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https://www.readbyqxmd.com/read/29790144/-prone-position-and-nursing-care
#1
Shu-Ju Lu, Shiao-Pei Wang
Acute respiratory distress syndrome (ARDS) is a life-threatening disease, as acute inflammation in the lungs typically leads to hypoxia and symptoms of dyspnea. The treatment modalities of ARDS include mechanical ventilation, corticosteroid, extracorporeal membranous oxygenation, inhaled nitrogen oxide, and the prone position. Among these, the prone position is supported by evidence showing significantly reduced mortality in patients that adopt this modality. Lying in the prone position reduces atelectatic lung volumes by recruitment of dependent parts and facilitates normal regulation of alveolar ventilation, giving better-matched ventilation perfusion and, thus, improved oxygenation...
June 2018: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/29787413/halving-the-volume-of-anaconda-evaluation-of-a-new-small-volume-anesthetic-reflector-in-a-test-lung-model
#2
Hagen Bomberg, Franziska Meiser, Philipp Daume, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
BACKGROUND: Volatile anesthetics are increasingly used for sedation in intensive care units. The most common administration system is AnaConDa-100 mL (ACD-100; Sedana Medical, Uppsala, Sweden), which reflects volatile anesthetics in open ventilation circuits. AnaConDa-50 mL (ACD-50) is a new device with half the volumetric dead space. Carbon dioxide (CO2) can be retained with both devices. We therefore compared the CO2 elimination and isoflurane reflection efficiency of both devices. METHODS: A test lung constantly insufflated with CO2 was ventilated with a tidal volume of 500 mL at 10 breaths/min...
May 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29787304/deterioration-of-regional-lung-strain-and-inflammation-during-early-lung-injury
#3
Gabriel C Motta-Ribeiro, Soshi Hashimoto, Tilo Winkler, Rebecca M Baron, Kira Grogg, Luís F S C Paula, Arnoldo Santos, Congli Zeng, Kathryn Hibbert, Robert S Harris, Ednan Bajwa, Marcos F Vidal Melo
RATIONALE: The contribution of aeration heterogeneity to lung injury during early mechanical ventilation of uninjured lungs is unknown. OBJECTIVE: Test the hypotheses that a strategy consistent with clinical practice does not protect from worsening in lung strains during the first 24h of ventilation of initially normal lungs exposed to mild systemic endotoxemia in supine versus prone position, and that local neutrophilic inflammation is associated with local strain and blood volume at global strains below a proposed injurious threshold...
May 22, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29776982/variable-effectiveness-of-stepwise-implementation-of-nudge-type-interventions-to-improve-provider-compliance-with-intraoperative-low-tidal-volume-ventilation
#4
Vikas N O'Reilly-Shah, George S Easton, Craig S Jabaley, Grant C Lynde
BACKGROUND: Identifying mechanisms to improve provider compliance with quality metrics is a common goal across medical disciplines. Nudge interventions are minimally invasive strategies that can influence behavioural changes and are increasingly used within healthcare settings. We hypothesised that nudge interventions may improve provider compliance with lung-protective ventilation (LPV) strategies during general anaesthesia. METHODS: We developed an audit and feedback dashboard that included information on both provider-level and department-level compliance with LPV strategies in two academic hospitals, two non-academic hospitals and two academic surgery centres affiliated with a single healthcare system...
May 18, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29764547/-comparison-of-lung-protection-for-hydrochloric-acid-or-oleic-acid-induced-rat-acute-respiratory-distress-syndrome-models-pretreated-with-penehyclidine
#5
Yumei Cheng, Zhou Yang, Feng Shen, Bo Liu, Yahui Wang, Yanqi Wu, Ling Yao, Yuqing Liu
OBJECTIVE: To compare the lung protection roles of intraperitoneal pre-injection with penehyclidine for two kinds of rat models with pulmonary and extrapulmonary acute respiratory distress syndrome (ARDSp and ARDSexp). METHODS: Forty healthy adult Sprague-Dawley (SD) rats were randomly divided into five groups (each n = 8): the rats in sham group received only tracheotomy; the ARDS rat models were reproduced by intratracheal inhalation of 0.1 mol/L hydrochloric acid (HCl) 2 mL/kg to simulate ARDSexp (HCl group) and 0...
May 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29754942/dead-space-analysis-at-different-levels-of-positive-end-expiratory-pressure-in-acute-respiratory-distress-syndrome-patients
#6
Emiliano Gogniat, Marcela Ducrey, José Dianti, Matías Madorno, Nicolás Roux, Alejandro Midley, Julio Raffo, Sergio Giannasi, Eduardo San Roman, Fernando Suarez-Sipmann, Gerardo Tusman
PURPOSE: To analyze the effects of positive end-expiratory pressure (PEEP) on Bohr's dead space (VDBohr /VT) in patients with acute respiratory distress syndrome (ARDS). MATERIAL AND METHODS: Fourteen ARDS patients under lung protective ventilation settings were submitted to 4 different levels of PEEP (0, 6, 10, 16 cmH2 O). Respiratory mechanics, hemodynamics and volumetric capnography were recorded at each protocol step. RESULTS: Two groups of patients responded differently to PEEP when comparing baseline with 16-PEEP: those in which driving pressure increased > 15% (∆P˃15% , n = 7, p = ...
