulmonary resuscitation (CPR) are based on a low level of scientific evidence. We hypothesized that practices about ventilation during CPR might be heterogeneous and may differ worldwide. To address this question, we surveyed physicians from several countries on their practices during CPR. METHODS: We used a Web-based opinion survey. Links to the survey were sent by e-mail newsletters and displayed on the Web sites of medical societies involved in CPR practice from December 2013 to March 2014...
May 8, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29739430/relax-restricted-versus-liberal-positive-end-expiratory-pressure-in-patients-without-ards-protocol-for-a-randomized-controlled-trial
#7
Anna Geke Algera, Luigi Pisani, Dennis C J Bergmans, Sylvia den Boer, Corianne A J de Borgie, Frank H Bosch, Karina Bruin, Thomas G Cherpanath, Rogier M Determann, Arjen M Dondorp, Dave A Dongelmans, Henrik Endeman, Jasper J Haringman, Janneke Horn, Nicole P Juffermans, David M van Meenen, Nardo J van der Meer, Maruschka P Merkus, Hazra S Moeniralam, Ilse Purmer, Pieter Roel Tuinman, Mathilde Slabbekoorn, Peter E Spronk, Alexander P J Vlaar, Marcelo Gama de Abreu, Paolo Pelosi, Ary Serpa Neto, Marcus J Schultz, Frederique Paulus
BACKGROUND: Evidence for benefit of high positive end-expiratory pressure (PEEP) is largely lacking for invasively ventilated, critically ill patients with uninjured lungs. We hypothesize that ventilation with low PEEP is noninferior to ventilation with high PEEP with regard to the number of ventilator-free days and being alive at day 28 in this population.  METHODS/DESIGN: The "REstricted versus Liberal positive end-expiratory pressure in patients without ARDS" trial (RELAx) is a national, multicenter, randomized controlled, noninferiority trial in adult intensive care unit (ICU) patients with uninjured lungs who are expected not to be extubated within 24 h...
May 9, 2018: Trials
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#8
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
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/29721820/hypothermic-total-liquid-ventilation-after-experimental-aspiration-associated-acute-respiratory-distress-syndrome
#10
Jérôme Rambaud, Fanny Lidouren, Michaël Sage, Matthias Kohlhauer, Mathieu Nadeau, Étienne Fortin-Pellerin, Philippe Micheau, Luca Zilberstein, Nicolas Mongardon, Jean-Damien Ricard, Megumi Terada, Patrick Bruneval, Alain Berdeaux, Bijan Ghaleh, Hervé Walti, Renaud Tissier
BACKGROUND: Ultrafast cooling by total liquid ventilation (TLV) provides potent cardio- and neuroprotection after experimental cardiac arrest. However, this was evaluated in animals with no initial lung injury, whereas out-of-hospital cardiac arrest is frequently associated with early-onset pneumonia, which may lead to acute respiratory distress syndrome (ARDS). Here, our objective was to determine whether hypothermic TLV could be safe or even beneficial in an aspiration-associated ARDS animal model...
May 2, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29708892/continuous-negative-abdominal-pressure-reduces-ventilator-induced-lung-injury-in-a-porcine-model
#11
Takeshi Yoshida, Doreen Engelberts, Gail Otulakowski, Bhushan Katira, Martin Post, Niall D Ferguson, Laurent Brochard, Marcelo B P Amato, Brian P Kavanagh
BACKGROUND: In supine patients with acute respiratory distress syndrome, the lung typically partitions into regions of dorsal atelectasis and ventral aeration ("baby lung"). Positive airway pressure is often used to recruit atelectasis, but often overinflates ventral (already aerated) regions. A novel approach to selective recruitment of dorsal atelectasis is by "continuous negative abdominal pressure." METHODS: A randomized laboratory study was performed in anesthetized pigs...
April 27, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29707341/short-term-one-lung-ventilation-does-not-influence-local-inflammatory-cytokine-response-after-lung-resection
#12
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/29692886/what-are-the-optimum-components-in-a-care-bundle-aimed-at-reducing-post-operative-pulmonary-complications-in-high-risk-patients
#13
Sophie V Griffiths, Daniel H Conway, Michael Sander, Ib Jammer, Michael P W Grocott, Ben C Creagh-Brown
Background: Post-operative pulmonary complications (POPC) are common, predictable and associated with increased morbidity and mortality, independent of pre-operative risk. Interventions to reduce the incidence of POPC have been studied individually, but the use of a care bundle has not been widely investigated. The purpose of our work was to use Delphi consensus methodology and an independently chosen expert panel to formulate a care bundle for patients identified as being at high of POPC, as preparation towards an evaluation of its effectiveness at reducing POPC...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29688788/respiratory-effects-of-low-versus-high-tidal-volume-with-or-without-positive-end-expiratory-pressure-in-anesthetized-dogs-with-healthy-lungs
#14
Valentina De Monte, Antonello Bufalari, Salvatore Grasso, Fabienne Ferrulli, Alberto Maria Crovace, Luca Lacitignola, Francesco Staffieri
OBJECTIVE To evaluate the impact of 2 tidal volumes (TV s) with or without positive end-expiratory pressure (PEEP) on lung mechanics, aeration, and gas exchange in healthy anesthetized dogs. ANIMALS 40 mixed-breed dogs with healthy lungs. PROCEDURES Anesthetized dogs were randomly assigned to 4 groups (n = 10/group) with different ventilatory settings: TV of 8 mL/kg and PEEP of 0 cm H2 O (low TV group), TV of 8 mL/kg and PEEP of 5 cm H2 O (low TV plus PEEP group), TV of 15 mL/kg and PEEP of 0 cm H2 O (high TV group), or TV of 15 mL/kg and PEEP of 5 cm H2 O (high TV plus PEEP group)...
