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mechanical ventilation in ARDS

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https://www.readbyqxmd.com/read/28542443/effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-damage-in-a-model-of-mild-extrapulmonary-acute-lung-injury-with-intra-abdominal-hypertension
#1
Cintia L Santos, Raquel S Santos, Lillian Moraes, Cynthia S Samary, Nathane S Felix, Johnatas D Silva, Marcelo M Morales, Robert Huhle, Marcelo G Abreu, Alberto Schanaider, Pedro L Silva, Paolo Pelosi, Patricia R M Rocco
Intra-abdominal hypertension (IAH) may co-occur with the acute respiratory distress syndrome (ARDS), with significant impact on morbidity and mortality. Lung-protective controlled mechanical ventilation with low tidal volume and positive end-expiratory pressure (PEEP) has been recommended in ARDS. However, mechanical ventilation with spontaneous breathing activity may be beneficial to lung function and reduce lung damage in mild ARDS. We hypothesized that preserving spontaneous breathing activity during pressure support ventilation (PSV) would improve respiratory function and minimize ventilator-induced lung injury (VILI) compared to pressure-controlled ventilation (PCV) in mild extrapulmonary acute lung injury (ALI) with IAH...
2017: PloS One
https://www.readbyqxmd.com/read/28535788/endexpiratory-lung-volume-measurement-correlates-with-the-ventilation-perfusion-mismatch-in-lung-injured-pigs
#2
Jens Kamuf, Andreas Garcia-Bardon, Bastian Duenges, Tanghua Liu, Antje Jahn-Eimermacher, Florian Heid, Matthias David, Erik K Hartmann
BACKGROUND: In acute respiratory respiratory distress syndrome (ARDS) a sustained mismatch of alveolar ventilation and perfusion (VA/Q) impairs the pulmonary gas exchange. Measurement of endexpiratory lung volume (EELV) by multiple breath-nitrogen washout/washin is a non-invasive, bedside technology to assess pulmonary function in mechanically ventilated patients. The present study examines the association between EELV changes and VA/Q distribution and the possibility to predict VA/Q normalization by means of EELV in a porcine model...
May 23, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28525416/is-there-a-preinterventional-mechanical-ventilation-time-limit-for-candidates-of-adult-respiratory-extracorporeal-membrane-oxygenation
#3
Meng-Yu Wu, Chung-Chi Huang, Tzu-I Wu, Yu-Sheng Chang, Chin-Liang Wang, Pyng-Jing Lin
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a useful life support in severe acute respiratory distress syndrome (ARDS). Although prolonged mechanical ventilation (MV) before institution of ECMO is known to be a poor prognostic factor for outcomes of VV-ECMO, a reasonable deadline for this period has not been defined yet. To discover the answer, we reviewed a 9 year institutional experience of adult respiratory ECMO in VV configuration and investigate the relationship between the MV time before ECMO and in-hospital mortality...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28511660/simvastatin-for-patients-with-acute-respiratory-distress-syndrome-long-term-outcomes-and-cost-effectiveness-from-a-randomised-controlled-trial
#4
A Agus, C Hulme, R M Verghis, C McDowell, C Jackson, C M O'Kane, J G Laffey, D F McAuley
BACKGROUND: Simvastatin therapy for patients with acute respiratory distress syndrome (ARDS) has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at 12 months. METHODS: This was a cost-utility analysis alongside a multicentre, double-blind, randomised controlled trial carried out in the UK and Ireland...
May 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28510501/mechanical-ventilation-in-the-acute-respiratory-distress-syndrome
#5
Oleg Epelbaum, Wilbert S Aronow
The management of the acute respiratory distress syndrome (ARDS) patient is fundamental to the field of intensive care medicine, and it presents unique challenges owing to the specialized mechanical ventilation techniques that such patients require. ARDS is a highly lethal disease, and there is compelling evidence that mechanical ventilation itself, if applied in an injurious fashion, can be a contributor to ARDS mortality. Therefore, it is imperative for any clinician central to the care of ARDS patients to understand the fundamental framework that underpins the approach to mechanical ventilation in this special scenario...
