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Mechanical Ventilation Anesthesia

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https://www.readbyqxmd.com/read/28053507/riluzole-5-mg-ml-oral-suspension-for-optimized-drug-delivery-in-amyotrophic-lateral-sclerosis
#1
Ann Margaret Dyer, Alan Smith
The aim of the present work is to extensively evaluate the pharmaceutical attributes of currently available riluzole presentations. The article describes the limitations and risks associated with the administration of crushed tablets, including the potential for inaccurate dosing and reduced rate of absorption when riluzole is administered with high-fat foods, and the advantages that a recently approved innovative oral liquid form of riluzole confers on amyotrophic lateral sclerosis (ALS) patients. The article further evaluates the patented and innovative controlled flocculation technology used in the pseudoplastic suspension formulation to reduce the oral anesthesia seen with crushed tablets, resulting in optimized drug delivery for riluzole...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28051988/ultraportable-oxygen-concentrator-use-in-u-s-army-special-operations-forward-area-surgery-a-proof-of-concept-in-multiple-environments
#2
Michael Rybak, Lynn C Huffman, Richard Nahouraii, John Loden, Marcos Gonzalez, Ramey Wilson, Paul D Danielson
INTRODUCTION: A limitation to surgical care in an austere environment is the supply of oxygen to support mechanical ventilation and general anesthesia. Portable oxygen concentrators (OCs) offer an alternative to traditional compressed oxygen tanks. OBJECTIVES: We set out to demonstrate that a low-pressure OC system could supply the mechanical ventilation needs in an austere operating environment. METHODS: An ultraportable OC (SAROS Model 3000, SeQual Technologies, Ball Ground, Georgia) was paired with an Impact 754 ventilator (Impact Instrumentation, West Caldwell, New Jersey) to evaluate the delivered fraction of inspired oxygen (FiO2) to a test lung across a range of minute ventilations and at altitudes of 1,200 and 6,500 feet above sea level...
January 2017: Military Medicine
https://www.readbyqxmd.com/read/28039643/respiratory-dynamics-and-dead-space-to-tidal-volume-ratio-of-volume-controlled-versus-pressure-controlled-ventilation-during-prolonged-gynecological-laparoscopic-surgery
#3
Ming Lian, Xiao Zhao, Hong Wang, Lianhua Chen, Shitong Li
BACKGROUND: Laparoscopic operations have become longer and more complex and applied to a broader patient population in the last decades. Prolonged gynecological laparoscopic surgeries require prolonged pneumoperitoneum and Trendelenburg position, which can influence respiratory dynamics and other measurements of pulmonary function. We investigated the differences between volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) and tried to determine the more efficient ventilation mode during prolonged pneumoperitoneum in gynecological laparoscopy...
December 30, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/28017167/effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#4
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28008896/-anesthesia-during-video-assisted-thoracoscopic-lobectomy-using-laryngeal-ductwork-and-auxiliary-mechanical-ventilation
#5
V A Porkhanov, I S Polyakov, V V Danilov, V B Kononenko, V A Zhikharev
The article presents the experience of video-assisted thoracoscopic lobectomies in patients without endotracheal intubation and sparing of spontaneous breathing. The results of intraoperative monitoring and laboratory data of all perioperative period are described. In view of these data it was concluded that such approach can decline the severity of stress-response against surgical aggression in this group of patients.
2016: Khirurgiia
https://www.readbyqxmd.com/read/28002714/hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#6
RANDOMIZED CONTROLLED TRIAL
Stephane Legriel, Virginie Lemiale, Maleka Schenck, Jonathan Chelly, Virginie Laurent, Fabrice Daviaud, Mohamed Srairi, Aicha Hamdi, Guillaume Geri, Thomas Rossignol, Julia Hilly-Ginoux, Julie Boisramé-Helms, Benjamin Louart, Isabelle Malissin, Nicolas Mongardon, Benjamin Planquette, Marina Thirion, Sybille Merceron, Emmanuel Canet, Fernando Pico, Yves-Roger Tran-Dinh, Jean-Pierre Bedos, Elie Azoulay, Matthieu Resche-Rigon, Alain Cariou
Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit)...
