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Recruitment Maneuvers

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https://www.readbyqxmd.com/read/29312748/acute-respiratory-distress-syndrome-in-traumatic-brain-injury-how-do-we-manage-it
#1
REVIEW
Valentina Della Torre, Rafael Badenes, Francesco Corradi, Fabrizio Racca, Andrea Lavinio, Basil Matta, Federico Bilotta, Chiara Robba
Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29290563/pulmonary-recruitment-maneuver-reduces-pain-after-laparoscopic-bariatric-surgery-a-randomized-controlled-clinical-trial
#2
Ebba Kihlstedt Pasquier, Ellen Andersson
BACKGROUND: Pulmonary recruitment maneuver (PRM) at the end of laparoscopic gynecologic surgery has been shown to reduce postoperative pain. This prospective, randomized, controlled clinical trial aimed to investigate postoperative pain (primary endpoint) and nausea when performing a ventilator-piloted PRM at the end of laparoscopic bariatric surgery. SETTINGS: A secondary-level public hospital in Sweden. METHODS: After giving written consent, patients undergoing elective laparoscopic bariatric surgery were randomized to receive routine exsufflation (control group) or a ventilator-piloted PRM to remove residual carbon dioxide from the abdomen at the end of surgery...
November 22, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29278864/stroke-volume-recruitability-during-the-third-trimester-of-pregnancy
#3
Sandra Herrera, Maggie J Kuhlmann-Capek, Sarah C Rogan, Antonio F Saad, George R Saade, Gary D V Hankins, Luis D Pacheco
OBJECTIVE:  It is unknown whether the heart operates in the ascending or flat portion of the Starling curve during normal pregnancy. Pregnant women do not respond to the passive leg-raising maneuver secondary to mechanical obstruction of the inferior vena cava by the gravid uterus. Our objective was to evaluate if administration of a fluid bolus increases baseline stroke volume (SV) among healthy pregnant patients during the third trimester. STUDY DESIGN:  Healthy pregnant women who underwent elective term cesarean sections were included...
December 26, 2017: American Journal of Perinatology
https://www.readbyqxmd.com/read/29277182/-application-of-digital-drainage-system-in-postoperative-refractory-prolonged-air-leaks-after-pulmonary-surgery
#4
Donglai Chen, Xiermaimaiti Kadeer, Zhe Shi, Yuxing Jin, Chang Chen
BACKGROUND: Postoperative prolonged air leaks is one of the most common complications secondary to pulmonary resections. Digital drainage system (DDS) is considered as an accurate and objective device which has been found to be comfortable and well tolerated by patients, economical as well. The aim of this study is to explore the application of DDS in patients with postoperative refractory prolonged air leaks after pulmonary surgery. METHODS: Prolonged air leak (PAL) is defined as air leaks lasting for more than 5 d after video-assisted surgery or more than 7 d after thoracotomy...
December 20, 2017: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29238260/the-effect-of-400-%C3%A2%C2%B5g-inhaled-salbutamol-on-3-km-time-trial-performance-in-a-low-humidity-environment
#5
John Molphy, John W Dickinson, Neil J Chester, Mike Loosemore, Gregory Whyte
The Objectives of the study were to investigate whether 400 µg inhaled salbutamol influences 3 km running time-trial performance and lung function in eucapnic voluntary hyperpnoea positive (EVH+ve) and negative (EVH-ve) individuals. Fourteen male participants (22.4 ± 1.6yrs; 76.4 ± 8.7kg; 1.80 ± 0.07 m); (7 EVH+ve; 7 EVH-ve) were recruited following written informed consent. All participants undertook an EVH challenge to identify either EVH+ve (↓FEV1>10%) or EVH-ve (↓FEV1<10%). Participants performed three separate 3 km running time-trials in a low-humidity (20-25%) environment on a non-motorized treadmill, 15 minutes following inhalation of salbutamol (400 µg), placebo (non-active inhalant) or control (no inhalant), in a randomized, single-blind, repeated measures design...
December 2017: Journal of Sports Science & Medicine
https://www.readbyqxmd.com/read/29219201/comparing-physical-examination-with-sonographic-versions-of-the-same-examination-techniques-for-splenomegaly
#6
Tara Cessford, Graydon S Meneilly, Shane Arishenkoff, Christopher Eddy, Luke Y C Chen, Daniel J Kim, Irene W Y Ma
OBJECTIVES: To determine whether sonographic versions of physical examination techniques can accurately identify splenomegaly, Castell's method (Ann Intern Med 1967; 67:1265-1267), the sonographic Castell's method, spleen tip palpation, and the sonographic spleen tip technique were compared with reference measurements. METHODS: Two clinicians trained in bedside sonography patients recruited from an urban hematology clinic. Each patient was examined for splenomegaly using conventional percussion and palpation techniques (Castell's method and spleen tip palpation, respectively), as well as the sonographic versions of these maneuvers (sonographic Castell's method and sonographic spleen tip technique)...
