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https://www.readbyqxmd.com/read/28204830/monoclonal-antibody-against-toll-like-receptor%C3%A2-4-attenuates-ventilator-induced-lung-injury-in-rats-by-inhibiting-myd88-and-nf-%C3%AE%C2%BAb-dependent-signaling
#1
Cuiyuan Huang, Linghui Pan, Fei Lin, Huijun Dai, Ruili Fu
The mechanisms through which mechanical ventilation causes non-infectious inflammatory diseases and lung injury are poorly understood. Animals models of this type of injury suggest that it involves signaling mediated by Toll‑like receptor (TLR)4 and 9. In this study, in order to gain further insight into the involvement of TLR4 in this type of injury, we performed in vivo and in vitro experiments to determine the mechanisms through which TLR4 triggers inflammation. We also examined whether the use of TLR4 monoclonal antibody (mAb) can alleviate this type of injury...
February 1, 2017: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/28199243/intraabdominal-surgery-and-anesthesia-management
#2
John Hedley-Whyte
: Inspired Oxygenation in Surgical Patients During General Anesthesia With Controlled Ventilation: A Concept of Atelectasis. By Bendixen HH, Hedley-Whyte J, and Laver MB. New Engl J Med 1963; 269:991-996. Reprinted with permission. ABSTRACT: The purpose of this study was to determine if the pattern of ventilation, by itself, influences oxygenation during anesthesia and surgery and examine the hypothesis that progressive pulmonary atelectasis may occur during constant ventilation whenever periodic hyperventilation is lacking, but is reversible by passive hyperinflation of the lungs...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28194537/strain-induced-inflammation-in-pulmonary-alveolar-tissue-due-to-mechanical-ventilation
#3
Parya Aghasafari, Israr Bin M Ibrahim, Ramana Pidaparti
Inflammation is the body's attempt at self-protection to remove harmful stimuli, including damaged cells, irritants, or pathogens and begin the healing process. In this study, strain-induced inflammation in pulmonary alveolar tissue under high tidal volume is investigated through a combination of an inflammation model and fluid structure interaction (FSI) analysis. A realistic three-dimensional organ model for alveolar sacs is built, and FSI is employed to evaluate strain distribution in alveolar tissue for different tidal volume (TV) values under the mechanical ventilation (MV) condition...
February 13, 2017: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/28189055/the-protective-effect-of-dopamine-on-ventilator-induced-lung-injury-via-the-inhibition-of-nlrp3-inflammasome
#4
Xiaomei Yang, Xiaotong Sun, Hongli Chen, Guangmin Xi, Yonghao Hou, Jianbo Wu, Dejie Liu, Huanliang Wang, Yuedong Hou, Jingui Yu
Dopamine (DA), a neurotransmitter, was previously shown to have anti-inflammatory effects. However, its role in ventilator-induced lung injury (VILI) has not been explicitly demonstrated. This study aimed to investigate the therapeutic efficacy and molecular mechanisms of dopamine in VILI. Rats were treated with dopamine during mechanical ventilation. Afterwards, the influence of dopamine on histological changes, pulmonary edema, the lung wet/dry (W/D) ratio, myeloperoxidase (MPO) activity, polymorphonuclear(PMN)counts, inflammatory cytokine levels, and NLRP3 inflammasome protein expression were examined...
February 7, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28188062/mechanical-ventilation-in-patients-subjected-to-extracorporeal-membrane-oxygenation-ecmo
#5
M L Sánchez
Mechanical ventilation (MV) is a crucial element in the management of acute respiratory distress syndrome (ARDS), because there is high level evidence that a low tidal volume of 6ml/kg (protective ventilation) improves survival. In these patients with refractory respiratory insufficiency, venovenous extracorporeal membrane oxygenation (ECMO) can be used. This salvage technique improves oxygenation, promotes CO2 clearance, and facilitates protective and ultraprotective MV, potentially minimizing ventilation-induced lung injury...