May 23, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28500585/systematic-review-and-meta-analysis-of-complications-and-mortality-of-veno-venous-extracorporeal-membrane-oxygenation-for-refractory-acute-respiratory-distress-syndrome
#6
REVIEW
Sergi Vaquer, Candelaria de Haro, Paula Peruga, Joan Carles Oliva, Antonio Artigas
Veno-venous extracorporeal membrane oxygenation (ECMO) for refractory acute respiratory distress syndrome (ARDS) is a rapidly expanding technique. We performed a systematic review and meta-analysis of the most recent literature to analyse complications and hospital mortality associated with this technique. Using the PRISMA guidelines for systematic reviews and meta-analysis, MEDLINE and EMBASE were systematically searched for studies reporting complications and hospital mortality of adult patients receiving veno-venous ECMO for severe and refractory ARDS...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28499130/extracorporeal-membrane-oxygenation-ecmo-as-a-treatment-strategy-for-severe-acute-respiratory-distress-syndrome-ards-in-the-low-tidal-volume-era-a-systematic-review
#7
REVIEW
Bourke W Tillmann, Michelle L Klingel, Alla E Iansavichene, Ian M Ball, A Dave Nagpal
OBJECTIVE: To evaluate the hospital survival in patients with severe ARDS managed with ECMO and low tidal volume ventilation as compared to patients managed with low tidal volume ventilation alone. METHODS: Electronic databases were searched for studies of at least 10 adult patients with severe ARDS comparing the use of ECMO with low tidal volume ventilation to mechanical ventilation with a low tidal volume alone. Only studies reporting hospital or ICU survival were included...
April 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28497420/the-role-of-high-airway-pressure-and-dynamic-strain-on-ventilator-induced-lung-injury-in-a-heterogeneous-acute-lung-injury-model
#8
Sumeet V Jain, Michaela Kollisch-Singule, Joshua Satalin, Quinn Searles, Luke Dombert, Osama Abdel-Razek, Natesh Yepuri, Antony Leonard, Angelika Gruessner, Penny Andrews, Fabeha Fazal, Qinghe Meng, Guirong Wang, Louis A Gatto, Nader M Habashi, Gary F Nieman
BACKGROUND: Acute respiratory distress syndrome causes a heterogeneous lung injury with normal and acutely injured lung tissue in the same lung. Improperly adjusted mechanical ventilation can exacerbate ARDS causing a secondary ventilator-induced lung injury (VILI). We hypothesized that a peak airway pressure of 40 cmH2O (static strain) alone would not cause additional injury in either the normal or acutely injured lung tissue unless combined with high tidal volume (dynamic strain). METHODS: Pigs were anesthetized, and heterogeneous acute lung injury (ALI) was created by Tween instillation via a bronchoscope to both diaphragmatic lung lobes...
December 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28495240/risk-factors-for-pulmonary-complication-following-operative-fixation-of-spine-fractures
#9
Douglas S Weinberg, Brian Z Hedges, Jonathan E Belding, Timothy A Moore, Heather A Vallier
BACKGROUND CONTEXT: Previous studies have suggested pulmonary complications are common among patients undergoing fixation for traumatic spine fractures. This leads to prolonged hospital stay, worse functional outcomes, and increased economic burden. However, only limited prognostic information exists regarding which patients are at greatest risk for pulmonary complications. PURPOSE: To identify factors predictive of perioperative pulmonary complications in patients undergoing fixation of spine fractures...