December 8, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29200636/effect-of-the-combination-of-mendelsohn-maneuver-and-effortful-swallowing-on-aspiration-in-patients-with-dysphagia-after-stroke
#7
Ji-Hoon Kim, Young-A Kim, Hye-Jin Lee, Keum-Sook Kim, Seung-Tae Kim, Tae-Sue Kim, Young-Seok Cho
[Purpose] This study investigated the effect of a combined method incorporating the Mendelsohn maneuver and effortful swallowing on aspiration in patients with dysphagia after stroke. [Subjects and Methods] Three patients with dysphagia were recruited. All patients were treated with a combined method consisting of the Mendelsohn maneuver and effortful swallowing. The intervention period was total 20 sessions. Evaluation was based on videofluoroscopic swallowing study and the degree of aspiration was assessed using penetration-aspiration scale...
November 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/29197407/low-tidal-volume-mechanical-ventilation-against-no-ventilation-during-cardiopulmonary-bypass-heart-surgery-mecano-study-protocol-for-a-randomized-controlled-trial
#8
Lee S Nguyen, Messaouda Merzoug, Philippe Estagnasie, Alain Brusset, Jean-Dominique Law Koune, Stephane Aubert, Thierry Waldmann, Jean-Michel Grinda, Hadrien Gibert, Pierre Squara
BACKGROUND: Postoperative pulmonary complications are a leading cause of morbidity and mortality after cardiac surgery. There are no recommendations on mechanical ventilation associated with cardiopulmonary bypass (CPB) during surgery and anesthesiologists perform either no ventilation (noV) at all during CPB or maintain low tidal volume (LTV) ventilation. Indirect evidence points towards better pulmonary outcomes when LTV is performed but no large-scale prospective trial has yet been published in cardiac surgery...
December 2, 2017: Trials
https://www.readbyqxmd.com/read/29171134/cardiovascular-autonomic-dysfunction-predicts-increasing-albumin-excretion-in-type-1-diabetes
#9
Liangjian Lu, M Loredana Marcovecchio, R Neil Dalton, David Dunger
OBJECTIVE: To determine the potential role of cardiovascular autonomic dysfunction in the development of renal complications in young people with type 1 diabetes (T1D). METHODS: In this prospective study, 199 children and adolescents recruited to the Oxford Regional Prospective Study underwent assessment of autonomic function ~5 years after diagnosis, and were subsequently followed with longitudinal assessments of HbA1c and urine albumin-creatinine ratio (ACR) over 8...
November 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29169952/development-and-face-validation-of-a-virtual-reality-epley-maneuver-system-vrems-for-home-epley-treatment-of-benign-paroxysmal-positional-vertigo-a-randomized-controlled-trial
#10
Reza Tabanfar, Harley H L Chan, Vincent Lin, Trung Le, Jonathan C Irish
PURPOSE: To develop and validate a smartphone based Virtual Reality Epley Maneuver System (VREMS) for home use. METHODS: A smartphone application was designed to produce stereoscopic views of a Virtual Reality (VR) environment, which when viewed after placing a smartphone in a virtual reality headset, allowed the user to be guided step-by-step through the Epley maneuver in a VR environment. Twenty healthy participants were recruited and randomized to undergo either assisted Epleys or self-administered Epleys following reading instructions from an Instructional Handout (IH)...
November 14, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29141185/increased-cross-bridge-recruitment-contributes-to-transient-increase-in-force-generation-beyond-maximal-capacity-in-human-myocardium
#11
Nima Milani-Nejad, Jae-Hoon Chung, Benjamin D Canan, Vadim V Fedorov, Bryan A Whitson, Ahmet Kilic, Peter J Mohler, Paul M L Janssen
Cross-bridge attachment allows force generation to occur, and rate of tension redevelopment (ktr) is a commonly used index of cross-bridge cycling rate. Tension overshoots have been observed briefly after a slack-restretch ktr maneuver in various species of animal models and humans. In this study, we set out to determine the properties of these overshoots and their possible underlying mechanism. Utilizing human cardiac trabeculae, we have found that tension overshoots are temperature-dependent and that they do not occur at resting states...