June 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29754418/comprehensive-outcomes-after-lung-retransplantation-a-single-center-review
#7
Kieran Halloran, Meghan Aversa, Kathryn Tinckam, Tereza Martinu, Matthew Binnie, Cecilia Chaparro, Chung-Wai Chow, Tom Waddell, Karen McRae, Andrew Pierre, Marc de Perrot, Kazuhiro Yasufuku, Marcelo Cypel, Shaf Keshavjee, Lianne G Singer
INTRODUCTION: Lung retransplantation is an important therapy for a growing population of lung transplant recipients with graft failure, but detailed outcome data are lacking. METHODS: We conducted a retrospective cohort study of adult lung retransplant in the Toronto Lung Transplant Program from 2001 to 2013 (n=38). We analyzed the post-operative course, graft function, renal function, microbiology, donor specific antibodies (DSA), quality of life and survival compared to a control cohort of primary transplant recipients matched for age and era...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29750051/angiotensin-ii-type-2-receptor-agonist-compound-21-attenuates-pulmonary-inflammation-in-a-model-of-acute-lung-injury
#8
Mario Menk, Jan Adriaan Graw, Clarissa von Haefen, Hendrik Steinkraus, Burkhard Lachmann, Claudia D Spies, David Schwaiberger
Purpose: Although the role of the angiotensin II type 2 (AT2) receptor in acute lung injury is not yet completely understood, a protective role of this receptor subtype has been suggested. We hypothesized that, in a rodent model of acute lung injury, stimulation of the AT2 receptor with the direct agonist Compound 21 (C21) might have a beneficial effect on pulmonary inflammation and might improve pulmonary gas exchange. Materials and methods: Male adult rats were divided into a treatment group that received pulmonary lavage followed by mechanical ventilation (LAV, n=9), a group receiving pulmonary lavage, mechanical ventilation, and direct stimulation of the AT2 receptor with C21 (LAV+C21, n=9), and a control group that received mechanical ventilation only (control, n=9)...
2018: Journal of Inflammation Research
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
#9
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/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#10
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/29732188/weaning-from-veno-venous-extracorporeal-membrane-oxygenation-how-i-do-it
#11
REVIEW
Lars M Broman, Maximilian V Malfertheiner, Andrea Montisci, Federico Pappalardo
Veno-venous extracorporeal membrane oxygenation (VV ECMO) is a rescue treatment for acute respiratory distress syndrome (ARDS) failing protective mechanical ventilation. It temporarily provides proper gas exchange: hypoxia is treated by adjusting the blood flow rate and fraction in spired oxygen over the ventilator (FiO2 ) on the extracorporeal membrane oxygenation (ECMO) circuit while CO2 removal is regulated by the ECMO fresh gas flow. Therefore, ventilator settings can be gradually reduced allowing the lungs to rest and recover...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#12
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29721820/hypothermic-total-liquid-ventilation-after-experimental-aspiration-associated-acute-respiratory-distress-syndrome
#13
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/29709437/the-effects-of-an-open-lung-approach-during-one-lung-ventilation-on-postoperative-pulmonary-complications-and-driving-pressure-a-descriptive-multicenter-national-study
#14
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/29707341/short-term-one-lung-ventilation-does-not-influence-local-inflammatory-cytokine-response-after-lung-resection
#15
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/29707296/sevoflurane-did-not-show-better-protective-effect-on-endothelial-glycocalyx-layer-compared-to-propofol-during-lung-resection-surgery-with-one-lung-ventilation
#16
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/29702725/effects-of-the-kv7-voltage-activated-potassium-channel-inhibitor-linopirdine-in-rat-models-of-hemorrhagic-shock
#17
Sean P Nassoiy, Favin S Babu, Heather M LaPorte, Kenneth L Byron, Matthias Majetschak
Recently, we demonstrated that Kv7 voltage-activated potassium channel inhibitors reduce fluid resuscitation requirements in short-term rat models of hemorrhagic shock. The aim of the present study was to further delineate the therapeutic potential and side effect profile of the Kv7 channel blocker linopirdine in various rat models of severe hemorrhagic shock over clinically relevant time periods. Intravenous administration of linopirdine, either before (1 or 3 mg/kg) or after (3 mg/kg) a 40% blood volume hemorrhage, did not affect blood pressure and survival in lethal hemorrhage models without fluid resuscitation...
April 27, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29702608/liver-injury-by-carbon-tetrachloride-intoxication-in-16-patients-treated-with-forced-ventilation-to-accelerate-toxin-removal-via-the-lungs-a-clinical-report
#18
REVIEW
Rolf Teschke
Carbon tetrachloride (CCl₄) is an efficient but highly toxic solvent, used in households and commercially in the industry under regulatory surveillance to ensure safety at the working place and to protect the workers&rsquo; health. However, acute unintentional or intentional intoxications by CCl₄ may rarely occur and are potentially life-threatening. In this review article, therapy options are discussed that are based on a literature review of traditional poisoning cases and the clinical experience with 16 patients with acute poisoning by CCl₄...
April 27, 2018: Toxics
https://www.readbyqxmd.com/read/29691422/pulmonary-effects-of-adjusting-tidal-volume-to-actual-or-ideal-body-weight-in-ventilated-obese-mice
#19
Elise Guivarch, Guillaume Voiriot, Anahita Rouzé, Stéphane Kerbrat, Jeanne Tran Van Nhieu, Philippe Montravers, Bernard Maitre, Armand Mekontso Dessap, Mathieu Desmard, Jorge Boczkowski
Obese patients could be more susceptible to mechanical ventilation (MV)-induced lung injury than non-obese patients due to weight-dependent changes in lung properties. The aim of this study was therefore to evaluate the pulmonary effects of 2 hours low VT MV in a diet-induced obese mice model, with VT calculated on either the actual body weight (VT aw) or the ideal body weight (VT iw) . First, we hypothesized that a MV with VT aw would be associated with altered lung mechanics and an increased lung inflammation...
April 24, 2018: Scientific Reports
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
#20
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
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