May 8, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28486866/the-predictive-value-of-coefficient-of-pct-%C3%A3-bg-for-anastomotic-leak-in-esophageal-carcinoma-patients-with-ards-after-esophagectomy
#10
Huan Li, Daofeng Wang, Wenxiao Wei, Lamei Ouyang, Ning Lou
Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Early recognition and intervention treatment of anastomotic leak may alleviate complication and improve outcome...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28485315/assessment-of-1-year-outcomes-in-survivors-of-severe-acute-respiratory-distress-syndrome-receiving-extracorporeal-membrane-oxygenation-or-mechanical-ventilation-a-prospective-observational-study
#11
Zhi-Yong Wang, Tong Li, Chun-Ting Wang, Lei Xu, Xin-Jing Gao
BACKGROUND: Little is known about the long-term outcomes of severe acute respiratory distress syndrome (ARDS) patients requiring extracorporeal membrane oxygenation (ECMO). This study aimed to investigate the 1-year outcomes of these patients or patients receiving mechanical ventilation (MV) and compare their health-related quality of life (HRQoL) to the general population. METHODS: Severe ARDS survivors admitted to two ICUs in China between January 2012 and January 2014 were enrolled...
May 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28459413/-advance-on-human-umbilical-cord-mesenchymal-stem-cells-for-treatment-of-ali-in-severe-burns
#12
Yu Wang, Xiaohong Hu
Severe burn is often accompanied by multiple organ damage. Acute lung injury (ALI) is one of the most common complications, and often occurs in the early stage of severe burns. If it is not treated in time, it will progress to acute respiratory distress syndrome (ARDS), which will be a serious threat to the lives of patients. At present, the treatment of ALI in patients with severe burn is still remained in some common ways, such as the liquid resuscitation, the primary wound treatment, ventilation support, and anti-infection...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459403/-evaluation-value-of-oxygenation-index-of-mechanical-ventilation-on-the-prognosis-of-patients-with-ards-a-retrospective-analysis-with-228-patients
#13
Ziyi Jia, Xiaowei Liu, Zhi Liu
OBJECTIVE: To investigate the evaluation value of oxygenation index at different times of mechanical ventilation (MV) on the prognosis of patients with acute respiratory distress syndrome (ARDS). METHODS: A retrospectively analysis was conducted. A total of 228 patients with ARDS admitted to Department of Emergency of China Medical University Affiliated First Hospital from February 2014 to June 2016 were enrolled. All patients underwent MV treatment, and recruitment maneuver (RM) was performed by pressure-controlled ventilation (PCV) 30 minutes after the implementation of the protective ventilation strategy...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459402/-effect-of-different-transpulmonary-pressures-guided-mechanical-ventilation-on-respiratory-and-hemodynamics-of-patients-with-ards-a-prospective-randomized-controlled-trial
#14
Jianqiu Li, Zhihui Luo, Xiaolei Li, Zhongyi Huang, Jie Han, Zifeng Li, Zhaoxiong Zhou, Houwang Chen
OBJECTIVE: To assess the effect of different transpulmonary pressures (Ptp) guided mechanical ventilation (MV) on respiratory function and hemodynamics parameters of patients with acute respiratory distress syndrome (ARDS), and to find out a more optimized Ptp. METHODS: A prospective randomized controlled trial (RCT) was conducted. The ventilated patients with ARDS admitted to Department of Critical Care Medicine (ICU) of Shenzhen Shajing Affiliated Hospital of Guangzhou Medical University and Department of Emergency and Critical Care Medicine (EICU) of Shenzhen Hospital of South Medical University from February 2013 to August 2016 were enrolled...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459401/-value-of-procalcitonin-on-predicting-the-severity-and-prognosis-in-patients-with-early-ards-a-prospective-observation-study
#15
Zhixin Yu, Musen Ji, Xiulan Hu, Jun Yan, Zhaochen Jin
OBJECTIVE: To investigate the value of procalcitonin (PCT) on predicting the severity and prognosis in patients with early acute respiratory distress syndrome (ARDS). METHODS: A prospective observation study was conducted. A total of 113 patients with ARDS undergoing mechanical ventilation admitted to intensive care unit (ICU) of Affiliated People's Hospital of Jiangsu University from October 2012 to April 2016 were enrolled. Based on oxygenation index (PaO2/FiO2), the patients were classified into mild, moderate, and severe groups according to Berlin Definition...