November 12, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/29134245/esophageal-pressure-research-or-clinical-tool
#12
REVIEW
E Baedorf Kassis, S H Loring, D Talmor
Esophageal manometry has traditionally been utilized for respiratory physiology research, but clinicians have recently found numerous applications within the intensive care unit. Esophageal pressure (PEs) is a surrogate for pleural pressures (PPl), and the difference between airway pressure (PAO) and PEs provides a good estimate for the pressure across the lung also known as the transpulmonary pressure (PL). Differentiating the effects of mechanical ventilation and spontaneous breathing on the respiratory system, chest wall, and across the lung allows for improved personalization in clinical decision making...
November 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29112971/effects-of-positive-end-expiratory-pressure-and-recruitment-maneuvers-in-a-ventilator-induced-injury-mouse-model
#13
Laura A Cagle, Lisa M Franzi, Angela L Linderholm, Jerold A Last, Jason Y Adams, Richart W Harper, Nicholas J Kenyon
BACKGROUND: Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury...
2017: PloS One
https://www.readbyqxmd.com/read/29105056/specific-anesthesia-induced-lung-volume-changes-from-induction-to-emergence-a-pilot-study
#14
P Kostic, A LoMauro, A Larsson, G Hedenstierna, P Frykholm, A Aliverti
BACKGROUND: Studies aimed at maintaining intraoperative lung volume to reduce post-operative pulmonary complications have been inconclusive because they mixed up the effect of general anesthesia and the surgical procedure. Our aims were to study: (1) lung volume during the entire course of anesthesia without the confounding effects of surgical procedures; (2) the combination of three interventions to maintain lung volume; and (3) the emergence phase with focus on the restored activation of the respiratory muscles...
November 3, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29066979/autonomic-dysfunction-in-wilson-s-disease-a-comprehensive-evaluation-during-a-3-year-follow-up
#15
Kai Li, Charlotte Lindauer, Rocco Haase, Heinz Rüdiger, Heinz Reichmann, Ulrike Reuner, Tjalf Ziemssen
Objectives: Wilson's disease is reported to have autonomic dysfunction, but comprehensive evaluation of autonomic function is lacking. Additionally, little is known about the change of autonomic function of Wilson's disease during continuous therapy. We assumed that patients with Wilson's disease had both sympathetic and parasympathetic autonomic impairments, and the autonomic dysfunction might be stable across a 3-year follow-up after years of optimal treatment. Methods: Twenty-six patients with Wilson's disease and twenty-six healthy controls were recruited...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#16
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
January 2018: Respiratory Care
https://www.readbyqxmd.com/read/29065674/two-segment-foot-model-for-the-biomechanical-analysis-of-squat
#17
E Panero, L Gastaldi, W Rapp
Squat exercise is acquiring interest in many fields, due to its benefits in improving health and its biomechanical similarities to a wide range of sport motions and the recruitment of many body segments in a single maneuver. Several researches had examined considerable biomechanical aspects of lower limbs during squat, but not without limitations. The main goal of this study focuses on the analysis of the foot contribution during a partial body weight squat, using a two-segment foot model that considers separately the forefoot and the hindfoot...
2017: Journal of Healthcare Engineering
https://www.readbyqxmd.com/read/29052467/the-effect-of-level-of-injury-and-physical-activity-on-heart-rate-variability-following-spinal-cord-injury
#18
Athanasios Kyriakides, Dimitrios Poulikakos, Angeliki Galata, Dimitrios Konstantinou, Elias Panagiotopoulos, Elisabeth Chroni
OBJECTIVE/BACKGROUND: To assess frequency domain heart rate variability (HRV) parameters at rest and in response to postural autonomic provocations in individuals with spinal cord injury (SCI) and investigate the autonomic influences on the heart of different physical activities. DESIGN: Cross-sectional study. METHODS: Ten subjects with complete cervical SCI and fourteen subjects with complete low thoracic SCI were prospectively recruited from the community and further divided in sedentary and physically active groups, the latter defined as regular weekly 4 hour physical activity for the preceding 3 months...
October 20, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29043837/lung-recruitment-maneuvers-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#19
Ewan Goligher, Carol Hodgson, Neill Kj Adhikari, Maureen O Meade, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: In patients with acute respiratory distress syndrome (ARDS), lung recruitment maneuvers (LRMs) may prevent ventilator-induced lung injury and improve survival. OBJECTIVES: To summarize the current evidence in support of the use of LRMs in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mechanical ventilation strategies with and without LRMs. Eligible trials were identified from previously published systematic reviews and an updated literature search...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29043834/higher-peep-versus-lower-peep-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#20
Allan J Walkey, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. OBJECTIVE: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. METHODS: We performed a systematic review and meta-analysis of clinical trials investigating mechanical ventilation strategies using higher versus lower PEEP levels...
October 18, 2017: Annals of the American Thoracic Society
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