February 7, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28179605/the-effects-of-different-bmi-on-blood-loss-and-transfusions-in-chinese-patients-undergoing-coronary-artery-bypass-grafting
#6
Mingya Wang, Ming Chen, Hushan Ao, Sipeng Chen, Zhifa Wang
OBJECTIVE: Blood loss is a predictor of outcomes after coronary artery bypass grafting (CABG). This study investigated the effects of body mass index (BMI) on blood loss, blood transfusion rate, and the variations in coagulation parameters of Chinese patients undergoing CABG. METHODS: A total of 1007 Chinese patients who consecutively underwent isolated, primary CABG at Fuwai Hospital from January 1, 2013 to December 31, 2013 were included in this study. They were categorized by BMI into <24 kg/m(2) (low and normal weight group), 24≤ BMI <28 kg/m(2) (overweight group), and BMI ≥28 kg/m(2) (obese group)...
February 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28168966/extracorporeal-membrane-oxygenation-for%C3%A2-acute-respiratory-distress-syndrome-after-pneumonectomy
#7
Jeremie Reeb, Anne Olland, Julien Pottecher, Xavier Delabranche, Mickael Schaeffer, Stephane Renaud, Nicola Santelmo, Romain Kessler, Gilbert Massard, Pierre-Emmanuel Falcoz
BACKGROUND: Postpneumonectomy acute respiratory distress syndrome (ppARDS) is a life-threatening condition with a disastrous prognosis. This study assessed the efficacy of venovenous extracorporeal membrane oxygenation (VV-ECMO) in adult patients with unresponsive severe ppARDS. METHODS: We retrospectively reviewed data of all patients treated with VV-ECMO for ppARDS from January 2009 to December 2015. We calculated the Sequential Organ Failure Assessment score before ECMO insertion and monitored the subsequent mechanical ventilation settings...
February 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28159772/%C3%AE-tocopherol-transfer-protein-mediates-protective-hypercapnia-in-murine-ventilator-induced-lung-injury
#8
Gail Otulakowski, Doreen Engelberts, Hajime Arima, Hiroyuki Hirate, Hülya Bayir, Martin Post, Brian P Kavanagh
RATIONALE: Hypercapnia is common in mechanically ventilated patients. Experimentally, 'therapeutic hypercapnia' can protect, but it can also cause harm, depending on the mechanism of injury. Hypercapnia suppresses multiple signalling pathways. Previous investigations have examined mechanisms that were known a priori, but only a limited number of pathways, each suppressed by CO2, have been reported. OBJECTIVE: Because of the complexity and interdependence of processes in acute lung injury, this study sought to fill in knowledge gaps using an unbiased screen, aiming to identify a specifically upregulated pathway...
February 3, 2017: Thorax
https://www.readbyqxmd.com/read/28157140/a-quasi-experimental-before-after-trial-examining-the-impact-of-an-emergency-department-mechanical-ventilator-protocol-on-clinical-outcomes-and-lung-protective-ventilation-in-acute-respiratory-distress-syndrome
#9
Brian M Fuller, Ian T Ferguson, Nicholas M Mohr, Anne M Drewry, Christopher Palmer, Brian T Wessman, Enyo Ablordeppey, Jacob Keeperman, Robert J Stephens, Cristopher C Briscoe, Angelina A Kolomiets, Richard S Hotchkiss, Marin H Kollef
OBJECTIVES: To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. DESIGN: Quasi-experimental, before-after trial. SETTING: Emergency department and ICUs of an academic center. PATIENTS: Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU...
February 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28154270/reassessment-of-acute-kidney-injury-after-cardiac-surgery-a-retrospective-study
#10
Xiangcheng Xie, Xin Wan, Xiaobing Ji, Xin Chen, Jian Liu, Wen Chen, Changchun Cao
Objective To evaluate the incidence, risk, or protective factors of acute kidney injury (AKI) in patients after cardiac surgery based on the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Methods A retrospective analysis of 2,575 patients undergoing their first documented cardiac surgery with cardiopulmonary bypass (CPB) was conducted. Perioperative variables were collected and analyzed. Univariate and multiple logistic regression models were used for determining the association between the development of AKI and risk factors...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28153465/-prevention-and-treatment-of-skin-lesions-associated-with-non-invasive-mechanical-ventilation-recommendations-of-experts
#11
M Raurell-Torredà, A Romero-Collado, M Rodríguez-Palma, M Farrés-Tarafa, J D Martí, B Hurtado-Pardos, L Peñarrubia-San Florencio, P Saez-Paredes, A M Esquinas
INTRODUCTION: In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. OBJECTIVES: To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. METHODOLOGY: Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel...