January 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28459339/fifty-years-of-research-in-ards-mechanical-ventilation-during-extracorporeal-support-for-acute-respiratory-distress-syndrome-for-now-a-necessary-evil
#16
Eddy Fan, Daniel Brodie, Arthur S Slutsky
No abstract text is available yet for this article.
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28459336/an-official-american-thoracic-society-european-society-of-intensive-care-medicine-society-of-critical-care-medicine-clinical-practice-guideline-mechanical-ventilation-in-adult-patients-with-acute-respiratory-distress-syndrome
#17
Eddy Fan, Lorenzo Del Sorbo, Ewan C Goligher, Carol L Hodgson, Laveena Munshi, Allan J Walkey, Neill K J Adhikari, Marcelo B P Amato, Richard Branson, Roy G Brower, Niall D Ferguson, Ognjen Gajic, Luciano Gattinoni, Dean Hess, Jordi Mancebo, Maureen O Meade, Daniel F McAuley, Antonio Pesenti, V Marco Ranieri, Gordon D Rubenfeld, Eileen Rubin, Maureen Seckel, Arthur S Slutsky, Daniel Talmor, B Taylor Thompson, Hannah Wunsch, Elizabeth Uleryk, Jan Brozek, Laurent J Brochard
BACKGROUND: This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). METHODS: A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. RESULTS: For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H2O) (moderate confidence in effect estimates)...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28459322/fifty-years-of-research-in-ards-is-extracorporeal-circulation-the-future-of-acute-respiratory-distress-syndrome-management
#18
Alain Combes, Antonio Pesenti, V Marco Ranieri
Mechanical ventilation (MV) remains the cornerstone of acute respiratory distress syndrome (ARDS) management. It guarantees sufficient alveolar ventilation, high FiO2 concentration, and high positive end-expiratory pressure levels. However, experimental and clinical studies have accumulated, demonstrating that MV also contributes to the high mortality observed in patients with ARDS by creating ventilator-induced lung injury. Under these circumstances, extracorporeal lung support (ECLS) may be beneficial in two distinct clinical settings: to rescue patients from the high risk for death associated with severe hypoxemia, hypercapnia, or both not responding to maximized conventional MV, and to replace MV and minimize/abolish the harmful effects of ventilator-induced lung injury...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28427745/how-to-approach-the-acute-respiratory-distress-syndrome-prevention-plan-and-prudence
#19
REVIEW
Younsuck Koh
The acute respiratory distress syndrome (ARDS) is typically manifested by refractory hypoxemia with high mortality. A correct diagnosis is the first step to achieve better outcomes. An early intervention to manage modifiable risk factors of ARDS development and the avoidance of aggravating factors that increase disease severity and progression should be carefully addressed. A management plan is necessary at an early stage of ARDS to determine the level of intensive care. It should be carefully decided which therapeutic measures should be performed depending on the patient׳s underlying clinical condition...
May 2017: Respiratory Investigation
https://www.readbyqxmd.com/read/28424124/acute-respiratory-distress-syndrome-incidence-but-not-mortality-has-decreased-nationwide-a-national-trauma-data-bank-study
#20
Michael Fahr, Glenn Jones, Hollis O'Neal, Juan Duchesne, Danielle Tatum
Acute respiratory distress syndrome (ARDS) incidence is reported to have decreased in recent years. However, no large-scale study to date has exclusively examined ARDS in the critically injured. We sought to examine the national incidence of ARDS and its associated outcomes exclusively in adult trauma patients. The National Trauma Data Bank (NTDB) was queried to evaluate the incidence of ARDS and associated outcomes over a 6-year study period (2007-2012). Included patients were ≥18 years old, with at least one ventilator day, and complications recorded...
April 1, 2017: American Surgeon
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