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27992862/endobronchial-valves-for-endoscopic-lung-volume-reduction-best-practice-recommendations-from-expert-panel-on-endoscopic-lung-volume-reduction
#7
Dirk-Jan Slebos, Pallav L Shah, Felix J F Herth, Arschang Valipour
Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patients with both heterogeneous and homogenous emphysema without collateral ventilation. In this "expert best practices" review, we will highlight the practical aspects of this therapy. Key selection criteria for ELVR are hyperinflation with a residual volume >175% of predicted, forced expiratory volume <50% of predicted, and a 6-min walking distance >100 m...
December 20, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27966337/the-incidence-of-pressure-ulcer-in-patients-on-mechanical-ventilation-andeffects-of-selected-risk-factors-on-pressure-ulcer-development
#8
Özgül Karayurt, Özay Akyol, Necmiye Kılıçaslan, Nuray Akgün, Ümran Sargın, Melike Kondakçı, Hanım Ekinci, Neslihan Sarı
BACKGROUND/AIM: This study aimed to determine the incidence of pressure ulcers in patients on mechanical ventilation and selected risk factors likely to play a role in pressure ulcer development. MATERIALS AND METHODS: The study included 110 patients recruited from an anesthesia critical care unit of a university hospital. Data were collected with a demographic and clinical characteristics form. The form was composed of questions about demographic characteristics and clinical features including diagnosis, duration of mechanical ventilation, general well-being, oxygenation, perfusion, and skin condition...
November 17, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/27942786/-ventilator-associated-pneumonia-vap-a%C3%A2-risk-already-at-the-time-of-anesthetic-induction
#9
L Vetter, C Konrad, G Schüpfer, M Rossi
BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the most common and preventable infections in mechanically ventilated patients. It is associated with a high mortality rate. To prevent VAP, various strategies address this issue using "VAP-bundles", which are implemented in many intensive care units. The risk of acquiring VAP starts with the induction of anesthesia, strictly speaking at the time of intubation. This article considers measures to prevent VAP during general anesthesia in adult patients (>18 years)...
December 9, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27924170/use-of-a-respiratory-volume-monitor-to-assess-respiratory-competence-in-cardiac-surgery-patients-after-extubation
#10
Stephan Ianchulev, Diane Ladd, C Marshall MacNabb, Lizeng Qin, Nathan Marengi, Jenny Freeman
BACKGROUND: Patients who have undergone cardiac surgery are generally mechanically ventilated postoperatively. Early postoperative extubation is currently recommended in anesthesia guidelines. No current technology can accurately, non-invasively, measure respiratory competence after extubation. Pulse oximetry has been helpful, but this is a late indicator of respiratory compromise. A novel, non-invasive, respiratory volume monitor (RVM) has been shown to deliver accurate continuous, real-time minute ventilation (MV), tidal volume (TV) and respiratory rate (RR) measurements and provide an objective measure of respiratory competence...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27922547/changes-in-stroke-volume-induced-by-lung-recruitment-maneuver-predict-fluid-responsiveness-in-mechanically-ventilated-patients-in-the-operating-room
#11
Matthieu Biais, Romain Lanchon, Musa Sesay, Lisa Le Gall, Bruno Pereira, Emmanuel Futier, Karine Nouette-Gaulain
BACKGROUND: Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. METHODS: Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#12
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27895443/the-validation-and-inter-rater-reliability-of-the-serbian-translation-of-the-richmond-agitation-and-sedation-scale-in-post-anesthesia-care-unit-patients
#13
Karlicic Stasevic, M Stasevic, S Jankovic, Dejanovic Djukic, A Dutina, I Grbic
BACKGROUND: Targeted light sedation is recommended because it shortens the time of mechanical ventilation and the length of stay in an intensive care unit (ICU). However, there is no validated scale for sedation and agitation in ICU in the Serbian speaking area. The aim of the current study was to validate, verify the reliability and enable the application of the Richmond Agitation and Sedation Scale (RASS) in the Serbian speaking area. METHODS: In this prospective cohort study, RASS was applied to 301 adult patients hospitalized in surgical ICUs by two different research team members...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27895441/a-retrospective-analysis-of-postoperative-patients-admitted-to-the-intensive-care-unit
#14
S Uzman, Y Yilmaz, M Toptas, I Akkoc, Y G Gul, H Daskaya, Y Toptas
BACKGROUND: The aim of this retrospective study was to evaluate postoperative patients admitted to the intensive care unit (ICU) and to describe their characteristics and outcomes. METHODS: We performed a retrospective chart review of 1,756 postoperative patients admitted to the ICU of a tertiary referral hospital from January 2008 to December 2012. For each patient we recorded: demographic data, reason for admission to the ICU, duration of mechanical ventilation, elective versus emergency surgery, type of anaesthesia, American Society of Anesthesiologists (ASA) physical status, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Glasgow Coma Score (GCS), and outcome...