January 30, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28149569/how-should-this-patient-with-repeated-aspiration-pneumonia-be-managed-and-treated-a-proposal-of-the-percutaneous-endoscopic-gastrostomy-and-tracheostomy-penlight-procedure
#12
REVIEW
Zhongheng Zhang, Jason Akulian, Yucai Hong, Ning Liu, Yuhao Chen
Cerebrovascular accident (CVA) is commonly seen among the elderly with a substantial proportion of patients suffering from long-term dysphagia and/or an inability to protect their airway. This potentially imposes on them an increased risk of malnutrition and aspiration pneumonia. In this article, we present a patient with malnutrition and dysphagia secondary to CVA. We propose a procedure for which we will name the Percutaneous ENdoscopIc Gastrostomy and Tracheostomy (PENlIGhT) procedure for placement of percutaneous endoscopic gastrostomy (PEG) and tracheostomy tube (TT) at the same time...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28135750/-ophthalmic-plastic-surgery-of-exposure-keratopathy-in-the-intensive-care-unit
#13
C Siebert, A Menges, F H Tost
Critically ill patients in the intensive care unit (ICU) may develop eye problems, due to impaired ocular protective mechanisms or direct involvement of the eye in severe systemic diseases. If eye infections or ocular surface disorders are not identified in time, endophthalmitis or corneal ulcer may develop and can cause permanent functional injuries of the eye. A retrospective analysis was performed and a total of 283 complete intensive care courses of treatment were evaluated, taking into account ophthalmic medical consultations for frequent cardinal symptoms...
January 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28135290/global-proteome-changes-in-the-rat-diaphragm-induced-by-endurance-exercise-training
#14
Kurt J Sollanek, Jatin G Burniston, Andreas N Kavazis, Aaron B Morton, Michael P Wiggs, Bumsoo Ahn, Ashley J Smuder, Scott K Powers
Mechanical ventilation (MV) is a life-saving intervention for many critically ill patients. Unfortunately, prolonged MV results in the rapid development of diaphragmatic atrophy and weakness. Importantly, endurance exercise training results in a diaphragmatic phenotype that is protected against ventilator-induced diaphragmatic atrophy and weakness. The mechanisms responsible for this exercise-induced protection against ventilator-induced diaphragmatic atrophy remain unknown. Therefore, to investigate exercise-induced changes in diaphragm muscle proteins, we compared the diaphragmatic proteome from sedentary and exercise-trained rats...
2017: PloS One
https://www.readbyqxmd.com/read/28132075/extracorporeal-carbon-dioxide-removal-ecco2r-in-patients-with-acute-respiratory-failure
#15
REVIEW
Andrea Morelli, Lorenzo Del Sorbo, Antonio Pesenti, V Marco Ranieri, Eddy Fan
PURPOSE: To review the available knowledge related to the use of ECCO2R as adjuvant strategy to mechanical ventilation (MV) in various clinical settings of acute respiratory failure (ARF). METHODS: Expert opinion and review of the literature. RESULTS: ECCO2R may be a promising adjuvant therapeutic strategy for the management of patients with severe exacerbations of COPD and for the achievement of protective or ultra-protective ventilation in patients with ARDS without life-threatening hypoxemia...