May 2018: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#15
Chuong Ngo, Stephan Dahlmanns, Thomas Vollmer, Berno Misgeld, Steffen Leonhardt
BACKGROUND AND OBJECTIVE: This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS: Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29606090/application-of-intraoperative-lung-protective-ventilation-varies-in-accordance-with-the-knowledge-of-anaesthesiologists-a-single-centre-questionnaire-study-and-a-retrospective-observational-study
#16
Seung Hyun Kim, Sungwon Na, Woo Kyung Lee, Hyunwoo Choi, Jeongmin Kim
BACKGROUND: The benefits of lung-protective ventilation (LPV) with a low tidal volume (6 mL/kg of ideal body weight [IBW]), limited plateau pressure (< 28-30 cm H2 O), and appropriate positive end-expiratory pressure (PEEP) in patients with acute respiratory distress syndrome have become apparent and it is now widely adopted in intensive care units. Recently evidence for LPV in general anaesthesia has been accumulated, but it is not yet generally applied by anaesthesiologists in the operating room...
April 2, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29578749/positive-end-expiratory-pressure-ventilation-induces-longitudinal-atrophy-in-diaphragm-fibers
#17
Johan Lindqvist, Marloes van den Berg, Robbert van der Pijl, Pleuni E Hooijman, Albertus Beishuizen, Judith Elshof, Monique de Waard, Armand Girbes, Angelique Spoelstra-de Man, Zhong-Hua Shi, Charissa van den Brom, Sylvia Bogaards, Shengyi Shen, Joshua Strom, Henk Granzier, Jeroen Kole, René J P Musters, Marinus A Paul, Leo M A Heunks, Coen A C Ottenheijm
RATIONALE: Diaphragm weakness in critically ill patients prolongs ventilator dependency and duration of hospital stay, and increases mortality and health care costs. The mechanisms underlying diaphragm weakness include cross-sectional fiber atrophy and contractile protein dysfunction, but whether additional mechanisms are at play is unknown. OBJECTIVES: To test the hypothesis that mechanical ventilation with positive end-expiratory pressure (PEEP) induces longitudinal atrophy by displacing the diaphragm in caudal direction and reducing the length of fibers...
March 26, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29576127/evaluation-of-lung-and-chest-wall-mechanics-during-anaesthesia-using-the-peep-step-method
#18
P Persson, O Stenqvist, S Lundin
BACKGROUND: Postoperative pulmonary complications are common. Between patients there are differences in lung and chest wall mechanics. Individualised mechanical ventilation based on measurement of transpulmonary pressures would be a step forward. A previously described method evaluates lung and chest wall mechanics from a change of ΔPEEP and calculation of change in end-expiratory lung volume (ΔEELV). The aim of the present study was to validate this PEEP-step method (PSM) during general anaesthesia by comparing it with the conventional method using oesophageal pressure (PES) measurements...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29576103/analysing-tidal-volumes-early-after-a-positive-end-expiratory-pressure-increase-a-new-way-to-determine-optimal-peep-in-the-operating-theatre
#19
EDITORIAL
S Shaefi, M Eikermann
No abstract text is available yet for this article.
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29561278/protective-ventilation-during-anaesthesia-reduces-major-postoperative-complications-after-lung-cancer-surgery-a-double-blind-randomised-controlled-trial
#20
Emmanuel Marret, Raphael Cinotti, Laurence Berard, Vincent Piriou, Jacques Jobard, Benoit Barrucand, Dragos Radu, Samir Jaber, Francis Bonnet
BACKGROUND: Thoracic surgery for lung resection is associated with a high incidence of postoperative pulmonary complications. Controlled ventilation with a large tidal volume has been documented to be a risk factor for postoperative respiratory complications after major abdominal surgery, whereas the use of low tidal volumes and positive end-expiratory pressure (PEEP) has a protective effect. OBJECTIVE: To evaluate the effects of ventilation with low tidal volume and PEEP on major complications after thoracic surgery...
March 19, 2018: European Journal of Anaesthesiology
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