January 2016: Hippokratia
https://www.readbyqxmd.com/read/27884349/endotoxemia-accelerates-diaphragm-dysfunction-in-ventilated-rabbits
#15
Yi Yang, Tao Yu, Chun Pan, Federico Longhini, Ling Liu, Yingzi Huang, Fengmei Guo, Haibo Qiu
BACKGROUND: Ventilators may induce diaphragm dysfunction, and most of the septic population who are admitted to the intensive care unit require mechanical ventilation. However, there is no evidence that sepsis accelerates the onset of ventilator-induced diaphragm dysfunction or affects the microcirculation. Our study investigated whether lipopolysaccharide (LPS)-induced endotoxemia accelerated diaphragm dysfunction in ventilated rabbits by evaluating microcirculation, lipid accumulation, and diaphragm contractility...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27871554/evaluation-of-ph-on-removed-tracheal-tubes-after-general-anesthesia-a-prospective-observational-study
#16
Shiho Deguchi, Nobuyasu Komasawa, Takeshi Ueno, Michi Omori, Toshiaki Minami
STUDY OBJECTIVE: Aspiration pneumonia is a complication of tracheal intubation and mechanical ventilation. We hypothesized that tracheal tubes removed after anesthesia that have an acidic pH may reflect latent regurgitation of gastric fluid. DESIGN: A prospective observational study. SETTING: Operating room. PATIENTS: Tracheal tubes removed from 200 patients (age range, 20-85 years) who had undergone general anesthesia with tracheal intubation and gastric tube placement were examined...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27843784/successful-conservative-management-of-tracheal-injury-after-forceful-coughing-during-extubation-a-case-report
#17
Joo Hyeon Oh, Sung Jun Hong, Sang Soo Kang, Sung Mi Hwang
A-56-year-old woman underwent carpal tunnel release surgery under general anesthesia. Thirty minutes after extubation, the patient complained of chest discomfort with dyspnea. Swelling of the neck and upper anterior chest was observed. Computed tomography of the chest showed tracheal rupture at the brachiocephalic trunk level, and bronchoscopy demonstrated a 5 cm linear tracheal defect in the posterior membranous wall, 6 cm proximal to the carina. Surgical repair of the tracheal injury was impossible due to its location...
August 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/27843744/delayed-recovery-from-paralysis-associated-with-plasma-cholinesterase-deficiency
#18
Wenqin Zhou, Sheng Lv
INTRODUCTION: This case was to describe a patient presented a 6 h length of apnea associated with low cholinesterase activity. CASE DESCRIPTION: A 32 years old female patient (body weight 50 kg, height 160 cm) was admitted to the hospital for laparoscopy combined with hysteroscopy exploration. The preoperative interrogation revealed no significant personal or family history of adverse reaction to anesthetics. The patient was healthy, with no chronic or systemic disease...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#19
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
January 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27830357/effects-of-ulinastatin-on-early-postoperative-cognitive-function-after-one-lung-ventilation-surgery-in-elderly-patients-receiving-neoadjuvant-chemotherapy
#20
Kai-Yuan Wang, Quan-Yong Yang, Peng Tang, Hui-Xia Li, Hong-Wei Zhao, Xiu-Bao Ren
We investigated the effects of ulinastatin on early postoperative cognitive dysfunction (POCD) after one-lung ventilation (OLV) surgery in elderly patients receiving neoadjuvant chemotherapy. Eighty elderly patients with preoperative neoadjuvant chemotherapy scheduling for radical esophagectomy under OLV were recruited. They were randomly divided into an ulinastatin pretreatment group (U group, n = 40) and a control group (C group, n = 40). The U group received 10,000 U/kg ulinastatin before anesthesia and 5000 U/kg daily on postoperative days 1 to 3, while C group received saline...
November 9, 2016: Metabolic Brain Disease
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