January 28, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28128878/heat-stroke-leading-to-acute-liver-injury-failure-a-case-series-from-the-acute-liver-failure-study-group
#16
Brian C Davis, Holly Tillman, Raymond T Chung, R Todd Stravitz, K Rajender Reddy, Robert J Fontana, Brendan McGuire, Timothy Davern, William M Lee
OBJECTIVE: In the United States, nearly 1000 annual cases of heat stroke are reported but the frequency and outcome of severe liver injury in such patients is not well described. The aim of this study was to describe cases of acute liver injury (ALI) or failure (ALF) caused by heat stroke in a large ALF registry. DATA SOURCES: Amongst 2,675 consecutive subjects enrolled in a prospective observational cohort of patients with ALI or ALF between January 1998 and April 2015, there were 8 subjects with heat stroke...
January 27, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28127231/mechanical-ventilation-during-extracorporeal-membrane-oxygenation-in-patients-with-acute-severe-respiratory-failure
#17
REVIEW
Zhongheng Zhang, Wan-Jie Gu, Kun Chen, Hongying Ni
Conventionally, a substantial number of patients with acute respiratory failure require mechanical ventilation (MV) to avert catastrophe of hypoxemia and hypercapnia. However, mechanical ventilation per se can cause lung injury, accelerating the disease progression. Extracorporeal membrane oxygenation (ECMO) provides an alternative to rescue patients with severe respiratory failure that conventional mechanical ventilation fails to maintain adequate gas exchange. The physiology behind ECMO and its interaction with MV were reviewed...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28121615/physiological-closed-loop-control-of-mechanical-ventilation-and-extracorporeal-membrane-oxygenation
#18
Christian Brendle, Thorsten Mülders, Jan Kühn, Thorsten Janisch, Rüdger Kopp, Rolf Rossaint, Andre Stollenwerk, Stefan Kowalewski, Berno Misgeld, Steffen Leonhardt, Marian Walter
A new concept is presented for cooperative automation of mechanical ventilation and extracorporeal membrane oxygenation (ECMO) therapy for treatment of acute respiratory distress syndrome (ARDS). While mechanical ventilation is continuously optimized to promote lung protection, extracorporeal gas transfer rates are simultaneously adjusted to control oxygen supply and carbon dioxide removal using a robust patient-in-the-loop control system. In addition, the cooperative therapy management uses higher-level algorithms to adjust both therapeutic approaches...
January 25, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28110904/-a-case-report-nursing-interventions-on-a-patient-with-anaphylactic-shock-in-icu
#19
G Zariquiey-Esteva, P Santa-Candela
INTRODUCTION AND OBJECTIVES: The care plan of a 42-year-old woman with anaphylactic shock, secondary to ingestion of amoxicillin/clavulanic acid, with upper airway involvement due to laryngeal angioedema, is presented. Previously she had had two episodes of angioedema of unknown origin. The incidence of this phenomenon is between 3.2 and 10 cases/100,000 people/year. CLINICAL OBSERVATION: An evaluation was made and three altered necessities stood out: breathing and circulation (she needed mechanical ventilation and noradrenalin perfusion), elimination (she required furosemide to keep an acceptable diuresis time), and hygiene and skin protection (she presented generalised hyperaemia, lip, lingual and oropharyngeal oedema)...
January 16, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28107207/dynamic-mechanical-interactions-between-neighboring-airspaces-determine-cyclic-opening-and-closure-in-injured-lung
#20
Ludovic Broche, Gaetano Perchiazzi, Liisa Porra, Angela Tannoia, Mariangela Pellegrini, Savino Derosa, Alessandra Sindaco, João Batista Borges, Loïc Degrugilliers, Anders Larsson, Göran Hedenstierna, Anthony S Wexler, Alberto Bravin, Sylvia Verbanck, Bradford J Smith, Jason H T Bates, Sam Bayat
OBJECTIVES: Positive pressure ventilation exposes the lung to mechanical stresses that can exacerbate injury. The exact mechanism of this pathologic process remains elusive. The goal of this study was to describe recruitment/derecruitment at acinar length scales over short-time frames and test the hypothesis that mechanical interdependence between neighboring lung units determines the spatial and temporal distributions of recruitment/derecruitment, using a computational model. DESIGN: Experimental animal study...
January 19, 2017: Critical Care Medicine
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